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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. 

It's a long way down from here.

Comments

If ever you were tapped inside my brain, Kerri, today is the day. GREAT post! I wish I had a Joslin Pregnancy Clinic!! It sounds like a great place to be!

Good Luuck Kerri, I know you can do it!

I need to be held accountable as well, which is why I had a weekly call set up with my doctor. I would fax my numbers in once a week and she would call Friday at 4. It was the first time ever that I had such constant feedback, and it allowed me to stay around 5.8 for the entire pregnancy.

You can totally do this. And once you ARE pregnant and then a mother, you will keep doing it because it won't just be for you. It's amazing what we can do for our kids, even the ones who are no yet born!

Good for you for recognizing the help you require and then demanding you get it!! You'll do great. Your future baby is one lucky little (insert gender here.)

Oh my God! I had that same conversation with myself this morning. I have an appointment with the Dr next week to start my new venture, "pump therapy". I log,prepare,monitor,log prepare, monitor. Then knock-knock where did I go? Then I get frustrated and feel that I have failed. We just need a good swift kick in the ass..:), and your blogs are my as.... kicker.

I stubbled on your blog through tu diabetes. I check your blogs almost everyday and your blogs are my inspiration for success. Thanks.

Diagnosed at 17 this is my 37 year.

You can do it, girl!!! Go, go, go!!! We're with you.

Good luck! I have to tell you that I get a huge kick out reading your blog. I do not have diabetes but my boyfriend does and it is wonderful to read about your experiences and know there is this amazing community out there. Thank you for sharing your life with us.

YOU CAN DO IT!!! You're gonna be the best mama!

Kerri

Let me know if I can help. Maybe an occasional tweet to cheer you on. Would that be #godiabetes?

Kerri:
YOU CAN AND WILL DO IT!
Kelly K

I'm so proud of you for demanding the accountability you need. And I'm thrilled that they listened and are finding ways to keep you on track.

Now, is there anything I can do to help? Want to block out some time to go for walks together on a regular basis? How about some shopping therapy to relieve stress? Come over and have Pete grill you up a healthy dinner? Just say the word. Because really, we diabetics are all in this together.

I had the best control when I was pregnant with Maya and my CDE wanted to review my food/BS logs every week. I need to be held accountable, too. Good for you on "making" them listen to you.

Best wishes in following through and getting pregnant. Sounds like you will be a great mom! I work for http://www.icyou.com. icyou is a user-generated website for health care videos. Thought you'd be interested in this video we have on our website: http://www.icyou.com/topics/diabetes/c-sections-and-diabetes+

Best wishes!

You can do it!! I know we can all relate to having the best intentions & somehow managing to wander off course but I just know this is your time! You've got a great support team behind you & I know you can do it!

You are going to do GREAT! Because you are smart enough to know you need help. You give me the courage to ask for help if I need it.

You can do it and you will do it!
You're going to be a great mother.
I wish my brother had 1/1000000 of your commitment to himself regarding the diabetes management.

If you find that three weeks is to long then break it down to a week, a day or an hour.

Whatever works and keeps you on track!!

Good luck! I'll be waiting to hear about your success.

go kerri GO! we're all rooting for you! i need to start doing this...while [my] chris and i aren't going to have kids for another 3 years, when he's out of pharmacy school, it's never too early to start.

You took the first big step by admitting you need help staying focused. I hope you realize that because that's huge! You can do it Kerri but if you have any doubts along the way, just think of all the people rooting for you that know you can "Kerri! Kerri! Kerri!" :)

Hang in there! This is hard to put into words, but I understand your frustration about having a hard time staying motivated. I understand it's got to be tough when you aren't pregnant. When you are, you go through the stages of being sick, starting a belly, growing, feeling the baby kick, and more. Going through those stages often keep you motivated and are a constant motivation to you to keep on track. I applaud you for doing what you are doing. It's tough, but your awareness and desire will be a lot of your motivation right now. Hang in there and don't beat yourself up over a bad day or two.

Yes you can.

A journey of 1,000 miles begins with a single step. - Lao Tzu

And great Block Island picture. Love that beach. Was there 2 summers ago.

I know you can do it Kerri!
And look at all the wonderful people who are rooting for you.
I'm sending you many positive thoughts and prayers.

Of course you will Kerri, of course you can. The greatest thing about your whole post was that you asked for what you needed. Marvelous. That's the first step you know, ask and you shall receive. The support you need will be there. Proud of you for asking for the extra help.

Kerri,

Your honesty and willingness to be so vulnerable are truly inspiring.

How about if you post how you're doing on a regular basis and ask your blog readers to be part of your accountability team?

Kerri:

You have been such an inspiration to many. It is time for us to inspire you. You CAN do this. You will be blessed, promise...

You're going to do awesome. As you know we're in a similar place now, but my role in the baby-making process is decidedly less complicated. I know it's not easy, but you're doing this for 2 great reasons...for your health and the health of your baby. Good luck, and remember we're always here if you need help (or someone to complain to)!!

Do you have a post around here of what you expect your pregnany to be like? That would be something interesting to write down, and be able to read later...for you, I mean. Part of me is applauding you and all of me is cheering you on. And there's a small eensy part of me that is hoping you will be able to enjoy your pregnancy. I did...and I found, that without going horribly out of my way, I had better control and better A1Cs through the entire 38 weeks. It's natural to want to, need to protect your baby, to check BGs more often, to eat better, to stay as active as possible. I'm positive you're going to do great. You don't have to be perfect to have a perfect baby. It's true. You could be a nondiabetic and still have a ten pound baby... :-0 Ack! Knock on wood. :D

Don't forget to enjoy the getting pregnant part. ;)

thinking all kinds of good thoughts for you my dear!

o Kerri! so many, including me, are behind you in support and encouragement! we are cheering for you and will celebrate with you your successes. i learn so much from you!

You can do it!

This is exactly my problem, too. I know exactly what I need to be doing. But it seems like as soon as you get one habit down another one slips away.

I can test often, record the results, plan healthy meals, count the carbs, correctly dose insulin, and exercise. But not all at once.

Good luck wrestling the hydra!

Good luck Kerri! My thoughts are with you.

I can completely relate to this post. My hubby and I are "allowed" to start trying NEXT MONTH!! YIKES and I still don't feel ready D-wise.

I start strong and then quickly lose steam...its very frustrating but I am trying very hard. I wish we had something like the Joslin Clinic close, it sounds like an amazing support system to have. :)

I'm so excited for you. You totally CAN do this. I had much more stress in the planning stages than I do now (25 weeks pregnant). It's a lot of work, yes, but it's so much better than I expected it to be. Constant contact with my endo (and insane logging of BG/food/activity/insulin doses) has made it rather stress-free. And I don't beat myself up over the numbers game - it's not perfect, but it's darn good with so many watchdogs out there for me. Completely possible and FUN! I'm rooting for you.

I'm sure you and Chris will do a great job!

Can't wait to read the post where you tell us all that you are pregnant!! We know it's coming soon because you can do this :)

If you need another type 1 momma to hold you accountable, I VOLUNTEER!! My Rx for test strips is still for 15 strips a day, left over from both my pregnancies. The round beautiful belly will be yours. test, test, test, correct correct, micro-manage, fine tune. A1C's in the 5's will be yours. Seriously, I am stay-at-home mom to 4 year old and 7-month old, and I would love to help you in any way I can!!!

Just wondering why you don't consider using the integrated CGMS that MM offers? I was just thinking that you could throw away your logbook and look at trends in a zillion helpful ways when you can use Carelink? I love, love, love it. It makes life so much easier not to have to record and truly I cannot imagine it is more difficult to use especially with the many reports your endo can generate. I know you gave it a short try but perhaps if you want to really hone in now for pregnancy you could reconsider. No...I do not work for them...I just really like having those tools at my fingertips.

Such a brave thing to admit to Kerri! It is so hard to even KNOW what your (and I mean, like mine and ours, etc) weak points are, much less fess up to them.

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