Friday, August 6, 2010

Responsible Choices

So, I've had a lot of doctor's appointments lately (not surprisingly, since I'm a pregnant diabetic in my third trimester) and have been reflecting a lot on my care from these doctors. It's been different, but equally satisfying, as the care I received in St. Louis.

I saw my obstetrician the other day, and he gave me a short talk on taking responsibility for mine and my baby's health. As far as I know, it wasn't prompted by any particular behavior of mine; it was simply his way of reminding me that I need to exhibit as much control and self-discipline over the things that are within my realm of influence. These include my blood sugars, exercise, and food intake. Self-discipline in these areas paves the way to healthy outcomes - not just during pregnancy, but in life generally. As we all know, some of us will still experience bad outcomes, but appropriate exertion of self-control reduces the likelihood of bad outcomes. As a bonus, it builds character that all parents need.

So what does it look like to take responsibility for these things? It will look different depending on your situation, for sure. For me, I'm trying out the following this time around, based on what I did last time and liked and what I wished I had done differently.

Eating smaller meals more frequently. Planning to eat a small amount every 2-3 hours, healthy things. Fruit if my blood sugar is low, protein nearly every time.
Eating dinner early, no dessert, and no post-dinner snacking. A large, late meal and eating into the evening makes getting my blood sugars under control before bed almost impossible (and with bedtime being as early as 9:00 some nights, it's important to get a head start!). Special indulgences are not out of the question, but better if they occur early in the day and infrequently.
Low carb meals. I'll still eat brown rice, potatoes, granola, whole grain toast, fruit, and a variety of carbohydrates, but just try to do so in smaller quantities. I plan on treating myself to my favorite salads, vegetable dishes, and plenty of meat.
Walking. Fortunately for me, I have a 14-month old that loves to be taken around the block in a Radio Flyer wagon. This gives me a good excuse to get moving, daily. When I was pregnant with my first baby, I was working and tried to get up early or walk during my lunch break.
Swimming. My son, grandpa, and I all love going to the pool. So we spend some time there a few times a week. I did not have the benefit of a pool membership the first time around, but am really enjoying it this time.

The last of my "responsible choices" hits home more closely, and challenges me the most of all. It also brings me to my reflections on the second of my doctor's visits this week, a visit to my endocrinologist, and a discussion about blood sugar management. I have always been extremely proactive and hands-on in the management of my blood sugars - and frequently, to my benefit. I am not afraid to adjust my own pump settings as necessary. In fact, during my last pregnancy, I usually simply reported my plans to my OB and my endocrinologist and they said, "sounds good." This suited my independent, "don't tell me what to do" attitude quite well. Now I am with a new endocrinologist who does things a little differently. I am struggling to come to grips with a provider that wants to be more hands-on with my blood sugar management, but in case you have the same fears that I do, let me tell you why I think it's good for me (and may be for you, too).

No matter how good you are at controlling your blood sugars, you could probably do it better. I do not intend this as an insult, though that is usually the way I hear it coming from anyone else. Instead, though, I have to remind myself that the point is improvement to my health, NOT "proving" myself as competent. When I saw that my doctor intended to be very hands-on with my blood sugars, I had to move my ego over and acknowledge that there probably is room for improvement.
A different perspective might help you hone your skills, or highlight problems that you didn't really think were problems. Again, instead of thinking of my doctor's suggestions as just plain criticism (which it almost never is), I have to look at it as striving towards improvement.
Just try it. If you are concerned about a recommendation, just try it for a few days. You may be surprised. Or you may not, and then you can decide how to proceed - talking to your doctor, maybe changing them back, and if your doctor thinks you're full of it but that doesn't make you feel better, finding another doctor.


  1. Hey! My name is Holly and I blog over at I'm really glad to have found another type 1 who believes in natural childbirth. We're not currently trying, but hope to in the next year or so. Thank you so much for all your info!

  2. Good to "meet" you, Holly! We love talking about it. If you have anything you'd like us to post on, just let us know!

  3. I've been reading through all your posts, from the start, and this is great stuff. It's so true about sometimes letting the endocrinologist take the reigns (despite my brittle type 1 ego!). Recently, I was having trouble with my basal rate in the wee hours of the morning, and was so skeptical of my doc's recommendations. I have over 8 basal rates and it's generally a complicated, changing-weekly mess. When she wanted me to go for the same basal rate from midnight to 8am, I thought it would never work... but it actually did! Well, for a whole 3 weeks, anyways :) Thanks so much for this blog, and for being inspirational!