Thursday, May 07, 2009

I came home giddy with excitement the other day. J was a 20 year old woman with type 1 diabetes. She was one of my first type 1 patients here when I joined the practice. At that time, things were a mess; her hemoglobin A1c was 11.2%. School and work kept getting in the way, and so she neglected her health. She was sent to me because she was also pregnant for the first time.
An eminent professor whose talks I’ve attended once said, you can get (almost) any mother to do anything if it means a healthy baby. That is very true- it’s easy to neglect our health if it didn’t involve anyone else. But take a mother, carrying her child, her flesh and blood, in her womb, her cocoon of safety, a mother would do anything.
In this case, it meant checking her glucose at least 4 times a day. 4 shots of insulin daily. Learning how to carb count, and adjust. Watching her diet. And even more challenging for this single mother, still at school.
Through it all, she persevered. Yes, she struggled, despite the frustrations, despite the brittle numbers as often seen in patients with type 1, and then with the increasing insulin needs because of the insulin resistance effects of gestation.
When I saw her, she was 9 days away from a planned induction. The OB has been pretty happy with the progress so far. No sign of macrosomia. And I proudly showed her her latest hemoglobin A1c: 6.5%.
Yes, my nurse and I were pretty excited for J; we feel like we have shared a significant part of this journey with her, not surprising since she has been coming in to see me monthly, and has been sending her logs to be every fortnight, just because of the high risk nature.
I hope she'll do well. And I hope she'll continue to do well postpartum, and not fall off the wagon after she delivers.