Take today. I saw PC back for post-partum follow up of her diabetes. She has type 1 diabetes, A1c was 13.1% when she got pregnant, which she brought down to 6.1% by the time she was at term. I made some changes to her pump after delivery, and she came back today to see if she needed more adjustments. She brought the baby along with her, and seeing that healthy baby boy and the proud parents just filled me with immense joy. I'm not exaggerating when I say my eyes teared up some.
Some patients, unfortunately, don't do as well. Another patient with uncontrolled type 2 whose A1c was >14% at first visit, called me the other day. She was trying her best, but the insulins and the frequent checks were a challenge. She tearfully told me that they had found a hypoplastic ventricle on ultrasound and were considering an abortion given the very high mortality associated with this. I tried not to choke on my words when I tried to offer her some words of comfort. I couldn't help but picture ourselves, Kristin and I, in a dire situation like that. I imagine as a father I would feel so helpless, knowing that there is nothing you can do.
And sometimes, I've had to bite my tongue, as I did when that 19 year old woman with diabetes and an unplanned pregnancy, callously told me "it was probably a good thing I had a miscarriage- I can eat whatever I want now...". Perhaps I'm just too judgmental, but I couldn't help but think, if you're not ready to be
I admit, this is catching me off-guard in many ways, how I seem to be assuming a more protective (paternalistic?) role?
Well, ladies and gentlemen- only 8 more weeks. Might as well get some practice.