Before & After

I had my gestational diabetes class this week on Wednesday. I had written a post before the class on Tuesday and one after the class on Thursday. As you can see, I was not in a good place on Tuesday, but after the class, some much needed soul searching, and loving support from hubby, I am doing much better now. Here are the posts I have been meaning to put on here!

Before – written on 11/17/09
I’m really trying to find a good place in my heart for this. I struggle because I have a huge problem trusting doctors. I always feel like they are so impersonal, looking at my numbers against a ‘norm’, which may not be the norm for all people. I’ve heard horror stories about how insurance companies have a huge influence on statistics and procedures doctors use, that I am frightened that my care is not the best care for me, but rather for the insurance company. How does one start to trust what is going on?

I went from low risk, easy pregnancy to high-risk high-alert pregnancy in the eyes of my Dr. All with just a test of borderline numbers which say I have gestational diabetes. My first meeting with my diabetes nurse is tomorrow. It’s two hours long, they will go over meal plans and glucose testing. The nurse said that if I can’t control this disease with a meal plan and exercise, then I will have to start taking some pill. And if the pill doesn’t work, then insulin shots. This may not sound like a big a deal, but what woman wants to go on a diet when they are pregnant? What woman wants to be told to get in an hour of rigorous, yet not-too-rigorous, exercise every single day when they are in their third trimester? What woman wants to be told to eat at the same time everyday and check her glucose levels four times a day while holding a full time job? I know I’m freaking out because I keep thinking “What if I fail? What if I can’t control it through diet and exercise? What if my baby turns out to be macro size and I can’t vaginally birth it? What if they make me get induced too early thinking the baby is big which causes complications for my baby? What if the baby is still born? What if, what if, what if, what if?” My insurance doesn’t cover ultrasounds so I have to pay $330 every time they do one and with GD, they do a couple in the last month to check the baby’s size. I can’t afford $330 each time. What if I deny the U/S and my Dr. turns around and denies me care saying I am putting my baby at risk by not allowing U/S I can’t afford? UGH!

Plus this is all happening in the last trimester where things do get a little harder like sleeping, walking, heart burn, etc. Plus the holidays and my showers are coming up and I can’t partake in anything a person considered ‘normal’ will get to partake in. This sucks and I hate it. Change is hard, especially hard when you know you are eating for two. I was trying to eat a balanced diet, getting all food groups in and exercise, but I was also allowing my body to tell me when it’s tired, when it’s hungry, what it’s craving. Now I have to be a meal plan and exercise nazi and this does not fit into my idea of pregnancy. It causes me way too much stress and I don’t know why. Maybe it’s the constant “Oh I am so sorry to hear that” or the “I’m sorry you are dealing with such a bad diagnosis” or the “I’m sorry you are suffering from this disease”. Well, the only suffering I’ve been doing is mental, physically I’m feeling great, despite the occasional hip pain at night. I haven’t had any ‘symptoms’ per se.

I wish I could find a non-angry place about this. I hate it too because it’s a huge warning sign that I will have diabetes as I get older, or maybe this GD will never go away, it will just transform itself into regular Type II diabetes. I feel like such a loser, a diagnosis, a pre-existing condition, a number. I no longer feel like the beautiful curvy woman that is awed by the magic and wonderment of pregnancy and birth. A little bit of my excitement has been turned into dread. We’ll see what happens tomorrow though.


After – written on 11/19/09
The clouds have lifted and I can see the horizon. It’s a bit brighter than I thought it was, especially when I was in a dark place Tuesday. I went to my gestational diabetes education class yesterday which was held privately with a registered nurse and a dietician at the hospital, both very nice and empathetic women. The nurse went over the science behind all diabetes, Type I, Type II, and gestational diabetes (GD). The nurse gave me a glucose testing meter from Walgreens, which I need to buy the strips and lancets (pokey needles) for. She showed me how to do it. I have to test my urine in the morning for ketones, then test my blood before breakfast, 2 hours after breakfast, 2 hours after lunch, and 2 hours after dinner. It is a lot of scheduling. She also would like for me to exercise in the morning, take a half hour walk after lunch, and a half hour walk after dinner. More on my new routine later.

In looking at my numbers, they both agreed that I am borderline and this can easily be regulated through diet and exercise. The dietician looked at my food intake the past 5 days and said I was already doing relatively good. She rearranged eating fruit and yogurt to the afternoons and eliminated all candy. She said I could keep having my Kashi cookie and milk at night, I love those cookies! They keep me regular and it’s so nice to have a dessert at night. We also discussed the holidays. She said to just eat all day and not all at once, make good choices, take a long walk after the meal, and maybe forget my meter……. I was happy to hear that because I was scared about what would happen with the holidays and my showers coming up. At least I know what I can have, not have, and what I need to limit now.

As for a schedule. Let me just say Virgos do well with a schedule, however on the flip side we have a tendency to go crazy if they are not perfectly followed. We are perfectionists at heart and that is what I have been working on for many years now, letting go of the rigid structure and beating myself up for going astray or not following it. I have given myself enough flexibility to be comfortable. As of yesterday I had to introduce a very structured and rigid schedule that I have to follow up through six weeks after baby’s birth – apparently that is when the sugar levels should go back to ‘normal’. I wanted to share what this schedule looks like, I tried to find other women’s blogs and posts about GD and their schedules, but there wasn’t much out there. Maybe it’s from embarrassment because it is kind of embarrassing to say you have diabetes as a pregnant woman and have to follow a diet…….

Good thing is, they are not limiting calories, they are limiting carbohydrate intake and when to eat them. They said I was already pretty much on a good eating routine, which was nice to hear. The dietician said some women are scared to eat the carbs and they will bring in their schedules and food logs and not have eaten breakfast or just eat lunch and a snack in the evening. Nope, not me, I was trying to eat balanced anyway, plus exercise, so really, this new routine isn’t so bad, I just have to make sure to follow it, no matter what.

I sat down this morning and it took me a half hour to plan out my day’s worth of eating. It shouldn’t be that way soon, once I get used to knowing the carb counts and foods, I can do all the planning on the weekend and have everything ready to go. So here is a typical schedule they want me to follow, which is based loosely off what I was already doing – except for the morning exercise:

6am: Wake and check Ketones in Urine
6am – 6:30am: 15 minutes elliptical, stretch and some weights
6:45: Check fasting blood sugar and record in book
8am: Eat breakfast - 30 grams of carbs, plus protein
10am: Check blood sugar and record in book
10:15am: Eat snack – 15 grams of carbs plus protein
12pm: Eat Lunch – 45 grams of carbs plus protein and veggies and fats
2pm: Check blood sugar and record in book
2:30pm: Eat snack – 15 grams of carbs plus protein
5pm - 5:30pm : yoga, stretch, breathing
6:30pm: Eat dinner – 45 grams of carbs plus protein and veggies and fats
7pm: Half hour brisk walk
8:30pm: Check blood sugar and record in book
9pm: Eat snack – 30 grams of carbs plus protein

When someone has diabetes, any type, eating a snack in the evenings will help keep their fasting blood sugar from spiking over night. A person eats all day, however at night you can go without food for 8 – 10 hours, which is when your liver would kick into producing your blood sugar for you and sometimes can’t regulate as well as food and therefore, a spike in blood sugar will happen come morning. Interesting as I had never know that. So for most people a small late night snack is actually a good thing……..

As for the extensive amount of exercise, I will keep up the walking. With working all day, I will try to walk at lunch although that may not always happen because of meetings. My department has been really great about this, they are making it especially fun too because they are making sure I am eating my snacks and they think it’s cool how I check my blood sugar with the little meter. I totally was embarrassed all day, but they have lightened the mood. Plus we have a couple ladies in my team that have similar issues, they are either allergic to something or they have some health things they need to watch closely. I don’t feel so alone.

It’s a bit of a struggle and today I am feeling relatively positive. I know this will change with days to come and I will have bad days where it’s hard to follow the schedule and I’ll feel bad for going astray, but that’s something to work on. If the majority of days are done right, then I won’t feel so bad about a few bad days. I am anticipating what my Dr will say in two weeks, I have an appointment with her the day after my check up with the dietician and nurse. They will be reporting my numbers back to my Dr. I have a lot of questions and comments for her and I need some feedback from her. From what I’ve heard from two other woman that used that practice and also had GD, they are pretty good about being lenient and not too freaked out about it, especially if my numbers are good. They both gave birth naturally to 7.5 and 8 lb babies. That was some good news I had to hear!

This has been an adventure and an eye opener. I can remember my grandma checking her sugars all the time and her little book she had to write in. She had type II diabetes and had to take insulin shots. I think back to what it must have been like for her, she was diagnosed much later in life. I think about her a lot when I do this and ask myself “do you want to be doing this the rest of your life?” No of course not, but it is in my genetic makeup and what I can do now, will only help prevent it in the future.