I am 24 weeks pregnant this week. And the cruel reality that I'm 6 months pregnant but I have 4 to go has hit me. Even though I'm over halfway through this pregnancy, I feel like I have a long way to go. Namely because I discussed my labor plans with my OB and endo this week, which means I have to think about her actually being here and that stresses me out because the only thing we've done is paint her room. (Actually, Trey painted. I'm banned from all paint fumes, and thus her room for the next few days.) This post is rather long, so I'll try to break it up into each appointment to give any readers proper intermission breaks.
My OB appointment last week was filled with more questions on my part. I'm pretty sure I talked more than my OB, but he's a patient guy and willing to indulge me for my sanity. The appointment started out the same as all the others: pee in this cup, step on this scale (I'm up 20 lbs total), sit here while we take your blood pressure (122/70). This was the first appointment where Trey didn't accompany me, and it felt weird. I told him he was welcome to come to any appointments he wanted, but he was busy with grad school shenanigans so I was flying solo this trip. The nurse used the Doppler to find my little monkey's heartbeat, which was whump-whumping at 163 bpm. She cooperated a little more this time, but I think she's running out of room to escape the intrusive wand.
The doctor came in and he immediately noticed my list of questions on my iPod sitting in my lap. "Go ahead. Fire away." The first thing I asked him was the plan for the rest of my appointments going forward. He said the plan is to keep seeing me once a month until 28 weeks, then I'll go to every 2 weeks until 36 weeks. After that I'll be going once a week to check my cervix (sorry, TMI) and baby's position for upcoming labor. In addition, I'll also be doing non-stress tests 2-3 times a week starting at 37 weeks. So for the last month of my pregnancy, I'll be camping at the doctor's office at least 3 times a week. (I think I'm gonna go ahead and start my maternity leave then, because I'll be spending more time with the doctor than at my own office.)
The next thing I asked about was the plans for labor. My OB said the current plan for me is to get to at least 39 weeks, but he will not let me go past 40 weeks. He doesn't want me going into labor on my own. Considering my mother didn't go into labor with me and my brother until 43 and 42 weeks, respectively (What were doctors in the 70s and 80s thinking, anyway?!), it's a good assumption that I will be induced. His reasoning for this is that he wants to keep an eye on my numbers from start to finish. I'm sure I'll do that on my own, especially with a CGM, but he'll be able to give me guidance on insulin dosage depending on what stage of labor I'm in. He also wants me to keep my pump on during labor (thank you! thank you! thank you!), and I'll be allowed to treat lows at my leisure with juice or whatever to eat (so no glucose drip, yes!).
At first, I was kinda "eh" about not being able to go into labor on my own. I'm not a natural childbirth advocate or anything, and I've already said that is not the most important thing to me. But I hate feeling like I don't even have the option. But such is the life with diabetes. Bottom line: there are certain things I'll never be able to do because of this stupid disease like join the military, become an astronaut (even though my friend April is going to break that rule), and be allowed to have a granola experience with child birthing. Now that I've had a few days to think it over, I'm at peace with this plan. I'm more comfortable with things being planned in advance, and I know my doctor won't force my body to do something it's not ready for (I do trust him, by the way). And I'd rather have time to get used to being induced and research it before that day arrives. So it looks like May 28th is the absolute latest for my girl's birthday, or earlier depending upon induction date.
I also had an endo appointment yesterday. I knew my numbers were still solid, but I didn't expect to hover around the 5.1% A1c I had last time. In fact, my A1c crept up to 5.4%. The nurse assured me that this is still a good number for pregnancy, but it's obvious that my insulin resistance is beginning. I've increased my basal rates by 3 units this week alone. But I also know that my number of lows has decreased dramatically. So I'm taking this increase as a sign that things are settling out more than "OMG, need more insulin now!" And I'm all for less lows.
My endo and I discussed my numbers and my recent ER visit. I told him my OB's plan for inducing me, and I asked him if he had any plans, insulin wise, that I should be aware of. I was a little surprised, because my endo told me that once I start having contractions I should suspend my pump. *insert confused face here* He explained that the uterus is one big muscle, and once it starts contracting it's like going through one long workout. And I always suspend my pump if I'm going to workout, so the logic makes sense. I just can't imagine going through such diabetes maintenance for 9 (10!) months just to say "Goodbye, pump! See you in a few hours!" He said even if I suspend my pump, it's still possible for me to see a lot of lows. I'm still wrapping my head around this plan, and a lot of it will be making decisions hour-by-hour. But right now I'm still walking around whispering "No pump? No pump?" I'm sure people think I need a white jacket.
And finally, I have one big concern that's bothering me: my belly button. I've always been sensitive about my belly button. I don't like anyone to touch it because it feels weird, like a dead sensation where there's no nerve endings but I know someone's touching and I don't like it! It drives Trey crazy because he thinks I have a cute belly button, especially now because it's pushing out into an outie. Well, it's like a half-outie at this point. The top part is pushing out, making my stomach look like a face with no eyes or mouth and a weird looking nose. And so that dead feeling is a constant because my belly button is rubbing on my tight shirts and maternity pants. I know that pregnant bellies are beautiful and people want to touch them, but I'm not liking this, not one bit.
My (whoa!) belly with said half-outie.
So to recap: baby is still in there (she moves all the time!) and doing great, both of my doctors are aware of the plan for the rest of my pregnancy and potential labor, and my expanding belly is sporting an outie belly button. I hope you've enjoyed this super long post, because I need a potty break (something I'm doing every hour I'm awake).