Monday, August 11, 2014

Tales of Tubing

Out with the old, in with the new.  That is what I thought when I decided to switch insulin pumps.  I didn't do so haphazardly.   I agonized for days over the thought of dealing with a new medical device company that I hadn't had any experience with, having to order all new supplies, using a different glucometer along with a pump, dealing with a different insulin on board (IOB) feature, and basically trading in my trusty right hand man that I had used for 8 years for something new.  Then I decided to cut the cord.  Literally.

Since my old Medtronic pump was out of warranty and had been acting a little goofy during every priming session, I decided to order the Omnipod.  I was excited about the thought of not having a 23 inches of tubing connecting me to my insulin pump and instead just sticking a pod with an insulin reservoir directly on my body and controlling it with a wireless device.  Got it in the mail, scheduled a training session, bought a cute new carrying case, and BAM.  Pod on.  It was glorious, as in I didn't have to clip anything to my underwear to stay alive while I was wearing a sundress.  The pod just stuck on my lower back discreetly and I could bolus from my wireless remote now tucked into a hot pink "skin".  It was awesome until it wasn't.

Over the course of the next two weeks I had some bad pod mojo going on.  I experienced 3 pod alarms causing a terrible high pitched screaming noise that could not be quieted by the remote.  I had to put the pods in the freezer to wear down the batteries and I just remembered I forgot to tell my mother in law about one of those...  Then 2 pods leaked and needed to be ripped off and changed immediately!  All of these pod problems resulted in stubborn high blood sugars, some worse than others.  Not to mention all of the insulin that I lost!  Some I was able to suck back out of the pods, but most was not retrievable!  Those precious life saving and expensive units wasted!  With each malfunction my mood was increasingly more foul and I was stuck in the land of hyperglycemia for hours with nausea, headache, exhaustion, and even ketones.  A recipe for disaster.

I am still supposed to meet with the trainer again to replace a box of pods and swap out my PDM which is the remote control.  I am hoping this fixes whatever the problems are, though I am not too hopeful about the leaking issue being resolved.  In the past I had issues using short length needles for injections and because the cannula length on these pods is shorter than my Medtronic ones this may be contributing to my problems.  I am praying that this situation sorts itself out and I can keep the Omnipod.

Aside from my new pump and related issues, my diabetes seems to be cooperating.  Last endo visit was good.  Both my endo and CDE were happy with my control in general and tweaked a bolus rate to try to avoid some highs.  Foot exam was good.  No signs of nerve damage or vascular problems.  The only bad news was that my thyroid has gone kaput after my pregnancy.  Apparently it wanted to join my pancreas in the lazy endocrine gland section.  Seems to be my thang.  Starting some thyroid hormone ASAP.  Hopefully my energy levels improve, along with my metabolism!  Oh, how I wish I was breastfeeding again.  It was a great calorie burner.**

**Since writing this post, I have returned the Omnipod system and gone back to my trusted Medtronic pump.  I am glad I tried the Omnipod but unfortunately it just was not reliable enough for me to use as my primary pump.  The waterproof feature would have been great for summer activities and the freedom of not having tubing to worry about was great.  But blood sugar control is too important to mess around.

Wednesday, March 19, 2014

Back on the Horse

My first concern when I was pregnant was my blood sugar.  How is it trending?  Can I head off an impending high or low?  Is that half cup of ice cream going to make me go high 4 hours later because it was full fat?  How much active insulin is left in my body?  Did I exercise today?  How many carbs are in that carrot stick?  I could keep adding to the list that rolled through my diabetic brain at any one time every single day, but that may be a snore for some of you.  Super tight control was the goal for a healthy pregnancy and healthy baby and I worked damn hard to achieve it.

Well you can guess what happen after E was born.

Suddenly I was not number one anymore.  Her needs came before mine.  Thinking back, there was a period of time when I barely managed to get anything to eat or drink let alone change an infusion set or Dexcom sensor.  However I was nursing so I was still putting in considerable effort to keep my blood sugar stable.  There are no studies to suggest that hyperglycemia in a breastfeeding mother leads to "sweetened" breast milk, but I figured if milk was being made from my body then all systems should be in tip-top shape.  So while my control was not as great as when I was pregnant, it was still pretty good.
Eventually I switched from nursing to giving E soy formula.  At that point my blood sugars began rising pretty consistently.  It was evident that nursing had been using a lot of calories.  To compensate for my slowing metabolism I had to increase my basal rates to try to get my blood sugars down.  They are now set to almost twice the rate as compared to when I was nursing.  During this time I sort of fell off the horse a little.  I ate foods that I would never have eaten while pregnant and never gave a thought to prebolusing for a meal.  Despite the highs that resulted from some of these choices, my 3 month postpartum hemoglobin A1c was still under 7%.  A small victory.  I am glad the results were considered "good" but it just doesn't sit right with me now that I've seen how tightly I can control my blood sugar.  Is it work?  Yes.  Is it worth it?  Absolutely.  I feel much better when my blood sugar is more stable throughout the day.

Now that things have settled into more of a routine with E, I am back to paying more attention to my blood.  I am actually using the CGM like I should be instead of turning off alarms or setting ridiculously high limits so that I won't be bothered by any beeps.  I have started prebolusing for some meals and am trying to cut back on carbs once again.  After seeing Awesome Endo and tweaking some basal and bolus rates my pump settings seem to be doing their thing.  Pretty soon I hope to add regular exercise back into the routine and hopefully by my next visit I can lower my A1c back into a more comfortable range for me.  In order to take care of my daughter I need to take care of myself.

Life with E is much different but much sweeter in many ways! ;)  I love her so much and I hope I can set a good example for her about how important it is to take care of your health!

Monday, February 3, 2014

New Normal

I can't believe how time flies with little E.  Today was my first day back to work and I was dreading leaving her all day!  She was in my mom's loving hands, but not it mine.  Sometimes after I put her to bed I miss her and actually look forward to picking her up for her night feeding.  Sounds sick for a new mom, right?  Believe me, not every day is like that.  As in I have ignored the whimpering on the monitor for as long as possible before dragging myself out of bed to avoid screams.  I have wished for an hour when I could take a shower [everyday] without dragging a bouncer into the bathroom only to get out of the tub with a head full of shampoo to soothe an overwrought baby.  I have sadly mastered how to eat breakfast without getting toast crumbs in E's hair because I am usually holding her during all mealtimes while B is at work.

I used to take going to the store for granted. Grocery shopping is now a treat to get out of the house.  It used to be so easy to run an errand which now requires planning and may not happen at all until someone is available to watch E.  Since it's been subzero degrees and E is so little I can't imagine getting her all bundled up just to pick up some Q-tips and a bag of marshmallows.

Regardless of these lifestyle changes, my love for E only grows.  One look at her smiling face erases the tiredness from the night before.  The smell of her head and the feel of her silky smooth hair on my cheek when I'm holding her melts my stress away.  Her beautiful blue eyes are ridiculous.  And when the tears fall from them, they nearly fall from my own.  Everyday I am more in love.  It is so fun learning about what makes her tick.  Seeing the changes and developments in her is so amazing.  My recent favorite is her "talking".  She will have conversations with us that are shockingly long.  And she loves looking in the mirror.  She is growing leaps and bounds and waiting for no one.

Having a child has changed me in many ways.  I worry more.  At the same time that I worry, I realize that I cannot control everything no matter how much I want to.  I can't prevent her from getting sick, or being tired when she refuses sleep.  I may not be able to help ease her bellyache.  I have to relinquish control and just accept that life is going to happen to her.  She's going to be uncomfortable or upset or hurt and sometimes I can't prevent it or help it.  Sometimes all I can do is hold her close and let her cry. And so I do.  So I do.


Saturday, January 4, 2014

The New Year

2013 is going to be hard to beat.  B and I found out I was pregnant and I had little E all within those 365 days.  It was a lot of work when I think back on it.  In fact it seems like I never could have done it.  But I did and she's here and it's wonderful!  2014 will bring many more happy moments and discoveries.  It already has brought about changes that make me smile.

-The wine rack above the microwave doesn't really hold any wine currently, but it does hold 3 cans of soy formula.

-Every room of the house has some baby related item in it.  Every. Room.

-A baby smile can make you smile even if you are exhausted.

-Baby fashion is awesome.

-Being home on New Year's Eve doesn't feel lame now.  It feels awesome!

-There's nothing cuter than a daddy with his daughter.

-I am used to packing up my own diabetes stuff before leaving the house.  Now I can pack a pretty mean diaper bag. 

-I feel like I have entered The Mom Club.  The club where moms comment on and like other moms' facebook pics of their kids, even if they have not spoken themselves in years.  It's like the Jeep nod or something like that. But I like it.  Hopefully we can keep the mom jeans out of the mix though.

Happy New Year!!!!!


Saturday, December 14, 2013

Mommihood Wows and Woes

Ellen is 4 weeks old!  While the hospital stay after the c-section feels like ages ago, I cannot believe a month has already gone by with Ellen "on the outside."  It has been a month of  continuous learning and little sleep.  While Christmas is less than 2 weeks away, it just doesn't feel like holiday time to me and I have done little besides take care of and dote upon my sweet baby.  We did manage to put the tree up, but I didn't bring down any other decorations, have not shopped, and have barely managed to bake a cookie.  (My mom and I finally remedied this yesterday.)

My first trip out without Ellen was to the grocery store.  B watched her and it was so bizarre to be at Heinen's without Ellen with me in some way.  However, it did make me feel a part of the human race again.  Much like showers do these days.  As a family, we went to Target for our first outing in the stroller.  Ellie behaved like a champ.  She's pretty good with constant motion.

We have gone through some new mommy trials... breaking down when I couldn't figure out how to ease her gas pains or make her stop crying.  Feeling hopeless when trying to nurse her only somewhat successfully at 3 in the morning with a low blood sugar, and then having to pump afterwards and change her.  There have been many 2 hour "feedings" which involve the actual feeding, and then the circus acts of trying to get her down afterwards.

There have been calls and trips to lactation consultants and a breastfeeding medicine physician.  Nursing is supposed to be natural, right?  Maybe for baby, but not for this mommy.  There has been a steep learning curve about what my body does and how to help her respond.  Latching has been hit or miss, but much improved as of late.  Oversupply issues have had her drowning in milk, but we are learning how to help that.  I have finally used the electric pump so that's not so intimidating anymore, and B can feed her at night sometimes with milk I pump during the day.  Extra goes in the freezer, though I can't seem to store it as fast as I'd like.  This child eats like a champ.  When she feeds from a bottle, she's eating 4 ounces at a time.  She's up to 11 pounds!

It's difficult to predict what my blood sugar will do after feeding her or pumping...sometimes it's stable and sometimes an hour or two later it's crashing.  I have gone through more juice boxes and boxes of raisins than I did in my first trimester of pregnancy!  I have not had a hot cup of coffee in 3 weeks. I have had to cut dairy out of my diet due to a supposed milk allergy. Some nights after getting up 3 times to nurse I think I cannot physically keep doing this.  But after she eats and we nap again in the morning and I see her beautiful face, I am in a better frame of mind.

The truth is, she still amazes me.  Her tiny body and features growing so fast, her beautiful blue eyes, her little cooes and cries that we are slowly figuring out.  The way her quivering lip and furrowed brow can pull at my heart strings and make me think of nothing else but comforting her.  The way her little fingers curl around mine, the smell of her... after she has been napping for awhile, I miss touching her and cuddling her.  I can't imagine life without her now.  My perfect daughter.

Even if we don't have tons of decorations, or cookies baked, or presents wrapped, we will have the merriest Christmas of all.  She is all we need.  The opportunity to know a parent's love is all we could ask for, and we have been blessed with that.  Merry Christmas!

Friday, November 22, 2013

Tiny Miracles

Today my daughter is 9 days old.  Nine days ago I checked in at the hospital for my c-section, my eyes  a little teary both from fear and a knowing that something was coming to an end.  Even if that meant a beautiful beginning.

My husband and parents walked in with me and I got situated in pre-op.  B was by my side the whole time, and then my parents came back when I was changed, monitored, and hooked up to an IV.  It all seemed so surreal.  Once things were getting started, I didn't feel too nervous anymore.  The anticipation had me a little excited.  I was constantly thinking about my blood sugar though.  As my endo had ordered and according to hospital policy for diabetics on insulin pumps, I was in charge of managing my diabetes the whole time, unless I was unable to.  The stress had my blood sugar a little higher than I'd like upon arrival and I gave insulin to correct, but because I was running only a percentage of my normal basal rate, it didn't come down to the 100-120 range I would have liked to see.

When they finally came to roll me back to the OR, my blood sugar was holding steady at around 140.  I kissed everyone goodbye and was pushed through the back halls into a rather intimidating looking operating room.  (I have only had surgery one other time and don't remember much.  But this looked like a sterile gymnasium with a bunch of alien equipment in it and about 30 people in scrubs circulating around.  What did I sign myself up for?!)

First they had to insert the spinal, which took 2 tries.  After the first, I was having second thoughts about having this baby.  Unfortunately I did not see a way out of this.  Finally the meds were administered and my legs were immediately floppy.  I felt a warm, tingly feeling all the way up my body into my arms and as high up as my throat.  It was such a strange sensation being able to feel the pressure of people touching me, but not pain or temperature in my numb lower half.  They let my husband back and he came up to sit by my head.  I felt much better when he was there.  My OB started the surgery and listening to him talking about what he was doing did not feel relaxing.  I asked B to talk to me so I could concentrate on something else.

Pretty soon my OB was saying the head was out, shoulders were out, that they were big and he thought I made a good decision [about the section].  Then I heard a cry.  Someone asked her name.  Ellen Frances.   Again, this didn't seem real.  B went to cut the cord and I waited impatiently for what seemed like an eternity before he walked back to my head carrying our daughter.

She was the most beautiful thing I have ever seen.

I will always remember that moment, like time stopped.  She was perfection, a miracle, a product of my husband and me that came with such hard work and anticipation and wonder.  I wanted to cry, but the anesthesia had such a strange effect on me, almost like it was suppressing all of my senses.  But after a minute or so of just staring at this beautiful person who had just entered this world, I was sobbing.  At this point the anesthesiologist was dabbing my tears away with pieces of gauze, which was comical thinking about it now.

I couldn't stop staring at her and her tiny, perfect features.  But diabetes was still on my mind even at this point.  I kept asking B to check my blood sugar on my meter, and the anesthesiologist to click on my CGM as I had heard that after the placenta gets delivered, insulin needs immediately decrease and hypoglycemia is a real possibility.  Everything was still holding pretty steady, only going down slightly.  When everything was finished we all went to PACU to recover.  B kept checking my blood sugar which was actually rising slightly, and the nurses were monitoring my daughter's.  I was a little sad when I learned her blood sugar was low, and then still low after supplementing her with formula.  A neonatologist was called, but he said he wasn't too worried about it, that it was common with babies of daibetic moms, and that they would monitor her blood sugar over the next 24 hours.  He also ordered supplementation with formula after each feed until her blood sugar was regulated.  I wasn't too upset about it.  I just wanted her to be ok, whatever it took.

We all went back to a post-partum room about 2 hours after recovery, my daughter in tow in a bassinet that we affectionately called "the tub".  My husband and I were in awe of her, still not believing she was here.  I felt such relief, such love, and wonderment of her and this process.  She is my heart and my world now.

Ellen Frances, we love you so much.  You are the best thing to happen to us.  You really are a tiny miracle and the reason I know a mother's love.  Thank you for expanding our hearts even more.


Friday, November 8, 2013

37 Weeks Thankful

Despite the aches and pains and general discomfort in the last month or so, I am genuinely thankful for this gift.  This opportunity to create a new little life, this time to carry our little girl.  Pregnancy is nothing short of a miracle which many people may agree with, but not really understand until it is personally experienced.  It is amazing and I feel so lucky to have been able to have this time with my baby that could never be duplicated.

I have worked hard to manage my diabetes and to take care of baby girl as much as humanly possible.  I feel like I have succeeded.  The moment of truth will come next week after I have my c-section and we get to meet her face to face.  There's no question now about the mode of delivery.  She is measuring too big to try for a vaginal birth and there are too many risks I am not comfortable with taking.  Plus my blood sugars have been slightly more erratic, so 38 weeks is the recommendation for delivery.  I have a plan with my endo for managing my insulin during surgery and post partum, and I know he will take good care of me.  I am in awe that soon we will hold her and love her and she will be a part of this world with us.  But I am just a little sad that pregnancy is coming to an end.  I will mostly remember it as a wonderful time.

There are many friends and family that have been so supportive throughout the last 9 months.  Baby girl will be lucky to have all of you in her life.  I'm so thankful for all of the emotional support and well wishes, and grateful for an amazing husband and mother who have both really gone above and beyond for me.

My mom drove me to a ton of appointments so I didn't  use my own gas and sat in countless waiting rooms with me when B could not be there.  She made meals and gave them to us so I wouldn't have to cook all the time.  She helped me clean to prepare for baby girl's big day.  She worried when I worried (and even when I didn't) because she's a mom.  She's my mom.  Always and forever, like I will be baby girl's mom always and forever.  I love you, Mom.  Thanks for sacrificing your own time and energy and even sleep when worrying for me, even if you didn't have to.

And to my husband, you are my rock and my soft place to fall all at the same time.  You endured my moments of despair and anxiety and hot flashes!  (There were many nights I slept with the window open and he was bundled up under 2 blankets!)   Thank you for going to appointments with me, picking up extra chores around the house, and listening to me talk about being pregnant ALL THE TIME.  Thank you for putting up with me getting up a zillion times a night to either run to the bathroom or check my blood sugar or eat a snack.  Thank you for sometimes getting those snacks.  Thank you for learning how to operate my insulin pump, for tolerating lower carb meals most days for my benefit, for running out to get me juice boxes and granola bars, for canvasing multiple CVS stores to buy glucagon late at night, for putting together all those baby items.  Mostly, thank you for being there 100% on this journey and for being my best friend.  For loving me and your unborn baby girl.  You will make the best daddy and I can't wait to see our little girl in your arms.  I hope she has your big heart.  If she has your eyes, I'm in trouble!

Much more to come next week with baby girl's arrival!