Motivation/inspiration/kick in the pants needed

Type 1 and LADA
#1

Hi all...

I'll try to keep this short, but basically I'm looking for some cyber-support about an appointment I have with my nurse practitioner today.

I'm WAY overdue for this appointment... can't tell you how long it's been... I've been putting it off. I've also missed appointments with my endocrinologist because I just can't face it.

As a result, I've been, well, a bad patient. I know we hate the term "noncompliant" - but that's what I am. I can't bring myself to type what my last A1c result was, but you can probably imagine.

I am forcing myself to go to this appointment today, even though I have no numbers, no progress, no ANYTHING to show. I am forcing myself to face the music and get on a path to doing the right thing (not just for me but for my two amazing kids...).

Any words of advice/comfort/empathy?

(And don't bother with the scolding... because I've done enough of that at myself.)

THANKS.

#2

First of all, a misconception that many of us in our society have, fostered of course, by the medical profession: You are not doing this for your nurse practitioner; you are doing it for you. So it really doesn't matter what he/she thinks.You are not "non-compliant" (I hate that term!) You do not deserve a scolding because you are not a "bad little girl". You are an adult who has been struggling, not very successfully with a chronic illness. If you change the way you look at it, it will make all the difference in the world!

So with that paradigm switch, go into the office, not like a kid being sent to the principal, but like a consumer who wants assistance from the medical provider they (or their insurance) is paying for their expertise. Talk about I:C ratios, talk about basal rates, talk about diet (though don't listen too much if she insists you eat tons of carbs); talk about ISF.

Then re-read your copy of Using Insulin by John Walsh or buy one if you don't have one or Think Like a Pancreas by Gary Scheiner. Then come on here and ask questions and work on starting somewhere anywhere, perhaps with basal rates and slowly but surely get into a better management program. Then come back on here down the road and brag!

#3

THANKS! I actually just had a phone conversation with the nurse and she was amazing. She came right out and told me there would be no scolding; we would look at what we can do to help me manage better from here forward. I'm so glad I talked to her so I'm not going in nervous. But you're right... it's all that attitude that we're supposed to go in and please the doctors. I'm lucky I actually do have a good endo who is very non-judgmental; I'm not sure why I've been avoiding him but I'm starting fresh today. :-)

#4

Thanks so much! All positive thoughts are gladly accepted and much appreciated. :-)

#5

Excellent! It's great you have an NP and endo who are not into shaming and will work with you towards meeting your goals...one step at a time. Whatever your A1C is (13.8?) your goal is to get it under 13, then under 12, etc. But more important than the numbers your goal is to develop a management plan that feels sustainable to you and one day at a time to start new habits. Like you said, starting today! Bring your logs, bring your questions and don't hesitate to ask questions even if they are things you "think you should already know".

#6

I hate the term “non compliant.” Living with T1D is HARD and it’s impossible for anyone who doesn’t have it what am overwhelming job it can be. In addition to that, we are subject to so much judgment and misconceptions, just compounding the difficulty. Something tells me that you don’t even need an appointment with a medical professional to get back to doing what you know you need to do to care for yourself. What is one thing about your current management that you want/need to change?

#7

Your children need you and want you in their lives for a long time. They are the prize in this. Being there and being healthy for them (and yourself) should be the priority. Best of luck with it all.

#8

Give yourself a break. We did not choose to be diabetic. Our job is to figure out how to enjoy our lives to the max while dealing with a chronic illness which is always lurking. The beauty is that you can press restart here and step by step figure out how to get back on track. Treat your appt as a restart opportunity. Every now and then I try to take the perspective of what would I tell me kids on how to handle the situation … And then apply that approach to myself.

Now stop jerking around and get to that appointment!

#9

I only have one thing to say to you Melissa. YOU CAN DO IT.

Now go to that appoitnment and hold your head up. The past is the past let it go and work towards the future. You have made the first big step...admitting you are not taking care of yourself and getting the medical help.

#10

Sending you lots of empathy! I think I struggle more with my Diabetes now than I did when first diagnosed 19 years ago.I have been non compliant T1 for years, until about a month ago. Keep taking it one day at a time, don't beat yourself up for not being "perfect" and keep logging onto this amazing site so you don't feel alone in your struggle. Go, Melissa!

#11

For me it's always helped to have a motivation outside of diabetes. When I was younger, it was playing in rock bands and wild partying, not really recommended by the AMA but not wanting to miss the fun motivated me to keep an eye on BG. It is also *extremely* difficult for me to tune guitars when my BG is off as the beat tones get all echoey. A few years ago, I felt dragged out and really out of shape (@ 275 lbs...) and started exercising and that's my new hobby, much more wholesome and productive, although perhaps paradoxically, running seems to be inculcating me with a bit of a "lone wolf" streak? Whatever that cost, I start getting ready for the weekend long run maybe Thursday, eating a bit more, not a ton but a bit of a load and then stop around lunch on Friday. Up early on Saturday and get the run done and have a great weekend. Usually my BG seems to survive but I will admit that I seem to have it easier than a lot of people. Perhaps because of a perspective on insulin developed during my wilder years?

Kids are a great thing but may be a bit unfocused. My daughter was 6 when I started working out and got dragged to stuff (Tae Kwon Do...) that she didn't really like but went along. Now I'm on my own and like to escape and go for runs. If you can escape into something, I think that succeeding at anything whether it's walking/ hiking, knitting (which is probably hard to do when your BG is messed up too?), anything, can give you a focus to say "ok, BG, I'm going to put you in your place so I can ______"

I also totally agree with Zoe about doing getting on track for yourself, rather than for your doctor. When I was heavier, I'd "shop" for doctors by looking for the heavier docs in their glamour shots online. I liked the GP I found that way a lot and, eventually, when I was able to start getting in shape, he'd say "I need to do what you are doing" which was a good feeling. At the same time, my BG drifted and I chose to try to fix it with a pump, which also worked out for me.

I'm glad to hear about the phone conversation w/ the nurse! Let us know how it went and I hope she was as good (or better?) in person!

#12

Diabetes Forecast has a recent article: The 9 words we hate. #1 is diabetic, as it comes in so many forms and is used as a label....

AND non compliant. There is no such thing. As has been said, you are struggling with an amazingly difficult chronic disability. It took me a long time to decide to become "compliant." :>)

Hang in there.

#13

Since you're in MA and a pumper, I highly recommend the insulin pumpers' support group that meets on the second Saturday of every month in Woburn. One of the regular participants there is a member here.

Do a 'member search' on Florian, and find the posts he makes about the meetings. It's a great bunch of folks, and it's about the only thing I miss about living in Massachusetts. I'm back home in Colorado - but I'm wondering about my home state - another whacko shooting incident here.

I just don't get it - I live in what may be the most beautiful state in the US, but between this crazy incident at the movie theatre, and the Columbine incident in 1999, I just don't understand why we have so many crazy people.

Tom

#14

In a recent thread there was a discussion about being "Bought In". To me it's not about being compliant or non compliant it's about being "Bought In" to the lifestyle. It's about accepting my circumstances and taking ownership of my care.

You'll hear no scolding from this corner, just support. Good luck with your visit.

Gary S

#15

THANKS for all of your amazing words of support!

My appointment yesterday was great. My A1c was 12.9... obviously, outrageously high... but I know where I am and where I want to eventually be. As the nurse said, I won't get from 12 to 7 in a month, but I have my marching orders: how often to test, add walking/exercise, see the nutritionist for a carbs check-up. The office also uses the "My Care Team" program so I can upload my #s online once a week and have tweaks done that way.

I know it's going to be a lot of work, but I'm positive.

EXCEPT that I just found out that my insurance has "changed its formulary" and no longer covers my One Touch strips! What the heck? And I'm out - thought I had a vial but it turns out it was empty! Argh! Guess I'll have to deal with that today... I really don't want to change my meter because this one talks to my pump... ah well, it's always something, right?

THANKS AGAIN, everyone. I'm so glad I came back here!! :-)

#16

We cant wait to hear how well you do! keep us updated!

#17

What strips DO they cover? Keep in mind that, if you use Minimed, they are converting to the Bayer Contour Link meter which talks to your pump just like the OneTouch Link. Perhaps your insurance company covers Bayer Contour strips? Contact Minimed to request the (no charge) Bayer Contour Link meter.

#18

Hey!! So I know you have already had the appointment and all but I wanted to respond anyways! I have been D for 27 years! I have, as I'm sure most have, gone through ups and downs! 3 years ago I was in a similar experience...not wanting to go because I didn't take care of myself! Well it didn't go so well for me! I was recently seperated with two young kids and ended up in a coma. I was out for 8 days! It was a horrible experience! Needless to say I got my life back on track and started to take care again! And then...stopped caring again! I have no idea why...I just din't like my dr and it made it hard to go and see him...and well I dont know why, but anyways ended up back in the hospital with ketoacidosis! Thats when I met the most amazing diabetic educator, she said you know the past has been rough but we can't change that! All we can do is work to fix the future! If I have a checkup with her and I have a bad week oe two...she doesn't make me feel like a failure! She just keeps saying lets keep going! I think that is what every diabetic needs to hear...we can't change what has happened lets just keep going forward and make the best of what we can! She told me we are diabetic and can't expect to be perfect all the time! And those two kids love you more then you know! They need their mommy! My kids are constantly asking if I'm low or if I have taken my blood...sometimes it becomes annoying lol but I know they do it because they care!
So it seems like I am rambling, so I'll stop now! Just know that we are here to support you no matter what!!

#19

Lissa if you need testing supplies in a hurry go to walmart. They have a meter that is only $9 and test stripes that are $37 for 100.

#20

I'm as "compliant" as can be and yet my BG got to 209 last Sunday, and over 145 two days in a row of late. I think my honeymoon is over. Happy D day, "two years old", for me was July 10. Hope just getting back on the old meds will be enough. I blame my stupid pancreas,never me.