Unexpected alignment with an MC Hammer song.
Unexpected alignment with an MC Hammer song.
Now, at the halfway mark of my pregnancy, insulin resistance is becoming a bit of a thing, and is going to progress into an Actual Thing as the weeks go on, which happened last time and I’m prepared for but it still a bit whoa and this sentence is a run-on.
Which means that basal rates are creeping up ever-so-slightly (my pre-pregnancy basal total was around 13u and I’m now up to 16.2u) and my insulin:carb ratios starting to dance (pre-pregnacy was 1:10, am now 1:9 … except lunch is 1:12 because why would things be consistent?). When I first found out I was pregnant, my endocrinologist told me that post-prandials contribute most to macrosomia, so keeping my post-meal blood sugars as in-range as possible would help mitigate that risk. (But let’s take a look at the risk list … pre-existing diabetes? Check. Over 35? Check. Previous pregnancies? Check. Having a boy? Check. Cool.)
The plan? Actively and aggressively pre-bolusing the shit out of my meals.
This sounds like an excellent plan, in a perfect world. Pre-bolusing works well for me when the bolus is delivered at least 20 minutes before eating, the meal is properly carb-counted, and nothing delays the process of eating. But one monkey wrench in that process can muck the whole mess up.
Pre-bolusing can feel spooky, like I’m tempting fate and inviting a low. Not doing it is like opening the door for a high. The middle ground could use some xanax.
Over the last few weeks, my pre-boluses have been executed with precision. A few fistfuls of jellybeans have worked their way into rotation when I’ve bolused too early, but that’s to be expected. The temp basal option on the t:slim is stupidly easy to employ, so sometimes I use a temp basal to help back me out of a mild low, but overall, I’ve seen my post-prandials come down nicely and hopefully my ultrasounds continue to show a very boring, predictable pregnancy progression.
Makes meals interesting, though. They’ve become a game of roulette.
“Do you think we’ll get seated right away?” Or, “I forgot to pre-heat the oven and now dinner is going to be 15 minutes later than I thought.” Or, “Fuck. I forgot to eat!”
I’m pre-bolusing all over the place. Usually it works fine. Sometimes I end up wicked low. But every time, it’s in effort to keep my post-prandials from causing chaos in my kid.
We’re a little over 20 weeks into this pregnancy, which means that I’m over halfway done baking (baking? brewing? percolating.) the new little Sparling. The last twenty weeks have been busy:
Doctors appointments. There are many of these. We started with the visits to the fertility clinic, where I had a lot of assessment visits and then, once we were actually pregnant, a series of progression checks before they felt comfortable releasing me to the wilds of a “regular high risk pregnancy.” I’ve seen my endocrinologist monthly since finding out about the pregnancy, my OB/GYN up in Boston every three weeks (approximately), my eye doctor once (with another exam on the books), a dietician once (this appointment involved plastic food, which was predictable and sad), and have appointments coming up for an EKG (for me) and a fetal echocardiogram (for the baby).
Having so many appointments is a blessing and a curse for my mental well-being. On one hand, it’s good to have all of these confirmation moments that the baby is growing well and that my health is holding steady. And in the event that something crops up as problematic, I’m glad I’m in the good hands of Boston doctors to help me see things through as best as possible.
But on the other hand, every two weeks I feel like I’m going in for a test, and these are not tests I want to fail. With so many milestones to mark and tests to take, it’s a constant reminder of how such a natural process can take unimaginable twists and turns. I feel like I’m in a cycle of gratefulness and panic, with little reprieve on tap until late summer. (When a new set of WTF and panic hits.)
Growth spurts. The baby is growing according to plan and is right on track. I, however, am growing much fasting in the belly department than I did when I was pregnant with Birdy. I felt like I was “showing” at 8 weeks, and now at 20, getting up from bed is not a direct bend but more of a roll. (In my mind, I look like a superhero rolling stealthly into a pose worthy of the movie poster, but in reality, I think I look like a dachshund trying to steady itself.) There’s a definitive belly going on. I had forgotten how quickly pregnancy changes my body, and it’s weird to look at photos from December where I look like myself to now when I look like a determined wrecking ball.
And it’s predictable, how infertility has shaped my view of my shape this round. With Birdy, I felt every bump of my expansion and worried about the change. This time, it’s weird how the itchy skin of abdomen expansion makes me feel unbelievably grateful.
Blood sugars. Diabetes was a pain in the behind last week, when highs came calling and refused to back down. But this is where I’m oddly thankful for my decades of diabetes experience, because I can be more nimble with my doses. Waiting to see my doctor to tweak my insulin ratios is ridiculous when my needs are starting to change every few days. I had forgotten about the increased insulin needs, but am reminded every few days, when a sticky 175 overnight on a Wednesday turns into the same thing on Thursday, which means a basal bump on Friday night because f*ck the bullshit.
But it’s working well because my A1Cs are exactly where I’d like them (for once), and despite highs here and there, I’m solidly in range the majority of the time, which makes me feel like the effort in is worth the outcomes.
There are still a lot of weeks to go before this baby escapes, so I hope I can keep the momentum and grateful-vibe going. Or, I may end up hiding in the closet with a container of Cool wHip until this whole thing is over.
Birdy. Birdy has named the baby. (We talked her out of Spiderman, laughed when she suggested “Peter Parker?” instead, and finally settled on a name that we plan to keep offline, per protocol.)
She’s excited to share her Batman bathroom, her frazzled parents, and her life with her baby brother. And hopefully she still feels that way after the first time he spits up on her.
On any average day, my glucose meter results are just mine.
… mostly. I worry about lows while I’m driving my daughter or traveling alone, but while a low might be witnessed by someone else, it’s my body that goes through the experience. (Not to minimize the experience of watching diabetes from a distance; that’s a whole other post.) The long-term influence of diabetes is still a process-in-progress, but on the whole, the individual meter results are mine to mitigate.
Right now, though, every number on the meter isn’t mine and only mine. These days, every high and low and all the bits in between belong to me and the baby I’m creating.
I take this job very seriously. It’s easier to play by every, single rule during pregnancy because there’s a definitive start and end to this process. 40 weeks marks the duration of an average pregnancy, which means that I need to be on the ball, knocking it out of the park, and other sports analogies for that timeframe. It’s important to plan ahead, if you can, and it’s important to keep at it once the baby is born, but diabetes is truly only shared in tandem for 40 weeks.
Which is why one stupid high is enough to send me into a spiral of panic and wtfuckery.
Yesterday, things got stupid for a few hours and I saw a number on my meter that made the string of curse words come easily. A pump site that needed to be changed and a Dexcom sensor that was repeatedly throwing wonky numbers and a pregnancy that is moving into the “upped insulin resistance” phase didn’t help matters. It took an injection of insulin and hours of frustration (because my body thought, perhaps, I had injected water instead) for the number to move in the right direction. The anger was intense. As was the guilt.
I know that days of highs, not hours, adversely influence a developing baby, but holy shit. This wasn’t just MY HIGH but it was OUR HIGH, and that left me feeling helpless. The best laid plains of NOD mice and women still had me higher than I wanted to be and higher than I felt safe being. I can deal with blood sugar fluctuations as a soloist, but bringing a baby into the mix makes me want to make my standard deviation less … deviant.
Eventually, the numbers started falling, and I cried – a wimpy, gross cry – when I saw the 74 mg/dL on my meter because it meant that I was back in the game. 23 weeks left to go, give or take, before diabetes is “all mine” again.
(Note: Crying is not limited to blood sugars. I also cried when the mailman asked me to sign for a package. Hormones are weird.)
Copyright © 2016 Kerri Sparling & Six Until Me. 2005 - 2016. All rights reserved.
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