What defines “wellness”?
Isn’t being well simply being happy?
Does wellness mean being healthy?
Isn’t being well those summer evenings when you have had just enough wine and a filling dinner made with fresh veggies from a local farm stand, and the sunlight fades through the trees, and you hear children laughing in the yard while you get dessert ready?
Isn’t wellness that feeling you have when you come out of the ocean after an hour or two of playing in the waves, the sun warming your shoulders, and your body exhausted—in a good way—from riding the ebb and flow of the midday tide?
Isn’t wellness that feeling of just waking up from a lazy afternoon nap, still warm under blankets and knowing there is nothing really pressing to do at that very moment?
Isn’t wellness both finishing and receiving compliments on a huge project at work?
Isn’t being well the feeling of being taken care of?
Isn’t wellness seeing a 104 mg/dl on your meter screen, after you’ve eaten pizza, ice cream, and fried dough at a carnival?
(Okay: the last one might be a tad unrealistic. Because has that ever happened in the history of people living with diabetes?! I’m sure it has…just not for me.)
I’ve been thinking a lot (clearly) about what “being well” really means. It seems that in pregnancy, being well—diabetes-wise—is not necessarily what “being well” means when you are not pregnant. Sure, being well means all of the things I listed above, and then some. “Being well,” rather living well with diabetes means so many things, too. At the outset of this pregnancy, I thought nothing would stop me from living well and growing one happy and healthy baby—diabetes or no diabetes. I was going to exercise daily, check my blood sugar and never get sick of it, have an A1c of 5.0%, and give birth naturally with no complications. Doctors would marvel at how “well” I was after 27 years of living with this stupid condition, and would present me as their poster-mama for patients contemplating pregnancy.
I am well—very well, really—but I am no poster-mama.
Two weeks ago, I had an appointment at my endocrinologist’s office, and was bowled over by being told that my A1c was 5.6% (an average blood sugar of around 117 by my very non-medical estimations). “Yes!” I thought to myself. “I have mastered pregnancy-y-y-y-y,” said the voice in my head like that guy who announces “Let’s get ready to rumblllllllllle” at…whatever events he announces that at. (Wrestling? Boxing? Roller derby? Chicken dances? I don’t know.)
Then, last week, I had my twenty-six week check-up with my high-risk OB. To be honest, the hub and I were flustered walking into this visit, as we waited at the end of the day for two and a half hours to see the doc whom we actually hadn’t seen in about two months due to the doctor being out on medical leave and vacation. We were anxious to get some questions answered by our doctor, not by a substitute doctor (such as, “So, like…do we need a birth plan?”), and were told that because the doc was running so late our questions would have to wait.
Dudes, this is our first kid! And I have diabetes! And this baby is coming out of me in three months. Do you know how freaked out we are?! We need a plan and we need to talk about it. Stat.
I was not feeling very “well” in that moment.
We took some deep breaths, realizing our questions could wait, and got on to looking at ultrasound pics and getting the doctor’s two cents about how the kiddo was growing.
“Everything looks great, except for this one number here,” the doctor said while circling a percentage on the ultrasound printout. “This is how we measure how big the baby is.”
The number read 85.8% which means that T-Rex was about 2.2 pounds last week, (26 weeks) which is where he should be this week (closer to 28 weeks).
“At this point, the doctor explained, “we really like to see this number in the 70th percentile. The doctor then asked, “Have you been having a lot of lows?”
“Well, I did in the beginning, as you know, but I feel like I’ve been becoming more and more insulin resistant by the day.”
(At this point, I have pretty much doubled my total daily insulin dose, and my pump reservoir only lasts me two and a half days, versus the normal three and then some.)
The doctor explained that I have to be more and more concerned with blood sugar spikes—which is why doc was asking me about lows. Staying low-ish is great for A1c purposes, but not good when you go too low and glom eight-bazillion carbs and spike up to over 200 mg/dl afterwards—even if your A1c reflects awesome average blood sugars. In addition, (and as I mentioned) I have been more and more insulin resistant—especially around meals, and especially at night—which for six blessed months has not seemed to be a problem. Spiking after meals means that T-Rex might be sucking up too much glucose and well, getting a little chubby around his midsection, which is the measurement that read at 85.8% last week.
So, part of me is freaked out that I am chubifying my kid, and the other part of me is saying “All will be well, Kate,” which is one of my mother’s favorite sayings, because I am doing everything I can to the best of my ability.
But…have I been doing…everything?
It’s true: I haven’t been exercising as much as I could be, mainly because I go so low when I do anything besides walk, and then just need to eat more. At this point, I don’t want to eat more because of the risk of spiking, and because my belly’s real estate is at a premium on my small-ish frame, and I get really full really quickly. Plus, a new pregnancy thing is acid reflux, and when I eat too much…it’s just all…ew. Point is, is not exercising as vigorously causing some kind of un-wellness for T-Rex and I? Perhaps I will try and haul my butt out of bed earlier so that I can exercise a bit when I am most insulin resistant: in the morning. But, if I am up half the night with acid reflux, or from T-Rex starting his own aerobics at three in the morning, what’s better: rest or exercise?
It’s also true that my sister had two very healthy nine-ish pound babies (and she’s much smaller than I am), and my sister in-law (who is married to my husband’s brother) had a very healthy eight and a half pound baby, and both my husband and his brother were around 10 pounds when they were born. Is T-Rex bigger because my blood sugars have been like a kid-size runaway train roller coaster, despite staying mostly between my Dexcom thresholds? Or, could he be growing bigger because of plain and simple genetics? Should I be freaking out? Is this un-wellness or is this, genetically speaking, right where T-Rex should be?
I won’t lie: I felt, and still feel, a little defeated after that last appointment. I felt unwell, and not motivated or excited about the third trimester. I felt like the light at the end of the tunnel was a loooooong way off. I don’t feel as though I could be anyone’s poster-mama; most especially my own child’s, which is just devastating. I took a few days off from keeping written logs because I just didn’t want to see the numbers on paper (and metaphorically hear them screaming at me), and just relied on my meter, Dexcom, and the pump to tell me what was going on (and trust me, that was plenty of numbers to look at, consider, and “listen” to). After a break this weekend, I felt I recharged enough to face the written log/pump log/Dexcom log music again, and am looking forward to talking about all of this with my endocrinologist this coming Friday. (I thought I would hate biweekly appointments and see them as a waste of time since I was going to be a diabetic-pregnancy rock star; now I am realizing there is a very real importance to them.)
I have been in touch with my endocrinologist already, and I think she picked up on my freak-out hypothesis that I am growing a ginormous T-Rex. She reassured me that both genetics and blood sugar control contribute to a larg(er) baby, and that we all “do the best we can.” I have to keep reminding myself that I am doing everything I can be doing all while staying sane, working full-time, managing some other big life changes other than preparing to have a child, and, most importantly, staying well each and every day.
Wellness and pregnancy does mean awesome A1cs, and staying within tight blood sugar ranges, but it also means enjoying slower and slower walks, deeper and deeper breaths, laughing a bunch at the fact that my husband now helps me tie my shoes, taking naps, and knowing that I am trying—valiantly—all the time even if numbers on paper don’t reflect triumph.
Actually, wellness means all of that that all of the time.
Trying at any measure is wellness.
Trying is triumph.
And, if pre-parenting has taught me anything thus far, it is that you never stop trying.