This is the second entry in a series of four posts by Shelly Jensen.
The Special Gift From Your Baby. If you are like me, you are not perfect. Before, during and after both pregnancies (yes, I did this twice, so it can’t be so bad!) I slipped up. I miscalculated my carbohydrate count, or I downright cheated. We are human, after all! Here is one positive outcome that can happen from your condition: your unborn child will give you a gift because, for the sake of him or her, you will never be so diligent about managing your diabetes.
For me, that meant agreeing to wear the pump. I knew this was great technology and a great tool for managing diabetes. However, I never used it before pregnancy for two reasons: I felt I was under good control without it (but not, as it turned out, in the exact recommended range to become pregnant) and I just could not bear the thought of having this machinery stuck to my body twenty-four hours a day. Because my pregnancy was a happy, unplanned “accident”, I was not on the pump nor was my A1C at an optimal number, although it was very close. Our second child was planned so I was able to get the proper green light before conceiving.
My first pregnancy was not the ideal situation as medical experts strongly urge women with Type 1 as well as Type 2 Diabetes to plan their pregnancies so that blood sugar control is in the recommended range at least three months before pregnancy. The minute I saw that positive pregnancy test (ok, fourth pregnancy test – I just could not believe the first three!) I told my husband and then I called my endocrinologist. The office squeezed me in for an appointment the next day. I said to my doctor and diabetic nurse, “I know I was not supposed to do this [unplanned pregnancy].” However, their response in unison was “congratulations”. They were both very optimistic people and were ready to help me have a healthy pregnancy. Then, again almost in unison, they said “you need the pump.”
As most mothers know, your body goes through a hormonal and physical shock during pregnancy, changing throughout each trimester. Imagine what that does to your blood sugar! So, my wonderful nurse sat me down and showed me how the pump worked. I could download my readings online and she could upload them, examine the resulting graphs, etc. and let me know exactly and precisely what changes to make in my insulin settings throughout the day on a weekly basis. Believe me, your body will change from week to week throughout your pregnancy. Despite the fact that I was previously terrified by the idea, I agreed to wear the pump for the sake of my unborn child. And, as it turns out, it was not that bad at all! It took some getting used to but the pump became a vital tool in managing my blood sugar throughout both of my pregnancies. Here is the one piece of medical advice I cannot keep inside: If you are pregnant or wish to become pregnant, and are not already on it, get on the pump. This can all be costly depending on your insurance coverage, so you should plan your finances in advance if possible.
You will also want to check your blood sugar as often as possible, more than before you were pregnant. I used to say, “I’m checking for two now!” You will notice that I do not use the word “test.” As a person with diabetes, one often feels guilty from high readings. We tend to use the words “good” or “bad” when “testing” our blood sugar. This can be compounded while pregnant because you have more than just yourself who is affected. It started to really affect my moods – if I had a “good” reading, I would be happy, while if I had a “bad” reading I would be despondent. I reminded myself that these were just numbers to empower my management, and nothing else. Therefore, I removed the words “test”, “good” and “bad” from my vocabulary. If I saw a high number, it was not because I “failed” or was “bad”. The numbers became simple data to help me manage the diabetes. This helped me get into the habit of checking my blood sugar more often and letting those numbers help me and my unborn baby stay healthy. I became more diligent and in-tune with my diabetes than I ever was before. I used to look at “testing” like getting on the scale – with one eye closed and not really wanting to look. Now, after the commitment brought on by my pregnancies, I very diligently and casually check and correct my blood sugars much more regularly than in the past. Thank you, my babies.
Love Your Team. My endocrinologist and diabetic nurse were exceptionally encouraging and supportive. I honestly feel as though I can never thank them enough for their amazing care. My endocrinologist sent me to a “high risk” (I was also over 35!) obstetrician who also became a lifeline to me throughout my pregnancy. The three of them were in constant communication as to what was going on with me and my baby. I saw more of my endocrinologist and diabetic nurse more than I ever had before, and I saw more of my obstetrician than most “normal” pregnant women do throughout their pregnancies.
Shelly Jensen
Because of the fear that comes along with being pregnant with Type 1 Diabetes, I often called my nurse in tears because of unexplained high numbers. If I were not pregnant, I would have been alarmed by these numbers but not so frightened. Every time this happened, I pictured my unborn baby suffering from it. Hormones do not help in this situation. My nurse was always calm and always took the time to talk with me to figure out the next step. She once let me invade her office with no appointment when I was convinced that my pump must have been malfunctioning. She explained what happened – I miscalculated the carbohydrates of a bagel and banana. She settled me down and assured me that my blood sugar levels would slowly but surely come down, which they did. She told me that she was not looking for perfection from me, that working together we would maintain the best possible blood sugar control throughout my pregnancy.
Later on, my obstetrician let me come in for an unscheduled non-stress test when I was afraid of what a high number might have done to my baby. He and his staff knew all about my condition and were very sensitive to the emotional toll it took on me. I got a hug from my obstetrician at the end of every visit with him. His medical aides were true cheerleaders even when they did not quite grasp some of the technical details of the disease. During a routine non-stress test, my baby was not moving, probably because she was asleep. The typical remedy to this situation is to give the mother-to-be some m&m’s in order to stir the baby. When I was handed some m&m’s I very happily ate them, kidding myself, “hey, I’m in a doctor’s office so it must be OK.” Just then my obstetrician walked in and scolded, “Great idea, give a diabetic woman m&m’s!” I blushed and we all laughed.
It is really important to like your team of specialists and feel comfortable calling them at any time of the day. Pregnancy can be hard enough without the added daily uncertainties you will face due to diabetes. Please make sure you are comfortable with each team member at the beginning of your pregnancy. If you have any doubts about the support your will get, both emotional and physical, do not hesitate to switch doctors. Remember, of this team of experts, you are the most important one and you should not hold back on taking a very active role in the process. Every pregnancy is different and every person with diabetes is different. It is up to you to foster communication with your doctors and nurses and take their advice. But it is also important be disciplined and committed throughout the next nine months. To be continued.
Post Script
Share your stories with me. As I continue to say, every pregnancy and every person with diabetes is different. These were my experiences but you will have your own unique experiences. Please write to me and let me know your own story. I would love to hear from you. Also, if you have Type 1 Diabetes and are hoping to become a mother, please contact me. My goal is to reach out other expectant mothers with Type 1 Diabetes. My wish is that the next woman who feels as frightened and alone as I did may be comforted by our stories.
This is the second entry in a series of four posts by Shelly Jensen.
