I often times feel a great deal of anxiety when I’m due for my quarterly endocrinology visit. The anxiety builds up from the time I realize I have an appointment coming up, to when I’ve checked in, to when I’m in the exam room waiting for the endocrinologist to arrive.
What will my “score” be this time? Better than last time, or worse? What am I expecting? Have my expectations ever really mattered before? How many times have I been positively sure it will be better only to be burned with something worse?
I am referring to my A1C result. This is a very routine test that I’ve been having done for as long as I can remember. This test is supposed to give the endocrinologist a pretty good picture of your overall control for the past three months. Results from the Diabetes Control and Complications Trial (DCCT) show reductions in A1C levels dramatically reduce the chances for complications. I think we’ve always known that lower is better, but the results from this study made it official.
When the doctor reads the results of my A1C test, there is usually just a resigned acceptance.
For some reason I feel a significant amount of unspoken blame or judgment, like I must be doing something wrong or not trying quite hard enough. That if I were just a little more disciplined I would be where I need to be. I think it’s just all in my head. I don’t believe in my case that it is anything the doctor is or isn’t doing.
Even in the general diabetes community, the A1C is used as a benchmark of how well a person is managing their condition. It gives a snap impression in the asker’s head of that person’s control, which in many cases could be translated into a person’s self-discipline and willpower.
How many times has another person with diabetes or health care professional asked what your A1C runs? How many times have I sidestepped that question, responding with some vague “Not where I want them,” type of answer.
I’m sure that there are many of us that feel like there is a tangible judgment or blame, and that’s really unfortunate because a high A1C does not equal lack of effort. We all want the best control we can achieve. Sometimes it is really a matter of not having a realistic game plan. Sometimes we feel so overwhelmed by the enormity of the situation we just don’t have clue where to start. Sometimes we feel so alone and helpless that we simply give up. It’s not a lack of will power or self-discipline – we just don’t know what that first step is.
Only I really know where my struggles are. I am the only one that can figure out what that first step is and take it. I am the only one that can continue to work through the frustrations and challenges. I am the only one that can ask for help when I need it. I am the only one who can keep fine-tuning things until the pieces of the puzzle fit.
The picture on that puzzle box is a picture of good control, and that is what this mess of unorganized pieces inside the box will be once they are all uncovered and put together. That is what we are all working towards.
I refuse be judged because my box of pieces has not yet been uncovered.
dLife's Daily Living columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team to find out what will work best for you.
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