Saturday, March 5, 2011

Prenatal Visit #3

My third prenatal visit went well enough.  The best part was when the nurse was trying to get a count on the baby's heart beat with the Doppler.  We heard it clear and strong last time, but I really got a kick out of it this time because the baby was on the move!  She'd find the heart beat, then it would just vanish and she'd be like, "Oh, you're just gonna kick away again, huh?" and start moving the Doppler.  This went on for a good 5 minutes, and she asked, "Are you feeding this child sugar or something?!  It won't stay still!!!"  It just makes the baby a little more real and interesting to know (s)he's moving around so much in there, even if I can't feel it yet.

The heartbeat was good, my belly measured at 17 weeks (I'm at 16 weeks), and I gained an appropriate 1 pound (in about two weeks).  I asked her at what rate I should gain since I'm already overweight, and she said it's the same as with any woman: anywhere from 1/4 pound to a pound a week.  She said 1/4 pound a week would be ideal, and I said that I'd really like to avoid gaining more than I need, so I'm going to think of 1/4 to 1/2 pound a week being right on target.  I don't feel like I need to worry too much, actually.  I let myself eat more than before pregnancy, but I think I keep things reasonable simply because diabetes means I can't mindlessly eat half a bag of chips or something.  I'm very conscious of every little thing I put in my mouth, so I don't think this is going to get away from me.

There was an interesting moment where that gulf I sometimes feel between me and someone without diabetes opened up.  My blood sugars have been mostly good, but I had one really crumby day on the two-week log I brought with me.  My OB asked about the high I'd had after brunch, and I explained that I'd had pancakes at diner without nutritional info, and I could really only chalk it up to those pancakes being higher in carbs than the "average" I looked up for their size (plus the fact that non-wholewheat pancakes tend to cause a bit of a spike for me, anyway).  She continued to look at that day and noted that I'd gone quite low (42, I think) after that high.  "And what happened with dinner?"  I had to pull my food log out for that one, because nothing about it stood out in my memory.  It turned out to be a meal I made at home with a known amount of carbs and a pretty reliable track record, but I went up to 160-something afterword.  But when I'd started eating, I was still in the 60s while recovering from that 40s low.  So I said, "Nothing happened, I knew the carbs in that meal.  I probably just went high because of the low.  My body can still have a glucagon reaction to a low sometimes."

She looked up and blinked in a way that made it clear she was really processing this statement.  That's when I felt that she was looking at me over that gulf.  I realized she probably technically knew this stuff, that the body makes glucagon to bring up a low blood sugar and that function isn't 100% gone in diabetics, but she's never lived it.  That 160s blood sugar was barely a blip on the radar for me because the cause was clear, so I just bolused to bring it down and moved on.  But as someone who is neither diabetic nor an expert in diabetes, she just saw a number and wondered what I did to cause yet another high.  She didn't see the pattern like I did without even trying.

I'm no expert in diabetes when you compare me to a veteran who's had it for years or a specialized health care provider, but managing type 1 diabetes for the past 10 months made me the expert in that room even though I wasn't the one with the medical degree.  It's amazing to look back to the first week after diagnosis and remember how little I really understood about my new treatment.  I've come such a long way in less than a year.

1 comment:

  1. Hi -- I also had a pregnancy with type 1 diabetes. I was 38 years old at the time and it was my third child. I'm going to give you the link to my blog so you can see what I've written. Has anyone looked at you with horrified eyes as a result of having seen the movie "Steel Magnolias" with Julia Roberts?