Wednesday, June 20, 2007

Oh, this is gonna be fun....

Seems like I've been away forever. Unlike SOME people (you know who you are) who disappear to tropical locals for weeks at a time, I've been spending most of my not-so-free-time in doctor's offices. Now, I'm accustomed to doing so with Husband, the man who makes me very happy to have decent insurance coverage. Even Son, since, well, he's a toddler in daycare. It just doesn't throw me that much.

However, this time, it's been for me. I'm not happy about this, not one bit. And the fun of it all is that it's only going to get worse until BabyA (she's got to finally get a name around here, doesn't she?) makes her debut.

As we suspected, and I greatly feared, my gestational diabetes is worse this time around. It seems that two years does not help matters much. My morning (fasting) numbers have not come down, even with diet modifications, and I'm now on insulin at night. I've really been struggling with this on an emotional level. Husband pointed out last night that this isn't my fault, it's not something that I'm doing wrong, that it's just out of my hands, and now I've got to play by the rules. The thing is, I AM playing by the rules, and nothing seems to be going in my favor. It just isn't fair.

My first stop (of the many) was with the outpatient clinic for diabetes attached to large hospital in ritzy suburb after I faxed in my numbers for May to Dr. Wonderful. I went through the education module with both the nurse and dietitian, and was told in no uncertain terms that even though I was trying to manage things by diet, I was being too hard on myself. I was throwing some decent keytones, and simply wasn't eating enough. I have to admit some degree of relief at hearing this-I was getting sick of being hungry all of the time. Basically, I wasn't eating enough over the course of the day, and my liver got its enzymes all in a bunch and was dumping glucose into my system while I slept to try to give me enough calories, hence my high fasting numbers. Stupid me took this to mean that I needed to cut back on my carbs even more, and to ignore that gnawing in my stomach before bed. Argh.

I saw the clinic on a Monday, and since Dr. Wonderful had made the referral to them with a recommendation of night insulin, they had me do a food journal and chart my numbers until Wednesday, when I was to fax them in and we would go from there. Even with following the food plan, but numbers still sucked. Thursday afternoon was spent getting my sample insulin pen and all of the accoutrement's that surround that. In the meantime, Dr. Wonderful's office had set up an appointment for me on the following Monday to go to an endocrinologist.

I played phone tag with Dr. Wonderful's nurse, but I was finally able to get hold of her. I asked her if it was because things were so bad that I was being sent to a specialist, or what. She said that Dr. Wonderful wanted to stay very much on top of this, and that this is the practice's procedure when a GD patient ends up on insulin. After I calmed down a bit, I realized that this was probably a good thing. I'm not one of those people who have PCOS as a result of being overweight-I've been this way since I was twelve. During high school, my twice yearly periods happened while being 5'2" and 130 pounds. For someone as active as I was, that was a pretty reasonable weight. I just had boobs and a butt, something most of my friends didn't. Anyway, at least now I will have a relationship with an endocrinologist, something that I haven't had before. She mentioned follow-up care during my appointment, since now I am at even higher risk of type II later on. Argh.

We went out of town over the weekend, with all the fun that surrounds a toddler, a four hour car ride, and what we now know is the beginnings of strep and a summer cold. It also isn't horribly conducive to following any sort of meal plan. I did the best that I could, but it was still pretty sucky.

On Monday afternoon I headed up the endocrinology clinic, which was surprisingly on top of things and running, get this "right on time." That was enough to make me fall over, since I thought that since I was a shoe horn appointment, I would end up waiting. I liked the endocrinologist-she respected that I knew a decent amount about what we are up against, although I was appreciative of the weight talk. I'm almost seven months pregnant and a bit stressed-can we tackle that trigger at some other time? PLEASE?? Regardless, I was shuffled off to the nurse/dietitian, given my prescriptions, and off I went. I need to fax everything over to them tomorrow afternoon to see if things are OK.

The thing is, things aren't OK. After some initial success with the insulin (a 96, with the threshold being 95), I am now back up in the 105 region in the morning, even on the increased dose. My one hours after meals are high (over the required 140) or in the upper ranges of normal. One thing that differed between the first clinic and the second is that the second wasn't quite as optimistic that I will be able to avoid the insulin before meals as well. Just call me a pincushion. Upwards of four shots a day, plus the four blood checks.

I know that people who have true type II do this every day. I know. I know. I know. However, like I told Husband through tears last night, it's just another case of my body screwing me over. I'm scared about what it is doing to BabyA, what it's doing to me. My stress levels are so high right now I sometimes wonder how I can make it to the next minute, the next day. It just feels so crushing sometimes, and I don't see a way out. This doesn't help my numbers at all.

I just feel like a bad mom already. Not only am I at risk for future problems, so are my kids. This never crossed my mind for a minute when I was dealing with our IF issues. All of the what-ifs are in my head. I'm scared something is going to happen to BabyA before she is born, and terrified that it will happen while she is being born. Will they take her early if she gets too big? How will that work with my leave, which is only being complicated by being out so much for appointments, etc. I oscillate between being mad, hurt, sad, ticked off, you name it. I just want it to be OK, for my body to cooperate just a little bit. So far, that ain't workin'.


Kristina said...

First of all- your husband is right. It is NOT your fault. So stop thinking that right now okay? I'm back from tropical paradise and I'll come and kick your butt if I here ANY more talk about you being a bad mom, okay? Okay.

I know you're scared- but remember one thing. You're doing everything you can, you are seeing doctors and specialists and yes, it's scary but these people are all going to do everything they can in order to keep you AND your little girl healthy and safe. You caught the GD, you've been monitoring you're food and your sugars and it's just boiling down to your body isn't doing it's thing and needs a little help.

Remember too that GD is temporary and while your risks for Type II are definitely increase, you still have time to make changes after BabyA arrives to avoid it. You're not sentenced to death and it's not certain you're going to get it. You can model good eating habits for your kids and minimize their diabetes risks.

You'll be okay, BabyA will be okay and you are the BEST mom for these two kids. It's not too much longer now- and you're working with specialists and dieticians who may be able to help you after BabyA arrives. I'm so sorry that you're stuck doing the insulin injections and with all the blood checks I'm sure you're sick to death of it.

Hang in there- there is still time to change the road you're on. And you're not going to do this alone. Okay? So there. You have to listen to me... I KNOW these things!! TTYL

Jen said...

Try not to worry too much (from a L&D nurse). We see GD a lot, it's a fairly common condition of pregnancy that requires close monitoring (with and without insulin). It is also labeled "high risk" because of what complications GD can have to delivery. The best part, though, is that the clinic identified you HAVE GD so that precautions and close monitoring can take place. They will likely do weekly NST's as you get closer, do some ultrasounds to monitor EFW (estimated fetal weight) and general progress of your baby girl. Seeing the specialist will hopefully put your mind at ease. You are doing your best by obtaining treatment for your diagnosis, responding appropriately and, most of all, caring for and about your daughter. You're doing GREAT!