Monday, October 15, 2012

Grumpy, rainy, blah, low day.

HB and I recently started watching the show Once Upon A Time and, for those of you who don't watch it, oh my goodness is it addictive.  The plot is a witty, complex hybrid of fairy tales and (Hollywood) reality that has story book characters fighting for their memories and lives in the fictional small town of Storybrooke, Maine.  The reason I bring this up is that there is a scene in Season One where Snow White is talking with Grumpy and the other dwarves about her intention to take a potion that will cause her to forget all of her pain.  Grumpy, who Snow is specifically trying to convince of the brilliance of her plan, talks her out of her voluntary amnesia by explaining to her that "as wretched as it is, I need my pain.  It makes me who I am.  It makes me grumpy."

Now, if you can't find the humor in that brilliant script writing then I have no further explanation of anything in this post worth reading.  But, in the feeble attempt to throw a grain of salted humor on an otherwise open wound, I have to admit that Grumpy totally has a point: we are a walking, talking portrait of our histories and, to be true to ourselves, we must acknowledge who we are and where we've come from.  So starting as a pregnant diabetic and going from there, I have somehow managed to turn into a crotchety, bearded dwarf in the past couple days. 

Someone really ought to call the tabloids. 

It's a combination of the stress of the last three weeks, the overcast, crumby, dank weather outside and the constant hypoglycemic blood sugars I keep fighting that have caused the change.  If it wasn't for GW's incessant hugs and kisses I'd probably shrink a couple inches and be permanently attached to a pickaxe by now, but seriously, you try to be low all the time and not turn grumpy! It makes me shake, it makes me sweat, it makes me short tempered, it makes me physically and mentally weak, and it makes me worried.  The last of which is by far the worst symptom.

As I've explained previously, at this point in a diabetic pregnancy - regardless of what type of diabetes you're talking about - the mother should be experiencing increasing insulin resistance as a result of the placenta creating copious amounts of pregnancy hormones that cause the body to ineffectively absorb insulin.  In other words, there should be increased insulin requirements, more regular hyperglycemic readings and very few hypoglycemic episodes.  But over the last couple days, I have been struggling to keep my blood sugars out of the 50s and I've been decreasing my basal and bolus rates to fight off the low, grumpy, blah blues... 

I mean, I wake up and my blood sugar is in the mid 60s so I eat breakfast to correct this and it some how manages to drop lower when it ought to even out.  I correct for it again (home made fudge for GW's bday, so good and sooo very full of carbs) and remain low.  I repeat this a couple more times and remain low.  And finally I under bolus at dinner and manage to get up into the 90s-130s for a while - but even at that point, while that is a safe, healthy number it is lower than it typically ought to be for a postprandial with "insufficient insulin." 

HB faxed my logs to the endocrinologist and, when she eventually calls back, I expect her to basically confirm that I should decrease my basal and bolus rates (which I've already done) - but that doesn't explain why my rates are decreasing.  We also contacted the perinatologist to get their take on it and make sure that we're not looking at the issue we were warned about at my infamously "healthy" week 29 appointment of placenta deterioration (aka the old placenta).  Unfortunately, all of my diabetes and pregnancy books and web sources indicate that this is likely the case but until the perinatologist confirms this I'm just not ready to go there. 

Ideally the situation would be entirely my fault due to poor carb counting or manual errors in programming my pump, but I know my pump is dead nuts where the endocrinologist told me have it at my last appointment and Lord help anyone who thinks I can't do the basic arithmetic it takes to do accurate carbohydrate counting.  I'm hard enough on myself about being diabetic and doing things right the first time that slacking or miscalculation just doesn't happen at this consistent rate... not exactly uplifting.    

Hopefully the docs will get back to me shortly, but for the time being I'm going to hide in my bedcover-cave and grumble whenever I have to emerge for yet another quick carb.  Definitely not the lying in bed eating bon-bons situation I'd like to be in. 


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