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. 

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. 

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 . . .

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!  

A picture worth a thousand kisses.

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