What I Learned at My Gestational Diabetes Management Class

Earlier this week I attended a class with 8 other pregnant women to go over how to manage our gestational diabetes.  A lot of the information that I recieved I already knew, because I read and research and wanted to know what to do before the class (which was 10 days after my diagnosis).  But I did learn some important things that I’m going to share in case it helps someone else.

1.  You’re expected to eat several small meals throughout the day, eating about every 2 to 3 hours.  Essentially – Breakfast, snack, lunch, snack, dinner, bedtime snack.

2.  Breakfast should be the smallest meal of the day – consisting of no more than 25-30 grams of carbs.  This meal should also exclude fruit.  It was explained to us that we shouldn’t eat fruit before 10 am (assuming that  you get up earlier than that).

3.  Lunch should be between 45 – 50 carbs and can include fruit.

4.  Dinner should be between 45-50 carbs and can include fruit as well.

5.  Snacks need to stay under 30 carbs

6.  When it comes to testing your blood sugar you need to test 2 hours (1 hour for some – go by what you doctor has said) after the first bite of food that you take – not when the meal is completed.

7.  Dinner shouldn’t be any later than 7 pm.  Eating too late can mess with your fasting reading the next morning.  Also, eating late means that you need to stay up so that you can test your dinner blood sugar – which is difficult to do when you’re full, and tired and it’s late (or at least it was for me).

8.  We were told that artificial sweeteners should be avoided.  These include: aspartame (Equal, Nutra Sweet), saccharin (Sweet ‘N Low) just to name a few.  At the same time, we were told we could make a judgement call on Splenda and Truvia, but if we do use them it needs to be kept in moderation.  Also, sugared sweeteners need to be avoided such as honey, agave nectar etc.  Your body processes these exactly like sugar and it can raise your blood glucose levels.

9.  Check food labels.  If it’s really high in carbs and the serving size is small (meaning you can’t just eat half or a quarter), you should probably avoid it.  Also, check the number of sugars there are in a food.  0-9 sugars are considered ok, anything over 10 should be avoided.

10.  It’s recommended to stay away from sweets and treats the whole time you have gestational diabetes, but if you absolutely must have something, be smart about it and only do it when your blood sugar readings have been good and you’re reasonably sure that your treat won’t push you over.

I think that’s everything that I wanted to mention.  It should be noted that I’m no where near an expert on this, and just reporting what was told to me.  Above all you should do what your doctor and your own nutritionist tell you.

Pineapple

Dear Poppy Seed –

We’ve now crossed the 31 week mark, which means just 9 more to go until your due date!  This week babycenter.com says that you’re the weight of 4 navel oranges, and thebump.com says that you’re the size of a pineapple.  Whatever the comparison is, you’re now about 16-18 inches long and just about finished growing in length, and weigh around 3 lbs.  The big news this week is that your brain is really starting to develop now.  You’re now processing a bunch of information,  and all of your five senses are now working, which is just pretty amazing.  One thing that I can certainly attest to is that your sleep cycles are evening out more and becoming easier to recognize (you’re awake right now, in case you were wondering).  Your movements are stronger, but different than there were earlier in the pregnancy.  I feel a lot of pressure from you lately, like your pushing up against the walls of my uterus instead of just smacking into them.  You can definitely see my tummy move when you do, it’s kinda crazy to watch.  According to my midwife you’re also in a head-down position, which is cool.  Let’s keep you in that position for the rest of the pregnancy, ok?

Sleep – it is the bane of my existence.  For the past couple of nights my hips have been what’s causing me to sleep so horribly.  I’ll wake up and whatever side I’m lying on – that hip will be on fire, so I’ll roll over (which almost takes an act of congress to accomplish) and then the cycle repeats itself.  I was finally able to get comfortable around 4:30 this morning and that’s when I was propped up in a reclining position with my pillows lying on my back.

The gestational diabetes is going ok, but not great.  My blood sugar readings for fasting, breakfast and lunch are all good – always under where they need to be, but dinner the past 3 nights has been causing me problems.  I’ll think that I’m doing great, but I mess up somewhere along the way.  I’m going one more night on my own before I break down and call the diabetes nutritionist that I’ve been assigned to.  I’m hoping that I can make it work tonight, I have a very light carb meal planned – pork chop, green beans and wild rice (nom nom nom).

Your diapers arrived last week, and I’ve been too busy to write about it!  But they are super cute and soft and I can’t wait to put your bum into one!  Here’s a demonstration for ya.  Just so you know, that diaper isn’t set on the smallest size, I was playing around with the toggles to see how to loosen and tighten it.

Your dad and I have some final things to do to your nursery, but it’s mostly complete (hopefully pictures will be coming soon!).  I’m going to be doing a lot of your laundry this weekend and putting things away/together to get it prepped even more.  So, hopefully by the time you arrive it will be perfect.

Keep growing and remember that I love you!

– Mom

Midwife Appointment

Yesterday I had my scheduled midwife appointment.  They got my weight (it’s been the same for the last 3 visits – which my midwife said is perfectly fine), my BP (which was 120/80 – also perfectly fine).  My doula came with me, as J couldn’t be there because of work.  She and I sat and chatted for a bit while we waited for the midwife to come in, we didn’t have to wait too long.

The first thing that we talked about was the gestational diabetes.  I took along a spreadsheet that I’d made that shows all of my blood sugar readings thus far – she seemed to be impressed by it and asked that I keep it up and bring in an updated one for the next appointment.  For the most part she said that all of my readings look good.  At that point in time I only had 2 that were over what they were supposed to be, and she said that she really wants me to work on having ALL of my readings perfect.  She said that after meals shouldn’t be anything over 130, and that some are now saying it shouldn’t be over 120 – so to keep that in mind.  But, at the same time, she was impressed that I was able to do so well without having had my diabetes counselling session yet (which is today).

We talked about the risk of gestational diabetes – she told me that if it is controlled that there are virtually no risks – so let that be my motivation.  If it goes uncontrolled I could have a monster sized baby, or a teeny tiny baby as the gestational diabetes can cause the placenta to not function they way it’s meant to, which could lead to preterm labor.  But, again, if it’s controlled there’s virtually no risks.  I asked if the diagnosis meant that I was considered high risk, and what it meant for me appointment wise – she told me that I’m not high risk, and that we’re just going to keep going the way we’ve been going – which was a great relief to hear.

I asked her about the thyroid reading and if she thinks that I have hypothyroidism.  She said that only one number was low (T4), and just based on that she doesn’t think that I have hypothyroidism.  She did say that they know that pregnancy affects the thyroid, so they want to watch it postpartum to make sure that my body doesn’t start attacking it, but that the likelihood of that is small.

We talked about the cardiologist appointment.  She didn’t seem to be too concerned about it, and that her gut feeling is that I just have an abnormally fast heart rate, but that we’ll wait and see what the cardiologist says at the next appointment.

We talked for a bit on preterm labor – the signs of it and what I should do if it happens.  She said that at this point in time if anything becomes painful and doesn’t go away with rest or hydration I’m to call or go in, that she’ll want to see me or send me to the ER.

 Next, she felt around on my belly and said that she thinks the baby is in the head down position.  She got out the doppler and we listened to his heart rate – it was between 150-160.  My fundal height was 32 centimeters, and as I’ll be 31 weeks tomorrow, I’m right on track.
Overall it was a great appointment, we discussed a lot and I think that we have a good game plan for the next little while.  I got back in two weeks, and next time I’m bringing my birth wishes to discuss with her.

Blood Sugar Issues

Ever since writing that post that everything seemed to be going well with tracking my blood sugar, things haven’t been so simple.  On Saturday, I had to go into work for a couple hours.  I took my lunch and my meter with me, and 2 hours after lunch I got everything ready to take my blood sugar.  I had the test strip out and the meter, and the lancing device with a new needle ready to go.  I chose and finger, pricked it….and nothing.  I couldn’t get a single drop of blood out of my finger.  So, I picked another finger, and the same thing happened!  I ended up having to stick myself 10 times before I was able to get any blood out of me and have it be enough to test.  Needless to say that my fingers were sore after all of that.  Looking back, I  now think that the main problem was that it was hot in the office that day and my hands and fingers were swollen and therefore caused me to not bleed so well or even at all.

Things have been going a little smoother since then.  I’ve found that it’s best to prime my fingers before I prick them – meaning that I’ll massage a finger for a few moments, pushing blood up into my finger, and then stab myself and squeeze the blood out.  This seems to go much better for me.

For those of you who are interested, here are my blood sugar reading so far.  Remeber that the fasting one needs to be under 90 and the ones after meals need to be under 130.

4/21

  • Fasting 77
  • Breakfast 98
  • Lunch 83
  • Dinner 139

4/22

  • Fasting 89
  • Breakfast 111
  • Lunch 94
  • Dinner 99

4/23

  • Fasting 90
  • Breakfast 97

Over all I think that I’m doing pretty well, especially since I’ve only been doing this for 3 days.

On the downside, I’ve been tracking what I eat on sparkpeople so that if my blood sugar reading is high, I can go back and see exactly where I miss stepped.  But, I don’t think that I’m eating enough for almost 31 weeks pregnant.  I’m generally only eating 1400-1500 calories a day.  I eat when I’m hungry, and  trying to make good choices.  And I can’t just eat whatever, because then my blood sugar will spike.  So, I need to find a way to eat more while still keeping my blood sugar in a reasonable range.

I go to a gestational diabetes class on Wednesday, so hopefully I’ll be able to learn more about what and how to eat.  I have to say that this is frustrating.  I want my baby to have all of the nutrients that he needs, but I also don’t want him to gain too much weight….and to be honest I have little to no control over any of this.

I guess all I can do is try my best….

Blood Sugar

I got my blood sugar meter yesterday at the pharmacy, and I made the pharmacist show me how to use it.  When he first started talking about it, I’ll admit that I got kinda queasy.  I don’t like blood or the idea of purposefully injuring myself to collect blood.  In my honest opinion blood belongs inside the body.  But, as that’s not an option for me right now I had to learn.  My meter has four parts to it.  The meter itself, which is a OneTouch Ultra Mini.

It has the  test strip which sucks up the blood (which is the thing poking out of the meter on the left).

There’s also the lancing device that holds the lancets (needles).  This is the part the pricks your fingers so you can get the drop of blood that you need for testing.

The lancing device has multiple settings that you can set the needle to, so you don’t need to over stab yourself.  Apparently though, my fingers don’t like to bleed, so I have to have it on the highest setting and even then I have to usually squeeze the blood out of my fingers to get enough to test.  This is nothing new for me, I once stopped bleeding when I was donating blood for the Red Cross.

The good news in all of this is that I’ve been doing well on my blood sugar readings so far (knock on wood).  Last night after dinner it was 112 and after all meals it needs to be under 130.  My fasting reading this morning was 77, and that needs to be under 90.  After breakfast today it was 98, which again is under 130, so I think that I’m doing well in my meal choices so far.  I’ll see how lunch affects me in a little bit.

At first, I do have to say that this sucked.  The first couple times I had to do it didn’t go so well.  I’d either not get enough blood out, or put the blood on the test strip before putting it in the meter, which would mean that I’d have to stab myself again and try again.  But I’m getting better and better about this as I do it and it’s really not so bad now.  I wouldn’t say that I enjoy it, or even look forward to it (I mean, who would?), but it’s not awful, and I can see it soon becoming a fact of life, and no big deal.

Cardiologist Appointment

I had my appointment with the cardiologist yesterday.  My appointment was first thing in the morning, and when I walked into the office, I swear that every person in the waiting room turned and looked at me, I’m not even kidding or exaggerating.  It didn’t help that I was the youngest person there, but I was also the only pregnant one.  Everyone else seemed to be pushing 90.  When I went up to the receptionist to get my paperwork started they asked me a whole bunch of questions and put the answers into the computer, so I didn’t have to fill out a whole bunch of paperwork.  The only problem with this is that the receptionist kept getting my birth date wrong.  It went something like this:

Receptionist:  “Your date of birth is 3-13-1954?”

Me:  “No, 3-13-1984”

Receptionist “1954”

Me: “No, 1984, I’m 28, not 58”

Receptionist “mmmhmmm”

The woman never looked up at me the whole time she was taking this information down, so I guess she didn’t realize that I was a full half century younger than everyone else in there.

Anyway, after filling out some paperwork I was taken to the back.  I was weighed, and apparently according to their scale I’ve lost two pounds, I don’t know if it’s because it’s a different scale or because of the new diet plan that I’m on.  I was then taken to an exam room and one nurse asked me questions, while another checked my blood pressure in each arm.  It was 130/88 in my left arm, and 124/72 in my right (I’m liking the right arm better).  I was then hooked up to an EKG machine.  For those of you who haven’t had an EKG before (this is my third) they put a whole bunch of sticky pads all over your chest in different areas and then each pad is hooked up to a cord which leads to a machine.  The machine turned on and the nurse got two print outs of my heart rate from it.  They then unhooked me from the machine and took all the sticky pads off and I sat and waited for the cardiologist to come in.

I didn’t have to wait long.  He came in and looked confused for a moment and asked “how old are you?”  I told him I was 28, and he starts scratching something out on my chart and says “someone put down that you’re 58.”  I replied that if I was 58, I was looking good for my age.  The Dr. looked at my EKG print out, but doesn’t say anything and then decides to listen to my heart with his stethoscope.  When he’s done he tells me that I have a fast heart rate (gee thanks, I didn’t know that already), but that he’s not sure why.  Some people have a naturally fast heart rate, like some people have a naturally slow one.  He said that he could put me on medication to slow it down, but he doesn’t want to because 1. he doesn’t know if there’s any actual medical reason to, and 2.  it would mess with my blood pressure too much – which wouldn’t be a good thing while I was pregnant.  So, his recommendation is that I be scheduled for an ultrasound of my heart.  He wants to make sure that everything is open and pumping the way that it should be, and then we’ll go from there.  He also wants me to come back in six months so he can see what my heart does when I’m not pregnant – and see if it’s the pregnancy that’s putting added stress on it.

He did say that my heart was beating pretty fast, at a resting rate of 146 bpm (I’m in agreement that this is fast).  He also seemed to be concerned that I can feel my heart beating at different points in the day and that it’s not exercise induced.  Apparently normal people can’t feel their heart beating….I didn’t know that – but now I guess I’m special.  So, I go back in 3 weeks for an ultrasound of my heart, and I’m kinda excited about it.  I mean, how often do you get to look at your heart and see it beat on a monitor?

I didn’t really learn all that much from this appointment that I didn’t already know.  But I’m glad that we’re taking steps to make sure that everything is ok and working the way it’s supposed to.  I’ll let you know more when I do.

Cabbage

Dear Poppy Seed –

You and I have made it to 30 weeks!  Ten more to go until your due date.  These weeks seem like they’re flying by.  Right now you’re about 3lbs and and getting close to 16 inches in length or the size of a head of cabbage!!  The new developments for you this week are that you can now regulate your own body temperature, which means that you’ll now be shedding the lanugo (downy hair that you grew to help you keep warm).  You’re brain is also getting wrinklier by the day, which means that you’re starting to get pretty smart in there!!  I’m not sure why, but 30 weeks seems like a milestone to me.  Maybe because it means that we’re 3/4 of the way done with the pregnancy, or maybe it’s a nice even number.  Whatever the reason, I’m happy that we’ve made it this far together and that you seem to be doing splendidly!

Goodness, there are a lot of developments with me within the past week.  I’m now a gestational diabetic – which means that the pregnancy is now considered high risk.  You and I will be monitored more, which means more midwife appointments and maybe another ultrasound or two.  I have to watch what I eat and monitor my blood sugar and work out regularly.  I think I’m doing a good job on all of this – even though it’s only been a couple days since I’ve been doing it,  but for the most part I do feel better.  Since changing my diet I’ve noticed that I have more energy and don’t get as tired as often, so that’s good.  I might have hypothyroidism, but definitely not hyperthyroidism.  And I went to see a cardiologist today about my heart rate and we’re not sure what’s going on there – but it looks like more testing needs to be done (more on this later).  In the mean time you just get to listen to fast heart rate (it was 146 bpm at the cardiologist’s this morning).

I’ve spent the last several days really worried about you and that I’m not doing enough to take care of you.  I would hate it if my life choices affect your life negatively now or 30+ years down the road.  I always want you to be healthy and to have the best of whatever I can provide for you.  I want you to know that I’m taking my diagnosis seriously and changing my habits so that you can be healthy and happy.  I’ll feel so much better when I can meet with a registered dietitian and form a plan to ensure that you’re going to be fine.  I don’t want you to be born early, I want to carry you to term.  I don’t want to deliver a “large” baby, I want you to be a perfect and healthy size.  I don’t want you to develop type 2 diabetes later in life or have propensity for obesity.  Your dad and I want to make good choices so that we can raise you and teach you how to be and stay healthy.  Remember that I always want the best for you.  Keep moving and growing!

Love,

-Mom