Tuesday, September 10, 2013

A Breakdown Of The Stress Before The Endo Appointment ~

Yep, I get stressed and anxious weeks before my Endo appointment  - Am I the only one?? 

22 day until my next endo appointment and the anxiety about the appointment has accompanied me for at least a week. 

I look at the date on my calendar and tell myself not to worry, not to stress and remind myself that these visits are good for my health - And that my Endo Dr J is wonderful - And for the record, I know all of this to be true. 
But the anxiety still radiates through me whenever I think about it - It always has - for every Endo appointment since 3rd grade - And most likely always will. 

The fear of the unknown and the known, the judgement  - both real and imagined and the the pressure I put on myself - And The Diabetes What Ifs

What if my labs are bad? 
What if my a1c is high? 
What if they discover something else wrong with me? 
What if I follow in  my sister Debbie's footsteps? 
What if my endo gets mad me - Or worse yet, disappointed in me? 

I hate that I let the stress get to me - Quite frankly, it pisses me off.

And I know Dr. J has the best bedside manor on the planet - he is there to help me, not to judge  - but to help. He never yells, never scolds, never tells me I can’t. 

Dr. J is an Endo that sees the diabetes glass half full and believes in his patients - And I know that to be true because I’ve experienced first hand - Every time I go to an Endo appointment.  But still..... The anxiety level regarding my endo appointment - my health in general is there - And the build up will continue. 

In a week, maybe 10 days from today, I will figure out when to do my fasting labs and as the lab day approaches I will stress about it. 
I will worry about breaking the fast due to a low blood sugar at 12:15 am for my 7 am lab appointment the next day. I will worry about blood work and creatine levels and  The Diabetes What Ifs will have their way with me. 

And the night before my lab work I will most likely be craving mexican or some other food that causes havic with my blood sugar - And will probably end up eating an omelette and toast instead. 
Before I go to bed I will check my blood sugar and if I need a correction bolus - I will most likely not give the full amount - Because I don't what to go low in the middle of the night and have to start the blasted fasting process all over again. 

I will talk myself down and tell myself to chill out and I will visualize good lab-work in all dimensions.

I will wake up early the next morning  and drink 15 ounces of water to fatten up the veins in my arms, not to mention keep my bladder full. I will shower and dress and suck down another 12 to 15 ounces of water in the car. I will park and utter “it’s show time” as I exit my car. And as I walk through Labcore’s building I will put on my brave face - But I will be nervous as hell inside. 

The labs will hopefully be quick and I will rush back home, grab coffee and breakfast and go to work. 
I will breathe a sigh of relief and do my best to go on about my business. 

But still, as my Endo appointment draws near, I will worry about my lab-work and lab-core - because there’s a 50/50 work they won’t deliver the my paperwork to my Endo’s office on time. 
And during those anxious 7 days before my appointment I will think about my sister who is no longer here - And I will wish I’d had more patience with her - And I will continually tell myself that we both did the best we could with the tools we had when it came to our diabetes and our lives. 

Finally, the day before the appointment arrives and I will make a list of questions for Dr. J - because I will be nervous when I see him and I don’t want to forget anything I want to talk to with him about. 
As I drive the hour to my appointment I will battle traffic and my Diabetes What If demons - I’ll practice yoga breathing and listen to music that will make me happy. 

I will struggle to find parking in the crowded city and I when I enter my Endo’s building I will make small chat with mustached security guard as I sign in. 

I will breathe deep and try to think good thoughts in the elevator and as I reach the 6th floor I will put a smile on my face and once again I will silently say to myself: It’s show time.

I will sign the patient register, wait for my name to be called and pay my redonkulous co-pay and  then sit down and wait to be called by a tech to be weighed; have my blood pressure taken and my blood sugar tested. 

I will worry that the clothesI wore are to “heavy for the scale,” but will remind myself that they take 2 lbs off for clothes and shoes.
And with that being said - I will make sure to remove my shoes before I get on the scale just the same. 

After being weighed ,the tech will take me back to the lab and ask what my last blood sugar was and when it was taken  - And no matter what, I will answer truthfully. 
If my blood sugar was within the hour, they’ll skip the office test and go right to taking my blood pressure. 
And then I will tell the tech that I have terrible White Coat Syndrome when it comes to my blood pressure and that she or he will probably have to check twice. 

 I will most likely think of the beach and swimming in the ocean and practice yoga breathing as the blood pressure cuff gets tighter. 

Finally, I will be led into an exam room and left to my own devices until the Attending come in. 
I will read the diabetes signage on the wall and maybe tweet or Instagram something diabetes related to calm my nerves.
Finally the Attending will enter, introduce his or her self and ask me about my family history of diabetes (and will most likely be shocked when I explain my background,)  pump settings, blood sugars and any concerns I might have. 
 I will crack self deprecating jokes to keep it light - Even when my questions are anything but. 

Then the Attending will leave and I will strain to see if I can here the chat the attending has with Dr. J - And if l'm  I'm lucky. I’ll catch snippets of sentences about yours truly.

Finally Dr. J will come in, impeccably dressed with a crisp dress shirt and silk tie instead of a white lab coat - And will shake my hand and ask me how I’m doing. 

We will chit chat about small talk - Most likely about our summer and how I saw him present his poster presentation at ADA in Chicago and how my niece is on the mother on HIMYM. 
We will chat and then he will turn the subject to diabetes, specifically, my diabetes - And my labs. 

I will hold my breath and tell myself to breathe as I open my notebook and begin to take notes. 

He will fill a glass of water up and tell me to drink it and then carefully examine my thyroid - And will most likely ask me to do it again. He''ll listen to my heart and my lungs and then check my wrists and ankles, all the while continuing to chat. And eventually he'll wind up taking my blood pressure again  - most likely while I'm in the middle of telling him a story. 

Then we will discuss diabetes game plans and come up with one - And Dr. J will answer my questions - both the ones in my notebook and the ones that pop into my head - And I will calm down  - And we will take it from there. 

And finally he will write my new prescriptions, hand me a bag of insulin samples & tell me what month I need to schedule my next appointment for. 

And we will say our goodbyes, and I will schedule my next appointment and then head toward the elevators - And by the time I walk out of the building & fingers crossed, I will most likely be relaxed and relieved.... Until the 30 days before my next Endo appointment - when the stress and anxiety of the Diabetes What Ifs start to creep up all over again. 
But here's the thing: I'm tougher than those damn Diabetes What Ifs, and I won't skip my next Endo appointment - or the one after that, either.


Wendy said...

I have similar anxiety. You are DEFINITELY not alone. I'd love to see your endo (though that's not possible being as I live out in North Dakota). Mine never checks my thyroid or some of the other things you mentioned. I just finally got him to allow me to do my lab work a week before my appointment instead of checking it after and sending me a letter about the results. A letter than I never receive, mind you.

I do go every 2 months instead of every 3. For me, it keeps me more vigilant about my own care rather than slacking off after an appointment and then trying to be hyper vigilant the last month in hoping to make my numbers better. It does take some of the anxiety away.

Karen said...

Oh yes, this is absolutely me every time too. Nothing is better than that feeling walking out of the endo building, knowing it's done and you have a good chunk of months off. :)

Mel@TwiceDiabetes said...

It is the "what ifs" that really get to you especially that fear of them finding something else wrong with you. THe irony being that diabetes is one of those conditions that you can go into your appt with endo/ophthalmologist or whatever feeling perfectly fine and come out with something wrong with you, you didn't know about :( Still early intervention is THE key to living well in the long term with D.

Here's to being stronger than the "what ifs", I like that.

Sophie said...

I can absolutely relate! One of my things is not doing overrides on my pump. I have a habit of ignoring what the bolus wizard is telling me - giving a bit more or less than what it says; a classic example is when it is telling me to knock off a whole unit, because my blood sugar is low before a meal, but I know it will just shoot up if I do! So the week before my appointment I am always very 'good' with doing what the wizard tells me :P My DSN actually told me that there are potential plans to introduce a wireless pump, which will continuously send your data to the hospital... she said it sounded a bit 'big brother' and I agree! You would feel watched all the time - it's too much! Thank-you for making this post, I could relate to it a lot! xxx

RenzaS said...

Even with a kind, caring non-judgmental endo, I still feel the same when I am preparing for an appointment. Great post, Kelly. Miss you heaps - and plotting a return to the US. x

Laddie said...

Kelly, you are the best badass woman with Type 1 on the web. I'm so sorry that these appointments are so stressful for you. The best part of your post is that at least the lab test days when you drinks tons of water are a different day from when you step on the scale.

I don't stress about endo appointments but my annual mammograms worry me because my mom and grandma had breast cancer. Talk about walking in feeling fine and then.... But this year was good again and I don't need to worry until next August.

Rich the Diabetic said...

Wow! That's a lot of stress Kelly? Reading the comments, I see that you're not alone, but I'm afraid I don't stress about my appointments. Maybe it's because I've never really had a doctor that cares? I don't care if he's upset at me. I just got a new nurse practitioner yesterday though, who I really like, so maybe I"ll stress now about disappointing her? LOL!

Alison Childs said...

That does sound like alot of stress and worrying. But I always believe a bit of stress is good for you so hopefully it helps to keep you "leveled"