My Awesome Endo Office Appointment

I had my endo appointment last Friday and I haven’t had much of a chance to post about it, so here we go.

I knew going into the appointment that I wouldn’t be meeting with my actual endo that day because she was out of the office, but I would be meeting with a nurse that I’ve known from a past career and ventures that I have done.  A quick background and explanation of that.  I used to travel to a lot of local diabetes event when I worked for a horrible company.  One of the events that I regularly attended was a CEU class that was taught by a diabetes educator and an MSRNP.  This MSRNP is now part of my official diabetes team.

Going into this appointment, I already knew how much respect I had for this medical professional.  Then our first conversation about my specific health issues began, and the respect grew even more.

First, we did not have my Dexcom graphs because their office computer was not working properly with the Dexcom software.  And I use a Mac so was not able to get the results ready before the meeting.  I explained what I was seeing in the results and explained that I noticed a large spike in my blood sugar right after I ate.  I told her that I felt it was because I was not taking my insulin enough time before I was eating.  She agreed.  We worked out a schedule and set a goal in trying to take my insulin 10-15 minutes before I actually eat.  She recommended that I set an alarm on my phone about 15-20 minutes before the times that I normally eat.  I said that this might work because I eat breakfast at 8 a.m. every day, lunch at 12-12:30 and dinner at 7.  I’ve set the alarms and so far they have worked 🙂

The next item we looked at was when she asked me why I was over-riding all of the bolus suggestions from the bolus wizard from the Medtronic pump.  My earlier suspicions were confirmed.  Since I am taking a lot of insulin and I have a 3:1 carb ratio, I’ve been taking more than 25 units at almost every meal.  If I have to take 32 units because of a meal and a correction, my pump maxes out at 25, so it looks like I am over-riding it, but I’m not, I’m just taking the max amount allowed.  Then once that 25 is finished, I have to take the remaining insulin….which never happens because I always forget.  So, there lies a problem.  She said that she never thought about that before and that’s something that Medtronic should fix.  I agree…Medtronic, you should fix that.

Next topic of discussion… where my Dexcom all the time.  Next topic.

Dual wave bolus.  I hardly ever use this, but I have been trying to learn, test and try it more often.  We discussed the 80-20 rule and went over a study from the ADA Scientific Sessions in San Diego about a possible 70-30 rule.  I loved the fact that during my appointment we spoke about studies and I actually remembered hearing something about that during the time the Sessions were going on.

The final part of the appointment was changing my basal rates to get my nighttime / morning sugars to a reasonable level.  My basal rates are ridiculously high, I really need to bring them down.  This is where the conversation moved to talking about my weight and dieting. She mentioned that if I can just cut out some of the meat that I eat, that I could potentially cut down on the amount of body fat that I have.  I am trying this at lunch, but it is damn hard for me.

Once the appointment was over, I started talking to her about the diabetes community and blogging and tweeting and the advocacy and all that fun stuff.  Then she hit me with one of the ideas that she has had, and I told her that I will do what I can to help her.  Her idea is that when she is going to speak to kids with diabetes, or the camps, or whatever group of kids she is working with, they are always in a classroom setting learning about diabetes.  She wants to get the kids active.  Her idea is to create a basketball team, a baseball team, a cheerleading team, some sort of team that can go and compete against others.  Not just any others, but children with diabetes from a different area.  It’s basically like a travel league team, but for diabetics.  I think it’s an awesome idea…. awesome I say.

Get back to me after the New Year and we’ll see how well all of this has been going for me.