Thursday, April 17, 2008

More written therapy...

Last week was my regular doctor's appointment and it included the 1 hour glucose tolerance test. I failed it. I went back yesterday for the three hour test. I failed it, too. :(

I am now officially classified as "high risk" because of gestational diabetes. Obviously, this was not part of my plan. Let me clarify that the best explanation for gestational diabetes is that the hormones from the placenta make the insulin I produce less effective so that it can no longer handle my regular sugar intake effectively. I have NOT been sitting around gobbling up five pound bags of sugar, or otherwise eating any more sugar than I ever have in my life. That's not what causes this. Prior to pregancy, my blood sugar was always very normal.

I have a diet to follow and will be monitoring my sugar at home. I go back to the doctor in 2 weeks, and will continue to go every 2 weeks until I reach 36 weeks (then I'll go every week). As long as I keep my sugar levels where they are supposed to be with my diet and exercise, I don't have to have insulin shots. (Please everyone, pray that I don't have to have insulin shots. I don't know if I can give myself a shot, plus I don't want to deal with all the headache that comes with managing insulin and sugar levels.)

Diet and exercise are fine. I can do those things (Oh, how I will miss Coke and chocolate ice cream!), my worries about this are the implications it has on my health, the baby's, and my birth plans. For me it means that my chances of having gestational diabetes in subsequent pregnancies is 2 out of 3. Even though I will most likely be back to normal after birth, it increases my risk of developing Type 2 diabetes later in life (I didn't really need any more help there, but God made me this way and it's my responsibility to take care of this temple.)

For the baby it means a risk of her growing too large, which then increases the chances that I may need to be induced early or end up with a c-section. It also increases the chances that she'll be born early spontaneously, though, if I control my sugar it shouldn't be so early that there are adverse effects on her. There is a chance that she could have high or low blood sugar at birth and need some special attention for that, and that she could be more at risk for diabetes later in life (She doesn't need any help with that either!). There are also some scarier risks, but they are usually in extreme cases when sugar isn't controlled or the mother had diabetes prior to the pregnancy.

For the birth, it blows the lid right off of my best laid plans. Things could go just fine with me going into labor spontaneously and delivering her without a hitch (that's the plan), but the high risk classification just opens the door for interventions. It's fairly common for doctors to induce at 38 weeks to prevent the baby from growing too large. Inducing early increases the risk of a c-section because the body isn't ready to give birth yet and induction fails. Carrying the baby to term with diabetes increases the chances of shoulder dystocia (when the head is delivered and the shoulders get stuck in the birth canal) because of a large sized baby (babies are considered large if they are over 8.8 lbs). Given all this information, it's difficult to say with any accuracy how big the baby will be until it gets here. Even ultrasounds late in pregnancy can be off by a pound or more, and just because I've been diagnosed with a diabetes does not mean I will have a huge baby. I have lots to think about, and lots to discuss with the doctor.

On to happier things. I am 28 weeks 1 day. She is about 10 inches long and 2 lbs 7 ounces, according to the pregnancy calendar. Last week, the doctor measured me for the first time and I measured right on time at 27 cms. While I may LOOK huge, I'm actually right where I'm supposed to be. So there!

By the way, I LOVE my doctor. I asked him a ton of questions last week and his answers were right in line with what I wanted to hear. He made me feel better about some things, and I trust him even more now to do what's best for me and the baby. The best part - I talked to him about hypnosis and he seemed intrigued. He has some training in hypnosis for childbirth, but he's never had the opportunity to use it. I will be his first patient to use that method. He wanted to know what program I am using and the websites where he can read more about it. He's very supportive!

On that note, I have solid confirmation that the techniques I've been practicing work. The other night I was lying in bed and my knees were throbbing in pain. I don't know why, but I had taken some Tylenol and it wasn't doing anything for me (drugs don't work as well when you are pregnant). I decided I would try hypnosis to see if I could make them stop hurting. It worked! It worked so well and so fast! It's very affirming to know that my mind is so powerful.

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