Liz Miller - Hope, MI
"If I hadn't had them in my circle fighting for me, I suspect I would have lost this pregnancy, too."
Exceptional Endocrine and Prenatal Care Helped Her Deliver a Healthy Baby Boy
Shortly after Liz Miller and her husband, Jeremy Jensen, moved to the Hope area last year, she had to visit the Emergency Department at MidMichigan Medical Center - Midland. Before administering an antibiotic, the staff ran a pregnancy test and the couple was surprised to learn that they were going to have a baby.
While this news would normally be cause for celebration, Miller had suffered 12 miscarriages over the course of the last 15 years. "I'd given up," she said. "I had lost too many and was numb. I had resigned myself to the idea that I would never have children."
Physicians treated her with antibiotics, but they also offered Miller advice and hope by assuring her that physicians at MidMichigan Health could help. Based on recommendations from staff members and after doing some research on her own, Miller connected with Obstetrician-Gynecologist John Lieberman, D.O., and Endocrinologist Sujay Madduri, M.D.
Miller thinks it's important that people know they can choose their provider and says they should do so carefully. "There are a lot of great doctors so do some research on your own and ask questions. Be your own advocate and make an educated decision about the physicians your work with," she said. "It's important to be an active participate, too. I had to follow through on my end."
In 2004, Miller was diagnosed with type 2 diabetes and was treated with oral medications. By 2007, she had to start using insulin. However, by 2009, she had lost a significant amount of weight and was able to go off insulin. Now she once again needed to manage her diabetes, this time more carefully than ever. "I never really got an answer as to why I miscarried so many times," Miller said.
"When Miller was referred to my clinic in January 2015, she had an A1C of 9.1 percent and was approximately eight weeks pregnant," said Dr. Madduri. "We brought her into the clinic the very next day after I received the referral request. I realized instantly that her undiagnosed thyroid disorder and uncontrolled diabetes were possible causes for her multiple pregnancy losses," said Dr. Madduri. "This was a very precious pregnancy for the couple. We started insulin shots for her diabetes and began treating her thyroid disease."
Miller was also able to get an insulin pump for tighter glucose control, and she said the pump made a dramatic difference. "It's a lot easier and reduced the stress level of my last trimester a lot," she said. Miller was also using a continuous glucose monitoring system (CGMS), a state-of-the-art technology in diabetes care. The CGMS made sure she was not having hypoglycemia (low sugar levels) that could harm her or the baby.
Miller saw Dr. Madduri every month during her pregnancy and her rapidly increasing insulin resistance required weekly increases in her insulin doses to achieve blood glucose targets. "Within weeks after her first visit, she required more than 100 units of insulin," said Dr. Madduri.
"When I first saw Dr. Madduri, my A1C was 9.1 percent and at the end of my pregnancy, it was 6.1 percent," she said.
The A1C test is a blood test that provides information about a person's average levels of blood glucose, also called blood sugar, over the preceding three months. The test is an important tool to help people control diabetes. A1C levels below 5.7 percent are considered normal; between 5.7 and 6.4 percent are considered prediabetes and levels 6.5 percent and above indicate diabetes. The American Diabetes Association recommends an A1C target or less than 6.0 percent during pregnancy and less than 7.0 pre-conception, if these can be achieved without hypoglycemia.
"When I would see Dr. Madduri and say 'here's what is going on,' he would immediately start working with me. It was the same with Dr. Lieberman. Both were willing to run the necessary tests to get to the root of my problems and they would communicate with each other," Miller said.
Miller appreciates the cooperative relationship she enjoyed with her health care partners. "I love that Dr. Madduri would listen to my concerns – truly hear me – and then give me options instead of orders," she said. "Together, we would develop a plan of care. He did all he could to make sure my mind was at ease. And I'm still on the insulin pump; it's been the best course of treatment for me. All I needed was a doctor to advocate for me."
Rexton, named for one of his dad's relatives, a WWII fighter pilot, was the first-born child to Miller in August 2015. Miller is thankful to all the people with whom she interacted at MidMichigan. "From the ER doctors who referred me to Dr. Madduri and his staff at the diabetes center, to Dr. Lieberman and his staff, they all did everything they could to help," she said. "If I had not had them in my circle and fighting for me, I suspect I would have lost this pregnancy, too."
Endocrinologist Sujay Madduri, M.D., and Obstetrician-Gynecologist John Lieberman, D.O., are accepting new patients. Those who would like to make an appointment or who would like referral assistance may contact Dr. Madduri’s office at (989) 488-5850 or Dr. Lieberman’s office at (989) 837-9400.