Wednesday, December 28, 2011

A1C Day (2 for 1 Special!)

Today was our three month A1c appointment.  I've written about the parent report card before and how I try to encourage our family (and others) to not look at this as though it were a graded exam. 

This is hard to do.

Very hard.

As soon as I think of the appointment, I start analyzing all of the ups and downs that we had during the past quarter of a year.

"What about that missed bolus?"

"Hey, remember that night that we went out to eat and under-guestimated those steak fries?"

"What about the surgery recovery highs?"

"Oh no!  Not right now.  We are still dealing with illness!  That is going to make our charts look crazy!"

Ok, so all of those moments are not exactly "ups" but more like the reality of living life while dealing with type 1 diabetes.  Unless we climb back under our rock, we are going to have to face all of these very real situations head on. 

That tricky little A1c doesn't represent everything that happened.  It is merely a number and a swiftly changing one at that.

We need support not judgement from our endocrinologist team to acknowledge that we are doing our best as second-rate actors in a recurring pancreas role.

With heavy hearts, we went to our appointments.  With both girls, I like to joke that we are a 2 for 1 special at the office. 

We arrived.  Turned in our blood sugar logs, had the children weighed and measured.  Blood was taken from their fingertips from the comically oversize doctor blood glucose/A1C meter and we were ushered into a room designed to fit a sparrow's nest.

And then we waited.  But while we waited a great thing happened. 

First our favorite social worker popped her head in but only to make small talk with our family.  She came simply because she knew we were in the building and wanted to say hello.  After marveling over the girls, she told us about things happening in her own life.  It felt comfortable as we have known her for quite a while.  It was conversation as we would have with any of our friends.

Our hearts grew a bit lighter.

Then, a moment more and one of our favorite endocrinologists stopped in because she saw that we were on the schedule and wanted to see how we were doing and to see if we needed help with anything.  She also brought our nutritionist and we chatted about the holidays and each of our own families.  We exchanged anecdotes on raising children and being parents with a healthy dose of diabetes care thrown in.  We told her about the many events that had transpired with the girls and she listened and encouraged all that we had done with their care.  Instead of the judgement that my husband and I so feared, we felt nothing but positive reinforcement.

Another moment more and our scheduled endocrinologist, whom we treasure as well, came in and while we did discuss diabetes, we were also told that we were doing things right.  We were offered suggestions on improving areas but asked for feedback on those suggestions as well.

It was a team discussion.  We didn't feel reprimanded or isolated in our care choices.  In fact, we felt encouraged that we had been on the right track.  Maybe our performance as a second rate actor for a pancreas could actually get us some credit!

Another one of our favorite nurses came by with some personal diabetes experience as she also has type 1 diabetes and we listened to her sage advice.  Not just addressing the adults in the room, she made a point to talk to the girls and to get feedback from them as well.

Throughout our three hours in the clinic, I noticed that my girls seemed happy.  Yes, I am sure that they would rather be off playing or running around, but they seemed to enjoy seeing all of the friendly faces that we have come to know so well.

For the girls, their experience has been nothing but positive.  They view the a1c appointment as a chance to see the doctors, nurses, nutritionist and social worker as part of their inner circle.  People whom have known them for over half their lives and have witnessed them growing up in leaps and bounds.  They see the endocrinologist team not just at the clinic, but at our JDRF events and even during the week-long diabetes camp.  Sometimes, we even see them while we are out and living life.  Nothing like a big hug at the shopping mall from a world-renowned medical specialist!

As our time came to a close, my husband and I looked at each other and breathed a sigh of relief.  We laughed a bit too as we felt the stress and tension release from our bodies.

We have to remind ourselves that diabetes isn't about one visit to the clinic, a random a1c or a list of everything that we did "wrong". 

Diabetes is a journey.

Which we walk together.

With a team who have become our friends and friends who are on our team.

We are not alone.

We are in this together.

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