Why Gestational Diabetes is a Pain in my Ass

Caden spots chickadees in his bird feeder

Last night Caden had a sleep over with his Grommy, and Cameron and I got to go on an early date. As seems to be the pattern with dates for us, I had a terrible resurgence of nausea in the afternoon that left me whimpering in bed not wanting to do anything. I took some Zofran, I slept, and around 3:00 asserted that I could do it. I told Caden he needed to put on clean clothes (as opposed to the egg, dog hair, and peanut butter covered ones he was sporting), and he cried and clutched at his clothes until he spotted in his closet a button down shirt with a little red tie I bought at some Christmas clearance sale. "I want to look fancy. I want to wear the shirt with the ribbon!" Be my guest son. So he chose his ripped and patched, but ever so soft blue corduroys, and a gray striped button down with a red pretied tie that velcros around his neck. Pretty dang cute. I ate a sandwich, Caden packed his backpack with the essentials (a mickey mouse keyboard) and we piled into the car. I entered my mother in laws condo and went straight for the fridge in a desperate search for something carbonated. Let us just pause now and consider the fact that I have gestational diabetes. Fucking gestational diabetes. Dealing with nausea, trying to catch up on weight gain, and following a diabetic diet has not been easy, and even though through these fertility struggles I have been the queen of special diets, I am not doing so great with this one. I found the carbonated stash, read the label on the lemon/lime Izzie's that looked so delicious, yikes! No way. Way too many carbs (read: carbs=sugar). I moved on to some vaguely flavored sparkling water and started munching on some gluten free pretzels she was using to make bread crumbs. Wait! Shit, carbs without protein! Pulled a cheese stick out of my purse and sat down to try and get the queasiness to settle. Caden, on the other hand, was wildly gesticulating telling Grommy about the chickadees that came to the bird feed he made, the pinball machines he played with his dad, and what he'd had for lunch that day. Then he stopped and said "Grommy, do you want to play with me?" Cameron and I left, our boy barely waving goodbye so enrapt with his Grandmother was he.

Next stop, Inside Llewyn Davis, the new Cohen Brother flick, at the Cinemagic. That theatre is in sad shape, but I appreciated that there were no weird commercials running before the show other than a little slide show of still ads for local business. I was again, totally nauseous, and bought a sprite. No, soda is not allowed on a diabetic diet, but as I have stopped carrying a little blue hospital puke bag with me, I really wanted to avoid hurling during the movie. I tried to temper it with nuts and cheese, and know what? The sprite was magic. Nausea went away! And I could settle into my broken back squeaky chair and travel through 1960's Greenwich Village without fear of vomit. I held my husband's hand and enjoyed. Sigh of relief.

Movie ended and we began to discuss dinner. I was verging on hungry, and hungry often means nausea and/or low blood sugars followed by spiked blood sugars when I eat, so I was anxious to get on it. My super smart husband had made reservations at a fancy Mexican restaurant for right that second! He called, and they said they would hold our table. At Xico, we were led to a cute little corner table with a window seat in a warm, colorful room with beautiful paper flowers, a chandelier of twisted orange and pink lights, and real calla lillies blooming within sight. We ordered appetizers, trying to temper all my needs: low glycemic index, low spice, gluten free. The agua fresca was prickly fruit, and I knew I couldn't have it, but I asked for soda water with just a splash. Delightful. We had queso fundido (salsas and chorizo on the side) with home made tortillas, guacamole and chips, and lamb barbacoa gorditas. Everything was so good, and my heart was all full and happy nestled in the corner with my husband who makes me laugh and lets me ramble about babies and other people's stories and my fantasies of travel for our ten year wedding anniversary. I tried to be aware of the carbs- not too many chips, not too many tortillas, but I was not really in the mood to deprive myself. When we wrapped up the meal I felt full and solid in my body, no racing heart or zingy limbs that can mean too much sugar in my blood. We walked for a while as that can help to keep sugars from spiking, and Cameron realized he needed to use some test card for his work so went into a convenience store and bought a couple things. when it was time to test, my blood sugars came in just within the normal range. Victory, or so I thought.

Here's the thing. With carbs, you get pretty immediate feeedback. In general they peak about an hour after you've eaten, and you've burned all the way through them in 2-3 hours. Proteins and fats are different. They burn slow, and fats raise your blood sugars slowly over the course of about 8 hours. As someone who is carrying twins and needs to gain weight to make up for what I lost in the first trimester, everyone agrees that I shouldn't follow the diabetic restrictions on portion size and fats. Being that I have for the past year or so been eating a high protein, high fat diet, this was a relief to me, and yet, those chips? That fried masa cake all that juicy lamb was stuffed into? Did that contribute to my high high high fasting glucose reading? Or was it my poor choice in night time snacks? Or maybe a combination of the two.

Remember that convenience store? I bought a Kind Bar advertised as "Low glycemic index, high protein!" When I looked at the label, it seemed alright, even though it had chocolate in it. I put it in my cooler bag I keep next to my bed at night with a glass of milk, and when I woke in the middle of the night I ate about half of it. Did it spike my blood sugar? Which was followed by a big drop, which then caused my body to dump a bunch of morning glucose? Probably. Because when I saw my blood sugar was really high this morning, what did I do? Did I get out of bed and make some eggs, which I know bring my morning blood sugar down? No. I ate the rest of that bar and finished off my milk because it was 5:30 and my son was at his grandmother's and I wanted to sleep in. Except that 20 minutes later my heart was slamming in my chest and my skin was prickly and itchy. I tested my blood sugars again. and Shit. Through the roof. I still tried to go back to sleep, but I felt all kinds of wrong, and I didn't want to have my blood sugar totally bottom out after the sugar high, so I got up, made some kale and eggs, and here I sit.

This isn't the first time I've been though a cycle like this, although this was the worst. For the most part in my day to day life I'm dong really well controlling the diabetes with diet and some mild exercise, but going out to eat, dates with friends, a night out with my husband, these are much harder for me to navigate and often leave me with whacked out blood sugars. I also pretty consistently have high numbers right when I wake up- and nothing has seemed to make much of a difference in that regard save eating yogurt and nuts around 3am, but I'm not always awake at 3am. And of course, this stresses me out. It stresses me out to think of my little turnip sized babies also going through weird sugar highs and lows, and their little pancreases working overtime to produce extra insulin because I made a ridiculous choice of a night time snack. And I worry that I will have to be induced or have a c-section early when we get near the end if I can't keep this under control. And I worry that when they are born they won't be able to regulate their blood sugars, and if they are small or early this could be another thing for their little bodies to handle in a rough transition into the world. I have been worrying.

It seems like the professionals counseling my on my diabetes don't completely know what to do with me. They are used to people with gestational diabetes being much further along in their pregnancies, carrying only one baby, and being overweight. At my first appointment the dietitian asked my with scolding in her voice "So, how much weight have you gained?" and was completely flabbergasted when I told her I'd actually lost weight since I'd been pregnant (how would she have reacted if I'd gained a lot? It seemed like a set up for some shaming, but I digress). Since then everyone keeps telling me I'll be fine, just keep eating, but my numbers are telling me differently. Also, since I'm in this for the long haul of the pregnancy, not just the third trimester, I keep getting the message that it's ok to splurge every now and then, but I'm not just not so sure. I've been so happy lately to have the energy to even go out, to see friends,  to sit in a restaurant and not find the smell of food completely repulsive, that I have been allowing myself to step outside the diabetes box from time to time, but I think as I see this pattern emerge, it is not worth the physical and emotional stress. My blood sugar is back in normal range now, but I still feel a little strange and jittery. In the end, it was a perfect date, and I don't want to ruin it with an overlay of guilt, but I have to be more careful. It was probably that bar more than dinner that whacked me out, but when I look at all the different cheats during the day yesterday, I wonder about the cumulative affect. I will probably have to go on some sort of medication soon to control those fasting morning numbers, and I can't help but feel like I've failed. And as someone who usually likes to do things naturally, I am on a lot of medication already! But then again, I suppose this pregnancy could never have occurred without medication. IVF is hardly natural.

The sun is up. I'm exhausted. Maybe I can forgive myself and sleep a while before it's time to go fetch Caden from his slumber party. Start the day again.