Transitioning to Pre-natal Parenting…with Diabetes

Pregnancy

It was a dark and stormy night…

… No, really. It was.

The rain was tickling the windows, and the last thing I wanted to do was pack. Both my husband I were traveling (to different places) for a long weekend, and it was so sludgy and awful out, I didn’t want to do anything but move off the couch since I got home from work.

Alas, we had to do laundry, and we had to get ready, so I peeled myself off the couch after coming up from yet another low (why had I been so low lately?). Before starting anything, I decided to take a pregnancy test.

“The last test didn’t work for some weird reason. I’m going to open up a new kit, and try again. I have a funny feeling,” I told The Hub.

He offered to take the laundry downstairs, and my fingers started to tear wrapping and reading instructions (for the eighty-seventh time). Though I wasn’t sure if I was mentally prepared for the news I was about to see, I ultimately felt it was time to face the music to see if I was pregnant again.

It had been a really rough couple of months. In December, my first pregnancy ended in miscarriage. I needed surgery, which no matter what is a pretty big deal. Then, I quickly transitioned from a new job that had almost immediately turned sour to a much more healthy workplace. I needed a lot of support in those months, and with that support I felt as though things were just getting better again.

“Am I ready for this?” I asked myself.

I had been prepping for pregnancy for about three and a half years. My A1C’s had been solidly around 6.8, and in the last year, more solidly around 6.5. My cycles were a bit wonky because of years of being on the pill, but acupuncture and yoga seemed to help regulate things.

“I guess I’m ready for this.”

And, about two and a half minutes later, I went downstairs, stick in hand, and just smiled at my husband.

We were thrilled, of course! But, for me, that’s also the moment that panic set in.

I was high for a few hours earlier that day. I had wine every night for the past week. Should I not use whitening toothpaste? I had cleaned the bathroom with stinky cleaner last weekend. I went for a run and kind of pulled a muscle on Tuesday. Did any of this do damage to the growing person (PERSON! What?!?!) inside of me?

What if I miscarry again?

Because of the previous miscarriage, I was lucky to have appointments every two weeks with a fertility clinic for monitoring purposes once I had a positive pregnancy test (though we did not use any fertility treatments). After four weeks, and two very positive looking ultrasounds, I was released to my “normal” high-risk OB (aka, Perinatologist), and since then, all has been looking well! As of today, I am about seventeen and a half weeks along.

But, the panic hasn’t gone away. I think parents will tell you that panic about their children never goes away. So begins this new transition from thirty year-old, relatively self-sufficient, adult to over-worried, over-wrought, and so-full-of-smothering-love parent.

Every low (and the first trimester was three months of straight-up lows), I was thinking, “This can’t be good.” Now, as my insulin resistance has seemed to take over as I transition from month four to five and I feel like I am battling highs all the time, I think to myself, “This can’t be good.” I’m steeling myself for the worst all the time because I am so afraid of losing or unintentionally harming this baby, especially as my belly starts to grow more and more.

All signs point to things being absolutely fine, but all I can wonder is if, “I am harming TRex.” (We named the baby TRex due to his tiny little arms. Oh, and by the way: yes, we found out it was a boy thanks to the Harmony test which I opted for given that I am thirty and eight months old and I wanted to know ahead of time if we were facing any challenges. Can I also just pause parenthetically here and note that this KID IS A BOY?! I was sure that it was a girl, and I am flabbergasted that my intuition was 100% wrong. Of course, we’re beyond thrilled [again], but I am still wrapping my head around the fact that I will be outnumbered in gender in my own house [not the case for me growing up]. Then again, if it were a girl, my husband would be outnumbered. It’s just weird [and wonderful] to think about this kid as a real, breathing, human being in the first place.)

So, harming the baby, especially due to diabetes management, or feeling like my lack thereof, is of utmost concern. I’m in nearly constant (well, weekly) contact with my doctor via email, and every single week we’ve changed routines and rates (this weekly routine comes with the need to update Java to upload pump data, which is royal pain in the arse especially when I am emailing my doc on the fly at lunch). My basals have dropped tremendously, which has surprised me, but what has surprised me even more is the fact that my insulin to carb ratios have also plummeted, which in fact means I am needing A LOT more insulin for food. My blood sugar is beginning to spike like crazy after meals, which makes for eating and nervousness to go hand in hand… which is tough, because I am just about ready to eat anything and everything in site. (Namely, cheese and crackers… I’m pretty sure this kid will arrive looking like a wheel of pasteurized brie.) I’m testing about thirteen times a day (no joke), and I’ve started using a Dexcom CGM, which is both a blessing and a curse because I want to check it every two seconds and I get really angry when I see double up arrows. I see my endo and OB every month, up until about 22 weeks, when I’ll start seeing them both twice monthly… then weekly, then twice weekly. I will also see an ophthalmologist every trimester (first visit was fine– no retinopathy or macular changes), and have already seen a nutritionist (which was actually very helpful, even after 26 years with diabetes), and will see a CDE, and a fetal cardiologist for a fetal echocardiogram in September.

My most recent endocrinology appointment was this afternoon, and we mainly discussed the last few days of frustratingly high blood sugars (i.e., blood sugars above 180). Pregnancy endo appointments aren’t like “regular” endo appointments (at least in my case) where you look at the last three or six months and work on the overall picture. Pregnancy brings you to the immediate present. Though my A1C is a steady 6 (and has been for five months), we dealt with the fact that I’ve had a pattern of highs for a measly four days. We adjusted insulin to carb ratios again, as well as correction factors (both of which I have many more throughout the day than I ever did before). If those adjustments don’t work after a few days, I will email my doctor and we will address, again, the last few days of numbers.

Obstetrically, next week is my eighteen-week ultrasound– a Level II ultrasound– where we get to check out the details of TRex’s brain and heart, and see how his spine is doing, along with lots of other details. I’m, of course, crazy nervous that something is drastically “wrong”, and yet I can’t wait for the day to be here and am praying that everything is just as it should be. This all said, I am perfectly happy waiting another five months to give birth: I’m not ready for that yet. I’m panicking that there is little to no time to get our apartment ready for this kid, or to take breastfeeding classes, or hospital tours, or figure out day care, or, or…

Deep breath, Kate.

Aside from all things diabetes, pregnancy has also come with its share of weird (and yet “normal”) bodily changes. It’s taken until now for my belly to start showing; as of a week ago, I felt as though I looked like I’d been deliberately eating too many donuts and wearing tent-like shirts and pants or shorts up to my eyeballs to be comfortable. My hair was crazy thick and wiry for a few months, and now when I take a shower, clumps of it shed. (Yes, I called my OB about this one: it’s perfectly normal.) I started out craving beans and oysters (which I refrained from eating), and now all I want is salty cheese and Nutella. (Not at the same time. Well, maybe sometimes.)

Since I’ll be chronicling this journey for Glu every two weeks, what kinds of questions do people have about pregnancy transitions, diabetes or otherwise? Do you mostly have questions about pregnancy preparation? I can’t answer postpartum questions yet, but trust me: no questions are too ridiculous, nor are they off limits– trust me, I’ve queried Dr. Google with some pretty bizarre scenarios and am happy to address any and all of them.

Read the next installment in Kate’s pregnancy journey!

By Kate Boylan – k8boylan
Person with Diabetes for 26 Years
Blogger (more and more sporadically) at tenaciouslysweet.com

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