Real-Life Superhero: Part I
First year reflections
With my son’s 1st birthday approaching, I’ve been reflecting on my pregnancy and birth experience. This journey in my life was arguably the most challenging yet rewarding experience and I would do it over again. Often, I wonder what it would have been like to walk through pregnancy without a chronic illness: perhaps less stressful, far easier, more enjoyable? Sure, but the kind of strength that I’ve embodied after carrying my son, giving birth, and raising him in the first year is something I’m not sure I’d experience without Type 1 diabetes.
After living with T1D for nearly six years prior to pregnancy, I feel as if this disease prepared me for all the unexpected that comes with pregnancy and birth. And now with an approaching toddler, I’d argue motherhood as well, but that is a story for another day. I often compare managing T1D to walking on a tightrope holding your breath while making very calculated decisions throughout the day, ultimately striving to keep blood sugars within range. We are always ready for both the expected and the unexpected, keeping us agile and on our toes. Naturally, we become master decision makers and CEO’s of our own bodies (pancreases at least) – identifying problems, devising a plan, and executing accordingly. We’re basically keeping ourselves alive by the seemingly thousands of decisions we make daily, 24/7 with zero breaks.
And just to complicate things further, let’s add pregnancy and all the complexities that come with growing a human. In my opinion, this sounds like a superhero in the making. Pregnancy alone opens us up a world of surprises, curveballs, and unexpected events. That’s why I believe Type 1 women are professionals when it comes to the pregnancy game. We handle change well and live in a world of adaptability, learning how to survive while running through fear, not away from it. This mindset we share is one that carried me through my pregnancy and all its challenges.
Two weeks before the NYC Marathon in 2017, I got the surprise of a lifetime – I was pregnant! Just as I trained my body months for the marathon, living with diabetes also prepared my body for pregnancy: the ultimate race. Although I could have ran the marathon the way I had trained for it, I scaled back with all the new body changes occurring early in my pregnancy.
Representing Beyond Type Run alongside my Type 1 teammates was one of my lifetime highlights, especially with the unique opportunity to run it with baby on board. Jack was later coined the Beyond Type Run Baby. Immediately after I crossed the finish line in Central Park, I ran to the hotel to pack my bags to catch a red eye back to Los Angeles for my first ultrasound the next morning – I was just shy of 6 weeks.
Day by day
After confirmation of the pregnancy via ultrasound and blood tests, I rolled up my sleeves and was ready to tackle this T1D pregnancy head on. My pregnancy game plan was to take it one day at a time, establish an early routine, and anticipate lots of change. I’d categorize my pregnancy into 3 themes: 1st trimester was all about survival, 2nd trimester was all about maintenance, and 3rd trimester was all about perseverance. Unfortunately, we don’t get to hit a snooze button on diabetes, and we carry that part of us through every stage of pregnancy.
Therefore, it’s important to establish a pregnancy team early on that you feel comfortable with. It was imperative that I developed a good working relationship with my endocrinologist. By the end of the pregnancy, we were communicating almost daily working on basal adjustments, carb ratios, and birth plans. One tool I found particularly useful during pregnancy was Tidepool. I would simply upload my insulin pump data for my endocrinologist to analyze and spot trends. Within an hour, she would send back her recommendations for pump settings and adjustments. Towards the end of the pregnancy, we would make changes several times per week. During my in-office visits, she would provide in-depth explanations of the changes that were happening to my body in terms of diabetes and would council me on best practices. It was during these visits that we devised a birth plan. And as I type this out, a birth plan seems somewhat contradictory to the world I live in as a T1D. Things rarely go as planned and are highly subject to change. We had a core plan with back-ups and flexibility for those moments of unpredictability.
I knew going into the final trimester that my birth was most likely going to be a c-section given various factors. If we’re speaking just genetics, my husband and I were both larger babies and my mom had given birth to 4 children all via c-section. As a T1D, I was more likely to carry a larger baby (which I did at 9lbs, 2 ounces) and along with it came polyhydramnios, which is basically an excess amount of amniotic fluid. Jack remained breach up until the very end and was growing like crazy at the end. Given his size, my team of doctors were leaning in agreement, towards a c-section. I really didn’t care – I just wanted what was safest for both Jack and I.
I had a relatively smooth pregnancy up until week 30 when insulin resistance kicked in. My insulin needs tripled and there were times when I would spike from eating a simple, dry salad (people with diabetes don’t really get the luxury of splurging on all those pregnancy cravings). I found myself constantly pumping insulin on top of injections while taking laps around the neighborhood after every meal just to combat any post-meal spikes. The last month of pregnancy was challenging – uncomfortably large belly, living off Zantac & Tums for raging heartburn, monitoring my blood sugars every minute, and living in doctor’s offices. After 32 weeks pregnant, my weekly doctor visits included: endocrinologist, OB, and high-risk OB monitoring my A1C/blood sugars, Non-Stress Tests (NST), ultrasounds, and fluid measurements. I was grateful for the dozens of appointments, but I was READY to have this baby!
Best laid plans
On June 27m 2018, I was 38 weeks, 5 days pregnant and I went in for a routine NST/ultrasound with my high-risk specialist. Although we had been monitoring my fluid levels throughout the pregnancy, my doctor seemed concerned with the recent elevated measurements from my last visit. After looking at my ultrasound, I heard the words, “Get ready to have this baby tonight.” My heart raced from pure excitement and immense relief that I was almost not pregnant anymore. My mind was spinning as I anxiously called Matt while I frantically planned to jump in the car, grab my hospital bags (that had been packed and waiting by the door for over a month), and head over to the hospital. The doctor said to wait for a call from their office to confirm the surgery time. I paced all afternoon, waiting for my phone to ring. Hours went by…
I got a call back and was informed that my OB was out of the country. His colleague, whom I had seen before, was also on vacation. WHAT??? Panic sank in. This definitely was not part of the birth plan. After working things out between various offices, my OB referred me to one of his trusted colleagues at another practice down the street in Beverly Hills. This doctor wanted to meet me first, which I greatly appreciated. I was scheduled to see him two days later, with a confirmed c-section procedure the following day. There was a whole lot of drama and crazy emotions during those couple days, let me tell you.
On June 29th 2018, I was 39 weeks pregnant and Matt and I went to see my new doctor for the first time – he would be performing the most important surgery of my life the next day. Honestly, I wasn’t nervous or upset about it. Sure, I would have preferred that the original OB perform my surgery, but this stuff happens. I trusted my OB to refer us to the best. After my final weigh-in (yikes), NST, and ultrasound we met with our doctor and hit it off right away. He made us laugh and put us at ease. We walked out of that office with a surge of excitement and readiness to meet baby Jack.
My scheduled surgery was 2pm. Ideally, I wanted the earliest slot in the morning due to fasting (yes, I get hangry and I’m a diabetic – RAWR!) But due to the unforeseen circumstances, the hospital had to work around last-minute schedules to make this happen. My last meal would be the night before my surgery, so we went to our favorite place – DK’s Donuts in Santa Monica. I didn’t eat anything remotely close to a donut during my entire pregnancy but decided to go big the night before. This makes zero sense, but we had fun with it. We went home and had our last night together as just Matt & Marci – I don’t think either of us slept one minute. We were about to become Mom & Dad, but we had no idea what was headed our way…
This story is a part of a series – check out Part II here.