I’m 24 weeks pregnant and still chugging along. Mostly I feel pretty good. I am tired often but I attribute that to my 10-month-old and general pregnancy fatigue. Trying hard to get a good night’s sleep these days.
I went for my 24 week ultrasound last Wednesday and everything looks great. No issues! All organs are normal and accounted for and the heart echo for baby was very normal. My baby is measuring in the 75th percentile. I’m so grateful to have a “normal” pregnancy after what I went through with my son.
After the ultrasound technician left the room she brought in the high risk OB/GYN in. He told me everything looked good, but then started asking really provoking questions, so much so that I felt like I had to defend my choices.
So let’s take a step back. If you’ve been following my pregnancies you know, with my first I saw my regular OB/GYN and a team of high risk OB/GYN’s. The high risk team was meant to help me manage my blood sugars. However, I felt that the high risk team added no value to my last pregnancy because I managed my sugars all on my own and on top of that, they constantly told me I wasn’t doing a good job. They would make drastic changes to my insulin doses that sent me into hypoglycemia. Towards the middle of my last pregnancy I continued to go to the appointments but didn’t follow through on their advice. I just did my own blood sugar management and what do you know? My son turned out FINE. He had no time spent in the NICU and was born perfectly healthy.
Fast-forward to this pregnancy and at my first prenatal appointment my regular OB/GYN suggested that I not even see the high risk team this time around. I was elated and so glad she suggested it. She said I did such an amazing job last pregnancy that she thought I would be fine to manage my blood sugars on my own. We both agreed that I would still have all the scheduled ultrasounds that a high risk pregnancy has so we can monitor growth, heart, have the necessary biophysical profiles, etc. We also agreed that if I felt my blood sugars were too much for me to manage, that we could seek counsel with the High Risk Team.
Ok so back to my appointment Wednesday. After my 20-week ultrasound the technician left the room and asked the high risk OB on duty to evaluate the scans. I don’t even know who was on duty that day because she came back in the room, told me he looked at the scans and they were great, no need to meet. I suppose different doctors have different priorities. At my 24-week scan this doctor came in and told me everything looked great.
Then he began to ask me how my blood sugars were. I said great, my A1C is 5.6-5.7 ish. Then he asked me who was monitoring my sugars. I said I was and my OB/Gyn helps sometimes. He didn’t like that answer at all. He asked me if I have a pump or if I’m using multiple daily injections. I said I have a pump. He asked me if I knew how to adjust my insulin doses.
This is where I started to get not only frustrated but defensive and offended.
I continued to smile almost laughing and listed off every single basal I had, what time it starts, along with every insulin to carb ratio I have programmed in my pump. Without looking at my pump!
He was still not satisfied. And almost laughed at me for having so many basal settings. I explained why I had all the settings. He proceeded to tell me that sometimes people with diabetes don’t know how to use their pumps or adjust the settings.
I told him I’ve had diabetes for almost 20 years and have had an insulin pump for 18. I’ve managed all my diabetes on my own since I was ten years old and do not need help.
I didn’t say this to him but I have literally had diabetes longer than he has been a doctor…probably a decade longer.
After all this questioning I said, “So the ultrasound was normal right?”
He said “Yes everything looks great.”
I asked about the size of the baby and he said the 75th percentile is normal for a mom with diabetes but he wanted to look at how big my son was. I told him he was in the 40th-45th percentile for most of the pregnancy but that was most likely attributed to him being a twin.
He became more concerned that my son was smaller (and totally disregarded my comment about him being a twin). He asked me how often my blood sugars are higher than 180. I said almost never. He looked at me as though he didn’t believe me which was infuriating. I would have offered for him to download my pump data to view my blood sugars to prove to him I was right, but I didn’t owe him anything. I’m not seeing the High risk team for a reason and I refuse to be evaluated by them.
I also mentioned that although my son was smaller I have no real data on how big or small a normal baby would be. My husband is a twin and was born premature, even so he was pretty big for being born at 32 weeks. My brothers, my cousins and I were all big babies. I was over 8 lbs, my youngest brother was 9 lbs 14 oz. I have read that this happens to pregnant type 1 diabetic moms a lot. Diabetes can make for a big baby, but so can genetics (just like a non-diabetic mom) but we get judged for our diabetes management either way.
I left that appointment happy that my baby was healthy but angry that I was questioned so harshly and my responses were not believed.
I have a number of friends in the medical field and they tell me that they are meant to assume a patient does not follow their instructions. Does that mean we should all have to suffer? Possibly. In the eyes of the high risk OB/GYNs they are only trying to ensure my baby is healthy. In their minds caring for me and my baby to ensure a healthy pregnancy far outweighs the risk of angering me.
I would be lying if I said that after that appointment I didn’t second guess my blood sugar management.
But then I looked at the facts. My sugars are controlled. My A1C is still 5.7. I rarely have a high blood sugar and when I do it’s a surprise and I take a walk. My baby is healthy. There is always room for improvement but I shouldn’t second guess my methods now.
I have worked my butt off for the past 3 years making my body a safe and healthy place for a baby to grow despite having an essential organ that decided to quit on me.
Imagine you have a red convertible. You researched it before buying it, you take excellent care of it. You get the best insurance coverage for it. You wash it weekly. You get the oil changed every 3,000 miles on the dot. You keep it in a garage. You park it a far distance from other cars so that no one scratches it. You keep the tire pressure at the right level. You fill it with premium fuel. You’ve never had an accident.
You take the car to a mechanic for a routine inspection and the mechanic says, “You know, you really should take good care of this car. It’s a nice car and doing preventative maintenance will prevent you from getting in an accident.”
That’s how that appointment felt.
Type 1 Pace 