Friday, January 8, 2010

How many needle sticks does it take to have a baby?

It's really not that bad. I mean, pricking your finger is nothing compared to a lupron injection, let alone HCG or the dreaded PIO (which, thankfully, I did not have to experience). But from 28w6d through the end of this pregnancy, I will be pricking my fingers 4 times each day to test my blood sugar levels. If the numbers cooperate, that's all I'll be doing. So far, I can't tell if they're cooperating or not. I've had two readings in two days that were above the "acceptable" maximum, but not by much.

I met with the nutritionist on Wednesday afternoon for my "diabetes education" session. I have a nifty meter to use 4 times each day to test my blood glucose level when I first wake in the morning and again one hour after each meal. It's essentially painless, just requires that I remember to do it on time and to bring the meter and test strips with me everywhere.

For those of you unfamiliar with the 3-hour glucose test, I'll provide some background. After fasting for 10 hours, a blood sample is drawn then the patient drinks a very sweet, sugary drink (I'm guessing it was about 16 ounces of the stuff). Additional blood draws occur 1, 2 and 3 hours after the beverage is consumed. The glucose content of each blood sample is measured and compared with acceptable standards. If any one number is significantly high, or if two or more are above "normal," then the patient is considered to have developed gestational diabetes (obviously, I am talking about pregnant patients here).

The acceptable results for each step are:
fasting < 95 mg/dL
1-hour < 180 mg/dL
2-hour < 155 mg/dL
3-hour < 140 mg/dL

My results were high for three of the four time periods.

The nutritionist explained to me that pregnancy hormones can make a woman insulin-resistant, so gestational diabetes isn't entirely dependent on weight or diet, although being overweight and eating a high-carb diet can contribute. The concern with GD is that the extra sugar in the mother's blood will pass to the growing baby and be stored as fat. When the baby is born and no longer receiving massive doses of sugar from the mom's blood, the insulin that the baby is used to making will cause hypoglycemia. Also, an overly-large baby can cause problems with the delivery.

The first step is to monitor blood sugar as I've been instructed, to pay close attention to my diet, and to continue exercising (I've taken to walking the local mall... the sidewalks are too choked with snow right now, and it gets dark far too early for me to feel safe walking my neighborhood streets) on a regular basis. The nutritionist emphasized that babies NEED carbs, so under no circumstances am I to adopt an excessively low- or no-carb diet. My daily menu should include:
Breakfast of approximately 30g carbohydrates;
Morning snack of ~15g carbs;
Lunch of ~45g carbs;
Afternoon snack of ~15g carbs;
Dinner of ~45

These numbers were given to me as MINIMUMS- much less, and there's a danger that the baby will not be receiving all that s/he needs. I was also told to test my urine (more pee-sticks!) each morning before eating to check for the presence of ketones. Ketones would indicate that I waited too long between meals, in which case I should have an evening snack, including about 15g of carbs and some protein, before bed each night.

So far, my glucose has been a bit high on two occasions in the last 2 days, but not excessively so. I'm hoping that I can maintain the right balance to avoid having to add insulin to the equation. Most of all, I want this baby to be healthy, and hopefully of a size that's conducive to a natural birth. C and I attended our first hypnobirthing class last night, and I'd love to come out of this with a healthy baby and something that approcahes my ideal birth experience. Top priority, though, is the healthy baby.

Eyes on the prize!

While we're thinking of healthy babies, please say a prayer or send positive vibes or whatever is your thing to do to my college friend who is having her baby delivered via c-section as we speak at 31 1/2 weeks. Getting to this point was not easy for her, and she and her DH will be incredible parents. I wish them all the best of outcomes.


IrishNYC said...

You can do it! Make sure you get those snacks in. I'm here if you have any questions at all.

Best of luck to your friend. I hope her little one is well.

sarah said...

It sounds like you are taking this in stride!

mekate said...

well crap about your GD, but glad you just need to test not treat at this point. Still though, bummer!

And should I be so lucky- my priorities are like yours
healthy momma, healthy baby
but I sure have loads of preferences on how to get there!

thinking of you,
and hoping your friend and her baby are doing wonderfully.


mekate said...

thanks for the comment and I so TOTALLY agree with you-- sometimes I get so wrapped up in my insides I cannot see anything else, perspective truly is amazing, both the close and the far. Wishing you a fine day!