Monday, April 27, 2015

Demystifying the Quarterly Clinic Visit

Quarterly visits tend to be full with various meet and greets, exams and open dialogue.  Often, I refer to them as "ours", as much of the conversation continues to flow with me deeply entrenched.  Although, as the girls have gotten older, many of the questions have shifted from me directly to them.   Oldest daughter has most all of her answers at the tip of her tongue while youngest daughter still pauses and looks to me for confirmation.  It isn't that she doesn't know what to say, it is that she is still adjusting to talking directly to adults.

For this appointment, the questions were very simple and our biggest take-away was a reminder to make sure that the girls are wearing ID bracelets (or necklaces, etc.).  For the summer, I completely agree that it is a must, especially as the girls are in and out of the water for hours at a time.  We are adding that to our to-do list and hopefully, will be making that a much needed habit.

A few small adjustments to both girls basal and bolus ratios were needed this time.  Oddly, after years of insulin increases, oldest daughter has been contending with many more lows during the past three months.  While she is away from home much of the week, I was nervous about her handling them, even with Dexcom Share, so I over-compensated on her basal rates.  Between the Endo, oldest daughter and myself, we made a joint decision in adjusting a tiny bit back, for a happy medium.  As of Friday's appointment, we have had to do one juice box shortly after bed, so I am not fully sure if that change will stay.  However, part of what "we" do, is to make adjustments based on the evidence that we have on hand with oldest daughter's blood sugar logs.  With teenagers, it is fully expected that there will, at times, be evidence not accurately represented with her daily bgs.  Not to say that oldest daughter has done anything wrong, but undeniably, her body is still in hormonal limbo.  Figuring it out is much akin to shooting arrows in the dark.  Conversely, youngest daughter is now at the age where I joke that she must be drinking the insulin because there is never quite enough in her little body... hormones, hormones, hormones, they are EVERYWHERE!  We do the best that we can and keep adjusting as we go.

Other than that, there really wasn't anything to share.  We made our appointments for mid-summer and knowing how much our youngest is growing, also discussed the next set of blood draws to gage the effect on her thyroid.  That might be just as important as managing the ups and downs of blood sugars during this period of growth.

In an effort to keep it real, I am sharing our latest A1c numbers.  I do this in attempt to demystify the A1c and perhaps, to slightly devalue the overall concept that one number defines success or failure during a three-month window.  Truly, there should be no shame or blame when it comes to a clinic visit and for whatever reason, it seems that much of those feelings revolve around this one number, which is utterly silly.  Remember, you are SO MUCH MORE THAN THAT!

Without further ado...

Oldest daughter = 7.5
Youngest daughter = 7.9

For pics of what the A1c looks like within our clinic home, you can view me on Twitter @natsweetsisters or by clicking on this link:

If you have anything to add or share about clinic visits or your A1c, please feel free to comment below or to send me a message.  I am still gathering information on #C3N and #Teent1d to help revamp the processes for our A1c visits and would love to hear from you!

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