September 29, 2006
Sometimes in the mornings after I drop the kids off at preschool, I go to Starbucks for a morning latte. (I managed to give up caffeine for all of three days this time around. I am currently restricting myself to no more than one cup of coffee or Coke Zero per day.)
Every time I go in, I carefully study the display of baked goods, hoping against all odds that today, there will be one thing, just one, that I could actually eat. A quiche, perhaps, or one of those turkey and cheese wraps. Something. Every day, I scan the case, and every day I see pumpkin muffins, lemon bread, chocolate chip cream cheese muffins, and oatmeal raisin cookies. The oatmeal raisin cookies are the "healthy" choice, according to the little sign in front of them. I assume this is because they contain trace quantities of oatmeal in addition to all of the corn syrup, white sugar, brown sugar, and white flour.
Every day, I sigh deeply and have a sugar-free vanilla latte and feel morally and nutritionally righteous, but gustatorily devoid.
I know I said yesterday that I was going to limit my discussions of blood sugar to once-weekly, but I don't care, it's on my mind and I'm going to talk about it. I'm feeling a little bummed out right now because my blood sugar has not been in the perfect control that one might hope for in the first trimester. The first trimester is when a neural tube defect will manifest, if it's going to, and therefore is the most important trimester in which to maintain good blood sugar control. Normal blood sugar is 60-90 before meals and up to 120 or so after meals, for reference.
Yesterday, I woke up with a pretty good fasting level of 91. Breakfast went okay, and I went into lunch starting out around 104 or so. Lunch was a turkey and cheese sandwich on whole wheat bread and a lite yogurt. I've been having trouble with lunch lately so instead of using a 1:10 ratio of insulin units to grams of carbohydrate, I went with 1.5:10. So for 30 grams of carbohydrate, I took 4.5 units of insulin. (Remember how I said that life turns into a math problem? I do this sort of calculation four times a day, bare minimum.)
Two hours later, I was feeling a little light-headed, checked my blood sugar, and it was 54. Okay, apparently 1.5:10 was too high of a ratio for that particular lunch. Maybe the sandwich and yogurt had less of an impact than the soup I'd had the day before (also 30g of carbohydrate) which had shot my blood sugar up like a rocket. I made myself a half-sandwich with some ham salad on it. Half an hour later my blood sugar was back up to 120, which was actually a little higher than I really wanted it to be. I worried that it was going to just keep rising, but didn't want to take more insulin in case 120 was where it was peaking out, in which case more insulin would just send me low again. I sighed, and packed the kids up for a trip to the library.
The library, unfortunately, was on the other side of about an hour's worth of horrific traffic caused by several accidents. I don't know what happened to the normally-excellent drivers in Columbus (pause for big laffs) yesterday, but people were crashing into each other, traffic medians, and trees with alarming frequency. On the way to the library I had a moment of weakness and ate one of the little snack-sized bags of Goldfish crackers we keep in the car for the kids. (26g of carbohydrate, total.)
Before going into the library, I checked my blood sugar. 185. Oops. I took two units of insulin. (Generally, one unit of insulin will drop my blood sugar 30 points in one hour, so two units should nominally have dropped me to 125 after an hour or so.) We spent some time at the library and then headed for home. In the car, an hour after having taken the previous bolus of insulin, I checked my blood sugar again. 190. Not only did it not go down, it actually climbed a little bit. This, mind you, is after a snack consisting of 26 freaking grams of carbohydrate. It's not like I pigged out on chocolate birthday cake. I took two more units.
Before dinner, my blood sugar had finally fallen to 145, which is still way too high for a pre-meal reading. We had grilled chicken and cheese sandwiches, peas, and green beans, approximately 35g of carbohydrate total. I took five units; that's a 1:10 ratio plus one extra unit per 10 points I was over target (i.e. 120) going into the meal. Two hours later, I was ready for bed -- we had a late dinner -- and I checked my blood sugar. It was 47. Great. I tried to convince Keith to make me a peanut butter and jelly sandwich, because I was starving for one. Hypoglycemia makes you 1) stupid, and 2) really hungry. He rightly told me that I needed something to bring my blood sugar up now, meaning something with almost pure carbohydrate and no fat or protein. He said, how about juice? I talked him into a glass of milk. We further negotiated a peanut butter and jelly sandwich, but only after the milk had had a chance to work.
Fifteen minutes later, feeling grumpy but not really super hungry anymore, a peanut butter and (no-sugar-added) jelly on rye bread sandwich arrived. (25g of carbohydrate; the milk had been approximately 12g of carbohydrate.) I ate it, and fell asleep. This morning I woke up to a fasting blood sugar of 120, which is really way too high for pregnancy, so obviously my blood sugar went pretty high after I ate the damn sandwich.
Welcome to my life. This is what I deal with every single day. It's like playing a game where the rules are constantly changing and you're always trying to adjust your strategy after the fact (kind of like the Bush Administration's approach to terrorism, ha ha). And the stakes are nothing less than the health and safety of your unborn fetus.
If you've stuck with me through this long and probably boring entry, I congratulate you. (Just imagine how boring it must be to actually live through it.) Tomorrow I may actually write something upbeat. We're taking the kids to the apple orchard later so there should be some good stories from there.
Posted at September 29, 2006 10:38 AM
Posted by: casey at September 29, 2006 11:07 AM
I just can't imagine. A constant roller-coaster, and not knowing what's going to cause up or down. Best of luck, Dear, in figuring this one out.
Posted by: Bibi at September 29, 2006 1:15 PM
I'm not bored, Jan! That's how I remember geatational diabetes. No matter what I did, it seemed wrong. "Good" food shot blood sugar up like aroclket, and bad foods were like "meh" sometimes. Weird, weird stuff.
Because I'm a geek I made spreadsheets and plots of my blood sugar and what I ate, and though it wasn't completely and utterly random, it wasn't as cut and dried as the medical profession would like to think.
Posted by: planetmort at September 29, 2006 2:17 PM
Wow, how frustrating and confusing. I guess I was really very lucky with my GD and never even had to worry about insulin. Ironically I just got the lab result tests back today (about an hour ago) with my 2 hour Glucose test and insulin levels (because I never went back for it since having Tristan) and am pleased to learn that my insulin levels (with PCOS I tend to be insulin resisitant) and glucose levels were fine!!!! Wild! And a relief. I was a little worried because I'm heavier now than I've ever been even since being pregnant!
Congratulations on Baby #3!!!! I'm so happy for you and a little envious. I always wanted three, but it's simply not going to happen for us (Michael's fixed), so I enjoy the two I have and try not to morn my last miscarriage too much.
*hugs* and I hope your blood sugars stay in check more in the future!!!
Posted by: Heidi at October 13, 2006 5:15 PM
Stupid fracking diabetes.