Monday, September 17, 2012

Quantity or Quality?

I refuse to test my blood sugars with home tests and meters.
I do not recommend this approach or encourage others to follow my obstinacy. I am blogging about my own life and experiences. I will detail the how’s and why’s of my situation, but I am not dispensing medical advice here. Constant home testing was necessary as I grew up in the 1970’s, but this was done with urine testing rather than constant blood letting. Standard modern thought is that this can be some 10% more inaccurate than constant blood monitoring. There is additional concern that thee accuracy can be further skewed if the diabetic has kidney damage. I counter this by saying the diabetic should be tested for kidney damage and told how to adjust.
I will get into the reasons, logical and perhaps some emotional, of my opposition to testing in the posts that will follow. Right now, I will outline how I do manage the sugar in broad terms. This is information sharing and not medical advice. Barring digressions and other topics that come up in life, the blog will focus on blood testing issues for a while. It’s a serious and central issue of diabetic "lifestyle" that I feel needs attention and further thought.
The not testing reveal comes with another public confession that I have only really alluded to in prior posts over the past year. My blood test numbers are typically astronomically high. My body operates well and in healthy regards with numbers in the 200’s and 300’s. Tests have shown spikes exceeding 600. At those times, my sugar felt high, but I have suffered symptoms of low blood sugar with numbers in the 400’s.
I know this sounds horrifying to people with even passing knowledge of the numbers game. The target of meter numbers is around 120. The target A1C is 6.5 to 7. Mine have been to 16.
My GP has said he does not understand how I have never been in a coma. Others don’t see how those numbers can be true because I have always been a fit and lean and healthy diabetic. All medical professionals see my refusal to self test and the high numbers as poor blood sugar control.
I don’t agree with the assessments. Not testing by pharmaceutical means is not the same as paying no attention to the underlying condition. I "manage" my diabetes by feel. My emphasis is on how I feel, not what the numbers say. I avoid "high" blood sugar–when it feel high–for the most basic reason: I don’t feel comfortable when the sugar feels high.
Since starting with the GP in 2005, I had several prolonged periods of getting my numbers significantly lower. A1C numbers of 14-16 have gone down to 9, still short of doctors’ targets and always conveyed to me as not enough.
The lower numbers are healthier, I am told. I haven’t been able to believe that, not because I am obstinate, but for a basic, almost primal reason. Every time my numbers get and stay into the "better" ranges, I feel like shit. Clinical depression overwhelms me. I can’t sleep right or function like the dynamo I prefer being. My quality of life feels non existent.
Therein lies the irreconcilable difference between me and my GP. He wants to paint by numbers until he can declare me healthy by statistical standards. I want to feel good. I see little to no value of a prolonged life if it is inescapable, endless days of feeling bad. There’s a quality over quantity issue over which we will never agree.

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