Three Part Update

Part One: My period...

...did arrive, but it was a couple of days late. It finally appeared on Saturday 24th, which makes a 30 day cycle. I'm glad the mystery was solved, although it was a slightly strange period - less bright and fresh looking than usual, and slightly clotted and lumpy. Erm... TMI?? Let's see how things work out next month.

Part Two: Fifth appointment at the Pre-Pregnancy/Diabetes Clinic

I went for my fifth visit to Dr Inspiring and co on Thursday 29 July. I spent most of my time with L, the dietician. She thinks I'm doing really well, although a look at my log book confirns that my biggest struggles are still around the dawn phenomenon (things are much better than they were, but it's definitely my biggest challenge). L suggested taking my evening Levemir at bedtime rather than dinnertime, in order to see whether moving the peak action to a different part of the night would help. This might also require some changes in the daytime dose, involving a certain amount of experimentation.

My appointment was a little later than usual. Normally I opt for the first appointment of the clinic, at 8.45am, which allows me to get into work reasonably early, and means that I don't get caught up in any clinic delays (they routinely overbook appointments, so Dr I suggested that the early appointments are better for someone like me who has a longish commute to work). My appointment was originally supposed to be on 9 July, but got cancelled and reorganised (initially for a date at the end of June, which I was unable to make as I was on holiday) and I ended up with a later time slot as a consequence. The hospital where I go for my appointments is currently experiencing a lot of rebuilding work, and as a result the walk from the main car park is now about ten times as long as it used to be (which I wasn't expecting), so by the time I arrived for my appointment I was huffing and puffing and my blood sugars were dropping. After a half hour wait before being called through I was just starting to go hypo (not badly, but enough that I'd need to treat). As L arrived in the room I was just crunching up my third glucose tab, and explained that I'd need to test in 15 minutes to check I was back on course. L suggested taking not three but seven tablets! Apparently I'm undertreating. But I'm keen not to overtreat, and three seems to work for me (when I'm not being naughty and using other less revolting options like chocolate drops from my baking stash, or mentos, or licorice!) L also told me that there's a local shop which stocks the big round yummy glucose tablets - which the clinic staff apparently reach for in the afternoons when their blood glucose dips! The idea that anyone would choose to eat glucose tablets suggested to me that these yummy ones might be the holy grail, but after a drive out to the said shop I struck out (none in stock).

We also talked about how I'm trying to even out the peaks and troughs in my blood sugars, and how I've been trying to work out my ideal doses, carb ratios and correction factors by using the methods suggested in the brilliant book I just got (Using Insulin by John Walsh). I've started by trying to identify my overnight dose via basal testing, and L said she'd email me the advice sheet that the clinic uses with patients on pumps (which also works for non-pumpers, with a few tweaks). We agreed that my swings appear to be reducing, and L thinks I should keep on with what I'm doing. She couldn't think of any changes to suggest beyond trying shifting my Levemir injection for a few days, and agreed that there aren't any clear patterns of hypos emerging from my log book.

We also talked a little bit about how long S and I have been trying (three months). I said that all I seem to do is count stuff and wait - either glucose tablets and 15 minute waits following a hypo, blood sugars and insulin doses every single day, or cycle days and two week waits! Dr Inspiring stuck his head round the door at this point in the appointment to say hi, and find out how things are going. He joked with L that I'm their 'star pupil'. They agreed that I should have the full pre-pregnancy bloods panel again (including the thyroid function tests), and after a quick conflab about how long we've been trying, they said that whilst there's nothing unusual in trying for three months without success, if I'm still not pregnant next time I come for an appointment, they'd start doing some blood tests and fertility investigations and will involve the obstetricians. They both recognise what hard work it is to keep your sugars in the narrow corridor needed for a healthy pregnancy, so are happy to get the ball rolling just in case. These people are great! Dr I suggested I come back in eight weeks, by which time we'll have had another couple of full cycles and will know the outcome of both. When Dr I had gone L suggested that I think about using ovulation prediction sticks - can't hurt and will make me feel like I'm doing something to take control! Apparently they're much less expensive if you buy them through Amazon, of all places! :)

I finished my appointment by having my bloods taken by the lovely nurse who has T1. We had a really good natter whilst she was searching for a worthwhile vein (mine are both tiddly and move around a lot under the skin). She was feeling a bit the worse for wear after a night time hypo, and I was able to sympathise. We talked a bit about all of the complex variables involved in good control, and how it's about much more than food, insulin and exercise. Things like stress, and illness, and god knows what else! We also talked about how isolating having T1 can be, and the fact that I've only ever met one other T1 of my own age. She's been trying to convince the clinic to set up some kind of a support group, and I agreed that this would be great. Hell, I'd even volunteer to help run it, and I said so! She said that she finds working in the clinic great because it means she can meet diabetic women. I asked whether she'd found the D.O.C., She hadn't, although she's been in contact with Ginger Viera via facebook. I suggested that she find Six Until Me - both because Kerri Sparling is great, and because she's so central to the D.O.C. and has such a complete blogroll! (I did warn her not to start reading that night though, on account of her needing a good night's sleep and the risk that she'd do what I did, and not be able to stop clicking on links!)

All in all, it was a good appointment, and I rolled out of the clinic very happy (if a bit late for work, and an important meeting. I arrived with three whole minutes to spare!)

Part Three: My HbA1C.

When I got to work, I had an email from L waiting for me with the clinic's basal testing sheet. What service! It occured to me that I hadn't asked if I'd be able to get my blood test results before my next appointment, like last time, so I emailed back to ask. 'No problem', came the answer - 'just call or email me tomorrow'. No clinic I've ever attended has done this, and I love it. It would be utter torture to wait eight weeks to find out my result! Instead I emailed back the next day, and found out that my HbA1C was 6.5%, down slightly from 6.6 last time. WA-HEY! :) So exciting. It's not been easy, but here I am, maintaining. L also wished me luck and said that she'd see me in eight weeks (if not before). FINGERS CROSSED. I just want to be pregnant now. It seems like everyone else is. Another friend who had her first exactly a year ago is now pregnant with number two and due in November. Please let us get pregnant soon, and let me be on top of my sugars, and let us have a happy and healthy littl'un that's part me and part S (it's our first wedding anniversary today, and pregnancy feels like the next step in our wonderful life together).

Here endeth the update. Had curry for dinner this evening (romantic meal with my lovely husband) which can play havoc with the sugars, so I'm off to do a blood test before bed, and an early start in the morning for yet another London meeting. Night night.