As the knowledge of my disease has progressed the importance of my endo has decreased. Now that I'm pretty patched into the diabetic network I can get the support and knowledge I need from a community of patient and care giver support rather than having to make an appointment to see a white coat. This has created a weird situation where my endo has become more of a gateway to a prescription rather than my outlet of all things diabetes.
On Monday this relationship became abundantly apparent as I met my new KP endocrinologist. Dr. Kantor seemed like a smart enough doctor but when I left the office I had this weird feeling that he could have been a robot and that would have been fine too. He asked me a series of questions about my basal rates, disease progression (to clarify if I had traditional Type 1 or the more recently claimed Latent Adult Onset Type 1 - I'm a traditional T1) and queried me for my bolus ratios. When I told him about my basal rate which is now about 17 units a day of insulin I mentioned that when I did IMCDA my basal rate was closer to 11. He asked about my job, so I told him I now work for a healthcare tech start up and also do work with a non-profit devoted to revolutionizing blood sugar management. At that he realized that I kind of have my sh*t together when it comes to all this and said something like, "it's amazing when a diagnosis like this happens and kind of transforms someone's life." After that it was just all about the prescriptions.
In the hallway I heard him tell his nurse that "I had everything under control and that I even do Ironmans so all I needed was my scripts." But that also brought up the question in my mind - what if I didn't have it all under control. What if I do triathlons, devote my life to healthcare, know my basal rates inside and out but have zero command of blood sugar. This isn't the case but very easily could be. I was surprised my A1c wasn't taken to confirm that I have transformed into this machine of blood sugar management.
I left the KP facility with 9 vials of insulin and 900 test strips realizing my brain had become a walking encyclopedia of type 1 diabetes knowledge. I can tell you the glycemic effect of just about any food, analyze the fat content versus carbohydrate amount in a given item and have full working knowledge of what exercise will do to my metabolic rate. Three plus years of constant knowledge seeking has made me my own walking white coat. Now the challenge is to stay as aware of my body and my disease as I have been so that the I continually expand my ability to manage my disease no matter how solid I have become at that task.