Educating the diabetes educator

Today was another baby appointment. After the last visit three weeks ago where I waited for over an hour I was concerned this visit might involve me flipping furniture in the lobby like Godzilla. They must have made a note in my file, though, because I was called back at 1:35pm for my 1:30pm appointment. They whirled through my blood pressure, weight and other stats in under 10 minutes and I was situated in the exam room. The rest of the visit is usually where the nurse listens for a heartbeat, the diabetes educator looks at my blood sugar logs for the last three weeks and I wait to chat with the OB for a bit about anything pertinent. They take a few vials of blood for lab work and I'm on my way.

I love my OB but have had a strained relationship with the diabetes educator, Georgia. Because I'm forced to deal with her each visit it adds stress to the entire process. In the last visit (after waiting over an hour and having her dump my purse on my chest during the ultrasound) I got a little snippy with her. I wondered if she would remember me.

Interestingly, a new diabetes educator, Marilyn, came into the exam room. She had obviously been prepped about me because she knew I don't use their precious book and didn't give me attitude about it. She seemed to do better about not judging my blood sugars but then we started talking food. She fussed that I'm not eating enough protein during the day. When I asked her what she suggested, she said "you could have cheese or Canadian bacon." Seriously? Those are the two first things that come to mind when you think about protein? And why Canadian bacon? Not chicken or regular bacon or ham, but Canadian bacon.

Me: "I don't eat cheese." Her: "Oh, are you allergic?" Me: "I'm 19 weeks pregnant and you can see my food logs for the last three weeks. I eat 10 grams of fiber every morning. As far as I'm concerned, cheese is evil." Her: "Ahhh. Well, there's always Canadian bacon or other meats."

Marilyn returned to my logs. "I see you had a burger and fries. That's high in fat and will mess up your blood sugars." I just waited stoicly for her to get to the next line. "Hmm, but your sugars seem fine afterwards." Yeah, I'm kinda down with the Five Guys cheeseburger and fries combo.

"Frosted Mini Wheats? You shouldn't be eating stuff like that." She actually shook her head and looked over her papers at me. "You should eat multi-grain Cheerios instead of sugary cereals like that." I just looked at her and didn't say a word. I was starting to wish I had just dealt with Georgia instead.

When I was first diagnosed with diabetes in 1985, I was told I had to go the children's hospital instead of my parents' preferred and closer hospital because the children's hospital apparently had experts on juvenile diagnosed diabetics. We learned later that I was the first juvenile diabetic they had ever treated. The dietitian told us that I could have all the fruit juice I wanted but no sodas because fruit juice was a natural sugar and wouldn't affect my blood sugars. These people went to school to tell us that. I was allowed to have eggs and toast and milk for breakfast but not allowed to have french toast without the syrup because french toast was a forbidden food.

When I got back to the office and could look up my precious Frosted Mini Wheats, I found they have 10 fewer calories per ounce than Cheerios and more protein. Besides, Cheerios is now considered a drug so I'm sure they're bad for the baby.

After Marilyn left, I still got a visit from Georgia. She asked her usual question of "am I going to like these numbers?". I stammered. I knew she would probably ask this question and I wondered how I would react. I had scripted a few caustic retorts but nothing really sounded right. So instead I just stammered.

Georgia: "That sounds like I'm not going to like them." Me: "No, it's more like I don't like the question. I've been diabetic for exactly 24 years and every doctor and dietitian has stressed that I am responsible for my blood sugars. It's a lot of pressure to feel like you're responsible for anything that goes wrong with your disease because you could have prevented it."

I was surprised at how calmly I delivered all that. I think Georgia was surprised too because she turned from her paperwork and her mouth fell open.

Georgia: "But that's not fair to say that. The hormones affect your sugars and you can't control those." Me: "I think the whole point is that it's not fair. I just think a better way to phrase the question would be to ask me if I am happy with my numbers or even just to ask if I'm having any issues or problems." Georgia: "I ... you're right. That's a much better way to phrase it. So are you happy with these numbers?" Me: "I'm relatively happy with them, but maybe we can fix a few things."

So my appointment was still not very speedy but they're trying. I think by the time this baby is born, we'll all be a little better educated about maternal fetal medicine.