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. 

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. 

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!  =)

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? 

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." 

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. 

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.