Wednesday, May 30, 2012

Living with Gestational Diabetes

This was my third pregnancy, my final pregnancy, and my toughest one. I expected the preterm labor issues of dealing with an irritable uterus. That entails dealing with minor and then major contractions, visits to the hospital, bed rest (almost impossible to do without a guilty conscious as a mother of two) and medication with wonderful side effects to ensure our little man made it to full term. That is nerve racking enough!

Around week 24, I went to the VA Medical Center here in Phoenix to attend a breast feeding class. Completing this class meant I left with a brand new breast pump and FOUR baskets full of items for our little guy, his big brother and sister, and for myself. The past couple of days leading to this class, I felt like something wasn't right. I was getting irritable, REALLY irritable for myself, I would shake and have this need to get food, mostly sweets to calm the shakes. After I ate something I'd get a headache and get so thirsty. I was meeting and surpassing my daily intake of water by the morning. Every couple of hours I'd go through this cycle and I kept telling my husband "Something is wrong with me. I don't know what it is but something is not right."

This same morning I had a doctor's appointment and I told the nurse what was going on but they chalked it up to be normal pregnancy symptoms. I told her several times, I'd never felt like this before. They checked my blood sugar, blood pressure and everything was normal. Mind you, I had just eaten prior to waling into that doctor's office because I was symptomatic. Anyways, so I'm in the breastfeeding class and I started feeling symptomatic again. I told the nurse that was in the class because I had a 2 year relationship with her. She knew me well and even stopped the class to ask how I was because she saw I wasn't quite right. I told her I didn't feel right and explained to her my symptoms. She took me back to a room and monitored my blood pressure. She took it laying down, and then sitting up. When I sat up, I passed out. When I came to, she gave me juice and crackers. Now prior to this, I had eaten breakfast and it was coming up on noon. I hadn't had anything to eat since. She let me be for a bout ten minutes and checked my blood sugar and it was in normal range. She couldn't find anything wrong with me. Because I was pregnant, passed out and was symptomatic, she sent me to the ER. I sat for four hours and while I was waiting my husband brought me dinner. They again couldn't find anything wrong with me.

After this incident at the hospital I started paying attention to my body and doing my own research because obviously the medical doctors weren't finding anything. I noticed that I didn't feel good if I waited too long to eat and if I ate like crap. My doctor did schedule a 3 hour glucose because I failed the one hour glucose test. It read 163. Normal readings range from 70-129.  It wasn't scheduled for another week, so during this time, I kept food on me all the time, ate well and noticed anything sweet and full of sugar made me feel awful. I went in for the three hour glucose test and that was a horrible experience.

This pregnancy was full of painful experiences and I truly feel like the lesson learned here was to gain even more patience and to learn to be cordial even through bouts of pain. These experiences definitely gave me plenty of times to practice this lesson. The three hour test basically was a very simple process. A patient shows up to the lab at a specific time, drinks a bottle of glucose, and each hour for three hours, gets blood drawn. The patient can not eat or drink eight hours prior to the test. By the time I got there, I was starving, so I was looking forward to the glucose drink. I was already a little symptomatic, so I downed it knowing full and well I was going to feel horrible. At about 45 minutes, the pounding headache kicked in, the confusion and the blurry vision. Two hours rolled by and I was still feeling symptomatic and tired. The third hour hit and I I started feeling ok. I failed the test miserably. The first hour my blood sugar levels were in the 200 range. The second hour was at 183 and the third hour was 162. Confirmed I had gestational diabetes.

So what is it? What does it mean? The American Diabetes Association describes gestational diabetes as being a condition where the mother's body is not able to make and use all the insulin she needs for pregnancy. Without the insulin, glucose can not leave the blood and be changed into energy, thus leaving glucose in the body creating high level blood sugar readings. It's believed that the placenta may to blame for gestational diabetes. Hormones from the placenta help the baby grow and develop but also the hormones block the mother's ability to allow insulin into her body.

Most women who develop gestational diabetes may be overweight, may have diabetes history in her family, may be part of a specific ethnic group, given birth to large babies previously, or have too much amniotic fluid. The only factor that fit me is the diabetes in my family. I have it on both sides with my father, most of his family and my mother's side. Her mother has it.

I was so symptomatic and so nervous about it that I went out and got my own blood sugar machine and started keeping track of my readings. Most people who are diabetic or deal with gestational diabetes have to follow a strict diet along with taking insulin or other medications that tell the pancreas to create insulin, like Glyburide.They also have to eat every few hours to sustain their blood sugar levels; hence why I was getting symptomatic at the VA hospital.  I figured out through controlling my diet before even going back to the doctor, anything processed, or that was a grain, like bread, cereals, pasta, regardless of whether it was whole grain or not, would increase my blood sugar levels. So what I did was put myself on a Paleo diet (all meats, vegetables, fruits, nuts, and healthy fats). When I went back to the doctor and told him what I was doing, he wasn't happy that I was depriving my little guy of breads and dairy so he prescribed Glyburide and because of the way the medication works, I took it once in the morning. It is a slow release medication and to be honest, I could have stayed off of it and followed the Paleo diet, I believe and been more healthy. I have my husband's taste buds during pregnancy and they did not fit the Paleo diet. I wanted everything that was bad for me, so I took the Glyburide and used it as my cructch to have the pasta and pizza sometimes. Even on the medication I still had to watch my diet. I switched to diet soda if I drank it, cut out pizza, pasta, anything with grains in it that wasn't whole grain. I mainly stuck to protein, non-starchy vegetables, light fruit options,  and no processed foods. It was very difficult to do and required a lot more work. The American diet is not built for diabetics at all.

Being diabetic, I had to go to the doctor twice a week to check on our little guy. We had to look at the placenta to ensure it was working the way that it should, check his size to ensure he wasn't getting too big and also make sure he was breathing the way he should. Going to the doctor twice a week I learned where and how big my placenta was, how to check for my little guy's breathing and noticed he was doing fantastic as far as size. All of this was because I was strict with my diet and my medication. I also didn't gain much weight because of the diet. I gained right at 20 lbs with this pregnancy which is something I didn't do with my first two. I was one that loved to eat while pregnant. Not this go round!

At week 35, I went into labor and I knew I went into labor because my blood sugar dropped and I could eat whatever I wanted without medication and without regulating my sugar. I didn't realize it until one morning after eating breakfast and taking my meds that my blood sugar dropped to 63. I was contracting quite a bit and the contractions had gotten more intense but I didn't really think about it because of the irritable uterus condition. Having an irritable uterus and a cervix of steel (as my doc says) I knew my contractions weren't making any progress.  With my first born son I labored after my water was broken for 38 hours with no epidural and dilated to a two. With my second I contracted all through my pregnancy and dilated to a 1. I went to the hospital because the contractions were so strong I was trembling, nauseous, and struggling to get through the pain. I got to the hospital and, like I thought, I was only dilated to a 1. The doctors gave me a shot of terbutaline and home I went. This time that shot stopped labor contractions...for four hours. It happened again at 37 weeks and 4 days. That time it slowed the contractions but didn't' stop. The doctor told me he wanted to keep my little guy in so that his lungs could develop as much as possible and I was going to have to deal with these contractions. THAT WAS PURE HELL but another story for another post.

This brings up the side effects of dealing with gestational diabetes and the side effects it can have on the baby. Uncontrolled diabetes can lead to the baby's respiratory system not fully developing, a baby being large, a baby having diabetes at birth or having low blood sugar issues at birth, and other major complications.

At this point, my blood sugar levels were just the opposite; they spiked significantly. I had to increase my medication to taking it twice a day and had to be even stricter with my diet. I was OK with that because during this period I was MISERABLE. The contractions were SO difficult to deal with. As much as I wanted to, I could not get a pattern on them and knew in my heart I wasn't because of that damn cervix of steel. I ended up making it to my scheduled date of 39 weeks and had a healthy baby boy. He was 7 lbs 4 oz and did not have any blood sugar issues. I also do not have any blood sugar issues, thank goodness, and had a list of foods I wanted to eat. The first one was a coke...a real one and my best friend was such a sweet heart, she brought me Krispy Kreme donuts that I had been craving and a bag of Dove chocolate, my favorite.

It's amazing what our bodies go through during pregnancy and even more so, proof of what willpower we humans hold. I'd gladly go through the experience again, if it meant my little guy comes out as healthy as he did. I wouldn't change my experience for anything. I've gained knowledge of how diabetics live and the struggle they have on a daily basis to sustain. I've also been reminded of what willpower is and how important healthy food is for our bodies. Thankfully, I'm losing my husband's taste buds and starting to crave those fresh veggies again and hopefully can stifle off diabetes in the future.

3 comments:

  1. Gestational diabetes is a fairly common complication of pregnancy, affect's approximately almost every tenth lady.Diabetes is a very tough disease to care for. You have to make huge changes in your diet and also carefully monitor and maintain your disease.The level of sugar in blood is most essential part and if it increases above the level causes lots of problems.

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  2. This is a very good post. Just wonderful. Truly, I am amazed at what informative things you've told us today Pregnancy Week by Week

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