Tuesday 19 June 2012

New "Diabetic Team"

I was a bit nervous going into yesterdays appointment.  After I was diagnosed I was assigned to the endocrinologist that had taken over my care in the last two days I was in the hospital.  He is a nice enough man, but after a couple of visits with him I knew we were not going to be a good fit.  When I asked him about adjusting my insulin for long distance running and other intense exercise he told me that I would be best giving those activities up now that I had diabetes.  I told him that I was not prepared to do that and he basically told me that when someone gets diabetes they often have to give up things to adjust.  Good thing I took this advice with a grain of salt!  There is no way I was about to change my lifestyle and stop pursuing my passions in life.  There were other things he was unable to help me with which I feel are important.  I asked him about how to adjust my lantus for "that time of the month" as I was experiencing extreme highs about a week before it came.  He told me that I would just have to play around to see what works.  For a newly diagnosed diabetic that made no sense to me at all! I was scared to start playing around with my insulin as I really had no idea where to start.  Another major deciding factor for me to move was the fact that he does not support pump therapy and felt that I would do fine on MDI forever.  I know that I want to go on a pump as it will suit my lifestyle better.  The dietitian I had access to was not very helpful either and was unable to help me in figuring out my carb ratio and correction factor. I went to my family doctor and was referred to the Grey Nuns Diabetic clinic.

From the moment I stepped into the clinic I got a great feeling.  The staff were very friendly and in fact most of them are diabetic themselves.  I spent two hours with the nurse and she was amazing.  She took my meter right away and downloaded the previous month of BS readings (other place did not do this).  We went over my numbers and she brought my attention to some of the trends.  In particular that I was going low in the middle of the night regularly.  Once she had background around my exercise regime she advised me right away to lower my basal from 24 units to 22 units and to track that for a week.  If I continued to go low I was to call her to decide whether to drop another unit at a time until we found a balance.  She also noticed the highs I experienced the week before my period and told me for the next month to raise my lantus by a couple of units and track how that effected me.  If need be we could raise it more for the five days or so that was needed.  She gave me her cell and told me I could call her with any questions if that was not working so we could work it out together.  She was very interested in hearing about my running and goals to get back to the marathon distance and in fact she encouraged it.  We did talk a bit about the pump and the advantages I would find.  She arranged for me to attend their next pump intro class to learn more and is going to find out the different payment plans that are offered here in Alberta should the PC government not cover pumps as they promised. 

I was then passed over to the dietitian who was a goldmine of good information.  She had done a lot of study around diabetics with celiac as well and had tons of stuff for me to look through.  We talked about nutrition for before, during and after running and she gave me some things to try once I get back to running longer distances.  In fact I think I am going to take myself out for at least 16km on the weekend and try some stuff out.  She looked over my food diary and numbers and went over my carb ratio and what my correction factor is.  She wants me to track another three days using these formula's and fax it over to her for review and she said she will call me to go over it again.  I am scheduled to see my new Endo in three weeks as well (he was on holiday).

When I left the clinic over three hours later I had a big smile on my face.  I felt like these people "got it" and was even a bit overwhelmed with the support they offer.  I am looking forward to learning more from them and hopefully in the not so distant future getting started on an insulin pump under their care.  What a difference!!  I feel very positive :)

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