High-Risk Pregnancy

In 2004 my first child was delivered via c-section. The c-section was planned, as was most everything about the pregnancy:

  • The switch, prior to conception, from oral medication to insulin (MDI – Multiple Daily Injections)
  • The counting of carbohydrates and adjusting of doses as hormone levels changed
  • The umpteen appointments with the endocrinologist, obstetrician, and perinatologist
  • The very many ultrasounds
  • And the birth plan that specified the endocrinologist’s favored delivery time: 11 AM

While I was grateful to be pregnant, I did not love the experience of it, as many women do. Instead, the frequent monitoring served as a constant reminder of the risky environment I felt I was providing for our growing fetus. Having a birth plan felt reassuring.

I was relieved and excited when the delivery date arrived. September 10, 2004 was a busy day in the labor and delivery wing. (Evidently, I wasn’t the only soon-to-be-mother hoping to spare her child a September 11th birthday.)

Despite my most proactive efforts, 11 o’clock came and went.

“Excuse me, my c-section was scheduled for 11 and it’s 11:30 now. I have diabetes. My blood sugar’s okay right now, but I haven’t eaten since 9 last night.”

“Excuse me, I can see you’re busy, but I was supposed to have surgery 90 minutes ago. I have diabetes and I haven’t eaten in over 15 hours…”

“Excuse me…”

I continued politely bothering the busy hospitalists. Eventually, 2 hours after the scheduled time, off we went to the operating room. I met the team, got hooked up to some equipment, was anesthesized, and within about a half hour everything was underway. Probably sensing that I’m nervous about the surgery, my OB made light chit-chat:

OB:      So, Emily, do you guys have a pediatrician picked out?
Me:      We do – it’s Dr. Papadopoulos.
OB:      Aww, he’s terrific! And such a nice man. Here’s a challenge – can you spell his last name?

[That I cannot spell the pediatrician’s long, Greek name doesn’t surprise my OB. It surprises me, though, as I’m generally a good speller. It’s my first clue that something is amiss.]

OB:     (New topic) So, when you’re in recovery where should your blood sugar be?
Me:     Well… Mmmmm… I think… Whatdidyousay? (Is that slurring?)
OB:     After surgery – your blood sugar. Where does your endo want your sugars?
Me:     (Can’t. Quite. Reach. The Words.)

Something’s wrong, I think.
I manage to ask the anesthesiologist if the anesthesia is scrambling my thoughts. Nope.
Something’s wrong, I think.

“Something’s wrong,” I say,I’m low. What’s my blood sugar?”

Anesth:   Where’s your meter?
Me:           I’m in surgery..I’m naked. I don’t have my purse.
Anesth:  I don’t have a meter.

(thunk.)

Me:           But – the plan… the blood sugar… how will you know if I need insulin?
Anesth:   We’re not doing any of that.
Me:           But, the plan…! I’m low. I’m very, very low.

[I’m not thinking anymore about the baby, or about being cut open. All I feel is the panic of an extreme low. A low that the plan – the one that nobody is following – was designed to prevent.]

I want my OB to remind everyone of our plan, but at this moment she’s tugging the baby out of me. I can’t catch her eye. I’m not her priority and I feel very afraid.

I hear the anesthesiologist say, “There’s no meter; every floor is supposed to have one.”

I’m not a player in this scene anymore. I am tired. I close my eyes so I can focus on listening, which now requires some effort.

I hear someone say, “Get her some orange juice.”
I hear my husband ask, “Are you sure you can give her orange juice during surgery?”
I hear a code announced over the PA system.
I start to wonder about the code, but doing so takes too much effort.

I hear drawers opening and closing. They sound like the junk drawers in our kitchen at home. The ones that have AAA batteries rolling around inside. I don’t feel afraid anymore. I feel tired and calm and focused and I wonder why a drawer in an operating room contains AAA batteries. I’m aware of the chaos around me but I feel detached and too tired to care about it.

Somebody finds 500cc of dextrose in a drawer.
10 seconds and I feel the change. So much faster than juice.

Someone asks how I feel.
“It’s helping. I’ll feel better soon.”

“You have a beautiful, healthy baby girl.”
I smile from the post-low haze.

It will be hours before I really feel better, but this lovely baby helps a lot.

Greta's-birth / diabetes-and-pregnancy

Happy, Lucky.

4th Annual Diabetes Blg Week 2013 / Diabetes-and-pregnancy

This post was written for Diabetes Blog Week

The Prompt (suggested by Jasmine at Silver-Lined): Share a memorable diabetes day. 

This entry was posted in Diabetes Blog Week, Diabetes Blog Week 2013, Living with Diabetes and tagged , , , , , , . Bookmark the permalink.

4 Responses to High-Risk Pregnancy

  1. Hillary says:

    Oh Em…what a powerful story. How wrong that you, the patient who did everything asked of you, was expected to also solve the problem the hospital had created by delaying your surgery and not planning for this scenario. Thank goodness they found that dextrose. But how maddening. And more than that, how careless and needlessly risky. Shame on the hospital. Have their procedures changed as a result?
    Thanks for sharing this. The dialog and your inner experience of the situation are riveting. It makes me appreciate how little I, as a non-diabetic mother, had to worry about or deal with while pregnant. Love the photo of you three. Best birth photo ever!

    • Emily says:

      Thanks, Hil.
      Among other things, the experience drove home for me the importance of having an additional health care advocate (besides oneself, I mean).
      I don’t know if the procedures changed or not at the hospital. It’s something I imagine I would have followed up on if I hadn’t been adjusting to motherhood at the time. The other awkward and confusing part was at the time I didn’t fully understand whose responsibility it was to follow the plan. In retrospect, that’s a question I should have asked at the outset – the endocrinologist (who was associated with a different hospital) proposed the surgery time. Was it then the OB’s responsibility to communicate it to the anesthesiologist and ensure his compliance? Was the OB empowered to abandon the plan if she elected to do so? If so, were there checks and balances if the anesthesiologist (or some other specialist) disagreed? I felt uncomfortable asking questions without knowing the potential consequences (for, say, my OB whom I liked a lot…).
      Thanks for reading and commenting!

  2. Ana says:

    Thanks for sharing your story, Emily. I agree with Hillary, maddening, and I am so relieved they found the dextrose. I have heard from several moms with kids with health issues, not diabetes, that having one point of reference or one health advocate to be in charge has been a game changer for the quality of care they have received.

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