Know when to fold ’em
Today is the NHL Trade Deadline. It’s the day when each club, via its roster moves, proclaims whether they think they have a legitimate chance at reaching the prize or whether they’ll throw in the towel and try again next year.
About three weeks before each A1C test, I go through a similar exercise in my mind – I need to decide whether I need that little extra push to reach my goal, or whether I’ve already slipped too far and am resigned to falling short of my target yet again.
My last A1C, early January, was a 7.3, and I was not too pleased. After going several years in the 6’s, I’ve crept back up into the 7’s over the last twelve months. Sure, I could rationalize it: the temptation of Halloween candy in the house, Thanksgiving dinner, a new baby re-planning my established routine, more celebratory meals in December than there are holidays, and so on. But those are just excuses, and diabetes doesn’t accept excuses. I decided then and there that I was going to make some changes. My endo told me to focus on the postprandial highs – those could make the difference between a 6.9 and a 7.3.
I made some changes to my pump and CGM targets and tried to mentally erase the “minimum carb requirement” for meals that would keep me from going low. I even bought Puming Insulin, the so-called “Bible of Basal and Bolus”. For the first week or so, it was great – my CGM nearly flatlined between 100 and 110 and my fasting BGs were as good as ever. My PPD spikes were nearly gone, and my morning BG’s were spectacular – even my Dawn Phenomenon was under control! I had a smile on my face.
But I must have also had a rumble in my belly, because quickly I fell back into my old routines: combo meals from Wendy’s for lunch, breaded chicken sub sandwiches from Quick-Chek for dinner (with pretzels on the side), snacking to fight boredom at work. Oh, and as for Pumping Insulin? I’m all the way up to page 4. As I write this, I’m balancing about six stacked boluses like a waiter balances plates of food, and my blood sugar is like the bratty kid, taunting and teasing (higher! higher!), just waiting to erupt in laughter when it finally comes crashes down all at once. (See the image at the top of this post, and – SIDEBAR – time for a RAGE BOLUS!)
Maybe it’s time to throw in the towel and try again at my July A1C.
Only problem is, while there are three or four A1C seasons in the year, diabetes doesn’t start over with a clean slate when we turn a page in the calendar. Those blood vessels, nerves, and eyes don’t get a chance to heal in the off-season. Poor performance doesn’t even get rewarded with a high draft pick.
Nope. There’s no consolation prize here. Inevitably, I’m going to walk out of my doctor’s office next time with my head held low and a tear running down my cheek, knowing that I could’ve done better – but I didn’t – and I’ll have no one to blame but myself. So what’s the point in trying now? Maybe I’ll do better next time.
In the 2010-2011 season, the New Jersey Devils were abysmal. They lost eight of their first ten games and 24 of their first 33 before making a coaching change. Under new head-coach Jacques Lemaire, they improved dramatically, at one point winning 23 of 28 consecutive bouts. The team’s early-season woes still kept the playoffs out-of-reach, but the team could be proud and hold their heads high because of their incredible improvement and enviable performance at the end.
So, for me, the stakes are still high. I need to find my motivation, even if a disappointing A1C is inevevitable.
For me, I’m playing for pride.