Over the past month or so, Tom and I have both been feeling like TJ's numbers have been in range - some highs, but mostly solid numbers, with what feels like many lows scattered throughout. I was happily anticipating our three month check-in with the fabulous Deb at the Joslin Clinic, where I was sure we would be applauded for our wonderful diabetes management, and ability to bring his A1C so low.
And then I downloaded the pump.
Many solid numbers, sure - but also LOTS of highs, and some lows, but not nearly as many as I remember. His three month average BG was 180. A quick search on the internet indicated that his A1C would be 8. Eight.
I am not a person who loves to do errands, chores, tasks around the house. I put off any and all household tasks until the situation is dire. If it were up to me entirely, we would all do laundry only when no one had clean underwear. Somehow, the task of downloading the pump, crunching the numbers, and making adjustments has fallen into the same "oh yeah, gotta do that chore" as laundry. Which is ridiculous, really. And a little pathetic. Yes, it is an annoying, redundant chore, much like clothes-washing. But the results - better long-term health for my CHILD - are far better than clean underwear. And still, it falls by the wayside.
Today we met with Deb, and as the amazing web predicted, TJ's A1C was exactly 8.0, a number Deb was actually fine with. In the past, TJ has been both higher and lower than 8, and it is the top of the goal Joslin sets. It does still seem like a bit of a failure on our part, but there were many other successes: Deb is pleased with how active TJ continues to be, as well as his increased weight - something we have been working hard at. We were able to put additional opportunities for TJ to be independent into his school plans, something TJ was excited about, and Deb was all in favor of. Overall a good visit.
As for the A1C - we'll have to keep at it. Maybe download that pump each time we do a load of laundry.
Showing posts with label A1C. Show all posts
Showing posts with label A1C. Show all posts
Thursday, July 1, 2010
Monday, May 18, 2009
Stuck in a Rut
Thomas had his appointment with our nurse educator Deb last Friday. Both Tom and I were excited for the appointment, because TJ has had what seem like great numbers lately and we were anticipating a fantastic A1C (and what, getting a gold star? I don't know).
The appointment went really well - Deb is pleased with his numbers, pleased with the adjustments we had made ourselves to his insulin/carb ratio and basal rate, pleased in general. We are A+ parents of a diabetic, apparently. (Which is great for me, grade-grubber that I am...) Oh, wait, but what's that....the A1C you ask. Yeah, still 7.9. Still high. Hmmmm....let's recalculate....B-.
Of course, I'm kidding. Joslin doesn't give out grades, and if there were grades in parenting mine would certainly be less than a B- based on lack of bedtime stories read alone. BUT, 7.9, really. We were sure it would be lower.
Deb was quick to let Tom know that 7.9 is a great A1C for a boy who is as active as Thomas. One might not know it from the A1C alone, but we've actually been struggling with lows lately, since TJ has been playing tons of soccer. Deb reminded us that 7.0 - 7.5 would be considered the best range for a sports-nut like TJ, but still....7.9, again?? Couldn't they have just tossed us a 7.7 to keep things interesting, keep our motivation level high?
So...we'll be back at it. Maybe logging, maybe making more adjustments. I might have to actually crack open that copy of Pumping Insulin I ordered from Amazon. But for now, we're in an A1C rut.
The appointment went really well - Deb is pleased with his numbers, pleased with the adjustments we had made ourselves to his insulin/carb ratio and basal rate, pleased in general. We are A+ parents of a diabetic, apparently. (Which is great for me, grade-grubber that I am...) Oh, wait, but what's that....the A1C you ask. Yeah, still 7.9. Still high. Hmmmm....let's recalculate....B-.
Of course, I'm kidding. Joslin doesn't give out grades, and if there were grades in parenting mine would certainly be less than a B- based on lack of bedtime stories read alone. BUT, 7.9, really. We were sure it would be lower.
Deb was quick to let Tom know that 7.9 is a great A1C for a boy who is as active as Thomas. One might not know it from the A1C alone, but we've actually been struggling with lows lately, since TJ has been playing tons of soccer. Deb reminded us that 7.0 - 7.5 would be considered the best range for a sports-nut like TJ, but still....7.9, again?? Couldn't they have just tossed us a 7.7 to keep things interesting, keep our motivation level high?
So...we'll be back at it. Maybe logging, maybe making more adjustments. I might have to actually crack open that copy of Pumping Insulin I ordered from Amazon. But for now, we're in an A1C rut.
Saturday, January 31, 2009
Letting it Go
Of course, winter has taken over, and blog posting has gone by the wayside. I have been busy, I think. Not sure what, exactly, I have accomplished, but every minute has felt scheduled and my house is NOT clean!
Thomas had a trip to Joslin in December - right before Christmas - and met his new endo. I liked his old endo, but love, love, love his new one. Dr. Ricker is fantastic. She is laid back, funny, and definitely gets it. As I pulled out his log (which of course was downloaded from his pump only for his appointment) and made a comment about all the "yellow" numbers (color coded because they are out of range), she cut me off with a quick "It's not a report card." Thank you Dr. Ricker!
I was nervous about the appointment, particularly the A1c, because he has had many more highs than over the summer, and we are not as quickto adjust highs because we are worried about lows in school. And, although he has seen many more highs since school started back up, his A1c is still 7.9. Still in range, as our nurse educator Deb so kindly reminded me. Is it perfect? Not at all. Is it a great A1c to aspire to? Not really. But it speaks to something new in my diabetes thought process. It is care I am comfortable with for Thomas for now.
Diabetes brings so many added responsibilities, so much extra in general for Thomas, that I hesitate to hover over him every minute and control his every movement. I want him to be able to to go to playdates and run off with neighborhood kids whose parents might not be so aware of diabetes. I want him to join the sledding down the local hill or the pick-up hockey game in the road. I want him to be able to enjoy school without 12 trips to the nurse (the 5 he makes each day are certainly enough, no?). And in order for him to do all those things, I need to know he is not going to go low all the time. And that means taking slightly higher numbers sometimes and living with them.
There are parents out there, I know, who would read this and claim that I am abusing my son by not managing his BG as agressively as possible. There are parents who wonder why I wouldn't push for CGMS to monitor his BG at all times and get his A1c as low as possible. It is, of course, an indicator of how his long term health might be. And, I do worry about managing his numbers and his long term health.
But I think in our house, with our child, we have made a somewhat unspoken agreement to do the best for the now. Thomas lives with the reality of diabetes. He leaves class to check his BG. He stays out of the pool when his friends are swimming because he is low. He doesn't get to go home on the bus to houses where the parents have not been trained in diabetes management. He wears an insulin pump and takes shots and tests his blood sugar all without complaining. If an A1c of 7.9 allows him a somewhat 'normal' childhood, and generally good health, too, than I will take it. For now.
Thomas had a trip to Joslin in December - right before Christmas - and met his new endo. I liked his old endo, but love, love, love his new one. Dr. Ricker is fantastic. She is laid back, funny, and definitely gets it. As I pulled out his log (which of course was downloaded from his pump only for his appointment) and made a comment about all the "yellow" numbers (color coded because they are out of range), she cut me off with a quick "It's not a report card." Thank you Dr. Ricker!
I was nervous about the appointment, particularly the A1c, because he has had many more highs than over the summer, and we are not as quickto adjust highs because we are worried about lows in school. And, although he has seen many more highs since school started back up, his A1c is still 7.9. Still in range, as our nurse educator Deb so kindly reminded me. Is it perfect? Not at all. Is it a great A1c to aspire to? Not really. But it speaks to something new in my diabetes thought process. It is care I am comfortable with for Thomas for now.
Diabetes brings so many added responsibilities, so much extra in general for Thomas, that I hesitate to hover over him every minute and control his every movement. I want him to be able to to go to playdates and run off with neighborhood kids whose parents might not be so aware of diabetes. I want him to join the sledding down the local hill or the pick-up hockey game in the road. I want him to be able to enjoy school without 12 trips to the nurse (the 5 he makes each day are certainly enough, no?). And in order for him to do all those things, I need to know he is not going to go low all the time. And that means taking slightly higher numbers sometimes and living with them.
There are parents out there, I know, who would read this and claim that I am abusing my son by not managing his BG as agressively as possible. There are parents who wonder why I wouldn't push for CGMS to monitor his BG at all times and get his A1c as low as possible. It is, of course, an indicator of how his long term health might be. And, I do worry about managing his numbers and his long term health.
But I think in our house, with our child, we have made a somewhat unspoken agreement to do the best for the now. Thomas lives with the reality of diabetes. He leaves class to check his BG. He stays out of the pool when his friends are swimming because he is low. He doesn't get to go home on the bus to houses where the parents have not been trained in diabetes management. He wears an insulin pump and takes shots and tests his blood sugar all without complaining. If an A1c of 7.9 allows him a somewhat 'normal' childhood, and generally good health, too, than I will take it. For now.
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