Tuesday, July 14, 2015

Diabetes America!- My First Appointment

Yesterday I went to my first appointment with Dr. Mora at Diabetes America!  (Which, by the way, I feel must me said with a cheerleader shout whenever I say it.)

I was so excited to be going to a new place, and to a new endocrinologist, to hopefully get some new ideas on wrangling in these roller coaster blood sugars I've been seeing on my Dexcom over the past year that I've been using it.

my dexcom meter. this is what a bad day looks like. less of this, please.
So excited, that when I stopped in at the restroom to wash my hands when I first arrived, I threw my glucometer in the toilet.

It was an accident.  Because the sink didn't have surrounding counter space, it seemed that the most logical and safe place to set down my meter was on the back of the toilet. I didn't realize there was a slight slope, just the perfect amount of slope, that as I turned to wash my hands, my glucometer fell right into the toilet water.  I tried drying it off and using it, but it had already drowned and was beyond saving.

I told the receptionist about my mishap, and she gave me a brand new meter, just like the one I tossed in their toilet.
old "one touch" glucometer that fell in the toilet/ new replacement glucometer
When it was time for my dreaded labwork, I took deep breaths, preparing to have blood taken from my vein.  That's how any endo I've ever been to in the past has done lab work.  And I hate it.  I've gotten faint plenty of times. I never gotten used to it, even though I've had it done way too many times to count.  But at Diabetes America! they just use a finger prick to get your A1c and cholesterol levels.  Annually, they do a more thorough blood panel which does require getting the blood from the vein, but not for this visit.  Yahoo! Already, I was in love with this place.

Also, the lab results were just about immediate, so by the time I met with the diabetic educator, we knew my results.  This makes a lot more sense than getting lab work results 3-5 days after my actual doctor appointment!  So we looked at not only my Dexcom results over the last week, but at my A1c as well.

After speaking with the educator, (which you have the option to do, or can forgo if you prefer) I met with Dr. Mora.  He had already been filled in on what I was wanting to address, medications I had asked about, and had an idea of my goals.

NovoPen Echo
Although I had asked about, and was hoping to try Farxiga or Invokana (drugs that to my understanding make you pee out excess sugar once your blood sugars go above 120 --please read more about it HERE because I'm not claiming that I got those facts exactly right!), Dr. Mora wants me to first just simply start using a new insulin pen that allows me to give shots in half unit increments due to my sensitivity to insulin.
Often, I have to opt to take a little too much, or a little too little insulin- but now, with the 1/2 unit options- POW!- this could really help me tighten up my control. Not only does the NovoPen Echo give me the ability to delivery in 1/2 unit increments, it also has a memory that tells me when I last took a shot, and how much I took.  Sometimes, even right after injecting insulin I'll think "Wait, how much did I just put in there?" So this added feature sure is nice. I trust the pen's memory better than my own.

He also suggested that I use a new glucometer.  It's one that not only give you a blood sugar reading, but also advises you on how much insulin to take,  based on how many carbs you tell it you're about to ingest. It's the Accu-Chek Aviva Expert.
accu-chek aviva expert
Obviously, this little calculation be done in my head, but I confessed to the diabetic educator that I don't really carb count, but instead use a very scientific method I call "Eye Balling".  I just sorta look at my meal and decide if I should take 1, 2, 3 or the occasional 4 units of insulin.  It usually works. When it doesn't I make a correction by either eating a little more, or taking a little more insulin.  I realize this method is slightly flawed and probably sounds crazy (or at the very least, lazy) to a medical team.  So, I think rather than trusting me, they want me to use a meter where they can actually see how much insulin I'm taking in relation to the amount of carbs I'm eating.

So for now, that's it.  A new meter that calculates my carb/insulin ratio, and a new pen that delivers 1/2 units of insulin. Hopefully, these two minor adjustments will make a difference and I'll have a little roller coaster that looks more like the "Mini-Mine Train" than the "Shock Wave".

an ideal day on the dexcom.  more of this, please.


  1. When you come over tomorrow, remind me to give you all my Aviva Expert supplies!!! I loved it, but don't use it now that I'm on the pump! Great blog post by the way! I'm super excited about you seeing Dr. Mora!

  2. oh!!! that is so awesome tanya! i would LOVE to put your aviva expert supplies to good use. thank you so much. :) so you manana!

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