A City With Broken Down Walls

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A year and a half ago, I was working in children’s church while we studied an important lesson. It was January, and in the spirit of New Year’s Resolutions, we learned the following verse:

“A person without self-control is like a city with broken down walls.” -Proverbs 25:28

At the time, the verse stood out to me. My husband and I had decided to (try to) have our first baby that year. In order to make that happen, I would have to get my blood sugar under control and then keep it there for many months.

I was up for the challenge. We joined a local gym, I sourced an old elliptical machine from my local freecycle group and I carefully planned our meals to best accommodate my goals.
In a short time, I was successful. I had dropped about 4-5 pounds and had excellent blood sugar control. The first time that I saw my a1c at 5.1 I burst into tears. It was proof that I could accomplish anything I set my mind to with God’s help.

I was pregnant as of April (a little earlier than I had thought it would happen), but my doctors were supportive. Throughout my pregnancy, my blood sugar was uncharacteristically low. I found myself checking and re-checking until my fingers were calloused and sore. I took walks at every possible break while at work and would get on the elliptical machine for at least 10 minutes after dinner every night.

After Layne arrived, I was in a sleepy haze of feedings, dietary changes to accommodate her milk/soy protein intolerance, trying to keep my sanity….I stopped checking my blood sugar regularly because it wasn’t my focus anymore. Layne was my entire focus, every minute of every day.

Then last night, while feeling a little “off,” I decided to check my postprandial blood glucose (measurement of blood sugar 2 hours after the start of a meal). It was 186. I must have checked it 4 times, after washing my hands and testing the meter for accuracy. Humbling. My blood sugar should have been about 120 at that point.

I jumped on the elliptical machine again to bring it down before bed. I made a high-fiber, high protein breakfast this morning and I tested my glucose two hours afterward to find it in the normal range again.

When I don’t take care of myself, I leave my body much like a city without walls. I invite infection, disease, lethargy, weight gain, etc. into my life. I invite those ills into our family as well. It is not good to give my daughter everything now at the expense of her having me around as she grows up.

Much like I did a year and a half ago, I am placing my focus on rebuilding my walls. On having self-control with my diet. On being self-disciplined with my exercise.

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30 Weeks: Fear is a Four Letter Word

There is nothing like impending motherhood to remind me of how little control I have over anything in my life. This uncertainty is just exacerbated by my raging hormones and constant re-thinking of every choice and decision I make on a daily basis.

Yesterday, I had a 30-week ultrasound to determine my baby’s growth and development. After marveling at detailed facial features (this baby might have my nose after all) and a perfectly functional heart (I could see all four chambers), I was informed that this child is in the 95th percentile for growth.

Wait a second….My child is big?

My shock transitioned into slight vindication when I realized the explanation for my 3.5 pound weight gain over the last few weeks, but then that quickly receded into fear. Fear for my child’s development, fear that I had somehow missed something with all of my blood sugar checks, fear for my ever-still-so-small lady parts!

The doctor only made it worse by bringing up cesearan section talk in the exam room following the ultrasound. It doesn’t take a genius to realize that my 5’2” frame probably would do better with a 6-7lb baby than a 10lb baby, but I resented him for even mentioning it yet. I resented my doctor for always bringing up every worst case scenario. I resented him for dismissing my objections with bringing my baby’s health into it.

“It isn’t about what you want. You might not have a choice…..”

I made sure to let him know that while he is only thinking about this child, I am thinking of my (up to) three other unborn children and their health and safety with delivery in the future. He told me that Vaginal Birth after Cesearean is common (yeah right!) and I shut down a little. The same doctor who told me that he would like to see me get to 38 weeks before induction due to my diabetes then told me that inducing early wouldn’t help me and that we would have to discuss scheduling a c-section if the baby continued to grow at this rate.

Frustration, coupled with pregnancy-magnified anxiety clouded me the whole drive home. I wasn’t thinking clearly and my mood was sour. I have done everything I can possibly do to ensure that my child has every fighting chance and a normal, non-diseased life. What the heck am I supposed to do now???? I put one hand on my belly while driving as if to excuse my child from having done anything wrong. 95th percentile should belong to children of really tall people, but if I am supposed to birth a linebacker, then so be it.

“My fears have worn me out…” – Switchfoot, Redemption
It wasn’t really until this morning that I realized where my fear and resentment were really coming from. When I failed to look to God to answer me in my distress I found my thoughts getting darker and more angry. Like the child who gets upset when his older sibling tells him he won’t get to do something when the parent or babysitter has clearly said otherwise, I looked only to my own doubt and frustration and never once thought that maybe God knows a little more about this child than the doctor does.

Psalm 139

13 “For you created my inmost being;
you knit me together in my mother’s womb.
14 I praise you because I am fearfully and wonderfully made;
your works are wonderful,
I know that full well.
15 My frame was not hidden from you
when I was made in the secret place,
when I was woven together in the depths of the earth.
16 Your eyes saw my unformed body;
all the days ordained for me were written in your book
before one of them came to be.”

“My frame was not hidden from you….Your eyes saw my unformed body….”

We can look at my child through monitors and sonograms and modern technology, but God sees this child with His eyes. Nothing is hidden from Him. He knows exactly the date and time that this child will pass through to this side of life and all my doctors can do is estimate, guess and rely on technology to make decisions. They do their best, but when they tell me educated guesses about my child or my ability to bear this child naturally, I can’t throw a fit and feel defeated. I have to look to God (who knows the ACTUAL weight and height and whose nose the child has) to give me my answers.

My Silent Partner in Life and Pregnancy: Diabetes

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After 8 months of testing for food allergies and strange bacterial infections, I was diagnosed with diabetes at nineteen.To say that the doctors weren’t looking for it is an understatement, as I showed no typical outward signs of being at risk for the disease. I am not heavy, I am not old and my family has virtually no history of carrying it (I did find out a few years later that my great-great grandfather on my mother’s side had it, but that was probably back when they treated it with pig insulin and gave patients a short life expectancy).

My diabetes had manifested itself as a nasty tongue rash. The rash resembled the sores that one might get after burning his or her tongue, but much more painful. All of the doctors dismissed it as some kind of allergic reaction to citrus or exposure to something environmental. I was given a magic mouthwash (with benadryl and some other antihistamine ingredients), a prescription for hydrocodone (vicodin), and told to take Benedryl on a daily basis. The oral surgeon, dentist, allergist, and ER doctor were all wrong! Something inside me knew it too, but never suspected diabetes.

The summer of 2005 was really hard for me to find work. It was between my freshman and sophomore years of college and I was to go on a college internship to Walt Disney World that fall. I had left my job as a waitress a few months before and the families I babysat for were going on vacations and didn’t need me very often. I was feeling better than I had during the spring, but my tongue issue had never really been resolved. I chalked it up to “one of those fluke things.”

In August, I consulted my sister to participate in a sleep study at the clinic she worked for in Detroit. I was told to keep track of my sleep patterns for a period of time (and write in a journal). After submitting these I was called in for a comprehensive blood test, urinalysis and physical to make sure I was a good candidate for the study. I remember sitting in the exam room, sipping a travel mug of coffee with sugar and milk in it. It was the last time I ever put sugar in my coffee.

I got the call from my sister a couple days later. She shouldn’t have had access to my medical results, but what was truly troubling was the diagnosis: Diabetes. My blood sugar was 373. This is a number I will never forget. It meant absolutely nothing to me at the time. Could there have been a mistake? Was it the sugar in the coffee I was drinking? Should I do the blood test again?

For those of you who may not know a lot about diabetes, a healthy person without the disease has a blood sugar rating of 60-99 (or so) when fasting. Although the reading that the clinic took was not a fasting reading, it never should have been over 120. When we eat foods that contain carbohydrates, our bodies break them down into sugars. The pancreas is responsible for releasing insulin. This insulin acts like a key to unlock the cells in our bodies (in all of our organs–think brain, muscles, etc) so that we can utilize the energy from the foods that we have eaten. In a person with diabetes, either the pancreas does not work properly and not enough (or any) insulin is released to carry the sugars to the cells, or the body becomes resistant to the insulin and it is not as effective as it should be. The result for people like me is that the sugars sit in our blood streams, our blood sugar levels rise, and the high levels of glucose can eventually damage our organs rather than help them.

After the doctors at the clinic confirmed that the test was accurate and would not need to be redone, I started my spiral of self-pity and mourning. I remembered being the fat kid on the playground and wondered to myself if I was to blame for this.

My emotional side dialogued with my rational side:

“Why me?”

“Why not you? What makes you special?”

“What did I do wrong?”

“At least it isn’t cancer.”

“I feel like a failure.”

“That is an overreaction. You aren’t going to die.”

“Will I ever be able to have children?!?!?”

I made it through college with the help of a wonderful doctor and caring parents who wanted me to get the best medical care we could find. I kept my blood sugar “under control” from a medical standpoint through the aid of pharmaceutical drugs, a few of which either had horrible side effects or have since been recalled.

When I graduated from college, I really started to look at my disease differently. I wanted to finally get my answers as to why I had it and what I could do about it. My experience with the doctors that I had seen–all of the poking and prodding and medicines–had made me skeptical about most medical interventions. I told my doctor that I was certain that there was a real reason why I had developed this disease, and that I suspected it was because something was off-balance in my body. He dismissed that with, “Everyone wants to believe that it is something else–that there is a reason. I’m afraid you are just another run-of-the-mill diabetic. It just is what it is.”

I didn’t accept that answer. In 2011, my doctor finally mentioned that I have a mild case of Hashimoto’s, which is when the thyroid is enlarged and doesn’t work as effectively as it should. I got frustrated. Even though the doctor said that my tests still showed my thyroid function in “normal” range, I knew where this was going: a few more years and then a good chance of being on thyroid replacement therapy for the rest of my life. My grandmother (on my mother’s side as well) has had a dead thyroid since she was in her forties. This WAS genetic.

And then it clicked. What if the two conditions were related? In 2012, I started to scour “non-medical” healing books to read about diseases and their origins. Under Hashimoto’s Hypothyroidism was a direct connection to the development of type 2 diabetes. Since both the pancreas and the thyroid are in the endocrine system, their function is directly related. When one stops working properly, it is likely that the other will eventually follow. Symptoms of an underactive thyroid include being cold all the time or having a baseline body temperature of less than 98 degrees. Mine has always been 97.4 or so. And NOBODY knew better to be looking for it.

Pregnancy and Diabetes

As I mentioned when I was first diagnosed, one of my top concerns with having diabetes was whether or not I would be able to have children. Or, more realistically, could I have children without screwing them up physically for life?

I actually had a former boyfriend / love interest tell me in conversation that he would never marry someone who had a disease because it would be too hard to deal with and it could affect their children. That was one of the most hurtful things anyone had ever said to me. Rejecting me, or people like me, based on something that we had no control over felt horrible and unfair  “I didn’t pick this!” I thought.

When I met my husband, my world started to make sense. He didn’t care that I had diabetes. He loved me and mentioned that he would be fine with adopting kids if we couldn’t have any. He was everything I had ever wanted in a husband ( and things I didn’t know I wanted until I met him ). I felt safe with him but still had a great fear of screwing up my unborn children. The drugs I was on were not safe for pregnancy, and I knew that I would have to control my blood sugar 100% better to prevent birth defects and other problems during pregnancy.

After three years of being on one medication that make me nauseous all the time, I told me doctor I was done December of last year. I told him I didn’t want to risk getting pregnant on this medication (Byetta) and that I was tired of being “sick.” He was fine with me going off the medication but cautioned me that I would most likely have to take insulin if I did, indeed, become pregnant.

After getting my a1C down to 5.4 (this is a 3-month blood glucose average of 115), I was given the go ahead to conceive. This happened almost immediately, as the fear of pregnancy went away. Most of my friends had taken months to conceive, and I had conceived without really trying. I was surprised and couldn’t believe that it was actually happening.

Since I became pregnant 6 months ago, I have heard all sorts of warnings from my doctors about eventually needing insulin to control my blood sugar, about delivering early, and about the risks of stillbirth if my blood sugar is high and I let the pregnancy go past 38 weeks. All the while, I have been checking my blood sugar 3-4 times daily and eating accordingly. My next a1C was 5.2 (108 average) and the next was 4.8 (93 average).

My doctors have been astounded as to how I can have better blood sugar than most non-diabetic patients they see in pregnancy. I might not know all of the inner workings of fetal growth and blood sugar, but I do know a few things:

  1. My blood sugar levels can only be controlled with God’s help. I pray over my baby daily and ask Him for help because I don’t want to screw this up. I can’t control one point of my blood sugar on my own. It is God who makes my body work and respond to exercise and treatments.
  2. There is no room for FEAR in pregnancy. I can only afford to have confidence that God has a plan for this child and for me as the mother. I CAN’T screw this up because that isn’t what God wants. He wants me to have a healthy baby.
  3. On earth, I am ultimately responsible for what happens to this child. No drug or fear-filled advice is more important than my own intuition. When my first doctor called in a prescription for a long-acting insulin when I was first pregnant and my numbers were just above normal, I gave it two days and (with faith) the blood sugar came down without intervention. Something told me not to pick it up and I am glad that I didn’t.
  4. Being on insulin or other diabetic drugs is NOT a bad thing. If I get into my third trimester and my blood sugar creeps up out of control, I WILL do what I have to do to keep it down. It is not failure to do what is best for my child, even when it involves medicine. Failure is choosing not to trust in God as He gives me peace or direction about what to do.

Right now, all I can do is take one day at a time and keep praying for this peanut. For the time being, however, pregnancy suits me. 🙂