Monday 31 May 2010

Who is causing all the fuss in the waiting room???

I don't know about you, but having my HbA1c done is the worst part of having diabetes for me. I don't mean in terms of the long term threats that come with the disease, the ones which are always at the back of your mind, ready to leap out when you have high sugars for no apparent reason. I know that kidney failure, neuropathy and blindness are quite obviously worse than having an A1c done! BUT, in terms of testing sugars, counting carbs, injections, hypos, hypers - you know, the daily grind - THIS is the bit I hate.

I think this probably comes from when I lived in Germany as a child. I have very VERY vivid memories of going to the doctor and being quite literally pinned down while blood was taken from my arm. I am using the word taken on purpose - in my head I was never giving it, it was taken from me forcebly while I wriggled and squirmed away, causing a massive a scene as I could.

Now that I am a bit older and wiser, I understand that it is necessary. Not because it has any effect on my diabetes in the way that taking insulin does, but because it is one of the most effective ways to establish the general level of control I have been able to achieve over the past 4-6 weeks. Much like everyday blood testing, it doesn't really have any effect on your BMs. You could probably go weeks and weeks without doing a blood test and nothing drastic would happen. BUT, blood tests do INFORM you. You can work out trends, effects of food/exercise and so on, by testing your bloods and reacting to the result. The A1c is the same. The fact that I had elevated A1cs for years was one of the reasons I was able to get a pump so easily - I was a mass of diabetic complications waiting to happen!

Now, at the beginning of the pump trial I had an A1c 'taken' so that there would be a clear before and after comparison to show the impact of the pump on my BMs. My last A1c was a somewhat disappointing 9.5%. I say disappointing because I had been putting in more effort around that time than I ever had before! I had just finished the DAFNE course and was trying my hardest, but I still knew that my sugars weren't much better. I probably couldn't tell from my blood tests alone, as they were always bad in my cynical mind, but I'm talking about the completely intrinsic sixth sense us diabetics seem to have. Just as when you know you are low or you wake up in the morning and don't even need to do a test to know you've been edging too high during the night. I just knew - and I was right. I had gone down a whole 0.1% in my HbA1c before and after the DAFNE course. About as impressive as getting 5 minutes off at the end of the day. Technically it's an early finish, but won't really have any effect on your day.

So today was a big step for me. I bought one of those home self-testing A1c tests made by A Menarini. Its called Glucomen and is apparently very precise and takes only 48 hours for the result to come back to you after they receive your sample. And the results come back by email nonetheless - how times have changed!

That being said the absolute clincher for me is that I don't have to have a giant needle stuck in my arm while my breathing becomes more and more shallow, my sight begins to darken and I feel more and more like I'm about to pass out. It meant I didn't need to sit in the clinic for 15 minutes with a bottle of water while I try my hardest not to faint, and I didn't need to make it back to the car by taking 1 minutes journeys at a time, while my poor fiance is forced to carry a very girly handbag, because using my arm makes me think I'll faint. And most of all, I didn't have to lie down to an hour afterwards, because apparently having an A1c done makes me pass out from the 'trauma'.

You would think after 23 years I would have adjusted to this.

I haven't.

With the Glucomen, all I had to do was fill out a form, prick my finger as I normally would for a blood test and fill two little material 'dots' at the base of the form with my sample. And this time, it was one I gave willingly! I didn't have to go through any of the faffing, shallow breathing, fainting or annoying other people which normally comes hand in hand with having an A1c taken.

It's a winner in my eyes!

I now await the result, praying that the result will reflect the good work the pump has had on me in the last four months. Granted I had a bit of an upset last weekend, with the whole kinking in the cannula drama, but generally as I understand it, the A1c isn't as much a reflection of how high or low you have been, but of how the general control has been. And in general, unless I've calculated something wrong, my result are not normally higher than 15. So I've got everything crossed that it will show how much my life has improved since plugging in for the first time. I know that there is an overall improvement in my levels and quality of life, but really, one of the main things the NHS will look at when deciding whether to fund this, is how much my A1c has improved. The final 6 month A1c is due in around 2 months, so depending on how this one goes, I could be in for a really easy 2 months, or I could be in for a strict 2 months.

Either way, the pump has been worth it to me. I just hope there will be some 'evidence' to shout even louder about!

Watch this space!