November 5, 2009

Best Laid Plans

Should've and could've are words we don't use,
they only depress us and give us the blues.

My mom used to say that to me, and really? It bugged the crap out of me. It's cutesly and rhymes and it's a little annoying.

But...

Like many annoying things in life, it's also true. Part of the reason it's annoying if someone says it to you is because they're right about the fact that you'e holding on to something you should let go of. Regret isn't something I'm very fond of. I think it's a waste of time and that energy is much better spent looking forward, not back.

I had my second appointment with my midwife yesterday and it didn't exactly go as I had planned. She got my records from my endocrinologist and whatever was contained therein indicated to her that I have had high blood sugar levels. And if I have high blood sugars and/or am at isk for gestational diabetes, she can't treat me. If I have high sugars, I have to have a doctor and a hospital birth.

ARGH! First off, I have NOT had high sugars. I have been diagnosed with insulin resistance, but they've never had me monitor my sugars until now. I passed my glucose tolerance test during my last pregnancy without even having to do the 3 hour, and passed again when not pregnant. I specifically asked my endocrinologist after my bloodwok whethere I was at risk for diabetes because it was something I was really concerned about and one of my reasons for wanting to lose weight. She said that I'm not prediabetic or high risk for diabetes. As fa as I am/was aware, I was put on Metformin ONLY to treat PCOS and my irregular cycles, and it had nothing to do with my insulin levels. But it doesn't seem like that fact was noted in my chart.

At my last appointment at the endocrinologist, I met with her ARNP, and she is a diabetes specialist. I thought I was going in for a followup on my bloodwork and instead I was met with a plethora of information about gestational diabetes, a blood sugar monitor, and the distinct feeling that I was being told I was going to GET gestational diabetes for sure. It was fairly upsetting for me, I was unhappy because I didn't feel like it was a positive way to look at things, and I was fine through my last pregnancy. However, she never told me anything about how high my risk was for getting GD or why. Thinking about that, and after my appointment with the midwife yesterday, I find myself wondering if she even knew what that appointment was for, and whether the nurse and the endocrinologist are even talking, and whether I am misunderstanding something about my being teated with Metformin. I'm wondering what my chart says and if it's correct.

I hate being confused about my own medical care, and I think I deserve to have correct information about my treatment and what is happening to my body.

In the end, we scheduled another appointment for 2 weeks and my midwife is giong to call and clarify things with the endocrinologist and my primary care doctor. For now, I've started taking my sugars every morning, but I'm worried. The TARGET level for pregnancy is 95 fasting, ie when you first wake up in the morning. But the normal acceptable range is large, from about 80 to 130 depending on where you look. This morning I tested at 104. So... higher than the target, but not super high. It just sucks that even if my levels are OK, if they're not PERFECT my whole pregnancy and birth plan could change.

She also told me that it would be good if I didn't gain any weight. I've lost 10 pounds since I got pregnant, so it's okay to gain that back, but I'm worried that I'll gain too much weight and that will suck especially since I just lost 30 pounds. I would like to not gain that back during the pregnancy, but I'm already feeling stressed out about monitoring my diet carefully and trying to eat right when food aversions and cravings come and go.

I broke down after the appointment yesterday and cried. I feel betrayed and I found myself almost wishing I'd never been diagnosed with insulin resistance. Of course I realize that without all my diagnoses and treatment I probably would not have even gotten pregnant in the first place. But I'm annoyed that my body can't just cooperate. I've had myself really excited about how this birth experience would be and it's really hard thinking about never getting to experience the birth I really wanted.

Today it still sucks. But I know whatever happens, it will turn out okay and as long ast he baby is healthy that's what is really important. I'm trying to prepare myself for the possibility of letting go fo this particular dream and moving on to just loving and looking forward to my new little son or daughter. For now, it's just 'we'll see.'

P.S. Unisom? Best thing ever. I am still not feeling 100% but in the last week things have GREATLY improved and I've been throwing up once a day or NOT AT ALL! Woo! I'm still tired, but things are definitely improving.

P.P.S. The baby is doing fine, we heard the heartbeat. I can't wait to feel him/her moving around.

8 comments:

Mighty M said...

Oh, so sorry all this is going on! How frustrating!!

Allison said...

Rachel, this is not how midwifery care should make you feel. Nothing you have said makes you seem like a bad candidate for an out-of-hospital birth. Birth Centers do sometimes have stricter "rules" though. If you want to talk about this let me know, I might be able to help. Midwifery is the world I live in! :) Hugs!
Allison

Mimi said...

I'm sorry things aren't going as you had hoped. I'll pray that everything works out for the best. Don't forget, this is a long process, and things could change any number of times!

Dumblond said...

Hmmm. I didn't know that if you had gestational diabetes, you couldn't have a more natural, mid-wife experience...I guess it's good that I never really wanted that with my first one...I was being constantly monitored for diabetes...
I hope things turn out better for you. And I'm glad to hear that you are feeling a bit better.

Melissa aka Equidae said...

our best plans for some reason always seen to fall apart but jsut relax breathe and let everything in gods hands!

Enz said...

What a mess this is. I can understand how you must be feeling.

It sounds like you need to sit down with your endo and ob/gyn and talk about what YOUR condition is and how/if it will affect your pregnancy.

Deep breaths...it is all going to work out in the end.

It can't hurt to monitor your blood sugar, the leap from high insulin to diabetes is very small and happens quickly. I can tell you the exact date my blood sugar went from normal to diabetic, but it was after years and years of normal blood sugar with high insulin levels.

Hang in there.......it WILL all work out.

Hugs.

Michele said...

Holy wow woman! Sounds like you need to do what I did - on a notebook, write down a bunch of questions that pop into your head every single day and make a point to ask them. Like you said, it's frustrating not knowing exactly what's going on. It can cause undue worry and stress which can cause more issues.

I hate you're so stressed and wish there was something I could do to help. Being on the opposite coast of the US makes that a bit of a challenge LOL! This is like when Chris was pregnant.. she even took a few videos to show me the baby moving and stuff. There's you a vlog idea for later on :) We long-distance friends want to be a part of it too :)

Megan R. said...

I feel your pain. It is VERY good that the RN/Midwife are going to talk with the endocrinologist, hopefully that clarifies things some.

If you are concerned about your sugars (probably a good idea to be since your fasting isn't under 100), I would just follow the GD diet. It is a REALLY good and healthy diet even for those who don't have GD.

I had to follow it since I did have GD, and I only gained 9lbs with Carson. And he was 11lbs, so really, I lost weight. About 2 weeks after he was born when all the swelling went down, I weighed 25 pounds less than I did before I got preggo!

I'm so sorry all of this has you so stressed!