Gestational Diabetes, or Pi Day Surprise

In the grand scheme of things, yesterday was not a tragedy or a disaster. But it was overwhelming, and the kind of day I just wanted to sleep off. I didn't, incidentally. I woke up around 1 and got only patchy sleep for the rest of the night, which means today I feel both overwhelmed and exhausted, and am having a hard time getting into the Pi Day spirit.

And to top it off, I can't properly celebrate Pi Day by eating pie, because the reason yesterday was overwhelming was that I was diagnosed with gestational diabetes.

What Happened
I had an appointment with my OB-GYN yesterday morning. I knew I'd be getting the results of the routine glucose tolerance test that every pregnant woman takes around week 28 (more on that below), but I wasn't super worried. Gestational diabetes is a condition that arises late in pregnancy when hormones from the placenta interfere with the mother's ability to produce insulin, and it goes away after pregnancy. Although some women are at higher risk than others, anyone can get it. Still, I thought my lack of risk factors would keep me safe.

But when my doctor walked in with my chart he said, "First things first. Your blood sugar levels are really not good," and in my memory I can almost feel the ground shifting beneath me as I sat there in the examination room.

Here's how the story usually plays out: You visit the lab a week before your 28 week appointment, chug down a super-concentrated 50 g glucose solution, wait an hour, and have your blood drawn. Most of the time the story ends there (that's what I was hoping for yesterday morning). But if your blood sugar is high (140-200), your doctor will let you know at your appointment and have you return to the lab to take a second test. For the second test, you take an extra-super-concentrated 100 g glucose solution after having your blood drawn as a baseline. Then every hour for three hours you have your blood drawn again. If your blood sugar exceeds certain levels for at least two of the blood draws, you are diagnosed with gestational diabetes. The first 1-hour test is a screening test, and turns up a lot of false positives, so failing that test does not mean you have gestational diabetes, just that you have to take the second test, and most (or at least many) women who do are fine. That's the second-best scenario, and I would have been happy with that. The worst-case scenario, of course, is failing the second test. Or so I thought.

Except sometimes your glucose levels after the first test are so high that they skip the second test altogether and jump right to the diagnosis. I actually didn't know this until yesterday. My glucose levels, it turns out, were just over 220, easily above the cutoff for jumping straight to diagnosis. This was the last thing I was expecting. In a cruel twist, even my doctor was surprised by how high my blood sugar levels were, and he wrote me a lab request for the 3 hour test anyway. As frighteningly high as my blood sugar levels were, I didn't even get to get out of the second test. That was worse than my worst-case scenario.

After getting the news at my appointment I went to campus to teach my one class of the day, skipped lunch because you have to take the 3 hour test fasting, and returned to the lab in the afternoon, for a very long time. It turns out that a 100 g glucose solution is just as twice-as-icky-as-a-50g-solution as it sounds, and 3 hours is just as long as you'd expect. I spent an awfully long time camped out on a chair outside the lab and gift shop of Orem Community Hospital, and it kind of started to feel like a little home. The whole ordeal was made easier by the lab technician, who remembered me from my test the previous week, and was just awesome. She checked up on me between blood extractions and gave me lots of encouraging words during, and really made me feel like she cared about me as a person. At the end of the test she pulled up the results of the first two blood draws so I wouldn't have to worry myself overnight, and when they did indeed come up (very, very) high, she hugged me and told me I'd be just fine.

How I Felt
I felt very composed at the doctor's office in the morning when I first learned how high my initial test readings were, but when I walked out to my car and called Brian to tell him the news (usually he comes with me to appointments, but this week school responsibilities meant he couldn't be there), I felt shaky and overwhelmed. I got past the shakiness, but I haven't stopped feeling overwhelmed. My overwhelmed feelings have jumped from little things, like not being able to drink the limeade Brian saved for me from the night before, or making cookies for a friend's wedding this weekend and not being able to eat the dough, to larger things, like the effect of unregulated diabetes on a fetus and the worry that in my ignorance I have been putting all sorts of things in my body that were sending too much sugar to the baby.

And I kind of felt a little embarrassed about the diagnosis, like I had done something wrong and had caused myself to have diabetes and put the baby at risk. I knew in my head that this was not true, but it still felt to me like I had not been taking care of my baby properly. The diagnosis is still new, and so I still kind of feel that way, and I don't expect the feeling to go away overnight. But already what's helping most is just telling people, and realizing that the reaction I get is sympathy and surprise, not judgment. I knew it would be, it just helps to actually experience it.

What It All Means
I have yet to meet with a dietician - that will probably happen early next week - but since yesterday morning I've been scouring the internet for what this all means for me and my baby over the next two months. What I've come up with is no sweets (right - no sweets), carb counting, carefully spaced meals and snacks, not to mention the three-times-a-day finger pricking to check my blood sugar levels. Several websites told me not to think of it as a restrictive diet, but just as a healthy diet "which you should be eating anyway," but it's hard for me not to see the gestational diabetes diet guidelines I read as non-restrictive when they look so different from my normal diet - and require so much more thought and monitoring!

I wish I could say that I feel brave and ready to take on the challenge for the good of my baby, but right now I'm kind of wallowing in the dauntingness of the two and a half months ahead. Still, I don't want to keep wallowing, and I'm trying to focus on the positives. For one, it's great that this was diagnosed at all. Gestational diabetes is something that can have an effect on our baby and on his future health, and it's wonderful that we live in a time when it can be caught and monitored before it does. Also, I have a very loving, understanding, supportive husband at my side, which makes everything that much easier. I'm also trying to focus less on things I like that I can't eat (chocolate, oatmeal with brown sugar in the morning, Easter candy, Pi Day pie, cake, muffins, cookie dough, ice cream) and instead to focus on the things I like that I still can (cottage cheese! carrots! peanut butter! hummus! scrambled eggs! black beans! tofu! yeah, it's not working quite yet).

Finally, it may be easier than I expect it to be or it may be harder, but regardless it's only for 2 1/2 months. Given how easy my pregnancy has been so far, I guess I can accept that something has to be hard.

If you have any experience with gestational diabetes or tips, I'd love to hear them.