Thursday, April 18, 2013

And So It Begins . . .

This is another post about pregnancy and Type 1 diabetes, so if you're not into reading about either of those, consider yourself warned. :)

So, in my last post I talked a little bit about planning for conception with Type 1 diabetes, and how much of a pain in the you-know-what it was.  Turns out it was a piece of cake compared with actually being pregnant.

Initial Doctors Visits & Setting up My Treatment Team

I found out I was pregnant by accident, sort of. I actually got the stomach flu. Like, the I-wish-I-was-vomiting-instead-of-pooping-my-brains-out-for-three-days stomach flu. It was awful. I lost 5 lbs while I was sick, and have kept it off through my entire first trimester, and so far into my second. That, to me, is a little ridiculous, because before I got pregnant, my endo wanted me to try to lose 5 lbs, and try as I might, I could just NOT get if to come off.  Apparently all I needed was a teensy stomach virus followed by a pregnancy to do the trick! Sheesh! Anyway, I got better for a few days, and then about two days after I'd been feeling better I started to feel sick again. But it was a different kind of sick, and it made me suspect something else was going on, so on a whim I took a pregnancy test and it was positive!

I immediately called my OB and my Endo (this was on a Wednesday) and I had appointments for that Thursday and  Friday to confirm my at-home pregnancy test and to get my thyroid levels checked.  My OB took my A1c in the office, and said it was 6.2, which I was happy about. We talked about blood sugar goals, and who help would manage my blood sugars while I was pregnant. They were happy with my control and said that they'd leave things up to me unless things started to get out of hand and then they'd refer me to a maternal-fetal medicine group.

My first appointment with my endo was really fast, they just wanted to make sure my thyroid levels were  perfect, which they were, and we set up an appointment for a few weeks later to discuss how we were going to handle blood sugar management, etc.

Incidentally, at first my endo wanted to send me to a maternal-fetal medicine group to help manage my blood sugars. She said that this group has a bazillion nurses whose job is to go over blood sugar records and make adjustments for you on a weekly or bi-weekly basis.  I've heard of this group, and I think I had a friend see them when she had gestational diabetes, and it made me really nervous to go to them.  I know they'd probably be OK, but they are a big group, they (most likely) deal with Type 2s, gestational and and fewer Type 1s (simply because there ARE less Type 1s in the world), and it seems like they really like to micromanage your control. I didn't want to be treated like I had gestational diabetes or Type 2 diabetes, I didn't want them to make me see a dietitian (seriously, I know how to count carbs, people!) and  I was afraid they'd put me on a meal schedule or plan, and that was really scary to me. The Exchange Diet I had to use when I was a kid has kind of scarred me for life, and I was soooo nervous that if I went to that group I'd have 9 months worth of  a seriously rigid schedule to deal with. And if anyone knows me, they know that the more someone tells me to do something in a specific way or at a specific time, the less I am inclined to do it. Also, I really love my endo! She and her PA know me, they know my diabetes, they are compassionate and thoughtful, and I really wanted someone who was going to work with me to manage my blood sugars and not dictate to me how to manage things. I've had this disease for 20 years now, and it really gets under my skin when doctors treat me as if I don't know what I'm doing. I was scared that if I went to that other group, that's how things would end up. Does that make sense? Any way, I was scared.

But, after my first full appointment with my endo, when I was about 11 weeks along, when they realized how good my control was, I think they were more comfortable managing me. My A1C had dropped from 6.2 to 5.6  in a month (more on that in a later blog), and I was testing and adjusting things well on my own already. My endo decided that they'd be fine helping me manage things unless things got really wacky, and then they'd ship me off to this maternal-fetal medicine group.

So far things have been going well. I meet with my endo or her PA once a month, and in between visits, I upload my bloodsugars twice a week to Diasend for them to review and give me feedback on.  I'm extremely fortunate to have an endo that uses the latest and greatest in diabetes technology.  They use electronic medical records, to which I have personal access, and they have a system set up that allows me to e-mail them whenever I have questions or needs.  And I get personal e-mail responses back from them which is kind of unheard of.  Really, they are wonderful, and I think that is why this is working out so well so far.

The blood sugar goals my endo has given me are pretty tight. Even tighter than what my OB wanted, actually.  My endo wants my blood sugars to be under 90 pre-meals, under 120 at 1 hour post meal and under 110 at 2 hours post-meals. This is pretty hard to do, but so far I've been pretty successful.  The proverbial first-trimester lows have helped a lot of with that, but also making sure I'm not eating too many carbs at once, and getting some exercise after eating if I do have more carbs has helped a lot.  It's still scary. When I do have a "high" (which to me, right now is like 130 or 140 instead of 200), I get nervous that my baby is going to end up with six legs or something.  But, as a good friend reminded me once, I'm doing way better than people who smoke or do drugs or drink during their pregnancy, so at least I'm not doing that! Our bodies have an amazing way of protecting fetuses (yay for biology!), so as long as I'm doing my best, that's all anyone can ask for.

OK, that's enough for now! I'll be talking more about first tri-mester lows in my next installment. It will be riveting, I'm sure!

1 comment:

  1. You go! :-) Don't forget, even though you may be classified as a "HR" pregnancy, you don't HAVE to do anything. You know your body and your baby better than anyone else. If you do end up with the MFM group at some point, seek out who will have your back. Different dx obviously, but I've gone against the grain in 2 MFM practices now and it can be done :-)

    Congratulations and I'm so excited for you guys!