Wednesday, July 04, 2007

An Update

First of all, Happy Fourth of July! Most of my day will involve getting my little cub scouts prepared to march in our town's annual Independence Day parade, and waiting at the end with a cooler of water bottles and popsicles (which reminds me that I need to get the freezer stocked with them so they're ready). I'll be the only den leader not marching in the parade, I'm sure, but the guys understand. No one wants to deliver a baby on the parade route :)

The month of June was a wash for me, knitting-wise. Summer of Socks has started very slowly, as I've been dealing with a ton of work stress, home stress, and baby stress. The great news is that the proteinuria issue seems to have resolved (most likely a false alarm), and I'm coming to grips with this whole diabetes thing. The visit to the perinatologist was uneventful on Friday, except that I did get one of those neat-o 3-D pictures. I swear, if I had to describe the image, I'd say "Cezanne on crack meets medical imaging." If hubby would stop nesting long enough to coax our tempermental scanner into working for me, I'd post one of them. At one point, when they had the 3-D paddle on my abdomen, L'il I smiled. I melted. He's fine -- in fact, the doc said that there was absolutely nothing remarkable at the ultrasound. But, because I'm a small-framed woman who has small babies, they do want to do weekly ultrasounds and non-stress tests just to make sure he doesn't get cramped in there. Enter the gestational diabetes.

You simply have to love it when the perinatologist says, "Well, the gestational diabetes diagnosis MAY be real. But you only failed the second number by one point." It kinda confirmed my feeling that perhaps this diagnosis is a CYA maneuver on the part of the obstetrician. But then he and I chatted about the numbers I've been getting (you see, I'm the pain in the butt patient who started testing in advance to make herself feel like she's in control), and he said right now it sounds like diet will do to manage this perceived risk. He did recommend going to the educational class ... and said the diet was pretty logical whether you're diabetic or not. I had been pondering that thought for a few days, and had come to the conclusion that it probably wouldn't be a bad idea to have folks take a nutrition class from the get-go anyway. We all get complacent about eating healthy.

Yesterday, I had a big day for baby. Went for the first non-stress test and ultrasound (everything was fine) and afterward had a sit-down with Dr. Serious. I explained to her that I felt as though everything was hitting like a freight train and getting extremely clinical, and how it felt to have "high risk" dropped on you with absolutely no counseling or explanation from a doctor, and how the extra stress was just, well, stressful, and that I didn't appreciate it. I also asked her why the proteinuria wasn't given the opportunity to resolve before the order was given to see the perinatologist, and she couldn't give me an answer (to her credit, it was a different OB that gave the order -- one I hadn't ever seen before). I told her that I fully understood the malpractice threats that OBs are facing (I work for a national medical organization -- urology -- and am well aware of the risks that our specialties are dealing with. Told her that I just resented the fact that I never had the opportunity to have an educated conversation with the OB before we started all of the high-risk approaches to a pregnancy that, aside from the marginal glucose, was progressing fine. She softened a bit, and then backed off a little. Said she was going to go over the perinatologist report in detail, and that she might be willing to go to a two-week biophysical scan schedule for the next few weeks and then re-bump it up to weekly if something catches her eye. I felt more reasonable after actually having the chance to sit and talk about it, and I feel like she met me halfway. She did not budge on the "high-risk" feeling ... but she's willing to move at a pace that's less frantic.

So yesterday, I went to the diabetes class. Two hours of learning about how the placenta is to blame for the whole deal, how carbohydrates should be measured, how many are best for me per meal/snack, how the body accesses fat stores when your sugar is really low, and what foods are "free" and which ones aren't. I now have to check my sugar four times a day and check for ketones first thing in the morning to make sure I'm not accessing the fat stores in my liver overnight. Personally, I think it was a pretty good use of two hours. I haven't really thought about this kind of thing since health class in high school (and that was a while ago). If they had every pregnant woman take a class like this, they might have less problems with GDM diagnoses. I mean, how many of us crave things that we don't normally eat? I'm really not a huge carb eater, and those cravings have waned a bit. It's entirely feasible to think that that glucola would shoot the numbers up and give a false positive. But, had I been eating a reasonable amount of carbs all along, perhaps my pancreas would have been more accustomed to reacting to that much sugar.

I've been tracking my food intake for the past week and monitoring my sugar, but I understand the process a bit better now (for instance, don't have fruit or fruit juice first thing in the a.m.!) and I know what I can fill up on to keep myself from starving. This will be a bit of a change for me, because I'm typically a grazer ... but now I know what I can graze on between meals without ruining my post-meal numbers. The only problem is that I can't have that afternoon jelly crimpet without sacrificing another carb :) I'll live ... and I think I'll feel better as a result. It's also good for the rest of the guys in my house ... they're already making comments to each other like, "Mommy says you should eat some cheese instead of having a bowl of pretzels" or "that has too much sugar in it and it will give you a sugar high." My hubby usually does most of the cooking and he's been focusing more on side salads and proteins, and watching his own carb portions too. What cracks me up is that I find cookie wrappers in the trash in the morning because he's snacking in the evening after I'm out of sight :)

June was a wash with knitting. Only a few socks finished, but I hope to pick up some steam in July. I have a Monkey in progress, along with the waving lace match and the go with the flow match. I hope July will bring a return to normal activities and go more smoothly than June!

1 comment:

Ruth said...

I had GD in my last pregnancy (marginal numbers, but they treat anything over the cutoff as a positive), which I was able to control totally with diet and light exercise. I remember being very cranky about the diet for the first few weeks (I don't like being told what I can and cannot eat), but must admit that once I adjusted it was not only easy, but very healthy.

It sounds as though you have a good attitude about the diet, and that the guys are being supportive. Hang in there ...