A Diabetes To-Do List.
I stood there with my best friend as she rubbed her pregnant belly. The whole waiting room was filled with these lovely women and their round beachball bellies of varying sizes.
And I felt oddly self-conscious with my lack of roundness.
Last Friday was my first official appointment at the Joslin pregnancy clinic. It's located at Beth Israel in Boston and is a beautiful hospital, different from the Joslin Clinic across the street that feels like home at this point. I'm not pregnant, and we aren't trying to become pregnant YET, but this appointment puts things into full swing to bring me to a safe level of pre-pregnancy health.
Sigh. This all sounds redundant, even to me. I've talked the Big Talk before. "Oooh, look at me! I'm going to really wrangle in my numbers and have an A1C you can bounce a quarter off!" And I'm all gung-ho for a week or two, armed with my little log book and my good intentions, but within a few days, Other Things start to creep in. Like work. And stress. And getting to the gym. And social stuff, like hanging out with my friends and going to RI on weekends. Eventually my good intentions end up in the spin cycle, and my log book starts to gather dust. My workload piles up. And my stress levels skyrocket.
I'm so frustrated because I want to have a career. And I want to have a baby. (I'd also love some tight control of my diabetes, too.) These things would be excellent, but it feels like tightly managing type 1 diabetes is a full time job unto itself. Slacking off is easy, and frustrating, and not healthy for me or any baby I'd like to have.
But I also realize this is one of my biggest hurdles when it comes to pregancy planning - the whole "sticking with the pre-program." This becomes more and more obvious to me when I go back and re-read old blog posts where I'm so excited to get back into better control, only to be derailed by those Other Things. So during the course of my appointments on Friday with the endocrinologist, the registered dietician, and the certified diabetes educator, I admitted my faults freely.
"I need help being held accountable."
They didn't quite hear me at first. "We can do some tweaking, and in a month or two, we can revisit your A1C and see if it's lower and then we can give you the green light for pregnancy."
I knew I needed more than that. I had to be completely honest.
"Guys, I really need to be held accountable. I know this sounds crazy and I seem very compliant, but I have trouble following through. I'm great out of the gate, but I lose steam after a few weeks and I'm at the point where it isn't good enough anymore. I'm out of excuses. And I'd really like to join the ranks of those pretty pregnant ladies out there. Please help me?"
And they listened. We spent the rest of the day working out a plan for me. One that will actually make a difference. One that will get me there.
I'll be in Boston every three weeks until I'm pregnant. This is a huge commitment but I need to make diabetes a priority without fail. I want this. I want to succeed at this more than anything else. I'll have my blood sugars logged for those three weeks and we (my husband and my diabetes team and I) will all review them together. Chris is in charge of my meals, in that he'll be helping me plan my day, food-wise, and he'll be counting carbs and measuring things for me. I'll be eating relatively similar items every day so I can manage the trends and control them. I'll continue to test all the live long day and wear the pump and the CGM, but I'll actually use these devices to their fullest potential, instead of just going through the motions.
With these appointments spaced just a few weeks from one another, I hope I can stay tuned in to intense diabetes management for three week stints. Being sent out for three or four months is too much for me. Obviously, because I burn out well before my follow-up appointments. I just plain can't pay rapt attention for that long. But three weeks? Can I do that?
I have to do that.
I will do that.