The Scrambled Egg Mystery

When we found out we were pregnant again, we were scheduled to take a trip to visit with good friends in the US. We had planned this trip for months, and it was on. We figured it would be ok, I just couldn’t ride any of the rollercoasters, and we bought groceries for lunches to mitigate our eating out while at the theme park central to our stay.

What made it even worse, and rather humorous, and kind of made us giggle and make jokes was, Well, we were meeting the gang in, of all places, Hershey, PA.

Yeah. Pregnant, Diabetic tired girl in the Chocolate capital of North America, at a theme park, filled with awesome rides she can’t get on, and awesome food she can’t have. Oh boy…

I was seeing good friends, and decided to make the best of it, and it was an amazing, exhausting, family-friendly trip. My son loved the kiddie rides, and we had a great time catching up with people we love so very much. We discovered my two year-old travels really well, and we had no melt downs in the park, or problems driving for long distances. All in all, a success, and not one motion sickness, preggo mama on the side of the road with first-trimester heaveys.

*Fistpump*

Let me tell you though, the air when you get out of the car at the Hershey theme park parking lot smells like chocolate. Everywhere you go, there are reminders of chocolate. There is a place called Chocolate World that sells reams and reams of chocolate. And here I was, not able to partake in the orgy of stuffing my face with the wonderful, creamy, stress-reducing, mood-altering goodness. People were hauling suitcases of the stuff back to their cars! Suitcases!! Yoi.

I was a good girl, and only nibbled on samples of said chocolate, and did pick up some sugar-free Reese’s Peanut butter Cups as a treat. I did have some ice cream one day, and a few kettle chips (from the gynormous bag my hubby bought), but I didn’t indulge in humongous amounts of bad-for-me foods.

It was a triumph of epic proportions. I love chocolate, and it was sometimes difficult not to break down and just have some.

What was harder than resisting the Hershey sugary goodness, in fact, was simply eating while we were travelling in the US. We had lots of groceries for snacks and lunches (mmm picnic lunch stuffs!), and that was a saving grace. But sometimes, you just gotta eat out when you’re travelling, and breakfast and dinner was usually in a restaurant.

Nowhere else were we reminded of the differences from Canada food guidelines and restaurants than sitting down to a meal with our friends, or while en route there and back. There were several times I had to literally waste most of the food on my plate in order to eat my proper carb portion and not overindulge, or order all sides.

Portions were enormous. Nutritional information was not readily available. Everything was swimming in butter, or so salty my hubby and I were taken aback at the tastes. We were amazed at the lack of vegetables and lean protein on menus, and the lack of understanding about Diabetic needs. I asked for a side of whole wheat toast, thinking I would get two slices of bread. I got six. SIX! I asked for skim milk for my coffee. “What’s that?” one waitress asked. With one supper, I asked what the veggie of the day was. The Waiter said “potatoes and corn”. Seriously? I looked it up afterwards. There are some beliefs in the US that potato is considered a vegetable serving. Corn I can understand. But potatoes?

Yeah, seriously.

But that wasn’t the cake topper (there I go with the cake again). For breakfast, our group reserved the big room in the breakfast buffet at the hotel we stayed at. The food looked good, I had lots of choices like eggs and bacon and sugar-free, low fat yogurt, as well as fruit and such. I figured we would be safe to have everyone eat ok there, and be healthy.

My son loved the scrambled eggs, and he’s not normally a scrambled egg kind of kid. We shrugged it off. They’re eggs, right? He wants to eat ‘em now, we won’t argue. They’re good for him. I had eggs as well, they are a good source of protein, and even with some milk that was likely mixed in, would be ok on my ratings. That, plus a half-slice of rye toast, and some bacon, and I was proud of myself. I did have a sip of my son’s orange juice one day, but that was because the bite of rye toast had gone down the wrong way, and my water was empty. *hork*

But, both days we ate there, I spiked after breakfast. Hard spike. Over 10 mmol/L. We were mystified. I re-did my counting, we went over the meal, and couldn’t see where the problem was. I scratched my head, and Hubby was concerned. I thought it might be the rye toast, but half a slice was well under my carb counts. We looked at the yogurt. Possible, but not likely. Was there anything else? Nope. A true mystery.

So, the day we were checking out, we ate at the restaurant nearby instead. I ordered my son a side of scrambled eggs. (read: heaping plate!) and he wouldn’t touch them. He was happier with the dollar pancakes he thought were super awesome as hats (read: sticky toddler).

Puzzled, I figured maybe there was something in the eggs at the buffet that made him like them more, like a spice.So, when I got back to the hotel, I asked the restaurant staff if they could tell me the ingredients in their scrambled eggs.

What they came back with nearly floored me. Literally, I had to shake my head and do a “really?” at the waitress who, after reading the ingredient list, was mystified as well.

There was sugar in the eggs. Liquid sugar.

Apparently, the eggs come in large bags, already mixed. All the cook has to do is open one corner, like a milk bag, and pour the mixture into the bin skillet, and cook them. The ingredients were: eggs, milk, liquid sugar, gelatine, colour, and spices. No wonder my son liked them so much! I couldn’t taste the sugar in them at all, neither could Hubby, but I like pepper on my eggs, and that may have masked the sweetness. Hubby didn’t eat enough of them to really notice, he said.

There was the reason I likely spiked. A hidden, nasty little surprise for Diabetics like me, assuming that eggs would be a safe bet, and finding out that they were not.

It reminded me how important it is to have information about what you are eating at your fingertips to make healthy, informed choices. In Canada, nutrition information must be provided at point of sale. This has saved us on so many occasions. I can safely eat at McDonalds, because their tray placemats have all the nutrition information on them, and you can ask for it at the counter! (BTW, their salads are great.)

Despite that, the trip was great, and my levels, for the most part, were regular. It is possible to travel with Diabetes, but depending on where you go, be prepared to ask a lot of questions, and be the customer every waiter hates when you demand special preparation and servings.

As a rule, here is what I say. If in doubt, ask, or leave it out.

Miscarriage and GDM

So I started this blog with the best of intentions, namely to keep myself motivated in the long, long 9 (10) months of pregnancy as a GDM mom. Not long after I posted my introduction, I miscarried.

We were at 9 weeks, had heard our Peanut's heartbeat, and were devastated. Even though the pregnancy was a bit of a surprise that required some financial finagling, we were going to be welcoming baby #2 by Christmas, and were hesitantly excited.

I couldn't really touch this blog until now. I didn't have anyting to say, really. But then I thought about the journey I have been on since I miscarried and I thought I should share.

A part of me was amazed at how quickly my blood sugars returned to normal afterwards. I kept testing for a few days after the official miscarriage began, and then sporadically until I had my next cycle. Normal, sometimes a tad high after we dined on "things-thou-shouldst-not-eat", but manageable, and not a cause for concern. I was concerned I had slipped into the Prediabetes or even Type 2 world, and was scared it was now going to be a full-time reality, not just a pregnant one.

I scheduled a visit with my doctor, of course, and he checked off every box on the bloodwork sheet when we discussed my overall health. He figured a physical might not be a bad idea to do, given we might find a problem, you never know. He checked B12 levels, since a deficiency in this vitamin can be risky in pregnancy. I think he also checked my iron and cholesterol levels to be sure. He tested me for PCOS (again), we did a random fasting bloodsugar, and did all kinds of hormone tests. Every test known to a doctor was done, I think, except for anything requiring my other bodily fluids I'd rather not mention here. Ew.

We discussed me, which I had expected. Yes, my weight needed to go lower, and my exercise level needed to be higher. Yes, I needed to keep going on eating better, as we had been doing since getting my test back high. He said to take someone with me to testing, since this was a lot of tests to take blood for, especially after fasting.

Whee! 7 vials of blood made the caffeine I put into my system afterwards very effective.

No red flags came up in the bloodwork, thankfully, and no mention of really high levels of fasting bloodsugar made my stress come down a notch or two on the "holycrapmylifeisover" meter. Likely, at my follow-up visit tomorrow, my awesome doctor will caution me that my levels were on the high end of normal, which they were last time we checked, but I was taking matters into my own hands with exercise and better eating already, and wasn't worried. Bring it on, man! *flex*

This whole thing got me thinking, though. Could my early diagnosis and high blood sugar levels have caused the miscarriage? When I was pregnant, I was scheduled to see the Diabetes doctor, but it was set for two weeks after I miscarried, so I was not able to get a perscription for insulin, and my sugars were getting harder to control each day. my levels were so wonky that I couldn't even look lovingly at a carb from across the table. A quarter cup of basmati rice was spiking me from a high 6 to a low 10! Not good. Not good at all.

I wondered - looking back at how difficult it was compared to my last pregnancy - if the lack of ability to control my bouncy blood sugar with diet was a contributing factor. So, with the thought of my GDM being a risk factor to miscarriage in the early days of pregnancy, I opened up the trusty Interwebs, and did some researching.

After looking through the Canadian Diabetes Association and the Public Health Agency of Canada, I found no convincing statistics that linked miscarriage to early onset GDM. It was mentioned, but each had conflicting stats, and thus, I couldn't verify anywhere else. Most mentioned that there was a risk, but identified more with type 2 Diabetes, rather than prediabetes, or GDM. In all cases, the percentage of risk was below 10%, and not a cause for major concern. Huh... ok, lets check some US sites.

US statistics and websites tended to be more fruitful. I did found a more concrete statement* while perusing the the WebMD network. The link to the page is here , with the following quoted from the section titled "Clinical":

Miscarriages

• In all women with preexisting diabetes mellitus, there is a 9-14% rate of miscarriage.
• Current data suggest a strong association between degree of glycemic control prior to pregnancy and miscarriage rate. Suboptimal glycemic control has been shown to double the miscarriage rate in women with diabetes. A correlation also exists between more advanced diabetes and miscarriage rates. Patients with long-standing (>10 y) and poorly controlled (glycohemoglobin exceeding 11%) diabetes have been shown to have a miscarriage rate of up to 44%. Conversely, reports demonstrate a normalization of miscarriage rate with excellent glycemic control.

I also found this statement on Healthsquare.com:

Illness

Miscarriages are much less common in the third trimester. Those that occur are more likely to be due to maternal factors, such as an illness in the mother, than to genetic abnormalities in the baby.

Women with poorly controlled diabetes are at great risk for miscarriage. Those whose diabetes is controlled, however, whether it existed before the pregnancy or developed after conception (gestational diabetes), are no more likely to lose a pregnancy than other women. A woman may not know that she has diabetes, however, until it is discovered during a search for the cause of repeated miscarriages. The routine blood and urine tests given during pregnancy are an effort to identify this problem while it still can be remedied.

Other diseases and conditions linked to increased risk of miscarriage include systemic lupus erythematosus (SLE, or lupus), high blood pressure, and certain infections, such as rubella (German measles), herpes simplex, and chlamydia. Experts disagree about the role of hypothyroidism, or an underactive thyroid gland, in miscarriage, but it's likely that a severe case increases the risk.

With conditions such as diabetes, treating or controlling the problem can improve the odds of a successful pregnancy. Special monitoring may also be required.

This was the first I read that my uncontrolled high levels might have contributed to the miscarriage. Should I feel guilty? Did I, because of my frustrating, unruly pancreas, cause my miscarriage?

I wasn't sure I wanted to put that heavy guilt burden on myself. I am no different than most women who go through miscarriage. You wonder if that bumpy carnival ride was to blame, or if the wand ultrasound technician-sadist who poked holes in your ovaries caused too much trauma, or the hot room yoga you were doing (before you knew you were preggo) made it happen. We look for causes, look for someone or something to blame other than simple nature and randomness of life.

I decided that no, I can't. Sometimes, it is what it is. We take the lesson and move forward, better prepared for the next curve ball. I think any pre-existing or high-risk condition in pregnancy can cause miscarriage, or other problems, it just depends on the individual, and their genetic makeup. Sometimes, even with best effort, things happen.

Next time, I will be better prepared to handle the onslaught of crazy my body will go through. Next time I will expect an early, if not immediate GDM problem, and act accordingly upon the positive pee-stick result. And because of my efforts to eat better and move more now, it might just be easier. I hope. We'll see.

* I can't verify all of this information, so please remember that when researching on the Internet, it is important to find several sources that say the same thing, are reputable, and reference other works themselves. Please take the statements quoted in this email with a grain of salt, and talk to your doctor about your concerns. He'sthe expert, not me.