I spent the Friday morning after I returned from my vacation at my primary care physician's office for a check up and some lab work. I've been having some concerning symptoms that I wanted to get checked and I also wanted an updated A1c since I'm switching endos next month. My PCP is competent albeit frustrating at times.

I went in with the following symptoms: occasional shortness of breath (like my breath is suddenly getting knocked out of me), tingling in my hands, shocking pains in my heels in the morning, and my ongoing fatigue that I've battled for several years now. My two main concerns were the tingling and the shortness of breath.

She confirmed my thoughts that the shocking pain in my heels in the morning (when I take my first steps) is plantar fasciitis. It seems better the last few days but she did say it could take up to a year to truly resolve itself. Stretching my feet seems to help and I'm trying to stay out of extreme heels as much as possible. I need to get a tennis ball as the doctor mentioned that might help in the morning and throughout the day to stretch my foot.

I went for a chest X-ray for the shortness of breath, which came back normal. I believe this may have been due to the severe cold that I had back in late December and it seems to have resolved over the past week, but I'll continue to watch for it and go back in for additional tests if it does occur again. It was very random to begin with and didn't occur at any particular point or activity.

I also had my B12, thyroid, kidney function, and the usual workup (CBC, etc) along with my A1c. My B12 came back at 258 with a deficient range starting at 211. I'm hopeful that my symptoms (tingling, fatigue, low blood pressure yet rapid heart rate) are due to the lower end of this range. I've been told by other doctors that a low B12 (but not deficient) can still cause symptoms. I'm planning to start a B12 supplement this week, especially since I'm still on the Metformin (which can lower B12 absorption).

Thyroid, CBC, and so forth came back all within normal range. My microalbumin urine came back high although creatinine and ratios were normal so I believe this might have been due to a lack of liquids that morning. I plan to discuss this at my endo appointment in March. My doctor didn't mention it so I assume that it's nothing urgent.

My A1c is the most exciting part. In late October, my A1c was at 9.1% which I was greatly disappointed in since I'd been trying to get my numbers lower. It's down to 8.1% now and I'm so proud of myself that I can hardly stand in. Just in time for my 19 year anniversary with type 1 next week! An entire point in 3 months is impressive for me given the hormonal insulin resistance that I experience.

For me, it was a matter of sticking with and charting my blood sugar checks so that I could actually make changes to my insulin needs. Staying on track with my workout routine has also helped because I've been able to not only lose 6 pounds but drop my insulin needs by a unit. I'm desperately trying to stay on the Metformin as well. I was on 250 mg for three weeks and raised it to 500 mg XR today. I'm crossing my fingers that 500mg doesn't give me any terrible side effects as I was doing okay at 250mg.

I know that it's slow progress with all of this and I can't expect overnight results with the B12, my weight, or my blood sugars but I'm just happy to see some improvement in a couple of areas. I'm determined to get my A1c down to 7.5% in the next three months and eventually maintain it at 7.0% until I'm ready to start trying for babies (disclaimer: my doctor and I have decided that anything below 7.0% is dangerous for me because of my history of seizures and severe lows, my lowest A1c was 6.9% and at that time I was fighting hypoglycemic unawareness every time I turned around).

As for the weight, I'm ready to lose about 8 more pounds and decide then if I want to go for another 5 pounds. I'm liking the compliments I'm getting and the way my clothes are fitting just with 6 pounds and I'm ready to fit back in my old jeans. The B12 is another story and we'll see if anything changes with the addition of that to my vitamins.