Diabetic Recipes
I'll get right to it. I'm not at all pleased with an A1c of 8.3. We got the result right away, and to be honest, it put me in a pretty sour mood for the rest of the three-hour appointment with Charlie's new diabetes team at Children's Hospital. The result is just about level with the last one taken in August.
The past three months, Charlie has had some of the best blood sugars he's ever had. His monthly average on his meter has been hovering in the 150s to 170s. Much lower than the 195-205 range we've gotten accustomed to seeing. Susanne and I were expecting better. Much, much better. We were also concerned about too many lows. That's troubling. If we seemingly had good blood sugars and even too many lows and still crossed the finish line with 8.3, what the hell? What do we have to do to get an A1c in the low to mid 7s? We've really worked hard at this. I'm so frustrated!
We were pretty impressed with CHOP though. We didn't like the result, but it was nice to get Charlie's A1c quik-serve style; from just a finger prick, in the time it would take to microwave a potato. At the old place it was the dreaded walk down to the phlebotomist for a world of hurt and a depressing result 4-5 days later.
We got a pretty good vibe from everyone we spoke to, but when finally talking to the nurse practitioner and the attending, there wasn't a whole lot to discuss. Most of my questions would need to be answered by the pump team. Unfortunately, we wouldn't be meeting with them at this first visit. When driving home, it occurred to me that it seems like pump technology may be phasing the doctors right out of the picture. The pump is Charlie's lifeline. It's everything. If the doctors are not experts in insulin pump therapy, they've become less useful in my opinion. I think we will benefit most from working with the pump team and the nutritionist. Clearly the doctors still serve a purpose, but perhaps it's becoming limited to observing vitals, evaluating growth and keeping an eye of potential complications.
Well, that's how I'm seeing it. How about you? If you're a pumper or a parent of a pumper or a parent of a pumper with pickled peppers - sorry - do you find that your doctor is a tad clueless I that area? Do they need to farm out all pump questions to someone else? Do they simply defer to the pump manufacturer's trainers? Are the doctors too old school to keep up with the technological aspect of diabetes management? In my experience, they are. I don't like it.
Oh, and for those keeping score at home, Charlie went with the sticky starfish (though he insists it's a squid) for starters and the space-themed projector flashlight for his main course at the hospital's gift shop. It's been two days and the starfish has yet to come down from the ceiling.
advertisement
October 12th, 2008
Category:
| Type 1 | Type 2 | Oral Meds | Insulin & Pumps |
| Children | Food | Highs & Lows | Relationships |
| Complications | Emotions | In the News | Fitness |
| Women's Issues | Men's Issues | Real Life |
01-10-2008 12:20 AM EST by Carey Potash
Categories: Type 1 Insulin & Pumps Children Real Life
Tags: A1C new endos
Views: 759
Categories: Type 1 Insulin & Pumps Children Real Life
Tags: A1C new endos
Views: 759
| Login to rate Rating (0): |
advertisement
Carey is a full-time hater of diabetes. The benefits stink. His 6-year-old son, Charlie, was diagnosed with type 1 diabetes when he was 22 months old. Carey's parenting humor has appeared in various websites and print magazines. He resides in the suburbs of Philadelphia with his wife and three children. (Read More)
Latest Posts: Waiting | Rocking Out with Diabetes - My Interview with Jacob Slichter | It Takes a Toll
Julia lives behind the Tofu Curtain, in the Pioneer Valley, in Western Massachusetts. It's a nice place. She likes it there. Her eldest daughter, Olivia, has type 1 diabetes. She's also 13. It's a real toss-up as to which is more difficult -- the diabetes or the teen-age drama. (Read More)
Latest Posts: Fine | Follow Up | Again
Our Other Bloggers: Lindsey Guerin, Michelle Kowalski, George Simmons, Kim Doty, Rebecca Abma, Scott Marvel, Nicole Purcell, Kerri Morrone, Andy Bell
Carey, I'm sorry. I know it's frustrating to work so hard and not see the results you were hoping for.
Maybe the pump team will be of some help. When do you see them?
Riley's endo also has the A1C machine that only requires a finger stick. It's nice.
We also seem to have a very rare endo. First off, she is the only doctor in her office. She has her own private practice. She doesn't even have a nurse. She does it all herself. Her entire office staff consists of her and a receptionists. She is also very knowledgeable of the pump and different sets. She can look at 3 day's worth of Riley's sugars for a few minutes and tell me exactly how to tweak his basals.
Maybe the pump team will be like that. (Or maybe you guys need to move to NC so you can see Dr. M too:-)
I have been trying to find a good endo and I'm in Durham, NC near Duke. Where/who is this "Dr. M"??
Thanks!
First, I love your name. Go Duke!!!! (UNC lost last night!Yay!)
Secondly, Dr. M only sees pediatric patients. Her name is Mary Ann Morris. Her office is located in Chapel Hill.
Brendon originally had an endo at CHOB (Children's of Boston) who didn't know much at all about the pump, but who wasn't opposed to him going on it. We thought it would be ridiculous to have him see someone who wouldn't be much help, so our Nurse Educator suggested we switch to another Endo at Children's who took on most of the kids who were on pumps. Brendon's current Endo is a Type 1 pumper. You can't get more expert than that. As for getting lower A1C's, don't go by the meter to determine whether you're getting good A1C numbers because you have to think about what numbers are going on in between the times you check him. Also, look at his basal/bolus ratios. Are they within a 50/50 range? Does Charlie eat all of his food at meal time? If so, consider dosing him before he eats. We managaed to get Brendon's A1C down to a 6.6 from the mid-7's by dosing him before meals. If Brendon says he isn't hungry, we dose him for half his meal before he eats, and then the remainder afterward. Little things like that help a lot.
Thanks Penny. We'll call you when we get to Atlanta. Tell Riley to make some room for us. We're movin' in. I'm optimistic about the pump team and thought it was nice that they called us yesterday to talk. Susanne will call them back today. I may have been quick to judge. We'll see. For all I know, the endo could be very knowledgable of the pump. I was just going by gut feeling.
Thanks Shannon. I really appreciate the suggestions. His ratio is almost exactly 50/50, he eats all his food almost always and we bolus before he eats. It's a tricky bugger but we're determined to find the culprit. I'm encouraged by working with the pump team. They apparently have people with different expertise. One specializes in CGMS, one is involved in a study of pump effectiveness, etc. So, we'll see.
Have you heard that some finger prick A1C machines can test up to 1 point higher than they actually are. I actually question their reliability.
Sara: Hi. I have heard that. We're going to the lab for bloodwork as well, so we'll get a chance to see how accurate it really is. Unfortunately, the nurse mentioned that lab results tend to come back slightly higher than results from their machine. Sigh.
Bummer! Well I hope it is the other way around for him!