Laura,

 

These labs aren't "freakin' horrible" or horribly ugly... so take a deep breath and try to give yourself a break here... you're just not accustomed to looking at them... and you have nothing to compare them to, so they could be "freakin' wonderful" compared to the last blood draw... I'm probably going to be wearing my nurse hat more than my aunt hat for this post, so don't get mad... 

 

From the notes, it looks like the A1C probably is trending downward and that's a good thing... the others I wouldn't be too concerned about at this point. For one thing, none of them are critical values... they're just a little off the mark... 

 

It would be good to get the triglycerides down if you can... but to put things in perspective, Uncle Bill's were 1376 when I met him... I had no idea they would go that high. That lab tube must have looked like it was full of crude oil!! I have seen one higher lab result since, but it wasn't his... the information that the CDE gave you is right on target... the first thing that you look for when trying to drop triglycerides is opportunity to reduce whole milk and white sugar... when I took him off whole milk and a steady diet of ice cream and pizza Uncle Bill's trigs took care of themself and have been normal ever since. You have a few more challenges in that you know Nate has metabolic challenges. But the dietary changes are the same. You have made lots of good changes... all this means is that a little more changes about a few things may be required... and yes, finding more vegetables and whole grains for a 2-yr-old in the place of white flour may be challenging until you get it figured out... we don't tend to think about goldfish being chock full of white flour, which is a simple starch that breaks down immediately to sugar... but you weren't stuffing his face with stuff you knew he shouldn't have... you have been on the right track. All the CDE is telling you is that a few more changes may be necessary to get that triglyceride under control... but again, you don't know what it has been running, and this could be an improvement!! She was honest and gave you sound advice... and if you think about it, that's just what you want her to do. There was no indictment of your parenting there, and if she soft-soaped you, you wouldn't trust her very long. She really does sound like "Mrs. Wonderful" to me! You truly are up to your ass in alligators, and I suspect your own fatigue and anxiety may have affected how you perceived her message.

One thing I would advise you not to do is to obsess over these labs... or any labs. Yes, you have to watch sugar and ketones carefully for Nate... that's as close as you need to come to obsessing... there's no reason to be checking Sofie's or Emma's as long as they are not showing any signs of diabetes. You don't want them to live in fear that they might have "caught it." You know that steroids are going to cause an increase in Sophie's BG temporarily, but even a doctor is not going to order fingersticks on her... and it is a self-limiting situation. Repressed anxiety can aggravate Crohn's/irritable gut for Sophie, and worrying about an expected abnormal phenomenon is creating a lot of unnecessary anxiety for you. And putting yourself through the wringer for every lab test that is a little aberrant is going to drive you crazy. You have more than enough on your plate without that! 

 

One lab test without critically "off" values does not a reason for a heart attack make (and if it is a "critical value," the form will say so)... and please know that I mean this to be reassuring, not reprimanding. You can always call me, and I hope you will before you let a test result or anything else cause you this kind of stress... I may not know the answer, but I will help you find it. 

 

Take Ms. Wonderful a posy the next time you see her... I think you and Nate are in good hands!! 

 

I love you!

 

Aunt Sharon, RN

 

I love my Aunt Sharon and I love that she can break it down, tell me how it is and now I feel much, much, much better.  

And we had donuts for breakfast.  That is all.   :)