Wednesday, March 27, 2013

Quick Update

So my A1C of the week (with my new G4!) was 7.2%!
Goal of the week is to put every exercise event into the G4.

Sunday, March 10, 2013

SMART goals/ A1C of the week

My previous work experience introduced me to the ideas of SMART goals: specific, measurable, attainable, relevant and time bound. I have been reintroduced to them at school this year as well. Normally, I do not worry so much about the structure of my goals because normally they have a defined endpoint like an exam at the end of a course. I find SMART a useful strategy to consider with longer more nebulous goals, especially with diabetes management which has no end point.

I’m going to try something new. To me, getting my A1C down always seems like a daunting task. 
In my head I say “how am I ever going to do better for an entire 3 months.” It seems nearly impossible and I always tell myself that it is about making small changes, but then a small change happens in the wrong direction and I don’t worry about it. That change cancels out one I made in the right direction. I need to find the difference between, not getting mad at myself and not caring.  I need more “how could I do that better next time” conversations in my head. So to encourage myself to do this I am going to try working in intervals less than 3 months. 
My goal has a weekly part and a monthly part.  Once a week, I am going to upload my CGM data, look for glaring patterns and get a weekly “average bg.” I know that it will not be perfect for the same reasons the CGM isn’t perfect, but I think it will give me an idea of where I am at.  Based on this I am going to try to set a small goal for the next week, e.g. less variability, better overnights, better post dinner, better average by 5pts.  Overall, the point will be to do a little better than the week before. I will also set a limit of not spending more than 10min on the “project.” (Set up for download, study/ do other work, look at the results and decide on a goal)

Then, once a month I will spend an hour looking at these on my own. The goal of this time will be finding patterns that are more sneaky, or realizing that it is worth making bigger changes, like dinnertime combo food limits (e.g. once a week, not within 4 hours of bed). (Improving breakfast foods has made a big difference for me, but it takes work so I have to see where the effort has the most impact.)

1.       Download dexcom every week between Wed at 6pm and Thursday at 6pm (between SCP and date night)
2.       Look at numbers and make a goal for the week.
a.       “A1C of the week”:
b.      Goal of the week:
3.       Monthly, spend 1 hour myself looking over data and making goals (Day 11-19 of the month)
a.       What should I do for more information:
b.      What changes should I make:

Realistically I need some more specifics for this so: must do weekly goals at least 3x/month. Re-evaluate April 15th


I have thought about creating a blog for a while.  It feels like a lot of pressure so I have been hesitant. I doubt I can do the things necessary to keep up a good following (like post regularly). My goal with this blog will be to post my goals and strategies and experiences. I want to shed some light on diabetes and on becoming a doctor, the two things that are most prevalent in my mind lately. In addition sharing my story, I would love to help the #doc understand health care providers a bit better, and health care providers understand diabetes and a life of chronic illness management better.

 I haven't really worked on my full disclaimer yet, this is a draft based on other blogs I read:

1. this is not medical advice.  While I am training to be a doctor, I am not one yet.  I am certainly not your doctor.  I can share what I do and ideas for the challenges I face with my own health and I can share anecdotes from people who will let me, but I can not tell you if they will work for you, some may harm you. This brings me to my next point...

2. YDMV = Your Diabetes May Vary
Everyone's bodies, lifestyles, management are different with diabetes. Any ideas that you get from me or anywhere else on the diabetes online community (#doc) should be run by your health care team. There are so many complexities to diabetes that I cannot possibly chronicle all the different sides of the issues.  For instance, in my first post on goals, there are lots of other things I do for my diabetes management, but I am not going to tell you all of them in this post or probably any of my posts. 

3. Medical school is a complex and intense process.  I am so grateful to be doing it, but sometimes it feels like it swallows me whole. I will likely have commentary about it as part of this blog. I may also narrate my thought process about figuring out what I want to do with my career. I am new to navigating health care social media (#hcsm) so if I commit a faux pas either let me know so I can fix or forgive me (or both).

This is the beginning of my diabetes posting. We'll see how it goes. I will update this disclaimer from time to time.