First Major Ultrasound

We had the first ultrasound today, other than the quick peek they took at my first prenatal visit when the baby was about the size of a peanut. It was totally fun to watch, but let's get the big part out of the way first:


The doc said, "Everything looks great."  *sigh of relief*

The size is right, resulting in an estimated due date at August 15th.  That's a mere 3 days earlier than the due date my OB gave me based on the date of my last period.  He did a great job of explaining what he was looking for regarding abnormalities, and confirmed that everything he saw pointed toward normal development.  He wants to see me again in six weeks so he can get a better look at the heart after a little more development, but said it currently looks great, too.

On to the fun stuff:  It's a boy!!!  I had actually suspected as much, because I noticed some of my body hair getting a little more noticeable and remembered my mom commenting that she'd noticed darker hair on her face when she was pregnant with my brother.  I guess it's all the testosterone it takes to turn a boy into a boy.  It'll have some effect on the mom, too.  Chad and I really didn't have much preference for gender (I've always said I'd love to have one of each), so the cool thing about knowing it's a boy is that we can really start working on names and pick out some boyish stuff for the registry.

He was a mover, too!  He kept kicking those little feet and thrashing those little arms, especially when the tech tried to get him to open up a hand.  This matched right up with his over-activity at the last OB's visit, while the nurse tried to get a count on his heartbeat.  He was just pushing himself all over the place!

We did have a little diabetes gem with the doctor.

Doc: So, tell me about your diabetes?  How long have you had it?
Me: I was diagnosed in May, so less than a year.
Doc: Uhuh.  And they thought it was type 1?  (Sounding skeptical.)
Me: Yeah, I was making hardly any insulin at the time of diagnosis.
Doc: That's interesting, because you're not the typical age to get type 1.  (Sounding even more skeptical.)
Me: Well, I'm not the typical age to get type 2 either, which is probably why my doctor decided to test for the type.
Doc: And who do you have as your endocrinologist?
Me: Dr. K.
Doc: Good.  (He finally sounded satisfied here, so I guess he trusts her judgement.)

After the doctor left the room, Chad gave me a patronizing look and said, "Are you surrrrre you're type 1?"  I could only shake my head and say, "Yeah, like they pass out type 1 diagnoses willy nilly to 30 year-olds."

This stuff is part of why I advocate; my pet cause is telling adults to never take it for granted that it's type 2 based entirely on age.  It's actually not uncommon for adults to get type 1 (just not as common), but even a lot of medical professionals are really quick to assume type 2.

Oh, and those 4D pictures?  Cool, but also kinda creepy.

(They seem to be extra creepy at this stage, because a baby doesn't have much fat at 17 weeks and so looks a little skeletal.)

It Looks Easy, Until You Look Closer

I recently had a moment when the gulf between me as a type 1 diabetic and someone else as a non-diabetic widened significantly.

A coworker started trying to figure out a food alternative for me.  She'd planned on pizza for a staff lunch, and I told her I couldn't eat delivery pizza and would just go pick something up for myself.  (Pizza isn't on some diabetic no-no list, but it's a tough food that doesn't work out for me.)  She immediately said, "Well, what can you eat?"

Enter another complication: my own fear of being an imposition.  I'm pretty much never going to say, "Let's get such-and-such food instead of pizza," in a situation like this, so I ventured, "Where are you ordering from?  I can look at their online menu and see if they have something like a good salad."

But she had no clue where she'd order the pizza from yet, and really just sought after a more general answer that would basically let her order like, "Hi, random pizza joint I picked about 5 seconds ago?  I'd like three pizzas, and do you have any salads?  OK, yeah, send a salad."

So I explained, "Well... it's just that I have to know what I'm getting, because I have to know how many carbs are in it."

So she asked again, "Well, what can you eat?"  And I think, fine, I'll give you a shot.  And I attempted to explain what, to me, has become a subtle and mostly quick process...

"There are a lot of factors, but it helps if it's not both high carb and high fat.  It's even better if it's not either."  Already her eyes started to glaze, probably from trying to think of convenient foods that are neither high carb or high fat.  "But the most important thing is that I know how many carbs are in what I'm eating, so I have to be able to either look up the nutrition or order something simple enough that I can make a really good guess based on the portion size."

Her eyes glazed further, and I knew it was time to stop.  She was staring at me across this great gulf of diabetes management that suddenly made me feel rather... separate and different.  I don't really expect others to know what my food and insulin involve, but I also didn't expect someone to look utterly at a loss when told the basics.  (And, honestly, I also wonder if she thought I was intentionally being difficult.)  So I let her off the hook (the hook she'd asked for!) with, "I can eat almost anywhere.  If you just tell me where the pizza's coming from, I can pick something else off the menu."

But she backed off of that hook even further with, "Why don't you just go pick something up?"  To which I gladly agreed.

The fact that this woman knew I'm diabetic and had eaten meals (which includes testing and bolusing) with me before yet seemed baffled by the simplest explanation of how I choose my food reminded me that, when I was first learning this stuff, I was so impressed by the people with T1 diabetes that I've known; they made all that stuff look so easy!  But the truth is that they'd simply incorporated it into their lives.  The decisions and calculations that were so new and awkward to me were just a part of their routine, so I had no idea how much went into them.  Had they started explaining everything to me (before it applied to me), maybe I'd have glazed over.

As I've said many times, diabetes management is doable.  I can do it, and you can do it if you have to (and I know some of you do!).  But it's still complicated and difficult, and even those people who make it look easy have a hard time of it once in a while.

(I wonder how my coworker would have reacted if I'd mentioned fast-acting carbs vs. slow-acting.  Her head might have exploded right then and there!)

How Much Disclosure?

I've started a new job... my first job change since diagnosis (aka, D-day). While I'm neither advertising or hiding my diabetes, I've had a couple struggles about how much to volunteer.

First of all, lunch time is more social. Today, a group went to a Chinese buffet. There are certainly some Chinese dishes that could be reasonably compatible with carb counting and a diabetic-friendly diet... but that doesn't really describe most food on a Chinese buffet. Plus, even if I found a couple acceptable items, OMG YUMMY CARBS ALL OVER THE BUFFET! Yeah, I love carby, fatty Chinese food. It would be very hard to resist the bad and hard-to-count stuff. So I did not join the lunch outing. I wasn't brokenhearted about it myself, but I do want to make a good, friendly impression with my coworkers.

Then one of the Big Bosses was handing out chocolate chip cookies from a bakery with no nutrition label. I could have looked up the "average" carbs for most chocolate chip cookies, but my blood sugar was already on the higher side... I didn't want to take the risk of miscounting and going even higher (or bolusing for both the high BG and the miscounted cookie, possibly making me go low). No thank you... but really, I appreciate it!

A few coworkers know I'm diabetic, and so does one of the Big Bosses, but I'm not in favor of labeling or limiting myself in their eyes. I don't care if everyone knows, but I don't always want to explain why I'm turning down a cookie today, but don't stop offering them to me because I really can eat them! Or that I'm not being snobby about your choice of lunch cuisine, I just find it very tough to eat Chinese food right now, but really, I can eat any kind of food! I'm just making a decision that is best for me today.

They're also putting together an emergency info list with everyone's important medical info and emergency contacts. This included any medical conditions that could be relevant. The "keeper" of this document is someone I'll work with pretty closely, so I went ahead and showed her that I keep a glucagon kit in my purse, in case I'm ever unconscious and someone around is comfortable enough to use it on me (and if not, then 911 is the answer)... but also followed that up with a disclaimer that, oh, I've never needed it, probably never will, because I don't want her thinking I'm going to keel over dead on them! I debated whether to tell her about the kit at all, but decided in the end that it's best for her to know in case there's a situation where 911 isn't an option.

Just feeling this stuff out... What's the balance? I want to be seen as independent and normal, but I also want to be safe and understood.

Nothing about this disease is easy.

Things I Hear

Things I hear from people, having been recently diagnosed with Type 1 Diabetes:

Did you have any symptoms?!?!

This is probably out of sheer surprise.  I'm at an odd age for either type of diabetes, and I wasn't clearly ill.  I have to admit that, at first, this question bothered me because I felt like maybe I should have gone to get tested far before I did.  Yes, as a matter of fact, I did have some symptoms... but I sure as hell never thought I had full-blown diabetes!  I remember one day thinking, "Why am I so thirsty lately?"  I also started getting up to pee in the middle of the night, whereas I hadn't needed to before.  And every once in a while, I lost a couple pounds when I expected to gain from all the sweets I'd been eating, but I attributed that to eating an otherwise decent diet.  Plus, I was hungry all the time and didn't have a lot of energy, which was especially frustrating to me.  But when you hear stories of diabetes symptoms, you hear that people drink gallons of water, pee every 30 minutes, lose 10 pounds in a week, and are flat out sick right before diagnosis.  After the fact, when I shared the above symptoms with my doctor, she was still surprised at the lack of obvious symptoms.  My dentist was also surprised by how well-hydrated my mouth was.  Go figure.

You're doing so well!

I hear this one a lot, from all sorts of people.  It means a lot from the people I know well.  For a while, I felt slightly uncomfortable hearing it from people I'm not as close to... Maybe because I felt they could have no idea how I was doing.  Did they really think I was "doing so well" simply because I showed up to work and managed to stare at the computer and not cry in front of people?  They weren't there for the time that I a cried over having to do 9 injections a day (before they got closer to my correct ratios), or miscalculated how much insulin I needed and made my blood sugar go borderline-low, or threw a genuine tantrum because I dropped my lunch all over our carpet after I'd already given myself my bolus insulin.  But hearing it from the people closest to me really matters.  I feel good that my mom is proud of me, and that my husband is impressed with the way I've adapted... especially since they've both let me cry and rant during my moments of frustration and self-pity.  It also means a lot from the members of my health care team, because I thrive on any sort of teacher-student dynamic and appreciate feedback that tells me I'm doing a good job.

This is a real, life-changing event.

People seemed quick to point this out at the beginning, often following it up with some sort of reassurance like, "But you can do it," or, "But you'll adjust in no time."  This statement has created the most conflict in me, because I just don't know what my opinion is on it yet.  Some days, I don't think it changes life that much.  I have a friend who is type 1, but I never would have known if it hadn't come up in a conversation.  Her lifestyle is very similar to what mine has always been.  Another type 1 I knew more casually had the pump, and that was the only sign of her diabetes.  But then, some days, I'm daunted by the idea of counting carbs and possibly battling the insurance companies for the rest of my life (come on Obama, get that health care reform moving!).  Some days, I'm terrified by the thought that my pancreas will soon be totally kaput, and then I'd die without my medication.  Some days, I read about other people's struggles to keep within their target range and worry that it will be that hard and time-consuming for me, too.  Yes, things are going to be different, but I just don't know what to think about how utterly life-changing this will be, yet.

I'm diabetic, and I can tell you you'll be fine.  Let me know if you need to talk.

I'm lucky to be receiving so much support from all of my friends and family, but I'm especially comforted by support and encouragement from people who are diabetic or who have a spouse/child/parent/sibling who is diabetic.  It's primarily that they're experienced in this, and yet they think I'll be OK.  It's so good to hear that.  Now that I know what a low blood sugar feels like and that I'm able to identify it before it gets really bad, my greatest fear is the major complications.  Hearing from diabetics without major complications eases the worst of my fears.  I really, truly, honestly intend to give myself the best possible treatment, and these people make me believe that it will be worth it.