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I remember the first time I got the "diabetics shouldn't have unplanned pregnancies" lecture from my doctor - I was asking him for a prescription for the pill. I remember thinking "hello - I'm requesting a prescription for a contraceptive." When he noticed the name change on my records a few years later, he correctly guessed I was now married. Yep, I got the lecture again. So I knew that the three of us, me, my husband and my doctor, would need to start planning any baby at least 12 months before we even contemplated conception. We gave the doctor his 12 months' notice, and I was started on an even tighter regime than I was previously on. OK, I'll admit it, any regime was tighter than the one I was on. But now instead of lying about how many blood tests I had per day, I actually did the required 4. Insulin was always taken before dinner, not merged with the supper shot. Eventually my HbA1c got low enough and all systems were go. I was pregnant within a month. As my gynocologist put it, "fertile, aren't we?" All went well for the first 5 weeks. I was keeping my sugars in check, taking the extra insulin if I felt my sugars were high. That was actually my down fall. I overcorrected one day and by 3.30pm I was so low I had no idea what was going on around me. My boss was screaming at me to get a package ready for the courier, and I had no idea. My hypo symptoms had changed, as had the speed with which they came on. By the time the ambulance arrived, I thought I had died and was being processed for reincarnation. I came to in the ambulance, and although I knew what had happened, I didn't. Kinda like waking up from a dream that you're trying to remember. Other than morning sickness, the first trimester was great. My insulin intake was falling dramatically, and I was having fairly major hypos daily. I had figured out that by treating it as soon as I began to suspect I was low, I was fine. The hypos were so severe though that chocolate was the only cure (no, honest!!). The standard barley sugars were not reacting quick enough or lasting long enough, so unfortunately it was Mars Bars! During my second trimester my insulin needs were beginning to rise again. This is due to certain hormones produced by the placenta actually inhibiting the body's absorption of insulin. The bigger the placenta gets, the more of these hormones that are secreted, therefore higher insulin doses are required. At 14 weeks I found out that my baby was going to be born no later than 38 weeks' gestation, so I was facing an almost certain caesarian. The birth wasn't something I had thought too much about, and all of a sudden I wasn't going to go into labour and deliver normally. It was kind of depressing. I asked my gynocologist if I had a vote in how my baby was to be born. I think the question stunned him a little, but he said yes. He said that if I was induced, he would let me be in labour for a maximum of 8 hours before performing a caesarian. I thought about it, and realised I'd probably go through 8 hours of pain, only to be operated on anyway. My vote - caesarian. That's when we picked my baby's birthday - May 20, 1999. Woke up one morning when I was about 5 months pregnant and suddenly realised I couldn't feel my legs. There I was thinking the baby is sitting on my spine funny, am I going to be bedridden for the rest of my pregnancy? Then husband had a brain wave. Yes, I was going hypo again. A few handfuls of barley sugar later, I'm adding a new symptom to my new list of hypo symptoms - paralysis of legs. Later I would add vomiting. During the third trimester I lost my battle with my blood sugars. At about 25 weeks I was at work one day calling the doctor with some rather nasty blood sugars, the next morning I'm ringing work from hospital. One morning I was being examined by a student midwife. She looks at my bulging tummy and says you're 27 weeks, aren't you? Nope, 25. Three days in a row this happens. On the third day I cornered her and asked if I was bigger than I should be. She refused to answer, or even make eye contact. My gynaecologist came in the next day and my fears were confirmed - the baby was too big for its age. An ultra sound was performed, and all was well except for a slightly too big baby. Fortunately we were able to slow the growth down. The reason why diabetic mums need to keep their sugars under control is simple - the baby uses any excess energy (sugar) it gets to grow bigger. In theory that sounds good, but the problem is baby soon runs out of room, but its essential organs are not yet ready to cope with life outside mum. It took a week for my sugars to get under control, then I got a cold and up they went again. Got over the cold, sugars came down, looks like I'm going home, nope, now I've got gastro, up go the sugars again. By the third week, the doctor was sick of visiting me and said near enough is good enough, go home. So I became a lady of leisure, which was good because now I was testing my sugars all day (and night). During the last two weeks of my pregnancy my blood pressure went up and I started to retain water. In my last week, I put on 4 kilos. Let's not even talk about shoes (I even contemplated my husband shoes at one stage. They were too big, but not by much). I was booked in to hospital on Monday May 17 to stabilise everything before surgery on Thursday. Woke up Monday morning to go to the loo, and that's when I discover I'm in labour. This is particularly frightening for me because I wasn't listening during prenatal classes when they discussed labour, pain relief and when to call the hospital. I didn't think I needed to. I ring mum, and she's having a panic attack. I call my husband just as he arrives at work (a 1 1/4 hour commute) and he turns around to come home. We get to the hospital, and I'm having a hypo again. This one doesn't go away all day, and I almost miss out on a theatre because of it. But the doctor pulls a few strings (it helps sometimes to have the best) and at 2.09pm Madeline Grace Daelman was born, weighing in at 3.72 kilos and 49 cms long. You'd think this is where the story ends, but it doesn't. The day before I was due to go home, my sugars hit the 20s again, and my doctor went on holidays. His parting words were "this is how much insulin I want you to take, you are allowed a maximum of 6 additional units. You know what to do." Yes, I know what to do when my body is functioning normally and I haven't just had a child! So there I was in the maternity ward under the care of medical ward staff. The sugars eventually came down to a reasonable level (its was that 'near enough is good enough, go home' thing again) and all of a sudden I was at home with a new born to look after and no midwife at the press of a red button away. I had never been so terrified in my life. Now I'm the very proud mum of an almost two year old, and I'm contemplating doing it all again. In fact, if I hadn't just moved interstate, my doctor would be getting the 12 month warning about now. Hope the new guy doesn't run away too fast when he reads my notes! Cathy Daelman |