The not so wonderful news is that my a1c was 7.4 ( I have no idea how that happened ) up from 7.2 in January.
When I heard the news from the Attending intern I was ready to cry. And I would have, except at that point my blood was boiling and I wanted to give myself a swift kick in the ass!
A few minutes later Dr.J walked in and said: "Hi Kelly, how are you doing?"
Dr. J: Why exactly?
Me: Because of my a1c. I test like crazy and my 24 hour insulin intake is somewhere between 32 & 39 units. I don't get what my problem is.
Dr. J: Kelly (I have to mention that he pronounces my name so it sounds like "Kel-lee") No more playing with basal rates and rearranging your life,we need to nip this in the bud now. If you have an issue with Metformin we need to try SYMLIN
Me: Metformin caused my hair to thin and clumps to end up on the carpet Dr J. Call me crazy, but that really freaked me out, good numbers or not. I could try basal testing again, and I could exercise more. I've really been lackadaisical on my exercise - I need to do better in that department.
Dr. J: We could spend weeks going back and forth Kelly. You work so hard on taking care of your diabetes. Symlin is going to help you. We can see how it works out, and if you still hate it by your next visit in November, we talk about something else. Deal?
Dr J and I agreed (and yes, it took him some convincing before we shook on it) that I need to start Symlin, like, tonight.
Dr J: Kelly Trust me, your going to be so happy with the results- I promise!
Then Dr. J ran out and grabbed me a Symlin Pen sample/DVD along with a generous amount of insulin samples and a new One Touch lime green mini to replace the one I spilled New York clam chowder on back in May.
And together we went over the Symlin instructions including; where to inject, priming of the pen, and dosage instructions.
Dr J: OK "Kel-lee", we are going to start with one shot before your dinner because you tell me that dinner and after is when you are most hungry- which is what most people say, so your not alone. OK this is what your going to do:
15 mcgs before dinner for one week.
Increase rate to 30 mcgs at dinner the second week
Increase to 45 mcg before dinner the third week
Increase to 60 mcg before dinner the forth week.
Afer the first month, we can talk about increasing it to your lunch time meal as well.
Now "Kel-lee" this is important, decrease your dinner bolus by 30 %, because most patients find that is the number that works to cover both their meal and the initial nausea. OK?
Dr. J: Now you might experience some nausea, but don't give up. If it becomes to much when you increase from 15 to 30 mcgs, call me and we can stretch out your body's introduction to Symlin, like we did when you were on Metformin.
Me: Nausea, I'm not really a fan Dr. J, but OK.
Dr. J: It's going to be OK- we are going to get through this.
Me: Yes, we will.
Dr J: OK, keep Cheryl (his right hand and awesome CDE) posted via email. She forwards me everyone of your emails and her and I work together to figure out what to do for you.
If all goes well, I'll see you in 3 or 4 months months and your a1c will be back in the 6's.
Me: OK, but I want to come back in 3 months, not 4.
Dr J: 3 months it is, no problem- looking forward to seeing you then.
We said our goodbyes, I held my head up high, and walked out of the office.
But inside, I still felt like a failure.
But I still had hope - and as we all know, hope floats. So here's my latest Diabetes Math equation that makes me smile and gives me a shot of hope at the same time.
+ the drive to succeed
+ a positive attitude
+ more exercise
+ the support of my diabetes pit crew
+ the support of my diabetes on-line community
Getting my a1c back to where I need it to be.
PS: If any of you have been a passenger on the Symlin Express & have any advice or thoughts you'd like to share, I'd really appreciate it!