Monday, May 20, 2013

An Introduction

My name is Craig Le Fevre and I am a person with diabetes.  On July 19, 2011, after discovering several issues I was having while on vacation were symptoms of diabetes, I was diagnosed as a Type 2 diabetic by my general practitioner.  I remember that day before my appointment my wife and I were talking and while in the back of my mind I think I knew what the final diagnosis was going to be, we told each other that it was probably something else that was no big deal.  The appointment was pretty quick; a urine test that showed high levels of sugar in my urine, a finger prick, and a few minutes of waiting followed by the big news.  "Craig, your blood sugar levels are much higher than normal, about 350.  You are very likely diabetic."  I left that appointment with a prescription, directions to not eat too many carbs (like it's that easy right? and how many is not too many?), a followup appointment a few days later, and a head full of questions.  I spent the next several days scouring the internet for anything I could find about diabetes, trying to ease my mind and answer my many questions.  I tried to choose my meals wisely, avoided the candy that I loved so dearly, drank lots and lots of water, stocked up on veggies and cheese, and took my medicine religiously.  At my next appointment the finger prick was repeated and my blood glucose had decreased.  For the doctor this confirmed his suspicion and he officially diagnosed me with Type 2 diabetes.  We both found this strange because I am thin, 140 lbs at the time, and have no family history.  I fit the bill for a Type 1 diabetic but because the medicine lowered by blood glucose he was confident I was Type 2.  My A1c was 10.7, a bought a meter, and began to adjust to this new life. 

Over the next several months I continued to learn as much as I could, improved my diet, tested religiously, and documented as much as I could.  I joined several online communities and asked questions as often as I could.  The message boards on the American Diabetes Association website became a daily visit if not more often.  In December my A1c had dropped to 6.3.  I was so excited to see my hard work paying off.  I made it through Halloween and Thanksgiving without getting too far off track and my blood glucose readings had stayed within the normal range.  The Christmas came, I relaxed a little, and things changed...

As diabetes became more of a routine thing I tested a little less often, cheated on my diet a little more often, and stopped paying as close attention.  In March I received news that I would be changing my schedule to the night shift.  I noticed that I wasn't feeling as well, and my fasting numbers were getting higher when I remembered to test.  My next routine exam was coming up and I was a little nervous.  I shared my concerns with the doctor.  I was worried that my glucose readings were climbing but suspected it was because of my indiscretions with my diet.  I was also concerned how my new schedule would effect things.  An A1c of 8.5 confirmed what I really already knew.  I wasn't managing things as tight as I should.  I renewed my commitment and wanted to get things back in good standing and did a pretty good job of it.  My fasting numbers continued to be a little higher than I liked but in June my A1c was down to 7.2.  I thought I had things figured out.  7.2 wasn't exactly what I wanted but it was moving in the right direction.  Once again I thought I had figured things out, but I was wrong again.

In the following months I kept pretty close to the same diet I had for the previous 3.  I didn't check my blood glucose everyday but when I did it was on the high side and slowly increasing.  My mood had changed, I was down a lot of the time, my temper was short, I just wanted to sleep, and I didn't enjoy things the same as I once did.  My next appointment wasn't scheduled until December but I got it moved up to November because I was very concerned.  I was shocked to see my A1c up to 14.4!  My doctor was not convinced that I was taking my medicine everyday.  His first thought was to add more medication but I could not afford this and I was already suspecting there was something else at work.  It took some convincing but we finally agreed that taking a basal insulin would be the best choice.  This seemed to move the needle in the right direction, but I still had concerns.  I brought up the possibility of LADA (Latent Autoimmune Diabetes) or delayed onset type 1 but the Doctor was convinced that my original meds would not have had an effect if I was Type 1.  I finally convinced him to send for some lab tests and as soon as I got home I started searching for a new doctor.  I felt like my current doctor only wanted to prescribe the latest and most expensive drugs that he had samples of and got perks for selling.  He didn't want to listen to my concerns and was unwilling to stray from his original diagnosis.  My blood test results showed signs of antibodies, and while I knew that because I had been using insulin this would have been the case either way I let the doctor use this to convince himself I was indeed Type 1.  He told he his office would set up a referral to an enocrinologist.  I probably would have felt abandoned and pawned off if I hadn't already set up an appointment with a new doctor. 

I continued to take oral meds and basal insulin until my January appointment with the new doctor.  At my appointment I explained what was going on and within 5 minutes she said she believe I was Type 1 all along.  Thank You!!!  Finally someone who seems to understand!  She told me she was sorry I had to deal with this and gave me time to be upset and talk about it.  She took time to explain the ins and outs and started me on rapid-acting insulin as well.  In that first appointment I spent more time and got more answers than in all my previous appointments combined.  At that time my A1c was in the 10's and within 3 months back into the 8 range.  I felt relieve but also scared.  That's pretty much where I sit now.  After over a year as a Type 2 diabetic and having adjusted to a new way of living I was back at square one and adjusting once again.  And once again I feel like I'm getting this figured out and moving in the right direction.  But if there is one thing I have learned in my short post-diagnosis life, it's that you shouldn't get too comfortable because you never know when things are going to change.

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