National Diabetes Month: Life With Diabetes

November is National Diabetes Month and Today is National Diabetes Day!

The American Recall Center is asking, "What Do You Want People to Know About Diabetes"
This is challenging to answer because at first I want people to know "everything" so I don't have to go into any long explanations! Second, I want people to understand that type 1 and type 2 diabetes are very different when it comes to treatment. Finally, I want people to know that having diabetes does not have to be devastating. It never goes away, there is never a break, and all that hard work should be a constant reminder of gratitude for being able to be healthy.

"I don't love the challenges and hardships from diabetes. I love to overcome diabetes and defy odds every hour of the day. I love what I learn from diabetes and the characteristics those lessons teach me."

This strong and positive attitude is not always easy to find. I've been struggle with it a bit this week as I face seeing the eye doctor tomorrow! Pregnancy and tight control can lead to changes in the eyes of a person with pre-exsisting diabetes. (Awful how better blood sugars can cause problems too huh? Diabetes is just rude!!!). I've been seeing "eye floaters" and have to go get checked out. It could be a normal pregnancy symptom or a sign of a serious eye problem. I've been so thankful to not have any diabetes related complications so far in life. Trying to keep that positive attitude and remember I can handle anything that is thrown at me! Today or tomorrow....

Managing my type 1 diabetes every day (especially during pregnancy) is a constant reminder of the blessing of modern medicine and that good health is worth hard work!

Type 1 Diabetes and Pregnancy: Weeks 20-26

The last few weeks have had consisted of the following highlights:

 

22 weeks

• Spiking blood sugars. Happened right at 18 weeks for me, and even worse after 20 weeks. I fought two different head colds during the last 5 weeks which didn't help. I had an appointment with the CDE dietician and have had to make weekly to daily insulin amount adjustments. My complete daily dosage has gone from 15-22 units pre-pregnancy to 40-50 units currently. Pretty crazy climb. Also a very natural part of any pregnancy, but the different is I can SEE my insulin needs change.
• While feeling down about a few crazy days with high blood sugar spikes I also got back another A1C.......5.5! Keeping it there will be another story, but thankfully I'm mid-pregnancy with a great average. Time to keep fighting the good fight.
• I began feeling baby more and at the start of week 25 my husband felt him too!
• I had a follow up ultrasound to look at the baby's heart and spine (again)!
• We took our childbirth classes during this time. Four Fridays talking about labor and delivery from 630pm-930pm was torturous. The highlight was that it turned out we were sitting right next to another mommy to be with type 1 diabetes! The instructor said she'd never had one type1 in a class let alone two! They were a great couple to relate with and swap stories. During introductions we all had to say something we liked about pregnancy for most moms it was "feeling the baby" followed by "getting to eat whatever". We were both quick to point out that we didn't have the option of "getting to eat whatever" and in fact we found ourselves having the opposite experience of "strictest diet ever". The instructor was super sweet and the information pretty good, but meeting the other type1 was the best part of the class for us. Because of our jobs and backgrounds the class moved slow for us and we felt the one day seminar would have been the smarter choice! (My husband is trained in emergency medicine and therefore to deliver babies/pediatric life support. I have education/clinical experience with being a nursing assistant in college, medical speech pathology, and early childhood development.) 

Accidental 24 week photo while testing out the video baby monitor. Kept it, because check out the growth spurt!

How far along: 26 weeks

Gender: Boy

Maternity clothes: Maternity jeans from Motherhood. Pregnancy Halloween baby skeleton shirt from Amazon.com

Stretch marks: None, but belly is getting itchy and I'm worried! Using Nivea cream and coconut oil like crazy!

Belly button in or out: In....questionable if it is staying there.

Sleep: Good!

Best moment this week: Halloween! Seeing my students in costume! Also, my doctor appointment was a highlight, hearing the heartbeat, and seeing my sweet OBGYN!

Worst moment this week: Upper back sore tight muscles. This happens to me when not pregnant though! Husband, heat pack, and tiger balm helping!

Miss anything: October has been a stressful month at work, so a shot of whiskey would be nice. I also hit another growth spurt and miss my pre-pregnancy wardrobe!

Movement: Lots of kicking and pretty sure hiccups!

Cravings: Biscuits. Made some gluten free low carb ones!

Queasy or sick: Feeling good! A little tired and cranky sometimes.

Looking forward to: Growth ultrasound at 29 weeks and Thanksgiving Break!

 

25 weeks 

 26 weeks

Type One Diabetes and Pregnancy Weeks 13-20....Gender Reveal

It has been a month since I've updated! Yikes time flew bye! This post will cover the last 6 weeks of pregnancy and catch up to the current moment in time!

It has been relatively un-eventful. I've enjoyed the return of energy and reduced nausea that everyone said would come with the second trimester. Although I'm still very tired all the time and my workouts exhaust me much faster, I do not sleep 12-16 hours a day anymore!

I got pretty lazy about taking "bump" pictures and have way too many of myself in gym clothes working out in our garage!!

I had a check up during week 15 with Dr. A, my regular OBGYN. This was a short appointment to listen to the heartbeat and measure my fundal height. I did blood work the same day for further prenatal screenings and to get my A1C. My A1C was still 5.7, which was unbelievably amazing. 

Enjoying a friend's wedding celebration around 16 weeks!! Somewhat still able to "hide" the bump.

My next appointment was with my endocrinologist during week 18. This turned out to be great timing because the insulin resistance that sets in around half way through pregnancy and gets worse until the end was just starting to show that week! We were able to make some small adjustments and my blood sugar averages came back down that same week. We planned for me to send my logs in to her via email, meet with the CDE (certified diabetes educator) dietician with my food and blood sugar logs, and then again with my endo in the weeks ahead. 

My superstar husband also went out and picked me up a used treadmill. This helps immensely with getting down high blood sugars! Thus far 10-15 minutes of walking and drinking a lot of water can help correct numbers like 240 to 140 and 178 to 70. As I've stated before, this works for my body and maybe not all type 1s. I also often wind up low, but I'd rather quickly correct a low than have hours of high blood sugars for baby's sake. The treadmill allows me to exercise at any time day or night if my blood sugar creeps up too high!

20 weeks=5months=OMGhalfwaythere!!!!

During week 19 we had our anatomy ultrasound. They spent almost 30 minutes taking pictures of every structure they could. My regular high risk doctor could not see me as he was held up with another patient. Another doctor covered for him and reviewed the pictures with us. She review my second trimester blood work. We also finally found out the baby's gender!!! IT'S A BOY......!!

We had a small gender reveal celebration and took some better than in-the-garage-working-out "bump" pictures!

Type 1 Diabetes and Pregnancy Weeks 12-13: First Trimester Doctor Appts and Ultrasound

Doctor Appointments (This is long, sorry!):

The day we returned from vacation I had a doctor appointment with my OB-GYN (Dr. A). My husband had to miss this one because of a work commitment. Dr. A asked how I was feeling and if there had been any bleeding or severe symptoms. She then used a "Doppler" machine to try to hear the baby's heartbeat. My heartbeat came on the machine and she said we were listening for something twice as fast. She heard it briefly but then lost it, I wasn't hearing anything. I was okay with this because I knew she was going to get the ultrasound machine out if she couldn't pick up on it! Sure enough I got to SEE baby instead. The heartbeat was there and heart rate was good!

It was exciting how much bigger baby was now! Baby looked like a baby and no longer like a peanut! Turns out the doctor had so much difficulty finding the heartbeat because baby was very active! Arms failing and legs kicking! Baby turned towards the ultrasound and I saw baby's skull bones/skeletal face!! It was cool, my poor husband really missed out. Thankfully, I had a nuchal translucency (NT) ultrasound scheduled the following week that he would definitely be attending!

Baby's Profile

The purpose of the NT ultrasound to my understanding is primarily to measure part of the back of the neck of the baby. This helps determine risk for down syndrome. The technician took pictures of every structure she could see; legs, arms, stomach, heart, and brain to name a few. We were able to watch the baby on the screen for a long time while she took these pictures. She even turned on the 4D images and we saw what looked like a claymation image of our baby. It was very fascinating.

Crazy weird 4D clay looking baby

Then a specialized OB-GYN high risk/maternal fetal medicine doctor (let's call him Dr. R) at this clinic reviewed my blood work and the images. I have been very blessed with brilliant doctors. This one was equally impressive. He reviewed practically my whole medical history with me asking very good background questions especially about my type 1 diabetes. He spoke with the same knowledge as my endocrinologist. He went into even further details than my regular OB-GYN (Dr. A) regarding upcoming specialized testing because of my type 1 diabetes. For example, he wanted to go ahead and do extra screenings of my eyes and kidneys just to have as baseline information. He was doing this he said as a precaution because with my history and blood sugars he was not concerned, just thorough. He definitely won me over with his praise of my A1Cs and in depth expertise with diabetes.

Dr. R stated that at week 20 we would come in for our anatomy ultrasound where we would find out the baby's gender. At week 22 they would check the baby's heart with a fetal echocardiogram. Starting at week 32 I will need to do "non-stress tests" where I sit for 20-30 minutes a week while they monitor the baby's heart. Dr. R said he actually wants his patients going twice a week. He reviewed the risk of preeclampsia, a pregnancy condition characterized by high blood pressure and common in women with diabetes. If I develop this I will likely be hospitalized and stabilized as long as possible to carry the baby as close to term as possible. Also, he stated that assuming everything goes wonderfully I will still be induced, because I am a diabetic, at 38 or 39 weeks.

I really appreciate his diligence and his brilliance, but doesn't change that this is going to be a very daunting and busy process. I knew this going into it though. On my own and with my husband we had consulted with many high risk OBGYNs and done our research. So none of this was new information. Very much still overwhelming.

Then we met with the genetic counselor. Typically women my age do not complete either of these appointments, these were done because I have diabetes. I have to be honest, the genetic appointment felt informative yet pointless for us. We reviewed family and medical histories on both sides. She recommended further testing for certain conditions based on some of my heritage. My husband and I decided against it. We both felt that I am undergoing enough testing and appointments already. This appointment caused extra anxiety and stress. High risk pregnancy involves a lot of talking about everything that can go wrong. Afterwards, my husband and I went out for a nice lunch and focused our minds to more positive thoughts!

Next I met with my endocrinologist. This appointment was pretty standard. We reviewed my logs and talked about how things were going. I mentioned to her about my eating habits and how I'd already gained 10lbs because I was eating to keep away the nausea. She was so sweet and told me she had the exact same experience her first pregnancy and then gained less later on. Thankfully none of my doctors were concerned about the weight gain at all, my endo had said her doctor during her pregnancy gave her a hard time. I've heard many stories about doctors telling expecting moms they are gaining too little or too much. My OBGYN seems more focused on checking the baby's growth than mine, for that I'm grateful!

Remembering our relaxing vacation after having almost 4 hours of doctor appointments in one day!

Type 1 Diabetes and Pregnancy Weeks 10-11: Babymoon and Symptoms

Diabetes:

My blood sugars continued to drop weeks 9-10. I lowered my basal rates even more, they were lower than my baselines. My bolus rates also dropped a little to 1:12 and then needed to be adjusted at week 12 to 1:10. I had a few crazy highs of mid 200s and almost 300 that left me feeling guilty. They continued to come down quickly with walking. I had my A1C done again around week 12 and thankfully came back as 5.7. This put my mind at ease because my averages were not affected.

Symptoms:

I continued to have severe fatigue, some days sleeping up to 16 hours. I noticed improvements when I exercised and started making more of an effort. The fatigue made it hard to be motivated. I also had nausea, although not really full "morning sickness". Mostly it felt like being massively hungover everyday. The symptoms made me want hangover/comfort foods with grease and carbs. Eating would curb the nausea so I was eating a lot and it was showing on the scale.

I started fighting the grease/carb urges, but still needed to eat often or felt sick. In fact, the only time I threw up is when I was so tired I slept in too long and didn't get something in my stomach soon enough. As long as I kept my stomach full I felt better, so I gave in to that. I still didn't have die hard cravings but wanted mango and lemonade pretty frequently.

Hawaii:

During week 11 we were on vacation or our "babymoon" to Kauai, Hawaii. It was romantic, beautiful, and relaxing. However, as I still had many first trimester symptoms, I can see why many women put off a vacation like that until the second trimester. It was fun to be in Hawaii before growing too much, yet I had a few days where I needed to take long naps or go to bed early because of fatigue and nausea. We tried to balance indulging in yummy meals with healthy meal cooking in our little condo we rented.

Despite the preggo symptoms, we had an amazing vacation. I got some last minute adventuring such as surfing! We were able to snorkel, hike, kayak, and sight-see. Kauai was gorgeous and we plan to return there when we can!