My first ever visit to an endocrinologist was two weeks after being diagnosed with diabetes. It was an oddly comforting visit because it was in fact where Dr. Kumagai told my wife and me that I had Type 1. Long-time readers of this blog may remember that prior to that first visit, the doctors who’d determined I had diabetes — no real stumper with an HbA1c of 14.5% and a blood glucose level at my initial doctor visit of near 450 mg/dl — well, they weren’t sure whether I had Type 1 or latent autoimmune diabetes in adults — LADA.
But enough about that. Unless, of course, you want to read my diagnosis story, in which case you can return to the early days of my blog, to my first endocrinologist visit, in my three-part kickoff series, “A Diabetes Neophyte’s Prologue”.
This past Monday I had yet another endocrinologist visit. Now, if I recall correctly from something I heard early on, we (people with Type 1 diabetes) are supposed to have quarterly checkups by our endocrinologists. I don’t know if you go to your endo four times a year, but I go when I’m told to go.
And yet, Monday’s visit did not follow a March visit. It had been five months since my previous visit. Why? Well, simply put, that was when Dr. Kumagai said he wanted to see me again.
I don’t question this man’s judgment. I’ve discussed before how much my wife and I admire Dr. Kumagai and all he does for us, and what he’s done with the Family Centered Experience program at the University of Michigan. And it’s in no small part that the good care I’ve received since my diagnosis has helped me build such a great foundation of self-management.
Back in January, Dr. Kumagai was not worried about my numbers, even though I was — even though, at the time, my HbA1c was higher than it had been in the previous 18 months (6.9%), and I’d put on a few pounds. (And by the way, I wrote about that visit.)
Because my self-management has been pretty consistent since my initial diagnosis, I assume that it isn’t necessary to hit the 90-day mark each and every time. The world won’t crumble.
Still, in early May it began to feel as if I was missing something. The three-month visits are nice… hmm, how to put it — kicks in the pants, or mile markers, or patrol cars sitting out there checking my speed. Knowing there’s an upcoming HbA1c reading provides that slight nudge to help me get past the moments when I might possibly stray from the path of diabetic righteousness. Knowing that I’ll get a cholesterol check, that my blood pressure is going to be measured, that I’m going to be weighed: these events sit in the back of my mind and help to keep me focused.
Oh, sure, we don’t want to live our lives worrying that our level of control will disappoint or satisfy our doctors. That’s not healthy. It’s not healthy to perform the constant, daily, ongoing management of diabetes for someone else (well, maybe family and loved ones, sure; but a doctor: not really, no. For ourselves first of all, yes!).
I’m saying, though, that for me, to have those assessment opportunities, as well as having an endocrinologist who, although I see him maybe a total of an hour each year, I consider a friend, and whose opinion of my level of care is important to me — well, it’s all part of the bigger picture of doing everything I can to make my way through life complication-free.
And this time my HbA1c was back down to 6.2%. I also took off about 10 of those winter pounds, and with the running happening consistently now (three times in the past week), I’m hoping it continues to go down. My blood pressure was 116/72. And I hope that the cholesterol test comes back with some good numbers.
My next appointment is in September. Three months away. What a relief.