Saturday, May 4, 2019

Type 1 Diabetes & Pregnancy: The A1C

When I started this blog I often imagined I'd be documenting all the monumental moments of my life.  I imagined I'd write about going to college / university, and I imagined I'd write about living on my own. I also imagined writing about my wedding day and eventually about starting a family.  And while ten years has quickly passed since starting this blog, I can smile here knowing that I did manage to check quite a bit off my list of things to of course blog about, but also to experience.

It's a Boy!  Photo by: Girard Photography
In December 2018, Mike and I got the most exciting gift to date, a positive on our pregnancy test. This was probably one of the most emotional and overwhelming feeling to date.  We are going to be parents!  The first person I called was my endocrinologist, followed by my family doctor.  Having never had a child before, I had no clue who I was supposed to tell first.  I knew that my endocrinologist had said that as soon as we were pregnant to give her a call, so that's what I did.

A year prior I wanted to prove to myself and my diabetes team that I was capable of maintaining an A1C that was safe for conceiving and carrying a baby.  I aimed for the low 6's every couple months that I got my A1C done. My endocrinologist told me that I could get one done every month, which really allowed me to stay motivated and on track.  I bounced between 6.5% and 6.2% which was deemed great. This was done with minimal highs and minimal lows, as I know that sometimes an A1C test is not a great predictor of blood sugar control.

I knew that I was capable of maintaining a good A1C all while still enjoying the food I enjoyed. It really amounted to pre bolusing (taking insulin x amount of time before my meal versus just as I was putting food in my mouth or after)  and paying attention to my blood sugars, rather than guessing and bolusing.

After conceiving, the new step of diabetes management was now in place.  The first trimester meant a lot of lows. This meant that I needed to be checking often and be prepared to drink juice or eat rockets at any moment.  This was an interesting balance of making sure that I wasn't overeating my lows out of fear, and hunger frankly and keeping that balance between the lines of 4.9 and 8 mmol/L where I wanted to be. (Everyone is different, that was just my goal target for myself!) 

With the lows in mind, but also knowing that I felt my lows, I was watching for them and I was prepared, I managed to have A1C's in the high 4 and low 5's since.  I am now in my second trimester and I am having less lows, but still attempting to keep within my personal goal target.    This is not to say that I do not ever go above 8 mmol/L, in fact more recently it has proven to be more difficult, and require a tremendous amount of brain power to try and prevent spikes. There are for sure moments that I go above and to be honest, panic a little.  My doctor reassured me that a random high was not going to be detrimental, which eased my worry.

A1C has always been a daunting phrase within the diabetes community because it holds so much power over how we personally view our diabetes management and also how health care providers gather an idea of our management, while I look forward to having some brain space for other things and not diabetes, for now, I will do anything for that little guy in my belly!

Kayla

Note: The A1C test is a blood test that provides information about your average levels of blood glucose, also called blood sugar, over the past 3 months. (
https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-test)

Wednesday, March 13, 2019

Cheers to Ten Years

June 2009
March 13th 2009, I was told that I have type 1 diabetes.  Now, March 13th 2019, ten years later, I sit here and marvel at the journey that my diabetes has taken me on.   Little did I know what living with type 1 diabetes meant at the time of diagnosis.

While ten years is quite the span in time, I can still picture my eighteen (almost nineteen year old self) in the waiting room. Waiting without any idea what was going on, crying as the doctor told me I had diabetes and then walked away and closed the door.  I remember trying to get a cell phone signal in the room so that I could text someone, anyone.   I recall the quick drive home after they told me get a bag together because I'd be staying at the hospital for a couple nights, something I'd never done before.  I remember the look of panic on my mom's face as she gathered my things together and then drove me to the Brantford General Hospital.

I remember a question I asked the first doctor I saw at the hospital.  I asked, "Will I still be able to have a family?"   it wasn't something that I was actively planning at the time, having to still complete College and University, but it was an important question for me to ask.  I remember him smiling and telling me, "of course." Probably wondering why out of all the things to ask during time of diagnosis, I decided to ask that.

Ten years later, and I am smiling thinking, 'of course' as my husband and I get ready to add a beautiful baby to our family in August.


Baby O'Connell Arrives in August! 
I remember sitting in the hospital bed, as the patient beside me went on about all that Popeye's Chicken had on their menu, laughing at how excited they sounded, "they've got spicy chicken, spicy wings, even spicy fries..."   I remember that wonderful nurse who let me use the computers to look up a group called Connected in Motion, which I believe full heartedly immediately paved a beautiful, growing, supportive path for my journey.

After that, I remember the doctor, the same one who answered my question about having a family, asking me why I kept smiling, as if I should be in sorrow, or mourning my forever broken pancreas. I remember shrugging my shoulders and not really knowing, but now looking back realize that when in doubt, smiling can take some of the pain away.

The fear I recall was when I was taken up to a room, them not letting me get out of the bed as they pushed me through the hallways and up the elevator.  Myself thinking, I can still walk, you know? 

I was nervous to be left alone as they asked the visitors give me time to rest, even though I felt that I would be much more restless without them.  I was most nervous to not know who laid behind the curtain of my shared room, as I saw some individuals in the waiting room that I imagined were beside me.  I wasn't scared about my diabetes, or what life with diabetes meant, which seems to be the way I have combatted my diabetes, without fear, just courage.

Mount Kilimanjaro 2013 
That day, although ten years ago now, still stays crisp in my mind, like it happened yesterday. But, remembering all that came in between reminds me just how long ago it was.  I have been incredibly privileged and lucky in my journey thus far. I have met so many incredible friends from around the world, and have been granted opportunities that I would have never imagined myself doing.  While diabetes has come with tears, anger and frustration along the way, knowing all that this journey has given me, it's hard to imagine without it.

I want to thank all of the amazing supportive people in my life, some that may have come and gone, but most definitely played an important part along the way.  My diabetes journey has been made successful because of all of your understanding and support.   Thank you for the people that have read this blog for nearly ten years and have continued to follow along with my journey.

I love you all.

Cheers to Ten Years,

Kayla