Saturday, September 26, 2015

Tap...Tap...Tap...Is That the Grim Reaper I Hear Knocking at the Door?

Dear George,
Few things are odder in life than visits to the doctor’s office.  It’s because they involve an uncomfortable degree of physical intimacy with strangers, though routinized, impersonal, and frequently bewildering.  The other day I went to see Dr. Cosgrove (pseudonym) about my high blood sugar.  I can’t remember how long my blood sugar has been on the high side, but it’s been quite a while.  I monitor it before breakfast each morning, pricking my index finger with a little jabber and watching the drop of blood flow into the test strip.  I always expect a superior result, but I’m inevitably disappointed.  People’s blood sugar gets classified as normal (below 100), pre-diabetic (100-119), or diabetic (120 and over).  Up until six months ago my readings vacillated between high-normal and pre-diabetic.  Then they started creeping upward, and July saw them zoom into the 130s.  That was unsettling.  Because many of Katja’s clients at the Association for the Blind suffered from diabetes, I realize it’s a nasty, unacceptable condition.  I called my doctor’s office, and they prescribed a daily pill and scheduled me for an A1c blood test in early September.  The A1c test is quite amazing.  By measuring how much glucose is stuck to the hemoglobin in your blood, it reliably assesses the average level of your blood sugar over the previous two to three months.   I took an A1c test a year ago, and it fell just inside the normal range.  It didn’t look like I’d be so lucky this time around.  

I went to the lab for my new A1c test. then saw the doctor a week later.  On the morning of my appointment I gathered together the various charts I’d been preparing (blood sugar, blood pressure, weight, etc.) and drove across town to Dr. Cosgrove’s office.  A nurse checked my vitals, and Dr. Cosgrove came in and asked how I was doing.  “Fine,” I said, “except my blood sugar is too high.  It went way up in July.”  Dr. Cosgrove checked my new A1c  result on his laptop.  Much to my amazement, my A1c score was identical to the score I’d obtained a year ago, still within the normal range.  I couldn’t believe it.  Apparently I am diabetic at home but revert to normal at the doctor’s office.  “Very puzzling,” Dr. Cosgrove said.  He asked which result I thought was correct.  I didn’t know though I privately thought my home-testing results were more compelling.  Probably Dr. Cosgrove believed more in his lab test.  In any case, he said that he was going to put me in charge of my own treatment.  He asked what I thought the next step should be.  When I drew a blank, Dr. Cosgrove suggested that I could simply come back and get another blood test in three months.  That sounded like a good course of action to me, and I agreed enthusiastically.  Dr. Cosgrove also recommended a flu shot, then shook my hand and bid me adieu.  Our meeting had lasted a little over five minutes.  It dawned on me later that Dr. Cosgrove never asked me about any symptoms I might have or given me any advice about how to lower my blood sugar.  On the other hand, I’d forgotten to show him my charts. 

Since my appointment I’ve stopped worrying about going blind.  Dr. Cosgrove doesn’t seem that worried, so I’m not going to torture myself.  I decided I will step up my exercise, be still more careful with my no-sweets diet, and try to lose a few pounds.  My next appointment is scheduled on Katja’s birthday in early December.  When I told Katja about the timing of my appointment I said that a low A1c score would be a nice birthday present for her.  Katja frowned.  She said a good A1c seemed like more of a birthday present for me than for her.  That’s probably true, though my birthday’s quite a ways off.  

As the first step in my new treatment plan, I decided to discontinue my daily two glasses of red wine.  Unfortunately, that didn’t have any impact at all.  I did a Google search and discovered that, if anything, red wine lowers your blood sugar.  Newly liberated, I promptly drank an entire bottle of my favorite $4.49 Cabernet Sauvignon in an hour or two.  The next morning my blood sugar level had dropped 30 points, and it’s been refreshingly lower ever since.  I may have stumbled upon a medical miracle.  Now I can’t wait for it to be Katja’s birthday so I can get my A1c test again.  I’m confident it will be the best birthday present ever.  

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