The A1c technician had scrubs in a lovely shade of orchid. We appreciate solid color scrubs in pediatric medicine. In the hospital we encountered Spongebob Scrubs, which made the whole scene feel like a really tedious birthday party BUT WITH IVs.
Yesterday = quarterly Endo appointment.
As usual, sift through scrawl after appointment, try remember new tips re How to Be.
Rate of Digestion
He seems to digest his food slowly—it seems like it takes more than two hours. (Do you mean the insulin peaks after more than two hours?) No, I mean the food continues to effect him for more than two hours. But that could be good. It could mean he is not eating a lot of junk food…
BUBS: I love junk food!
…because you know, we’ve learned that high fiber foods stay with you longer, provide a more sustained energy source.
Bigfoot kind of put off by this kernel. Seriously, endo think Bigfoot family not aware dietary fiber? Also: what to make of Bubs’s allegedly slow digestion? Seems normal digestion for Bigfoot science because food/insulin both last approx-but-longer-than 2 hours. Was this some endocrinological mutterings or was information for use? And if latter, what use?
4′ 9.25″/ 77.8 lbs.
Hmmh. He has grown taller, but has not gained any weight since last time; and that time he had lost some weight since the previous appointment. (And is that ok?) Yeah, it’s fine. He’s probably just very active. You might want to try to give him more to eat, but look at him: he is not skin and bones. Well, maybe try to feed him more but don’t worry about it. His BMI is still normal.
Again: this A Thing? This mean maybe not enough insulin for body store new muscles/fat? Seemed more like casual front-porch musings than actual directive.
Thyroid
Yup, thyroid’s still there. No need for any hormone replacement yet.
Damn! Should have asked if allegedly slow digestion is thyroid clue. But then would gain weight—like what happen w. Oprah.
extreme close-up (FINGERS)
Callouses
Dexcom buzz w. blood drop icon while in appointment, Bubs test for callibration. Endo notice Bubs’s Fasclix method of click-click-click instead of just one click at deeper setting. Bubs likes setting 2.5, even though takes multiple tries. Bigfoot use 3.5 @night, just one pop & DONE. Endo agog: Bubs, you should not have to poke yourself that many times! Doesn’t it hurt? (Bubs shrugs not really. That’s just how I like to do it.)
Then endo examine fingers. Did you know that you should never be ashamed of your callouses? They’re what makes it possible for you to get pokes that don’t usually hurt. Then this: See this? He’s getting too close to the center. Bubs, you shouldn’t be poking here. Go more toward the fingernail, stay to the outside. There are so many nerves at the center of your fingertips and you don’t want to create nerve damage.
Well, shoot. Everyone know that. Learn in hospital. But sure enough, examine Bubs’s fingers up close, callouses creeping toward center. Sorry. Maybe some benefit if become classical guitar player?
Dexcom G4 Platinum
Apparently Bubs this endo’s 1st patient w. DG4P. Marvel at size. Report transmitter much larger than Medtroinc’s transmitter. Does it bother you at all?
BUBS: No!
ENDO: Not even when you’re sleeping?
BUBS: Nuh-uh
ENDO: Do you wear it all of the time?
BUBS: Yup.
ENDO: Doesn’t hurt?
BUBS: No
ENDO: Does it hurt going in?
BUBS: Nope
ENDO: It is kind of a pain having to carry another device?
BUBS: I don’t care
ENDO: You have to carry it like a necklace?
BUBS: Or on my Spibelt with my pump
ENDO: Do you ever feel like you could do it like some kids wear it for three days and then take a break for a month?
BUBS: No, I like it.
While underway, questions seem kind of geared toward DG4P disillusionment, but afterward realize questions are for help Endo know what tell other parents/kids. Tell them like Macklemore: This is hmm-hmm awesome.
Bolus Insulin/Basal Insulin
Vaguely remember ideal is maybe keep amounts pretty even? Like…if 9 total units basal/day, should bolus 9 units/day. That even true? But as Endo delve into unknown areas pump, notice bolus much more than basal. One day he bolused 22 units! So make some adjustments: oomph up morning basal, decrease breakfast insulin. Also decrease dinner insulin from 1:15 –> 1:18. Like that.
Sites
His sites look great. Perfect. You can keep using just your bum. That’s fine.
A1c
6.1. That tiny peep higher than last time. Probably insignificant.
They Just Keep Coming
On way out, endo call in next patient. Sweet little mocha cream puff of girl dressed in hydrangea shorts-tank top, foldover ankle socks, sneakers/dark circles-eyes mom/actively weeping abuela clutching crumpled tissue wad.
