Doctorly stuff

I crossed paths with medical professionals three times last week.

In chronological order:

Monday, June 11th

I had my six-month check-up with my ophthalmologist

How do you spell that?

I am almost certain I have misspelled that word several times in this blog. I'm usually pretty picky about things like this. But seriously, when did they put that "h" in there?

I've always pronounced it "Op-tho-mol-o-gist", which is probably hideously wrong. Could it really be pronounced "Of-thal-mol-o-gist"? Not sure. Anybody know?

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on Monday afternoon. The eyes are holding steady. It's been about a year since my laser surgery for my diabetic retinopathy. At my first six-month check-up, the doc noticed a new microaneurysm near the center of my eye (aka, my macula). He seemed concerned about this, but not too, too much. Basically, the microaneurysm is still there and holding steady. He said if it leaked, I could notice some blurry vision, at which point I should then come in to have some more laser treatment. This would be slightly different from the panretinal photocoagulation that I had before, and be specifically targeted at this microaneurysm. But since it's so close to the center of my field of vision, he wants to hold off on doing this because of the potential small loss of vision where the laser treatment is performed.

But it's also likely that this microaneurysm could either stay stable for many years or even go away without any need for further laser treatment (which is obviously what I'm and strongly hoping for).

Tuesday, June 12th

Thankfully, my saucer-like pupils returned to normal

Damn Insurance

They used to have drops to help speed up the pupils returning to normal, but they don't provide them at this office anymore because they're apparently too expensive, not necessary, and insurance won't cover the cost of them any longer.

Not necessary my ass. Try walking or driving on a sunny afternoon with your pupils maxed out. It's not fun.

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by the next morning so I could see the most recent pictures of... the babies!! (NB: two exclamation points).

They're doing great. Baby A is now head down, and Baby B is still in a breech position (we're not finding out the genders of the babies - but more on that later). We're at 24 weeks now. It's highly likely that they can flip and flop around into new positions in there for a little while longer (before they run out of space!). But positioning of the babies has EVERYTHING to do with whether the babies will be born vaginally or by C-section (if either one is breech, most docs these days won't even consider a vaginal delivery).

So, like I mentioned above, we don't want to find out the genders of the babies. But when I say "we", what I mean is: I don't want to know, and so Megan is not going to find out either. She wants to find out (very badly, in fact), but can't come up with a reason for wanting to know other than "just 'cause I want to!" and so she doesn't feel like this is a good enough reason to over-rule my not wanting to know. (And before anyone suggests it: she can't keep secrets very well, so her knowing and my not certainly wouldn't work).

Toward the end or our ultrasound session, Meg actually asked the sonographer:
"So, do you know the genders of the babies?"
"Oh, yeah, I know."
Honestly, I'm not sure how we got out of that room without finding out.

Baby A:


Baby B (sucking his/her thumb, even):

Wednesday, June 13th

A week or so ago, I went and had my blood work done for my A1c test. When I got into the office on Wednesday morning, there was a phone message from my endocrinologist congratulating me on my A1c reading: 6.9.

If you've read this blog for any amount of time, you might know that I've been struggling, and struggling, and struggling, and struggling, and struggling to get my A1c below 7.0 for the past year. Getting this reading was so anticlimactic it wasn't even funny. I felt almost no joy, which kinda sucks.

All I'm asking for is a little internal consistancy, is that so much?
For instance:
When one's meter averages go down, their A1c score should go down, no?
(Answer: mine stayed the same)
Or how 'bout this one:
When one's meter averages go up, one would expect their A1c score to go up, right?
(Answer: mine went down!)

IT JUST SIMPLY DOESN'T MAKE ANY SENSE. Urrrrrrgggggghhhhhh.
(see this previous post for a review of my stats to see what I mean).

I feel like the A1c test has become a meaningless benchmark (at least for me).
If there's no correlation between my A1c scores and the average readings I get out of my meter, how am I supposed to interpret the results? Do I just choose to judge how well I'm doing based on one versus the other?

Clinically, it's nice if there's a single quantifiable score that can be used to judge how well one is doing (kinda like the apgar score). But there's also the pitfall

Atari rules

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of such a score being an oversimplification of one's health status. Although I've been told there's mounting evidence (I realize I should support this claim with a reference, but unfortunately I don't have one, so caveat emptor) that blood pressure and lipid profile (not to mention microalbumin concentration) are more important than just an A1c score in gauging the overall well-being of a person with diabetes, the A1c is still the industry standard.

So anyway...stick that in your pipe and run it up a flag pole.
I've reached my goal. Whoop-dee-doo.