That is, the traffic is unpredictable, with swings in perception and mood that cannot be foreseen. As a result, M and I routinely leave 2 hours ahead of our scheduled appointment. Sometimes the journey takes one hour and a quarter from my place of work. More typically it takes about an hour and a half.
Today it took two hours and twenty minutes.
We were ten minutes late.
We had been repeatedly warned that being late for an appointment can result in having to reschedule it, so I was panicked. I don't have time for this again in the near future.
Fortunately, the dire warnings must allow for some traffic-related flexibility. Everyone in the office was telling me not to worry about it.
I was probably still in my traffic-induced anxiety when we were ushered in to see Dr.
Firstly, I want to say that Dr. looks great now that her braces are off.
She also looks really fat in the middle, as if carrying a basketball under her shirt. Apparently this will be child number three for her.
Before M goes in to see the doctor, she typically hands over her bg meter to the nurse, who then gathers information from it via some really cool computer thing. This time, the nurse collected M's insulin pump from her, and apparently gathered a multitude of information from it, printed out the information, and handed it over to Dr. Dr. looked at the printout of M's readings from her insulin pump.
The good news was that M's A1C was 6.3, the lowest it had ever been. Again, great news, except that it might be due to the many, many episodes of low bg that occurred over the last two weeks.
I expressed my frustration at the insane variation of numbers and lack of control I felt. I began to tear up as I explained how tired I was, how concerned I was that her numbers were dangerously all over the place, and how I am not finding the pump to be any better than the basal-bolus system with Lantus and Humalog.
I told her that I need logic, and while I am trying to make sense of how these numbers can go from one extreme to another, I am growing frustrated, because I can't make heads or tails of it.
Dr. listened and nodded as she looked over M's printout. She was silent, biting her lip as she tried to make sense of the numbers she was seeing.
Then she dropped the bomb.
"M. I think that it is clear that your numbers are higher when you eat a large number of carbs. For example, here, on Sunday (Easter Sunday), you ate 527 carbs in one day." (!!!)
M tried to say that she couldn't have, but Dr. politely stopped her protests. "I see here that you covered for every carb you ate, and that's great. I am really glad you are doing that, but it might be a good idea for you to visit with Karen, our dietician."
She looked at the printout again, and cited other days with high carb amounts (over 200 in a day). She looked at me meaningfully as she explained that M really should try to keep her carb count below 170 per day.
While Dr. was looking at me, I was looking at M with the same meaningful gaze. M and I had had this conversation before. Many times. She typically glared, got angry, got defensive, covered her tracks, and sneaked food. Thank God she always covered for her food with insulin, but I knew she wasn't always telling me the truth when she told me what she ate.
Now we have proof.
M can't hide from the numbers. Because of the pump, which tracks everything for which she boluses, what her bg is, and how much insulin she takes, we can now have a real, honest conversation about managing her diet, and therefore her diabetes.
But she won't like it.
When we first started on this diabetic adventure, M and I were a team. We were going to show diabetes who was boss! And we did. We counted carbs with precision, logged exercise and insulin doses into a cute little book, and learned how to fill her up with low-carb snacks.
But it got old for M. After all, it's not an adventure. It's a hassle having a life-threatening illness. Two years is a long time to keep up one's adventuresome spirit about managing something that you are stuck with for life. There is only so much sugar-free jello one can eat.
Because I am a mom, however, it will never get old for me. I will continue to remind, suggest, and advise (nag, from M's point of view), because I understand the consequences if I don't.
This is where worlds collide.
So yes, we will make our appointment with Karen. It might be good for M to hear the same information from another source besides her annoying mother. And Dr., you might want to start addressing this information to the perfectly capable 13-year-old.
It is she who is ultimately responsible for what goes in her mouth.
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| Choose your poison. |
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