Tuesday, July 8, 2014

Endo Search Is Over!!!!

And the winner is…………. Dr. Carmichael!

I have to admit that I’ve been pretty stressed for the past week whenever I have thought about my appointment for this morning with a new endo. Not only have I been apprehensive due to past bad experiences but also the location. He is out of Barnes Jewish Washington University medical research hospital in downtown St. Louis, not too far from my house but  I’m so not accustom to driving in the city for one, and for two, it’s a HUGE hospital! So many buildings, so many facilities, so many wings, so much traffic and just dang huge on top of not being sure where I was going. I had been referred to him by a couple of the women at the Diabetic Divas group that I’ve been to a couple times. He was one of two doctors that these ladies raved about so I called 4 months ago and made an appointment with the first available doctor. Dr. Carmichael was the lucky winner to get me. I think a lot of my nervousness started a couple weeks ago when I got the new patient paper work in the mail to be filled out and sent in beforehand. One of the things that had me groaning was the in depth meal plan that I was to list. They wanted me to list what I eat on a daily basis including snacks and carbs and asking if I follow a diabetic diet. I eat just about the same thing every day for breakfast, although I have been switching it up a bit lately. I mean, I count carbs, skip out on ice cream when everyone else around me is eating it and I know it’s a bad move at the time for me to indulge, so yeah, I’d classify that as a diabetic diet. Wasn’t so sure that they would see it that way.

 My appointment was at 8:40 but all the paperwork said to arrive no later than 8:10. I left the house at 7:30 to be sure I didn’t run into traffic or parking issues and I’m so glad I left when I did. Parking was a bit of an event in itself. Then there was going from the 4th floor that I was parked on to the 3rd floor to get to the elevators for the medical buildings I needed to be at in order to get to the 13th floor. When I got up there it was just a wall of windows that the diabetes center was facing, such a beautiful view of the city, one that I’ve never seen.

It was impressive, as well as the diabetes center office. It was bright and friendly feeling just like the staff and nurses.

 I was feeling more at ease as I talked to the receptionist and even as I waited in the waiting room. I spent a total of a little over 2 hours there with only about 30 minutes of it waiting. Considering past experiences this is a huge plus! I spent about 5 minutes with a nurse who took my vitals, weight and A1C, then 5 minutes with another nurse who took blood to get labs done, another huge perk in my book that they will do that in the office and send it to the lab of my insurance choice and I don’t have to make another trip to a lab. All the rest of the time I spent with the doctor himself! He was knowledgeable, had good bedside manner, and was very happy with what my Dexcom, meter and pump graphs showed. He was happy with what Deb my CDE at the perinatologist office has been doing, he encouraged me that I’m not OCD on checking my blood sugars and that I’m not paranoid, I just want to be healthy and that I’m doing a great job at it. When I told him about how the last doctor told me that I was OCD about checking my BGs he looked at me and said, "When it comes to diabetes, when it comes to your life there is no such thing as OCD. I have patients that have told me that they have had days that they have had to check 20+ times and that happens. When you are having a day of highs and need to get down you will check check check. When you are low for hours you will check multiple times in an hour to be sure you are not going to end up in a hypoglycemic episode. Also, especially since you have been trying to get pregnant it's important for you to check check check." Hearing this was very comforting.  He really had no changes to make to my pump settings, he did a very thorough exam of my feet and going over all my past medical history and records from the other doctors that I had sent. He made sure that he covered all my questions and treated me with respect when I asked a question or made a statement about something that I clearly know what I was talking about. He even printed me a copy of his notes and said that he would send them over to my primary and parinatologist. One thing he said he isn’t completely convinced of is that I truly have Diabetes Insipidus or DI.  He is getting all the records including the MRI I had done in 2011 from my nephrologists and he said he would look over them and see if it’s truly conclusive that I do in fact have DI. He mentioned that it might be possible that I have another very rare autoimmune disease of the pituitary gland that is not DI. Dr. Carmichael will be treating me from now on for that since it’s really another endocrine issue and not a kidney issue. That will be one less doctor to deal with which is nice.

Oh and more good news! I don’t necessarily like to write about what my A1C is because I really have no tips on how to get it to this point and knowing that others in the DOC work so hard to get it down I don’t like to write about mine and seem like I’m bragging, because, well I’m not. But I have to share this time because this is a huge thing! I’ve not been so low since the diabetes! I was sure that I had gone up and not down since my last A1C check in April. I was just hoping I hadn’t gone above 6, so I was totally and completely shocked when he told me that I was at 5.6!!! WHAT!!! That’s like almost non diabetic! Whoooooo hooooooo!!!!!!!!!!!!!! I did ask if he was sure that was correct and after looking at all my graphs and logs more he said yes, he didn’t see that there was any discrepancy of any sort. For any of you that are reading this and trying so hard to reach whatever your goal may be, I really wish I had some great advice how to get there. All I can say is that in my mind I think I am pretty anal about checking my BGs and constantly looking at my Dexcom to see what direction they are heading. I can be pretty obsessive and strict on when and what I do eat. Not saying I never indulge, as a matter of fact I did treat myself to a Dairy Queen chocolate extreme mini blizzard this afternoon. But I have set up certain rules for myself when I know how certain things affect my BGs. For one, I don’t eat ice cream after 6pm. I know that even if I bolus the correct amount of insulin ahead of time and wait 15-20 minutes before eating it, it will usually be 6 hours or so before it fully hits me and my BGs will rise. That’s something I can’t be on top of the way I like in the middle of the night. Same thing with other certain sweets in the evening. I also know that when I’m swagging, I can tend to over estimate my carbs in order to keep from going high, so then it results in lows. I’m not down playing my A1C by any means, just giving the only tips I can think of as to why it’s gotten to this point. I’ve also been so anal about it since trying to get my body baby ready. If I wasn’t trying so hard for that I don’t know what my A1C would be, but quite honestly, I doubt that it would be so low.

So peeps, looks like I have found a good doctor after almost 6 years of T1. This makes me so happy!


  1. Congrats on the great A1C and new doc! That's great news :)

  2. Yay! I love this blog post. I'm so happy you found an endo you are happy with. That's awesome that he spent so much time with you and it was nice he asked you to write everything down food wise so he can get a better understanding of things. Also, congrats on your A1C!!!

    Also: check

  4. A good endo is always a plus. And congrats on the excellent A1c!