Monday, March 28, 2011

Who’s in control here? Pregnancy hormones, stomach flu, and Type 1 diabetes

What a week I’ve had – a total physical and emotional roller coaster.

I came down with the stomach flu on Tuesday. Here’s the highlight reel: fever, achiness, headache, vomiting, the works. Mix on top of that pregnancy and Type 1 diabetes, and you’ve got yourself a real walk through the park.

When the flu first struck, I could not get my blood sugars above 55 for two hours. And let me tell you – I tried. While nauseous, I had 8 or 10 glucose tablets, two 4 oz glasses of orange juice, a whole banana (which would typically make my sugar soar), and two pieces of toast. And my sugar went to 63 an hour later. I put on a temp basal - which injected less insulin into my blood stream - hoping that would help. I tried not to fall asleep, but I did. The phone kept ringing every fifteen minutes thankfully – literally, I kid you not - as though someone was looking out for me from the great beyond. And so I would check my sugars at each phone call.

(Dangerously low blood sugars can cause a diabetic to lapse into a diabetic coma. Falling asleep is not the best way to deal with this, as you can fall into a coma and not realize it. Plus, there was no one else home. The phone ringing helped me stay on top of my sugars, despite the sleep.)

Two hours later, I checked my blood sugar, and it finally went up to around 105, which is normal. Then I found myself correcting higher sugars for half a day. I had to make up for that banana and well, the fever.

I felt so lousy, that a gun to the head seemed like a really great option for feeling better. I was worried about the twins. I wasn’t sleeping right. My sugars were out of control. And I’m convinced that the misery hormone takes over when you’ve got the flu.

I started feeling better on Thursday and went back to work. Lior and I watched The Office that night, and that’s when I’m sure that pregnancy hormones struck. I was crying hysterically – bawling – when Michael asked Holly to marry him. I have cried like that during a few movies/shows in my life – Pride and Prejudice, The English Patient, when Chandler asked Monica to marry him on Friends, the first Sex and the City movie, and the Lost finale. But not The Office. I mean really? But yes, I wept. I couldn’t breathe, I was crying so hard.

Then on Friday, at work, I was skipping around my real office because I got excited about labels. Well, really I was excited about wine. A volunteer for our organization found really great wine at a good price, and it got me all excited. The labels were going to go on the wine. I was running around telling everyone in the office. And yes, they were looking at me strangely. It made my day. I love wine, but in the grand scheme of things, I was thoroughly over thrilled. Perhaps taking the excitement a wee bit too far.

Hadn’t I thought of how great a revolver to the head would be two days before?

The ups and downs continued all weekend, and here we are on blog Monday talking about it. Learning from it.

I have always been the sensitive type. It’s one of my greatest strengths, and one of my greatest weaknesses. I believe that I am good at what I do because of my sensitivity to others and our globe. I get upset when an ant is killed. But I also notice things that others tend not to, because I’m so sensitive. At the same time, I’ll get upset over something menial. Sensitivity is what helps me write, be creative, be good at personal relationships, among other things. I’ve toughened up over the years, but my authentic nature is to be sensitive. And I’ve learned to manage it over the years.

But this week, I felt really out of control over my emotions. I always say that most of life is out of our control, but we can control our thoughts, actions, and words. This week, I wasn’t even able to do that most of the time.

So who’s in control here anyway? Could be the flu mixed with the diabetes. Could be the twins. What I do know is that it wasn’t me!

I can say now in hindsight that what helped me get through a tough week was repeating Eckhart Tolle’s mantra: This too shall pass.

I find his insight to be a life-changing one. His point is that everything in life is temporary and transient. Nothing in this world is either good or bad. So when something happens – whether “good” or “bad” – it is important to remember that this too shall pass, or in other words, change. Not to grasp onto it, or hold onto anything for dear life, as it will change and move on.

For people who grasp onto things that are good or who are struck by things that are bad, these changes can be devastating. But the “This too shall pass” mantra keeps it all in perspective. It never allows you to grow too attached to anything. Not to define oneself by things.

The flu passes. Pregnancy lasts around nine months. Diabetes will be with me for quite a bit longer, but blood sugars change constantly. The wine shall be drunk, and labels will come and go. So rather than try to control the situation, perhaps it’s better to observe it all as it passes us by?

Monday, March 21, 2011

Feeling philosophical today: A lesson in humility

Why? So often I have asked why things happen or don’t happen as I would like. I know I have asked that question from time to time – especially when things don’t go as I would like them to, or had expected them to.

Why did I get Type 1 diabetes at age 3? Why did I wind up with Celiac? Isn’t Type 1 diabetes challenging enough? Do I need more challenges? Okay, yeah, I know the science behind it. But that’s not what I’m asking.

What I’m really asking is: Why, God, why?

And then there’s the recent global why: Why Sendai, Japan? Why a tsunami and an earthquake? Why do some people die, while others suffer, and others survive?

I can take it further of course: Why do we exist? Why is the Earth round and the sky blue? Why do the tides ebb and flow?

Sure, we could start to talk about gravity to explain quite a bit of those questions, but then why does gravity exist? Do people die randomly or is there a greater design behind it? We could talk about the ring of fire and how plates of land deep within the Earth’s surface rub against each other which causes an earthquake. Well, then why are they there?

The recent global events in Japan have reminded me that our knowledge of science has come a long way, but true understanding can only go so far. There's much for us to learn, and much more that we may never learn. Because it's out of our hands.

Any answers we give to the really big "why questions" are pure conjecture. Any belief system we espouse is great for finding comfort and solace – especially when we’re faced with life’s really tough questions. But in reality, we really don’t know the answers.

I am learning this week that all conjecture is really a lesson in humility.

So rather than ask why, perhaps the better question to ask is: What lesson can we learn?

The recent earthquake, tsunami, and nuclear reactor disasters in Japan are humbling. They remind me of how out of control we really are. Many times we humans try to fool ourselves into thinking that we have more control than we do – through scientific research, hypothesis, or even conjecture into the wisdom of God.

But in reality, we know nothing. The best we can do is ask questions and learn lessons.

We can build higher towers, lengthier walls, bigger dams, and nature will in turn create an even bigger flood. The Earth is reminding us that we are visitors here, and nature is teaching us a lesson in humility. Science has come a long way over the years, and I am grateful for all of the medical advances out there. But in reality, our understanding of science pales in comparison to the efficiency, exactness, and vast powers of nature.

I don’t know why nature chose me to be diabetic. I also don’t know why I wasn’t chosen for something else. All I can do is ask: What lessons can I learn? Diabetes is, as are all of life’s challenges, a life-long lesson in humility, inquiry, and learning.

Monday, March 14, 2011

An intuitive approach to feeding and sleeping schedules for twins

At this point in my pregnancy (26 weeks), I’ve started thinking about those first few months after the twins are born. I have a number of people who are very close to me who have twins – both family and friends - who have all highly, let me say this again HIGHLY, recommended scheduling the twins’ feedings.

They say that it is better for everyone – mom and the babies. It will hopefully provide me with some semblance of emotional and physical sanity. The babies are known to sleep better, eat better, and be less fussy. I have heard multiple stories of twins (no pun intended) who sleep through the night at 12 weeks because of the schedule.

So I have been hard at work learning about the schedule. Turns out that there is a whole philosophy behind this, and I have a feeling that this topic will come up again in my blogs – especially once I have experience with it.

To be honest, as I’ve been learning, the whole scheduling thing has been kind of stressing me out. What I understood from everyone who has experience with it is that you don’t feed the kids on demand. You feed them certain amounts at certain times of the day, and with multiples, you urge them to eat together. Otherwise, mom – in this case soon to be me – will never have a moment of much-needed rest, i.e., sanity.

Baby nurses have told me that newborns eat every two to three hours in the beginning. If those twins aren’t eating and sleeping at the same time….well, I’m sure you can figure out what that might be like.

But at the same time, I have understood from a lot of people – including the same baby nurses – that the babies themselves let you know what their schedule is – which seems on the surface to be contrary to the other pieces that I’ve been told.

After lots of talking, I totally get that the schedule is key. I’m a fan of the concept, and I want to learn about it and implement it.

I’m at the point now where I want someone to tell me exactly what to do: “Feeding #1 is at 7 am; feeding #2 is at 10 am” and so on. But I have to wait. I’ve been told that the hospital will create the schedule, which has made me feel better.

Besides the not knowing where to turn to learn about the schedule, I have also been stressed about not wanting the schedule to be messed up. I’ve met with different childcare professionals who are not into the schedule. They believe in feeding when the baby is hungry. But they assure me that they will follow what we ask.

I want to be sure to get this right so that I don’t wind up torturing these two little ones and starving them to death, but at the same time, keep the schedule so that it works for all of us. Healthy mom, healthy babies, happy everyone.

As for the first stressor: the how. The answer totally hit me just the morning. I’m on a schedule. A diabetic schedule. Please, I’ve been living the schedule all of my life. Check sugars at these times, eat at those times, and take insulin at such and such times. I’m so scheduled that it’s hard for me to not be on a schedule. (And I do sleep well.) The doctors tell me when to check my sugars and what to do. I’ve got this one down.

I suppose the difference is that soon I’ll be responsible for two little helpless beings’ schedules. That’s the freaky part. My wonderful friends gave me the best advice they could give: You’ll just know. Intuitively.

Intuition is a beautiful thing. Probably the smartest advice out there. I need to step out of my own way. Calm those crazy thoughts. Get out of my head. And just breathe. And then let the real me – the intuitive me – do the talking.

The second stressor: Dependent on others to abide by my wishes. Even freakier.
Here we go with that “letting go” lesson again….I can’t control others. I need to just trust that they will listen and do what’s best.

Pregnant or not, diabetic or not – we all get sucked into stressful thoughts. They’re fear based. And the best thing for all of us is to get out of our own heads. Be present and wisdom will follow. Have some faith and trust.

We can all heed the advice of mothers around the world – and just trust our intuition no matter what the circumstance. I’ll let you know how it goes…

Monday, March 7, 2011

Type 1 diabetes at 25 weeks of pregnancy

I’ve reached that point in my pregnancy where my fabulous blood sugar readings have started climbing.

I’m 25 weeks pregnant with twins, and my sugars began to rise about a week or two ago. I’ve been told that this is totally normal and expected at this point in a diabetic pregnancy, according to my doctor and all the research articles on pregnancy and diabetes that I’ve come across. (Please note: I am not a trained medical professional. I am a Type 1 diabetic sharing my experiences. Be sure to speak with a doctor for medical consultation on all matters related to diabetes.)

My first and second trimesters have been marked by fabulous controls. According to all those same doctors and articles, low sugars are quite typical during the first trimester, and I had many of those. I could eat a cup of straight cane sugar, and my blood sugars would not rise past 80. Now, I eat a celery stick, and my sugar goes to 180.

Alright, maybe I’m exaggerating a tiny bit. But seriously, my last A1C was 5.8. I don’t remember ever seeing an A1C like that in over 36 years of living with diabetes!

And now I am struggling to bring down 180s, 160s, 190s, 210s….

Correcting sugars like mad. Faxing food and blood sugar logs to my doc on a weekly basis (more or less). Raising my basal rates, and giving myself more insulin at meal time. Changing my pump more often – going from every three days now to every 2.5 days (expecting, according to the doctors, that I’ll have to change it to every 2 days in another couple of weeks).

And, worrying about the health of the babies as a result of all this.

The only thing I can do is to continue what I’m doing – checking sugars, taking my insulin in a systematic, informed way, keeping track of it all, heeding the advice of my doctors. I eat healthy more often than not, and I exercise regularly. I do my best to keep stress levels low, and I try to rest with my feet up often (very necessary for me at this point in twin pregnancy).

The worrying part is the part that doesn’t help. I know this – logically. But sometimes, I can’t help but worry a little bit. Usually someone is there to make me feel better and lend an encouraging ear. And sometimes I am a total worrywart in my own little out of control tailspin world. Worrying is a totally normal emotion. I am becoming a mother, right?

I know it doesn’t help me though.

And that’s when I remind myself: The best thing I can do is accept that managing blood sugar fluctuations is a part of being pregnant with Type 1 diabetes. And act accordingly. The rest is out of my control.

I don’t know if the babies will be affected or not. I’ll actually probably never know.

By the way, the high risk doctor told me that high blood sugars typically affect the babies when you have sugars that continuously read 250 to 300, or higher. That does make me feel better since I don’t have those kinds of sugars.

So is all this worry for nothing? My experience in life has been that worrying usually is just that – for nothing. Especially worrying over things that are totally out of our control.

I’ve been told that motherhood is a lesson in letting go. How about motherhood with Type 1 diabetes and twins? I guess it’s time to learn the lesson. You can only do what you can do. Life does the rest.