I had called L, the dietician, in advance of this appointment to get the results of my HbA1C, and had to endure a frustrating wait of a few days whilst she was on holiday. I'd been really hopefully that it would be under 7.0%, and was gutted to find that it was still 7.3.
When I arrived at my appointment Dr Inspiring came bounding in and told me how well I looked, and then gave me the HbA1C result. 'What do you think?' he asked. 'Well...', I said, 'I'm pretty disappointed that it doesn't start with a 6.' Dr I then proceeded to tell me that I was beating myself up for making spectacular progress. He told me that he could see that I'd worked extremely hard, and took a quick look at my log book before proclaiming that my HbA1C should be less than 7.0% within four weeks. As it turns out his enthusiasm is pretty infectious, and his comment totally made my day!
He wondered aloud if I'd thought about switching from Lantus to Levemir, and when I explained that L and I had discussed it last appointment, and that I was keen to try it, he wrote me a prescription for a snazzy new Novopen and one box of 5 cartridges. We agreed that I'd try it and would see how I went. He advised starting the new insulin at a weekend, so that I could have a couple of days to settle in before going back to work. He wasn't sure if 1:1 would be the right conversion ration between insulins, as apparently it varies between people, so he told me to test frequently to start off with. Apparently it can take time for the Lantus to leave your system, so I might need to adjust things after the first few days.
We talked about my very frequent hypos, and he agreed that my strategy of holding back some food from each meal was a good one. Many of his patients eat small packets of carb throughout the day, rather than having three 'big' meals. 'Treat it like a military campaign...' he said, 'maintain the same level of food, but have more meals - small meal, snack, small meal, snack...' He gave me a leaflet about how to treat hypos, and I promised I'd try to stick to its advice, rather than doing my usual 'hoover up all the carbs within reach' approach and then rebounding. Glucose tabs are truly disgusting though, so I've not been as good as I might have. Still, I'm trying.
I asked again about my thyroid results, having had some time to digest them and read up on the internet. Dr I said that it was nothing to worry about at present, but that he'd keep a close eye on my levels.
As for TTC, Dr I suggested that we could start trying in May. I left with an appointment for 13 May, and was given a blood test request form so that I could have an HbA1C the week before my appointment. I also left with a book recommendation, having admitted reading the NICE Guidelines from cover to cover. I've promised myself that once we get pregnant I'll treat myself to the following medical tome: Managing Pre-Existing Diabetes Mellitus in Pregnancy by J.L. Kitzmiller et al (American Diabetes Association). Stupid, I know, but I don't want to order it until I see a positive test, just in case I jinx myself. I am a rational person, honest, but this TTC stuff can fry your brain just a little!
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