A few weeks ago I had labs drawn for my quarterly endo appointment. This was nothing new, but what was different was that I was actually looking forward to getting the results. The average BG on my meter and Dex were all pointing toward a good A1c. I'd really been kicking it up a notch the last few months: pre-bolusing for almost every meal, counting carbs, taking daily walks, not over treating lows. Quite frankly, I couldn't remember a time I'd ever felt so on top of managing my diabetes and in control.
Two days after the draw I clicked open an email to see the following: A1c = 7.8%
And then all. hell. broke. loose. After staring at the number in silence for a good minute the tears started streaming and then I was full blown sobbing. The kind of sobbing where your body is heaved over and you're on the floor gasping for breath. Based on the effort and data I had going into the draw I COULD NOT grasp what I was seeing.
Of course my first thought was that the A1c had to be wrong, but what if it wasn't? What if my absolute best ability to control my diabetes meant 7.8%? All I could hear was diabetes laughing and pointing at me saying, "you can keep trying all your little tactics, but I'm always going to win in the end." Needless to say, it was a bad, horrible, terrible night and I still had 5 days until my appointment.
The appointment finally came and it only took the doctor asking me how I was doing before the sobbing started again. She waited calmly and then she said this, "Katie, you are not a number. Katie does not equal 7.8. You can't look at this number and see a passing or failing grade. It is a piece of information, one data point at a moment in time. That is all."
I'd like to stop for a minute and ask you to re-read that last paragraph because as diabetics, we don't remember this often enough.
Once I could compose myself enough to speak, we started brainstorming what could be going on. She started by tweaking a few late afternoon and evening basal rates and then we talked about the days that I was really high: bad pod site, bad insulin, too much cookout food/not enough insulin. However, those minor changes and explanations could not add up to an A1c of 7.8%. I still didn't feel like I had a solid reason for what my labs were showing.
And that's when it hit me, this was the first A1c I'd had drawn since I started using my OmniPod PDM exclusively to test my BG. After telling her that her eyebrow went up and I said, "do you think the OmniPod meter isn't accurate? Perhaps it's saying I'm lower than I really am?" That's when she said, "you were 44 last night at 3:30 a.m., did you feel 44?" I stopped to think about it and said, "actually, no, I didn't feel anywhere near that low, more like mid-60s maybe."
At that point she asked if I'd do a meter experiment (I would have done ANYTHING she asked). I already have a One Touch meter so she just gave me 20 more strips. She also gave me a Contour Next kit with 20 strips. The plan was to set up my OmniPod, OneTouch and Contour side-by-side, prick my finger and with the same blood sample go down the line. Once I had 20 tests under my belt we'd decide what our next course of action would be.
When I left the appointment I was already starting to feel better. We'd made some adjustments and now I had a hypothesis to test. Armed with a plan I already started to feel like I was regaining some control.
“You may encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it.” ~Maya Angelou
Later that day while I was at work I kept thinking about everything that was going on and that's when a post written by Melissa at Sweetly Voiced popped back into my brain. During the April 30-day blog challenge, Melissa shared her experience with using the OmniPod as her meter. Her experience was that she saw a discrepancy between her meter and her lab results, but changing the test strip code to 18 made the result match her lab draws more closely.
Why I read this back in April and didn't do anything about it then AND didn't remember it until now is beyond me, but I thank GOD Melissa shared her story and that I finally did remember reading about it.
Reminded of the "code 18" theory, I added that into the mix of my meter experiment. Now I would prick my finger, test all three machines, pull out the strip I had coded 16, put in a new strip and code it 18 and then, with the same blood drop, finally test using code 18. (I learned very quickly to always start with the OneTouch meter because that sucker requires a HUGE drop of blood.)
|L-R: OmniPod (16), OneTouch, Contour, OmniPod (18)|
On the far right side in parenthesis is how far off the code 16 was to the code 18. By the end of the 20 strips (which took about 2+ days), the average difference between the two was 25 points. SERIOUSLY?! If anyone is curious, OmniPod (18) and OneTouch were almost always neck and neck, then Contour with OmniPod (16) always, always reading the lowest.
|Not a proper experiment unless you have blood stains.|
|Example of code 16 on the OmniPod compared to the other two.|
It's now been about 2 weeks since I switched to using code 18. I'm doing my best to let go of that last lab draw and move forward. As my mother so succinctly stated, "Katie, your technology failed you."
I share this story for a couple of reasons:
1) If you use FreeStyle strips that require you to input a code AND your lab results are not matching your technology, I strongly encourage you to do your own meter experiment. Better yet, don't wait for your next lab draw, do the experiment now.
2) Take 5 minutes a day to remind yourself that you are not your diabetes. You are not the trend line on your DexCom, you are not the low blood sugar at 2 a.m. and you are not the A1c result at your quarterly visit. You are a beautiful person who is so much more than data on a spreadsheet. Don't ever forget it.
3) Never underestimate the power of sharing your story. You never know who is reading your blog, what they will remember, or when it will save them, but it will. Keep writing, keep sharing; long live the diabetes online community.
|Best friend bought this t-shirt for me in Canada. It made me laugh and cry, because it's true.|