Ever seen a physician speechless? I have now.
Three months ago I had my very first appointment with an endocrinologist after 12 years of not needing one. (Yay me!). But unfortunately in that 12 years, I got older (Well that sucks!) and so now I need and have a great one. If you have read my previous post, you'll notice I was beaming over my lab results. My A1C went from 9 to 6.6 mmols in 3 months.
Am I proud of that? Yup.
Did I make some changes? Yup.
Did the new meds do it? YUP!!!
So off I toddle to my appointment thinking, "I done good!". This being only my second appointment with the endo I wasn't sure if he'd be as happy as I was or if his goal for me would be tighter control. After all, he is an endo. I get there a few minutes early and walk in not really knowing what to expect. I know from my first appointment he's a quiet man, a good match for me since I'm a little on the anxious side but I hide that piece pretty well. I'm just hoping he's as pleased with the result as I am.
There we are. Me in the chair. He with his big-a** computer screen. He's pulling up my results. He tells me, they are good. I can see he's scrolling through them. He mentions I went from 9 to 6.6 in 3 months. He continues scrolling through the rest of my results, tells me they're all good. I'm watching him. He's talking to me but also to himself out loud as he's going through them a second time. I can see him making sure he's processing what he's seeing correctly. I almost wanted to giggle because this wasn't the reaction I expected. He also commented that I had lost 10 pounds in the time period. (Drs almost NEVER make a comment about a woman's weight, positive or negative. I'm so proud he noticed!!)
Then he asks me a question I didn't see coming: "What did you do?". In my head, I'm answering with a slight bit of sarcasm, "What I should be doing". Out loud I tell him I'm logging what I eat, tracking my carbs and I'm walking again.
My turn. I have questions about my lab work. My LDL cholesterol (the lousy one) went up slightly. It is still in the tight range for a diabetic but I wanted to ask anyway. He told me for the slight rise, it was likely the Jardiance that did that. I didn't know that.
Should I be concerned, I ask? No.
Next I have questions about the kidney function results. As usual, good ol' Dr Google confused the h*** out of me as I tried to understand the creatinine value and the eGFR number. Which one was the more important? Oh I got an explanation on google for what each meant but not which was the important one to pay attention to. He tells me the eGFR is the important one. Great! That number is good and in the hoped for range.
Next, I ask about the meds on hold. About 2 weeks after I'd seen the endo for my first visit, I started to feel bad on the metformin again. When I called in, he told me to go off it and we'd talk about it at the next appointment. I wasn't having any trouble with the Jardiance or the injectable Trulicity. He also put the Coversyl (iACE) on hold at that time because my blood pressure was running low. The iACE is meant to protect your kidneys from the damage diabetes can do by lowering blood pressure. I presented him with my current blood pressures. Stay off the Coversyl, doesn't want me to pass out from low blood pressure (and my kidney function numbers are good so we know the kidney is already protected).
The metformin piece kinda threw him for a couple minutes. Let me explain. At that first appointment, I was asked to be part of research study that was looking at the results of Glucophage use. To be honest, I agreed to be a part of the study because the data needed for the study was done through chart review or the office submitting anonymous data. He asked me a couple times about being off the glucophage. I reminded him I called in and cleared that with him. I think he inadvertently took me out of the study when he put the drug on hold during my phone call. Lol. I think he realized then he was the one who did it. No big from the chair I sit in. I no longer felt sick. I'm pretty sure I'll be the statistic that dropped out of the study due to drug intolerance.
He headed for the door to go get my lab requisition for my next appointment saying, and I quote:
"I don't want to change anything. I might break you." LOL. LOL. LOL.
I had one final question when he returned. Obviously the weight loss is good. Since the med is doing it, how do I slow it down when I reached my goal weight in the next 10 lbs? He grinned at me and said that the med only contributes minimally to the weight loss and only for a short defined period of time. In other words, I did it, not the med. I'm so proud.
I'm doing my happy dance again!
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