Pregnancy Update - GD

This pregnancy is going well.  I’ve been tired, but still able to get up every day and get to work.  I’ve been sick, but still able to make dinners most days.  I’ve been crabby, but not too much worse than usual. :-)

With Junior, I developed Gestatio.nal Diabe.tes (“GD”).  I spent the last 2.5 months of the pregnancy hungry.  I did a pretty good job of controlling my blood sugars with diet and exercise alone.  And let me tell you, even though I LOVE me some food, I’ll happily give up food if it means I don’t have to exercise.  Because I HATE me some exercise.  It was a miserable autumn for me in Michigan with the restricted diet.  Autumn is my favorite food time of the year…all the apples, apple pie, caramel apples, cider, Thanksgiving food, comfort food…mmm, my mouth just started watering while I was typing that list.  And I couldn’t eat any of it.

With this pregnancy, I started the diabetic diet right away.  I started testing my blood sugars around 13 weeks and was pleasantly surprised to see them all in the “normal” range they recommend during pregnancy.  I also had a 3 hour glucose tolerance test around 17 weeks and I passed the test…barely.  After several weeks, I stopped testing because my readings were normal and test strips are expensive so I didn’t want to waste them.  Then, around 27 weeks I went in for the one-hour glucose test.  I failed.  By A LOT.  My levels needed to be 129 or below.  I got 158.  Yikes!

My doctor ordered another 3 hour test to confirm GD, but I declined and asked them to just assume that I have it and move on.  So I avoided the “pain” of the 3 hour test, but was sent immediately for a consult with a Maternal Fetal Medicine Specialist.  Oh, and an appointment with the Diab.etes Counselor.   Fun, Fun.

I had my appointment with the MFM doctor this week and it started with a nearly hour long ultrasound.  Normally, I would be thrilled to get to peer at baby girl for that long, but my belly is really sore and having that ultrasound wand pressed all over for an hour was unpleasant to put it mildly.  Baby girl looked good…they were spending a lot of time on her heart which got me a little freaked out, but they said her heart is fine, it’s just difficult to get good images this far along in the pregnancy.  She is a wiggly little thing though, so they also had a hard time getting good measurements because she wouldn’t hold still.  After the ultrasound, I spoke with the doctor who wanted me to start either insulin at night or an oral medication to help control my morning sugars which are about 15-20 points higher than they’d like them.  Oral medication, please?  She wrote the script and sent me for my non-stress test.  Ah, the non-stress test.  Sat back, feet up, monitors on, button in hand to press when baby girl moves.  That’s the life.  I could even watch TV while they do it.  So pleasant.

Then out to scheduling.  I had forgotten how many appointments are necessary when they diagnose GD.  I am currently 30 weeks pregnant.  I need to go once a week for a non-stress test and an ultrasound biophysical profile of baby until I reach 32 weeks…then I go twice a week.  Plus my regular OB appointments.  Plus work, if I can manage to squeeze it in.

The next day I went for my diabetes counselor appointment.  I didn’t need a monitor or instructions on how to use one since I already have one and know how to use it.  So I only had to meet with the counselor for a refresher on how to determine the amount of carbs in any given food item and go over diet.  The counselor was very nice and went over my history, food allergies, food preferences and self-imposed restrictions with me.  Then she crafted a “custom” meal plan for me.  I say “custom” because there was nothing custom about it.  She managed to include all the foods I am allergic to despite our having JUST TALKED ABOUT MY ALLERGIES.  She gave me a very generous 3 units of carbs at breakfast, which I had just told her I couldn’t eat that many first thing in the morning because my sugars are too high in the morning already and if I eat more than 1 carb unit my after breakfast sugars are too high.  Oh well, I decided to ignore it and just take the plan and leave.  Now I am supposed to keep a food journal for her with the time I ate, what I ate, how much I ate and my sugars in the journal.  I also have to keep my sugars on a separate journal for her.  And I have a third journal of my sugars for the MFM specialist that has to be faxed to her every Monday morning.

I also had been keeping my sugars on an electronic app on my phone.  I hate to give that up as it gives me cool graphs, averages over the day, week, month, etc.  Who knew I would get so into journaling during this pregnancy?!?!  I sure didn’t.  I don’t think I will.

I am likely to just do the best I can on diet (it’s been good so far) and just fill in whatever the counselor wants to see on the food journal.  I’ll say I ate whatever she wants me to eat.  As long as my numbers stay in the right range and my weight gain doesn’t get out of control…I’ll be fine.  As for the 2 sugar journals…I’ll fill out the one from the MFM doctor…and the counselor will just have to get used to it.  The counselor actually said hers is easier because it is two sided…I laughed…our fax machine doesn’t do two sided faxes, so how is that easier?  Whatever.

I took the prescription for the oral medication to the pharmacy to be filled.  I told them I'd wait for it and they said it'd be ready in 15 minutes.  Forty-five minutes later, they finally called me up to the counter to ask me if I am pregnant.  I looked down at my gigantic 30+ week belly, that looks extremely full-term, then looked back at her and said, "yes." She then asked how far along I was and if my doctor knows about the pregnancy because the medication shouldn't be taken within 2 weeks of delivery.  Yes, yes, my doctor who wrote the prescription, on the prescription pad that says "Maternal Fetal Medicine Specialist", knows I am pregnant.  She even knows how far along I am if you can believe it!  I went through this same conversation with the pharmacist when I took the same medicine at the same point in my first pregnancy.  I know they are trying to be helpful, but what I really find helpful is people paying attention.  Just try it, you may like it.

So here I am, hungry again.  At least it is during the summer when my sole temptation is frozen custard at my favorite frozen custard place.  And that restriction is only in effect until I deliver, hopefully early, at the end of July or early August because I just don’t want to go all the way to August 15^th!  So I’ll still get to have my frozen custard this summer.