A1c: Working 9 to 5
Scott Benner
I remember the first time that I was able to make Arden's A1c decrease on purpose.
I don't remember what her level was or where it moved to but I remember making an adjustment to her regiment that worked as I anticipated and the moment that her Nurse Practitioner walked up to me to share the good news.
The decrease was minimal and Arden's A1c was still much higher (in the 9s) than where we hoped for it to be, but still I broke down and cried in the waiting area when the NP told me the news. I must have been quite the site because after a moment I felt the NP put her arms around me and she hugged me tightly without saying a word.
That moment in our lives occurred many years ago. On that day I believed that I was crying because Arden's A1c was lower, but today I think that the relief I was feeling stemmed from success – effort was finally turning into results. Moving that number however how slightly, was the result of hard work, hours of contemplation and months of trial and error. The tears that I shed had accumulated from all of the moments that I wanted to cry but didn't and it felt right to release them in celebration, I could sense that the tide was turning.
In the years that followed more adjustments were made. We added the OmniPod insulin pump, a decision that led to a large decrease in A1c. We also changed how we thought about many foods but the final piece of the puzzle was adding a Dexcom CGM which gave me the confidence to use insulin more boldly. We now had the tools that I felt I needed and the path to travel was clearly in front. We just needed to learn how to walk. Each step was a learning process that led to incremental improvements for Arden but we were finally moving forward with purpose and that seemed like a huge leap.
I love to tell these stories because even though it doesn't feel like it today, you won't be reading this blog for much longer, at least not for the same reasons as when you began. Arden's Day readers are mostly made up of the parents of newly or newer diagnosed children and folks who are still finding their way with type 1 diabetes. One day, much sooner than you think, you will have the accumulated knowledge, courage, and hope that you will need to make Arden's stories your own. Then you can get back to using the Internet for good stuff like reposting photoshopped pictures of Kim Kardashian's shiny ass, taunting your friends on Facebook when their sports teams lose and 'liking' pictures on Instagram.
Here in present time... it was Endo day. I tried to give Arden my obligatory speech about A1c levels and ready her for an unexpected increase that will likely happen at some point. I want to prepare her because we have been on some kind of a crazy run over the past two years and my hope is to limit her disappointment, should things go the other way. Arden stopped me before I could finish and said, "I know, I know, you tell me every time - I won't be disappointed if it goes up". Seems that my sly parenting skills aren't so sly anymore...
When we arrived the nurse recorded Arden's weight, height and BP and then we made our way to the little room where the blood stuff happens. The A1c machine began it's test as we were being ushered into an exam room. Not long after we sat down, the NP brought Arden's A1c results to us. When she spoke the number out loud there were no tears of joy, no relief, no sense that we had been working hard for what was achieved and deserved this. Arden's A1c had reached a new level, one that I certainly didn't expect we would arrive at for maybe another year. Hearing the number only caused me to feel calm. "I knew this was going to happen if we just kept at it", I thought to myself.
I put my hand on Arden's back and congratulated her and then texted my wife Kelly with only this image, her response was...
"Shut up!!"
This post is for everyone who is at the point where 5.9 feels unobtainable. I am here to promise you that it is within your reach. Each of you can do this with time and patience. It hasn't been easy. We've added technology, switched insulin, adjusted diets, sacrificed sleep and persevered countless setbacks, some of which I thought could break my spirit. Yet here we are at 5.9.
I don't know how long we can hang on to this number. Maybe this is our new normal, maybe it's a fleeting moment and puberty will come and knock us into oblivion, who knows. None of that matters because I know and believe that we can find our way back here again; this time with purpose.
