Type 2 · call recap
When one thing improves and another gets worse
3 June 202613 attendedHeld by Mira
Four members arrived with results that had moved in two directions at once, and the room was much better at this than it would have been a year ago. The subject is uncomfortable because it does not fit the story either the internet or a hopeful patient wants, and because there is no single explanation available.
Where the room started
Confused and, in two cases, suspecting they had been misled. Ravi's A1c had improved substantially over two years and his lipid panel had not followed. Gwenda's blood pressure had come down enough to have a tablet reduced, while her liver enzymes had come up mildly and were being watched. Two others had smaller versions of the same shape.
What none of them had been given was any account of why, and in the absence of an account people build one, usually a frightening one.
What came up
That there is not one cause and I will not invent one. Some of it is other medication changing. Some of it is what people are eating now, which is different in composition as well as amount. Some of it is a mildly abnormal result that would have been mildly abnormal anyway and nobody had looked before. Some of it is not explained.
Solomon, who describes himself as a reformed bloodwork obsessive, made the contribution of the hour: a single result is a photograph and a trend is a film, and he had spent a year reacting to photographs. Three people asked him how he tracks his and the answer was a page in a notebook, one line per test, dated.
Where we left it
With four members writing one question each about the result that had moved the wrong way, and with an explicit refusal from me to say what any of it meant. I explain the words. Their clinicians read their results. That distinction is the reason this circle can exist at all.