I’m Sorry, Doctor But I Take Exception to Something You Just Said

I think I understand what he was trying to convey, but it definitely comes off wrong. The grades are pretty accurate in terms of just where you fall and here’s why I kind of like his suggestions: They are completely realistic compared to the ADA who says everyone needs to be at 6% or whatever crazy numbers they came up with that someone without diabetes should have.

The second part I completely agree with you and like your response. We don’t get to simply fold that shitty hand and go to the next one… we just die.

These comments don’t really surprise me anymore when it comes from an authority that doesn’t actually have diabetes. Show me a T1 Doctor and I’ll show you more realistic and grounded comments.

Thanks for sharing Scott!

The problem with analogies is just that: they’re analogies. They’re not perfect. Yes, the “grading” system doesn’t work for everyone, but for many people, it puts it into a familiar context. Grades tell you how you’re doing. So do A1Cs. Grades tell you if you need to improve or if you’re doing good. So do A1Cs. It’s very hard to tell based on one reading or two readings or even 10 readings how well a person is doing. But an A1C? Yeah, that’s a pretty good judge of how things are *trending*. And I don’t think any parent would say “Oh you got a C? YOU ARE A HORRIBLE PERSON!” No, of course not. They would say (or should say) “OK, you’re struggling here. Let’s figure out what happened and work on it.” It’s especially important when there’s a change in the grade. Have you been an A+ student and all of a sudden you’re a C+? Maybe there are some new things to focus on. Or maybe you went from flunking to being a C student. Yes, you have room for improvement, but look how good you’re getting. It’s all about perception, and the A1C merely tells you where you fall. If being a C+ “diabetes” student is making you feel guilty, maybe that’s because you (the royal you, not you Scott) know that you can do better.

You know, I was in the 8s for almost three years, and I kept coming up with reasons why I could “justify” it. I was traveling. It was the holidays. I was stressed. I was sick. I wasn’t exercising. After awhile, nobody gives a shit what your excuses are. I knew I wasn’t doing what I was supposed to be doing and I knew it was only making things more difficult for me. Sometimes, you do need someone to tell you to shut up and stop making excuses.

(Again, not you personally, just the royal you).

With that closing line you should put on sunglasses and walk out of the camera shot as The Who play ‘Wont Get Fooled Again’. (This comment only works if you’ve seen 5 minutes of CSI: Miami)

Either way, fantastic post.

REALLY GREAT POST!
We are more than just a number, a1c or otherwise. Grading systems are why many people never go back to their endo after the first visit!
And as far as comparing me/us to having been dealt a bad hand in the poker game of life, screw that thought!
We’ve been dealt an interesting, be it complicated hand that requires to do more work than most, but that doesn’t mean we don’t hit the jackpot!
It does mean that we’re allowed to get upset from time to time, in order to pick ourselves up, dust ourselves off, and start the game all over again!

FYI: Most diabetics I know have plenty of “aces up their sleeves!”

Right on both accounts.
It is actually good advice, though simplistic, to try to make the best of it.
The poker hand analogy is terrible. Often the absolute best thing you can do with a bad poker hand is chuck it in and wait for the next deal of the cards.
But this is my whole life. Yes, I am “All in.”
Grading diabetes management based on the A1c is just stupid, for all the reasons you pointed out, and the failure to consider highs and lows, standard deviation, etc.
Even if there were a valid reason to do grade the A1c, I wouldn’t use the numbers the way he did. Personally, I’ve seen my numbers come out better than that without what I would call an A+ effort.
So, yeah, each of us is different at different times. A lot more needs to be considered.

Great post, very well said.

I agree. HbA1c is not a grade, or even an accurate measure of how much a person is doing to manage their condition. As long as we can only control 4-5 of the 13-19 variables that influence blood glucose levels, patients do not truly “control” the disease, at best, we manage it.

Whoa with the poker analogy! Like.

Great post. No one should be graded, unless they’re in school. Stay positive? Can we poke this guy, repeatedly? That makes me “feel” positive, that counts, right?

As always, my friend, great post here. Love the poker analogies you offer there. I also don’t like the use of them as this “doctor” has done, and it does seem like this person is only talking the talk. I do agree with Allison on a point where she says sometimes you need someone to just tell you to STFU and do what’s needed. That’s kind of where I am at. But that doesn’t diminish the need to be able to vent and talk honestly, and how “you” should be able to go through those periodic times of burnout without feeling judged and less-worthy for it. That’s human and only natural. These days, I’m not feeling overly optimistic and have been feeling pretty down on myself overall – and it’s something I have chosen in part not to discuss because honestly I don’t want to bring others down. Including my wife. In some ways, I feel that D is winning and robbing me and it scares the hell of out of me. Some of that historic hopelessness I’ve felt before seems to be coming back, and interfering with my ability to just “do it” and actually do what’s required. It’s a vicious cycle, and most of it is mental. That is where I think the talking, coping, DOC support, and life-coaching aspects come in most handy and can help people. Glad to have you writing this, Scott. We ARE more than numbers or grades. So right on.

Standing ovation! Thank you.

Wow – so glad my 12 year old son’s Endo is NOTHING like this Dr! Great Post! I am surprised he didn’t say “Well at least you don’t have cancer” Which has actually been said to my son before!