I have an appointment with my endocrinologist next week. And dear God, I do not want to go.
Here's the thing: I know my A1c has gone up. Life got a little complicated over the holiday season, and I never managed to snag that Dexcom CGM like I had planned (although it's still on my wish list). I have a pretty good idea of where my A1c is sitting at right now and let's just say, it's not pretty. On top of that, I know what I need to do to manage my diabetes...
I've had better A1cs before. In the past, I've dropped more than a full percent between appointments. I know what I did to get there. I know that to tackle my diabetes properly I need to: test frequently, do my basal tests, exercise regularly and slowly step away from the Starbucks Marshmallow Dream Bars (or at least finally figure out how many carbs are in one!). When your job is writing about diabetes and when you've had diabetes for three-quarters of your life, after awhile, you just know what you need to do.
It's the doing that is the problem. But that's not even what this post is about.
For the past few days, I've been weighing the pros and cons of keeping my endocrinologist appointment. My main cons here are that: 1) altogether, a single appointment takes about 3 hours of my time (getting there, being there, and going home), and 2) my endo isn't going to tell me anything I don't already know (see above). So it seems like a waste of time.
The pros of going are... Well, there's consistency. I've never skipped an endo appointment before in my life, and I feel like this could tarnish some kind of record of mine. Besides, I like my endo. She's nice, and she never makes me feel guilty. She never judges me. But I also think that if I use the "Life is just getting in the way" excuse one more time, her head may explode. Or maybe my head will explode from saying it yet again.
I have never found that knowing my A1c result is much of a motivator. As much as I try to not to let it get to me, if my A1c goes down, I feel good about myself and if it goes up, I feel bad about myself. That's not motivation, that's judgment. Right now, my meter average is already making me feel pretty crappy, and having the final judgment of an A1c come down on me just doesn't sound appealing.
It's true that for me, finding out my A1c tells me whether or not my evaluation of my diabetes management matches reality. Meter averages don't take into consideration things like post-prandial spikes, overtreating low blood sugars, or the dawn phenomenon, so if you're thinking you're doing great, your A1c will tell you just how accurate that is. But I know that I'm not doing great, and I don't need a little slip of paper with a "bad grade" to emphasize the point.
While I've been thinking about the pros and cons of keeping my endo appointment, I've been giving more thought as to why we repeatedly go to the endocrinologist in the first place. Here are a list of reasons I created:
1) To find out whether or not you're doing as well (or as poorly?) as you think you are (I'm doing as bad as I think I am, trust me)
2) To get physically examined — heart rate, blood pressure, feet (Possibly a motivation, though I've always done well on these parameters)
3) To discuss blood sugar management strategies, and discuss any new meds or devices that may be needed (We discussed what I need to do at my last appointment, and I, um... haven't done them yet...)
4) To get emotional support and encouragement (My endo is great for this, but I get plenty of support from the DOC!)
5) Getting prescriptions for things (Most of my prescriptions I either already have, or my endo calls into the pharmacy)
Am I missing anything? What do you get out of an endo appointment? What makes it feel worthwhile? If you've ever felt like "calling in sick" to the doctor's, but went anyway, I would love to hear what your motivation is. Because right now, I've got nothing...
A good friend suggested that I just reschedule the appointment for later in the Spring, to give me a chance to re-prioritize diabetes and then check in on my diabetes progress later. I can't help but feel a bit guilty (there's that word again!) for skipping out on my doctor's appointment. Would postponing just be procrastinating on facing all the stuff I haven't been doing — knowing that I'll find myself in this exact same predicament in a couple of months?
I feel like I'm making a bunch of lame excuses, but I'm also wondering if there are times when a doctor's appointment is actually less beneficial than advertised. Is playing diabetes hookie always a bad thing?
Update: Thank you all for your thoughtful comments! You made some excellent points and gave me a lot to think about. After giving it a lot of consideration, I decided to reschedule my endocrinologist appointment. I have it now scheduled for May 1st. You can look for another update in early May! Thanks again!