May 2, 2006

A confession

One of the several quirks of the office of my new endo, Dr. Reassurance, is that it has no laboratory for drawing blood.

Actually, I really can't judge whether this is a quirk in the larger scheme of medical care in the U.S., or whether I was just lucky/spoiled in Minnesota. My old endo had a miniature lab with a trio of technicians who could draw blood faster than I could sit down in the chair, almost. My old primary care doc did too. The blood was sent elsewhere for analysis, but it was drawn then and there, on the premises, no escape.

Dr. Reassurance, whom I saw in March, gave me a form with orders for the bloodwork she wanted done and a list of the places I could go to make my donation of bodily fluids. One of them is 8 blocks from my home. It's even open on Saturday. All I have to do is call the day before, fast that morning, and show up.

The form is still sitting on the kitchen counter. It's been 7 weeks.

What the hell is my problem? I haven't had my A1C done since November. I know better than this. I'm mortified and ashamed.

Am I afraid of the number? A little. Not a lot. It will be somewhat worse than the last number, and Dr. Reassurance will probably call. I know a lot more about pumping than she does, though, so I rather doubt she'll have much to tell me that I haven't read or heard before.

Am I resistant to entering New York City's draconian new diabetes tracking system, in which my a1C will be reported to the city health department, which will monitor my results and conduct voluntary interventions of its own devise? Yeah, somewhat. That whole deal pisses me off more than I can articulate at this hour of the night. Others in the blogosphere have already said it better than I can, anyhow. (Hint to NYC: if you want people to control their diabetes better, put some fucking blood labs inside the offices of health care providers so that patients don't have to make 4 (or more) annual trips to the lab PLUS 4 to the endo PLUS 1 to the primary care doc PLUS 1 to the OB/GYN for chicks PLUS 12 to the pharmacy.)

That's a grand total of 22 health-related voyages I'll be making per year as a New Yorker, if anyone's counting, assuming I have no problems of any kind other than diabetes. Oh, wait. Forgot the eye doctor. Dr. Reassurance also wants me to see a podiatrist. (Yeah, right. Suck my toes.) So now we're up to 24.

And therein lies the real reason, I think, that the damn bloodwork form is nesting so comfortably on my kitchen counter. Am I lazy? Yes. Whiny and ungrateful too. Also just damn tired of marching myself all over creation for the sake of the disease, even after only 20 months.

I guess I'm a little burned out right now.

I didn't have this problem during my first year after dx, when I poured endless energy into self-education, self-help, self-everything. I was a little diabetes-managing machine.

Year Two has lost that shiny, luminous glow. I'm still two+ years from trying for a baby, so my A1C is not currently the magic beacon to motherhood I once imagined. It's not that I don't care. I do. I'm testing and watching the sugars and the boluses and all that daily stuff, with reasonable success. I just can't seem to manage this lab thing. And now I'm mortified that the date on the form is almost two months old. They're going to yell at me at the lab, I just know it. Or else Dr. Reassurance will.

Maybe I can find a new endo and start all over, with a clean slate and a pure soul. And maybe I can relocate my sense of humor, which I think I left behind on the F train a few weeks ago. (It's really hard to check your blood sugar while standing in a packed and moving subway car.)

Meanwhile, maybe I can use the back of the form to chart my recent blood sugars. Err...that is...I could if I'd been writing them down. Ahem.


  1. I live in NY. My old primary doc had a lab in office. My new primary doc doesn't. I've never had an endo that did, though my current endo is in a hospital, so I imagine there is someplace I could go there. For me I prefer the labs outside, cause then I don't have to show up at doctor appointment fasting, I can go when convienant for me.

    If you don't want your A1c reported, simply opt out.

  2. Thanks for the comment, Megan. The last I'd heard, the city hadn't yet devised the "opt-out" system--but obviously, since I haven't gone to the damn lab, my info is likely to be out of date...

  3. Violet -- Your sense of humor seems to have reported for duty on this post.

    This disease -- and its attendant appointments and costs and obligations -- is a bitch to handle, sometimes. You should stop beating yourself up -- we're all allowed a little diabetes down-time in my opinion.

  4. I agree! You're definitely allowed some down-time. Give yourself a break - clearly you're still taking good care of yourself and that's what's important.

  5. I feel like I live at the doctor's office, and I'm not the one with diabetes. I can totally relate to that burned out feeling. I think it's pretty normal and not something you should really stress about. It sounds like you're still taking good care of yourself - that's all that really matters.

    Would you want to find a new endo who had a lab in their office? Or do you prefer Dr. Reassurance? I guess you have to figure out what you want to give on - for me, it would be the convenience of having the lab right there - if not in the office, then in the same building.

  6. Thanks for the support, everyone. Nicole, I think you're right: the thing I lost on the F train was my positive attitude. The sense of humor is still functional at times.

    Julia, I definitely want a new endo. Dr. Reassurance has an awesome demeanor (hence the nickname) but isn't an expert on pumping. She gave me quite horrible advice about time zone changes. Plus no lab in office, no CDE. I'm definitely looking for a new clinic.

  7. Isn't Naomi Berrie in NYC? Or is that where Dr. R is located? Does Joslin have a branch down there? The only info I have on NYC-area endos are for pediatric ones.

  8. Violet,

    It's not surprising you're feeling burned out-- you put an amazing amount of energy into learning about and managing this disease that first year.

    (Frankly, I can relate to so much of what you describe here as we're coming up on two years since Joseph's diagnosis. At times, the whole thing just feels relentless.)

    As others have said, allow yourself some down-time, and please don't ever feel guilty for taking it.

    Oh, and I agree-- it's definitely time to dismiss Dr. Reassurance...