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Reclaiming my throne

Last Monday, I had an appointment with my CDE. As I'm sure you know, such an appointment comes with a little baggage. Not only is she the recipient of all my food/insuling/BG logs (insert dirty, scowling look here), she's also the person I rely on for basal tweaking and nutrition information. I haven't been so thrilled with this interaction as of late, so I'd been dreading the visit. And I'm talking the kind of sheer dread that had my BGs hanging out - sticky, unmoving - in the 180s until dinner time.

I came armed with logs and Dexcom graphs. She - once again - lowered my frakking basal rates. I - once again - felt confused and disappointed, since I knew that lowering them would result in higher average blood sugars for the next three days. She said stay the course, try these new rates, and send my logs in on Friday - she'd share them with my endo, and maybe I'd get my coveted little head pat after that. So I listened to her. After all, she's the professional, right?

Fast forward to Friday. I send her all my logs and this email:

Attached are my logs and Dexcom graphs since we saw each other on Monday.

The two things of note are the BG mountain on Thursday (which is a correction mountain that's the direct result of the graham crackers I overtreated with after over-bolusing for the pasta - I give myself an F and declare to only treat with juice for the rest of my life now) and the weird jump I had last night between midnight and 4 a.m. I had a horrific nightmare that woke me up around 3. I got up, got a drink to shake it off and went to bed. 30 minutes later, my high alarm is going off and I'd jumped from around 80 to 140. Have you ever heard of nightmares doing that before?! So lame!

Anyway, here they are. Please, oh please, tell me something happy!


Ok, let’s make these changes:
Change time of 6 am basal to 6:30
Change 9 am to .35
Change 10 pm to .40

I don't know that I can accurately convey how upset I was. No mention of the endo, no explanation of why she's making these reductions in my basals (again!!), no nothing. In the end, I tried to get her to explain exactly what she was trying to achieve with these basal tweaks, and was told she's working on the early morning rather than the overnights. Which was confusing, really, since she was reducing my insulin and I hadn't noticed any lows in the early morning. If anything, I had elevated blood sugars at that time because of my getting-ready-spike. So I, again, asked for clarification. I didn't think it was odd to want to understand the motivations and end goals behind all these basal tweaks...but apparently she did. All I got as a response was "Ok, leave everything the same." Ummm. She wanted to change my basals until I asked her about it? There was a problem with my regimen until I asked for clarification? How in the hell does that make any sense?

Needless to say, I was furious. Still am, in fact. Enough so that I'm on the cusp of staging my own little revolution to reclaim my Diabetes Queendom. No one knows my body like I do. No one knows where I cheat, where I'm SWAGing, where I had a stressful meeting or didn't wait quite long enough between bolus and eating. For that matter, no one else seems to care about these subtleties. So I'm done. I'll send my logs, I'll do my due diligence, but I'll no longer passively accept changes to my regimen. It's been nearly a year since I started on the pump, and it's time I stepped up and stopped letting other people be the boss of me. Posted by Karen Hoffman at 1:40 PM Labels: basals, D equipment, Dexcom, el doctor, Minimed pump
