So I participated in this week’s #ppdchat on Twitter hosted by the wonderful Lauren Hale – http://mypostpartumvoice.com/2012/04/23/ppdchat-topic-not-glowing-pregnant-depressed/?tw_p=twt. The more we talked about this; I realized that I had felt anxious throughout my entire second pregnancy. I was relieved to know that I wasn’t the only one that suffered like this. I was saddened that I spent so much time suffering when I could have been proactive.
Part of my anxiety stemmed from my gestational diabetes. I had gestational diabetes with Munch. When I discussed getting pregnant again with my OB, she advised me that I would start the diet and begin testing my blood sugar after my first prenatal appointment. I had met with my endocrinologist when I was pregnant with Munch. We discussed my family history of type II diabetes. My mother, her identical twin sisters, and my maternal grandmother all have type II diabetes. Since my endocrinologist used to treat one of the twins, he was aware of the strong family history. This was very comforting and encouraging. My OB, my endocrinologist, and my CDE (certified diabetes educator) were in constant communication throughout my entire pregnancy. I loved my CDE. He was a type I diabetic, so he understood how challenging this was. He would run through my numbers and look for patterns and make suggestions.
As soon as I received my positive pregnancy test with my second child, I contacted my OB. Since gestational diabetes makes me a high risk patient, they wanted to see me right away. At my first prenatal appointment, they contacted my CDE from my first pregnancy and set me up with an appointment that same week. I was happy that we were being proactive.
What I did not count on was how exhausting it would be to monitor everything that went into my mouth for ten months. I have a new found respect and appreciation for diabetics who do this on a daily basis. I was miserable that I could not eat what I wanted when I wanted. I lived my life through my blood glucose numbers. If I was over where I should be, I berated myself. I was doing this all to take care of my little Skeeter so she would be healthy.
When she was born, she had a low blood sugar reading of less than 40 mg/dL. Since her sugar was low, she was given a half ounce of formula. I was devastated. I thought that I had failed her. I was upset with myself for electing to have another C-section. If I had attempted a VBAC, maybe her blood sugar wouldn’t have dipped so low. I thought it was all my fault because I hadn’t maintained the stability of my blood sugars. In reality, I tested my blood sugar four times a day and used exercise and diet to maintain my sugars very stable throughout this second pregnancy. My CDE complimented me on being such a diligent and conscientious patient.
After my six-week postpartum check-up, I had to get tested to see if my gestational diabetes had resolved itself. This was a three-hour fasting test. I was extremely nauseous and weak. I couldn’t even drink water. I was notified by phone that I had failed the test and that I needed to contact my endocrinologist right away. I started sobbing on the phone and called my mom immediately.
She managed to calm me down by asking me what the actual results of the test were. In my panic and hysteria, I hadn’t gotten any of this information. It turns out that I was slightly elevated on one of the test results; the other numbers were within the recommended range. I took down the results, and I called in to make an appointment. The receptionist was very soothing. She was able to get me an appointment within the next forty-eight hours. I went to see my endocrinologist. He checked me out physically and asked me about my diet and sleep.
He reassured me that it was still too early postpartum to conclusively decide anything. He advised me to come back in six weeks and retake the three-hour fasting test. He told me not to modify my diet at all. Since I was nursing, it was crucial that I not restrict my caloric intake. He told me to relax and enjoy the holidays with my brand new baby. He said that I could indulge in sweets, but that I should enjoy them in moderation. When I asked him about Claudia’s low blood sugar, he reassured me that it was nothing that I did. He gently advised me that I had followed the diet and maintained my blood sugar levels wonderfully throughout this pregnancy. He then pointed his finger at me and said “don’t worry”. I look back on that moment and wonder if he and my CDE saw something in me that I didn’t see in myself at the time. Was my anxiety like a flashing neon sign on my forehead? I received such wonderful care throughout this pregnancy, but I still could not convey how anxious I was feeling. I talked frequently with my OB about my stress levels, but I don’t think I seemed particularly anxious. Did I just stuff those feelings down and not express them? I was terrified of going on oral medication or having to inject myself with insulin. In my mind, that would have equated to failure.
**Author’s note: I successfully passed the second three-hour test, and I show no indication of type II diabetes at this time. I continue to be tested on a yearly basis by both my primary care physician and my OB/GYN. Since there is such a strong family history, I know that I need to pay attention to what I eat and exercise as much as I can. **