Giving Up Control

I wrote last week about my OB appointment and my disappointment at the prospect of a birth experience that was nothing close to what I'd imagined thanks to the fact that I'm automatically high risk due to my diabetes.  Since then, with a lot of thinking and a new perspective (thanks, hubby!), I've come to realize that (a) I can't control everything, in life or labor; and (b) as important as the idea of the labor and delivery experience is to me, it really doesn't matter as much as having a healthy baby in the end.

Of course, all of this may be a non-issue if she doesn't head south pretty soon.  I had another ultrasound (which was a Biophysical Profile, or BPP) the day before yesterday, and while it did go super fast since she was moving, responding, and "breathing" like a pro, she was still breech.  Since I'm at 33 weeks right now, we have just a couple more weeks for her to turn (until week 36) before we'll have to think about an external cephalic version in which the doctor attempts to turn the baby manually.  If you're curious (like I was) about what this procedure looks like, here's a video to help you visualize it:

The problem is, it's not only supposed to be uncomfortable; it also only has a success rate of about 58%.  And, of course, there are several factors that make it less likely to work, of which I have at least a couple.  My OB said that because this is my first pregnancy (and, therefore, my ab muscles are still tight) and since my fluid level is on the lower side of normal, there is a greater likelihood that a version attempt wouldn't be successful.  For that reason (along with the already low success rate), I'm wondering if it's even worth it to try.  There are, of course, risks associated with the procedure as well, and although they're rare, they are pretty scary: placental abruption (which causes bleeding), uterine rupture (yikes), and premature labor due to rupture of the membranes.

At this point, I suppose it's just a waiting game.  If she turns on her own (Note to baby: Please do!), we won't have to worry about the alternatives.  If not, we'll have to go from there.  If anything, mentally dealing with these prospective outcomes has made me a lot more flexible in terms of my expectations of labor and delivery...There is definitely something to be said for giving up control and going with the flow!  Of course, I should realize all of this by now.  As anyone with diabetes knows, you can only control so much when it comes to your body; the rest is up in the air.  Even eating and doing the exact same thing on two different days will produce different blood sugar results, and sometimes you just can't predict how your body is going to respond to certain things.

Even so, there comes a point when you realize that there are some things you can control, and all you can do is your best when it comes to those things...and the rest?  Well, you just hope that it all leads to stable blood sugars.  If not, you correct it and go on.  That perfect balance is so hard to find, and impossible to have all the time.  It's probably one of the most frustrating things about this disease, and leaves you feeling like you're playing a huge guessing game (see also: S.W.A.G. Bolus).  Either way, you learn to live with it (and accept it)...eventually...most of the time.

So the moral of today's story is that, as with diabetes, there are just some things in pregnancy (and life) that you have no control over...and the best thing you can do to keep yourself sane is to accept it and go with the flow.  Otherwise, you'll end up like I do a lot of the time: pulling your metaphorical hair out over things that you have absolutely no influence over, and usually not realizing this until you're metaphorically bald.  Hopefully this time I can follow my own advice.  ;)

God grant me the serenity to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference

OB Appointment//Limitations Due to Diabetes

I had my latest ultrasound and OB appointment yesterday, and while it wasn't super eventful, it was a little frustrating.  We found out that our little one is still breech, so she only has a couple more weeks to flip or we'll have to start discussing a C-section or an external cephalic version, neither of which are options I hoped to be considering.  For those of you who are familiar with my personality, you know that (a) I'm a slight perfectionist and (b) that I like to know as much as possible about everything that is happening to me (or might be in the future).  Because of this, I've not only read more than 20 books on pregnancy (and I'm not even exaggerating--just ask my husband, who gets exasperated by the stacks laying around the house!); I've also read another five or more books specifically on labor and childbirth--all so I can feel more prepared for what's to come.

The more I came to learn about everything, the more I realized that I wanted as natural a birth as possible with little or no interventions.  As long as the baby and I are doing well, I want to go into labor on my own and be allowed to progress naturally (i.e., no Pitocin, artificial rupture of membranes, etc.) with no stringent time limits.  I want to be able to be as active as possible during labor, with access to a birthing ball and bath/shower instead of an epidural.  Of course this means that I would forgo the usual EFM (External Fetal Monitoring) in favor of a nurse listening to the baby's heartbeat intermittently with a Doppler or fetoscope, because EFM requires you to be tethered to a machine.  Ideally, I would like to be allowed to eat and drink as needed, especially because I've had no issues with nausea during my pregnancy.  I will control my insulin pump as long as I am capable to do so.  When it comes time to push, I want to try pushing spontaneously (NOT on my back) without stringent time limits, and to risk a natural tear rather than having an episiotomy.  After delivery, I want to be able to hold the baby immediately, before any routine procedures are done.  I also want the cord to be cut only after it stops pulsating and to deliver the placenta spontaneously and without assistance.  Because I plan to breastfeed exclusively, I would ask that no sugar water, pacifiers, or formula are given unless deemed medically necessary.

I completely realize that this scenario is somewhat idealistic, and relies on everything going perfectly.  And of course, there is also that big elephant in the room that begs everyone's attention: the fact that my diabetes automatically labels me "high-risk," even if everything was to go perfectly.  Apparently, my diabetes makes medical professionals nervous, even though I've had an almost superwoman-like level of control and everything up to this point has progressed easily with no red flags...which brings me to the most frustrating part of my visit yesterday.  My OB has been fairly laid-back about everything thus far, but once we started discussing labor and delivery, it became clear that in his eyes, my having diabetes limits my options drastically.  Never mind that I've only dealt with this disease for a little over a year, or that my highest A1c to date (right after diagnosis) has been 6.5%...or that I've had absolutely NO complications to speak of--not even a hint of the possibility of a complication, or that I'm otherwise healthy.  Apparently, the fact that I (very purposefully) brought my A1c down to 5.7% (well within a normal person without diabetes' normal range) prior to conception and to 4.9% during the first half of my pregnancy doesn't matter when it comes to statistics.  Women with diabetes have a higher incidence of certain complications, and that's that.  That is what I have a problem with: I have a sneaking suspicion that when people refer to these statistics, they fail to differentiate among all of the factors and extremes of the disease.  All of us, type 1 and type 2, poor-controlled and well-controlled, those with complications and those with none, are lumped into one giant category of "women with diabetes."  Of course there will be a higher incidence of risk in such a group when these factors are not controlled for!

For that reason, I have a huge problem with being treated according to statistics instead of being evaluated as an individual.  I refuse to be placed in the same category as someone who has a very poor level of control, preexisting complications from the disease, and little interest in their health overall.  I also feel that the fact that my sister (who also has T1 diabetes and had blood pressure problems during her pregnancy) saw the same OB works against me.  Yes, we are sisters, and yes, we both have diabetes; however, we are very different in every way, least of all in regard to our individual disease.  Just because she happened to have a not-so-great outcome for her pregnancy (she delivered in late October by emergency C-section at 34 weeks due to the preeclampsia, but the baby is fine now) doesn't mean that I will.  I do not appreciate being told that "things can go downhill very fast for women with diabetes," because once again, there has been zero evidence to lead us to believe that this will be the case in my case.

I was super disheartened after my appointment yesterday, and still haven't decided what to do.  On one hand, I wonder if it's worth it to confront my OB about all of this, because you just can't change some people's minds.  On the other hand, I feel like I have the responsibility to at least try, not only for me but also for the women with diabetes that will come after me.  At this point, I'm just so tired.  It's not fair that I have to fight to be treated normally because of a disease I did not ask for, or that it would all be a non-issue if I didn't have diabetes.  I feel like I fight this fight on a daily basis in order to change the public's perception of the disease, so that I have to deal with this while trying to enjoy the last of my pregnancy seems especially cruel. Like many women with diabetes have commented, this is the one time I've truly felt limited by my disease.  If I had to have a C-section due to the fact that my baby is breech, fine--that's obviously beyond my control; but to be told that I can't have the birth experience that I so badly want solely due to my diabetes, even and especially if everything goes perfectly, is heartbreaking and extremely frustrating.  I want to be a part of changing the world's perception of this disease, but sometimes that mission can seem so futile and tiring.  Sometimes, and especially now, I just wish more than anything that I could have a normal, working pancreas.

Basal Rates, Artificial Pancreata, and D-Judgment

Oh, how quickly time seems to get away from me these days...I intend to write a blog post, then other things come up, and before you know it it's been another two weeks since I last posted!  I have to say, I really admire those in the DOC who are able to consistently update their blogs on a daily basis.  Between managing diabetes (which, of course, is another full-time job) and life in general, I have a hard time keeping up with mine at times.  Sometimes I wonder how I'm going to manage it all once the baby is here, but I know it'll work out...somehow!

At least life according to the D-monster has been better lately.  I was getting frustrated with my numbers and my apparent inability to control them despite all of my effort, so I finally (FINALLY!) took a step back to evaluate the situation.  Duh.  My basal rate patterns didn't make sense at all, and it took me a couple of months to figure that little piece of information out!  I suppose with everything going on, I was just increasing the rates themselves over time without looking at how my overall pattern was functioning (not well, by the way).  The day that I realized this, I decided to start from square one and recalculate everything based on the total daily dose of insulin I'd been using.  To do so, I had to pull out my trusty "Think Like a Pancreas" book by Gary Scheiner and review how to calculate all of the basal/bolus rates and ratios.  With a little math (which I always enjoy--seriously, because I'm a nerd), I had a basal/bolus pattern that was a little more sane looking:

 

Before

After

It had been so long since I'd done such a complete overhaul that I was a little worried about highs and lows the next day, but everything worked out surprisingly well.  It's amazing what a little perspective can do...I was just metaphorically kicking myself for not doing it sooner!  My numbers have been much more even, and I haven't had near as many out-of-range results as I was having before.  Not that they were horrible before; it's just that I'm kind of a perfectionist and like for all of them to be as close to "normal" as possible--is that so much to ask?!

In other D-news, how about that Artificial Pancreas Project?!  I'm so excited that the FDA has started the process that will hopefully lead to approval in a timely fashion.  It's such a major step in the right direction for those of us living with T1, and although it's not a cure, it does represent a major advancement in treatment technology.  For more on what this means for us, please read this article:  Interpreting the FDA Guidance for the Artificial Pancreas

This morning I got a blog update from Jacquie Wojcik at Typical Type 1 in my email, and it was an awesome one.  You can read the full post here, but the general gist of the post was about how judgmental people without diabetes can be at times.  If you deal with this disease, no matter the type, you've no doubt encountered it at some point--if not more frequently.  Even when people don't make rude comments or say anything out loud, sometimes you can feel their judgment anyway.  It can make eating in public a psychologically difficult experience, because you know that if you split a dessert with your lunch buddy, there will probably be somebody who is thinking, "She has diabetes, she shouldn't be eating that!"  It's not that I mind talking about my disease or correcting misconceptions when people are genuinely interested; it's the ones that try to impress their diabetes "knowledge" and horror stories upon you that can be irritating at times.

I like to think I generally have a good, positive attitude and outlook on life, but even that can be challenged when dealing with this type of thing on a regular basis.  I've thought before about printing some of these diabetes etiquette cards for people who don't have diabetes to keep on hand for such situations, but I don't know how well received or effective that would be.  Instead, the action I've taken is one I'm super comfortable with: I wrote.  I mentioned it in my last post, but for American Diabetes Month I wrote an article for our local newspaper about the myths and misconceptions surrounding the disease so that maybe-just maybe-it will reach those that need to know these things.  Like I've said before, even though it's hard, I can deal with the negativity...it's the kiddos who live with diabetes that I worry about.  Life with this disease is hard enough without having to defend yourself and your decisions all the time.  We already have to micromanage ourselves, so it's no fun when others try to do it for us as well.  Like one person in the comments said of Jacquie's post,  "It’s amazing how much more people care about/watch what I eat since I was diagnosed Type 1. They didn’t give a crap about what was on my plate before."  So very true.  The not-so-nice part of me sometimes wants to ask these people, "So just because you don't have diabetes, it's okay for you to eat that third piece of cake?!"  But I don't, because I could never actually say that to anyone, no matter how rude they've been to me.  In the end, I have to realize that there are some people who just don't get it.  I can try to change their perceptions, but sometimes their ideas are so long-held and concrete that there's not much anyone could do or say to fix the situation.  So instead, I just try to do the best I can and educate the ones who are willing to learn.

Update Time!

I honestly can't believe it's been so long since I last posted!  Suffice it to say, it's been an incredibly busy one, especially because it's American Diabetes Month...It seems like I've had something diabetes-related to do since the beginning of November.  I'm not complaining, though--I am a very willing participant in all of the awareness activities I've done, and truly believe that all of our efforts are making a difference for the people who benefit from them!

I was contacted last month by Laura from Extreme Southern Couponing.  She has a 9 year old daughter who was diagnosed with type 1 diabetes two years ago, so she was putting together guest posts to feature on her blog throughout the month of November.  She had come across my blog and asked me to share my story with her readers.  Many of you already know most of the details of my diagnosis and journey thus far with T1, but if you're interested you can read it on her site here.

On November 15th, I had an OB appointment and ultrasound in Amarillo, so my mom, sister, and I met my aunt and cousin at Beef O'Brady's for their second "Dining for Diabetes" fundraiser.  They donated a portion of their ticket sales that night to the JDRF, so we got to eat some good food for an awesome cause!  I also got to meet the Branch Manager for the Panhandle JDRF in person, as well as some of the other board members.  They are all incredibly nice, welcoming people, and I can't wait to work with them.

The next day, the article I wrote for the local paper on diabetes awareness was published.  I was incredibly excited to see it happen, because it's something I've wanted to do for a while.  I decided to focus on the myths related to diabetes, because there are so many misconceptions surrounding the disease.  For those of us living with it, having to clear up these myths on a regular basis adds to an already challenging life, so my hope was that by reaching people in our community on a larger scale, things would be a little easier for people with diabetes--especially the kids and young adults who have to deal with it.  It turned out to be a long article, so I'll save it for another post!

I *think* that covers everything diabetes-month related thus far, but I could be missing something.  I was reading "Do Chocolate Lovers Have Sweeter Babies? The Surprising Science of Pregnancy" a few nights ago, and it said that a woman's brain shrinks by 4-6% during the nine months of pregnancy in order to build the baby's brain (at least according to one theory)...my husband says I'm definitely on the 6% end of the range!  Either way, my brain power has been somewhat diminished for the past several months...it's a strange feeling, being in a constant fog.  Then there are the days that I'm convinced I'm losing it, like the day I posted this on Facebook:

I've come to the conclusion that I'm losing my mind! I had to call Mom to ask her a question, but when I dialed her number on my cell phone, the office phone started ringing, so I had to hang up on her. I then picked up the office phone, and no one was there, so I tried Mom's number again. About that time, the office phone started ringing again, so I had to hang up to answer it...And once again, there was nobody there. This went on about five times and I was starting to get extremely frustrated before I realized that *I* was actually calling the office instead of Mom's cell phone number and hanging up on MYSELF. I think I need a break...♥

The diminished mental status and achy hips and back, though, I can deal with.  They're constant reminders that my body is on a higher level of functioning right now to make sure our baby gets everything it needs, and I'm completely okay with that.  When I had my ultrasound on the 15th, I was nervous once again--though not quite as nervous as I was before our first big one in September.  I suppose the worry that everything is developing as it should never quite goes away, but I'm glad that things were still on track with our little one!  She's in the 60th percentile even though I'm measuring smaller, and although she was breech, everything else was where it should be.  As it is in diabetes, "normal" is an amazing thing when it comes to your baby's development!  I'm just hoping she decides to head south sometime in the next 9-10 weeks...=)

My sister also had her baby a month ago after she developed preeclampsia and had to have a c-section at 34 weeks.  Her baby is still in the NICU-she had some breathing problems in the beginning and digestive issues after that, but she's stabilized and is doing better.  She just has to meet all of her milestones before they'll let her go home!  My relationship with my sister has been better since her baby was born, and I'm glad that we've been able to put most of the anguish of the past several months behind us.  The selfish part of me still finds it hard that everything is revolving around her and her baby at this point, but that's just because everyone is so focused on all of that that I sometimes forget we're having a baby soon.  I hear about it so often that I sometimes think of our little one by her baby's name, and that frustrates me!

It's also been hard having my parents gone so often, because it leaves me to take care of the office by myself--something that isn't out of the ordinary, but that can be incredibly stressful at times...and right now, I need to start slowing down rather than taking on more than my share.  We don't have much longer until she'll be here, and we still have so much to do!  I know it will all get finished, but it's still hard sitting at the office when I know there's so much I could be doing at home.  Hopefully I'll have enough time off in the end to get a few things done that I haven't been able to work on, like the quilt that I started over a year ago...The quilting part is not far from being finished, and then I have to bind it, but I never have a solid chunk of time to get it done.

Then I still need to get in touch with a pediatrician, work on my birth plan (/wish list), and about a million other things to prepare for the actual labor and delivery part of things...I try to not let it all stress me out, but sometimes the amount of things I have left to do hits me like a ton of bricks--or at least with the force with which our little girl kicks me sometimes!  Oh-speaking of her kicks, my hubby finally got to feel her kick for the first time about a week ago...I'd been able to feel it from the outside for about a month, but she never would cooperate when he was around!

Well, I think that pretty much covers what's happened over the past few weeks, so I guess I better get back to work!

Diabetes Article in Health Magazine--Another Setback

I was initially excited when I saw an article in the November 2011 issue of Health magazine about diabetes—after all, November is American Diabetes Month!  However, once I started actually reading the article, I was appalled.  Not only was it filled with misinformation and incorrect but rampant diabetes stereotypes, it was completely insensitive.  No wonder people like the woman in the article are “embarrassed” to let others know they have diabetes!  What disappoints me the most is to see such a great opportunity for public education and awareness turned into such a misrepresentation of the disease…a misrepresentation that people with diabetes, like myself, have to fight every day to correct.

I was diagnosed last year with type 1 diabetes.  My younger sister also has type 1, and my dad (along with a lot of my extended family) has type 2.  When I was diagnosed, I made it a point to learn as much as I could about the disease, and have read countless books on the subject.  I also keep up with diabetes news and research and follow others’ diabetes blogs on a daily basis in addition to hosting my own.  In addition, I was recently appointed as a board member for the local branch of the JDRF.  Even though it’s not my paying job, diabetes advocacy is incredibly important to me.  The biggest problem I encounter, however, is not that people don’t know about the disease; it’s that what they think they know is usually incorrect—and usually, it’s due to years of exposure to myths and half-truths about the disease, thanks at least in part to media publications such as this one that further reinforce its falsehoods.

Although it is true that being overweight or obese is a risk factor for developing diabetes (at least for type 2, that is), it isn’t the be all and end all of the disease.  First of all, not everyone with diabetes is overweight.  Type 1 diabetes develops irrespective of weight or health status, and there are many people with type 2 who are of normal weight.  Furthermore, what many sources neglect to point out is that you have to have the genetic predisposition and other risk factors to develop the disease—therefore, not all people who are overweight will develop diabetes.  Secondly, losing weight is not a magical “cure” for the disease.  I have a real problem with people using the word “reverse” in relation to the disease, because “reversing” diabetes is simply not possible.  Remission is a better word, because it at least acknowledges that if you gain the weight back, change your activity level, or become ill, the symptoms of the disease will return.  What is most important to note, however, that even in symptom “remission,” the disease is still very much there.  Diabetes is a progressive disease, and insulin resistance (the main disease mechanism of type 2 diabetes) increases with age.  Even those who are initially able to completely manage their diabetes with weight loss might eventually have to pursue more aggressive treatment options as the natural progress of the disease occurs.  Failing to recognize this is simply dangerous, because it leads people to believe that once their disease is well-managed, it will never be a problem for them again.  I truly believe that this leads a lot of people with type 2 diabetes to not get the proper care and treatment that they need, because they then fail to give their disease the attention it requires.  Therefore, to call weight loss a “groundbreaking new way” to treat diabetes is not only ignorant (weight loss has been used as a part of treatment plans for type 2 diabetes for years), it is also incredibly irresponsible—and to call the woman in the article a “former diabetic” only serves to reinforce this dangerous fallacy.

Articles like this one are responsible for supporting incorrect and negative ideas about diabetes that those of us living with the disease are forced to combat on a daily basis.  The statement that “Most people with type 2 diabetes could actually reverse it if they lose enough weight” is especially harmful, because it bolsters the notion that diabetes is a “fat, lazy person’s” disease that could be controlled if only they would work hard enough.  This stereotype is not only hurtful and extremely insensitive; it also has the potential for damaging fundraising efforts…after all, why contribute to diabetes research if it’s something people can “cure” themselves if only they’d work hard enough?  For those of us with type 1, especially children, this typecast is particularly harmful.  Many people do not understand the differences between the two types of diabetes, and all of these ideas could lead to dangerous non-management of the disease.  There is also a growing problem among adolescents with type 1 in which patients will purposefully withhold insulin in order to lose weight.  This leads to dangerously high blood sugars that force the breakdown of muscle and fat, but can also cause diabetic ketoacidosis and other complications.

These are the reasons I felt compelled to write such a lengthy, detailed letter...a letter that was too long to actually send to the editor, of course!  Articles on disease awareness (especially in major publications) are wonderful, but only if they contain accurate information.  In the future, I beg all magazines to please keep this in mind when undertaking such ventures!  Diabetes awareness and education is achieved one person at a time, but so are harmful setbacks.  I hope that from now on, all publications will make an effort to be part of the former.

For those of you who are interested in reading the article in its entirety, it begins on page 95 of the November 2011 issue of Health.  I couldn't find it online, otherwise I would have linked to it here!

Spreading the News/JDRF

Last week I got some amazing news that I couldn't wait to share...But since "real" life often gets in the way of blog posting, I had to wait until I got caught up on everything before I could post anything.  Now that I have a break in my workload (but not my personal life!), I decided I better take advantage of it and get to writing!

This past Thursday, I received a call from my CDE while I was at work.  After some catching up, she told me that the Panhandle Branch of the JDRF, based in Amarillo, was trying to expand awareness into other areas around the Texas Panhandle.  She said they had an opening on the board, and was wondering if I would be interested in taking the position since I live in a small town in the surrounding area and because she thought I would be a good fit for the "job."  She told me that they had a board meeting that day and that after she brought up my name for nomination and they voted on it, she would let me know something.  After I got off the phone with her, I couldn't help but tear up as I was telling my mom about it...Not only do my pregnancy hormones have me in tears more often than not these days, I was just so honored that she would think of me for something so special!

I am incredibly excited for the opportunity to be involved in raising diabetes awareness, especially on such an awesome level for someone as relatively young as I am (at least I think 23 is still considered "young" these days!).  I had always told my family that I wished I could become a CDE in order to help people in our area manage their diabetes better, but since that requires prior experience as a nurse/psychologist/dietician/etc., there is no way that it would be an option for me--at least not anytime in the near future.  As a local JDRF board member, I will be able to be a part of diabetes education, outreach, and fundraising while still maintaining my regular job, which is something I didn't think would ever be possible.  I was already planning on writing an article for the local paper in November for American Diabetes Month, but now I can do it in a more "official" capacity!

This morning I got a call from the two of the ladies from Panhandle JDRF welcoming me to the board and filling me in on the details about what's to come.  They want to organize some school walks around the area, and I'm ready to get involved!  The next few months are going to be busy ones for me (especially since we only have around 14 weeks or so before our little princess is here!), but I know that God usually gives us these kinds of opportunities when we least expect them, and it's up to us to take advantage of them.  I would have never in a million years let this pass me by, and I am so grateful to everyone involved for giving me the chance!

Before I go, I wanted to share the link to the Artificial Pancreas Petition for the JDRF.  If you haven't already signed it (or heard of it), I would encourage you to follow the link to find out more!  This is the biggest advance in diabetes technology in our lifetime, and it has the potential to change lives--so needless to say, it's very important that the FDA approves it.  It only takes a minute, but it will make a big difference in the lives of those with diabetes!

JDRF Artificial Pancreas Petition

The Tough Things in Life

Anyone who deals with diabetes on a daily basis knows it's not easy.  I never in a million years thought it would be something I'd have to deal with personally--it was something that happened to "other people."  Then, once I was diagnosed, I realized that even though it's overwhelming at times, it is manageable.  Some days are easier than others, of course, but even with all the carb counting, insulin-balancing, and trying not to let it take over your life, it's doable.  Some people tell me that they "don't know how [I] do it," or that they admire how "strong" I am...Little do they know that when you have a chronic illness, being strong is the only choice you have--otherwise, the disease wins.  I definitely went through a grieving process over the loss of my former "no diabetes" self, but eventually (with a lot of help/reality checks from my husband), I came to terms with the fact that this was just something I'd have to deal with (for the rest of my life).  Some days I don't want to do it, but I do--because I refuse to give in to diabetes.  It may be my stubbornness, but from day one, I've been determined to keep it in check as much as I can and/or kick its butt when I'm feeling up to it.

On the days I'm feeling especially triumphant, I'm able to see that there has even been some good that has come from my diagnosis.  For starters, I lost somewhere around 10-15 lbs as a result of my carb counting, and I took up running--which is something that would shock my junior high and high school coaches!  Most importantly (through lots of hard work, research, and help from my awesome CDE), I was able to rise to the challenge of the diabetes learning curve fairly quickly and take control of my blood sugars to bring my A1C down to the proper pre-pregnancy levels I was shooting for.  It wasn't easy (and still isn't), but I did it.  I would never say that I've conquered diabetes, though, because as soon as you think you have the hang of things, it throws you for a loop again...I just refuse to ever give it the opportunity to conquer me.

On the brighter side of things, diabetes has made me a stronger person.  I suppose you don't realize how strong you are until you're faced with one of your biggest fears, which for me has always been losing my health.  Even though I technically (and thankfully) haven't actually lost it, I do feel like I can no longer consider myself a "normal," healthy person, even if I'm otherwise healthier than a lot of my acquaintances.  When you are forced to face your fears, though, something happens: you (usually) realize that it isn't as bad as you imagined it to be.  Some days diabetes looms in the background, waiting to pounce if I let my guard down long enough; others, it's very much front and center, demanding my attention on a sometimes minute-to-minute basis.  Either way, it's a pain (sometimes literally), but doable.

One thing dealing with diabetes didn't prepare me for, though, is one of the other biggest challenges I've faced in my life.  I've written a few times about how my sister's pregnancy has affected me, and it's still an ongoing and very emotional battle.  It's something else that I never thought I'd have to go through, so finding myself in the middle of it all wasn't just a shock; it's truly been one of the hardest things I've ever had to deal with.  I think a lot of it has to do with the fact that it's a situation I have no control over, even though it affects me and the rest of my family in a huge way.  I resent the fact that she's the one who made her decisions, and yet we're all having to deal with the consequences.  From an outsider's view, many people may wonder why this would be such a difficult situation--after all, women (and younger girls) have unplanned pregnancies all the time.  That's the kicker, though...we all still wonder (and probably always will) if my sister's pregnancy wasn't planned, due to a lot of variables that were in place at the time.  In addition, the timing of it all made it even worse, because it happened right before I was supposed to get my A1C results back so that my husband and I could get the green light to start our family, something I'd been working towards for months, and that everyone knew about.  That, combined with the fact that I have to work full-time to keep my insurance in order to pay for my diabetes-related supplies and expenses and contribute to our bills while she has been jobless her entire pregnancy and has therefore been living off my parents, contributes to feelings of resentment toward her and everything related to the situation.

Even though people tell me all the time not to let her pregnancy interefere with ours, the reality is that it does.  Especially now that her due date is getting closer, my parents are stretched thin taking care of her preparations and appointments (which are very frequent since she's considered double-high-risk due to her own diabetes being so out of control when she got pregnant), and that takes a toll on everyone.  They're stressed out trying to get things done, and that impacts me directly since I work with them every day.  Furthermore, their being stressed makes me feel guilty for expecting anything related to my pregnancy from them since they're already so all-consumed with her.  My mom has been taking me to the majority of my appointments since my husband can't get off work to come with me, but even though my appointments are still three weeks apart, that means more time away for her (both of us see a doctor and will deliver two hours away from our small town since we're high-risk).  Also, my mom always told me she'd paint the nursery for me, but I don't think that's going to happen either.  My parents stopped by one night last week to see the paint color I'd picked out, and my dad told me they'd come help me "after they got done with [my sister's] stuff."  Even though my husband (very lovingly) told me he'd take care of it and I've had friends offer to help, it still hurts to know a lot of things like that wouldn't be an issue if I weren't pregnant at the same time as her.  It may sound horrible, but I honestly can't help but think about how different everything would be if things would have happened the way they were planned instead of the way they've turned out.  I know that all of this is somehow part of God's plan, but it's so hard to see how at the time.

The last couple of days have been particularly tough emotionally, and I sometimes wonder how I can handle all of this anymore.  I'm just so tired of having to deal with all the comments and no one knowing that I'm pregnant ("too"); or even if they do, only asking about her baby.  Even though I know that no one means bad by any of it, it still hurts...a lot.  I spend a lot of the time I'm in public trying to hold myself together, because I can only deal with so much before I can't stop the tears from coming any longer.  What's even harder than that, though, is dealing with my own family's tendancy to talk about my sister all the time.  My mom has been having a lot of fun buying baby stuff, which is great; however, she can't tell me about anything she's bought for our baby without telling me about my sister's gifts as well.  We literally can't have a conversation about my pregnancy specifically or anything baby/pregnancy-related without it somehow relating back to hers, and that wears on me--especially since I'm already more emotional than usual these days.  My mom knows exactly how I feel about everything, and even though I know she'd rather us all get along, it's just not going to happen anytime soon.  I wish that rather than trying to force the issue, she'd just let me enjoy what's left of our pregnancy without having to focus on my sister.  I already feel like I've had to share everything up to this point with her, and now that I'm finally able to enjoy things a little more since we've found out the sex of our baby (girl!), I just want to be able to that without being hindered by anything else...Is that really so much to ask?!