In order to start the process towards a health pregnancy; I changed to a better health insurance, saw new doctors, and move my prescriptions to mail order. I became involved in the diabetes community and attended a "Take Control Of Your Diabetes" TCYOD conference. I met and talked at length to other type 1s who had children and had experienced pregnancy with type 1 diabetes.
I have had "in control" A1Cs over the last few years. They range sometimes in the 6s, but mostly low 7s. In December 2012 my A1C was 7.3. I knew that this number needed to be lower, but my previous endocrinologist (diabetes doctor) always told me I was doing great. This was part of why I switched my insurance, I needed to be able to find a doctor with higher standards and more in depth knowledge/experience working with type 1 and pregnancy. I searched HOURS on the internet reading reviews and backgrounds for endocrinologists trying to choose. This was a long process and it made me nervous.
The endocrinologist I found went above and beyond my high expectations. I met with both her and an OBGYN on the same date in March. This was unplanned, it just worked out that way. The OBGYN was not based out of the same clinic. I received an overwhelming amount of information that day all about planning for pregnancy and that I could not start trying until my A1C came back lower than 6.5 and as close to 6.0 or lower as possible. I had known this, however, it still felt like a daunting task. Type 1 diabetes takes constant attention every hour of the day and I had not been putting it first.
I felt great about my endocrinologist, she had been so sympathetic, understanding, and it was like talking to a friend as much as a doctor! She also provided me the guidance and motivation I needed. She was able to give me tons of information on diabetes and pregnancy. She shared stories of other type 1s she had worked with, giving me extreme confidence in her experience as well as motivated me to accomplish my health goals. The OBGYN I saw that day was helpful, but I was less impressed with her knowledge/experience with type 1 diabetes and decided after that I would not be seeing her again. I would be finding a OBGYN through my current endocrinologist's same clinic/health group.
I felt very overwhelmed after these doctor appointments. To get personal, I came home and basically cried my eyes out for a week. This was the most difficult grieving for my diabetes that I had every experienced. I took my diagnosis like a champ. I have always felt blessed by the lessons diabetes gives me and the pride I have in taking care of myself. That doesn't mean it is easy, but I work hard at making the most out of the negative situation. Well, March 2013 was a different story. I cried over diabetes at work, in the car, and at home. It was because it was the first time I felt different, scared, overwhelmed, and that it didn't just affect me anymore but my future, the health of my child, and my ability to live a normal life. It felt unfair that pregnancy would be so much harder for me than for most of my peers. Especially when I felt like a normal health 27 year old, despite the occasional annoyance of diabetes.
How did I pick myself off the floor? Finding supportive and knowledgeable doctors was the first step. The second was getting my blood sugars down. I had been on an extended "break" from my insulin pump. I was taking shots of NPH and humalog instead. After a long conversation with my doctor I finally agreed that I shouldn't wait until I found out I was pregnant to switch back over. Switching back and forth has always been easy for me. This was tested when my pump broke just a month later!!
Third step for me was finding the book, Balancing Pregnancy with Pre-existing Diabetes by Cheryl Alkon. I discovered this book online the day after my doctor appointments, ordered it, and had it by the end of the week. This was a turning point for me. The first few pages were exactly what I needed to hear! It was like picking up the phone and having an instant friend with type 1 who was telling me everything I was feeling and saying, "It's going to be okay, you can do this". I started highlighting and reading excerpts to my husband.
Fourth, I established my support network. My friends were amazing and listen to me whine and complain more than I ever have (or so I think). I didn't hold back, I shared with the people closest to me what I was feeling. I began explaining diabetes more often and the things I was doing to take care of myself on daily basis. My husband and I talked at length about things I was concerned about and how he would be a part of the team in managing my diabetes.
Fifth, I attended the TCOYD conference. I needed this conference more than I knew. My husband went with me and we both felt such a great connection to everyone there. He turned to me and said what I was thinking, that it was so nice to feel like you could instantly relate. We were surrounded by type 1s all day, which was nice because I can't always relate to type 2 diabetes despite some similarities. We met a young husband and wife with a new baby. The wife had type 1 and we were able to stay in touch with them. She gave me great advice such as how to curb after meal high blood sugars by "super bolusing".
Sixth, I got a continuous glucose monitor (CGM) after meeting with the reps from Dexcom at the TCOYD conference. Seventh, armed with all these tools, some crazy blood sugar logging charts, and help from training for a half marathon... I got my blood sugars down. At my endo appointment on May 6th my A1C was down to 6.3!! I told my doctor that with her approval I would like to start trying for a baby in July with possibly an even better A1C (6.3 is pretty crazy good, I was hoping to hit "normal" territory of just under 6.0). She said that sounded great but that she also felt if it happened sooner, it was fine. She said many endocrinologists would say to be 6.0 or below for pregnancy. However, she said understood how difficult this is for type 1s (amen to that) and that she was more than comfortable with us trying with an A1C below 6.5!!
Eigth, following my doctor appointment I made an appointment to meet with a Dietician who also was a Certified Diabetes Educator. This appointment gave me the ground work for understanding what foods to eat during pregnancy as well as helped me with my non-pregnancy meal choices! I started following her advice immediately and began snacking less and feeling more full!
Thank goodness my doctor said "no worries if it happens before July", because that same month, not 4 weeks after my endo appointment I was already pregnant!!
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