One Down, Another 49 or So To Go

I generally have a pretty good memory, even for the most obscure trivia, but names and dates have always been a weak spot for me.   I do remember the two most important dates (and the names of the people who make them important) in my life -- my wedding anniversary and my daughter's birthday.

For the past six years, April has meant the celebration of Chelsea's birth.  This year, it also marks the first anniversary of my diagnosis of diabetes. 

I can't really tell you what my diabetes anniversary date is though because I'm not sure what date I should use to mark the occasion.  Is it the date that the doctor said, "Yup, it's diabetes"?  Is it the date of the blood test that confirmed the suspicions?  And, if so, which blood test -- the initial high one or the one that confirmed that the high one was actually high?  Regardless, it also isn't exactly accurate to say that I've been diabetic for a year when the reality is that I had probably been diagnosed for some time before; maybe years.  Ultimately, "the" date doesn't really matter to me.

So please forgive me if I didn't throw myself a party to commemorate the date of my diagnosis.  It doesn't mean that I'm not appreciative of making it through a full year of pricking my fingers, counting my carbs and walking hundreds of miles in an attempt to keep my glucose levels under control.  As I thought about the milestone approaching, I really did give some thought about how much my life has changed over the past 365 days or so.

I remember not really being ready to hear that I was diabetic and not having to get the courage to see the doctor for a diagnosis when I first suspected it.  So I'm not sure why after having dragged my feet about it I was finally able to dive headfirst into battling it but I knew I needed to attack and not let up.  I've said before that diabetes doesn't take a day off and I'm proud of myself for not having taken a day off in managing it this past year.  I measure and weigh my portions.  I study carb content on nutritional labels.  I took my medicine every day when it was prescribed to me.  I keep my doctors' appointments.  I exercise at least an hour a day.

I'm not perfect and I've had some cheats.  Like the time I had six or seven frosted gingerbread men cookies around Christmas time.  Or the time I had to throw away a bag of candy because I indulged in it -- 15 grams of carbs at a time -- for a morning, afternoon and evening snack.  Or the time I couldn't stop eating from a jar of trail mix by the handful.  Sometimes, if I want a little taste of something that I probably shouldn't be eating, I'll sneak it in the kitchen so my wife can't see me eating it.  What's so funny about all of these examples is that I wouldn't have batted an eye about enjoying any of it a year ago.  Most of what I described would have been me just warming up, not something that I'd want to hide because I felt a little guilty about it.

My thrice-weekly monitoring of my glucose has been steadily excellent as has been my A1C.  But with these successes, I've also experienced some lows -- literally.  When I first started treatment, I had recurring hypos that were anything but fun.  What a horrible feeling!  Luckily, I got my meds fixed quickly to help avoid those really low lows.  But I still suffer from some mild ones from time to time and I can act like a real ass when they hit.  Like yelling at the cashier at Carl's Jr. because she didn't ring up my combo meal the right way.  It's not an excuse to say that I was experiencing a low but that was the reason.  Now, my wife orders for me.  She's a saint who just rolls with the grumpiness that comes with the lows.  I appreciate her and my daughter putting up with me when I get too low.  It's really nothing personal.

I "know" that I'm healthier than before I was diagnosed, though I don't necessarily "feel" that way.  I've really experienced some ill feelings since taking on diabetes -- dizziness, lightheadness, general malaise, lethargy, vision issues.  My neuropathy hasn't seemingly improved.  My retinopathy has gotten worse.  The blood pressure is down but is often too low.  I've been told its dehydration.  I've been told it's because I have a chronic illness.  I've been told by the doctors that they don't have a clue as to what's causing it.  I don't know that it has gotten any better over the past year but I think I deal with it a lot better than before.  I wasn't sure I was going to make it after the first two months of managing the diabetes but I'm more cautiously optimistic today that I'll survive.  I've adjusted.  If working out during the day makes me feel lousy, I'll exercise at night.  If I feel weak or tired when doing yard work or while visiting an amusement park, I'll take more breaks.  I don't like feeling like I'm an old man when I know that I'm a pretty physically fit 30-something guy but I make the necessary adjustments to keep going.

Yes, I've had some ups and downs over the past year.  That's life.  I wish I could feel normal again.  I wish that I didn't have to worry about how many carbs I'm eating at any given meal.  I wish that I could take a night off from exercise and just sit on the couch and watch TV.  I do what I do because I do remember those two most important dates and the people who make them special.  I have to be this way because I need to be there for my wife and daughter.  So while I'm proud of myself for what I've done over the past year, I'm selfish and greedy.  It's not enough.  I've got another 49 years or so to go doing what I need to do to keep things in check with regards to my diabetes care.  Managing diabetes is a marathon not a sprint and being just one year into it, the race has only just begun.

Free Diabetes Monitoring Service

Got an email last night telling me about a free diabetes monitoring service at MinuteClinic.  Since I'm about right in between my now 6-month checkup with the endo I decided I'd go down to my local CVS and check it out.

Among the things they say they check for are:

• A1C and blood glucose test
• Blood pressure check
• Body Mass Index
• Cholesterol check
• Comprehensive foot exam
• Kidney function check

The exam's done by the nurse practicioner or whoever MinuteClinic uses to work the place.  I had been earlier this year for a TB test so they had most of my info in the computer already but there were still a number of questions asked before she did the test, mostly related to my diabetes history (monitoring frequency; lowest/highest measurement in the past 3 months; date of last A1C; date of last foot check; date of last dialated eye exam, etc.).  Got weighed and measured for height (which was way off from my last measurement), temperature read, blood pressure checked, heart rate checked, blood drawn from my finger for the in-office A1C and cholesterol checks, and a visual exam of my feet with monofilament testing performed to detect sensation.

The initial results from the cholesterol reading was way too low so she checked the meter with some control solution and it came back in the proper range but she decided to do it again and this time it came back a lot closer to where it should have been.  Overall, I did fairly well with the numbers pretty close to lab results from my doctors' office visits.  A1C came in at a 5.4%, a tenth less than my last test 3 months ago, total cholesterol is 142 (my HDL is still a little low at 42 though but better than the <15 the machine initially said it was) and I actually felt the majority of the pokes on my feet in spite of my neuropathy.  She didn't perform a finger stick glucose test so I didn't get a fasting number from her and without a urinary albumin test, I'm not sure what kidney functions were checked.

The total charges were listed at $119 and it looks like they did a $50 write off with the remaining $69 paid for by ACCU-CHECK, which is sponsoring the testing.  I can't be entirely sure that the overall results are totally accurate compared to real lab results, especially considering the couple of issues with height measurement and initial cholesterol results, but for a spot check between visits to the doctor, I thought free was a pretty good deal.  And I'm happy to see what appears to be continuously good and consistent maintenence of my diabetes.

Anyway, if anyone else is interested, there are details about the free checkup online at http://www.minuteclinic.com/diabetes/  There's no ending date for the testing -- just a "supplies are limited" notice.  It also doesn't look like the deal is good in Massachusetts, Maryland or Texas.  Hope your guys' results are equally good!