Beyond the Basics: Answers,Delivered

For three years, I've looked for an answer that no one could tell me. Not even my extremily intelligent Endocrinologist,nor the OBGYN,nor the high risk perinatologist that I saw.

Today,I found that answer..on a random Google search.

http://www.redorbit.com/news/health/346710/fidgety_babies_of_diabetic_moms_dont_get_large/?print=true

Brief Summary: in some mothers with diabetes,babies don't get large because the kid is so hyperactive that they essentially block those excess calories and turn out normal weight. Regardless of your BG control.

And reading that was like the floodgates of Heaven coming down and illuminating 

my poor,confused little brain..because from Week Nine of my pregnancy straight through to delivery my Endo would warn me how I was set to have a very,very large baby. Most of pregnancy was spent in the mid-upper 6's a1c wise,& for me that was stellar good.And I kept wondering when that weight gain was going to hit(baby,not me. I had no problem packing on an extra 40 lb) & it never happened,which is why my OBGYN and peri never told me big baby diabetic horror stories and I was allowed to go to 39 weeks before scheduled induction(only my body decided 38 wk 4 days was its limit). The feeling of my OB

was if everything is going hunky dory,then the diabetes must be as well. And the feeling of the high risk perinatologist was 

that if the scans/stress tests went ok then everything is good. I was set to be induced via them,but went into labor several days early. My Endo/CDE were pretty great about adjusting things,but it's something that you just have to plunge right into before you know how it will be. Anyway, based on all the stories I'd heard I was prepared for my kid to be larger but that didn't happen,& I now know it to be from his hyperactivity(Week 15-Week 38) the child is still a very,very active bundle of energy)..I guess hyperactivity has its perks. I guess it's partly a genetic and partly a personality thing. The thing is,the human body does things we still don't understand..and why some people have a1cs of 4.8 and 10 lbs babies and others a 7.0 and a 7 lb x oz babies no one really gets. It's not all control and it's not all genetics. I think people blame diabetes far too much for everything. And while the truth of the matter is that another pregnancy could yield a totally different child(& birth weight)knowing this has solved the "why" and proved that doctors really don't know everything.

Imposter

I'm a little upset right now.

(Warning: what you are about to read will probably disgust you...proceed with caution. And if you should read the entire thing do not,in any way, take the content therein then other then that of my own personal diabetes opinions.)

This is my child. He is 19 months old, bright,funny, a social-ite (and overall, quite healthy except for the occasional ear infection.)

Having said that, you may feel free to head over to a certain large diabetes website & listen to a webcast from a certain leading expert on diabetes & pregnancy.

I didn't make it very far,switching it off when I heard the words "I don't care about the mother. I only care about the baby."(apparently, it got even worse,when she said that every women with diabetes should have to view graphic!!dead baby images as a sort of scare tactic) In a flashback, I was back in my Endocrinologist's office again, crying hysterically over the best a1c of my life. Listening to her telling me that I was a horrible mother & killing my baby.)I had alot of guilt during pregnancy, guilt that because I couldn't reach that a1c that they wanted, my baby would surely be born impaired, or dead.(or I would die trying to reach that a1c) I spent the entire pregnancy locked in my little world of denial,& possibility of disaster.(yes, I had issues. A therapist probably could have helped.Trying to work through those.)
Here, on the other side, I can tell you that babies are tough little guys. I can tell you that doctors don't know it all, and sometimes a compromise must be made between what they want and the limits of you personally can handle. I can tell you (from the past)what a seizure from a low blood sugar feels like,& how I wasn't ever going to subject my baby to the effects of THAT(cut off of oxygen,brain damage, brain damage to baby?no thank you. I can tell you that given my a1c, my normal weight baby should have been fatter then he was..further proof that docs don't know it all.(and the guilt I feel when women with better control then mine beat themselves up for the weight of their baby. Please don't do that, you did a beautiful job. I'm convinced its 98% a genetics lottery.) We all do the best we can.
I'm convinced that the expert in question would be in favor of abortions for anyone not in the "under 6" crowd.(quote: There should be no surprises.) And while I worked my tail off during pregnancy, I wasn't (nor will I ever be..it's simply not safe for me in that subcategory. And I've further concluded, that many women with D decide not to have children because their doctors have played up the whole baby-is-doomed at X a1c scenario, which simply isn't true.(Not that you don't try to drop it ASAP,but it's much easier to drop actually after you get pregnant then before..it drops slightly naturally,and again,this is not medical advice in any way shape or form. Some people can actually get those sub 6 and sub 5 a1cs.(more power to ya,but not everyone can)But no pregnancy should be composed of docs (like her) telling you all those horrible things..we know. We know things can go wrong. We live it for ten months,every high,every low, every bite of food we put in our mouths. We hardly need a guilt accelerator.(She would never be my doc,not in a million years. I think my Endo, at least, kept the scare tactics under control for the most part when it became obvious that none of that crap was going to be true.)

Wordless Wednesday: The 259th Day

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Yesterday morning, as I rolled out of bed, I was positive that this was the day. I don't think you really want to know precisely why I was so positive (let's just say that it had to do with gross body substances) & that, combined with rocking cramps, had me convinced that this, was it.

Well, it didn't quite work out that way. Husband took me to the OB-GYN (a normal appointment, all ready scheduled) and I'm not in labor...not yet. I am 2 cm dilated (seems to be progressing at the rate of 1 cm/week) but unless 6 cups of amniotic fluid exit the building, I'm not really "in labor". I am also GBS (group B streptococcal?) positive, so labor will involve antibiotics in my IV. And also, the hospital doesn't allow you to wear your own insulin pump, something that doesn't make me too happy because I've been planning on this for months (barring any emergencies). OB-GYN assured me that they have a team of internal medicine guys to "get my diabetes back on track with pump adjustments" after delivery. (yeah, right. NO offense, but my diabetes is never "on track") And then...the issue about blood sugars during actual delivery. He said they like to run them on the high side. (and by that, I'm guessing 100-120,which is kind of laughable to think about those numbers being on the high side! And that's perfectly alright, if that works out to be the case but I'm envisioning having to get ALOT of IV dextrose if they're the ones who actually run the D-show) My Endo doesn't have privileges there, so she doesn't have any say in the matter. I'm not sure that I can refuse to go off my pump (and not be admitted there), I've never been refused the use of my pump for an extended period of time.

And then, it was off to the NST/biophysical profile which went pretty routinely. I never pass the NST, but the biophysical profile always comes out ok. (8/10 is normal) Perinatologist doctor wanted to know what OB/GYN doctor had planned (in terms of delivery)...its kind of like the two offices never communicate. (the answer is:vaginal delivery, unless it hasn't happened by the 39th week, and then they will schedule an induction) I have to get a magnesium infusion (via IV) this week, to prepare for delivery & in the hospital, they'll be checking my electrolytes daily (and the babies electrolytes at birth, to screen for any problems). He also updated all the names/numbers of my Endo,the OBGYN group, the pediatrician that we chose, and my Nephrologist into the hospital computer system in preparation for that day.(suite at the hospital=booked,patient with zillion medical issues coming through)
The antibiotics will fortunately be penicillin (I'm allergic to doxycycline). I don't really know I'm really going to know if I'm in labor if the amniotic sac doesn't burst, because I have contractions (both painful, and not) already,but I'm guessing that if dilation continues at this rate at some point it will switch from "latent"(0-3 cm) to "active"(4+ cm)and things will steamroll from there. I've survived Christmas, so now I'm hoping I have a New Year's baby (you get a ton of free stuff if you've the first baby on Jan.1) & the baby is mature enough, so if he wishes to make his appearance on that date, I'm more then agreeable to that.

Day #26 (NaPoBloMo)

There was a time when life, as you knew it, was much more simple. When you didn't have to measure,carb-count, guess-ti-mate,SWAG etc. every single carbohydrate that went into your mouth. When food was food,not something that could simultaneously kill/save you.

That was before. Before D came along. Some of us have never really really known a "before", for others, there were many years spent with the "before." The thing about the "before",is,that for many of us, it may never come again (sorry for the downer opinion,yours may vary,& I certainly hope I'm not right). The years dull the memories of some things but for others, the diabetes stuff gets so hardwired into your psyche that you doubt it ever could get itself undone. It's all normal.

Fact: I'm ready to go back to the "just diabetes" phase of existence. I miss sleep, I miss my back muscles not hurting, I miss Chai Tea Lattes (and everything Starbucks),I miss having clothes that would fit, and I miss not having to bolus a unit every time I even look at a carbohydrate, I miss just worrying about the D-Stuff. Vaguely I recall those days where doctor appointments weren't every week,and I'm ready to go back to them. I guess just because something becomes "normal", it still doesn't mean that you particularly love it. I know there are people for whom pregnancy is a 10 month nightmare(bed rest, the whole 9 yards)but I can't even begin to explain what its like, with diabetes. Every day that ends (without disaster) is the best thing that happened that day. I guess when you go to the doc (and everything is a constant stream of negativity) that really doesn't put you in the mindframe of "enjoying your pregnancy." I'm not afraid of caring for a newborn anymore, for even the demands of that is the successful conclusion of the 3rd Trimester. And yeah, I'm nowhere NEAR 39 weeks. My patience has kind of run out (and I would really like to hop in a time machine & fast-forward to the end of December) & I want a healthy,bouncing, bundle o' joy to be here.(NOW) And if it sounds like I'm complaining, I guess I am..there's gotta be some place I can let it all out & it had just as well be here. (which very few folks go) It's my opinion that the people who enjoy their pregnancies don't have complicating medical conditions involved.

29 Weeks

Dear Baby,


Wow, 29 weeks? I barely remember those early weeks of bemoaning that it would never, ever,be obvious that you are in there...because in the past 5 weeks, its now become that(to the world). Ah, the joys of the third trimester.(most notably:back muscles turned to silly putty,heartburn,and random strikes of shortness of breath) As for low blood sugars,they aren't really much of a concern these days...I'm not going to say they're non-existent,but the likelihood of a serious one is slightly higher then the likelihood of getting hit by a random meteor. Daily TDD is 50 units and climbing. (it should continue to climb for the next 6-7 weeks)

And...the never ending doctor appointments. Now that it's the third trimester, I go to the OBGYN every two weeks. (starting around week 32,that will be switching to weekly with the OBGYN) As for the perinatologist, up to this point I've gone in every four weeks but depending on the results of next week's ultrasound I may be going in every week from that point onwards. (non-stress test, biophysical profile) The last ultrasound showed normal weight,etc.but the amniotic fluid index was elevated (which could be due to diabetes, and could be due to genetic diseases...such as Bartters Syndrome)I wasn't happy at all to find that out but the perinatologist told me it could be from many different reasons,(sometimes unknown)none of which could be determined at this point & the important thing was to monitor it closely. Sometimes it just goes away on its own,& if the levels greatly increase by the next ultrasound its most likely to be from a genetic cause.(he didn't seem to think that the cause was from diabetes.And I might beg to differ,given that I'm still no diabetes angel cc "results of last a1c" but still,the 'betes control is in the "fair" category) The important thing is to monitor the whole package(any signs of swelling,high blood pressure,contractions,movement etc)and to try not to freak out too much about this one finding. (and I don't have any of that...to date) Baby X is still pretty active in there. (he's always been active,which is comforting, in a world full of uncertainty)

There have been no references to the C word (CSection)...actually,there have been no references to labor, period. (I'm guessing that with diabetes,there's just no way to say "you'll likely be able to due this naturally" when the world can turn on a dime,& the most important thing is deliver the baby,ASAP. I guess that in the next few weeks that Csection word is going to become a reality if my amniotic fluid volume doesn't go down. Which, after you've actually been in an OR and seen all the gory details live is not a comforting thought.

But the most important thing is a healthy baby.

The Hitchhiker's Guide to the Galaxy

It's impossible to stay mad at someone offering you a diet coke...(or,these days, a diet caffeine less coke!)

The One that Wasn't

In retrospect, I knew it would probably happen. School stress, D-stress, pregnancy stress, concurrent Endo appt. (when did that ever turn out well?)

Regardless of that fact, my a1c rang in at 6.5...a marked 0.4 improvement. (not that I expected my Endo to go all gaga over over it, because true to form, she didn't). But what happened next put the icing on the cake.

"Well, you knew what you were getting yourself into (suck it up)." (really lady? that's all you've got to say,& thank you very much,not that I regret said choice,but it's the first time in my life that I've been 27 weeks,hugely insulin resistant,25 excess lbs,and I don't really think anyone "knows" what they're getting into). And then she went on to tell me such additional goodies as how every day in this 9 month stretch mattered,you can never redo it,if you screw up the kid its permanant, blahblahblah at which point I completely lost it.

I burst into tears, which I don't think I've ever done in a doctor's office before. (not even being diagnosed with diabetes did that) There's only so much blame a person can take,and you can pretty much 1/2 that when you're pregnant. (and thank you very much, I have enough blame to last me every single day of my life, it doesn't need to be coming from you.) After that, she toned it down a little bit (remarking drily that my blood glucose, in office, was 296 (OF COURSE IT IS,YOU'VE JUST PUT IT THERE but no additional comments (and at that point, I would have walked out the door and not come back,I was that upset). Why is it that doctors feel the need to tell you what you already know? I'm not here because I've got this crap figured out, I'm here because I NEED HELP & SUPPORT. Which clearly I wasn't getting from her.

So yeah,that appt. was not the greatest. She did try to be slightly more sensitive after that,but the remarks she made left a permanant scar on my already tender psyche. I don't know if I can forgive her, much less go back to her, after that.

I then went forth, spent several hours getting it out of my system, complained on Twitter, took a nap, called a friend, and feel much better now.
Thank goodness for the D-Community,because no one else truly gets it.