Hurry Up and Wait

Hi Baby,

I thought I’d want to write immediately after we met with Dr. FB on May 4^th for our first pre-conception visit. I think I put it off because while that was a fine meeting, it wasn’t really anything BIG. Then as the weeks continued and we headed towards my follow-up with her I thought I’d jot down a few thoughts. Then I didn’t. Then we met with our special obstetrician a few days ago and I thought, “Shouldn’t this be the thing compelling me to write a blog post?” And, again, it wasn’t anything BIG so I put it off for a while. I think the problem is, and will continue to be, that until you get here, it’s a whole lot of hurry-up-and-wait.

However, we did meet with Dr. T and the fact was not lost on me that this was the person who will very likely be the first person to see and hold you. If she’s on call when you arrive, that is. Which she reminded us might not be the case…which I’m adjusting to.

So here’s the trajectory of the last 8 weeks: May 4^th we met with Dr. FB at Joslin to get this ball rolling. My A1c had come down, but only to 6.9%. She was fine with it, but not ecstatic. She said if we made a few more changes to get those mornings down (they had been weirdly creeping back up ever since our San Francisco trip in late April) she’d bet my A1c would decrease even more. So we made some tweaks, used our noggins, and got to a much better, more stable place. As has been true in the previous two years, my last two months of the school year were pretty gorgeous numbers wise. So I went back last Friday by myself for a follow up. A1c: 6.7%. She turned to me and politely asked, “What would you say if I said you could go ahead and start trying?” I stuttered, “I’d…I’d feel great.” And then quickly followed up with, “But we’re not quite ready yet!” To which she gave me a look that said, “I don’t really care to know exactly when you’re going to have sex.”

Three days ago we had our pre-conception consultation with Dr. T, an obstetrician specializing in high-risk patients, specifically diabetic. The best thing Dr. FB told me when I was there was that even though I was automatically high-risk because of having T1D, I was “the lowest risk of her high risk patients.” Whew! That felt great. Dr. T was a little more conservative in her reassurance. She was friendly, open, confident, smart, and made good eye contact while using our first names. I liked her. Your dad feels sure in her ability to, as he put it, “have my entire family’s life in her hands.” She was honest. Not scary, just factual. There are risks involved in this endeavor and even though some are only very slightly higher than any run of the mill pregnancy, they are there. So we are getting blood tests for cystic fibrosis carriers, I’m taking a pre-natal vitamin to load up on folic acid (apparently spina bifida occurrence is higher in T1Ds), and I’ll go back to Joslin in 8 weeks to make sure I’m still on a good track. I’m nervous now that my schedule is totally different from how it was during the school year, and I am having more frequent lows than before, but I’m tip-toeing through the summer to get to a place, in the very near future, where we can give it a go. I know, it’s cringe-inducing to hear about your parents planning to create you because of what’s involved, but at this point, with all the planning and scheming, and counting of days, and thinking of timing, it’s just a fact of life. Pun intended.

Up All Night

April 2, 2012

Well, baby, you’re still on my mind but, I have to admit, not as obsessively as 6 weeks ago. And this is a good thing. I can’t fully explain it except as a mixture of things: The weather has gotten nicer so my overall mood has lifted. I started socializing with a great group of T1 ladies, and made a cool friend in the process. Work has been super super busy due to MCAS ramping up and just because of where we are in the year. Probably most of all because B (aka “Dad”) and I have been more aggressive with getting my overnight/morning numbers down to improve my A1c. Not surprisingly, I’m totally focused on getting this magical number down in time for our next dr. appointment in about one month. Like so many T1Ds, I have a lot of emotion, self-worth, and failure/success perspectives wrapped up in my A1c. I think this is very easy for other PWDs to understand; I think many people in the health care profession don’t quite comprehend how much that one little number can make or break our day and attitude. Also, where you are concerned, the A1c is paramount. I have to be below 7.0 to get the go ahead to concieve. A year ago I scoffed at that fact—Oh, please, I thought, that will be no problem. I’d been between 5.8 and 6.4 for over a year (my first year, I might add, of even having diabetes. Oh naïve one.). In January, when my endo dropped the “7.0” bomb on me, I cried. But, through that news, both B and I learned a lot and finally became more proactive of late. Basically, I had a “duh” moment: The averages displayed on my PDM or digital log book only counted the numbers recorded when I tested 6-9 times a day. Obvious, right? But, hell-O!, then there were a whole 8-10 hours (depending on day of the week) where no finger pricks were happening! Between the before bed and before breakfast tests, my blood sugar was just hanging out, free wheeling, doing whatever it wanted, sowing it’s wild oats, no curfew, no nothin’. And I was paying for it via my A1c.

I’d been waking up with high numbers for a while but, because before January my A1cs were so good, no one thought to be too focused on it. Now, however, I had a wake up call that I needed to see what the hell was going on overnight. And what a wake up call it was—last week and into this week I started setting my alarm for one to two times a night to wake up and test. You wouldn’t think waking up twice a night for a measly 45 seconds to prick your finger would matter much in your level of exhaustion. WRONG. Let me tell you, I was beat last week. Mid-week, I thought, “Hey! This is good practice for when I’m up with a bambino twice a night. See this isn’t so bad.” Then I realized that that 45 seconds would likely be more like 45 minutes. And it probably wouldn’t be only twice a night. And that I was going to be tired. Really really tired. Oh, baby, you’re already disrupting my sleep. Thanks.

We changed my 8pm-12am basal last night, raising it from 3.5 u/hr to 4.5. My number at the 12:00am alarm: 184. But at 6:00a.m? 102! Yippee! 7:20? 73. Oookk…pre-meal, that’s okay. But at 8:00 after I’d taken a full dose of insulin for breakfast? Well, so low I skipped the testing and went straight for the fruit snacks since I was cross eyed and the kids were arriving in 15 minutes. So we still have some work to do, but things are definitely headed in the right direction. Meanwhile, I’ll think of you tonight when my alarm cries for the 3:00 a.m. testing.

First One

February 24, 2012

Dear Baby,
It seems like ever since your dad and I started talking about actually making you come to be, I see you everywhere I look. This morning I was waiting for the microwave to finish and I glanced over at the dining table and I saw what a highchair would look like in our kitchen. When I walk into the second bedroom I always think, “What will we do with all this junk when it’s time to turn this into a nursery?” And lately, whenever I test my blood sugar and see a number outside the range I want, I think, “How am I going to keep my baby safe and healthy when I’m pregnant?” That question is one that has been weighing on me a lot this week. I think it’s because last weekend your dad and I really decided, like really REALLY decided, that we want to start to try to make you happen this summer/fall. Also, I’m on school vacation so I’ve had a lot of time to think; just me and my obsessive thoughts and worries. I did some reading on the internet, found a great blog by a diabetic woman who had a successful pregnancy, and ordered a book written by professionals at Joslin on pre-pregnancy and pregnancy guidelines.

I spent a lot of this week feeling overwhelmed and depressed. How am I going to do this? How am I going to do better than I’m doing now? I already count carbs, adjust basals, test 7-9 times a day, and try so hard to be successful at this despicable disease. I am conscientious, responsible, smart, and careful. And still I’m not where I want to be and should be when trying to become pregnant. Your dad, always the voice of support if not always reason, has reassured me that I’m doing just what I should be doing. That we’re months away from embarking on this battle and journey so all I need to be doing now is tightening my numbers up and moving towards our first meeting with Dr. For Baby* at Joslin on May 4.

Joslin recommends women/couples begin planning for pregnancy 6-9 months before conception. So much for spontaneity. So much for enjoying being “just” married and then deciding together to get pregnant and trying then and there. Thank goodness B and I are natural planners. And thank goodness we both want you so much. But it still makes me angry. I can’t do anything, it feels like, without mapping it out. I can’t work out, I can’t eat, I can’t travel and I can’t have a baby without a very careful plan. I will admit, most of the days, my diabetes is a side dish to my life. B, school, my family and friends, those are the main courses. But no matter how many times I’ve welled up in frustration and or freaked out with fear this week, I have never once doubted my decision. Never once did I ask myself if all this work and planning, is and will be worth it. Because you, sweet one, are the dessert.








*Alias. Correction: Funny alias.