October 30, 2013

23 Weeks: I Won't Give Up My Control

118 days to go.

Boy, where to start... ? The sea monkey is doing just fine - he's weighing in right on target, our fetal echocardiograms are great so far, he's constantly doing his kung-fu ninja moves, and his heartbeat measures perfect every time. He's perfect. And that's really all that matters.

In my opinion, anyway. Things are significantly more difficult for me, but I'm dealing and dealing well. But the frustration... gah. You see, I do not enjoy my Endocrinologist. He and I are like oil and water - I self-manage my Type 1 Diabetes to a degree that most Diabetic specialists are not used to. One would think that this would result in an Endo who is nothing but encouraging and pleased; alas, not mine. I had my monthly visit with him this morning and it went as it always seems to, resulting in my frustration and anger.

My A1c measured in at 5.5%. Freaking AWESOME. What's important to note here is that this A1c is based on a low number of hypoglycemic episodes, so it's not an issue of a lot of low BG's pulling the number down. No, it means that my blood sugar is averaging around 6.0 mmol/L. It means I'm maintaining non-diabetic BG's for the majority of each day, and doing every thing within MY power to ensure that this child will be born without any effects of my disease. If I continue to do this through the following 118 days, I minimize the risk of having a large baby due to high blood sugars. I minimize the risk of his lungs being underdeveloped or his own blood sugar going dangerously low after he's delivered, among many other potential issues. I also significantly increase the chance of a healthy, normal, natural labour and delivery rather than requiring medication and surgery! All of my sacrifices are worth that.

My Endo, however, is possibly on crack or just has his own control issues... you be the judge. Because today he told me that my control is good enough that I can sacrifice it in order to stop weight gain.
Say WHAT??

I've gained almost 50 lbs over the past 6 months. Believe me, I don't like it myself - I was about 25 lbs overweight when I got pregnant, and slowly working at losing that. But I liked my body... now, I hate it. I don't have the cute little baby bump - I have the planet-sized mountain on my abdomen that has everyone wondering if I'm possibly having twins. It's HUGE. I feel fat and icky and gross and I want my pre-baby body baaaaaaaaack!!!!

But there is no freaking way in Hell that I am going to let my blood sugars go UP and increase the potential risks to my innocent little baby to avoid gaining another 20 lbs.

And that's what I told him. I asked him how he can justify my baby's health against my weight and his response: he's aware of studies that suggest that excessive weight gain in the Mother can lead to future obesity in the child.

Okay, so in his opinion it's more important that my child not maybe get fat some day, than it is for us to have a healthy, safe labour and delivery of a child who will not have any heart or neural defects or be oversized due to my elevated blood sugars.

I told him that I plan on teaching my child good eating habits, just like my Mom did for me. My Mom, who is 56 years old and in better shape than most 20 year olds. Who gained 70 lbs during her pregnancy with my older sister, who I should note is not obese. I grew up at a healthy weight and maintained that until college, but I was never obese either, and that had nothing to do with genes.

I walk every day, usually twice a day. I eat balanced meals - in fact, if anything I could be accused of not eating Enough rather than eating too much. I'm in a weekly prenatal dance class and a weekly yoga class, and I dance around the house. A lot. I log the food that I eat and consistently maintain a caloric intake between 1900 - 2000 calories as suggested by my Dietician, who I also touch base with at least once a month.

So tell me, how exactly would it help for me to stop controlling my BG's so tightly???

I've also been dealing with the inevitable 2nd through 3rd trimester insulin insensitivity, which basically means that my normally overly-sensitive to insulin body is now struggling a bit in using injected insulin to manage the meals that I eat. I've started cutting carbs and walking after breakfast and dinner in order to alleviate this, but today I asked the Endo if he has any other suggestions for managing this issue. Nope... in fact, rather than encouraging me or offering me any sort of constructive advice, he instead told me that it's going to happen and there's nothing that I can do about it.
Bullshit. Don't EVER tell me I can't do something, particularly when it comes to this disease!!! I know better than anyone that there's always something that can be done, I just have to find the tools. 

I'm beginning to suspect that what's happening is that the Endo has nothing to do when he sees me. I don't look to him to make changes to any of my pump settings; he knows that I'll take his suggestions but probably won't use them (sadly, they're usually no good!). I'm perfect in every possible way... except for the weight gain. So he grabs on to it like the last raft off a sinking ship and just goes with it. Maybe he just wants to be right (I prove him wrong, a lot!), maybe that's what it is.

All I know is that today's visit and the comments he made were the last straw; I'm going to be asking to see a new Endocrinologist going forward.  Someone who is able to understand that I don't need to be controlled by my doctor - I do that better than any Endo ever could.

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