[BlueSky]

I went to see the endo yesterday. I have been seeing Rick for about 10 years and we get on well. So I never miss the annual appointment, even though I know that I will most likely be told stuff I don't particularly want to hear - like I should be taking a statin and I should maintain higher blood glucose levels .

Anyway, he agreed that perhaps I don't need to worry about the cholesterol. LDL has come down from 4.3(167) to 3.1(120) over the last 2 years, in spite of getting no treatment for it and eating lots of saturated fat. All we could attribute this reduction to was lower stress levels and improved sleep.

The HBA1c came out at 6.0%, which to me was a pleasing result. Rick always cautions me not to try too hard because of the hypo risk. The DEs get quite edgy about it. And I have to keep on reassuring them that lowering the HBA1c is not an end in itself. It is the result of reducing variation in blood glucose levels, which means fewer and less sever hypos too. I told them emphatically that I hardly ever have hypos anymore .

I was having some difficulty articulating all this. And Rick had noticed some perspiration while he was taking my blood pressure, which was lot higher than it usually is. So he tested my BS and it was 2.5(45) . That was very embarrassing.

I think I lost that round of the debate. I had had a hectic morning and over corrected a high before leaving the office. What I didn't tell them was that I had done the correction into a muscle and it had worked a bit too well. Maybe Rick is right - I shouldn't try so hard .

[shiftzor]

Don't let it rule your life too much, but it sounds like you’re doing fine. We all make mistakes, it’s only human. My endo does the same thing, my last A1c she was worried that I was going low too many times which was partly true. Hopefully my next A1c will be decent with less lows

[Jan B]

Blue Sky,

Going to the doctor, even one you like, is nearly always stressful. My blood pressure is always up a bit, and that just aggravates me! I can laugh at what happened with the low reading after having a hard time articulating the bg swings, etc.! I sure would not be laughing if that happened to me!

Do you feel like you are trying too hard? Does your tight control feel like you are taking some of the fun out of your life? You can be your own judge. I haven't been brave enough to shoot in the muscle; I don't have any real judgement on that. I know that I enjoy much smaller bg variations by eating much lower carb foods. I keep thinking about the look on my doctor's face when he sees my next HBA1c. I was at 8 in December. I'm hoping for 6 in mid-April . . .

Does your T1 daughter think you try too hard?

[Kim_in_TN]

YIKES! I'm glad you were in a safe place when that happened!!!

[Gary_W]

Don't beat yourself up; you always seem confident in the way you treat your diabetes and for the most part it works for you. That's almost certainly more than can be said for most of the other patients on his books...

The thing that doctors don't seem to 'get' is that once your control is good and you stay in a decent range for the most part, running high can make you feel pretty grim. It's just the baseline you are used to.

I can remember when diagnosed my BG came back as a 27 or so (486). Once the insulin started, it came down to decentish levels within a few days. The first time I had the symptoms of hypo, my BG was over 7 (126) so I was anything but. However, I genuinely believe your brain gets used to an awful lot and, once you're in that zone for a good long while, doesn't complain anywhere near as badly as perhaps it should. Hence both hypo unawareness and the reason why there are loads of off the rails or undiagnosed folks out there running in the mid 20's (400's) day in day out without batting an eyelid...

When I split my Lantus dose in February, I ran quite a bit higher for the most part and I felt just plain awful. I wasn't silly, spilling ketones high. Just up there a bit. It made my brain wilt so badly that I had to go back to the previous methods and stuff myself before bed. If doctors could get how bad a prolonged 10 (180) feels to me when I'm used to running between 4 and 7 then I'm sure appointments would be more pleasant.

Gary

[BlueSky]

Thanks for the support

Originally Posted by Jan B

... Do you feel like you are trying too hard? Does your tight control feel like you are taking some of the fun out of your life? .....

Mmmm ... you have opened a can of worms there . It is a complex question. I do believe, having lived with it for so long, that there is a real risk of diabetes management becoming the unfortunate recipient of nonproductive and unhealthy energies. Managing blood sugar becomes part of a coping mechanism that can be quite destructive, and it manifests in different ways with different people.

I am painfully aware that, when I am having to deal with other frustrations, I redirect this negative energy into managing the diabetes. Perhaps it is because I feel the much sought-after sense of control that has abandoned me in my other activities (especially work). When this happens, my control tends to become somewhat uncompromising and aggressive. This is not good. It can lead to bad outcomes. The fact that it is a subconscious though pattern makes observing and dealing with it difficult. I guess sometimes we just need to take step back from ourselves so we can watch what is going on.

The high blood pressure was probably because of the hypo - all those stress hormones. And yes, Caroline thinks I am way too anal about everything!

[R2112]

Originally Posted by BlueSky

I guess sometimes we just need to take step back from ourselves so we can watch what is going on.

I think that is the most poignant thing you could have said and for all to do once in awhile!

Very well put Blue!

Try not to let this bring you down, most of us really appreciate the your comments and suggestions that you and others give, given how you have had this complicated disordered.

[Jan B]

Originally Posted by BlueSky

Managing blood sugar becomes part of a coping mechanism that can be quite destructive, and it manifests in different ways with different people.

I am painfully aware that, when I am having to deal with other frustrations, I redirect this negative energy into managing the diabetes. Perhaps it is because I feel the much sought-after sense of control that has abandoned me in my other activities (especially work). When this happens, my control tends to become somewhat uncompromising and aggressive. This is not good. It can lead to bad outcomes. The fact that it is a subconscious though pattern makes observing and dealing with it difficult. I guess sometimes we just need to take step back from ourselves so we can watch what is going on.

Wow the above is so true, and also a description of my life, along with some good ideas. I've got the career frustration going and I supercontrol some things, knowing I do it because of the lack of control in other areas. You've got a friend here. I always appreciate your thoughtful input. It makes me sad when someone like you -- self-confident and sure, intelligent and caring -- gets down or unsure. You don't always have to be the strong one! I'm glad you are here Blue.

[morrisma]

Originally Posted by BlueSky

I think I lost that round of the debate. I had had a hectic morning and over corrected a high before leaving the office. What I didn't tell them was that I had done the correction into a muscle and it had worked a bit too well. Maybe Rick is right - I shouldn't try so hard .

Lost? Not a bit of it. You've worked too long and too hard to fold up on a single point especially when the debate centers on your health & life. Not many long term type 1's have a 6.0 A1c.

OTOH, if you see that slippage from one area of your life negatively affecting others, it may be time for adjustment. From the public 'forum' side of your life you seem confident, well informed, and straight up with info & opinions. Not a bad way to live.
Mike

[Eddy]

Remember, trained professionals know what they know care of coalesced information gleaned from observation. You deal with "the source" in a far more intimate, constant, and specific manner than _any_ doctor.

I'd chalk it all up to stress, actually. My BG tends to get wonky when I go in for a doctor's visit. Add your IM bolus (which I've not had the courage to try), and I cast my vote for "caught a well-controlled T1 during a bad moment". Or, put more directly... you-know-what happens.

If you feel that your control regimen works for you, and is the best alternative... just relish the irony, and keep sharing your thoughts and experiences with us.

[mzteacher]

hi blue...
we have never communicated directly....but i have read many of your posts....i appreciate the wisdom you are always so generous to share....i am sure from reading so much of what you have to say...you will work out the balance that you need and feel comfortable with....any how...good luck...you come across and a great guy!
susna

[xMenace]

Originally Posted by BlueSky

The HBA1c came out at 6.0%, which to me was a pleasing result. Rick always cautions me not to try too hard because of the hypo risk. The DEs get quite edgy about it. And I have to keep on reassuring them that lowering the HBA1c is not an end in itself. It is the result of reducing variation in blood glucose levels, which means fewer and less sever hypos too. I told them emphatically that I hardly ever have hypos anymore:D .

I was having some difficulty articulating all this. And Rick had noticed some perspiration while he was taking my blood pressure, which was lot higher than it usually is. So he tested my BS and it was 2.5(45) . That was very embarrassing.

Yes, I'd be embarassed too. They always seem to hit at the very worst times.

And yes I totally agree with your assertion. Better control is exactly that: better control.

I don't think any of us could put the Beetus out of our minds and take it easy. Whenever I do I end up paying for it.

[Mich]

Hi there Blue Sky,

Well, you nailed it for many of us. Channeling stress into diabetes management at times, trying to ignore low sugar when we have something important to do. All people analyze the overall picture of their lives occasionally, but we do it in a particular context.

It's different with diabetes. The anal among us tend to take the best care of ourselves. Are we all a bit obsessive-compulsive about the whole thing? Probably. Do most of us find a way to have a life anyway? Mostly.

To me, you seem pretty normal. But thank you for sharing and for the introspection you triggered in several of us.

Here's to the rest of the week being stress-free.

Mich

[Emm]

You know how some people have that 'going to work naked' nightmare... my fear is going hypo at the doctors lol. You lived my nightmare!!

I think it only worries me because I know they think I'm obsessed. They don't understand me testing so often and seem to think my steady 6.2 A1c is a little low (and here's me aiming for 6 or lower). But only *I* know my body and my style... so I carry on the way I am and nod and smile at them :p

Anyhoo, I reckon you do whatever suits YOU. We all have our own style of diabetes, our own version of control which fits into our families / jobs / lifestyle.

Do you think it takes over your life? I wondered about this myself a while back so I took a break from forums and slackened control off just a tad. I felt gross! Life was getting messy. I thought it would be nice if I didn't have to worry about D so much - but I ended up worrying more because I wasn't testing as much, was hitting more lows & highs, and it became this mysterious mess of an illness (Yeh, I actually felt like a sick person) instead of just something I worked on a little bit each day.

Do what works for you. Sing along with Frank Sinatra... I did it myyyyyyyyy wayyyy

[Gary_W]

Originally Posted by Mich

Hi there Blue Sky,

Well, you nailed it for many of us. Channeling stress into diabetes management at times, trying to ignore low sugar when we have something important to do. All people analyze the overall picture of their lives occasionally, but we do it in a particular context.

It's different with diabetes. The anal among us tend to take the best care of ourselves. Are we all a bit obsessive-compulsive about the whole thing? Probably. Do most of us find a way to have a life anyway? Mostly.

To me, you seem pretty normal. But thank you for sharing and for the introspection you triggered in several of us.

Here's to the rest of the week being stress-free.

Mich

Guilty as charged as well. We all like to feel we control diabetes rather than it controlling us. When other areas of our life slip from our control then controling the one thing we know we can becomes super-important and can become very consuming. The thought of letting the betes get out of control as well as all the other stuff is scary, as then you start to feel like you are riding your life rather than driving it (and that the person driving the ride has gone off for a beer!).

I have several things in my life at the moment about which I can do very little (you can't always accept that this is the case even when it's plainly true). I know it certainly makes me focus on diabetes more, especially as going high makes me very down in the dumps these days. The last thing you need when life throws a whole bunch at you is sub-optimal control making you into too much of a negative nancy to deal with it, and that's what happens to me when I am out of control...

Good luck, BlueSky, and thanks for starting this thread