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Oh, High!

I hope BSparl is going okay in there.Back at the Diabetes 2.0 conference in Florida in November, I was talking to Manny Hernandez about how evenly  my numbers were running due to the pregnancy.

"Dude, it's like a cure.  It's creeping me right out, but I am NOT complaining.  Whatever keeps this baby safest!"

Oh how I wish that was still the case.

The lows chased me all around the house for about five months, helping my A1C drop like a rock and keeping highs out of the rotation for approximately twenty weeks.  A blood sugar of 150 mg/dl felt HIGH (which was a far cry from the 250's I was sadly bonding with this time last year) and my low symptoms weren't kicking in at all (see also:  the 29 mg/dl without a whisper of a hint). 

Tomorrow I'll be in the 23rd week of my pregnancy, and the highs are back.  With a freaking vengeance. 

It started innocently enough - with some spiky numbers in the middle of the night.  Nothing chaotic, but 120's where there were 80's the day before, and they continued to climb a bit every day.  For about four days straight, I was waking up at 4:30 in the morning between 120 - 140 mg/dl, correcting back down to 100 mg/dl, and then the creeping would start again around 10 am.  It was like my body wanted to incubate BSparl at a steady blood sugar of ... 180?  NO WAY. 

After a quick chat with my endocrinologist (who told me, in no uncertain terms:  "Pregnancy is completely different.  Two days is a pattern now.  You know what you're doing - adjust your basals as often as needed."), I starting hiking up my basal rates.  Before I got pregnant, my total daily dosage was around 24u per day, thanks to a low basal rate and a lower-carbohydrate diet.  Now?  Five months and 3 weeks into my pregnancy and 17 lbs heavier?  My TDD is 45u and climbing. 

I am wearing my Dexcom and testing very regularly, but it seems like full-out stalking is necessary for the next four months.  I'm also changing my insulin pump infusion set every three days, like clockwork, to keep absorption issues from adding to the pile of variables.  What's becoming challenging is avoiding basal stacking.  As in, if I'm 140 mg/dl and I bolus it down, I need to be patient and let the insulin do its work.  I can't freak out and take another bolus 35 minutes later just because I'm nervous.  Bolus stacking (and rage bolusing, too) are totally counterproductive when they result in a nasty low blood sugar that leaves me spinning.

So what's the moral of this story?  ... honestly, I have no idea.  All I know is that blood sugar management during pregnancy just went from literal cakewalk (as in, I'd take a step and would require cake to take another step) to a struggle that has me acting like an emotional wreck.  My last A1C came in a little higher than the one the month before (went from 6.1% back up to 6.3%), and I know this is because the lows are tapering.  But I don't want to crest back up towards 7% because I'm unable to wrangle in these stupid highs.  

There's a lot of guilt when it comes to diabetes.  I knew that before.  But what I didn't realize before becoming pregnant is how much I worry about this little baby while she's growing inside of me.  Every time I test and see a number above 130 mg/dl, I feel so sad and frustrated.  My hands immediately go to my belly and I want to feel her kicking, because that at least soothes my heart, knowing she's still okay in there.

Actually, she's rolling around in there as I type this.  My blood sugar is 96 mg/dl and holding, I hope.  I have every confidence that I can do this and that she and I will be okay, but these last few days have been really emotionally tough, and I've found myself praying more now than I ever have before.

(Thank goodness for cute baby girl clip art.)


Kerri - you are doing an awesome job! BGSparl is already blessed to have such attentive parents.

While I hope her face looks a little different than the baby girl clip art, I hope her hair looks just like that when she is born :)

ohhh...taking me right back there again...I know those feelings all too well but I can say from experience you are doing everything in your power to keep BSparl safe...it's not easy & I'm really proud of you! Everything you talk about is perfectly normal that it's not normal :)... I remember writing a letter out of guilt to Ally & crying my eyes out and praying everything would be okay...everything will be wonderful!! & you'll feel so different when you hold her in your arms (a whole new nervous heehee)...Hugs and Prayers!

You are so on top of things- what an incredible job you're doing! You have a lot of people praying for you and BSparl, and wishing you all the best! Stay positive :)

I am sorry you are feeling so nervous and guilty. You are doing a fabulous job. You are doing all you can! Keep up the great work and the prayers. You, Chris, and BSparl will be taken care of.

Kerri: I forwarded your newest blog on to my mom, with the subject line: "Only a D-mom can understand." She sent this in response and I thought it would be a good comment to add....

"Very true. You know, 30 years ago, I didn't have a blood meter or a pump. I took 2 shots a day. Once you started kicking, and then when you didn't move in there, I would panic because I was sure you were dead. I would be paralized in fear until you moved again. All the tools there are now to help monitor are so much better." - Mom

Kerri - you are doing such a fabulous job with the pregnancy and caring for GSparl. You should be so proud of yourself! Beat yourself up for a few minutes, then get right back on that horse missy, cause you CAN do this and you ARE doing this - fantastically I might add.
No one ever said it was gonna be easy. But luckily, the things that are the hardest are the most worth it.
You are in my thoughts and prayers, and so is that cutie-patootie GSparl!

Your blog is so encouraging for me to read. I'm about 8 weeks behind you on the baby-growing. I'm so excited and nervous about my up-coming baby. When I read your blog it lightens the load to know that someone else out there understands the emotional side of this blessed jouney.

keep at it kerri, you're such an inspiration! Reading your blog of bsparl, and seeing that it can be done is giving me hope for my own little sproglet one day :) xxx

It is scary...I was so anxious to get my baby girl out of me (where I considered there to be more danger than necessary) and out into the world, where my own health didn't impact her so directly.
Funny thing was, I was just as scared once she was here because I still wanted to protect her from everything. Motherhood changes it all...you are doing a great job, and she is fine! But I totally get where you are coming from.

Kerri- you are doing such a great job, and are super diligent. You provide inspiration and encouragement to me everyday when i read your blog. You can do this and are doing it. Keep up the great work- I am sure your baby girl is already amazed by her mommy's hard work!

I have to second Heidi's comment! My girls are 1 and 4 and I am just as anxious about keeping them safe as when that stick first turned pink! Even more so I'm sure. But it is a joy keeping my little butterflies safe.

Something my excellent perinatologist told me when I was pg that really helped: your placenta is kind of like a buffer between YOUR high and low bgs and your baby's. It's really the average (i.e. your a1c) that really affects baby. And yours sounds great, you are doing awesome!

I wish I could offer advice but since I've never been where you are, I can't. But I can say that I can imagine just how scary and guilt ridden those highs can be - given how scary and guilt ridden they are when they are only affecting me. With a baby on board, I know it must be magnified a million times. But I also know you are strong and more than capable. You've got your team working with you and I know you and BSparl are doing fabulously!!! Keep up the good work, don't beat yourself up and remember that you are doing great!!

I can't begin to really understand the anxiety you are going through, but with every word you type I can feel the overwhelming love you have for your child. Your child will no doubt reflect that love and care as a beautiful, happy, and HEALTHY baby girl. You are doing a wonderful job, and as Nicole Johnson said over and over "It's worth it."

You are the best MOM!

I cannot believe how intense, but convienent the process is now for D-Mom's. Insulin Pumps, CGMS, better self control processes.

I reviewed the comment from Michael Hoskin's Mom. That is how it was for me also. Type 1 37 years. Thirty years ago meters had just came to the world (I participated in a DRI research) and they gave a group of Diabetic pregnanet woman meters for the first time. I took one shot a day, NPH insulin. Dr's were very controlling about how we used Regular Insulin on our own without very close control to adjust glucose. The goal for BS were in the 175 range just to be safe.

I had many hospital stays just for insulin adjustments for maternal changes that occured.

You are doing a fab Job! Keep up the good work.

You are doing a great job and I soooo understand your anxiety as I have it and I am not pregnant and it is getting worse the longer I have the D. I truly believe that everything will end up wonderful and great and truly believe the above comments of producing wonderful children when there were no meters and only two shots a day. Sometimes I think it is better and easier on the body and your little one if your bgs don't roller coaster and are more consistent even if a little high.

From someone who will be in your situation soon from what I read you are a rockstar!! Try and cut yourself some slack and focus on how AWESOME you really are doing because.... you are :)

Hi Kerri,
From about week 24 in my pregnancy with Adam my insulin requirements started to rise. Don't stress and feel guilty. You're doing an amazing job -- you're doing everything you can for bsparl.

I've never been pregnant, but I always change my infusion site every other day (endo's orders.) I'd suggest you do the same!

I had my daughter 6 months ago, and by the end of my pregnancy my basal rates were 4x what they were when I started. Get ready to adjust, adjust, and then re-adjust. By the way, enjoy carbs now, because the further you get the more insulin you will need to cover the carbs. I'm now 8 weeks pregnant and going through the roller coaster again - so I sympathize about how you feel. I know that my numbers were not perfect the first time and my daughter is perfect. I know that as long as I correct as soon as I see a high, and keep on top of how my blood sugar is running everything should be great again. PS - I didn't have a CGM so it was all done by regular old poking. Also - you may want to try a longer infusion cannula - I switched to the 9mm about halfway through my 1st pregnancy and it helped.

Hey Kerri, I remember going through this EXACT same situation! When I could, I exercised to get my bg down instead of bolusing because it worked more quickly for me. (I even ran up and down the stairs in our townhouse at 3am... my husband thought I was crazy but stair workouts are the best!!) Also-- get to know your new BFF, which are low-carb snacks. I ate a lot of Greek yogurt (the kind with no sugar, of course, and I added Splenda to it), peanut butter, black beans, and lean protein. Those foods really helped keep my numbers in line. Keep up the great work-- it will all be worth it. :)

Kerri - I'm 24 weeks along right now, and last week went through the exact same thing with my BGs rising, adjusting basal rates, rising, adjusting, and so on. I was terrified all week, and felt guilty for eating meals when my BG was trending upwards, knowing it would result in a higher number. I relax every time my little guy gives a kick, knowing he must be doing okay in there, despite how nervous I feel. It's too much stress sometimes, but it's good to know there are others out there feeling the same, and going through the same thing. We'll both get through this with flying colors, I have no doubt. It sounds like you and I are both on the same page as far as tracking numbers and making sure those highs come down! Good luck in the next few months!

I'm at 34 weeks, Kerri. The highs hit me around week 23/24, too. My TDD is now over 120 most days, up from maybe 38 units pre-preg. I'm ready to swig the stuff right from the bottle (if that would do any good). It's now normal for me to take a 30 unit bolus for a meal.

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