Trial Period

As most of you know, we have been on a trial period home from the hospital since Monday evening. The hope was I would be able to continue the same regimen without IV insulin at home and stay home.
Well, this simply has not been the case.

The good news is my blood sugars are short of perfect for the entire day and night...until 6am.
What happens at 6am, you ask? Am I getting up and eating a snickers?

Well in keeping my blood sugars between 55-110 all the time, the body gets nervous when you fall asleep so you don't pass out and die. Good right? Well yes if you're not pregnant. See there is this thing called the dawn affect. Basically, your liver has stored forms of sugar and fat called glucagen. This is only released when your body is in crisis like hypoglycemia.

Well since I am having what my body percieves as hypoglycemia, even though the range is okay during pregnancy, at or around 3am my body releases lots of glucagen or an "internal snickers bar" to compensate and keep me safe. So I get all of the calories and fat and none of the fun. What it is really doing is rebounding my blood sugar back up to a way too high number. This fasting blood sugar when higher than 100 has been proven to cause problems with diabetic babies. Mine is often in the 200s, even though just 3 hours previous it was 60-80s.

So just give me more insulin at that time right? Traditionally, this has worked. But for some reason my body bottoms out on any insulin I get overnight and refuses to go down after 5-6am. This is what put me in the hospital last time, because I need IV insulin quickly to get it down in a safe range.

We decided over the course of the hospital stay we turn off the pump. It was contradictory to everything I know about diabetes, but I was having absorption issues and it was leaking a lot because of the demand I was putting on it, requiring so much insulin. I am now on old school injections 6 times a day and wearing a sensor (which is horrible!) to quickly detect highs or lows. The sensor reads sugars every 2-5minutes and alarms when unstable. The problem is they are very unreliable in pregnancy. However, it has helped us look at trends a bit and we have come to the conclusion, well..that is just HARD! Really HARD.  The docs are stumped. I am stumped. And we are running out of options.

We go today to talk to the doctor in the office and decide the next game plan. It may mean turning my pump back on overnight and using it in conjuction with the shots, but we tried that before and it didn't work any better. Also, that plan means another hospital stay to regulate the numbers.

There is also some things we can do to normally "trick" the body, like give a bigger snack at night to prevent the lows from happening in the first place or time the insulin differently. We have tried IT ALL!

As you can imagine we are growing weary and nervous. I am 27 weeks tomorrow and we just need this baby be okay. I am not sure we handle the loss of another child. Keep in mind delivering a diabetic baby, especially a boy, early causes lots of breathing issues. But we feel very confident in our NICU and docs to perform the correct treatment plan if that needed to happen. We don't forsee an early delivery, but when exactly to deliver will be tricky. I am trying every moment to do my part. In fact, I have barely slept in days between the 25-30 finger sticks and injections and alarms and treatments of lows and highs. It is actually a little nicer being in the hospital on the that front because I can at least sleep a little easier through the nights and know someone will come recheck my blood sugar so I don't have to stay awake the whole time.

I am sorry for this detailed and probably over medical post, but I am hearing from lots of people tips and suggestions on how to control my diabetes. I love all care people are giving us, but the fact is ultimately I am doing my best with the teams of incredibly educated docs and it still isn't enough. That is the sad fact. Diabetes is a killer. We know it killed our last child, despite the best control I had with any pregnancy. We are trying to give our son the best chance of survival and also keep me from having the least impacts on my body we can. It is a delicate balance with often no rhythm or reason.

We appreciate your support and kind words more than we can say. Please don't interpret this message as negative. We still have tons of hope for this child, but this is our reality and want you all to be aware of it.