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One thing about diabetes that can be particularly frustrating is not knowing how our body will react to stress. I've had just as many highs from stress as I have had unexpected lows.

Strangely, I think I more often go lowish from certain kinds of stress. Namely medical stress. Just over a year ago, for example, I had to have an MRI on my hip with contrasting dye and it was really an experience I was not prepared for. Sitting in the waiting area before the procedure I was high. During the part where the doctor injected the dye into my hip, I felt myself going low and thought I was going to pass out.

And then there was the minor hand surgery I had two and a half years ago where my sugar stayed low all morning until my mid-day surgery.

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It's a shame in a way that such little things can be so influential.

By now you've read about my struggle to find an endocrinologist since moving to Phoenix. The first doctor I saw? What a joke. And then to Mayo where I loved the staff, but couldn't afford the out of network bills. While I've been mostly satisfied with Dr. R's office I have felt for a while that I settled on this office. And I don't really want the bad karma, but I seriously think I did settle.

And I think that point was driven home last week when a friend of mine saw a different doctor at Dr. R's practice. Her first experience there was much like my first endo experience here. She was completely unsatisfied and has vowed to never go back.

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So, as predicted, my blood sugar was lowish most of Friday morning. In fact, I believe my fasting was under 90, so I had to eat a granola bar before going for my walk. I stayed under 100 until lunch time.

It was totally crazy. Thank you stress and nerves!

I knew I'd need some complex carbs to get me through the afternoon without going low. So I went for my favorite soft pretzel spot for lunch. So, so yummy. And so, so rough on my blood sugar. I can usually count on hanging out in the 200s for about five or six hours no matter what I do when I have one of those pretzels.

Just before leaving for the doctor's office, I checked my sugar and was around 240. I really hadn't wanted to be that high, but was slightly comforted knowing that I wouldn't go low during the procedure.

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The recession has finally caught up to my employer, who has painstakingly tried to shield us from it as much as possible. However, next month may bring a restructuring that may include layoffs. No one knows yet who may or may not be on the chopping block.
 

I’ve been unemployed before and it sucks. And I don’t want to do it again. But then, I didn’t have diabetes. Then, I didn’t rely on an insulin pump to stay healthy. Now, I think being unemployed would be a much worse situation.
 

When I heard the news about what may happen next month my first thoughts were about how we would continue to pay the two mortgages (no, the house in Missouri hasn’t sold yet!), buy groceries and continue to provide the basics for our family without losing our minds. The thoughts of how I would continue to pay for my health care needs were delayed, strangely.
 

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What are you thinking about right now? Is it the color purple? Because that's what you should be thinking about right now. Purple. Now it's everywhere, right? All of a sudden it seems to be everywhere you look. See, right there? No, on your left. It's purple.

Everywhere.

That's what I've been dealing with for the last roughly five months -- finally being able to put my finger on something and then it's freaking everywhere. Earlier this year I had a "routine" ultrasound on my thyroid. I've been taking medication for more than 10 years because of my thyroid and my new endo is the first doctor to ever suggest I have an ultrasound.

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I like to be prepared for things. Especially when it comes to medical procedures. And especially especially when those medical procedures involve getting a needle stuck in my neck.

A couple weeks ago when I saw Dr. R she recommended that I have a repeat biopsy on my thyroid nodule. The one that's so freaking gigantic. Although she said I'm not symptomatic and that I've likely had it for years, the American Thyroid Association (I think that's the one) recommends nodules over a certain size (which mine is) be biopsied until a diagnosis can be made. And since the last biopsy I had came back non-diagnostic (which means they didn't get enough cells in the biopsy to determine anything) she thought we should do another.

"How did you do with it last time?" she asked me.

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If you expect to hear it, then should it really be that bad?

Yes and no. 

Today's endo appointment wasn't as bad as I thought it would be in terms of feeling like I was getting raked over the coals. First, the good news: the thyroid nodule hasn't grown and I don't need to follow up on it until March 2012. Like K said when they first discovered it, I've probably had it forever. And nodules are apparently pretty common.

So the bad news: cholesterol is up, thyroid out of whack for the first time in ages, A1C up. Everything is up except my mood.

I think I generally take this kind of news in stride during the appointment. It's typically hours later when I realize what I went through. And that's when I start kicking myself and hating diabetes and thinking about how nice it would be to not have to think about all this stuff all the time.

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Yesterday I was a tad run down and equally cranky. This morning, while I did get up and walk, I felt heavy and tired and run down. Wasn't sure I was going to make it until 2 p.m. for the repeat needle biopsy on my thyroid nodule.

9:30 a.m. I was getting settled at my desk and had already started counting the hours. My legs were restless and I think I looked at the clock about every 30 seconds.

Acutely aware of my nerves, I tried to take lots of deep breaths, tried to focus, tried to pray, tried to calm down. And then I think I gave in: there just was not going to be a calm Michelle until after the biopsy.

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Soooo.... I tried not to walk into Dr. R's office last week with a chip on my shoulder -- even recognized that it was there while I was sitting in the room waiting for her and tried to think happy thoughts -- but I don't think I succeeded.

I actually met with Dr. R this time, not the physician's assistant. I should say that I really don't mind meeting with the PA because at this point I feel like I have a good handle on what's going on and what needs to happen. So maybe some of my anxiety with this appointment was more that it was really the first time we've had an appointment together.

And yet, I still can't shake the feeling that we rubbed each other the wrong way. I waited longer than I wanted to for her to come in and when she finally did come in she said she had been looking over my pump records.

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1.       Well, my new physician’s assistant. I don’t actually see my endo, just the PA.

2.       My old PA moved on to hospital management.

3.       When my new PA made me wait 15 minutes before coming into the patient room I got pretty aggravated. My old PA was in the room within 5 minutes.

4.       We talked for a long time. Actually, she talked and I listened and answered questions. Since we are new to each other she was information gathering, which is fine. But it can be kind of a pain in the ass to go through your medical history all the time.

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