Monday, January 28, 2013

The first endocrinologist visit of the year.....and participating in a research study.

I have such mixed feelings about our quarterly visits with Ashlyn's Pediatric Endocrinologist right now.
Her A1C has been very high for the last year.
She is still right at 9.8%.
It needs to be at 7%.
We always hear how the endocrinology clinic at Children's Hospital in Dallas has 1700 patients they treat with 250 new patients each year.
That makes me feel like they are extraordinarily busy, understaffed, and if we didn't show up,
their feelings wouldn't be hurt.
I've resigned myself to the fact that Ashlyn, even at 12.5 years old, is too immature and irresponsible to track her blood sugars throughout the day, so her numbers and ultimately her health is left up to me to manage.
Clearly, we have much more work to do with her on this whole "being responsible" thing.
Most days it feels very lonely and overwhelming when we have no one in our daily lives who understand what this entails on a daily basis and very little family nearby to help support us in this fight.
So, I often go into this with some dread.

But, on the other hand, I usually walk out encouraged.
Our endocrinologist is no nonsense, but witty.
He always listens to my concerns and gives encouragement to KEEP ON, full of grace, and never harsh or judgmental.
He did make Ashlyn look him in the face this last week though, and tell her that she needed to grow up and be more of a participant in this journey.

She has grown nearly an inch in the last 3 months.
He mentioned that being in the throes of puberty usually whacks out blood sugar numbers for a couple YEARS!
He also said that she has some insulin resistance going on as well which is why she takes way more insulin than other girls her age.
She currently takes 52 units (FIFTY-TWO!) of Lantus split between the evening and morning, plus her mealtime Humalog with ratios of 1:4 units for breakfast, 1:4 for lunch, and 1:3 for dinner.  For between meal snacks, we use the most recent mealtime ratio.
As long as we chart every. single. blood sugar reading, and write down every. single. carb she eats, and how much insulin we gave to cover those carbs, we manage to keep her numbers in acceptable ranges (80-150).
But the minute we miss a meal or a snack or a single morsel of food she pops in her mouth.....UUUUP spikes her numbers and throws that A1C off.

As we were preparing to wrap up our visit, our endocrinologist mentioned that another doctor would be popping in to talk with us.
We had never met this doctor before and she began telling us about a study she was conducting on the "impact of pet ownership on glycemic control in youth with Type 1 Diabetes."
This is the perfect thing for Ashlyn!!
Fortunately, we fit the criteria, and fortunately, she was chosen to receive a fish to care for.
She had to fill out a questionnaire about her diabetes and she was immediately reimbursed with a $5 Target gift card!
We walked out of the office with a small little tank, fish food and suppliess, and a $5 gift card to our local PetSmart store to buy a betta fish.

She was instructed to feed the fish both morning and evening and to use those times to also check her blood sugar.
Then, once a week she is to change out the water and also go over her blood sugar readings for the week at the same time.
We're to keep the fish for a year and Ashlyn's A1C will be tracked throughout the year at her quarterly visits with the endocrinologist.
I'm interested to see how this new responsibility will motivate Ashlyn to look for ways to better manage her diabetes.

Ashlyn and her new fish "Periwinkle"

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