10: The August 2021 Results

So, what is normal?

That word has been at the heart of discussions many times of late. Some discussions are more interesting than others, but the word normal can mean just about anything.

Normal is such an ambiguous word that we don't allow student nurses to use the word to describe anything. Once upon a time, Electronic Health Record (EHR) systems had a check box next to the phrase Within Normal Limits (WNL).

When you hovered your cursor over this phrase, a myriad of normal health-related items. Perhaps your lungs were clear to auscultation. Heart sounds were regular rate and rhythm. Bowel sounds active in all four quadrants. Full use of all extremities. These are, but a few of the assessments nurses could make, and the WNL was a blanket phrase to cover it all. But quickly, WNL got a very negative connotation. WNL started to mean We Never Looked.

The problem with blanket statements is those phrases can become very easy to overlook for anyone. It's easy for someone to see it, decide each is ok, and move on to the next. I remember the first time a colleague pointed out that I had a cold shiver run down my spine. I had never thought of WNL that way before, and after hearing that, I could never look at the phrase the same way again. From then on, I always documented how I assessed, so no one could ever claim that I never looked.

I was always thorough in my assessments of others as a nurse. I wasn't nearly as thorough, however, about myself.

My lack of self-assessment had gotten me where I was by March 2021. That all changed immediately following the close of that month. I had been working hard for nearly five months when the time came in August to do a 3-month assessment of my A1c. I was stoked! Not only had I achieved lowering my A1c from 10 to 7.2 by May, but I believed I had lowered it even more by August.

From May 18, 2021, through August 19, 2021, I had lost 29 lbs and was now weighing in at 202 lbs, down from the 214 I was 91 days earlier. I had to wait to come back for an A1c check for 90 days, so I had the check after 91 to be sure.  With the prior visit, I had lost 17 lbs in 6 weeks. Now I had lost an additional 12 lbs in the past 3 months. 

During this 3 month period, I had been incorporating some things back into my diet to help slow the weight loss. As my provider said, I didn't need to lose too fast; my goal was to be between 200-205 lbs minimum. Resting at 202 lbs was perfect! That meant my diet and exercise routine were stable, and I was not losing weight too quickly, nor had I put any of it back on again. Summer months can be hard trying to balance things out sometimes. Usually, during the summer, I would go see a bunch of movies and indulge in popcorn, candy, and other junk foods. This summer of 2021 was different, though. Because COVID was still prominent, and the Delta variant was wreaking havoc by this time in August, I didn't go see many movies, which allowed my diet to stay balanced. Later years, when things were back to "normal," would prove to be more challenging.

By this time in August, I had started eating some sweets like ice cream again. I loved the first time I indulged in Baskin Robbins Chocolate Mint ice cream again. Oh my, was it good! I would scoop out a few tasty bits of the ice cream and put it into a souvenir Atlanta Braves helmet cup to eat it. Those helmet cups helped me manage portion sizes better and not overeat the ice cream.

I also added back in things like mac and cheese, some fried foods like chicken fingers, and even the occasional frozen Twix mini candy bar. I love frozen Twix candy bars. If you've never had one, try it. The biggest things that were helping me, though, were maintaining a good solid diet and exercising regularly. At that time, I was still lifting weights and was up to 130 lbs for 3 sets of 10 reps. Along with doing the gauntlet and other exercises, that was keeping me strong. I was also still running but hadn't as much due to the heat of the summer. I ran in the Flight for the Fight 5K in Six Mile that month. It's a lovely country, 5K, with some rolling hills and a steeper one as you head up Liberty Highway to the finish. I ran that 5K in 28:59, so I managed to break 30 minutes for both races I ran during the summer of 2021. These were the first 2 5Ks I had run in 2 years, so I was very proud of myself for how I performed.

Everything looked so good, so when I got the news of my new A1c, I couldn't wait to tell everyone about it.

5.6

In the words of my provider, that was considered "normal."

Normal.

There was that word to describe my level. I had taken a 10 and turned it into a 5.6, the same reading I had from March 2018, the last time I had my A1c checked before 2021.

My body was regulating itself correctly again. I wasn't feeling tired, had no polyuria, and had no issues with my heart rate, and now the weight loss was because of me shedding unwanted pounds and not because of poor body chemistry. Additionally, from a work standpoint, my job was going well, as was my dissertation, as my committee would now discuss a possible proposal defense date with me.

My reading was normal, and I felt "normal" again.

The truth was, I was better than normal. I was returning to myself and feeling positive about where life was heading. That was the real key to the whole thing, a positive mindset to guide me through. I would need that mindset from now on, as sometimes life tries to throw little curveballs our way. Living with diabetes is more like a rollercoaster ride. You have the ups and then the downs. Although things were great by August 2021, much work was left to be done to maintain that level of 5.6 or lower from now on.

Tune in next time for 10: The Ups and Downs.