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Monday, October 1, 2012

Halfway There!

As of last week, I have officially lost half of my baby weight! I'm down 7.5 lbs, and I feel great about it! I got on my first pair of pre-pregnancy jeans this past weekend. I had a huge muffin top and the button felt like it was about to pop off, but they were buttoned (dangit)!

I'm losing weight at a rate of half a pound every week, which I'm happy with. I'm mainly sticking to strength training using the Total Gym because it doesn't cause my blood sugar to drop and I'm increasing my metabolism. I sneak in a 30-minute workout in the mornings while monkey takes her nap. She usually won't give me much more than that. If Trey is home or the grandparents are visiting, I will go out for a run around our neighborhood.

I'm glad that I am losing weight, but I do wish it would come off a little faster. At this rate, I'll hopefully lose it all by January--that is if the holidays don't totally mess me up.  I just wish it didn't take so much effort! I am working out almost every weekday and sometimes on the weekends. I've tried cutting back on my diet, but it never seems to be enough to warrant more than a half pound/week weight loss. I just keep telling myself that slow and steady will win the race, little turtle.

I know not everyone can lose the baby weight, so I am grateful that I've lost even this much. I just hope losing the 2nd half isn't harder. Even if I get down to my pre-pregnancy number, my body will never be the same. I'm still getting used to having a tummy, which I have never EVER had. But all this working out will mean that even at my pre-pregnancy number, I'll be much more toned than I was before monkey was here. 

Friday, August 3, 2012

What I'm Doing for Her

Today we had Monkey's 2 month checkup, and she is growing along famously!  She is 13 lbs 13 oz and 24.5 in long, above the 95th percentile for weight and height.  She literally is a chunky monkey!  I'm still exclusively breastfeeding her (And by exclusively, I mean ONLY breast-feeding!  Kid will not take a bottle to save her life.), which makes me feel good that she is getting a great source of nutrition from yours truly.  I know that breastfeeding is not a 100% guarantee against her getting type 1 diabetes, but it definitely won't be from lack of source from me. 

Since she is literally breast-fed only, it makes it difficult to do certain things because she has to be where I am or at least not longer than a 2-hour timespan.   I still haven't made it through a church service without having to go to the nursery and hide in their nursing room.  And if I have somewhere I need to be by myself (like my own doctors' appointments), I have to strategically time my departure to where I feed her right before I leave.  It's a little inconvenient, but this is a small portion of time in her life that we'll have this bond, and not everyone is blessed to be able to breastfeed.  So I'm just going with the flow (literally, ha!) and making myself available to her whenever she needs me.  Soon enough, I'll be able to leave the house without worrying about my outfit being nursing friendly. 

Also, we have decided as parents to spread out her vaccine schedule in hopes of avoiding the genetic bullseye on her back.  There is plenty of research out there about whether or not a culmination of vaccines can lead to a diabetes diagnosis later in life (so do your own googling), and I feel more at peace with introducing vaccines to her minimally rather than 3 or 4 at a time.  So for her first round of shots, she only got the diptheria, tetanus, and pertussis combination shot and the rotovirus oral vaccine today.  She'll get the pneumococcal vaccine in 2 weeks, and our pediatrician is comfortable with delaying her hepatitis B vaccine until she's a year old.  This decision was made after doing my own research and discussion with our pediatrician.  Plus, with her only getting one vaccine at a time, we avoid her getting fussy and needing any baby Tylenol and can save her from possible liver damage. 

In addition to breastfeeding and a turtle's pace vaccine schedule, we are joining the ranks of several type 1 parents and avoiding introducing gluten for the first year.  My hope is for her first solid foods to be at Thanksgiving, when she'll be almost exactly 6 months old.  There is some research to indicate that postponing gluten can make sure her immune system doesn't treat it is a "bad thing" later on and attack her pancreas--much in the same way parents with peanut allergies avoid exposing their child to peanuts until they're toddlers, only my "peanut" is glutenous carbs.  In my perfect world, I would love for her diet to be breastmilk, vegetables, and fruit until her first birthday.  As long as it's what's best for her.  

But when I'm not planning out her diet and vaccines for the next year, I get to enjoy her precious smile every morning.  She has also starting cooing and making consonant sounds in her own baby language.  The next few months should be interesting for us because we'll start to see her own personality develop.  I'm so excited to see these changes, but at the same time I would love a "Pause" button.

Thursday, July 26, 2012

Keeping Up with the Regular Stuff

Last week, I had an appointment with my General Practitioner to update some of my non-diabetes prescriptions (yes, I have some of those!) and to talk about my post-pregnancy body.  Some things came up towards the end of my pregnancy that I wanted to talk to someone about, so I made an appointment a month after I had my baby girl.  

First, I have a mole on my stomach that I've had my whole life, and at the height of my pregnancy it started to change colors on one side.  I think it had something to do with all the hormones going through my body, but I knew something changing color was not a normal thing.  My GP didn't take any chances and scheduled a surgery appointment to have it removed in 2 weeks.  She doesn't think it is anything to worry about, but she'll send it off to be tested after it's removed.  And now I can say that I've talked about the grossest thing on my body.  

But wait.  There's more! 

During the last month of my pregnancy, when my feet were so swollen that all I could wear were flip flops, I developed a wart on the bottom of my foot.  Pretty sure I exposed my foot to some yuckiness during the warm, spring months.  And flip flops are still my footwear of choice as a stay at home mom.  I tried freezing it off with that OTC wart remover stuff, twice, but it's still there.  So I brought it up to my GP, and instead of attempting to removing it herself, she referred me to a podiatrist.  I know it's one of those doctors that I should see as a type 1 diabetic, so might as well kill two birds with one stone.  

So from one appointment, I leave with one prescription and two more appointments.  I thought I was done with the plethora of doctors' appointments when my pregnancy was over, but such is not the case with this body of mine.  Hopefully the mole is just an appendage I can be glad to part with, and the podiatrist is nice to me and my ugly feet.  And now you know there's more to recover from in the wide world of pregnancy than stretch marks and sore abs. 

Monday, July 16, 2012

Losing It

Two weeks ago, I had my 6-week pp appointment with my OB. I have been cleared to resume my normal physical activities, including working out. When I was pregnant and watching the scale continue to increase, I said to myself I wouldn't worry about the number as long as me and baby were healthy. Well, now we're on the other side of pregnancy, and I'm staring at a closet full of clothes that I still can't wear. 

Officially, I gained 40-45 lbs (depending upon the scale) by the time my daughter was born. By my 6-week appointment, where I officially count my "need to lose weight", I was +15 lbs from my pre-pregnancy weight. And considering I wanted to be 15 lbs lighter than that to reach the "healthy" range, I have about 30 lbs to lose all together. 

Losing that much weight seems like a lofty goal, but I'm not planning on any crash diets or exercise regimen to get me there. I figured it took me 9 months to put it on and it will take at least that long to take it off. So I'm tracking my progress using the MyFitnessPal tracker up there at the top of my blog. This is basically my way (weigh?) of keeping myself accountable. I like MFP because they have a huge database of food to track, plus they add in calories based on exercise. So I won't go hungry because I'm starving and just ran 2 miles; I can eat those burned calories if I want. 

I started working out again last week using the Total Gym. I've said multiple times on here that I loathe going to the gym and much prefer working out at home. Plus, with a little one with me, I feel better about working out while she is in earshot. So I'll be utilizing the Total Gym, some Wii software, and some workout videos on Netflix as my arsenal for toning this flabby body. And once the weather cools down outside, I'll try to start a running routine with the jogging stroller (because neither one of us enjoy being outside while it's 90+ degrees Fahrenheit). 

As far as dieting, I'll mainly be trying to limit my carb intake as much as I can handle and upping the protein. I'll have my splurges now and then, but that keeps me sane rather than trying to go cold turkey (hey protein!). I enjoy food, and I see no reason to completely cut out a food group. Everything in moderation, right? 

I hope to find some routine that works and can be enjoyable at the same time. Because regardless of the number on the scale, I need to enjoy what I'm doing while I work out. Maybe I can enjoy my gym time as much as my daughter does:  

Wednesday, June 27, 2012

New Lifestyle, New Basal Rates

Before I got pregnant, my basal rates were dictated by my schedule.  When I got up, how busy my work was, when I tried to work out most days, when I went to bed, etc.  So I had several basal rates throughout the day.  When I got pregnant, I stuck with one basal rate for the whole day, mainly because my rates changed so often that it was useless to try and nail down a change for every hour of the day.  

I ended up being way too aggressive with my rates, giving me a lot of lows, but I justified it with the little monkey growing inside me.  But now that my daughter is on the outside and it's been 5 weeks since my surgery, I'm finally starting to nail down some basal rates that actually mirror my new life.  

And what a life it is!  My new life revolves around this sweet little girl napping next to me.  Instead of going to meetings and spending most of my day in front of a computer, usually programming something in MATLAB, I go back and forth between changing diapers, feeding my daughter, burping her, and trying to do some housework while she naps.  And that changes everyday as she gets bigger and sleeps less during the day (but she's currently starting to sleep 6 hours at night, which I can function with).  

One disadvantage to being at home all the time is that there is an abundant source of snack food at my disposal, whereas when I went to work I would only pack what I needed to eat for lunch and a few snacks.  So I'm noticing that I tend to go high around the afternoons when my snacking tends to get the best of me and I may miss a bolus or two.  Plus, with breastfeeding I tend to stay hungrier all throughout the day.  It's like I have to eat right after she eats.  

Immediately after her birth, my endocrinologist instructed me to go back to my pre-pregnancy basal rate, which I tried to remember to the best of my knowledge.  But it looks like I need about 80% of that rate right now, which is mostly due to breastfeeding because I'm still +15 lbs from before pregnancy.  This rate is perfect overnight because I usually wake up around the 80s, but I definitely need more during the daytime.  

So now that monkey and I are starting to get into a routine, I'm finally starting to make some changes to even out my numbers.  Of course, I'm sure this will all change in a few months, because diabetes likes to do that just because.  Next week is my 6-week follow up with my OB, and that means I'll be able to released to exercise.  And that's a whole 'nother post altogether! 

Friday, June 15, 2012

We Did This!

Today is a very special day for my friend Kim who started the You Can Do This project on this day last year.  YCDT is a movement for members of the DOC to post videos of their journey with diabetes for other people with diabetes to relate to, be inspired by, or simply not feel alone.  It's a great website to visit for those days when diabetes becomes too much to handle.  I know a lot of people will join me in thanking Kim for this awesome movement and what's meant to all people affected by diabetes.  

I've yet to make a video, but my idea for one is in the works.  First, I need to by some shotgun shells and a movie poster to "Steel Magnolias".  You feel me? 

Thursday, June 14, 2012

Just Call Me Bessy

Before I had my daughter, I knew I wanted to try breastfeeding.  I didn't put a lot of pressure on myself to absolutely breastfeed because I didn't want to be stressed out if it didn't work.  I knew I couldn't be a good mom if I felt like my baby wasn't getting nourished.  But I wanted to give it my best shot.  And so far it is working out great, and I've got a chunky little baby sleeping next to me for proof.  

The first time I tried to feed her was in the mini recovery room following my surgery.  She was tired and sleepy after just being born, and I was tired and groggy from the anesthesia.  So she didn't latch on very well, but it was at least an attempt.  She stayed in the nursery her first night and had some formula to feed her something and to make sure her blood sugar didn't drop (it did slightly, so they had to supplement with sugar water but she bounced back immediately).  The morning after her birthday, we requested that she be brought to our room as soon as they could bring her.  She was brought to our room around 6:30 am, and she stayed with us the rest of the time in the hospital.  

The first 12 hours after her birth, breastfeeding was challenging because newborns tend to go into a deep sleep following birth (it's a rough day, after all).  But around lunch time the next day, she and I finally got the hang of it and she fed for a good 20 minutes.  Coincidentally, this was the same time that we started receiving visitors, so anyone that came into our room had to be OK with a slight boob shot or give me time to put on my nursing cover.  They checked her blood sugar every few hours for her first day, but once we got the hang of feeding, her numbers were stellar and they stopped checking. 


The day that we were released to go home was the same day that my milk came in.  And holy frijoles it felt like I was carrying softballs in my chest!  Pumping or feeding seemed to help the engorgement issue, but those first few days were rock solid (pun!).  She continued to be a great nurser, though.  However, she tended to favor my left side.  For the next 2 weeks, she only wanted to be on that side, so I would pump the right side so I wouldn't look lopsided.  The hospital lactation consultant contacted me a week after she was born to see how things were going, and when I told her about her one-sidedness, she said to keep offering her the right side and she would eventually take it.  So I would feed her on my left side, pump the right, and keep offering the right side to her at various times.  It took awhile, but she will finally take both sides.  

Diabetes wise, I've had to run a more conservative basal rate because she eats so much that my overall insulin needs have decreased.  The one thing with feeding her breastmilk is that it is digested more quickly, so she eats every 2 hours or less.  So it is not an unusual site to see me feeding her while chugging a glass of juice.  Things seemed to have settled out now, but I have no idea if my basal rates or bolus ratios are accurate but they are keeping me from going low.  

I am very happy that breastfeeding is working out for us, and I hope to continue it as long as we can.  The problem we face now is that she like breastfeeding, literally, too much.  We've only had a few successes with a pumped bottle, she much prefers the boob.  This makes things a little awkward when we're at someone's house and she gets fussy.  "Excuse me, do you have a room I could borrow?"  I'm not the most outgoing person, but my daughter needs to be fed.  The true test comes when I will have to nurse her in public.  I just hope she's better at taking the bottle by then. 

Wednesday, June 13, 2012

Recovery

It's been 3 weeks since my daughter's birth, and I'm still recovering from the C-section surgery and the pregnancy itself.  Immediately following my surgery, my numbers shot up to the 300s for the next several hours.  I think the spike had more to do with the fact that I hadn't eaten anything in 36 hours.  I was still wearing my CGM and pump, so I was able to keep tabs on my numbers pretty well.  However, the morning after, the soreness started to settle in so I was given some acetaminophen-based medicine.  I took off my CGM and kept it off until we went home that Friday.  

The soreness was centralized in my core ab muscles, which is perplexing since my incision was down near my bikini line.  I never got a good look at my cut until we got home because the hospital didn't have any full-length mirrors, thankfully.  I honestly didn't want to look at first.  I was afraid of seeing myself as some sort of Frankenstein creature with the staples and all.  But the first time I saw them, it actually wasn't too bad.  The scar is below my bikini line, so I have the option of wearing two-piece bathing suits (Someday, way WAY in the future because my ab muscles currently look like a sad, deflated balloon).  It's about 8 in. long and has a slight pinkish red hue to it now.  It doesn't look near as bad as I thought it would while I imagined it in the hospital. 

I went to my doctor's office the next week to have the staples removed and replaced with medical tape.  The nurse who saw me said everyone was so proud of me for making it as far as I did and were sad to hear that I had to be sectioned.  But after learning what my other "option" was for a vaginal delivery, I was quite pleased to have a C-section.  Basically, if I had attempted a vaginal delivery, my vagina and rear end would have become roommates instead of neighbors.  My doctor calls it a "vaginal section".  The recovery of this procedure would have been substantial, and it might have taken me longer to be released for intimacy or bowel movements any time soon.  

Once we got home, I was instructed to lay out on the couch and not move.  My parents and Trey took care of everything around the house while I stayed busy feeding my little girl on demand.  I had 2 prescriptions filled for pain:  one with acetaminophen and one without (Motrin).  After a few days, I was able to handle just the Motrin and was able to put a sensor back on.  This was probably the best thing I could do for my diabetes management at the moment because taking care of  newborn has pushed testing to the back burner.  I am lucky to get in 4 tests all day long, so if Constance is accurate, I rely on her a lot throughout the day.  I know this isn't the proper way to use a CGM and it doesn't replace finger tests and blah blah blah, but I'm giving myself a little wiggle room while I get used to parenthood.  I'm pretty convinced that CGMs were solely created for type 1 pregnant women and moms because it has been invaluable to me for those occasions. 

I certainly don't consider myself "healed" yet, especially since I haven't seen my doctor for my 6-week follow up appointment yet.  But I feel like I'm ready to start getting my body back to where it was before I got pregnant.  I'm currently +15 lbs. from my pre-pregnancy weight, but I'm not doing any hard exercising until I'm released to do so.  The only exercise I'm doing right now is keeping up with small housework while feeding my daughter every few hours (breastfeeding burns calories!), and I'm eating roughly the same without decreasing my calories because I want to stay nourished for my milk supply.  I'm hoping in the next 3 weeks that I'll be slightly closer to my pre-pregnancy weight, because thinking about losing twice the amount of my daughter's weight is exhausting me already. 

Thursday, May 31, 2012

Birth Story: Part 2

See Part 1 here.  

Dr. P gets into her scrubs while W instructs me on how to push.  I was to wait until I'm at the peak of my contraction, hold my breath, curl over my stomach, and push into my bottom like I'm about to poo.  I would push for 10 seconds, take a breath, and do it again 3 times for each contraction.  The next contraction comes and I go to push.  I pushed so hard I started shaking.  The nurses told me to hold my breath and go again.  I would get 2 good pushes, but the third was too exhausting for me to give my full strength.  

Pushing wasn't relieving or felt like it was going anywhere.  Dr. P checked me in between contractions and she had a look on her face that I knew wasn't good.  "Listen, sweetheart, if you want to get this baby out, you're going to be pushing for a long time.  I'm just warning you.  She's still really high."  Her words were discouraging, but they didn't stop me.  I kept pushing as hard as I could.  All the nurses were really encouraging and kept telling me how good I was doing, but Dr. P's face remained cold.  She checked me again and told me that baby was sunny side up and still really high.  (Note: A sunny side up baby is really difficult to push out because a baby's spine naturally curves into a C-shape while in utero.  So a baby facing up is coming from the back part of the vagina and against gravity.  It's like trying to take a poop upside down.)  She said if I had had an epidural that she might have been able to turn her.  Go figure, my plan to avoid pain meds to keep the labor progressing backfired on me.  

I tried a few more pushes, but still nothing was happening.  Dr. P got really serious with me.  "I know I'm not your doctor, so it won't hurt my feelings if you want to wait.  But I'm telling you now, it's looking futile for the baby to come out this way."  She asked what I wanted to do.  I looked at Trey and he said, "Do you want to go in and get her?"  I shook my head and said I wanted to wait on my doctor.  Dr. P went to go call my doctor on her cell phone, but as soon as she hit send, he comes through the door.  Everyone let out a "Hey!" because it surprised all of us.  Dr. P caught him up about my sunny side up baby and the fact that I had been pushing for 1.5 hours and the baby wasn't moving.  My doctor let me try a few pushes with him there, and he agreed.  With the greatest sincerity, he looked at me and said, "You can keep pushing if you want.  Baby's heart rate is fine at this point, but it's unlikely that pushing would change her position.  Or you would push just enough that she could get stuck, then it becomes an emergency situation.  If you were my wife, I would tell you it would be best for both of you if I go in and get her."  

I turned to my left and looked at my husband.  "I can't make this decision by myself.  What should I do?"  Stroking my hair, "I want both of you out of here in one piece.  Let's go get her!"  I turned back to my doctor.  "Is that what you think I should do?"  "I do, sweetheart.  Let's get her now while she is still in good shape."  At this point, all eyes are on me.  It didn't matter what my doctor thought, my husband thought, or what the janitor thought.  I was the one who needed to make this decision.  The silent pause was deafening.  I closed my eyes and said, "OK, let's go get her."  

Everyone started moving.  One of the nurses gave Trey some scrubs to put over his clothes.  I leaned over in the bed, still trying to get through the contractions I was feeling.  But without the pressure to push, I just clenched up and tried to get through the pain.  Before the nurses took me out, my doctor leaned over the bed, put his hand on my head, and whispered, "I'm so sorry.  I know this wasn't what you wanted.  But I promise it will be fine."  I shook my head in agreement.  "I know."  

The doors opened and I was wheeled into the bright lights of the hallway down to the operating room.  A contraction hit right as I was wheeled into the room.  So the anesthesiologist had to wait to administer the spinal until it was over.  An older nurse, who I never got her name but I affectionately referred to as "Madge", helped me sit up and let me hug her while the contraction had me writhing in pain.  Once the contraction was over, the anesthesiologist gave me a shot of morphin to calm me, then the spinal.  As soon the spinal took effect, my legs immediately felt like jello and the relief was overwhelming.  I was feeling GOOOOOOD!  All the pain was gone, and I was calm enough to take in what was happening.  I kept asking where Trey was, and the nurse said he's right outside.  (I would later learn that he and my doctor were outside talking together, and they were discussing how I much I had made the right decision.  But more on that in a later post.)   

My doctor comes in and asks me if I could feel the pinch he just gave me.  I couldn't feel anything past my chest.  I joked that I would pinch him later.  I could hear him laugh underneath his mask.  In the pain-free state I was in, I got the courage to thank him for everything he had done for me since day one of my pregnancy.  "My pleasure," he said.  Finally, Trey comes in, scrubs and hairnet attire, and takes a seat at my head.  He kissed me on the forehead and told me he loved me and how proud he was of me.  Not sure if kissing was allowed in the operating room, but we stole one as our daughter was being born. 

Not 5 minutes later, one of the nurses asked if Dad had brought a camera.  In the chaos from the labor and delivery room to the OR, no one thought to grab our camera.  I remember I said that it was OK, that I didn't want my baby's first pictures to be from a surgery room.  A few seconds later, I hear this gurgling sound followed by a baby crying.  My baby was crying!  Trey stood up and looked over the curtain to see.  I started crying and listening to the sounds of her strong lungs.  Trey got up and went with the nurse to wrap her up.  They brought her over to me and showed me her head full of hair and all her fingers and toes.  "Give her a kiss, Momma.  She's going to go with Dad to be checked out."  I gave her a kiss on her temple.  Her skin was so soft and warm.  "Hi there!  I'll see you later, OK?"  And my daughter left in my husband's arms to the nursery.  

My doctor stitched me up.  I remember at one point that one of the nurses asked "Staples or sutures?"  "Staples, she's diabetic."  I was so tired.  I kept looking at the ceiling and coming down from the high of the pain and the few seconds that just happened.  I almost fell asleep right there.  After I was put back together, I was wheeled into the short-term recovery room.  

In the recovery room, my first nurse K was there and going over my vitals.  She said I would be here roughly an hour.  Trey walked in, no scrubs but still with a hairnet, holding our daughter in a burrito swaddle.  "You wanna hold her?"  I only had enough strength to nod my head.  Because I was still so out of it from the surgery, Trey helped me put her on my chest.  I kept staring at her.  She looked like my dad.  All the grandparents came in one-by-one to check on me and to take another peek at our little girl.  We both just laid there and I took in the moment that I was holding my daughter.  I didn't want to be anywhere else in the world at that moment. 

Wednesday, May 30, 2012

Birth Story: Part 1

It's been a week since my daughter's birth.  And I finally feel ready to blog about it.  Partly because I've finally had time to collect my thoughts on it, but mostly because I've had time to deal with it emotionally.  Let's get one thing straight first:  I have a perfectly healthy little girl sleeping in my lap right now and that was always the priority.  But I want to be sincere about how things went, that's always been my goal with this blog.  If you wanted to stop by and read a pleasant birth story that ended in rainbows and unicorns, then I suggest you search on.  I also will not spare the gruesome details (Sorry, guys.) because I am writing this story as if I'm writing to myself from a year ago.  I wanted to know all the gritty details, emotions included.  With all that said, on to the story!

My doctor scheduled my induction beginning Monday night the 21st.  Trey and I went in to the hospital around 9 pm to check in.  My nurse K instructed me to lose all my clothes (but I was given the option of keeping my bra, which I took) and gave me a smock to wear that tied on the side.  Then she set up the fetal monitors on my belly that would keep track of baby's heartbeat and my contractions.  As soon as she set up the monitors, she could see that I was already having contractions of my own!  Really small ones, about 5 minutes apart, that I couldn't feel at all.  So that was encouraging to hear.  Because I was already contracting on my own, I was only give a half dose of cytotec to soften up my cervix (which was still at 1 cm, 80% effaced).  She put in my IV, which was the worst part for me to get through.  Trey held my right hand while she inserted the needle into my left vein.  My blood pressure rose during this part, but that was the only time it gave me any trouble.  

Finally, we were left to sleep for 4 hours until she would come back and give me the other half dose of cytotec.  At this point, I still have my pump on and keeping track of my blood sugars myself with testing and my CGM.  About 15 minutes before I was to get my second round of cytotec, I had a bad low blood sugar of 44 mg/dL.  The contractions I wasn't feeling were starting to have an effect on me.  I brought my own juice boxes, so I drained 2 and turned off my pump (it stayed off until about 9 am the next morning).  I took the second dose of cytotec and started feeling mini contractions around the time I woke up at 5 AM.  They weren't painful, just exciting because I was started to feel something.  

At 7 am on the 22nd, I met my day nurses W and M.  They would be by my side during the entire labor process.  They checked me again and I was now 2 cm but still 80% effaced, the goal of cytotec was to get me to 3 cm.  They went to consult my doctor to see if they wanted to administer another round of cytotec, which would delay starting the pitocin another 4 hours, or if we wanted to get the show on the road.  The result was to go ahead and start pitocin.  So by 7:45 am, I was on the pitocin IV drip.  I asked W when I would start feeling anything, and she said it usually takes about an hour.  At this point, things were not painful and, honestly, kind of boring.  I practiced breathing through the mini contractions that I did feel while listening to the radio on my iPod.  

The nurses contacted my endocrinologist about putting me on an insulin drip, but he made the call to let me keep my pump on and check myself every hour.  I was forever grateful that decision was made, because it gave me control in a situation where everything else was out of my control.  So I was checking myself every hour, and the nurses would record it.  I was cruising in the 150s for most of my labor, but my endocrinologist said that was fine as long as I didn't go over 200.  I think the risk of me going low during labor was more important than trying to keep a perfect 100 the whole time. 

At 9:30 am, my OB came in and greeted me.  He gave me the option of continuing with my labor as it was or going ahead and breaking my water.  I chose to break my water because I still wasn't feeling the contractions and I was still at 2 cm, so I figured we needed more momentum.  After my water was broken, I got on an aerobic ball and started breathing through my contractions that started to be noticeable.  Nurse W asked what would be the best care for me, and I said I just didn't want to stall out on my labor.  I wasn't afraid of the pain because I have  pretty high pain tolerance.  I was only worried about my endurance and being in labor for days!  So W wrote on the white board on my wall:  "Keep things going" as my goal for care.  

About an hour later, I hit active labor.  My contractions were coming in waves and becoming more intense, but still nothing I would consider painful or something I couldn't get through.  So far, Trey has just been hanging out with me and eating breakfast.  I told him I would let him know when he needed to come into the game.  All I said was "I need you" and he jumped in like a pitcher coming out of the bull pen.  He applied counter pressure to my back and hips through each contraction.  And in between contractions he rubbed my shoulders and feet to give me comfort.  The ball worked great for me in working through the contractions.  The best position for me was being on the ball, rocking back and forth, with Trey behind me on the edge of the bed or in a chair.  Also at this time, my contractions required all my concentration.  So when it was time to check my blood sugar, I would just stick my hand out and Trey would check it for me.  I know I wouldn't have made it through labor without his support.  

Around lunch time, my doctor came to check me again and I was at 4 cm.  I was starting to get a little frustrated with how slow this whole thing was going.  So M suggested that I labor on my sides for awhile to help the baby move down into my pelvis.  This was not a comfortable position at all, but it seemed to intensify the contractions.  Trey got out the heating pad we brought and applied it to my back during my contractions with pressure.  He eventually had to go eat lunch, so W and he rotated out during back compressions.   The pain was increasing, and I started low moaning.  I thought I would feel embarrassed doing this, but the nurses actually coached me through the breathing so I didn't feel so awkward. 

Sometime in the afternoon, M was keeping an eye on baby's heartbeat.  She was fine, but she wasn't responding to the contractions like they wanted.  So they gave me an oxygen mask to wake her up.  The mask was great because it gave me cool air to breathe and was very relaxing during this whole process.  At this point, I'm laboring on my knees on the bed, leaning over the back of the bed.  So imagine this picture:  a woman in labor, wearing a smock, low moaning every 2-3 minutes like a cow, with an oxygen mask on her face.  I had officially lost my dignity.  

Around 5 pm, things really picked up because I was at 7cm, 90% thinned out.  "Sweet!"  I remember sighing.  Trey laughed.  This meant I had made it.  I was at the point of no return for pain meds and it looked like I would be delivering my baby soon.  However, the contractions were increasing in intensity.  It took all my strength to moan and breathe through them.  Only once did I say, "I can't do this!" to which Trey quickly responded "Yes, you can.  You are doing it!"  I just had to get through each contraction and rest.  I felt enough relief in between each contraction to refill my energy tank.  

It seemed like I went from 7 cm to fully dilated within an hour, so the nurses went to call my doctor and have him come over for delivery.  Meanwhile, my contractions were stretching my pelvis to the max.  It felt like I had a 25-lb. medicine ball that was being stretched to a 50-lb. ball and deflating back down to 25-lbs.  I wasn't getting the full relief of the contractions I had at 7 cm.  Also, M told me that my doctor got called to an emergency surgery, so I had at least an hour before I could start pushing.  I went from low moaning to grunting/screaming during contractions, squeezing the bed rails like I was going through an exorcism.  They turned off the pitocin to hopefully give me some relief before my doctor could get there.  It didn't help.  My contractions went from every 2 minutes to every 3 minutes, but still no downtime from the pain.  

After an hour of being fully dilated, the nurses decided that the baby was coming soon and someone needed to be there to catch it.  So they got the on-call doctor and my room doubled in audience almost immediately.  I initially requested that Trey be the only family member in the room when the baby was born, and I'm glad because I'm not sure where anyone else would go!  I had my 2 nurses, the baby's nurse--who I would officially meet the next day--prepping the incubator table right next to me, and 3 delivery nurses (not sure, but I think one was an observing student).  They brought up the stirrups for me to start pushing.  I was so exhausted from being in labor for 10 hours, but I felt relieved that the end was in sight.  I just needed to muster the strength to push.  

The on-call doctor comes in and introduces herself while I'm fully naked (minus my sports bra) with my goods pointing straight out to the world, sweat pouring out from every surface I had.  "Hello, I'm Dr. P and I'll be delivering your baby." 

Part 2 . . .

Saturday, May 26, 2012

In Love

It's been a crazy week at the hospital since my induction started on Monday night, but most importantly is the fact that my daughter is here and healthy.  She was born on May 22, 2012 at 7:18 pm, 8 lbs 8 oz and 20.5 inches long.  She is perfect, from her full head of hair to her audible poops.  Full story to come later, until then a picture!  

My beautiful daughter!
A picture worth a thousand kisses.

Monday, May 21, 2012

Dear Daughter

Dear Daughter,

Hello, Sweetheart. I don't know if you can hear me, but you seem to respond when I laugh or hear Daddy talk. So I'm going to assume that you can for just a little bit.

Tomorrow is a big day for you because it is your birthday! I know it's probably not what you're expecting. I know you'd rather hang out in your hot tub for a few more days or weeks, even. But this is hopefully the ONLY time in your life that diabetes will affect a moment in yours. I did my best to give you the proper place to grow for the past 9 months, but the doctor thinks it's best for you and me if you came out now. Don't be scared. They are the very best and they will keep an eye on you and me the whole time. Then I'll get to hold you just as I have been this whole time, only this time it will be with my hands rather than my belly.

One thing I want you to know more than anything is that you are so SO wanted! What started out as a silent prayer said at Cocoa Beach, Florida turned into your heartbeat a few days later. You are so strong! From your fast heartbeat at every appointment to the kicks and jabs you give me, you've proven to me and your dad that you like to make your presence known. I can't wait to get to know you! Your dad is in love with you already, and he is so excited to meet you. Lean on him for love and encouragement, he will freely give it. We will do our best to teach you about your Heavenly Father who loves you more than we do, if you can believe that!

I'm so anxious to meet you, and I can't wait to hold you. I love you so much!

Love,
Your Mommy

Friday, May 18, 2012

38 Weeks: Ready or Not, Here She Comes

This week has been a real busy week in preparing for our daughter's arrival.  I had so much anxiety about my OB appointment on Wednesday because I was worried about her size and being induced earlier than I wanted.  This appointment would also be my last regular appointment before the 39 week goal that my doctor set for me.  I wanted to end things on a good note and go into my induction with hope and optimism.  I also had my last endocrinology appointment on Thursday, so I was rounding things out in my last week as a diabetic pregnant woman.  

My OB appointment started out with an ultrasound again to check on baby's size and fluid levels.  Last week, she was measuring around 8 lbs 10 oz, and my doctor was worried about her getting over 9 lbs and being too big for me to push out.  Thankfully, it seems my daughter has ceased growing and is just chilling out in there because she came back at 8 lbs 11 oz this week.  My fluid levels were still good, too.  My doctor still seemed puzzled by the fact that I was carrying a large baby when my diabetic control has been as good as it's been.  I explained to him that Trey and I were both 9 lb babies when we were born.  And it was as if a light bulb went off in his head and he exclaimed, "Oh, well that explains it!  You just breed big, healthy babies.  That's all!"  So it turns out that I'm a "big breeder", nothing more.  But it does give me more pressure to keep stellar control for other pregnancies since my kids will more than likely land on the larger side anyway.  

My blood pressure came back fine.  Not great, but it wasn't higher than last week, so my doc didn't seem worried about it.  Next was my first internal exam.  I have to admit that I was really worried about this.  I had read horror stories about how painful they were and they could accidentally strip your membranes and put you in early labor!  Well, it wasn't nearly as bad as I thought, just went to a happy place and counted the tiles on the ceiling.  Right now I'm 1 cm dialated and 50% thinned out, which my doctor said is very optimistic before being induced.  Looks like my dedication to walk 2 miles everyday in these last few weeks might have paid off.  

The plan is if I haven't gone into labor on my own by Monday at 10 PM (which I highly doubt), I am to go to the maternity center and check in to start the induction process.  They'll start with something called cytotec that will thin out my cervix even more overnight.  The nurse told me that sometimes it is enough to send some moms into spontaneous labor.  Then we'll start an IV of pitocin, the drug that kick starts labor, early Tuesday morning.  After 3 PM on Monday, I can only have clear liquids (water, sports drinks, jello, chicken broth, etc.) because the drugs can cause some nausea.  

Yesterday, I had my final endocrinology appointment before having my daughter.  The nurse checked all my vitals while my A1c was spinning.  I asked for a refill on all my prescriptions, just in case I might be close to running out and I wasn't coming back to the office for 4 months.  I have been spoiled a little bit by coming in once a month, I don't worry about checking my prescriptions before I come in for an appointment.  My A1c came back at 5.3%, which makes my overall pregnancy range 5.1 to 5.6.  I was quite proud of myself at this fact and feel confident that I did the best I could, diabetes wise, to give my daughter the safest place to grow.  My endocrinologist and I discussed the plan for me during labor.  I'll keep my pump on until they start the pitocin, and I'll keep it off until she is born.  "And I can put it on right after, right?"  I'm not a big fan of IVs, so I have this image of immediately ripping them out (a la the Hulk) right after I hear her first cry.  They will check my blood sugar once every hour while the IV is in, but of course I can check at my leisure as well as having my CGM.  Then I can reconnect the pump using my pre-pregnancy basal rates and bolus ratios, because once she's out and the placenta is delivered my insulin needs will dramatically decrease.  

So everything is set in place.  My daughter will be here by this time next week.  I got a little emotional leaving my OB's office after scheduling the induction.  I wasn't scared or anxious, just overall emotional from the culmination of "This is it!  She's coming!"  This weekend, we're busy doing last minute things and preparing for incoming family.  We're also planning a last date night that involves a movie trip (Battleship) and a trip to Babies-R-Us to pick up last minute things.  I've also been busy putting things in the hospital bag, most of it we may not need.  The car seat is in the car, along with the essential Boppy.  

I'm excited to meet her, but I'm more scared and anxious right now.  I'm mentally putting on my game face and getting ready for what the labor process will be like (and how long it will take).  I'm afraid I'm not strong enough to handle it.  But at the same time I have no idea what to expect, so I'm hoping I surprise myself.  I just keep imagining that moment when the doctor says "She's almost here!" and I hear her first cry and we get to hold her, finally.  That moment is my trophy that I'm running towards. 

Thursday, May 10, 2012

37 Weeks: Not Yet

I'm there!  I'm officially considered full term, which means that my little girl could choose to make her arrival any day now.  However, I'm not holding my breath because most of the women in my family tend to go over their due date.  But it means that I've reached a huge hurdle as a high-risk type 1 diabetic by making it to full term.  Every week from here on out is a victory lap.  

I had my official 37-week appointment yesterday, too.  I was really excited about the first part of my appointment because it began with an ultrasound to see how my girl is doing.  Her heartrate was steadily beating along in the 130s--slower than what she has been so it means she is running out of room to do her aerobics.  Her fluid levels and placenta were still great, so there's no worry about placenta abruption, something that's usually a concern with diabetic pregnancies.  She is also head down and face in, the perfectly engaged position for a normal labor.  I'm happy about that, but part of me is still wishing that whole stork idea will pan out.  

However, her size was something took us all by surprise.  She is perfectly proportioned but measuring about 2 weeks ahead and weighing an estimated 8 lbs 10 oz.  I was a little shocked by that number, and so was my doctor.  He told us that if she got to 9 lbs or more that he would offer us the option for an induction.  At closer to 10 lbs, he would recommend an induction (and I would probably agree).  Trey and I were both 9 lb babies when we were born, so I'm not exactly expecting a peanut-sized baby.  But I don't want her to get too big, especially if it's my fault.  My doctor was quick to mention the correlation between diabetes and big babies, but I'm skeptical to think that's 100% the cause.  I'm also aware that ultrasounds can be off in measurements the further along the baby gets. 

After my ultrasound, I had my standard appointment stuff:  urine sample, weight, and blood pressure.  My sample and weight came back fine, but my blood pressure was elevated at 140/90.  For the past month or so, I've had readings come back in the 120s/70s.  Since my urine sample came back with nothing in it, no one was concerned.  But my doctor said if it was still elevated at my next appointment in a week that we would look at inducing earlier than 39 weeks.  I also found out that I am Strep B positive, so I have to be put on antibiotics before I'm induced or as soon as I go into labor.  These were the less than positive things that happened at my appointment.  

I made my appointment for exactly a week later when I'll be 38 weeks.  I really don't want to have to make the decision to induce next week if her size comes back close to 9 lbs.  I worry that my body isn't ready to go into labor, and I don't want to force my body to do something it's not ready to do.  I'm hoping my rogue blood pressure spike will settle itself enough to not force my doctor to send me to the maternity center right away.  Our goal has always been to get to 39 weeks, so I would only be 1 week away from that goal and my baby girl is perfectly healthy enough to handle labor.  But I want to finish this thing on a positive note and not feel like my body is giving out at the last lap.  

Frankly, I'm just not ready.  I know plenty of people have babies before their due date and they come out just fine.  But I want to give my girl as much time as she wants before she makes her arrival.  I know that might sound weird for a 37-week pregnant woman to say, but I'm not screaming, "Just get her out of me!"  I'm uncomfortable, sure, but I want to do what's best for her.  I keep telling myself, "Just one more week. Just one more week."  This whole journey for me has been done with that mentality, so I just need to get to next week and say it again. 

Wednesday, May 2, 2012

Deciding to Bank

There are a lot of big decisions that need to be made before having a baby.  "What kind of travel system should we get?  What color should we paint the nursery?  What prenatal classes should we take?  What hospital should we go to?"  Just to name a few.  And when you get towards the end of the pregnancy, you start thinking about planning for the child's future.  This could involve opening a 529 savings account for her education or putting aside money for her future wedding (kids, especially girls, are expensive!).  

One of the things we've also decided to do for our daughter's arrival is plan for her medical future.  In short, we've decided to bank the cord blood following her birth.  If you don't know much about cord blood banking, the basic premise is that the cells in the umbilical cord are a form of the child's own stem cells.  The blood is stored and cryogenially frozen in a fancy scientific facility.  These stem cells can be used to treat a plethora of diseases from various forms of cancer, blood disorders, and immune deficiencies.  (Can you guess where this is going?)  In addition to treating diseases, there's a lot of research being done with stem cells from cord blood.  And there's a lot of research being done on using stem cells to regenerate the pancreas for someone with type 1 diabetes.  (I tried to find a web reference for this last sentence, but I don't want to bias someone's opinion based on one source.  So google "cord blood banking type 1 diabetes" if you want to do your own research.)  

Banking the cord blood is something that I had thought about before but didn't seriously consider until we met a representative for a local cord blood banking company at our prenatal class.  We asked a lot of questions like "Can we use the cord blood for other children if we decide to only do it once?  What security measures are taken to insure the quality of the cord blood over time?  How much?$?$?"  Banking the cord blood is not an inexpensive endeavor, but considering the amount of diseases that can be easily treated with it, we believe it is worth it.   And if the research continues to progress in treating type 1 diabetes and, Heaven forbid, our daughter gets it, I like knowing that we have some sort of plan for attempting to keep it at bay in the long-term.  

This was an extremely personal decision for us as parents, much like a lot of things when it comes to being parents (breastfeeding vs. formula, where they go to school, crunchy vs. creamy peanut butter--this is a source of conflict in our house because I favor creamy and Trey likes . . . the wrong kind, etc.).  So I'm not saying that every parent should bank their child's cord blood.  And I'm not saying every parent that has type 1 diabetes should bank their child's cord blood, either!  Some people can't justify the cost and annual fee or don't believe that the research is far enough along to invest in its promise.  We went through all these discussions as we were deciding to go through with this.  In the end, we felt that this is a one-time action that we could potentially use to save our daughter from a significant amount of diseases.  If 10 years from now she developed some cord-blood treated blood disorder, we would regret not doing this now. 

My only suggestion if you want to consider cord blood banking for your child in the future is to do your research, find a reputable company and machine gun them with questions, and go with your gut feeling.  I feel at peace with our decision.  And I feel very giddy that I got to talk about something scientific on my blog for the first time!  =)

Monday, April 30, 2012

Tough Weekend with Arnold

In the 4.5 years that I have been on an insulin pump, I've had very few instances where the pump had a malfunction.  Usually, I can contribute any random highs on operator error.  But this weekend, I had several instances where I was so frustrated with my pump that I want to call my endocrinologist to go back on MDI (haven't yet, but I'm still considering it).  

I guess it all started when I noticed that my most recent box of infusion sets seemed to be made of flimsy plastic because I would have little bits break off when I would insert the cap into the reservoir.  It never caused any trouble with the pump working, so I brushed it off.  But Saturday morning, I woke up to a high BG of 219 mg/dL, which is a far cry from the 100ish average I try to maintain in the last month of my pregnancy.  I got up to confirm the high alarm, and noticed that the tube on my pump was dangling towards the floor and not connected to the site on my thigh.  "Oh, well that explains it."  I reconnected with a new infusion set, and bolused a correction.  

The problem was that I was never able to get back into normal range, despite dialing in correction after correction.  I feel into a heap on the bathroom floor because I was so frustrated.  Even rage bolusing wasn't working.  (And by rage bolusing, I mean 5 extra units "just because".)  I finally come down after 5 hours of being above my preferred line.  The rest of the day went on as normal.  

Then yesterday, I laid down to take a nap (random occurrence for me these days) and when I woke up I started going high like I just ate a cupcake sprinkled with sweet tarts.  But I hadn't eaten anything in 4 hours!  I got up to 297 mg/dL and three failed correction boluses before I finally gave myself an injection, ignoring all of my active insulin.  I finally came back in range 2 hours late to 125 mg/dL without a crash, which should have been inevitable considering I gave double what I needed.  

After 2 calls to Medtronic, we decided that I have a bad box of infusion sets.  So I changed my site for the 3rd time in two days with a new reservoir and infusion set from a different box.  I bolused for dinner after not eating for almost 8 hours and waited to see if my blood sugar would actually come down before I took a bite.  Thirty minutes later, I was cruising towards my low threshold, so I concluded that the new site was working.  

Even today, I'm still not happy with how quickly my insulin takes to work.  Everything with my site change yesterday was new, including a fresh, cold vial of insulin from the fridge.  But so far I've had to give 2 additional corrections following breakfast.  It might be that my insulin:carb ratio needs adjusting (again!), but I still am not happy waiting over an hour for my insulin to bring my blood sugar down.  

I feel absolutely hopeless when this vital technology fails me.  I don't want to go back to MDI, but the time it takes for insulin to kick in is considerably less than waiting on a bolus from the pump.  It may save me from lows, but I'm spending far too much time over 100 mg/dL to justify it.  Even thought my last A1c was fine (5.6%), I don't want to let up in these last 4 weeks of pregnancy.  I want to keep the same steam that I've had the whole time.  And I can't do that when I don't trust the technology that I rely on to keep me there.  

It's the final lap, Arnold.  Do we need to come in for a quick tire change and fuel up before we win this thing? 

Friday, April 20, 2012

High Risk Outcast

For the past month or so, I'm thankful to say that my pregnancy has been fairly boring.  My weight gain has plateaued (34 lbs.) and so has my insulin resistance (42 units basal, and 1:6 bolus ratio).  The last 2 OB appointments have gone very smooth; in fact, I've spent more time in the waiting room than actually seeing my doctor.  My blood pressure and urine have all come back fine, which I count as a huge blessing.  For most of my formerly-pregnant friends who ended up getting complications such as preeclampsia, the symptoms started showing by now.  So I feel like I've beat some personal goal by making it to 34 weeks and everything about me seems like a normal, non-diabetic pregnant woman. 

But I feel very at home with my OB, and he treats me as a unique patient and doesn't generalize me for my type 1 diabetes.  That hasn't been the case everywhere else.  For example, at our prepared childbirth class last weekend.  Initially, I was very excited about this class because I wanted to get an idea of what to expect during labor (either naturally or induced) and I was anxious to tour the maternity center where I would be giving said birth.  

The class started out great.  We went through the overall process of labor from early labor to transition to PUUUUUUUUSHing.  The morning teacher made me feel like I could handle the type of labor I wanted because it is 90% mental anyway.  Plus, she said regardless of how long ago it happens, every woman remembers the details of her child's birth.  So it's so important to mentally prepare yourself and fight for what you want.  We broke for lunch, and I felt great.  At this point, no one knew I was a type 1 diabetic or that I was considered "high risk".  

Then came the afternoon, and a different teacher took over.  Her job was to talk to us about medical interventions like inductions, epidurals, and C-sections.  I wasn't scared of this part because I figured some of these interventions might be in my future.  Before we got into the part on C-sections, the teacher threw out this random statistic because she had just got back from a conference on diabetes and pregnancy.  "Did you know that 85% of all diabetic pregnancies end in a C-section?"  And she starts the video.  

I lost it.  I looked at Trey and said, "Well, isn't that wonderful?"  Tears began falling down my face.  Snot was running down my nose.  And I had to muffle my mouth from the heaves that were coming up.  Really?!  85 percent?!  So even if I do everything right, I only have a 15% chance of having a vaginal delivery?!  I was distraught and could barely pay attention to the video.  It ends and the lights come on.  I calm myself enough to listen to the cord blood banking guy, the last talk before the maternity center tour.  

I tried pushing that number out of my mind while we went on the tour.  I reserved that I would deal with it later.  One of the reasons I chose the hospital I chose is because a) my doctor is right next door and b) they have these LDRP rooms where every process of labor is done in one room.  I wouldn't have to labor in one room and then be escorted to another room for recovery.  These rooms are great, they're set up like your grandmother's bedroom with a quilted bed, rocking chair, and warm decorations.  The same afternoon teacher told us that these rooms have everything that a typical LDR room has, but you get to stay here the whole time after baby is born.  "However, we typically only use these rooms for our low-risk patients."  I raised my hand and revealed myself to the whole class.  "So with me being type 1 . . . "  She responded, "Yeah, it's unlikely you'll get to use these rooms."  Again, I was shot down due to my category and nothing to do with me.  

Trey and I got in the car and headed home, and I felt like I had completely wasted the entire day.  I felt so defeated.  I don't care if I have to have a C-section or have to be quarantined to a room deemed suitable for high-risk patients if my daughter comes out healthy and safe.  BUT.  I feel like my story has already been written even before I'm there.  I want to have some say in how my body is dealt with, but right then I felt like I was just at the doctor's will.  I cried the whole way home, and that's a long 30-minute drive.  

Thankfully, I had an OB appointment this past Monday, and I basically told him everything that happened at the childbirth class.  I told him I felt very discouraged.  My doctor, always the sensitive guy, looked me in the eye and said, "That's not true.  That 85% MIGHT be true for uncontrolled diabetics, but definitely not for you.  And you have the choice to use the LDRP room, I'll see to it.  As far as I'm concerned, you have a good chance at a vaginal delivery."  I dried my eyes that had been wet for the past 2 days, and made my appointment for 36 weeks.  My endo even told me that given how good my pregnancy has gone, he would let me go to 40 weeks no problem.  

I know I shouldn't let these things get to me.  I should be used to people generalizing diabetics into some doomsday category.  My story is still unwritten.  I want every pregnant type 1 to know that they don't have to submit to anything that "should be" just because of our category.  We are high-risk, not "high maintenance enough that we don't want to give you a chance".  Several people have already asked me if they were going to take my baby early or if I have a C-section scheduled.  No and no!  If you take away this stupid disease and just look at ME, I am 100% healthy and so is my little girl.  Let's take off the vial glasses and look at ourselves as individuals.  Because as one of my good friends says, "Diabetes doesn't define me (!), it just explains me." 

Monday, March 26, 2012

Midnight Low Etiquette with/as a Houseguest

Late night lows are no fun.  They make me lose sleep, I consume extra calories that I don't want to, and I worry afterward about over-correcting.  My usual routine for late night lows is to shift out of bed, stumble down the hallway to the kitchen, drain some juice until I stop shaking, and follow it with some peanut butter (the only tasty saving grace from a low).  This stumbling routine is fine with just me and my sleeping husband in the house.  However, it's a whole different game when we have guests at our house or we're guests at other people's homes.  

We normally have guests sleep over about once a month, usually out-of-town family members.  Most of the time, guests stay in our guest bedroom that is closed off from the hallway and my stumbling ways.  However, we sometimes have enough guests that a few people have to snag a couch in the living room, right in the path to the kitchen from our bedroom.  So handling lows during this situation requires a little more thought, something that's hard to do with low brain.  

First of all, I have to remember to get appropriately dressed before I walk through the house.  I don't like pajamas, never have.  But I try to remember to wear . . . something . . . when we have people over, but it's hit or miss.  But that's why God (and The GAP) invented robes.  But putting on a robe is exactly what I want to do when my body is drenched in sweat (/sarcasm), but I do in case I happen to wake anyone sleeping on the couch.  I also have to be careful about turning on any lights, which I tend to do at each turn when it's just me walking through the house.  This is where that trusty light function on the pump comes in handy.  And to avoid that bright refrigerator light, I will go for a banana sitting on the counter top instead of juice.  Then I stealthily grab the peanut butter from the cabinet and a spoon from the drawer and head back to my bedroom.  Thankfully, I've never woken any houseguests (that I know of) or they haven't mentioned it the next morning.  

The other side of this scenario is when we're staying at someone's house as a guest.  Most of the time, this scenario is either at my or Trey's parents' house.  In both cases, the guest room is closest to the kitchen.  So I do the same SEAL-like operation but in somewhat unfamiliar territory.  And I usually settle for whatever I find to treat my low--cranberry blackberry juice cocktail with a granola bar?  Sure!  One time, I was looking for a piece of bread to munch on after drinking some juice at my in-laws.  I happen to wake up Trey this time and he walked into the kitchen, sleepily looked at me and said, "What are you doing?"  I was trying to open a pantry with no handles.  "I'm trying to open this thing but there's no handles and I'm really low and want to sleep where's the peanut butter sad face."  He helped me open the magic pantry and we found some bread on the middle shelf. 

Now, some people may ask why I don't just resort to glucose tabs in these situations.  Here's the thing:  those chalky tabs don't work well enough for me.  Even if I can get up from a low with those things, I still need some good protein to follow them to keep me from crashing again (hence, peanut butter).  I have a jar of those in my purse, but I save them only for when I'm trapped somewhere without juice or money and access to a vending machine.  There are truly a last resort treatment option for me, and it's worth the risk of pouncing through the house in the middle of the night in my underwear to avoid them. 

Tuesday, March 20, 2012

30 Weeks: More of the Same

Things are starting to speed up on the pregnancy front these days.  I've began going to my OB every two weeks, and I'm still seeing my endo once a month.  So that means I have an appointment every week for 3 weeks out of the month.  But my appointments are as quick as going through a revolving door.  It seems that each appointment is simply checking for any problems (blood pressure issues, protein in my urine, weight check) and sending me on my merry way.  Thankfully, nothing is sending up any red flags, so I'm in and out very quickly.  

Endo:  

I had my 7 month endo appointment last week.  I wasn't that worried about my A1c because my numbers had been pretty stable over the past few weeks.  I've got into a groove where I'm changing my site every 3 days or less, leaving my old site in for a few hours to prevent any highs, and steadily increasing my basal rates once a week.  I've been in this groove since about 25 weeks, and it seems to be working.  Even though I have my bad days, I wasn't worried about the result because I had had an ultrasound the week before and I knew my little girl was growing as she should be with no evidence of diabetes on her.  So even if my A1c had crept up a little bit, my baby was not suffering for it.  

After waiting the excruciating 5 minutes watching the machine count down to 0:00 for my A1c, I was surprised to see that it actually went down to 5.3% (from 5.4% a month ago).  And considering that this A1c is mostly the 2nd trimester when my insulin resistance started to kick in, this A1c represents less lows and more control.  A major win!  My endo was, of course, pleased with this number.  He made some recommendations for changes to my pump, but to be honest I'm taking them all with a grain of salt.  He always wants to prevent lows for me as much as possible, but I'm not going to worry about it with that A1c.  That might make me a non-compliant patient, but sometimes I trust myself more.  Kids, don't try this at home (see Disclaimer below).  I made my next appointment with him for a month from now, which might be my last appointment with him before my little girl's arrival!  

OB:  

Yesterday, I had my 30 week appointment with my OB.  Due to some changes for me at work, I switched from morning appointments to afternoons.  So my wait was considerably longer due to the domino affect of previous appointments getting behind, but I don't mind when I know my doctor will give me as much time as I want.  Sign of a great doctor!  

The appointment started out with my usual "deposit" in the bathroom.  And I was surprised when the little cubby hole where I put my sample already had another cup in it!  Now I know why the nurse always asks me to label my cup before I fill it.  I mean, could you identify your pee if you had to?!  

Next was my weight check, which is getting more depressing each and every time.  I'm up a total of 31 lbs. so far, and I originally wanted to cap my entire weight gain at 30 lbs.  I still have 10 weeks left, so I can only hope that my weight gain at least slows down.  I told myself in the beginning that I didn't care what the number was as long as my baby was healthy.  But man that's hard when you see that number on the scale and require help getting off the couch (or at least a beginning roll to get some momentum).  Either way, as long as baby girl gets here safe and sound on the outside, I'll deal.  

Finally was my blood pressure check, which I loathe each time because it's always high at this office.  I have selective white coat syndrome because it's normal at my endo.  This time it was 140/80, but the nurse didn't make me lie down on my left side like last time.  That's only if the lower number goes over 80, so I was allowed to stay vertical until the doctor got there.  

The doctor comes into my room and greets me.  He asks me how my blood sugars are doing, and I gave him my report from my endo appointment and he was all smiles with that number.  He measures my fundal height, which came in at 33 cm--thank you, 5'2" stature--a little ahead but right on target.  He did make a note that my blood pressure has climbed a little bit over time, but he said he's not worried about it since my blood sugars, urine, and growth measurements are all fine.  If anything else was going awry, we might have to take some action.  But right now it seems to be a normal part of a high-risk pregnancy.  Huh?! 

I mentioned to him the swelling I've been experiencing in the past week or so.  I don't know if it's the summer-like weather or pregnancy or both, but by the end of the day my feet feel like they're going to pop out of my shoes and I have to move my wedding ring to my pinky.  He said it is simply a normal, annoying part of pregnancy that will go away after the baby is born.  The best I can do for now is to try and put up my feet as much as possible (yay!) and decrease my salt intake.  So I'm taking advantage of the weather and wearing flip flops as much as I can.  

I also brought up the fact that I have been having some contraction-like feelings throughout the day.  I really can't tell if they're Braxton-Hicks or not because I have no idea what "real" contractions feel like.  He said not to worry unless I'm having more than 6 contractions an hour, or one every 10 minutes.  I'm not sure if this will be the same rule when I get to full-term because my doctor has made it clear that he doesn't want me to go into labor on my own.  We'll see, I guess.       

Less than 10 weeks left to go, and I feel like I just want to hold my breath until she's here.  It seems like there's so much left to do (childbirth classes, showers, more and more appointments).  Being pregnant has become a full-time job, and one I'll be glad to give my two weeks' notice when it's time.  I'm so excited to have her here on the outside, I can barely wait. 

Tuesday, March 6, 2012

28 Weeks: Dealing with High Blood Pressure and a Cute, Chubby Face

Yesterday I had my 28 week checkup with my OB. I was rather excited about this appointment because it had been over a month since my last appointment (you'd think I was missing the place) and this appointment included an ultrasound. I hadn't seen our little girl for 10 weeks when we found out that she was going to be a she. So regardless of my weight, blood pressure, or anything going on in my urine, I knew I was going to get some face time with my daughter. And that would trump anything else going on that day.

I was called back and Trey followed me into the ultrasound room. I've been very fortunate with my OB's office, even though he is a high-risk doc, that his office is small enough that I see the same people every time. So it's nice to see the same girl that showed me my baby's heartbeat a lifetime ago. I climbed on the table and she put the blue gel on my stomach. She turned on the screen and it amazed me to see how big my baby has grown! She doesn't fit on the screen anymore, but we got some great shots of her face. And her face! I can already tell that she has the chubbiest little cheeks. And she had her hand up by her head, like she was a fainting damsel or something.  Best of all, her stomach and head are perfectly in proportion with one another, so there's no worry about growing a big baby from my diabetes. She's also measuring ahead by 10 days, but those measurements can be off the further along I get. It looks like she weighs right at 3 lbs even right now. (So where in the world is my extra 25 lbs coming from?!)

Alien Baby by Arnold_and_Me
Her cute little profile.

After my ultrasound, I began my "regular" appointment, which included the usual routine: pee here, step on here (weight), stick your arm out here (blood pressure). As I mentioned, I'm up a total of 25 lbs so far this pregnancy. And I definitely feel it after walking for awhile and I get a cramp on my side. I've never had a lot of weight in my middle (bottom, sure, but not middle), so I feel very unbalanced these days. Next, the nurse took my blood pressure that came back high at 140/90. Calmly, she told me that I needed to go lie down on my left side and she would come take my reading again. I didn't freak out about this, surprisingly, I just got caught up in her instructions and did what I was told. I know I've had normal blood pressure readings at other times, and there was little I could do about it at that point. So Trey and I waited in a room, me laying on the paper-draped table and him reading from his phone and cooing over our baby's pictures. I closed my eyes and nearly fell asleep, listening the sounds of feet shuffling past us. Fifteen minutes later, the nurse came back and took my pressure again: 122/74. Everyone was pleased with that number, so I was free to sit up at that point.

Finally, my doctor came in and greeted us, "Baby looks great!" I'm glad that was the first thing he mentioned, because it reminded me that's the priority around here.  He asked me how my numbers were doing, and I said I have my good days and bad days but the good seem to outnumber the bad. I asked about our baby measuring a week and a half ahead and if he would change my due date. He said he would not change my due date and would allow my baby to stay in there until a full 40 weeks. I was relieved. I know it's best for her to camp out as long as she wants to, and I don't want to force an eviction earlier than necessary. I mentioned the rogue contractions I seem to be having, and he said he's only concerned if I'm having more than 6 contractions an hour (right now it's about one a day). And lastly, he said he's not worried about my blood pressure because I wasn't spilling any sugar or protein. I just wonder how many high readings they'll allow me or if they're OK with it as long as everything else is OK.

I set my next appointment for 2 weeks from now, so I begin the expedited appointments until her arrival. I'm so glad to know that my daughter seems to be thriving in there, it gives me a peace that I'm doing a better job than I give myself credit for. Doctors are doctors, and I'm not sure I'll ever be settled with being there. I just wish they had more comfortable beds or something to watch.
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Disclaimer

DISCLAIMER: I am not a doctor, nurse, certified diabetes educator (CDE) or any medical professional of any kind. (But I did stay at a Holiday Inn Express!) Therefore, please do not use any of my postings as medical fact. I am simply a blogger expressing my highs and lows (pun intended) with diabetes. For changes in your medication, exercise regiment, or diet please consult a qualified physician.

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My name is Holly and I live in north Alabama with my hubby, two cats, and a dog.