July 16, 2009

• Tales from the trenches of the third trimester (from a gestational diabetic)

  As my pregnancy is coming down to the last month, I realize that there’s one thing I will really miss about it.  I will miss the connection I have with our little baby.  Right now, our lives are intertwined.  When s/he moves, I am completely aware of it… and it’s special.  The rolls and jabs are like evidences of little miracles, reminders that there’s a little life inside.  Later on, if I want to see or touch the baby, I will have to physically go to where s/he is.  Right now, it’s constant, continual, ongoing.  Yup, that’s definitely what I will miss.

  But there’s one thing about pregnancy I won’t miss.  In this last trimester, I have had to adjust to a new lifestyle as a diabetic, with the pressure that if I don’t adhere closely to the dietary plan, I will bring risk to the baby.  I’m thankful that God has given me a new found compassion for diabetics, but it has been challenging!  Here’s a little of what it has looked like.  (A record mostly for me to remember in the future.)

  Every morning when I wake up, I take 1/2 of a glyburide pill (glyburide is a catalyst for insulin) immediately and take my blood sugar level before rolling out of bed.  The diabetic nurse said that getting up to walk around could skew my measurement, so I should do it immediately while still in bed. 

  Taking my blood sugar level includes pricking my finger, squeezing blood out, putting in the test strip, getting the blood into the strip, then recording the measurement.  The first one in the morning has to be below 89.

  After I get out of bed, I wait an hour before I eat anything, so that the glyburide can kick in.  I’m usually pretty hungry while I wait, but it’s gotten easier as time has gone by, and my stomach has gotten used to the discipline.

  For breakfast, I can have 1 slice of whole wheat bread (if the total carbohydrates is 15 g or less), 2 eggs and 2 turkey bacon.  No milk or fruit.  An hour after the start time of my breakfast, I prick myself and test my blood sugar again.  The reading should be below 129. 

  Usually, I have my “snack” right after I test my breakfast blood sugar because a whole hour has had to pass and I am usually pretty hungry.  At this point, I usually have a yogurt (must be below 15 g of total carbs) and then some nuts.  I try to wait as long as possible before I eat lunch though because if I have lunch too soon, my blood sugar will be too high.

  At lunch, I’ll have 1/2 cup brown rice, plus some kind of protein (beef, chicken) and veggies.  An hour after I started eating, I test my blood sugar again.  Like at breakfast, my reading should be below 129.  Before the weather got so hot, I would usually take a 15-20 minute walk right after I ate because that helped make my blood sugar level go down.  Exercise works like a charm.  Unfortunately, it’s been so hot lately, and I haven’t been able to come up with a good alternative. 

  The hardest stretch is between lunch & dinner and dinner & bedtime.  There are so many hours in between, and I’m allotted only 1 starch or 1 milk or 1 fruit. However, I can have as much protein & veggies as I want.

  Dinner is the same as lunch – in terms of portions and taking glucose measurements.  I try to take a 15-20 minute walk after dinner as well. 

  The after dinner/before bedtime snack is more generous than the other snack allotments.  At this time, I can have 1 milk and 1 starch (instead of one or the other), plus a protein.  I usually have 1 slice of wheat bread with a slice of cheese and a cup of whole milk.  (Interesting, 1% or 2% milk may be less fattening but contains more total carbs.  Something I learned from the diabetes nurse is that anything lowfat or fatfree has more carbs in it because sugar is added to make it more tasty.) 

  Before bedtime, I usually take 1 glyburide pill.  If I don’t go to sleep within an hour of taking the pill, I get really hungry (since the glyburide is inducing insulin production).

  That’s pretty much my day – every day.  And, everyday, I also record everything I’ve eaten as well as all my blood sugar level readings in a document. At the end of the week, I send it to a nurse who monitors and evaluates my numbers and calls me to tell me if I’m doing everything right or wrong.

  One thing I’ve found is that going out to eat is committing blood sugar suicide.  Even if I’m careful about what I choose from the menu, my glucose inevitably skyrockets.  Even salads are dangerous because of the sugar in dressing or the tasty fruits added (mandarin oranges, dried cranberries, etc).  Everything else has tons of starch.  The only 2 places I’ve been able to eat have been Tofu House and El Pollo Loco.  But the upside has been that since I was diagnosed with gestational diabetes, I’ve been able to eat chicken again.  (If you remember, during my 1st and 2nd trimesters, eating chicken made me nauseated and caused me to vomit).  Being able to eat chicken has helped so much!

  The other part of gestational diabetes has been all the additional doctor visits and tests.  There are two additional ultrasounds (at 32 and 35 weeks) in order to measure the baby to make sure Baby hasn’t gotten too large. 

  Here’s the “4d” ultrasound of Baby at 32 weeks:
    

  I also go the doctor’s office twice a week (starting at week 34) to do “non-stress” tests for the baby.  In the non-stress test, I’m hooked up to a fetal monitor.  Baby’s heartbeat and my stomach’s movements are monitored.  Baby has to make two major movements where heart rate goes up 15 more beats per minute than the average heart rate, lasting at least 15 seconds, and this has to happen twice in 15 minutes.  If this doesn’t happen, we have to start the time over again… and wait until it does.  This test is frustrating to me because sometimes the baby is sleeping.  If the baby doesn’t perform to their satisfaction, I would have to go to the hospital post haste and do more stringent tests that last for a few hours. 

  The hardest part of gestational diabetes is not being able to eat whatever I want.  With pregnancy comes cravings, and it’s been difficult to deny those cravings.  Sometimes the cravings are so strong, I’m afraid that I will give in.  Fortunately, there’s only 2 more weeks until I am full-term and 5 more weeks before the baby MUST come out.  One month — manageable, possible, within sight…hopefully.  Then I will get to see this little baby face-to-face…and go back to my normal diet!

  Here’s a picture of me and my big belly, taken yesterday!
   

  • 5:33 pm
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