Friday, March 8, 2013

3 Month Check Up

So I am having a really hard time believing that it has already been 3 months since my last endocrinology check up, but since GV is already 14 weeks old and time just seems to be flying past I guess I buy it.  Originally, my appointment was scheduled for two days ago, but seeing as this is Northern Virginia and any sign of snow makes the entire region shut down, the "snowquester" got it pushed back to this afternoon.

With GW, GV and Grandmama in tow, I met with the wonderful Dr. Rogacz for a routine diabetes check-up for the first time!  Pleased with my weight loss and new HgA1C number of 5.8 (that is down from 6.2 mind you), she announced she wasn't concerned about my diabetes care in the slightest and that I am doing remarkably well.

Inquiring about my longer term plans for additional pregnancies and care planning purposes, I told Dr. Rogacz I intend to spend the next 12+ months training for and running in endurance races.  Since pregnancies, diabetes and running don't work together in the slightest, she seemed a bit relieved to know we wouldn't be putting my body through more of that any time soon, but it did cause her to use a term that I dread from endocrinologists: CGM.

Pump with infusion site on right; CGM on left.
CGM, Continuous Glucose Monitoring, is a technology that works with insulin therapy to keep a diabetics blood sugar as tight as possible.  As an additional attachment to the body, the CGM tests blood sugar every four minutes and logs the results so as to indicate the trending direction of your blood sugar and therefore making it easier to catch it as it goes up or as it goes down.  It'd be incredibly helpful for me on my training runs, it'd ensure my safety overnight by alerting me to lows before they happen, it'd help me keep my A1C lower by giving me constant readings and I'd generally be armed with much more information than I currently get with just my Free Style Lite test strips.  Essentially it is an extraordinarily handy tool and wonderful technology to have... I just don't want it.

Here's my logic:

Because I wear an insulin pump and have an infusion site adhered to my body 24/7/365, I constantly carry a 2" by 3" by 1" visual reminder in my pocket that I'm diseased.  Granted it is an extremely helpful piece of plastic to have and I'd be worse off with out it (multiple injections are so not my thing), but I resent the fact that I LOOK diabetic because I wear this tubed device everywhere I go.  Now, if I were to add a CGM, not only would I be attached to the insulin port that is necessary for my pump to operate, I'd have this transmitting device inserted into my subcutaneous jiggle that would make it all the more difficult to hide my disease under my clothes.

I understand that it is incredibly superficial of me to be concerned about "looking diabetic" and how this beneficial technology would impact the fit of my sweaters, especially since most people don't know what they're looking at anyway, but hasn't diabetes already consumed enough of my life?  I mean I can't even have a cup of coffee in the morning without needing to compose my little grey cells enough to test my blood sugar and calculate my bolus, why should I give another portion of my abdomen over to yet another accessory for my broken pancreas?

Don't get me wrong, that was an entirely rhetorical question and I understand the benefits of it.  I mean, okay, there is something to be said for having an HgA1C estimate whenever I want and, hypothetically, it'd protect me from severe hypoglycemia by averting it's onset in the first place, but I'm incredibly sensitive to lows as is and assuming my daily readings stay within a certain range I know my A1C is where I want it to be without knowing exactly where it is.  Perhaps I am being stupidly stubborn on this, but STILL.  I'm just not ready for that.  I feel diabetic enough as it is.

Maybe sometime down the line I'll come around and will willingly participate in the next level of self-care, but for the time being my answer is HELL NO.    Sorry to disappoint you, Dr Rogacz, I'd love to be your shining star patient with all the bells and whistles, but I'll take my low-tech stellar A1C and go on my way.  See you in June.

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