Wednesday, August 29, 2012

And that, my friends, is the Webster's definition of amazing.

So my endocrinology appointment on Monday came and went with next to no fanfare.  I anticipated the doctor to tell me that my numbers this past week were atrocious and that my body is obviously becoming insulin resistant, but instead she looked at my numbers over the past three months and decided that I actually need to turn my sensitivity levels down from 80 ml/dl per unit of insulin to 85 and that if I continue to see regular lows I should decrease it even further to 90.  Fair enough...  beyond that she had nothing else to say about my self care and asked to see me every three weeks until the baby  is delivered.

Unfortunately their office was out of the in-office HgA1C test kits and they were unable to tell me right away the most important information of the appointment.  HB, GW and I trotted down stairs to the hospital lab to have them run the test and I must say that I had the best phlebotomist I think I've ever encountered draw my blood with absolutely zero pain.  Maybe I'm getting too used to needles, but seriously this girl managed to get four vials of blood without even the smallest pinch!

Any way, I had to wait and wait and wait and wait and... wait before finding out what the number was.  But instead of eventually receiving a random phone call from the nurse's assistant, the doctor herself called to deliver the news. My HgA1C is down and that it is the wholly impressive number of 5.3!  Yes, people, that is in non-diabetic range and, yes, I have been doing that well with my blood sugar control.  Little party for me!

For the time being, I'm continuing as is until my next appointment with her on September 14. The reason she wants to see me every three weeks until delivery is to make sure that my sugars are in the range they need to be in for the third trimester of pregnancy.  It's particularly important that my blood glucose be under control now because if they are too high too often then the baby will grow larger than she ought to and that could lead to issues with delivery.  Furthermore, it is very important that my sugars are in control with regards to my other pregnancy complications because if Baby could arrive whenever it is extremely important that my sugars are normal so that the baby is born with normal blood sugars as well.  If my sugars are high, that glucose is transmitted via the placenta to the baby and causes her pancreas to increase insulin production to combat her resulting high bgs.  But if she is born while I am hyperglycemic and she is subsequently disconnected from the placenta (aka the source of extra glucose) she will be born hypoglycemic and will need to be put in the NICU until her sugars stabilize.  Which I, obviously, want to avoid to the best of my ability.

I'm planning to keep my sugars on lock down until she's out, but even during delivery I am planning to run my own diabetes management.  Typically most hospitals want to take over checking a diabetic's sugars and administering insulin via an IV drip for the patient, but I am not comfortable with anyone's standards but my own - so I'm going to do it.  Either HB or I will check my bg every 30 minutes and we'll keep my pump on so that we can fine tune as necessary to keep me at 120 mg/dl or under throughout labor.  If I have to have an emergency c-section, obviously that goes out the window, but in all other scenarios I'll fight anyone tooth and nail to maintain as much control over my body and my pancreas as I possibly can.  It's my responsibility, after all, to grow this baby and raise her once she's out, so while I am willing to accept outside help I reject anyone's suggestion that I hand over the responsibility for my baby daughter while she is encountering the world for the first time.

Yes, I am stubborn, but you probably noticed that already.  Ah well, this stubbornness is why my HgA1C rocks the socks off of my endocrinologist... pardon me while I keep it up!


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