Now What?!

A Grumpy Guide to Pregnancy

Monday, December 10, 2007

The other shoe drops

Weeks 29-30: Well. I knew that this eye-of-the-hurricane period couldn't last, that the transition into the final weeks' growth spurt and other physical changes would mean some kind of shift in my experience again. But I wasn't really expecting the big news to be this: gestational diabetes. My weight gain is in the target range, my belly is the right size, I'm active (in a lumbering but regular way) and eat mostly healthily, but none of that matters. The hormone surge makes your cells insulin-resistant, and either your pancreas can ramp up insulin production to compensate, or it can't. Apparently mine can't. And that brings all kinds of risks for the baby, from huge size to delivery complications, so we want to get it under control...

So, I got some equipment last week for testing my blood sugar, and then had home visits from an R.N. to explain the concerns and interventions, and from a dietician to lay out a new (and somewhat bizarre) mode of eating that I should follow, in hopes that that (and getting exercise) will be enough. Basically it involves making meals smaller and having more snacks, and also making sure that you never have carbs (bread, milk, fruit) at a time that you don't also have protein. Logical, but not how most people eat. Not least, my morning Cheerios should have eggs alongside, and I'll have cheese cubes or nuts as snacks between every meal, measure down lunch and dinner, blah blah. It's manageable, but means much more attention to food than one would prefer to need. And I'm aware of being hungry much more often, without knowing whether it's a symptom of the diabetes or just the next phase of pregnancy. (The same could be said of any number of belly sensations. meh.)

After a few days of this regulation, I'll report the results (from those many finger-pricks per day) to the nurse and my doctor, and either things will be ok or they'll decide I need insulin shots. I rather suspect the latter, given my early blood readings and the fact that I'm already active, etc., so may not gain much through the lifestyle recommendations. But who knows.

Initially I found this news/diagnosis very depressing. I think I've been rather proud of my general fitness and careful handling of the pregnancy, and this felt like all that had failed, somehow. Also, going from a near-normal period to a medically regimented lifestyle is about the worst transition that could come, short of late-stage morning sickness. But I'm feeling a bit calmer about it all just now, probably from the combination of Spouse's rising to the challenge of helping me figure out meals and snacks that will work with the regimen, plus my natural geeky/scientific tendencies that fit well with the careful blood sugar note-taking, spiffy gizmo involved, etc.

diabetes self-test kit

In other news, I've also been warned that the third trimester can bring a return of some first trimester symptoms, including nausea and progesterone-based mood-dampening, which should really dovetail nicely with my new hypochondria and related worries. Looking like a fun stretch ahead!


Liz said...

Sorry to hear about the bummer diagnosis, but good on you for your attitude and how you're handling it. Hope all goes well for you and the little sprout.

Medley said...

Sucks. :( Many sympathies..

(About a year ago my then-gyn conjectured that I have polycystic ovary syndrome (long story, and I'm dubious.. but too much to type) -- upshot is that IF I have it, it has insulin implications, so I'll be doing glucose testing early and often starting at my next appointment. Le sigh.)