Revisiting an older poetry post, recorded in my kitchen with a healthy dose of a Rhode Island accent.
Because we are resilient, damn it.
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.
When I asked folks in the DOC if they’d be willing to lend their voices and perspectives for a guest blog post, I was excited to hear from Susannah (aka @bessiebelle on Instagram and Twitter). Susannah grew up in South Australia and is now working as a lawyer in Cambridge, in the UK. She was diagnosed with type 1 diabetes during the course of her last year of high school (2000) and is currently using a Dexcom with her Animas Vibe insulin pump.
Today, she’s taking over SUM to talk about diabetes in the work place, and how to handle the moments when discretion is preferred but diabetes still needs attention, and she’s looking from tips from our community on handling diabetes in the workplace.
* * *
A significant aspect of my life with diabetes which I often feel is ignored is how it fits into my career. Diabetes goes with me to work everyday and has seen the highs (completing deals) and lows (being at work at 2am) of work and as well as sugar!
When I started to write this post about working life with diabetes I was armed with a list of anecdotes but I didn’t expect life to serve up another example of when the two worlds collide. One of the frustrating things that any diabetic knows is it can always throw you something unexpected.
After a seemingly average Sunday afternoon gym session Monday morning last week saw me battling a hypo that just wouldn’t respond (to glucose tabs, reduced basal plus bread with strawberry jam for good measure). With heart still racing and a foggy brain at 9am I emailed my boss to let him know I was somewhat delayed but I’d be in soon. Moments like this make me glad that I’ve been open with my boss about being a type 1 diabetic but also make me anxious that I will be judged as less capable because of it.
Am I the only one who feels like that?
The emotional side of diabetes creeps in too easily. After an experience like that morning I’m left worried that I’ll be judged because of it. Being late on Monday morning is the least of it… We all know there are the doctors’ appointments (6 monthly checks, annual reviews, eye checks, and other specialists – always longer than expected and involving long times in waiting rooms), hypos setting you back (sometimes only a few minutes, other times for much longer), pump sites pulled out causing hassle and even spurting fingers resulting in blood stained shirts! Some of these take up more time than others but they all intrude on what might otherwise be a normal day in the office. Something that I’m acutely reminded of when I’m filling in my 7 hours of 6 minute units of time each day.
I fear hypos at work more than anywhere else. I don’t want to explain why I’m sweating at my desk like I’ve been for a run or to be faced by a deadline but struggling to gather my thoughts clearly. I don’t feel any more comfortable in this situation now than I did when I first started work as a law clerk 10 years ago. Luckily, for many years I had the luxury of my own office and the ability to shut the door gave a level of privacy when required. Recently, I moved to an open plan firm and I am having to reconsider many things I took for granted with a (glass) door… pump site changes at my desk are a thing of the past (cue a few panicked mornings hastily inserting a new site and refilling so that I won’t have to later). I’ve been lucky not to ever have a hypo in a meeting, but this is not without taking care. Meetings with clients or all parties to negotiate a document are a balancing act of starting the meeting high enough not to crash but not so high that I feel sluggish. (and that’s not considering the blood sugar spikes from stress).
Thankfully there are the comical moments – taking a draft document to my boss and having to explain the red smudges on the print out (after 15 years it’s fairly easy to squeeze blood from my favourite fingers… I tested as I typed this and got blood on cue!); being in a meeting with the same boss and having my pump alarm go off – after a quizzical expression from a colleague my boss calmly commented “Don’t worry, Susannah’s bra is ringing!” Needless to say my pump alarms are strictly on vibrate these days.
There are moments that call for advocacy whether I feel like it or not. In a previous job I was surprised when HR requested that I remove my spare insulin from the work fridge or alternatively hide it in a container so other people didn’t have to worry about ‘contamination’. Why?! To this day I haven’t quite figured out who raised the concern (or why?!) but I defiantly ignored that request (with colleagues’ support) and also politely explained to HR that it was not a risk to anyone’s sandwich.
I’m always interested to hear how others handle disclosure with their employers (as well as see photos of their diabetes supplies stashed in their desk), and am always surprised by people who manage not to disclose it. I’m yet to perfect my ‘I’m busy having a hypo so please don’t ask me a question face’ so disclosure is what feels best for me. It may not be for someone else (YDMV). In contemplating my days in the office I realise I have it pretty easy if the worst is getting blood on a contract! I’m in awe of the many people who manage their diabetes while being responsible for others (whether a mother, teacher, nurse or doctor, just to list a few).
How do you handle your diabetes at work? Any tips on how to stress less?
Copyright © 2016 Kerri Sparling & Six Until Me. 2005 - 2016. All rights reserved.
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