Gestational Diabetes ladies - I need to be talked down...

[grailseeker14]

So I was diagnosed with gestational diabetes about 2 1/2 weeks ago. I met with a dietician last week and started revising my diet, and then the nurse had me start monitoring blood glucose starting this past Monday. SO much to take in and get figured out!!! I thought I was doing a good job wrangling things into some sensible range, but then today has been a particularly bad day as far as my blood monitoring after meals goes. Even keeping within my carb choice limits, my after-meal glucose is has been between 20-80 mg/dL above the max (120 mg/dL). The 80 mg/dL above max was definitely an outlier, I haven't had results anywhere near that high ever before.

Add on top of that, I had an appointment with my OB today. I love my OB, I always feel calmed and reassured during our meetings, but then a few hours after the appointment things sink in and I start feeling anxious. He was okay with my glucose numbers so far (discounting the one spike this morning as an outlier) but went directly into talking about going on insulin at some point in the near future and being induced at 39w or sooner (I'm 28w now).

Cue inner freakout.

I haven't had any other days like this before, but pair it with my doctor talking plans that blow my "dream birth" out of the water just has me on the verge of meltdown, feeling overwhelmed, and really alone.

How do you all deal with those "bad days" on the blood glucose #s?
How are your doctors approaching things like insulin and eventual induction?

[downtheshore]

I'm sorry that your doctor is not on board with your plans for how you'd like your birth to go. That's frustrating and disappointing. Hugs. Sorry I don't have advice with the GD but it sounds like you are doing everything right.

[flippinchica]

I'm sorry for the GD diagnosis. That sucks. I haven't gotten to that point myself but it does seem that as a general rule docs like to deliver early-ish for GD pregnancies. I think I've heard by EDD for diet controlled and 39 weeks for those on insulin.
Sending all the hugs. Why can't it be easy?

[heathersf11]

I'm sorry that you have to deal with this. It is always disappointing when things don't go as we would like them to. ((((hugs))))

[taberbtb]

I am so sorry that you are feeling anxious about everything. I don't have any experience with GD, but just today had the discussion with my MW about induction for being post-date. It not at all how I planned things but i just need to keep reminding myself it about what's best for LO. There's still a small chance you could go into labour early and not require an induction but regardless of how LO arrives it won't even matter once you are holding your rainbow!! GL!!

[mrsjac1210]

No advice...but lots of ((hugs))

[mrsk91011]

Sorry to hear you have GD.

I had it with DD and my dietician let me call her for follow up questions. Check out meal and snack ideas from the American diabetes association. It is not very fun, but with the help of the dietician, it can be done without insulin. I would suggest that you call your dietician and work with her some more before you let your doc put you on insulin, especially since you have only had three days with the glucose monitor. Write down what you have been eating and the amounts and show it to the dietician and she what she says.

GD is not fun at all, but I know you can do it. ((Hugs))

Feel free to PM me anytime.

[grailseeker14]

downtheshore - it's not so much that he's not on board with my plans as that we haven't discussed my preferences and he's already talking about what he thinks will be necessary. Some others have mentioned to me that perhaps he's doing his due diligence to give me a heads up on what *might* happen but isn't necessarily pushing for it or guaranteeing it... it's me hearing it that way. I dunno - I plan to talk with him more about it at our next visit (or sometime sooner if I don't get some control over my blood sugar).

flippinchica - yeah! why can't it be easy? I was hoping to be able to control by diet so I could go into labor on my own hopefully on/around EDD... I wasn't feeling too confident about that today with a day of bad numbers (until dinner... I rocked it with dinner, Chipotle steak burrito bowl FOR THE WIN!) - I was feeling doomed to insulin and induction. Maybe/hopefully I can get some control and today will have been a freak out over nothing.

heathersf11 and mrsjac1210- thanks for the hugs

taberbtb - I hope your birth goes as closely to how you want and need! And you're so right -- none of this will matter, and in fact will all be worth it, once rainbow girl is in my arms. Must keep that in mind...

alleycat39 - ain't that the truth!!! Thanks for the hugs

mrsk91011 - that's a great suggestion! My OB's been having me keep a food + exercise journal alongside my glucose monitor log, and while I have a follow-up with the dietician in 2 weeks she did encourage me to email her if I had questions or need help tweaking my menus before then. Don't know why I didn't think to email her! Thanks for pointing me in that direction It's my goal to manage as well as I can with diet/exercise. Oh and I need to bookmark the american diabetes ass'n website... it's good stuff!

Thank you all - you helped talk me down and I'm feeling more grounded and better. (((HUGS))) and gratitude for you all

[darksidefootprint]

Jan 29, 2015 16:45:24 GMT -5 grailseeker14 said:

So I was diagnosed with gestational diabetes about 2 1/2 weeks ago. I met with a dietician last week and started revising my diet, and then the nurse had me start monitoring blood glucose starting this past Monday. SO much to take in and get figured out!!! I thought I was doing a good job wrangling things into some sensible range, but then today has been a particularly bad day as far as my blood monitoring after meals goes. Even keeping within my carb choice limits, my after-meal glucose is has been between 20-80 mg/dL above the max (120 mg/dL). The 80 mg/dL above max was definitely an outlier, I haven't had results anywhere near that high ever before.

Add on top of that, I had an appointment with my OB today. I love my OB, I always feel calmed and reassured during our meetings, but then a few hours after the appointment things sink in and I start feeling anxious. He was okay with my glucose numbers so far (discounting the one spike this morning as an outlier) but went directly into talking about going on insulin at some point in the near future and being induced at 39w or sooner (I'm 28w now).

Cue inner freakout.

I haven't had any other days like this before, but pair it with my doctor talking plans that blow my "dream birth" out of the water just has me on the verge of meltdown, feeling overwhelmed, and really alone.

How do you all deal with those "bad days" on the blood glucose #s?
How are your doctors approaching things like insulin and eventual induction?

According to my really brief Internet research, about 30 percent of women with GD are unable to control blood sugar levels with diet alone and rely on insulin. Don't be upset if you need to go on insulin - it might be disappointing to you but I strongly urge you to never feel bad when you are doing the best thing possible for you and your baby. Induction is a scary possibility but I wouldn't worry about it until it is decided with your doctor. With my son (when I had GD) my OB never mentioned induction and we got to 36w5d.

I know this all sucks, and GD sucks, and I really, really know the feeling that your body is letting you down, but you will get through this. You will not have your dream birth but most women don't -- and not because of GD or induction but because we can't plan for every contingency. It's like the saying "We plan. God laughs." I would think that everything seems overwhelming right now, but trust in your ability to kick ass in any given situation.

[grailseeker14]

darksidefootprint - I love what you said, thank you so much. I might have to paste these words on my fridge to remember them for the time being

[darksidefootprint]

Jan 29, 2015 22:29:58 GMT -5 grailseeker14 said:

darksidefootprint - I love what you said, thank you so much. I might have to paste these words on my fridge to remember them for the time being

After writing that to you, I think I was writing more to myself! I am 37w and keep being sent to L&D because my swelling is out of control, but (knock wood) no pre-e diagnosis. Being PgAL makes the stakes so much higher and terrifying. We can do this!

[shandorfml2]

I am sorry sweetie for the GD diagnosis. I think the ladies above have given good advice. I agree that your OB is probably being proactive, saying what "might" need to happen and because we are pgal, they tend to go to that next level quicker than if we didn't have a loss history. I wish you all the luck!

[BookishMomma]

No personal experience, but I wanted to stop in to say that one of my close friends had GD with both of her pregnancies and had to take insulin. Her kids are super healthy and she had great pregnancies. She did end up with C sections for both, but for the first she did go into labor on her own but it lasted too long with not enough progress, so she ended up with a C. So not directly related to the GD and the sort of scenario that could happen to anyone. For #2 she was given the option of a VBAC, but decided not to. So truly it seems like there are options. ((hugs))

[mpiemont]

Sorry I'm so late to this post- I'm sorry you are dealing with this but it sounds like you got some great advice from those who have had GD. I hope you can get a handle on things- I'm sure it takes some time. It's nice that you can email your dietician for help in between appointments. Keep us posted. I'll be thinking about you.

[KMW08]

What brand of meter are you using? I found that the ReliOn Prime was waaay off on my numbers. Ended up using a OneTouch and it was much more accurate.

I'm no help about insulin, but I agree that your dr is probably just thinking ahead about what coulds. I will say that it does get harder to manage the further along you get, whomp whomp.

At the end of the day, the baby is the most important thing. Your goal is to get this baby here safe and sound no matter how that may happen.

[dawnstar898]

(((hugs))) Sorry about the GD diagnosis. I had a friend who had it as well, she ended up on insulin but her baby was born happy and healthy!

[grailseeker14]

KMW08 - I'm using a OneTouch Verio IQ (it's just the one the nurse ordered for me). Amazingly simple, although I'm going to be plenty over with the pokes by the end of this

Thanks all for the reminder that in the end, frustrating as it is, that frustration is worth safely bringing home a healthy baby --- I can and will do whatever it takes.

My #s are looking better today, so been aiming well at the moving target for today at least. Getting better at meal planning and timing, exercise, and starting to get used to the fact that I just need to roll with things and not get too hung up on individual numbers.

Thanks everyone!

[KMW08]

Jan 31, 2015 19:01:59 GMT -5 grailseeker14 said:

KMW08 - I'm using a OneTouch Verio IQ (it's just the one the nurse ordered for me). Amazingly simple, although I'm going to be plenty over with the pokes by the end of this

Thanks all for the reminder that in the end, frustrating as it is, that frustration is worth safely bringing home a healthy baby --- I can and will do whatever it takes.

My #s are looking better today, so been aiming well at the moving target for today at least. Getting better at meal planning and timing, exercise, and starting to get used to the fact that I just need to roll with things and not get too hung up on individual numbers.

Thanks everyone!

I also wanted to add to try some different things. No idea why (maybe enough protein to off set?) but reese's candy didn't cause much change in my numbers. Ice cream didn't do much to me either as long as I ate a small bowl. Bread and rice were my biggest enemies when it came to making my numbers do crazy things.

[grailseeker14]

Jan 31, 2015 19:06:07 GMT -5 KMW08 said:

I also wanted to add to try some different things. No idea why (maybe enough protein to off set?) but reese's candy didn't cause much change in my numbers. Ice cream didn't do much to me either as long as I ate a small bowl. Bread and rice were my biggest enemies when it came to making my numbers do crazy things.

Reese's - gonna have to try that out, we are big Reese's fans in our house. A couple of the minis probably would satisfy

I've so far noticed that if I up my protein and stay within my carb choice limits (which actually is easier than I thought for all meals except breakfast - breakfast is rough), seems like my numbers stay in range better. I'm too gunshy to try ice cream just yet, because I have a tendency to binge... but eventually I'll want a scoop so I'll get a chance to experiment with it. For now gonna try greek yogurt with nuts or berries as my "treat". I also need to get used to trying different forms of protein --- I'm to the point where I can barely gag down chicken breast and eggs (this was happening before I knew about the GD). Gonna try upping the fish a little (lots of salmon available here) and find more beef based recipes

Bread and pasta are my mortal enemies at the moment... which makes me sad because I love breads and pastas! Rice I do okay if I keep my portion small, and I like brown rice better than white rice anyway. OH, and I miss orange juice soooo much.

The things we do for the health and well-being our beloved little ones

[fourthtimesacharm]

grailseeker14, I got my GD dx almost 2 weeks ago and have been monitoring for about a week and a half. My nutritionist told me (based on my 1 hr and 3 hr results) that I would need insulin. I haven't seen my mw yet, appt is on Tue, so I don't really know what the plan is. I wanted to tell you good luck with your GD, maybe your midwife will be open to your plans if your sugar is under control (with our without insulin). Also, walking and being active immediately after eating makes a huge change in my numbers, it might help lower yours too.

[chicagojackie]

I'm going to pop in here and provide some perspective from the pre-existing diabetic camp. That's right, not GD, regular diabetes.

As you know this is my third kid, with my daughter being nearly 2.5, one first trimester m/c and 37 weeks with a little rainbow boy tomorrow.

You need to take a giant deep breath and calm down. The diabetic diet is simply a healthy lower carb approach. Doing a finger stick glucose is also no big deal, really changes how you make dietary decisions.

Moms with existing DM get to take their sugars five times a day starting from two lines on the stick. It is what it is.

DM and GDM are not fair. Agreed. But a lot of us have them. If you're an otherwise healthy not overweight person that makes some good dietary changes...guess what? once you push your baby out you are likely in the group of women that get to leave Planet Diabetes.

As for not getting your previous birth plan, seriously? You don't know that yet. After you work really hard to keep yourself and this baby healthy and then follow what ever increased monitoring protocols you get to do at your hospital because of GDM, who cares how you have the baby as long as you're both healthy and safe?

As for injecting insulin or any other drug, once your baby is out you get to stop! Temporary measures. Diabetics aren't the only ones that have to rake injectables during pregnancy. Think about the hyper-coag moms on lovenox, etc. The anti phospholipid moms take it indefinitely if they get a blood clot.

Sorry I'm not all glitter and rainbows but that's not my style. You have a temporary condition that requires you to watch your diet, stick your finger, and maybe take a pill or a shot, and have some increased monitoring done. Do what's in your power and move on.

[grailseeker14]

umm - chicagojackie - I get where you're coming from and I respect your experience and knowledge, but I have to say that waking up to your holier-than-thou, condescending "boo hoo, get over it, I've had this my whole life so you have it easy" approach is rubbing me the wrong way. I came over from TB too so I didn't come here expecting glitter and unicorns (I'm much more glitter and rainbows on PgAL / CAR than I was on my BMB) and I get the tough love / snark approach but there's a time and a place for it, ya know. I posted this thread a few days ago in an emotional panic. If you had taken the time to read the thread, the supportive and useful suggestions from the wise ladies here, and my responses to them, I, and other GD ladies, am/are doing what I/we can to get it together and move forward. Feeling less alone and hearing some practical suggestions from the other ladies in this thread are helping me do that. The drill sergeant type "wah wah, you got nothin' to cry about" feel I get from your post doesn't really help much other than make me think your perspective is that if someone doesn't have it as bad as you than they've got nothing to complain about... which, no glitter here, is bullshit. I hope you don't carry that perspective in your work, because that would really suck for your patients.

Here's the rub: as a lifetime diabetic, you may have forgotten those early days of adjusting and figuring it all out. Perhaps you had no emotional reaction and no learning curve and no time needed to adjust to a lifetime diagnosis. you just figured it out and moved on like a pro. Maybe your diagnosis came at a time when you already were a pro at all things medical, so you have a different set of resources and frame of reference to help you adjust. Well here I am, and a few other women too, finding out for ourselves very recently and in the middle of that whirlwind of trying to figure everything out and make what may amount to be huge lifestyle adjustments very quickly. I have 10-11 weeks left of this pregnancy - I don't have the benefit of time to get things under control slowly.

Prior to this I had nothing more than a very distant frame of reference for what diabetes is and how it works. One of the only people I know IRL who is living with diabetes doesn't keep up with any aspect of it at all, so aside from my medical team, I have no one IRL who knows and can help me get focused/centered. I'm now eyeball deep in a complete and permanent overhaul of my lifestyle kitchen and eating (we eat relatively healthy but were pretty carb heavy in some areas) for not only myself but my whole family (since I can't do it alone), and finding it harder than I expected to hit my glucose targets consistently. I've only been on the meter a fucking week, and I've only had the dietary guidelines for a week and a half, so please forgive the early moment of freak out when I feel like this diagnosis, temporary as it may or may not be, was burying me when I reached out here.

Behind much of my freak-out was also frustration and hurt that my body, yet again, has found a way to fuck with me or make things difficult. You want to play pain olympics with the lifetime diabetic thing, I'll show up in another event --- I too have to stick my fingers 4-5x a day, I CAN and WILL do insulin if it comes down to it, but for fucks sake the only chance I had at even conceiving this one, and possibly only rainbow, is through an IVF cycle --- so since before the two lines/positive beta test I'd been sticking myself with needles multiple times a day every day just for the slim chance of ever becoming a mother in the first place. Not to mention all the testing and monitoring that also required sticks and pokes. I can and will do the needles for as long as I have to, but damn if I didn't have a moment of just wanting to be done with sticking myself with needles and anger at my body for the continuing parade of disappointment at moments when it counts. Yes, hopefully that day will come in a few months, when I can be done with daily needle pokes, but the original post of this thread came at a time frustration, fear, a sense of isolation, and feeling on the ledge about all things diabetes in the wake of an initial diagnosis.

I think it's fair to take a moment and mourn the potential loss of the dreamed of birth --- but hey, I'm a FTM and not a nurse so what the hell do I know. All I know is that I have dreamed of this baby for a long time, jumped through extra hoops just to conceive her, will jump through more hoops to make sure she comes into the world as healthy and safely as possible. But along the way I also dreamed of having a single moment of normalcy in the otherwise chaotic and confusing world of a first-time pregnancy. Not to say that I was overly attached to a specific birth plan, I was just really dreaming of and preparing for the most important part of this pregnancy going smoothly. Two things were important to me for my own reasons: I wanted to avoid pain meds (I do horribly with them) and wanted to avoid c-section. Hearing my doctor doing his due diligence about the what coulds (induction, possible c-section) sent me into thinking those what coulds were what will bes... and in that I felt the need to mourn the loss of my vision so I could prepare for whatever comes. I had to start thinking about where do I roll over and let my doctors dictate everything and where do I advocate for the things that are important to me? What is negotiable? I don't even fucking know, so not only was I beginning to mourn I was utterly confused.

But as you say, I just need to get it together and get over it. So much easier said than done, and I'm glad you've got it all figured out for yourself. As for me, I'll go about figuring it out my own way, thanking the ladies here for their supportive and practical/useful suggestions, and hope to let this thread fall off page 1.

[chicagojackie]

Oh wow. Sounds like you're really bent out of shape about this. Just wanted to offer a different perspective.

No pain Olympics needed just perspective that this is a temporary situation for you and that well managed GDM just like well managed DM or anything else tends to have good outcomes.

You also had to know your IVF pregnancy would be high risk and at higher risk for everything.

Hopefully things go well for you and you feel better emotionally and medically and are able to have things go more how you would like.

[grailseeker14]

I know my IVF cycle put me in the high risk category for monitoring but my RE repeatedly said from point of a positive test forward my pregnancy was not likely any higher risk than any non-IVF cycle. It also doesn't predispose to GD or any other complication in a statistically significant way so it doesn't stand to reason that just because I underwent IVF that I shouldn't be surprised, have feelings, seek support, need to vent, or need a period of adjustment to the GD diagnosis.

While I appreciate your intention, I was trying to communicate that your approach to the perspective you're offering wasn't helpful, and was what contributed to my feeling bent out of shape. Perhaps it was your wording or tone, it just struck me as condescending, insensitive, and dismissive. I certainly did not get you saying that well managed GD tends to have good outcomes. Perhaps reread your post as if you were a newbie to GD and see what other, maybe unintended, messages you communicated in your post that completely obscure the positive intention you say you had.

And FWIW, in the few days since I originally posted and had a chance to incorporate helpful ideas and suggestions offered by ladies here and on my BMB I am doing much better, thank you. I didn't need your drill-sergeant approach to a pep talk at this point (probably not at all). My bent out of shape-ness was entirely in response to the tone of your message, which is the point I'm trying to convey here. Am I overly sensitive? Perhaps. But you came across more condescending than perhaps you intend, and I felt compelled to respond to you to let you know how your post landed in case you didn't realize it could be taken poorly by someone so new to dealing with diabetes. I don't want to fight with you. Just offering a dose of glitter-less feedback much in the same way you thought you were doing with me. I know you're a longstanding and valued member of this community, and I've appreciated much of your participation and learned a lot from your posts since I joined. Maybe you were having a harder day or feeling less tolerant than usual when you responded to my post, I don't know. Either way, there's no need to harp on further. Let's just put this to rest and move on, okay?