Wednesday, July 17, 2019

The Five Stages of Gestational Diabetes


"What do we say to the God of Death?"
"Not today."

--Melisandre & Arya Stark, “Game of Thrones”

As I waddled around the office to close the loop on a few business projects on my last week of work before maternity leave, one of my coworkers remarked, "You're the fittest, happiest pregnant woman I've ever seen." I smiled and thanked her for the compliment, but truthfully told her that I was far from the fittest. I had nagged Facilities to put in an Expectant Mother's parking spot closer to the building (they didn't). I parked my car under trees oozing sap all over the windshield and carried my laptop-laden backpack to work those last few mornings since I couldn't bear to walk further. My pregnancy, though thankfully incubating a healthy baby, wasn't exactly easy, and I dealt with wacky things such as:
  • 14 weeks + 5 days of persistent nausea (yep, counted)
  • Recurring yeast infections and BV (a first for me, ever)

Probiotics for combating recurring yeast infections
  • Constant colds and coughs that I would catch every other week (got to intimately know natural remedies such as saline nasal flushes, salt gargles, elderberry syrup, and sleeping with a humidifier)
  •  A fractured tooth that I postponed getting fixed until the second trimester, and then had to undergo getting a crown without x-rays
  • Now surpassing "the most pregnant I have ever been" point at almost 39 weeks, the debilitating pain of a sciatic nerve in my left leg, spasms of lower-back pain, swollen feet, and the lovely sensation of a full-term baby simultaneously ramming me in the cervix with her head and squeezing my bladder

The topper on the cake, though, is getting the diagnosis at 28 weeks of pregnancy, after downing 75 grams of a disgustingly, sugary-sweet drink for my 2-hour Glucose Tolerance Test, that I have gestational diabetes for the first time in my life. Naturally, I passed through all 5 stages of grief:

1. Denial
Impossible. I passed that test with my first pregnancy. I only went 5 points over my 1-hour draw.

Failed the 1-hour draw by 5 points


Can't they just pass me? There's no way I can set an alarm for an hour after the first bite of every meal, prick my fingers 4 times a day, and keep a log of everything I eat and drink. Who has time to do that?

Me, that's who. Gotta do what you gotta do.


2. Anger
Screw all these people posting pictures of bread, pasta, and pastries on Facebook. We're all drowning in sugar and eating ourselves to death with super-sized portions in America. Why did my team members just bring in a box of Krispy Kreme donuts AND followed lunch with a boba tea run? Do they have no sympathy?

3. Bargaining
Let's see if my blood sugars will spike if I sneak in 3/4 cup rice instead of 1/2 cup. What if I eat a sweet snack right after a good test number, and not test again until after the next meal? What if I sneak in my cravings of ramen or a four-cheese Hot Pocket for breakfast, and then walk for 40 minutes instead of 20? After I deliver this child, I want a Cream ice cream sandwich with strawberry ice cream and warm, freshly baked Snickerdoodles.

One of my many baked goods on the weekends with Luc

I want a Cinnabon roll with caramel and pecans. I want a cheesecake with strawberries on top. I wonder if the hospital serves Belgian waffles. Smothered in syrup. No need for real maple syrup, that fake, generic stuff is just fine.

4. Depression
I am hungry all the time. I can't cave to my cravings. There is no way I can control my carb intake and still be full. No way I can remain on this diet and still gain some weight per the dietician's instructions. Does this mean my baby is also losing weight? Am I hurting her? I am so far from the end; how can I make it? Statistically, women who develop gestational diabetes have a higher chance of developing postpartum depression, and also a higher chance of developing Type 2 diabetes later in life. Not great odds to mull over.

Striving for that ideal reading: over 100 and less than 130 mg/dL after meals

Weekly non-stressed tests to check on Baby


5. Acceptance
A healthy baby trumps all. I'll do it. Eat the quinoa and soak chia seeds and cook oatmeal with flax.

Snacking healthy: cheese assortment with stone-ground wheat crackers

I'll cut down my rice portions for dinner. Eat salad for weeks. Switch to nasty pasta made from lentils. Drink no-sugar-added almond, soy, and macadamia nut milk. Stop eating cold cereal in cow's milk for breakfast. Give up pizza, my craving for Vietnamese banh cuon, stop baking treats loaded with refined sugar.

Baking my own healthier oat bars for snacking

 Reduce my boba tea consumption, having an occasional treat at 30% sugar, no toppings, every-other-week, and drink only half a day. Commit to light yoga every morning. Walk twice a day after breakfast and lunch, with a waddling pregnant belly, in 80-100-degree summer heat. Log my food, snacks, and drinks religiously, and never miss a blood test.

A typical food + glucose reading log

It has been 11 weeks since my diagnosis, and I have successfully managed my gestational diabetes through diet and exercise, avoiding insulin injections. What a feat for someone who loves food, has never had to diet thanks to a high metabolism, and has low resistance to saying no to treats.


11 weeks' worth of sharps

I didn't have the most affable or sympathetic dietician to guide me through my GD journey. She nitpicked on all my little red numbers that went over the max allowable threshold, told me to cut down on everything but still somehow gain some weight since I had plateau'ed, and rarely gave any positive reinforcement of the things I did right so far. She even threatened that she had recently put a woman in her 37th week of pregnancy on insulin, as if I must not slip up or face the consequences. It wasn't until I switched dieticians at the very end that I was praised for the amount of walking I fit in, given liberty to indulge in reduced portions of any cravings, and was told I was doing a great job keeping down my numbers.

Maybe that discouragement from my first dietician was part of the reason why I was determined to conquer this transient disease, to not let it rule me or my baby. I asked myself, after all that I had already been through to carry this baby to a healthy full term, if I would let it defeat me.

Not today, gestational diabetes. Not today.