Over the next year and a half after my son's birth, I was sick all the time. I tried to get back in to shape but I'd work out for a few days and then get a head cold or the flu again and again. Infections persisted. Vision changes persisted. Through a lucky break I got a family doctor in the winter of 2008. Fabe and I wanted two children and I thought it was better to have the second sooner and get over all the misery that was pregnancy and move on with my life.
I got pregnant with Theoren in August 2008. I went for my first check up with my doctor and told her that I was "borderline" gestational diabetic in my first pregnancy. She ran the usual tests and I heard nothing back. I did have the same vomiting and dramatic weight loss I had with my pregnancy with Darius. When I was 25 weeks along, I took the glucose tolerance test. Two weeks later, a nurse from my doctor's office called.
"Hi, yes Kelly. I'm calling to confirm your referral to the diabetes in pregnancy clinic."
"Whaaaa?"
"Dr. Maclean has referred you to the diabetes in pregnancy clinic."
"I didn't know I had diabetes."
"Yes, you failed the glucose test."
"I thought that test was just to see if you needed another test to confirm dia..."
"Oh no, you have diabetes! You've had high sugar in your urine since beginning of pregnancy..."
Nice.
The Diabetes in Pregnancy Clinic runs group classes to educate women who are diagnosed with gestational diabetes. Fabe went with me. All the other women were over 35, some were overweight and all had history of Type 2 diabetes in their family. I was none of these things, although I was adopted at birth so my family history is uncertain. After the class, the nurse took me aside and said that she needed to run more tests for me because they were concerned. She said my OGTT was 18 mmol! I took the blood tests and saw the endo the following week. She told me she had sent me for an A1c. It was 6.7. That meant I probably had underlying diabetes that began before I got pregnant. Then she said, "I also checked your thyroid, everything's fine there." They gave me a free meter and test strips and told me to eat 1 to 2 servings of carbs per meal and monitor my blood sugar for two days.
The target for blood sugars two hours after a meal was between 5-7 mmols and below 5.3 fasting. My numbers were in the 9-11 mmols range and in the 7s fasting. They put me on 6 units of regular insulin before meals at 10 units of NPH at night. I was taught to adjust as necessary. Within a week I felt like a million bucks. I had so much energy I was cleaning the house at 11 at night. My nausea went away and within a month I stopped taking
meds for it completely! Those last three months or so of pregnancy were the only time I truly enjoyed being an expectant mother. I was so happy and healthy. I gave birth to Theoren on May 15, 2009 via a cesarean after I had a
placental abruption in early labour. Theoren and I stayed at the hospital for four and a half days and had our blood sugar checked several times. He was fine but mine ranged from 6.1 to 10.9 mmols. An endo came to visit me and told me that I likely had a mild Type 2 and if I worked really hard lost the baby weight and got into better shape I could manage it with diet and exercise. He advised me to track it for the next few weeks and bring the numbers to my doctor.
My blood sugars were pre-diabetic for about six weeks. I bid goodbye to the endo as it was not her mandate to treat women outside of pregnancy. I felt ok and in July I was well enough to go on vacation to see relatives. I left my meter at home in an effort to stop worrying.
But man was I thirsty. There was a heat wave running through central Alberta and I was breastfeeding. That must be why! I got home, tested my blood sugar -- 16 mmols! And I hadn't eaten in three hours. Over the next two days I saw numbers I had never seen before (as high as 19 and no lower than 10) so I made an appointment to see my family doc. She said she thought I had a honeymoon after giving birth and that the high numbers were due to the hormones from breastfeeding. She put me on 6 units of NPH twice daily. It sucked. NPH kicks in whenever it feels like it. I was high. I was low. I was gaining weight. I easily could have a 15 and a 3 in the same day. By October I'd had enough.
At this point I was assumed to be a mild Type 2, but I was taking insulin because it was safest for breastfeeding. I wanted off NPH so badly that I decided to wean the baby. I saw my family doc and told her of my decision. She asked me to stop taking insulin when the baby was weaned and to come back in a few weeks and see where I sit.
Bad idea. Within three days, my numbers were back up to the high teens and I got a very bad cold. I tolerated this for six days. Then one morning I woke up and looked in the mirror and the area around my eyes was swollen. I called "Health Link" an over-the-phone health advice program in my health region and was told it was probably an allergic reaction and to take an antihistamine. Two days later, still swollen. I went to emergency. The doc there said it was probably either related to my cold or I had eaten too much salt at Thanksgiving. I was so annoyed and pissed off that I didn’t even wait to get discharged. Two days later, no change. I went back to my family doc. She wasn't in but another doc in the practice agreed to see me. He thought the swelling was due to all the hormonal changes from weaning, etc. He also admitted that he didn't know what I looked like so he couldn't judge how bad it was and he decided to send me for a blood tests to be on the safe side.
The next day his nurse called me and asked me to come see him the following day. Results were in and he said I had hypothyroidism. I was so shocked. The endo told me I was fine. None of this made sense. I didn't want to cry in front of him, so I asked quickly asked him for Metformin -- the drug my doc was going to put me on -- so that I could leave. He said he thought once the thyroid thing was settled I wouldn't need the Metformin. He gave me a
requisition for more blood tests and I left. Later I found out I was right. I did not have a thyroid problem until recently. My TSH test was 0.2 when I was pregnant with Theoren and when I was tested in October it was 8.63 (normal range is 0-6).
I kept taking insulin, but I went back to taking Regular and NPH because I could better manage my highs and lows. After a month of taking the thyroid meds nothing had changed on the bg front so I asked for a referral to an endo. Finally I would get the answers I sought.
My endo, Dr. Ross, looked like my grandpa if my grandpa had been an East Indian Brit. He is the sweetest man. He started off our conversation by saying, "You've had a rough time haven't you?" Yes. I. Have.
He said the doc that diagnosed the thyroid problem did me a huge favour. He sent me for a test to measure the antibodies against my thyroid. Normal range is <30. Mine was <600! He said this meant that I have Hashimoto's Thyroiditis. Typically if you have one autoimmune disease you have another and he believed I have Type 1 diabetes. He wasn't sure so he prescribed 1000 mg of Glumetza once daily, saying to keep an eye on my blood sugars and if they were out of control, take my insulin and call him. The Glumetza didn't work at all. I saw him again and he told me I’m a Type 1 diabetic and he had no choice but to begin an insulin regime, a better insulin regime than before.
I have never been happier in my life to hear that. Of course, I would rather have been told I was healthy, but I knew that wasn’t true. After years of being told it’s all in my head, it’s things I’m doing wrong, I finally have answers and a proper course of treatment!
I’m putting this in writing to put the past behind me. I don’t want to sit around and think, “what if”… There were mistakes that I made and there were mistakes others have made. You may think that I’m giving the optician I saw in 2004 too much credit. But I’ve come to realize there are two types of health professionals – those who make assumptions, and those who investigate, just as there are patients who accept and who question. Until recently I was never the latter type.
They say that there is an epidemic of Type 2 diabetes in North America. There is also an epidemic of undiagnosed or misdiagnosed Type 1s (1.5) who are suffering needlessly for years because they don’t fit the typical picture. My first job in my field was working as an editorial assistant at one of the daily newspapers here. When I was hired, the city editor at the time gave me a piece of advice I followed in my professional life but never, until now, saw its relevance in my personal life. He said, “You have to be unafraid to say, ‘The emperor has no clothes.’”