Another Month Gone

Got my period yesterday.

It's been four months of TTC, or trying to conceive, as they say, and Mr. Lyrehca and I are impatient.

Back in August, after eight months of fine-tuning the blood sugars, after an unrelated health issue on Mr. Lyrehca's part, after somehow feeling more OK about the whole baby thing than ever, I stopped taking the Pill.

My blood sugars were actually looking good, even to me. My always-low A1Cs crept even lower. The secret to having managable blood sugars, I figured, was eating pretty much the same thing every day.

Breakfast, it's oatmeal, Splenda-sweetened peanut butter, another packet of Splenda, and some raspberries or blueberries mushed together with a side of skim milk. It's a glorious deconstructed peanut butter and jelly sandwich that reacts appropriately to a bolus and doesn't (usually) send me soaring high an hour after I've eaten (as those white simple carbs do). I will eat this meal for the rest of my life.

Lunch, I'm keeping the local French sandwich shop across the street from my office in business. Since January 2005, I have eaten a turkey or chicken sandwich with herb mayo, Swiss, cucumbers and onions on whole grain bread. People at work can't believe I eat the same lunch every day, but as I tell them, it's easier for me to do the same bolus every day and forget about it. My sugars, again, react appropriately. (The office doesn't know I'm TTC, but they know about the diabetes. They'll learn about the reason behind my daily same-sandwich-schtick in due time).

Dinner's the wild card, because really, a girl's gotta have her fun sometime. And since I go out and socialize over dinner more often than I do over lunch or breakfast, dinner's when I carb count and bolus and generally eat whatever I want to eat.

That means my overnight blood sugars are generally whatever they want to be.

I am awake nearly every night in the wee hours, testing to see if I'm actually within range (which always shocks but pleases me) or woefully high (hello, bolus button!) or low (hello, LifeSavers!)

So, back to the TTC. (Interesting, all the acronyms and fake names for this activity. We're having sex without birth control so we can have a kid, People. Is that so hard to type? But on bulletin boards about pregnancy and elsewhere, TTC is the common term. Besides the more-sanitized TTC, I've seen the appalling BD, for doing the "Baby Dance." or BM, for "Baby Making." Doing the baby dance? Oy. We're trying to fuck over here--move the top hats and tutus to another bed.)

OK, off the soapbox.

August, went off the Pill, was told to have protected sex for a month to get said Pill out of the system, and September, we're going at it.

Early October, the period arrives (and its name is NOT "Aunt Flo," another cringe-worthy pseudonym). I call my high risk doc and endo and ask if we're doing something wrong.

"Get an ovulation prediction kit," I'm told.

We get the kit, which consists of seven sticks I'm supposed to pee on after a certain number of days after the last period. I pee. I see lines telling me I'm about to ovulate. We have our sex.

And again, the period arrives.

I call the high risk ob again and tell her we're still impatient. And since we're 35, we don't want to sit around, literally pissing the time away if there's a problem.

I'm given the phone number of a local infertility clinic and call in November. They don't have an opening until January, which I take. I figure if there's still no positive pregnancy result in the new year, it'll be closer to the "six months of unprotected sex and no pregnancy" definition of infertility, anyway.

In November, I do two things. I call the infertility clinic and tell them I want blood work for an ovarian reserve test, which are blood tests done on the third day of your period to determine if you're even producing enough eggs or not. (Being a researcher is handy; my super diabetes endo didn't know what I was talking about when I called her about this, but thankfully the infertility folks did.) Although my appointment's not for two months, I figure, if I can get the test done and figure out the results, I'll know we're not wasting time these two months if there's no egg to fertilize. I get the blood work done at my primary care doc's office, and get the results faxed to the infertility clinic and myself. And while the infertility clinic won't discuss the results with me til my Jan. appointment (and why would they? They haven't even met me yet, the nutty impatient research-happy diabetic who just wants to get the show on the road already), I can analyze the results myself through the wonder of Google. As far as I can tell, I've still got eggs aplenty. So cross premature menopause off the list.

I also start charting my waking temperatures and oy! observing my cervical mucus. According to a very-often-quoted book out there in pregnancy- and conception-land, taking your temperature first thing in the morning and checking out consistency of your vaginal goop will tell you when you're ovulating so you can figure out when to best fuck for fertility.

There's a nifty online package of this charting thing where you can enter your temps and goop reports online, and the program will pinpoint when you're ovulating (as long as there's no underlying medical problem). So in December, I take my temperature. I check out the mucus downstairs. I keep online records. I tell Mr. Lyrehca when it's time for sex. My computer chart looks great.

And then yesterday the period arrived.

I know next month might work for us and then I can cancel the expensive and not-covered-by-insurance infertility appoinment. I know in two weeks I could conceive and that this stuff just takes time for some people. I also wonder if there's something clogged in my uterus or tubes that's preventing things from connecting and moving along, or if Mr. Lyrehca's swimmers aren't swimming, in which case, bring on the infertility experts.

But right now, all we can do is wait.

And as you can guess if you're still reading along, patience ain't one of my virtues.

It Started Nearly A Year Ago

I married Mr. Lyrehca just over a year ago and we figured that since we were both approaching 35, we should think seriously about the baby thing. He, frankly, was more into it than I was, but intellectually I knew my eggs were getting older and heck, the diabetes wouldn't make things easy.

So we met with a high risk doc who works in tandem with my excellent endocrinologist. The endo focuses on pregnant diabetics, so I figured I was in good hands.

I've heard about those diabetichicks who are like, "I know my sugars weren't where they were supposed to be, but it just happened and now I'm pregnant," or those who aren't aware that super-tight blood sugar control is the best for a growing fetus. Or women who say, "I had a baby years as a T1 mom ago before we knew about such tight A1cs and the baby was born healthy."

I'm not one of those.

Instead, I'm a researcher who finds out the tiniest detail about something before it actually happens. I'd had a fairly hard-core endo when I lived in a different state back in my single days, and she too focused on pregnant type one patients. Her thought was that the A1c should be 6 or below before trying to conceive.

For those non-Ds following along, an A1c of 4-6 is a healthy non-diabetic range. It's generally considered that an A1c below 7 is a good place for a diabetic to consider trying to conceive, or TTC. My current endo says the 7 cutoff is what she recommends.

A year or so ago, my A1cs were actually around 6.3 or so, which may sound great, but for some odd reason, my A1cs have always been in that range, EVEN WHEN MY DAILY METER READINGS (WITH TEN OR SO TESTS A DAY) had much higher averages. So I never really thought my control was as good as my docs thought it was.

The recommended blood sugars for someone trying to get or remain pregnant go like this:

Pre-meals, 70-90
One hour post meal, 140
Two hours post meal, 120

Since I've had readings bounce from 40-400 in a day (thankfully, not that often), and I was seeing averages on the meter from 160 to 180, the idea of remaining around 100 all the time seemed impossible to me.

When Mr. Lyrehca and I first heard about this, I actually teared up and got, as we say, "klempy," which my husband, being more gooey about the baby idea than I was, thought I was crying tears of joy and getting verklempt.

But really, I was freaked out.

I mean, it's one thing for me to have a 200 and feel crappy. I've been doing this schtick for a long time and I know that I'm not going to die tomorrow if my blood sugar is 200 all day, particularly if I'm bolusing what I can to get myself back to normal. Besides, in the most frank possible way, I'm only hurting myself.

But having a baby depending on me for everything, growing inside me, and basically choking in a sugar brine because I can't get my blood to go down, makes me feel horrific and terrified that the kid is doomed from the start.

When I pointed this out to both my doctor and my husband, they had some calming words.

My endo said, and I think about this daily, that it's the average blood sugars that are most beneficial to a growing fetus, and that one high blood sugar once in awhile isn't going to harm the fetus in the way I think it will. It's the average A1C that's important.

She also, at my urging, also does fructosamine tests now, which measure your average blood sugar over the past two to three weeks, rather than the past two to three months an A1C tests. And while she saw how my fructosamines were more in line with my meter readings than my A1Cs were, she also pointed out that my averages, overall, weren't as high as I thought they were.

It's been said before, and I agree, that being a T1 is a never-ending battle for compliance. Sure, my A1C may be under 7, but there's the non-diabetic range that's lower. I may have a week of terrific blood sugar numbers, but that doesn't mean I'll have them next week, or even the next day. It's an ongoing struggle for control, and even when my A1Cs drop in the non-diabetic range, I'm still having a ton of lows and the occaisonal high.

My husband says he'll help me however he can when it comes to keeping certain foods or Diet Coke out of the house so it'll be easier for me to eat right and keep my sugars tight. He says he'll do whatever he can.

But as terrific as he is, and as great as my endo is, and as healthy as all those kids of diabetic moms have turned out to be, and as supportive as all you fellow D people are out there, I'm still doing this on my own. Still doing it all to try to have a healthy baby grow inside me and be born the healthiest that kid can be.

And that still scares the (*)*%^& out of me.

Another Day Educating the World

I just got in from my weekly Weight Watchers meeting. You may ask why I am doing WW when I am one, a diabetic, and therefore already counting carbs and two, trying to get pregnant.

While I'm not pregnant right this minute that I know of, I'm definitely overweight. And while I know how to count carbs and balance insulin ratios, I also know how to eat. And while my sugars and A1cs are great, so too is my ass.

I figure I'll try to lose whatever weight I can before I get pregnant and if the at-home test happens to turn positive before all the excess poundage is gone, so be it.

I've been going for a few weeks now, and like the weekly leader enough to stick around for the motivational meetings. Today she read some sort of holiday fable based on the movie "It's A Wonderful Life." I'm not big into Christmas schtick, but the story is about the guy who wonders what life would be like if he'd never been born. In her story, the character wondered what life would be like if she'd never joined Weight Watchers.

(Bear with me; the go-girl diabetes moment is coming up.)

So the leader says how the character realizes she's twenty pounds overweight, and how that puts her at risk for heart problems and DIABETES. Immediately, I'm thinking, "Where's the Type 2 qualifier in that statement?"

I waited til she was done with her story, and people around the room talked about the challenges of eating during the holidays, and all that. Then I spoke up and pointed out that "Being overweight has nothing to do with being a Type 1 diabetic, and while Type 2 diabetes is far more common, you should really make the distinction between T1 and T2."

The leader thanked me and said she hadn't known that about diabetes and other people around the room said the same thing.

Just one small step in the road to public awareness.

Back to quietly counting carbs and points now.

The Backstory

I've been a T1 diabetic nearly my whole life--28 years out of 35. I'm down with the diabetic scene. Been on a pump for five years, been shooting insulin for two decades before. I prick my fingers every day, many times. I count carbs. I exercise. I know how to do it.

Except I'm trying to have a kid and it's pretty unfamiliar terrain.

I'm amazed by how many diabetic blogs are out there and figure today's my day to join the crowd. I haven't seen anyone else write about being a type 1 diabetic pregnant woman on a daily blog. (If you're out there, let me know!) I've been reading a few diabetic pregnancy newsgroups for awhile now, and they're great. But everyone's in a different stage of being pregnant, and since I'm not even there yet, it's hard to know what will help me when I'm farther down that road.

I also have a terrific posse of T1 diabetic pals. They're all savvy chicks like me, longtime T1s. Between three of them, they have four kids. So I've talked their ears off. Heard them tell me it's possible to have a healthy child even with longterm diabetes. Heard them say it's possible to keep the A1Cs well within healthy ranges. Heard them say they can eat well and maintain the blood sugars and keep the kid healthy inside. I hope I can do it, too.

I've never been one of those "I've been dreaming of being a mom all my life/I can't wait to experience birth/I want a natural experience" people. To be honest, having a kid really scares me. I know how much can go wrong. But at the same time, I think if I chose not to ever try to have children, I'd feel I missed out on something huge. So it's time. For me, it's a question of where I am in life, how old I am, and finally finding the right partner to do it all with.

So here I go. It's going to be a long, wild, and crazy ride.