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! 

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? 

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. 

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.