It was our first experience with this office, this doctor, and an ultrasound that projected on a large flat-screen TV in front of us. Actually, it was Aaron's first everything - this was the first baby appointment which he's been able to attend.
Level 2 ultrasounds are also referred to as anatomy scans, which as you may guess, means that we got to see lots of detail this time: organs like the kidneys, heart, and stomach, as well as bones, feet, arms and hands, and some lovely profile shots. There were wonderful moments where we watched our baby's mouth move, its arms wiggle about, and its feet kick to and fro. Magical? Yes.
The good news is that, so far, everything looks normal and happy and just as it should be. I was asked to come back in four weeks for another ultrasound check, as they'll want to check the heart out again. "We're trying to measure something that's, right now, about this big", our doctor said while gesturing with the tip of his pinky finger, "so in four weeks we should be able to get a better look at it".
We must have asked him four or five different ways: "But everything looks okay? Nothing to be concerned about? The baby looks good so far?" And while we received all answers in the affirmative, the fact remains that I'm a woman with type 1 diabetes who is pregnant. To a doctor who sees a wide variety of high-risk patients in various states of self-care, that means a need to inform us of all the "what if"s. He began by asking me how my diabetes was, and because every other doctor in my medical history has seemed to want that answered with an A1C result, that's how I responded.
I found it curious, then, when he smirked. "Actually, I don't care much about your A1C." I'm not sure what, exactly, he cared about - I think he was looking for a bigger picture answer, or maybe that I could say that I've never launched above 120 mg/dL ever. I think he wanted to know if I knew the fasting and post-prandial goals to shoot for (which, as he told it, are under 100 for fasting numbers, and under 120 two hours after meals), or if I realized the myriad of complications that could occur due to a large baby. For a few minutes it was all Charlie Brown's teacher: "wah wah wuh wah stillbirth mrph wah wah c-section mrph wurr wah deliver early wah wah wurr pre-eclampsia wurr wah", and I suspected then that I had never really, seriously, discussed any of these possibilities with Aaron. Our conversation during the walk back to our car confirmed my suspicion.
I don't mean to cast our Maternal-Fetal doc in a bad light - he is doing his job, which is to make sure his patients are informed and cognizant of what may lie ahead. But I couldn't help but be reminded of something I've heard Dr. Polonsky say time and again:
"While poorly managed diabetes is the leading cause of most of the scary long-term complications, well-managed diabetes is the leading cause of...nothing."
That's why these risks are not top of mind for me, or something I mull over often. It's not that I'm naive; at least, I don't think I am. I know that any of this could happen. But much like worrying about a car accident every time I drive, a crashing plane every time I fly, or a gray strand every time I brush my hair, living life cannot be a process that is dictated by fear. It's why you wear a seatbelt; why planes are designed so carefully; why they invented hair dye. I am doing the very best I know how in order to have a healthy pregnancy, and while I'm placing some possibly unearned trust in my body, I also have to accept that the rest of it is out of my hands. Worrying is futile (and unhealthy for you, anyway); if something happens, we'll deal with it then, and in the meantime, I'll do the best I can to keep us both healthy.
I'd rather focus on the greatest "what if" of all: "What if everything turns out absolutely okay?"
* * * * *
I recently contributed a blog post to the Diabetes Advocates site on the topic of diabetes and pregnancy, sharing a bit of my own experience, as well as linking to resources for those planning a pregnancy while living with diabetes. Go check it out here, and if you know of a resource or blog we should add to the growing list, please share it!