By the Numbers

I have found for most of my life that if I work hard enough at something I want to accomplish, I can usually eventually achieve it. Of course, it helps that I generally set my sights on attainable feats. I find few things as annoying as circumstances that are theoretically under my control and at the same time not at all under my control.

Nikki, meet your endocrine system.
Nikki, meet your match.

So, I was diagnosed with gestational diabetes about two weeks ago now. I had one week to stew in my juices before I received dietary instructions, and then the day after I received them, we were off to spend time with Daniel's family for the memorial service for his dad. (About that... I have pictures that I intend to post and things to say about the trip, but I am not well organized on that front yet, so it will have to be saved for another time.)

The trip was great and I am very glad I went, but it made it nearly impossible to accomplish the blood glucose goals I had been given, in spite of what Daniel would probably call heroic measures on my part to try to follow the instructions to the letter, even though I had little control over my schedule, my location and everything else I had to try to work around. Just to give you an idea of how exacting the instructions are, I have to eat 6 evenly-spaced times (3 meals/3 snacks, snacks are marginally smaller meals, really) with specific carbohydrate counts (adjusted for fiber, of course) approximately every 3 hours. I also have to test my glucose one hour after meals and when I get up in the morning, for a total of 4 required tests per day. As you might imagine, some of my snack or meal times came when I couldn't possibly eat -- I was in a service or on the road in the middle of nowhere, Arkansas, or delayed deplaning because they forgot how to park it properly (no joke) -- in spite of my best planning. Daniel's family was extremely understanding and supportive, but there were limits to what I could manage, even with lots of help.

When I got home and reviewed my chart, it was clear: by the numbers, I had failed.

Okay, so when my numbers looked bad enough that the doctor started talking medicine when I got back on Monday, I was bummed, but I felt I had done my best. We discussed the fact that I was losing weight (not a great thing in the third trimester, as you might imagine) and that I just felt undernourished and was spilling ketones, meaning my body has been cannibalizing itself to get energy. Rather than sending me to get my pills, he gave me a week's reprieve. I was to add some calories somehow and do whatever other tweaking I needed to do, and then come back in a week to show him my numbers, with the proviso that medication seems imminent either way.

On Tuesday I talked to my nurse/dietitian and got her suggestions for where to add the calories. The plan was to add protein all day long and to add carbs to lunch and dinner. Yesterday I got to try the new plan out (plus exercise), and I finally got good numbers ALL day long. I was so happy!

This morning, I woke up and had good fasting glucose levels. I was really happy! Then I had breakfast - the SAME breakfast that has produced good breakfast numbers 3 times in the past, and when I tested after breakfast, my glucose was too high - and not just by a few points!

Gaaaaaahhhhhhhhh!

What's at stake here is medication or diet alone, and, as you might imagine, I think diet alone is a much better way to go when there is a developing baby to consider. The sobering part is that my body may simply be uncooperative such that I have to have medication to make the diet work.

I felt my eyes tearing up a bit when I saw that number on the meter screen, but then I decided to look around online for anything that might give me some clue about why my numbers were so bad under what should have been conditions controlled for success, so that if there is anything I can do to keep it from happening again, I will know what it is. What I find is this:

"The truth about Diabetes is that some days 1+1=2. Other days, 1+1=43. It's best to just be prepared for the unexpected."

You mean I am not in control? No. Not really. The hormones secreted by the placenta, my stress levels, my activity... they are to some degree, but I can only plead with them to behave. I can't control them.

So, I did what I could. I packed up my carefully measured snack (the food scale is my friend these days...), a book, my meter and some water, and I headed over to the Arboretum for a walk, followed by some scheduled reading, eating and relaxation.

Why? I may have met my match, but I intend to keep on fighting the only ways I know how! Perhaps, just perhaps, I can at least make 1+1=3, and squeak by under the limits.