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ninanevermore.
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Yesterday I drove almost 50 miles to see my endocrinologist. It is possible for me to find one a little closer to me, but it is very hard for me to find one I like. When I walk into an endocrinologist’s office, the doctor must be amazed by me, or I refuse to make another appointment. If I explain why I take what I take, when I take it, and why I do so, they need to respect that. I’ve been doing this Type 1 Diabetes thing for 33 years (as of this week). I have lived with this condition since I was 8 and it was called Juvenile Diabetes and they had no idea what caused it (now, they suspect my immune system killed some cells it ought not have – oopsies!), with these results: I am not blind, my kidney’s still work, and the nerves in my extremities still work – all with no medical intervention beyond the care I give myself.
I am a wonder, damnit. Respect that. The only reason I see an endocrinologist at all is so that they write me the prescriptions that I need to live and run the tests they need to so they can tell me I am a wonder. I like that last part, because it’s good my ego.
Some doctors I have seen have puzzled over why I still take N insulin, which peaks after about 10 hours. This is a very old type of insulin, and most doctors prescribe newer varieties that don’t peak at all. I take it because my blood sugar rises very high in the mornings (something called the Dawn Effect), and having an insulin that peaks at that time of day – I take a large dose at bedtime – means I can wake up with a normal blood sugar level. When I tell a new doctor this, I expect his eyes to grow a little wide and then he is supposed to tell me how clever and resourceful I am. If he looks skeptical, he fails the test, and is fired. I will make my next appointment with someone else.
The other test is when they write my prescriptions. For a typical diabetic patient, they like to see them every 3 to 4 months. Some doctors will write a 3 month prescription to ensure that I came back in 3 months. The effect of this is that they ensure that I won’t come back to see them at all. I am an adult, and I expect to be treated like one. If they want my respect, they better show me a little respect. I won’t argue with them; I will fill the prescription, and find another doctor to see in 3 months.
When I find a doctor I like, I am loyal. I tell them I will see them every 6 months to a year, and they are to be okay with that. Dr. Thomas, my current endocrinologist, is. I like him. He’s worth the drive down into the Houston Medical center.
In a few more months, I will see my ophthalmologists, Dr. Lemos. He also respects that I am a wonder, and told me so on my first visit.
“You are very special,” he told me in his thick Columbian accent.
“Thank you,” I said.
“What I mean is, you should have damage to your eyes after this time, and you don’t.”
“I keep pretty tight control,” I said modestly, meaning that I make an effort to keep my glucose levels in check.
“Yes, but some people keep excellent control; they still get problems with their eyes after only a few years. Others keep poor control, and they don’t. It should make a difference, but it doesn’t. You’re one of people who is protected. Whoever figures out what it is about you that makes you special, that person will be the Nobel Prize.”
Dr. Thomas essentially told me the same thing. “I would love to do a study on people like you to figure what protects you and why you don’t get the side effects that other people do.” He loves seeing me. His face lights up when he walks in the room and asks how I’m doing. He knows I will be doing fine, and it’s like a coffee break away from the problems of his other patients.
I told him that if he ever does his study and wants to run tests, I’d be happy to help. If they could find the lucky charm in my DNA that has shielded me from so many problems, I would love to share that with other people.
Yesterday, though, I had to tell him that the Hemoglobin A1C, which tests my average blood sugar level in the past 6 months, was probably going to show poor control. I explained about the stress of what is going on with my son, and how in the month of September, which I can hardly remember, I missed – forgot - multiple shots and had blood sugars in the 400s and 500s on more than a few occasions.
“I’m better now; it took me awhile to snap out of it. But the tests are not going to be as good as they usually are.”
“All right, so this time, we won’t worry too much about the A1C. You sure everything is okay now? That you’re doing better?” He is a bit younger than me, and has a kindergartner himself.
I told him that I am. He believed me, but when he said he wants to see me in April, I knew he was still a little concerned; usually he sees me once a year. I didn’t argue.
I should mention I am not immune to all problems related to diabetes: I do have a tendency toward something called tendonitis. Our bodies are able to move due to a pulley system; then tendons are like ropes that move through our joints. With tendonitis, the tendons swell up and no longer move through the pulleys like they should. I have had it in the fingers of both hands, resulting in what is known as a “trigger finger” that locks into a position (either curled up or extended) and doesn’t move easily. When it is mild, the finger pops when you move it. When it is severe the only way to move the digit is to use your other hand to either lock the finder down or extend it. I have had this happen with the middle finger in each hand, which has made me look like a very rude person at times in my life. Sometimes a shot of cortisone will clear it up. After a few shots of cortisone fail to do the trick (I’ve had it take up to 4 shots over a period of months in some cases), they do a surgery where they slice open the tendon to make it work again. I have a couple of scars on my right palm from having this procedure done.
The most vexing case of tendonitis has not been in my hands, though; it has been in my right shoulder. After my son was born, I felt pain whenever I moved my right arm, which made me all but stop moving my right arm since I assumed it was a pulled muscle that needed to heal. The pain was from a swollen tendon, and by not moving it I wound up with what is known as a frozen shoulder; I had very limited movement in that arm: I could put my hair in a pony tail at the nape of my neck, but not at the top of my head. I could not hold my right arm up above my head. The surgery to fix this would mean cutting through the shoulder muscle and would involve months of physical therapy. I opted to rely on my left arm for all my reaching, instead. They told me the condition, without surgery, is permanent.
My right arm has been hurting me again lately when I wake up, and as I was writing this it occurred to me that I failed to mention this pain to the nurse when she asked if I was having any pain (at that moment, since I had been awake for hours, the answer was no). Out of curiosity, I reached behind me with both hands to see if the frozen shoulder had gotten any worse, and pulled my hair together in a ponytail at the top of my head. I held it there for a moment, my eyes wide with surprise.
I then touched the back of my neck with each hand, one after the other. I lifted both arms high above my head until I was confident that, yes, for the first time in 6 years I have the same range of motion in both arms.
Did I tell you I was a wonder, or what?
* ~ * ~ * ~ * ~ * ~ * ~ * # * ~ * ~ * ~ * ~ * ~ * ~ *
.
.
Yesterday I drove almost 50 miles to see my endocrinologist. It is possible for me to find one a little closer to me, but it is very hard for me to find one I like. When I walk into an endocrinologist’s office, the doctor must be amazed by me, or I refuse to make another appointment. If I explain why I take what I take, when I take it, and why I do so, they need to respect that. I’ve been doing this Type 1 Diabetes thing for 33 years (as of this week). I have lived with this condition since I was 8 and it was called Juvenile Diabetes and they had no idea what caused it (now, they suspect my immune system killed some cells it ought not have – oopsies!), with these results: I am not blind, my kidney’s still work, and the nerves in my extremities still work – all with no medical intervention beyond the care I give myself.
I am a wonder, damnit. Respect that. The only reason I see an endocrinologist at all is so that they write me the prescriptions that I need to live and run the tests they need to so they can tell me I am a wonder. I like that last part, because it’s good my ego.
Some doctors I have seen have puzzled over why I still take N insulin, which peaks after about 10 hours. This is a very old type of insulin, and most doctors prescribe newer varieties that don’t peak at all. I take it because my blood sugar rises very high in the mornings (something called the Dawn Effect), and having an insulin that peaks at that time of day – I take a large dose at bedtime – means I can wake up with a normal blood sugar level. When I tell a new doctor this, I expect his eyes to grow a little wide and then he is supposed to tell me how clever and resourceful I am. If he looks skeptical, he fails the test, and is fired. I will make my next appointment with someone else.
The other test is when they write my prescriptions. For a typical diabetic patient, they like to see them every 3 to 4 months. Some doctors will write a 3 month prescription to ensure that I came back in 3 months. The effect of this is that they ensure that I won’t come back to see them at all. I am an adult, and I expect to be treated like one. If they want my respect, they better show me a little respect. I won’t argue with them; I will fill the prescription, and find another doctor to see in 3 months.
When I find a doctor I like, I am loyal. I tell them I will see them every 6 months to a year, and they are to be okay with that. Dr. Thomas, my current endocrinologist, is. I like him. He’s worth the drive down into the Houston Medical center.
In a few more months, I will see my ophthalmologists, Dr. Lemos. He also respects that I am a wonder, and told me so on my first visit.
“You are very special,” he told me in his thick Columbian accent.
“Thank you,” I said.
“What I mean is, you should have damage to your eyes after this time, and you don’t.”
“I keep pretty tight control,” I said modestly, meaning that I make an effort to keep my glucose levels in check.
“Yes, but some people keep excellent control; they still get problems with their eyes after only a few years. Others keep poor control, and they don’t. It should make a difference, but it doesn’t. You’re one of people who is protected. Whoever figures out what it is about you that makes you special, that person will be the Nobel Prize.”
Dr. Thomas essentially told me the same thing. “I would love to do a study on people like you to figure what protects you and why you don’t get the side effects that other people do.” He loves seeing me. His face lights up when he walks in the room and asks how I’m doing. He knows I will be doing fine, and it’s like a coffee break away from the problems of his other patients.
I told him that if he ever does his study and wants to run tests, I’d be happy to help. If they could find the lucky charm in my DNA that has shielded me from so many problems, I would love to share that with other people.
Yesterday, though, I had to tell him that the Hemoglobin A1C, which tests my average blood sugar level in the past 6 months, was probably going to show poor control. I explained about the stress of what is going on with my son, and how in the month of September, which I can hardly remember, I missed – forgot - multiple shots and had blood sugars in the 400s and 500s on more than a few occasions.
“I’m better now; it took me awhile to snap out of it. But the tests are not going to be as good as they usually are.”
“All right, so this time, we won’t worry too much about the A1C. You sure everything is okay now? That you’re doing better?” He is a bit younger than me, and has a kindergartner himself.
I told him that I am. He believed me, but when he said he wants to see me in April, I knew he was still a little concerned; usually he sees me once a year. I didn’t argue.
I should mention I am not immune to all problems related to diabetes: I do have a tendency toward something called tendonitis. Our bodies are able to move due to a pulley system; then tendons are like ropes that move through our joints. With tendonitis, the tendons swell up and no longer move through the pulleys like they should. I have had it in the fingers of both hands, resulting in what is known as a “trigger finger” that locks into a position (either curled up or extended) and doesn’t move easily. When it is mild, the finger pops when you move it. When it is severe the only way to move the digit is to use your other hand to either lock the finder down or extend it. I have had this happen with the middle finger in each hand, which has made me look like a very rude person at times in my life. Sometimes a shot of cortisone will clear it up. After a few shots of cortisone fail to do the trick (I’ve had it take up to 4 shots over a period of months in some cases), they do a surgery where they slice open the tendon to make it work again. I have a couple of scars on my right palm from having this procedure done.
The most vexing case of tendonitis has not been in my hands, though; it has been in my right shoulder. After my son was born, I felt pain whenever I moved my right arm, which made me all but stop moving my right arm since I assumed it was a pulled muscle that needed to heal. The pain was from a swollen tendon, and by not moving it I wound up with what is known as a frozen shoulder; I had very limited movement in that arm: I could put my hair in a pony tail at the nape of my neck, but not at the top of my head. I could not hold my right arm up above my head. The surgery to fix this would mean cutting through the shoulder muscle and would involve months of physical therapy. I opted to rely on my left arm for all my reaching, instead. They told me the condition, without surgery, is permanent.
My right arm has been hurting me again lately when I wake up, and as I was writing this it occurred to me that I failed to mention this pain to the nurse when she asked if I was having any pain (at that moment, since I had been awake for hours, the answer was no). Out of curiosity, I reached behind me with both hands to see if the frozen shoulder had gotten any worse, and pulled my hair together in a ponytail at the top of my head. I held it there for a moment, my eyes wide with surprise.
I then touched the back of my neck with each hand, one after the other. I lifted both arms high above my head until I was confident that, yes, for the first time in 6 years I have the same range of motion in both arms.
Did I tell you I was a wonder, or what?
