Coming into Focus

Today was a good day.  I went to see my OB today and had another ultrasound.  I got to see my baby's heart beating, and then I heard it as well.  It was a rather awe-inspiring moment.  There really are no words to describe what it is to know that there is someone growing inside you.  

I found out something else as well. I am only seven weeks along as opposed to the eight weeks that the doctor figured based on my last period.  This is excellent news.

It means that my blood sugars were under control a whole week ealier in my pregnancy than my health care team thought originally.  I have to say that made me very happy.  It means that more of the crucial developement time was spent in a healthy environment.

I think that the reality is really hitting me today.  The finger sticking and carb counting is a lot easier to do when I can see the tiny reason for it all.

Even if it was only a grainy black and white picture on an ultrasound.

It is all about the moments

I think that every woman's pregnancy is full of "big relief" moments.  These are the moments when at least one of the nagging worries that have been keeping her awake at night is finally dispelled.  These moments come in many forms: the results of a blood test, the images of a sonogram, the first movement of a tiny body, or just a reassuring voice saying "That's normal."

It was almost a month ago that I took a home pregnancy test and got a positive result.  Of course, I took it at the office and then proceeded to  have a minor breakdown for several reasons.  The first was because I was a smoker.  I decided that I wasn't going to be one of those anymore as I stood staring at the two pink lines, and I have not had a cigarette since.  The second reason was that my husband was at work and I really did not feel that this was the type of news that should be conveyed over the phone.  And the third reason for my small breakdown was because the battery in my blood sugar monitor was dead.

I left work early and got another one and then went home to wait for my husband to get home from work.  

I of course started to test my blood sugars constantly.  Basically, I was testing every two hours.  The problem was that my blood sugars were nowhere near the normal target range of 70-150 mg/dL.  They were running around 275 mg/dL.  I started taking short acting insulin every two hours trying to get my blood sugars down into the normal range.  

I was scared to eat, afraid that it would drive my sugar level up even higher.  Every two hours the numbers on the monitor were like a slap in the face.  They would not stay down and if I did get them to go down they went too far down and I was forced to eat more.  Treating the lows seemed to send the numbers straight back up into the 200's.   Nothing seemed to be working and I was scared.

I was scared because I had read many articles about Type 1 Diabetes and pregnancy.  The information all said two things. 1) High blood sugars in the early weeks of pregnancy increase the risk of cardiac and nervous system birth defects.  2) Most women's insulin requirements are lower in the first trimester, in part due to morning sickness.  

Well, my insulin requirements were not going down and all the googling I could do wasn't giving me any answers.  I called my Primary Care doctor and asked for a referral to a new endocrinologist, because of course the one that I had been working with for the past five years had recently retired.  I called the OB/GYN office that I had an appointment with the next week and they referred me back to the endo.  It was a long day and a half waiting for the endo office to call me back and they finally got me in for an appointment 4 days after I found out that I was pregnant.

It was the first of the "big relief" moments of this pregnancy.  The doctor told me that the rise in my blood sugars was not at all uncommon in Type 1 diabetics.  She told me that the hormones of pregnancy make a woman's body insulin resistant.  It was going to take more insulin to produce a good range of blood sugars.  I also found out that while I am pregnant I will need to keep my blood sugars in a tighter range of control: 70-120 mg/dL.  

I was put on the testing and eating schedule that I posted in my last entry, 
and my insulin doses were increased. It took about a week, 
but my blood sugar levels came down to where they are supposed to be.  

There have been a few ups and quite a few downs with my blood sugars in the 
past few weeks, but I have come to the  conclusion that I can do this.

Tomorrow I will be officially 8 weeks pregnant.
Tomorrow I go back to see the OB again and get another ultrasound.
Tomorrow, if all is well, my husband and I will be able to see our child for the first time.

Tomorrow will hopefully be another "big relief" moment.

The Schedule

This is my life right now:

5:00 am: Wake up and use the bathroom.

6:30 am: Hit the snooze button.

6:45 am: Get out of bed, use the bathroom again. Check my urine for ketones by peeing on a plastic strip. Take shower and get dressed.

7:30 am: Stab my finger and test my blood sugar. Take a shot of insulin and measure out 30 grams of carbohydrates for breakfast. Eat breakfast and then pack a lunch that contains 75 grams of carbohydrates and two 15 grams of carbohydrates snacks for the day.

8:00am: Start 40 minute commute to work

8:40 am: Arrive at work 10 minutes late and put lunch and snack in the refrigerator. Start my day as a Mental Health Case Manager.

9:30 am: Stab finger and check blood sugar. If it is over 120 take insulin.

10:00 am: Eat first 15 grams of carbohydrate snack.

12:00 noon: Stab finger and test blood sugar. Take shot of insulin and eat 75 grams of carbohydrates for lunch.

2:00 pm: Stab finger and test blood sugar, adjust with insulin if it is over 120.

2:30pm: Eat second 15 grams of carbohydrate snack.

5:00pm: Drive home.

6:00pm: Arrive at home and start dinner.

6:30pm: Stab finger and check blood sugar. Take insulin and eat 75 grams of carbohydrates for
dinner.

8:30pm: Stab finger and check blood sugar.

9:30pm: Have 15-30 grams of carbohydrates for a bedtime snack.

10:00pm: Take 24 hour long acting insulin.

10:30pm: Stab finger and check blood sugar before going to bed.


I have Type One Diabetes. I was diagnosed when I was 12 years old. Now I am 31 years old and seven and a half weeks pregnant with my first child.

My first challenge and responsibility as a mother is to keep my child safe from high blood sugar levels. So I follow the schedule that you see above. I have been following it religiously for the past three weeks since I found out that I was pregnant. I wanted to blog my experiences so that others in my situation would know that they are not alone. Because some days I feel horribly alone. And in some ways I am alone. I am the only one who can protect and nurture my child right now and I guess that is going to be the case for the rest of my life. There are certain things that only my mother could do for me and I am starting to understand that there are some things that only I can do for my child.