Prenatal Visit #2

I had my second prenatal visit yesterday, exactly at the 12 week mark. Chad went with me and we got to hear the baby's heartbeat!  I loved that we got to share that.  His excitement just encourages my own.  :)

This time I met with my doctor instead of primarily with her nurse practitioner, which is who handled most of the first appointment.  All of my labs looked good, except that the proteins in my urine were in the upper range of normal for pregnancy.  She said there's not much I can do about that other than generally taking care of myself and my kidney's.  My A1c was 5.6, which is awesome and totally thrilled her because, at first, she looked at an older lab result that was 6.1.  I'm pretty stoked about a 5.6, myself.

She took a look at my blood sugar and I had a couple post-meal numbers that were higher than she wanted, but most of it looked great.  Her guidelines are slightly looser than my endo's as she's OK with up to 135 after meals (and my endo wants under 120).  She indicated that I should definitely stick to my endo's guidelines, but that she just wasn't worried if I came in a little over 120 sometimes.  So, cool, that's good to know even though I'll still aim for below 120.

Talking about the possible effects of diabetes on my pregnancy, she wasn't discouraging.  She commented that there is a "slightly higher chance you'll have a C-section, but that does not mean you will have one."  She also said that placentas tend to "age faster" in diabetic mothers, but that has to do with higher blood sugar so the better I control it the better off my placenta will be.  Because of this, and probably because I'm statistically at a higher risk of a lot of other things just based on my diagnosis, I'll be having more ultrasounds than average and they will all be with a doctor who specializes in "fetal medicine & maternal medicine."

The only slight concern she seemed to have was that I've lost half a pound rather than gaining anything (though I'm betting I may have been a tad less hydrated than usual).  I'm supposed to go by next week just for a weigh-in, and I'll be faxing her my blood sugars every week now.  She commented that she may "tweak the settings" on my pump if she has any concerns... I didn't say it, but any "tweaks" she tells me to make are going to go through my endo before I apply them!  It's not that I don't trust her, it's just that it makes the most sense to have the doctor who specializes in my disease treatment make the decisions on that treatment!

In other news, I have new prescription coverage that only covers three glucose test strips a day for type 1 diabetics.  Three!!!  My endo's office is pretty sure they can get "prior authorization" for more, especially considering my pregnancy, but I'm still just aghast that they wouldn't automatically cover at least six (preferably eight) a day for a type 1. Do they think we never need to know our post-meal numbers?  Or that we never have low or high blood sugars that need to be confirmed with a test before we treat?  Do they honestly not know what it takes to manage type one diabetes?  I mean, wow.