Blood test measurements, and certainly my reactions to them, are loaded with emotion. My results are just that - mine; personal, meaningful, emotive, and loaded with context. And having someone I don't know look over them with a judging eye from their tower of objective reasoning makes those emotions rise up in me. They shouldn't, because I know as well as the next person that any result I see is 'just a number' and that I should only ever treat them as a snapshot of information at that moment, at that time. But taking a step back is hard when your life is littered with words like 'balance', 'control, 'good' and 'bad'.
My 29 years with the condition have taught me that diabetes is one of the most complex science experiments in the world. Why? Because our experiment is happening in 'real life' and countless factors are constantly at play. I know that how much sleep I have, what I ate for dinner last night and how hot or cold the weather is, for example, all play a role in impacting my blood sugars. And pregnancy has opened up a pandora's box of reasons filed under 'other' which can affect my blood sugar control. My usual diabetes pump team, who have spent 6 years working with me to help me achieve the level of control I am happy with know this, and are usually the ones reminding me not to concentrate too much on the results above or below where I would like them. They are the masters of patting me on the back and giving me some positive perspective.
A few days ago I attended my first maternity diabetes clinic appointment. Until now I've been attending usual maternity appointments with my wonderful midwife, and have seen my usual beloved pump team for the rest of my diabetes management every 2-3 weeks. But now that I have reached the 25 week milestone in my pregnancy, my care is transferred down to what I call the 'warehouse'. My hospital is a verylarge hospital on the South Coast of England, with an enormous amount of speciailist departments and thousands of women coming from across the county to manage their pregnancies and give birth to their children. Because of these numbers, it can come across as sheer pandemonium when the unit is full of large waddling ladies being hearded from scan department to generic health check areas. Seeing the same person twice, other than the familiar faces of the diabetes team, is a rarity.
As I sat down in the specialist registrar's office having never met her before, and whipped out my weathered and paint-chipped blood glucose meter, placing it on her desk for her to see, I was fairly happy that I had been doing all I could to manage my diabetes during the notorious second trimester of pregnancy, when insulin resistance and reduction in mobility means my blood sugars have been a little more 'rollercoaster' than I would have liked.
As she scrolled through my meter, her eyebrows raising intermittently as she let out little puzzled breaths, asking me what arrows meant and whether or not certain blood sugar results felt a certain way, I was getting little read on what she was thinking, but was starting to feel protective of the numbers she held in her hands. I was starting to feel judged.
"Are you aware of the targets in pregnancy?" she asked, not looking at me.
"Yes. 5.5mmol before a meal and 7.5mmol after." I replied, a little perturbed considering the 5.3mmol currently trending on my CGM.
"I often just use the meter at the extremes because my CGM tells me what I am doing the rest of the time." I said, trying to explain myself, my guard now firmly up. She looked at my bag where the CGM was poking out of the top, clearly in such regular use that packing it away in a zip-pocket was pointless. I could tell she didn’t really understand what a CGM was.
As the questions rolled I clocked my husband shifting in his seat, also getting uncomfortable about the loaded questions from the stranger flicking through my numbers . To add a little context, my baby is currently measuring in the 50th percentile for growth, meaning if you took 100 babies, mine would be perfectly smack bang in the middle for growth; not too big, not too small. My A1c is still in the mid 6s even with the second trimester mayhem, and my CGM trace shows an 80% in target spectrum of blood sugars. The 'out of range' figures are also neither drastic, nor regular. Baby is kicking away hourly and I've been feeling amazing, diabetically speaking and otherwise. I do not need to explain myself.
With a few more comments fired about being too low a little too often, and trying not to rebound from them, Jamie and I were shuffled back out of the office and seated back in the warehouse for our scan, a moment we'd been both excited and anxious about. But now we were a little more focussed on whether I really was doing OK or not, considering the registrar had just carried out what felt like brain surgery on my last 2 week's results.
I've come to learn that being subjective about people's responses to my numbers is not one of my strong points, and that I need to let certain things go. But as we took our seats and exchanged knowing glances, Jamie managed to sum up how I felt in one word.
"Judged", he scoffed.
"It's not just me then", I replied, glad that my husband 'gets it' and was ready to jump to my defence given that he has seen first hand how hard a job pregnancy has been at times. I've tried to avoid being the over-sensitive pregnamonster, but picking apart remarks I take the wrong way because of beasty hormones, over ones with genuine carelessness or malice, can be tough. But seeing that Jamie has also picked up on the tone and the questioning made me feel better. Like I wasn't the crazy emotional one.
With that, we rolled the comments off our backs and chose to start focusing on seeing the baby again, and on celebrating the excellent blood pressure and clear urine analysis I'd already been told about that day. But with my blood test meter now firmly back in my bag, locked away for my eyes only, I was reminded of the sharp sense of privacy-invasion that exposing my results for the 'panel' makes me feel. Everything is under scrutiny when you are pregnant, and those whiley hormones have a habit of making you even more sensitive to anything which looks vaguely like criticism. The fact that in three months there won’t be a team of people ready to assess and evaluate my every blood sugar is an idea I grow more fond of each day.
Three months, and counting.