Michael is young enough that he should have appointments every 3 months, but the sad reality is, there are too many children in our state who have Type 1 Diabetes-- so we have to have our appointments every 6 months instead. This shouts to the need of more pediatric endocrinologists! It's much better and safer to manage diabetes with appointments every 3 months as opposed to every 6 months. Part of this is due to something called the A1C.
The A1C is obtained via a finger prick. The A1C is simply a number that corresponds to what an average blood sugar has been over the past 3 months. So you see? It would be so great if all Type 1 Diabetics could get an appointment every 3 months so that they could know what is their most current A1C.
When Michael was diagnosed in August 2014, his A1C at diagnosis was 11. That meant, his average blood sugar over the 3 months leading up to diagnosis was 269. His blood sugar should be between 90 and 180 each day. When we were diagnosed from the hospital, they scheduled his initial follow-up visit to be 3 months in the future so that we could get another A1C test done.
So, November 2014 rolls around and Michael's A1C was 8.9! We lowered it! That was fantastic! An A1C of 8.9 meant that Michael's blood sugar average over the 3 months leading up to that appointment was 209. The doctors and nurses would like Michael's A1C to get below 8.5 eventually. A "well controlled" diabetic usually has an A1C of 7 or below. You and I? We probably have an A1C of 5 or lower. This shows you how hard people with Type 1 Diabetes have to work at keeping a tight reign on their blood sugars. It's not easy.
When we left the hospital clinic at our November 2014 appointment, they scheduled his next appointment for 6 months in the future. Womp womp. In that 6 month period, Michael attended daycare for 3 months, he was also awfully sick one time (and that greatly affects blood sugar), and he had numerous ear infections (which also affect blood sugar). We didn't get the opportunity to have that 3-month check-up and see what his current A1C was, so we had to wait it out for the whole 6 months.
Unfortunately in May 2015 when we had the follow-up appointment, Michael's A1C was 12. That meant his average blood sugar over the 3 months leading up to that appointment was 298. I was crushed. It is immensely hard to be the parent of a Type 1 Diabetic and I was trying my best each day to keep my son safe and I felt like I had completely failed. We made our 6-month appointment for November 2015. On this day in May, we decided to get Michael on an insulin pump. We altered how our family ate. We started eating whole foods and focusing on "real" ingredients and not heavily processed items.
Since we made the decision to get Michael on an insulin pump, we had a couple of appointments in June to get things rolling. The rule with insulin pump start-up is that Michael had to have 2 appointments that were one week apart in June as we learned about the pump and got it all hooked up. Then, Michael was set to have a 2-month follow-up appointment to meet with the doctor and to see if the pump was the right choice for him. Well, lo and behold-- our appointment was set for August 2015-- which was two months after our pump-start in June, but even more important-- it was 3 months from our appointment in May! Michael could have another A1C done and we could get a real understanding of whether the pump was making a positive impact in his life. Isn't God good? He knew what the timing needed to be in order for Michael to get the medical attention that he needed.
So, in August 2015, Michael's A1C was 9.1! Yay! We had lowered it from 12! An A1C of 9.1 meant Michael's average blood sugars during the summertime as we got acclimated to the pump was 211. That was quite a significant change from an A1C of 12! We were thrilled. Since the August appointment was really due to him being on a pump and having that follow-up visit, we didn't have to cancel his November 2015 appointment since the purpose of these appointments were two different things (the August appointment was a pump-follow-up appointment, and the November appointment was a routine endocrinology check-up).
Yesterday was our November appointment. Michael's A1C was 8.9! (Seems to be a November trend!) So his average blood sugar over these last 3 months was 209. Even though a change from 9.1 to 8.9 isn't super huge, it is still significant because we were able to lower the "score" even just that little amount. So it means things are going in the right direction.
We had to schedule our next appointment for May 2016-- 6 months in the future. However, I can call the clinic in February (3 months from now) and have them fax an order to a local lab here for an A1C test. Then at least I can keep track of the progress we're going to make.
I am so proud of how Michael handled himself. He was polite to each nurse, nurse practitioner, doctor, educator, and receptionist we came in contact with. This is the most well-behaved he's been and maybe it's an age thing. He's matured even since turning 3 in August. Yes, I will admit, we still have days of melt downs and the car ride home was filled with screaming tantrums because I wouldn't let him have ice cream (that I didn't have access to in the car anyhow), and because I wouldn't let him out of his car seat on the highway (why he'd even want to do that I have no idea).
We left Children's Hospital at 3:45pm. It usually takes us an hour to get home. Well, we spent over an hour travelling just one mile on the highway as we got stuck in a construction zone. By the time we actually got to where the construction was, they were packing up their "construction zone" signs to head home for the night. Yeah, buddy, I hear you! I wanted to be home too! So, we pulled into our driveway at 6:55pm. Fortunately, my mother in law was with me and could dole out snacks to Michael on the ride. These snacks counted as his dinner, and I'm SO GRATEFUL that I packed a boatload of stuff for him to eat while we drove so that his blood sugar wouldn't drop mid-trip.
We were wiped out when we got home. Michael ate a bedtime snack, brushed his teeth and got into bed. I told him over and over again how proud I was of him and his behavior.
The nurse practitioner and the doctor made some changes to Michael's insulin amounts, so for the next 2 nights I will be checking a 2:00am blood sugar to make sure Michael is in a safe range (I already completed night 1 of 3 last night).
Don't forget, this is Diabetes Awareness Month. Show your support for those living with this invisible disease by wearing blue on Saturday November 14th for World Diabetes Day! There are two main types of diabetes. We hear about Type 2 a lot in the media (we'll leave it at that and I'll choose not to rant about how hurtful some comments are about type 2). Michael has the more rare form of diabetes, which is Type 1. This is when the immune system gets a crossed signal from the brain and the immune system attacks the insulin-producing cells of the pancreas, rendering them dead and unable to generate insulin. Without insulin, our bodies cannot turn sugar (ie, carbs) into energy. Without insulin, we will die. You and I have working pancreas(es)(?) that precisely dole out the insulin we need to cover our mindless carbs. People living with Type 1 must inject insulin into their bodies to work with the carbs they have eaten. This is not an exact science. Too little insulin will send a blood sugar too high. High blood sugar over time is fatal. Too much insulin (even the smallest amount too much) will drop a blood sugar. This is deadly because low blood sugar turns into an emergency situation within minutes.
So today, on your journeys, say a prayer for those living with Type 1. Recognize that they did nothing to cause this and there is currently no cure.
Wear blue on November 14th and show support for those living with diabetes!
Until Next Time,
Much love, Reba