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.
Showing posts with label complications of pregnancy. Show all posts
Showing posts with label complications of pregnancy. Show all posts
Thursday, June 4, 2009
Wednesday, May 20, 2009
Hooray for High Risk!
Well... not really, but I have landed back in that category again with today's diagnosis: yep, I have gestational diabetes. Apparently I failed the oral glucose tolerance test "spectacularly" and my numbers were "off the charts". I don't know how far off the charts until I pick up a copy of my medical records tomorrow... I requested them so that I can take them with me when we travel.
What all of this means for me personally remains to be seen, but I will have an instructional class next week at which I will get a meter, etc. I suppose I shall have to wing it in the meantime.
*sigh*
What all of this means for me personally remains to be seen, but I will have an instructional class next week at which I will get a meter, etc. I suppose I shall have to wing it in the meantime.
*sigh*
Sunday, February 1, 2009
13 Weeks and Growing
Barring vitamin trouble, mercury poisoning or the thousands of other things I am tempted to worry about almost constantly, Baby J has reached 13 weeks of gestation as of today. He or she posed for some photos on Friday, at 12 weeks 5 days, and proud Mommy and Daddy are excited to share the pictures with our small blog-viewing public.
But first, some background.
Ahhh - they joys and trials of pregnancy. Just when I talk myself out of one neurosis, I find reason for another.
Today, it's that my prescription prenatal vitamins have been recalled. That's not news one wants at a time like this. I *did* have sense enough to research the whys of the recall in order to avoid a meltdown, and I discovered that the reason is rather benign: some pills may be oversized in certain lots. I don't think my lot is affected since this is a rather visible flaw, but I sent Daniel back to WalMart pharmacy to make sure that my pills were not from the recalled lot anyway. WalMart didn't know... but they gave us a new bottle with non-affected vitamins for Dan's trouble. This is not one of the times in my life that gambling seems attractive.
Friday my neurosis was just how much king crab leg I ate on one of our very, very rare restaurant visits. We had a gift card, and I wanted crab. I knew it to be low mercury and fairly safe, but I didn't know they had brought me 20 ounces until I had enjoyed every one of those ounces thoroughly and then thought to ask, just out of curiosity, how much crab they brought me anyway. Who feeds you 20 ounces of any meat!? So, Friday night was spent, in part, researching probably mercury levels in king crab legs, shelled weight of meat (since my portion was 20-ish ounces with shell) and the possible mercury consumption based on the two combined figures. That took more work than I expected, but the numbers produced by a handy calculator I found online indicated that we probably escaped harm - even after I added to my weekly seafood menu some shrimp and salmon for good measure. This mommy-to-be will probably not crab binge again for a very loooooong time.
----------
Week 12 was rather difficult for us. On Sunday night one week ago, I started to pass a frightening quantity of red blood and clots. The bleeding came at scary timing (don't get me wrong, it is always scary), because apparently miscarriages are most common during the weeks when the mother would have menstruated: weeks 4, 8, 12 and 16. When I began to bleed on day one of week 12, I was very afraid that we were about to become an incidence of the statistic. I called the OB on call and was told to just wait and see if the bleeding got worse or if any other symptoms developed (cramping, etc.), in which case we'd be sent to the hospital. We are grateful to report that the bleeding lightened up considerably within 3 hours, and stopped completely within 36. I called the OB office during office hours the next day and arranged to go in to have them check me out. They didn't find active bleeding, and everything looked okay, except that my cervix is a bit irritated. They checked for baby's heartbeat with a portable ultrasound, and we got to see him or her, albeit rather blurry and indistinct, bopping away in there with a good, strong heartbeat.
I had a first trimester ultrasound scheduled for Friday already (the stated purpose is to screen for Down Syndrome, which we would have done only for the sake of information, and which is why we hesitated to have it done), and although I had been on the verge of canceling it when I went in on Tuesday, the doctor who checked me out said that she thought it might be a good idea to have that more-detailed ultrasound on Friday so that we could also see if there was any visible reason for the bleeding.
The ultrasound proved helpful. Not only did it produce really great images of our baby - complete with brains! - but it reassured me a great deal and revealed a couple of things that I would not have otherwise known. One of them is that I have what is referred to as a marginal placenta previa. This means that the placenta has attached low enough in the uterus that it is bordering the cervix. This could be a problem if it remains in that location as the baby grows towards term, but, the likelihood is that the placenta will move up as the top of the uterus stretches away from the base. Worst case, the placenta doesn't move up, and I would require a c-section and somewhat closer monitoring towards the end of pregnancy for any bleeding that would indicate a problem. The placenta is, however, well-attached and has normal vascular activity. The Sonographer was unable to find any evidence of blood clots or pools that would explain my recent bleeding. This may mean that the clot/blood pool (subchorionic hemorrhage) that was visible in an ultrasound at 6-ish weeks has healed, which is great.
[Aside, I have to wonder if the placenta previa explains the bleeding. It can cause bleeding, usually much later on (keeping in mind that the condition is usually diagnosed several weeks later), which is red and painless, just like what I experienced this past week.]
Bleeding like this is labeled a "threatened miscarriage" by the medical community, which isn't the most comforting choice of words. We have, however, gotten past week 12, and we're hopeful for a quieter week 13. As you may imagine, the myterious bleeds are still a cause of concern. As the doctor put it, "I hope that was just a freak occurance and that you won't have further problems." We hope so, too. We'd appreciate your prayers to that end.
In the meantime, I am trying to keep myself pretty low-key in terms of excitment and activity. The bleed came just about the time I decided that I was fine, so I may have overdone it - if overdoing it means just doing things around the house and occassionally venturing outside. *sigh*
And now, as promised... our little trooper!
But first, some background.
Ahhh - they joys and trials of pregnancy. Just when I talk myself out of one neurosis, I find reason for another.
Today, it's that my prescription prenatal vitamins have been recalled. That's not news one wants at a time like this. I *did* have sense enough to research the whys of the recall in order to avoid a meltdown, and I discovered that the reason is rather benign: some pills may be oversized in certain lots. I don't think my lot is affected since this is a rather visible flaw, but I sent Daniel back to WalMart pharmacy to make sure that my pills were not from the recalled lot anyway. WalMart didn't know... but they gave us a new bottle with non-affected vitamins for Dan's trouble. This is not one of the times in my life that gambling seems attractive.
Friday my neurosis was just how much king crab leg I ate on one of our very, very rare restaurant visits. We had a gift card, and I wanted crab. I knew it to be low mercury and fairly safe, but I didn't know they had brought me 20 ounces until I had enjoyed every one of those ounces thoroughly and then thought to ask, just out of curiosity, how much crab they brought me anyway. Who feeds you 20 ounces of any meat!? So, Friday night was spent, in part, researching probably mercury levels in king crab legs, shelled weight of meat (since my portion was 20-ish ounces with shell) and the possible mercury consumption based on the two combined figures. That took more work than I expected, but the numbers produced by a handy calculator I found online indicated that we probably escaped harm - even after I added to my weekly seafood menu some shrimp and salmon for good measure. This mommy-to-be will probably not crab binge again for a very loooooong time.
----------
Week 12 was rather difficult for us. On Sunday night one week ago, I started to pass a frightening quantity of red blood and clots. The bleeding came at scary timing (don't get me wrong, it is always scary), because apparently miscarriages are most common during the weeks when the mother would have menstruated: weeks 4, 8, 12 and 16. When I began to bleed on day one of week 12, I was very afraid that we were about to become an incidence of the statistic. I called the OB on call and was told to just wait and see if the bleeding got worse or if any other symptoms developed (cramping, etc.), in which case we'd be sent to the hospital. We are grateful to report that the bleeding lightened up considerably within 3 hours, and stopped completely within 36. I called the OB office during office hours the next day and arranged to go in to have them check me out. They didn't find active bleeding, and everything looked okay, except that my cervix is a bit irritated. They checked for baby's heartbeat with a portable ultrasound, and we got to see him or her, albeit rather blurry and indistinct, bopping away in there with a good, strong heartbeat.
I had a first trimester ultrasound scheduled for Friday already (the stated purpose is to screen for Down Syndrome, which we would have done only for the sake of information, and which is why we hesitated to have it done), and although I had been on the verge of canceling it when I went in on Tuesday, the doctor who checked me out said that she thought it might be a good idea to have that more-detailed ultrasound on Friday so that we could also see if there was any visible reason for the bleeding.
The ultrasound proved helpful. Not only did it produce really great images of our baby - complete with brains! - but it reassured me a great deal and revealed a couple of things that I would not have otherwise known. One of them is that I have what is referred to as a marginal placenta previa. This means that the placenta has attached low enough in the uterus that it is bordering the cervix. This could be a problem if it remains in that location as the baby grows towards term, but, the likelihood is that the placenta will move up as the top of the uterus stretches away from the base. Worst case, the placenta doesn't move up, and I would require a c-section and somewhat closer monitoring towards the end of pregnancy for any bleeding that would indicate a problem. The placenta is, however, well-attached and has normal vascular activity. The Sonographer was unable to find any evidence of blood clots or pools that would explain my recent bleeding. This may mean that the clot/blood pool (subchorionic hemorrhage) that was visible in an ultrasound at 6-ish weeks has healed, which is great.
[Aside, I have to wonder if the placenta previa explains the bleeding. It can cause bleeding, usually much later on (keeping in mind that the condition is usually diagnosed several weeks later), which is red and painless, just like what I experienced this past week.]
Bleeding like this is labeled a "threatened miscarriage" by the medical community, which isn't the most comforting choice of words. We have, however, gotten past week 12, and we're hopeful for a quieter week 13. As you may imagine, the myterious bleeds are still a cause of concern. As the doctor put it, "I hope that was just a freak occurance and that you won't have further problems." We hope so, too. We'd appreciate your prayers to that end.
In the meantime, I am trying to keep myself pretty low-key in terms of excitment and activity. The bleed came just about the time I decided that I was fine, so I may have overdone it - if overdoing it means just doing things around the house and occassionally venturing outside. *sigh*
And now, as promised... our little trooper!
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