Friday, November 27, 2009

Insulin Shots

It's been two weeks since I've been on the gestational diabetes (GD) roller coaster. On Wednesday I met with an endocrinologist who has put me on long-acting insulin, twice a day. I have to take it, via injection, once before bed (10 p.m.) and again upon waking (by 7 a.m.). We're starting with this protocol first, and then, if it's not working I'll have to go to injecting short-acting insulin 4 times a day (before each meal and before bed).

I was devastated at first, especially since I found out on my birthday that I'd need to start shots (last Tuesday). By Wednesday I had resolved myself to this new turn but was still not too pleased. I don't care how many people say "this is not your fault - it's nothing you've done," it doesn't make it any easier. To me that's like telling someone with cancer "it's not your fault" - does it make it any easier for them to deal with the diagnosis and treatment that follows? I highly doubt it.

Intellectually, I know this isn't my fault. I know that it happens to many women of all shapes, sizes and ages. I know it happens for some in one pregnancy and never again. I know some can control it with diet and exercise and that some, even though they follow that regimen perfectly, still need to take insulin. I know. I know. And yet, knowing all of this does not make it suck any less.

What's worse is that the endocrinologist was coming at me with all of these assumptions. Having never met me before and only peeking at my chart, I guess I can understand why. My weight, my age, the fact that my mother and her parents are all Type II diabetics. She asked if I needed medical assistance to get pregnant (especially because this is my first baby)...assuming, I guess, that I have PCOS or some other IF issues. The answer is no. 4 cycles off BCP and two cycles TTC did the trick. I don't have PCOS and have even been tested for it by a reproductive endocrinologist a few years ago. My thyroid is fine. My blood pressure is always on the low side (although it was a bit higher that day, probably due to the stress of it all). Cholesterol is good. Never been hospitalized. I eat well and exercise most days and have only gained 10 lbs. this entire pregnancy. All of this seemed to just floor her...for surely this pregnant, twinkie-eating-soda-slurping, coach-potato-with-gray-hair-shining-through-her-dye-job must have seen this coming! UGH.

Then she casually blurts out, "This means you have a 90% of having Type II diabetes after the baby is born." WHAT?!?!?!? This is the first statistic of this gravity that I have heard. I have read 50-60% of GD women will go on to develop Type II in the 5-10 years after they give birth. But not 90%. That's damn-near a guarantee in my book. In fact the statistic I've read is that 90% of women with GD will have it go away as soon as they give birth. So that pissed me off. And I looked at my husband and said, "well, I'll just have to be that 10% who doesn't." She wrote out a script for 6 units of insulin, twice a day and made an appointment to see me in 4 weeks. I couldn't get out of her office fast enough.

The type of insulin I am taking is called Humulin and it comes preloaded in an injection pen called a Humalog Pen, made by Eli Lilly. I have to prep it each time with a new needle and some clicks and pumps and then stick it in my belly (pinching an inch or so of fat), push the plunger on the pen and hold it there for 5 seconds. That's it. It doesn't really hurt. Although I'd say pinching an inch on my belly right now is more of a challenge than I thought it would be! For one, my belly is tauter than it usually is without a growing baby inside of it. And second, my boobs are so big that in order to find a place to pinch that I can actually see itis interesting. And I have to change the injection site each time, which adds to the fun.

After my appointment on Wednesday I went to the pharmacy to fill my prescription for the Humalog injection pen and needles. It took 90 minutes! I swear I could have filled it myself...I could see the boxes right on the shelf behind the counter! Later that night Mr. Divasaur, nurse-in-training, gave me my shot. It wasn't so bad (although I cannot stand the smell of the insulin...it's very medical/chemical smelling to me). By Thursday morning I was ready to do it to myself.

So here I am...four injections of insulin later. They seem to be working, especially with my morning numbers. I have been under 95 the past two days. I was even under 120 after my lunchtime Thanksgiving meal (I had a teeny bit of cranberry sauce and sage stuffing with my turkey). Last night, after having some leftover turkey, a smidgen of sweet potato and a little more dressing for dinner, I was 121. So it's working, I think. I see my GD counselor next Thursday and hopefully this will be working enough that I don't need to progress to more frequent injections.

I will continue to track everything that I eat (portions as well as time of day consumed), my blood glucose 4 times a day, my ketones (by POAS) each morning (I have to drink a glass of milk between 2-3 a.m. to keep them in check, so I do it when I get up to potty in the middle of the night) and inject myself with insulin each day and night. And I am doing all of this for Libby...I love her so much and will do anything to bring her into this world safely.

3 comments:

  1. Speaking as someone who works in pharmacy - I hope you don't mind if I put my 2 cents in..

    "It took 90 minutes! I swear I could have filled it myself...I could see the boxes right on the shelf behind the counter!"

    What most people can't see when they are waiting for a prescription is the pile of prescriptions that came in to be filled before theirs. The people may not be right there at that time waiting which gives the false illusion that the pharmacy is not busy. Plus, filling a prescription does involve many steps - entry into the computer, dealing with drug plans (if applicable), filling, labelling and double checking. Most pharmacists are pulled in many directions (i.e. doctors phoning, patients wanting counselling on OTC & RX products as well as checking the prescriptions.) Unfortunately, it means waiting for a while sometimes. I believe accuracy is very important when filling prescriptions. Sorry that was so long! I just like to take the opportunity to pass on some inside info when I can.

    I am glad the insulin is doing the trick and that you are getting the hang of it. Libby is one lucky little girl to have a Mom who cares about her so much!

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  2. I get it, but I was super annoyed because they said it would only take 30 minutes. Had they said "we're busy and it will take 90 minutes" I would have gone and run some errands, etc.

    That sort of lack of customer service irks me whether I am at the pharmacy, doctor's office, or a restaurant. If they're going to give estimated wait times, they should try to at least be accurate within 10 minutes or so.

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  3. I would have been annoyed too! There is a huge difference between 90 minutes and 30 minutes. You are right - terrible customer service for sure!

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