Guest Post: Pregnancy, Miscarriage, and Type 1 Diabetes.
Today's guest post comes from my dear friend Kate Boylan, who has experienced a journey with diabetes, pregnancy, and miscarriage. I'm grateful that there are people like Kate who put it out there like this, even when it must still feel raw. I hope there's some healing found for her in sharing.
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“It has absolutely nothing to do with diabetes.”
That is what the renowned Boston-area high-risk obstetrician reported to me and my husband right after she told us that I was miscarrying my first pregnancy. She went on, “Based on the irregular heartbeat, and the lack of growth in the last week, I am almost positive that this is not a viable pregnancy.”
The pregnancy I had been dreaming about being “viable”… well, forever.
Also: “Viable.” It’s kind of a harsh word especially when talking about life, no?
The pregnancy was almost a little too perfect: I’d been told from my endocrinologist and myriad other doctors that I was the picture of health for about a year. I started a new job this September that finally paid a solid, professional salary commensurate with my experience and master’s degree. We were still able to finagle our trip to Ireland, Scotland and England that we had been planning for years in October. I turned 30 on that trip and celebrated with wonderful friends. After getting home and easing into the new job, we thought, “OK. Now’s about as good as a time as any to try not trying to not get pregnant.” (That’s a whole heck of a lot of double negatives: point is, we would try not using birth control and see what happened.) We didn’t want to get all stressed about trying, so, we just let things happen without really focusing on what could conceivably (bad-dum-ching!) happen, or not happen. And, well, pregnancy happened pretty much immediately.
After a few weeks of serious PMS symptoms, it dawned on me that this might not be my wacky cycle being later than usual (thanks to genetics, and maybe diabetes—who knows?—my cycles are typically around 40-45 days long). It was the night before Thanksgiving, and being tired and cranky and questioning why on earth I offered to host Thanksgiving when I was tired and cranky, I went to CVS on my way home from work to pick up a few pregnancy test kits. I bought two different kinds, because, I don’t know. Why not “be safe”?
I got home, and used the first kit. And, then I used the other kit. (I thought to myself, “Oooo! This kit turns pink when you pee on the stick!” Sometimes, it’s the small things in life.) And, after waiting the prescribed 30 seconds or five minutes (I just know it felt like nine hours), both of them had very distinct “+” signs indicating “PREGNANT,” according to the directions. I called my husband.
“Hi. Where are you?”
Something in my voice apparently set off the pregnancy alarm bells.
“Are you pregnant?”
“Uhhh… Yes. It would seem that way. Can you come home?”
Again: almost too easy. Too good to be true.
I called my endocrinologist’s office immediately. Then my regular OB/GYN. Then the high risk OB/GYN. Then my PCP. I got many congratulations, and advice, especially from the endocrinologist about what my blood sugars should look like, and adjusting my basal rates to help me get to staying between 75-95 mg/dl all the time. Thanksgiving happened along with many, many naps, and my husband and I started thinking about moving, the baby’s room, names, schools, and momentous occasions to come with our growing family.
After two grueling weeks, it was time for the first ultrasound with my regular OB. “Ok, so according to your last period, you should be at about eight weeks one day,” Dr. K. said. She then pressed on my belly with the wand, kept pressing and digging and trying to move "things" around. She kept saying that my uterus was flipped back, which was totally frustrating, because: really. What does that even mean? I asked her, and she explained something about my bladder being full and that it would be "upright" at ten weeks. I felt like I was Liz Lemon (yet again) with her misshapen and "uninhabitable" uterus.
The doc left and came back a few times, which only freaked me out big time, then finally came back in and said that she made me an appointment for an internal sonogram (so much fun!) the next morning when they would be able to get a clearer picture of everything. We then got the listeria talk, the Downs Syndrome risk talk (it's awesome being two months over the 30 threshold), and the "I'm very hopeful everything is fine, given your symptoms" talk. We agreed to talk post-sonogram in the morning, and my husband and I left relatively silent, but hand-in-hand to have a quiet, reflective night at home.
I could barely sleep that night since all sorts of terrifying scenarios were playing in my head, and I bolted out of bed to shower and get up and out the door in the morning. I go to the radiology lab (my husband couldn't come with me because of work-related travel), and take a deep breath as things "get started." (Being a woman is SO MUCH FUN.) The radiology nurse explains that it looks as though I am about five and a half weeks along, and that I wouldn't be able to hear a heartbeat until at least six weeks. The radiology doc comes in, and explains the same thing, suggesting I come back in a week. So, somehow, I did not absolutely wig out, and made another appointment and went to work.
Then I get a call from my doctor, who explains, again, that it looks like I am five and a half weeks along, and that she is not very optimistic given how long I have had symptoms and given we thought I was about eight weeks along. Dr. K. said, "The chromosomes probably didn't line up correctly. When I say that conception and the manifestation of DNA is like origami, I really mean it, Kate. Everything has to line up and be perfect. This isn't anything you did; be sure of that." Then she explains, AGAIN, that the only way to be sure was to have another sonogram next week to see if things change, given that there is a slight chance the dating of the pregnancy could be off given my wacky cycles. If they don't change: it's a miscarriage. If not, then, well, life is good. Plain and simple.
The next week, I had another sonogram indicating I was at six weeks and one day. Dr. K. noticed I would see the high risk OB the next week, and said, “This is good news! Since there was growth, let’s see where you are next week.” And then I saw Dr. T, the high risk OB/GYN, that next week, and well, you’re up to speed. I had a one last sonogram to make sure I was miscarrying, which confirmed internal bleeding and an even slower heartbeat, and then dilation and curettage just before Christmas.
That was it.
I can't tell you how many questions I have asked myself, and thoughts I have gone over time and time again, "Was that extra glass of wine when I must have been days pregnant necessary?" "Even though I have been kicking ass with checking and blood sugars, I did have that crazy 395 six weeks ago. Might that have effed with the chromosomes lining up correctly?" "Even though I have been kicking ass with checking and blood sugars, I've been waking up over 100. Did that cause a miscarriage? How does that bode for the future if we want to try again?" "I sit with my laptop on my knees with my legs up. Are microwaves a problem?" "Did I not catch a low in time?" "Dammit. I should have looked into getting a Dexcom MONTHS ago. What if I am high and low and don't know it?"
It's heartbreaking, and I can't help but feel like this is indeed my fault. Dr. T’s words of “This has absolutely nothing to do with diabetes. Your A1C’s are perfect—they are what really matter, and you have done everything right” play on a constant loop in my head daily. I can say for sure that I did everything to the best of my ability, but I still feel as though I have failed in some way. That my body failed me again.
Isn’t a life with diabetes enough, Universe?
It is weird to think about the fact that I am in perfect health, and that “this has nothing to do with diabetes.” EVERYTHING in my life has had something to do with diabetes for 26 years. How could something so integral to my every day really have nothing to do with why this pregnancy didn’t work? It just seems so unfair. I kind of want to blame it on something, and diabetes seems like a perfect go-to. I understand, and am glad that the medical community thinks I am in great control and that it may very well be true: it might not have had anything to do with diabetes. It’s just such a huge conundrum that goes against thinking that I have had for almost my entire life.
So, like trying again (and again, and again, and again!) to beat the lows and highs of diabetes, my husband and I will actively have to try again for there to be a next pregnancy. I will keep trying my darndest to be “the picture of health,” and even though I am just about ready to give up and not care, I hope that the Universe has some good, healthy things in store for us. As Yoda wisely said, “Do or do not. There is no try.” Well, as much as I love our short green leader, in this case, I will “do” trying.
In a way, it has everything to do with diabetes.
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Kate has been living with type 1 diabetes since the age of four, and currently lives in Boston with her partner in crime, "The Hub." She's self-described as: "... wayyyyy into music, I try to maintain being athletic and stuff; I love food and cooking and good red wine, and single-malt scotch nice and neat, and baking, and art and museums, and movies and film theory, and libraries and old books, and family and friends and traveling everywhere and people. Whew, right?" You can connect with Kate through her blog, Tenaciously Sweet.