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Friday, April 20, 2012

High Risk Outcast

For the past month or so, I'm thankful to say that my pregnancy has been fairly boring.  My weight gain has plateaued (34 lbs.) and so has my insulin resistance (42 units basal, and 1:6 bolus ratio).  The last 2 OB appointments have gone very smooth; in fact, I've spent more time in the waiting room than actually seeing my doctor.  My blood pressure and urine have all come back fine, which I count as a huge blessing.  For most of my formerly-pregnant friends who ended up getting complications such as preeclampsia, the symptoms started showing by now.  So I feel like I've beat some personal goal by making it to 34 weeks and everything about me seems like a normal, non-diabetic pregnant woman. 

But I feel very at home with my OB, and he treats me as a unique patient and doesn't generalize me for my type 1 diabetes.  That hasn't been the case everywhere else.  For example, at our prepared childbirth class last weekend.  Initially, I was very excited about this class because I wanted to get an idea of what to expect during labor (either naturally or induced) and I was anxious to tour the maternity center where I would be giving said birth.  

The class started out great.  We went through the overall process of labor from early labor to transition to PUUUUUUUUSHing.  The morning teacher made me feel like I could handle the type of labor I wanted because it is 90% mental anyway.  Plus, she said regardless of how long ago it happens, every woman remembers the details of her child's birth.  So it's so important to mentally prepare yourself and fight for what you want.  We broke for lunch, and I felt great.  At this point, no one knew I was a type 1 diabetic or that I was considered "high risk".  

Then came the afternoon, and a different teacher took over.  Her job was to talk to us about medical interventions like inductions, epidurals, and C-sections.  I wasn't scared of this part because I figured some of these interventions might be in my future.  Before we got into the part on C-sections, the teacher threw out this random statistic because she had just got back from a conference on diabetes and pregnancy.  "Did you know that 85% of all diabetic pregnancies end in a C-section?"  And she starts the video.  

I lost it.  I looked at Trey and said, "Well, isn't that wonderful?"  Tears began falling down my face.  Snot was running down my nose.  And I had to muffle my mouth from the heaves that were coming up.  Really?!  85 percent?!  So even if I do everything right, I only have a 15% chance of having a vaginal delivery?!  I was distraught and could barely pay attention to the video.  It ends and the lights come on.  I calm myself enough to listen to the cord blood banking guy, the last talk before the maternity center tour.  

I tried pushing that number out of my mind while we went on the tour.  I reserved that I would deal with it later.  One of the reasons I chose the hospital I chose is because a) my doctor is right next door and b) they have these LDRP rooms where every process of labor is done in one room.  I wouldn't have to labor in one room and then be escorted to another room for recovery.  These rooms are great, they're set up like your grandmother's bedroom with a quilted bed, rocking chair, and warm decorations.  The same afternoon teacher told us that these rooms have everything that a typical LDR room has, but you get to stay here the whole time after baby is born.  "However, we typically only use these rooms for our low-risk patients."  I raised my hand and revealed myself to the whole class.  "So with me being type 1 . . . "  She responded, "Yeah, it's unlikely you'll get to use these rooms."  Again, I was shot down due to my category and nothing to do with me.  

Trey and I got in the car and headed home, and I felt like I had completely wasted the entire day.  I felt so defeated.  I don't care if I have to have a C-section or have to be quarantined to a room deemed suitable for high-risk patients if my daughter comes out healthy and safe.  BUT.  I feel like my story has already been written even before I'm there.  I want to have some say in how my body is dealt with, but right then I felt like I was just at the doctor's will.  I cried the whole way home, and that's a long 30-minute drive.  

Thankfully, I had an OB appointment this past Monday, and I basically told him everything that happened at the childbirth class.  I told him I felt very discouraged.  My doctor, always the sensitive guy, looked me in the eye and said, "That's not true.  That 85% MIGHT be true for uncontrolled diabetics, but definitely not for you.  And you have the choice to use the LDRP room, I'll see to it.  As far as I'm concerned, you have a good chance at a vaginal delivery."  I dried my eyes that had been wet for the past 2 days, and made my appointment for 36 weeks.  My endo even told me that given how good my pregnancy has gone, he would let me go to 40 weeks no problem.  

I know I shouldn't let these things get to me.  I should be used to people generalizing diabetics into some doomsday category.  My story is still unwritten.  I want every pregnant type 1 to know that they don't have to submit to anything that "should be" just because of our category.  We are high-risk, not "high maintenance enough that we don't want to give you a chance".  Several people have already asked me if they were going to take my baby early or if I have a C-section scheduled.  No and no!  If you take away this stupid disease and just look at ME, I am 100% healthy and so is my little girl.  Let's take off the vial glasses and look at ourselves as individuals.  Because as one of my good friends says, "Diabetes doesn't define me (!), it just explains me." 

7 comments:

  1. I can't even imagine how that must have felt. I can relate, to an extent, in wanting a vaginal delivery badly, but only to be defeated by the very factors that made me high-risk. I had both experiences, in a way: 28 hours in the nice LDRP room, a quick emergency C, and back in a LDRP room until they could make room for me upstairs (40 babies born the same day!). I'm glad your doctor has both your physical and emotional/mental health states at the forefront - sounds like a great person. Good luck on the end of your pregnancy!

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  2. Oh, Holly. :( I'm grateful for your OB; he sounds great and did just what you'd hope he would - be supportive! Big hugs to you, friend.

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  3. Aw, man. I'm trying to choose a childbirth class right now, and I'm facing the same kinds of fears. Some of my friends have done the natural-ish birthing stuff (Bradley Method, etc.), and I'm afraid of those because they're so judgey from the other direction -- they want you to do everything WITHOUT medical intervention, and I know I have to be open to that possibility.

    I get you on the "story already written" front, too. I feel like some doctors walk into a room and expect to see a 350-pound double amputee with a pacemaker or something. And then they're so pleasantly surprised when, like you said, I'm 100% healthy when you take away this stupid disease.

    We're going to be okay, Holly! I promise!

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  4. Oh Holly, that's terrible. I had a perfect, uneventful pregnancy until the 36th week. I ended up going in for my regular appt. and my blood pressure was elevated and my urine had protein, yes I had developed pre-eclampsia and I had a perfect checkup just the week before. It was a bummer but turned out to be not so bad. I had to stay in the hospital for about 6 days before my water broke on it's own and I had a vaginal delivery. Things may not go exactly like you want or expect but You're going to be fine and don't let anyone tell you otherwise!

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  5. So glad you have such a sensitive supportive OB. There are lots of high risk pregnancies and Type 1 is only one reason for high risk.... even though, with an A1c in the fives, you are technically in the non-diabetic category as far as risk goes. I think you have every reason you can expect to deliver without a C-section. Anything can happen at the last minute with any pregnancy necessitating a C-Section but expect the norm. It is wrong for someone to get you all worried and worked up in advance; you need to be able to relax and enjoy this special time. A first baby! So exciting! Congratulations. I'm sure everything is going to work out well.

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  6. Holly - I just read this and it almost made me cry with you! I hope your delivery went well!

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  7. I hate how t1d writes my life story, too. Even though both of my babies were born vaginally, I had to deliver them in the operating room because they were preemies. The first is two years old now, and the second is three weeks old and still in the NICU. Fun stuff. I hope your baby is able to bake longer than mine did!

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DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.