Disconnected

This past weekend, my husband and I took advantage of the long, cool weekend and went camping. For us, camping means sleeping in a tent and cooking over a fire or a propane-fueled grill. It was the perfect weather with cool 30 degree nights and calm 70 degree days.

Each day we took a hike through the beautiful scenery. The first day was only a 1.5 mile walk that left me at 38 mg/dL and draining a can of lemon-lime soda. The second day we planned for a 3.5 mile hike, so I did a little more pre-planning before the walk. I disconnected my pump completely about 30 minutes before the hike and packed some granola bars and glucose tabs to have just in case.

About halfway through our hike, we found this ginormous oak tree! Pretty sure it was the biggest tree I've seen in real life.  Trey got a picture of me at its base for a nice perspective. 

Holy Oak Tree!!!

At this time, we took a break to split a granola bar and a mini-bag of pretzels. Still un-pumped, we continued our walk back to camp. By the time we got back, I had been disconnected for over 2 hours, with a granola bar and a handful of pretzels, and my blood sugar was 133 mg/dL. Seeing that number was almost as beautiful as the fall leaves. Almost.

There were some scary moments during the trip, too. Like getting my first ever "TEMPERATURE WARNING" on my meter after the first night of 30 degree temps. I had to keep my meter in my jacket pocket so it would keep warm. There was also the time I woke up drenched in sweat (at 31 F, that's a cool wake up) and finished off my jar of raspberry glucose tabs and a bar of chocolate that was reserved for smores. I woke up later at 95 mg/dL, thankful that I decided against bolusing for the chocolate bar.

Camping also seemed to agree with my pregnancy symptoms, or lack thereof during the trip. The relaxing atmosphere and fresh air pretty much ceased my nausea and fatigue. If I could live in the woods for the rest of my pregnancy, I would. So long as there's a fire.

A1c Thoughts

When I found out I was pregnant and excitedly told my endo, the first thing he did was increase my basal rates 0.1u/hr.  This increase made my daily total jump from roughly 16 units to almost 20 units.  This puzzled me at first, because I had only heard of the plaguing first trimester lows associated with a diabetic pregnancy.  So I thought my basal rates should decrease or at least stay the same.  My endo warned me that I needed to arm myself constantly with fast-acting carbs for these oncoming lows. 

For the first few days after that appointment, I followed my low-treating guidelines by the book.  I religiously corrected using the 15/15 rule with scary precision.  But I kept correcting, and kept correcting, and kept correcting.  Eventually, I got tired of constantly correcting with oh-so-perfectly measured glasses of juice or exactly 4 glucose tabs.  Especially in the middle of the night, low correcting rules go out the window.  My low treating method became something like this:  drink enough juice that gets rid of the shakes, eat a tablespoon of peanut butter, chase with more juice or chocolate milk.  I'll admit that this resulted in some scary rebound highs that left me crying and vowing never to go outside the rules again. 

Things seem to finally be settling down and my 24-hour window on my CGM doesn't look like the cutting side of a bread knife.  Part of the resolution is learning my limits when correcting lows (like filling a glass of juice is always less than drinking it straight from the jug) and maintaining a constantly grazing schedule (like every 2 hours or less, seriously!). 

I know that being friendly with lows is good for Ferbie at this point in my pregnancy, and I'm quite proud that my A1c is in the 5s for the first time since I went on the pump.  But I must admit I could not do this everyday for normal diabetes management.  I know that everyone's comfort zone for A1c is different, but I feel the best when I land between 6.0-6.5% for my A1c.  Higher than that means I am hanging out on my higher end too much, but lower than that means I am spending a good majority of my days being low. 

I am coming to the conclusion, though, that the A1c holds a lot more value than it should.  My endo might give me a "Good job!" with an A1c of 5.5%, but looking back at the past month in my meter log shows that my body is roughly 50% apple juice.  I really put more value in my quarterly blood work for my kidneys and cholesterol, my yearly eye exam, and my overall "feeling" of health.  As long as those things get an A+ from all the medical personnel, I don't think it should matter what my A1c is when they happened. 

What Makes My Heart Skip a Beat?

I had never been more nervous for any appointment than I was before our first ultrasound appointment.  I don't know why I was so nervous.  I suppose because up to that point, it hadn't been "real" yet.  Sure, I had been puking like a champ everyday for two weeks, but the idea of actually having another life inside of me hadn't hit me.  I was also worried that things weren't going to be 100% perfect--a product of living with an imperfect condition, I guess. 

The nurse called us back to the ultrasound room where I hoisted myself on the table and held my breath.  The entire room was dark except for the screen facing away from me, towards the technician and Trey.  I waited anxiously while she looked for the baby and, more importantly, a little heartbeat.  A few seconds later, she said, "Oh yeah, there it is."  She turned the screen towards me, and what I saw absolutely took my breath away.  It was the tiniest little peanut with a flicker on the left side.  Seeing the heart actually move at its own rhythm caused me to instantly break out some tears.  Instantly, I felt the need to apologize.  "You're probably used to this, right?  Pregnant women crying?" 

She printed out a few snapshots of the little peanut for us to take home (which now are proudly being displayed on our refrigerator).  While we waited on the doctor, Trey and I kept looking at the pictures and smiling at each other.  This was real.  This was happening.  Holy crap! 

The doctor walked in and said, "That's a good looking baby!"  He let us ask a plethora of questions, from who should take over cat litter duties (Trey gets to take it on for the next 7 months. *score*) to how long before the puke fest should subside.  The last question I asked him was the most important one in my mind, "Have you ever done a type 1 pregnancy before?"  I knew my OB was high-risk, but this question was important because it was personal to me.  I needed to know his experience with "my kind". 

He looked at me, one eyebrow up, "Of course!  I've been around for over 20 years, and have certainly seen my share of type 1s."  Actually, he said that type 1s are usually some of his healthiest patients because they're diligent about their health before they're pregnant.  I've always loved my OB, but seeing him that day made extremely grateful to have him as my doctor in this process. 

We got to see little Ferbie (yes, my creative nickname.  better than "it".) again yesterday, and the little teddy graham was dancing in there like it was doing hula hoops.  I'm already proud of this little squirt. 

Sounds Like a Dinasour

Because of my diabetes, I'm automatically put in the "high risk" category for pregnancy. Therefore, I get to enjoy all of these extra tests, beginning with blood work immediately after I find out I'm pregnant to see how "pregnant" I am. The two variables they check are hcg, which basically measures how the baby's growing, and progesterone, which measures how my body's supporting the pregnancy.


They did back-to-back bloodwork to make sure my levels were doubling or at least rising. I'll be honest and say I didn't know anything about these variables or what they should be during pregnancy. All I could think of was that "progesterone" sounded like a name of some dinosaur.


 

"Rawr, I make babies grow."

My first results were fine, right on schedule for where I should be. But my second results were less than stellar. My hcg levels were fine, almost doubling from 500 to 970. But my progesterone levels actually went down from 18 to 12.


The nurse prescribed for me to go on progesterone supplements to get my levels back up above 15. Even though she said it is normal for those numbers to go down, I was still freaked out. If this is normal, why am I being put on supplements? I googled progesterone levels and what they should be at this point in my pregnancy. Big, big mistake. Never ever google anything related to your health, especially pregnancy. I pretty much scared myself into stressing out and crying at random times (of course, that could be the pregnancy itself). I was also dealing with a weird complex of taking these supplements and wondering "Am I not woman enough to carry my own child?"

I went back in for more blood work the next week to make sure my levels were still rising. I had to wait 24 hours for the results: torture! I had less than a day's worth of supplements in me, so I was worried about the time between my last blood work that was 4 days ago. However, I got the best call the next day. "Hello Holly? Your results are wonderful. Your progesterone increased to 25 and your hcg increased to 9,000!" I was so relieved! The next set of blood work they took the next day made the nurse sing, "Your results are out-stand-ing!" Progesterone stayed the same at 25 (the nurse said that was fine) and hcg increased to 18,000.


These results made me so relieved! Also, the fact that my progesterone levels doubled in 4 days mostly from me (and not the supplements) made me feel a lot better. And the fact that the hcg levels (a.k.a the baby) increased out-stand-ing-ly made me feel like he/she is doing great regardless of my shortcomings.


All in all, I'm somewhat grateful to be placed in the "high risk" category because of my diabetes. It means I get the comfort of extra monitoring and testing that lets me know that the baby and I are doing OK. It can be stressful if there are any hiccups, but the doctors can do their thing to help me or the baby before anything bad happens.

Pregnancy Update and Morning Sickness

First of all, I want to thank everyone for all the wonderful comments on my pregnancy announcement. I still go back and read all of them multiple times throughout the day. I definitely feel the support and love of the DOC. Now that I'm "out", I wanted to give you guys a quick update on my pregnancy so far these past 9 weeks.

When I first found out I was pregnant, I didn't really have any symptoms. I had some soreness and cramping, but nothing that was discomforting. But once I hit 6 weeks, it was like the plethora of pregnancy symptoms hit me like a ton of bricks.

I had heard about the pregnancy lows accompanied with a type 1 diabetic pregnancy, but I didn't realize that they were on a completely different scale. It's like my body wants to be at 60 mg/dL all the time without any symptoms. All I can say is THANK GOODNESS I have a CGM. The majority of the time, Constance catches my lows before I feel them. I honestly don't know how low I could be most of the time without her alerting me. The only problem with this is she seems to go off all. the. time! Especially when I (try to) sleep, she keeps beeping at me every hour that I'm below 70 mg/dL. And when she woke me up last night at 1 AM for the 5 millionth time, I busted out into tears because I just freaking wanted to sleep. I know these lows are manageable and it's better for me to hang out in the basement end of my range for the next few weeks, but I'm looking forward to getting back to the 100s as "normal".

Another symptom that hit me in the gut is morning (umm, all day) sickness. I've always had a pretty strong stomach. Even if I get a whiff of something that turns my stomach, I can usually hold it in and still eat like nothing happened. But it seems that pregnancy has turned my iron stomach into mush. And the main culprit that makes me run to the bathroom? Ground beef. Even just typing that makes me try to think of something else. But as it stands right now, I can't even look at a hamburger right now without turning the other way (towards the bathroom).

This pregnancy side effect actually caused me to lose 5 pounds the first three weeks I was pregnant. But it seems I have turned a corner recently because I can eat something larger than a tennis ball. The nausea is still there, mainly when I first wake up and if I go more than 3 hours between meals.

At my 2nd appointment with my endo since I found out I was pregnant (where my A1c was 5.5%! Woo!), I asked him what was the standard procedure with insulin and puking. Because I mainly worry about "eliminating" something I just bolused for and the oncoming low. He said the best thing I can do is either suspend my pump or put my bolus on an extended square for an hour or two to make sure I keep most of my meal down.

I've got roughly 3 more weeks of the pukes before it hopefully gives up altogether. Until then, I'll keep my diabetes supplies stashed with diet ginger ale and whole wheat crackers.

My new love.

Music Therapy

I love listening to music!  I'm not musically-inclined at all (minus that one year I played flute in junior high), but I definitely feel my soul lifting when I hear a good song.  I gravitate towards songs that have some inspiration behind them.  One of my favorite artists right now is Manafest (a Canadian Christian rapper, eh?), and I'm really digging on his new song "Every Time You Run".  I've heard this song a couple times before, but today when I heard the chorus I thought about the DOC. 

Every time you run, every time you hide

Every time it hurts, every time you cry

Every time you run away, every time you hide your face

And it feels so far away, I'm right here with you

I know we all experience some bought of diabetes burnout at some point or another.  When I heard this song today, I just wanted to give everyone in the DOC a big hug and let you know that we are here together.  We are in this together.  You can lean on us whenever you just feel like throwing your hands in the air and saying "Forget it!"  I love you, DOC, and I'm right here with you.  

The Day I Found Out I Am PREGNANT!!!

It feels weird to be writing this post since you guys probably won't see it for another month or so, but I know this time in my pregnancy is important and I need to get down every emotion and feeling.  This post was written on September 26, 2011.  

I'm 5 weeks!  It feels awesome to be writing those words.  I feel so incredibly blessed and excited with this pregnancy.  Trey is excited, too!  Every once in a while he'll just look at me and giggle--I don't have to guess what he's thinking about.

We found out I was pregnant last Tuesday, September 20th.  I knew there was a strong possibility I could be pregnant because I was 2 days late, and that never EVER happens to me.  I'm very . . . "on time"?

The dogs started their usual stirring around 4:30 AM, and instead of telling them to "Shhh, lay down!" to try and get those few extra minutes of sleep, I went ahead and let them out so I could take the test.  I did the test and put it on the counter to wait the instructed 3 minutes, but I didn't have to wait that long.  After less than a minute, the "Pregnant" line showed up clear as day, and after 3 minutes it looked like this:

The proof!

I woke up Trey and said, "Come look at this!"  My sleepy husband got out of bed and came to the bathroom.  He looked down at the test and said, "I told you so!"  He had guessed a few days ago that I was pregnant, but I wanted to wait until I was officially late to test.  We hugged and kissed, then looked at each other.  "So what do we do now?" he asked.  "I'll call my OB later and my endo to get the ball rolling."

I went to my OB that afternoon to do the initial blood work.  I got a call back the next day that my levels were right on schedule for someone who's 4 weeks, my hcg levels were over 500.  I did another blood draw on Thursday, which I'm still waiting for the results. My first ultrasound was scheduled for October 20th, I'll be 8.5 weeks and praying they find a good, solid heart beat.  (If you guys are reading this, then they did.)  ;-) 

I saw my endo that afternoon as well.  He congratulated me on my pregnancy and took my A1c.  To be honest, I was a little nervous about what the number would be.  We figured we had gotten pregnant while on vacation and I was CGM-less for a week, not the best environment for good blood sugar control.  However, I was astonished when I saw 5.6!  I actually asked the nurse, "Is that right?"  She looked back at the machine and said, "It's right.  Not gonna argue with it are you?"  "Not at all!" I said with a smile.  I texted Trey and said "A1c = 5.6! Hellz yeah!"  We set up my next appointment for October 24th, with blood work a week before. 

I haven't really been having any bad symptoms yet.  I keep having this nagging worry that something will happen before our first ultrasound; it plagues my mind all day.  I have made conscious efforts to keep those thoughts out of my mind, even to the point of writing down reasons why I shouldn't worry:  I'm a young, healthy female.  My numbers are solid.  There's absolutely no reason to be worried and every reason to celebrate.

I'm sitting with a smile on my face at that last sentence.  For the first 4 weeks of this pregnancy, I haven't really celebrated because I was so worried.  But now that we've seen the heartbeat and know there's a baby inside me and not a monster causing my morning sickness (more on that later), I can't help but smile . . . and freakin' tear up a tiny bit.