the Lanfords

November 2006

I will never forget the day I discovered I was no longer safe from diabetes.
I was standing at the stove, preparing dinner. It was kielbasa with peppers, and broccoli.
I remember it so vividly, the way the kitchen smelled. Salty and earthy.
I felt a little jittery and had a headache that wouldn’t stop. I just didn’t feel like myself.
A little voice told me to check my blood sugar.
I resisted. I didn’t want to. I was done with diabetes. I was done.

Cailyn was about six months old.
Carys was almost three.
And I was delaying the inevitable.

I checked my blood sugar.
I looked at the number and panicked.
It could not be true.
I checked it again.
And then a third time, just to be sure.

It was 586.
A normal person’s blood sugar is typically below 130.
My glucometer shuts off at 599, which I’ve found out the hard way a few times since then.

Suddenly, it all made sense.
I was nursing Cailyn, and hadn’t thought much about the weight loss I had been experiencing.
I had welcomed it. I loved it. I felt like I was getting my body back.
I was insanely thirsty and I visited the bathroom more times than I could count.
I really didn’t think much of it.
I was nursing; I was burning calories, resulting in weight loss.
I was nursing; I was thirsty. Extremely thirsty.
I was nursing; I used the bathroom a lot. Because I drank a lot. Because I was nursing.
This was all because I was nursing.
And because I had a busy, full life chasing two kids around.

It was not because I had an issue with my blood sugar.
It couldn’t be.
I was happy. I was healthy.
I had a new baby, and a big baby.
I was able to stay home with my girls, which was a dream come true.
I was fine. Absolutely fine.

Just to be sure, I checked my ketones.
I had been given a ketone test kit when I was pregnant with Cailyn to test my urine randomly.
The doctors wanted to make sure I wasn’t spilling ketones; a vital test to make sure I was controlling diabetes well.
Ketones are produced when the body burns fat for energy or fuel. They are also produced when you lose weight or if there is not enough insulin to help your body use sugar for energy. Without enough insulin, glucose builds up in the blood. Since the body is unable to use glucose for energy, it breaks down fat instead. When this occurs, ketones form in the blood and spill into the urine. These ketones can make you very sick.

The test showed that I was spilling ketones alright. And a lot of them.
The test strip container has a comparison chart, to tell much (or little) ketones you’re producing. The colors range from light pink to dark mauve-purple; few ketones to large ketones respectively.
My strip was nearly black.

I did the responsible thing and called my endocrinologist.
It was a Wednesday evening, and I got the nurse’s voicemail.
I left a brief message that I was about 6-month post-partum after a bout with gestational diabetes. I told her I had a high glucose reading, and I was spilling ketones.

About twenty minutes later, she called back.
She asked me a few questions and said she’d call back after she talked with my doctor.

About ten minutes after that, the phone rang.
The caller id displayed the endocrinologist’s office was calling.
When I answered, I was a bit shocked it was actually my doctor, and not the nurse.
I knew it was serious. Why would he take time to call me personally?

He: I hear you’re spilling ketones and have a high blood sugar reading?
Me: Yes, I am. I do.
He: I want you to go to the nearest emergency room or urgent care. Right Now.
Me: Really? Because I feel okay. Really, I do.
He: No. Go. Now. I’m putting you on my schedule for Friday evening. I don’t have an appointment, but I will not leave the office until I see you Friday afternoon.

I was scared to death.
The ER? Really? Because I feel fine. It’s just a headache.
I was freaking out.

I went to urgent care, and told them what was going on.
The PA there was wonderful, and got me through the office quickly.
I left with a prescription for insulin and syringes.
Again.

I was devastated.

Friday afternoon came.
Chad & I made our way to my endocrinologist’s office, a little worried about what we’d be told.
True to his word, Dr. Becker saw me around 6:00 that evening. We talked a lot, he listened. I listened.
And it was determined that I would need more blood work.
Great. Just what I always wanted.
Oh, and by the way, he also found my thyroid to be out of whack.
More blood work.

He went through the obligatory statements about women with gestational diabetes having a greater chance of developing Type 2 diabetes later in life. In my case, it was sooner than later.
We all agreed that I could handle my “old” regimen of insulin injections and carb counting.
And I would start a different medication for the thyroid issue.
Things would be okay, he said.

And they were.
For a little while.

I often stick my foot in my mouth.
Often.
Did I mention I do it, often? Stick my foot in my mouth?
Yea, well, I do.
Sometimes it comes back to bite me. So I just shut up as often as I can now.

2003 was a year of great change. Chad and I had been married a little under two years. We had just bought our first home, and I was struggling to find the balance between being a young, married, post-college girl and a career-oriented wife with a home and real responsibilities.
In April of that year, I discovered we were expecting our first child. Having a baby on the way kind of lit a fire under my butt to move a little quicker than I’d planned on the career front. When I was 13 weeks pregnant, I switched jobs.  None of my friends were in the baby-making business yet, so I felt a little alone in the adventure. Excited, but alone.

At my new job, there was another preggo, Sue. She was a few weeks ahead of me in her pregnancy, and was in great shape. It calmed me down to have a fellow first-timer around; we commiserated about swollen ankles, late-night bathroom breaks, extreme hunger, increasing belly sizes and the little feet that seemed to be perpetually lodged beneath our respective rib cages. We compared doctor’s visits and talked excitedly (and a bit nervously) about the tiny diapers, bibs, pacifiers and thing-a-ma-bobs that were starting to take over our spare-bedrooms-turned-nurserys.

Around the 24-week mark, Sue had the dreaded glucose tolerance test I’d read about in the What to Expect book. She came back a bit upset, and told me that she had to stay away from sugar and eat a low carb diet. She didn’t have gestational diabetes, but she was borderline. She was playing it safe.
I think I replied by stuffing the rest of a Krispy Kreme crueller in my face.
A few weeks later, we were at an office birthday fiesta in the break room. There was a beautiful, glorious cake. And I couldn’t wait to have some. I planned my day of sales calls around the 3pm cake call, actually.
And poor, poor Sue. She didn’t have any. I felt a bid bad for her. But I also felt a bit bad that people might think I was feeding a starving Ethiopian village under my shirt with extra slices of cake.
Here’s where I stuck my big fat foot in my mouth…I flippantly said, “No cake? That sucks. I hope I don’t have to deal with that.” What a stupid, insensitive thing to say. I immediately regretted it, but it was already out there. Stoopid.
I can still taste the faint bitterness of red toe nail polish…and none of the cake.

A few weeks after I finished cleaning the foot-funk from my mouth, I had my very own dreaded glucose tolerance test. The test itself wasn’t bad. I had to drink a bit of sweet orange fluid, much like flat Sunkist orange soda. SO many people had told me how terrible it was, and that I would need crackers or something afterward to help me from getting sick form the high amount of sugar.
Nah. I didn’t need any of that. I tolerated it well.
The results weren’t great and I had to complete a 3-hour test the following week.
The results of that test were also high.
I cried when I got the results. I was scared to death I was going to unintentionally hurt my growing baby.
I was sent to a nutritionist, who taught me more than I ever cared to know about carbohydrate counting. I felt confident I could make some small changes and make a big difference with my glucose levels.
With a controlled diet and strict glucose monitoring, I was able to keep my blood sugar at normal levels.
I delivered a beautiful 8 pound, 7 ounce baby girl a few days before my scheduled induction.
She was perfectly healthy. And I was perfectly thankful.
Immediately after delivery, my blood sugar returned to normal. I was given permission to resume a normal diet.
I was warned that I would be at an increased risk for Type 2 diabetes later in my life, and should be careful of what I eat and keep my weight in check. I joined Weight Watchers and after a lot of effort and frustration, got my weight down to a normal number.

Then I got pregnant with Cailyn in late 2005.
Almost immediately, I began to feel strange. Shaky if I didn’t eat at certain times, nervous and jittery if I ate to much.
I was nervous when I went in for my first prenatal visit. I told the OB I was feeling strange, and I thought it was blood-sugar related. She didn’t seem concerned and told me I’d be checked a little earlier in my pregnancy, since I had a history of gestational diabetes.
During a routine obstetric visit, a nurse tested my urine and blood. They found a large amount of glucose in both.
I was immediately given the 3-hour glucose tolerance test, and the results stunk. I was around 13 weeks pregnant.
I was sent to an endocrinologist and started insulin. Immediately. There was no “let’s try a diet restriction” approach, it was straight to medication. I was devastated. I felt that I had failed myself, and was failing my baby.
I was on a mission to be as healthy as possible and make sure the baby’s health was not compromised.
I checked my glucose religiously. I took insulin injections at least four times a day.
And I cried.
A lot.
I threw myself a pity party almost every day the first few months.
And I fervently hoped that I wouldn’t have to continue the nightmare after Cailyn was born.

I continued to be strict with my regimen, hoping to keep Cailyn growing safely in my body.
I went to the OB two times a week for a fetal stress test, to make sure Cai wasn’t under any strain from my bout with gestational diabetes.

In June of 2006, she was born, two weeks early, at a whopping 9 pounds, 11 ounces.
She was perfectly healthy. And again, I was perfectly thankful — especially that she came early. Can you imagine what she would have weighed had she stayed on my sugar-fueled diet for two more weeks? Yikes!

My glucose levels seemed to return to normal immediately following delivery. I was thrilled to be back to “normal”. I ditched the insulin syringes and said “Adios!” to my endocrinologist. My OB told me that the best cure for gestational diabetes was delivery, and that’s all I needed to hear. I was so done with being a pin cushion with routine finger pricks and insulin injections.

Yet, it was not over.
It was just beginning.