Tuesday, July 28, 2009

It's a good thing I'm not much of a foodie. Also, I love my mommy and daddy.

Well, shame on me for being all glib and smug about my blood sugar and how all I needed was a meal plan or a list of what I could and couldn't eat to get everything under control.  

Because it turns out that, for whatever reason (possibly my age), this pregnancy has brought on an unbelievable level of insulin resistance in my body, meaning that the slightest thing -- half an english muffin, a single graham cracker square, or even a cup of milk (and I mean 1 cup as measured by a measuring cup) -- sends my glucose numbers through the roof.  

Which is bad.

I went to my class last week and was provided with a meal plan and a book detailing all different kinds of foods and what constitutes a serving, for purposes of the meal plan.  I had my trusty blood glucose monitor, as well as extra lancets and testing strips.  I had even already read the directions and practiced using the monitor a few times, in order to truly cement my status as the class nerd.  And the dietician/nurse taught us all about what gestational diabetes is and what causes it and what kinds of pregnancy complications it can bring on and how to measure portions and how to space out your meals and snacks and blah blee bloo.  

The meal plan is very precise, and looked something like this:
Breakfast:  3 carb servings (15 g of carbs = a serving), including a cup of milk, but no fruit; 1 protein serving; 1 fat serving (like a pat of butter or olive oil for cooking)

Morning snack:  1 carb servings, but no fruit

Lunch: 3 carbs (including 1 cup of milk); 3 proteins; 1 fat; and additional servings of non-starchy vegetables*

Afternoon snack:  1 carb, 1 protein

Dinner:  3 carbs (including milk); 3 proteins; 1 fat; non-starchy veggies

Late night snack:  1 carb, 1 protein
I'm to test my blood sugar levels 4 times a day:  a fasting level first thing in the morning, and then 1 hour after breakfast, lunch and dinner.

As a classic oldest child/numbers-and-data geek who thrives on a regimen and can't stand disappointing anyone (including a dietician I've never met), I arranged my papers with the meal plan and charts for writing down all of my meals, meal times, and blood sugar numbers in a handy-dandy folder.  I went to the grocery store and stocked up on the recommended foods and started working out my meals for the week.  And I was kind of psyched, because carb servings, according to my book, can include small servings of pasta or rice or a few graham crackers or goldfish or fruit (in the afternoon).  So it didn't seem like I would be that limited in what I'd be allowed to eat.  I'd just have to watch portion sizes and be sensible.  

I followed the meal plan to the letter.  I tried not to deviate from the portion sizes by even a measly gram.  I wrote everything down.  I tested my blood an hour after eating, timing the testing to the minute.  I was a good girl.

And still, my numbers were way too high.

So after a few days, I called the dietician, and we tweaked the meal plan so that I would eat fewer carb servings and more protein servings at a giving meal.  For example, instead of having 3 carbs and 1 protein at breakfast, I'd have 2 carbs (including the milk) and 2 proteins at breakfast.  So instead of an english muffin (both slices), a cup of milk, and an egg, I'd have one english muffin slice, a cup of milk, and 2 eggs.  Instead of having 1 carb as a morning snack (say, 4 graham cracker squares), I'd have the graham crackers plus a protein serving (a piece of string cheese).  

Once again, I followed the instructions religiously.  I wrote everything down.  I tested my blood.  I was a good girl.

And still, my numbers weren't where they should be, particularly the fasting number (taken first thing in the morning), which is the number over which I have the least amount of control.  I tried changing the timing of my late night snack, I tried cutting out the carbs altogether and just having a small cup of cottage cheese with some almonds sprinkled on top, and nothing worked.

So I kept on tweaking and tweaking the menu to the point where I am now eating no fruit and no starches or flour-based carbs at all (i.e., no pasta, rice, bread, potatoes, or sugar of any kind).  I'm using supplemental shakes and protein bars that you find in the diabetics' aisle at the drug store.  I'm still drinking milk, because it's good for the baby and keeps my teeth from being leeched of all calcium by the little parasite living in my belly, but I drink it a little while after a meal, because if I drink it with a meal, it sends my numbers up too high.

And only now are my post-prandial blood sugar numbers in an acceptable range.  But my fasting number is still too high.

The entire ordeal has completely stressed me out.  I had a period of about 36 hours from Sunday through last night in which I spent much of my waking hours crying or on the verge of tears.  Because all of this diabetes shit is on top of my generally constant level of exhaustion, worrying about how I'm going to pay my bills while on maternity leave (I have no maternity leave benefits this time around), how I'm going to pay for a second round of daycare when I took a huge pay-cut to work for a non-profit, how I'm going to take care of two kids by myself during the week while Jason is in Vail, and on and on.

But today I went to see my OB, and she put me on some glucose lowering medication that should bring my fasting levels down, and bring the other numbers down with it.  It's a low dose, I only have to take it once a day, and it should help.  I still am on heightened monitoring over the next 9 weeks to look at the baby's growth and development, but it seems like all should be well.

And yesterday I talked to my parents, and they are so sweet and supportive, and assured me that I didn't need to worry about money, they would help me with anything Jason and I needed. 

My dad said, "listen, you and Jason left Hawaii for legitimate reasons, and you managed to move to a new city and you both found decent jobs in the worst economy this country has seen in 80 years.  You're wonderful parents, you work hard, you don't live extravagantly.  Whatever you need, we're happy to help you out."

"But I don't want to take your money.  I should be able to deal with this on my own."

"Honey, that's what parents are for.  Everyone goes through tough financial times, and you'll come out of this because you're smart and talented.  My dad helped me what I needed it, and I will help you.  It's how it should be.  So I can't do anything about your blood glucose numbers, but I don't want you worrying about money, because your mom and I won't let anything happen to you."

"Thanks, Dad.  I really appreciate it.  You and mom have been so great."

"Well, we love you.  You are a wonderful daughter, and you've always made us proud, and we're happy to be in a position to be able to help you.  And we love Jason.  He's a great father and a great husband."

"We love you too."

"We'll just take Zeke as collateral."

Seems fair.
*Veggies have carbs, but don't cause big spikes in blood glucose numbers because it takes the body longer to break them down.  So while you could eat a portion of pasta or a portion of veggies and they might have similar grams of carbs, the pasta will cause blood sugar spikes whereas the veggies won't.


  1. Oh, Wendy, that's hugely stressful. I'm glad your parents are so awesome. My friend Tej had GD and her fasting numbers were off as well, and then she started taking some pill - I imagine the same one as you - and it evened things out. I hope it does the same for you. Hang in there!

  2. Oh Wendy, I'm so sorry to hear about your stress. Sounds like your GD is under control, though, so that's good. And I know that feeling about not wanting to lean on your parents, but you know what? It's very, very common for our generation. If Fred's parents hadn't helped us out, we wouldn't have been able to buy our apartment, and I have no idea how we'd pay for Walt's preschool. My parents pretty much pay for our one vacation a year to Hilton Head. Like you and Jason, we don't live extravagantly nor spend more than we make. It's just tough.

  3. You seriously do have wonderful parents. I hope that things smooth out for you very, very soon.

  4. Lisa -- thanks. I'm hopeful that the meds will get my numbers under better control, because otherwise I'll have to start insulin injections, which I really really really don't want to do.

    Anne -- it is amazing how much we still rely on our parents. I guess I struggle with it because only a few years ago, I was living in Atlanta with a great job and a low mortgage payment and plenty of disposable income. And it's hard to be on the other end of the spectrum now. But this too shall pass.

    Lisa -- they are the greatest. I feel incredibly blessed.

  5. Your parents sound exactly like mine.

    We are damn lucky, aren't we? ;-)

  6. with my second pregnancy, they thought i was diabetic. i pretty much cried in the doctor's office because i didn't think i could do without my thrice weekly Mexican food.

    so sorry for all the stress.this time should be fun not upsetting.

  7. Wendy, this time will pass. And everyone single person I know is in the boat of "Things are Not As Good As They Once Were." Including us, for sure. Just be glad that you are not paying for your parents. (Shhhhhh Not that I know anyone who is.)

  8. LiLu - damn straight.

    gorillabuns - mmmm. Mexican food.

    Elizabeth - being a grownup blows sometimes. But I would gladly do anything for my parents if they needed me.