Friday, February 25, 2011

Moving Along Pretty Smoothly

I'm at 15 weeks, and I've been feeling better lately.  Not super fantabulous, but better, and I'll take what I can get!  I'm not getting random nausea anymore, I've had days of good moods, and I actually have some focus and energy every now and then (though I'm still more tired than before pregnancy).

Blood sugars haven't been bad.  Some weirdness and randomness continues and I'm not always in range, but they're not bad and I've started stressing a little less about them.  I still see them as vitally important, but I'm able to just bolus and go on without freaking out if I'm a little high.  (I did, however, have a recent restless night due to highs followed by lows.  I'm so glad to have Dex keeping an eye on my glucose levels while I sleep, but sometimes I want to just throw him across the room!)

One annoying blood sugar trend I've been dealing with is slightly low blood sugar immediately after eating.  More often than not, I'm right around 70 when I eat lunch or dinner.  So I bolus and eat, then watch my blood sugars drop little by little for a while, probably 30 minutes, and then it finally starts coming up.  Normally, no big deal.  60s aren't bad when you know you have carbs about to kick in.  But once in a while, it'll keep dipping into the 50s.  I'm not OK with 50s.  (On those occasions, I eat a small amount of fast-acting carbs then bolus for them once my bood sugar started on an upward trend.)  Because of this trend, I've started limiting the recommended 20 minute wait between bolus and food to if I am 80+ (or 90+, if my blood sugar is on a downward slope).

I do have a "baby bump" now, and will likely be wearing maternity pants to work pretty soon.  I'm still doing the rubber band trick for now!  Other people's reactions remain the most interesting part of pregnancy for me.  My mom got excited when I told her I'm almost ready for maternity pants, for example.  I also have a very sweet coworker who has made doe-eyed comments about my belly.  "Aw, Mama!" or, "It's beautiful!"  So, very sweet, but it still makes me feel very self-conscious!  I hope it's not too regular of an occurrence for the rest of the pregnancy.

The one weird thing that gets my anxiety up a little is I feel like there's a little tension between me and my OB regarding my diabetes monitoring.  First off, she commented that she might make changes to my pump settings if she sees things imy blood sugar she wants to change.  I just said, "OK," but the truth is that I really only want my endo (and me) to make those calls.  Anything she asks me to do, I'm going to fax to my endo for approval before implementing.  It's not that I think my OB will make bad calls, but rather that I have a specialist whose entire career is centered around the management of my disease.  She's the one who's most qualified to help me manage my blood sugar.

Second, after I decided that, fine, I'll do a monthly A1c test for my OB's preference in addition to the twice-monthly fructosamine tests that my endo feels are far more useful during pregnancy, I got a little attitude from her staff because I said I'd rather do the test at my endo's office instead of the OB's office (and then the results would get faxed to my OB).

(On the phone.)
Staff: Dr. L wants you to come pick up a slip and go to the lab to do a hemoglobin A1c.
Me: Just an A1c?
Staff: Yep, just a hemoglobin A1c.
Me: I go to my endocrinologist's office next week and they'll draw blood for a fructosamine test anyway, so I'll just call and ask that they also plan to do an A1c.  And they'll fax it to you.
Staff: *with clear annoyance* Dr. L doesn't know how to follow the fructosamine tests.
Me: Yeah, I know, that's why I just said I'd have them also do an A1c at the same time.  I'd really rather get stuck once.
Staff: *sigh* I'll tell Dr. L that's what you plan to do.

The honest truth is that I also don't want to get stuck at my OB's lab anymore than I have to.  They bruise my arm every single time, and it definitely hurts more than when I have blood drawn by the nurse at my endo's office.  Plus, getting it done in one visit means I don't have to spend the extra time or gas that it takes to go to my OB's building and wait around to have my name called at the lab.  This pregnancy takes up a lot of time!!!


  1. Glad you're doing well! I've never heard of the fructosamine test. I've not have my peris do that during either pregnancy. What exactly are they looking for with that? So glad you're figuring out what works for you :)

  2. Thanks you! :)

    The fructosamine test serves the same purpose as an A1c, but it covers more like 2 or 3 weeks instead of 2 or 3 months. I'm sure there are sites that will explain it much better than me, but fructosamine is something that builds up in your system in reaction to glucose.

    The problem is that the numbers are totally different than an A1c. Like my last one was a 230, and had to worked a little formula to figure out that it's similar to having an A1c around 5.5 or 5.6. And it's been around for a long time, but it's just not as widely used as an A1c (I gather it's mainly used when an A1c would be inaccurate for some reason, or when your insulin management is changing rapidly). My OB had never even heard of it before (neither had I!), and she totally brushed me off when I told her my endo had said she'd be happy to explain how to read and use it. She'd rather just stick to what she's familiar with. (Which I understand and have decided to just live with, but I'm not going into her crappy lab for anymore blood draws than I have to!)