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!
Saturday, December 14, 2013
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.
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!
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!
Saturday, October 26, 2013
35 Week Bumpdate
Again, good reports for Baby Girl this week. NST was normal. Good accelerations of her heart rate with movements. Apparently I was also having fairly regular contractions every 2 to 4 minutes, but not feeling them. The OB said they are likely Braxton Hicks. My uterus is practicing. I wish it would practice HARDER and do the real thing soon. I don't think this belly can get much bigger!
Hubby took off for the BPP this week. She must have been happy her daddy went because she immediately did her practice breathing and body rolls. Baby Girl scored 8/8 points again, everything looking normal. The doctor came to check us out and said, "So, looks like scheduled c-section for 39 weeks." Well... kind of... assuming she's not growing to the size of a small dinosaur in there. I told her last week the other doctor had mentioned the possibility of an earlier delivery due to her increasing size, and we would have to keep monitoring. Then she said, "Mmhmmm well yes, we will have to measure her but I think at this point 39 weeks is reasonable." OK. I am done with everyone and their different opinions. That has been one of the most frustrating experiences so far during this pregnancy. I know a lot of things depend on what may or may not happen and there are no definitive answers at certain points, but at least get together people and think about what your patient is thinking every time she hears a different opinion!
And that's definitely a problem when you see a group of physicians. I cannot adjust my schedule to make an appointment with the same MFM physician every week because A.) I work and B.) They float from facility to facility without rhyme or reason to their schedule and C.) I have 30 other appointments that are scheduled. While it would probably be best (the least frustrating) to see the same doctor each week, for most people in my situation it's not very practical and so you end up with 3 different opinions about the same issue. However, they all have the same chart in front of them with the same data, they are in the same practice, so why do these opinions vary so much?
I am really looking forward to next week's BPP when they measure her again. That should give us a better idea of when they might want to deliver her, if need be.
I am getting a little more tired, physically and mentally. I am not as on the ball with my diabetes logging as I once was, feverishly writing down every carb I ingested and every unit of insulin I injected. And sometimes I even eat things that can make my blood sugar a little more (gasp!) unpredictable. Thirty-five weeks of super intense management is wearing. I have never paid so much attention to diabetes in my life. Don't get me wrong, it's ALWAYS there somewhere, but it can sometimes be pushed to the back of your mind...at least for a few hours. Not with pregnancy. I feel like it's forefront and center nearly 24/7. It's been a lot of hard work and I am ready to see the result! And to eat a high carb breakfast or a bowl of cereal again. I am getting really tired of cottage cheese and eggs.
A few humorous points:
- My belly is so big that it is sometimes difficult to wash my hands in certain sinks.
- My belly seems to bump into people and things a lot. I am used to 29 years of living without a beachball in my belly.
- Pregnancy makes you burp. A lot. Around the clock. Well, me anyway.
- Getting out of bed sort of resembles a Weeble wobbling. Like this.
- The cats are really interested in sitting on my belly now. I think they know something.
And a very happy birthday to my husband and dad this week! I love you both!
Hubby took off for the BPP this week. She must have been happy her daddy went because she immediately did her practice breathing and body rolls. Baby Girl scored 8/8 points again, everything looking normal. The doctor came to check us out and said, "So, looks like scheduled c-section for 39 weeks." Well... kind of... assuming she's not growing to the size of a small dinosaur in there. I told her last week the other doctor had mentioned the possibility of an earlier delivery due to her increasing size, and we would have to keep monitoring. Then she said, "Mmhmmm well yes, we will have to measure her but I think at this point 39 weeks is reasonable." OK. I am done with everyone and their different opinions. That has been one of the most frustrating experiences so far during this pregnancy. I know a lot of things depend on what may or may not happen and there are no definitive answers at certain points, but at least get together people and think about what your patient is thinking every time she hears a different opinion!
And that's definitely a problem when you see a group of physicians. I cannot adjust my schedule to make an appointment with the same MFM physician every week because A.) I work and B.) They float from facility to facility without rhyme or reason to their schedule and C.) I have 30 other appointments that are scheduled. While it would probably be best (the least frustrating) to see the same doctor each week, for most people in my situation it's not very practical and so you end up with 3 different opinions about the same issue. However, they all have the same chart in front of them with the same data, they are in the same practice, so why do these opinions vary so much?
I am really looking forward to next week's BPP when they measure her again. That should give us a better idea of when they might want to deliver her, if need be.
I am getting a little more tired, physically and mentally. I am not as on the ball with my diabetes logging as I once was, feverishly writing down every carb I ingested and every unit of insulin I injected. And sometimes I even eat things that can make my blood sugar a little more (gasp!) unpredictable. Thirty-five weeks of super intense management is wearing. I have never paid so much attention to diabetes in my life. Don't get me wrong, it's ALWAYS there somewhere, but it can sometimes be pushed to the back of your mind...at least for a few hours. Not with pregnancy. I feel like it's forefront and center nearly 24/7. It's been a lot of hard work and I am ready to see the result! And to eat a high carb breakfast or a bowl of cereal again. I am getting really tired of cottage cheese and eggs.
A few humorous points:
- My belly is so big that it is sometimes difficult to wash my hands in certain sinks.
- My belly seems to bump into people and things a lot. I am used to 29 years of living without a beachball in my belly.
- Pregnancy makes you burp. A lot. Around the clock. Well, me anyway.
- Getting out of bed sort of resembles a Weeble wobbling. Like this.
- The cats are really interested in sitting on my belly now. I think they know something.
And a very happy birthday to my husband and dad this week! I love you both!
Thursday, October 17, 2013
34 Week Bumpdate
This week began on a high note. My husband and I celebrated our second anniversary on Tuesday. He took the day off to go to my appointments with me, and then we cooked a nice dinner together. We started off at the endocrinologist's office with a pretty standard appointment. Still happy with my control, but some adjustments were needed. We actually backed off a little on some overnight basals to prevent me from getting up low and drinking a juice box every night as had been the trend for the last 5 days or so. My endo said the baby is most active at night and so she's using up some of my glucose stores. Especially now that she's bigger herself and requiring more energy to move. And we increased my breakfast and dinner bolus ratios AGAIN. I am now requiring 1 unit of insulin per gram of carbohydrate I consume meaning I am bolusing the HUGEST amounts of insulin I have ever heard of. Definitely concerning at times, as in how am I not dying from giving 45 units of insulin for a salad, fruit, and bread? I don't know. It just works. I have been easing myself into dosing these crazy amounts by using the old 1:1.5 ratio and adding a random amount of extra units not quite equal to the 1:1 ratio and then usually deciding later that I could have bolused 1:1 and been fine. I'd just rather test the waters first since these amounts of insulin are so crazy.
My endo also reassured me that I was still doing a great job and sometimes no matter what your blood sugar control, you are still going to grow a larger baby. Another diabetes mystery. But hearing it from his lips made me feel a teensy bit better. After the endo we went to pick up some groceries for our anniversary dinner. Nothing with too much sodium or too many carbs to try to curb highs and prevent swelling, so we decided on filets with broccolini and a small side of mashed potatoes. And I mean a small amount of potatoes because my husband had also bought a small replica of our wedding cake to celebrate, and I wanted to eat it!
Next we went to my regular OB appointment. Again, the NST was perfectly normal along with my blood pressure and urine specimen. No signs of preeclampsia. Since we were both present, we also had the chance to tell the OB how we felt as a couple about our chosen mode of delivery. We stated very clearly that we did not want an induction and felt that a c-section would be better for my health if the baby has to come early. This time I think she got the message and made a note in my chart. Hopefully there is no further talk of induction because for me, it's not really up for discussion. I've made my decision after considering everyone's opinions because I feel it's best for me and Baby Girl.
Today I had my weekly BPP test. Baby Girl scored 8/8 points again and everything looked fine. I got a few printouts of some cute 3D pics of her little face. It's hard to say who she's looking like, but I'm thinking Daddy.
So, all status quo for this week. Hard to believe she could be here as soon as 3 weeks from now! It will be nice to be able to sleep comfortably again (even if it's not for a long period of time), to not pee every hour, to be able to bend over without squishing all internal organs, and to be able to get out of a position without feeling like my pubic bone is splitting. Why do women keep the crotch pain a secret??? Expanding cartilage is painful! Maybe everyone forgets about it, otherwise no one would have more than one kid! Have a good week!
My endo also reassured me that I was still doing a great job and sometimes no matter what your blood sugar control, you are still going to grow a larger baby. Another diabetes mystery. But hearing it from his lips made me feel a teensy bit better. After the endo we went to pick up some groceries for our anniversary dinner. Nothing with too much sodium or too many carbs to try to curb highs and prevent swelling, so we decided on filets with broccolini and a small side of mashed potatoes. And I mean a small amount of potatoes because my husband had also bought a small replica of our wedding cake to celebrate, and I wanted to eat it!
Next we went to my regular OB appointment. Again, the NST was perfectly normal along with my blood pressure and urine specimen. No signs of preeclampsia. Since we were both present, we also had the chance to tell the OB how we felt as a couple about our chosen mode of delivery. We stated very clearly that we did not want an induction and felt that a c-section would be better for my health if the baby has to come early. This time I think she got the message and made a note in my chart. Hopefully there is no further talk of induction because for me, it's not really up for discussion. I've made my decision after considering everyone's opinions because I feel it's best for me and Baby Girl.
Today I had my weekly BPP test. Baby Girl scored 8/8 points again and everything looked fine. I got a few printouts of some cute 3D pics of her little face. It's hard to say who she's looking like, but I'm thinking Daddy.
So, all status quo for this week. Hard to believe she could be here as soon as 3 weeks from now! It will be nice to be able to sleep comfortably again (even if it's not for a long period of time), to not pee every hour, to be able to bend over without squishing all internal organs, and to be able to get out of a position without feeling like my pubic bone is splitting. Why do women keep the crotch pain a secret??? Expanding cartilage is painful! Maybe everyone forgets about it, otherwise no one would have more than one kid! Have a good week!
Friday, October 11, 2013
33 Week Bumpdate with a side of Mommy Guilt
33 Weeks. Wow! Baby Girl and I only had 2 appointments this week. One with the regular OB for my non-stress test and one with MFM for a BPP. Again, everything looked beautiful on the NST. Her heart rate was accelerating when she moved and then returning to baseline. Every time they hook me up to that machine I feel like I am at the racetrack. Her heartbeat sounds like a galloping horse. My blood pressure remains completely normal and my weight is still on track.
Baby Girl also passed her BPP with 8 out of 8 points again. Amniotic fluid looks good, placenta seems ok, baby is moving around in there doing her baby yoga while staying head down. And she is doing her practice breathing consistently. Aside from my new found discomfort this week in my lower pelvis and my inability to get a good night's rest, everything has been moving along pretty swimmingly.
Until the doctor came in and we started talking about her measurements. Just three weeks ago she was measuring 3 pounds 6 ounces, ranking her in the 68th percentile. This week she is measuring 5 pounds 7 ounces, shooting her into the 82nd percentile. Not what I wanted to hear. Also her abdominal measurement is slightly ahead of that at the 91st percentile. I felt disappointment. Guilt. Failure.
I was hoping I would have the exemplary pregnancy with type 1 diabetes. I was hoping I would not have a "big baby"associated with poor diabetes control. My control has been fantastic throughout my pregnancy, but others will still attribute her size to something I did. And I did do a lot... right. I've stalked my blood sugar into compliance most of the time. But it doesn't seem to be enough. I feel exactly like Kim in this post.
Maybe I would have had a larger baby even without diabetes in the picture. I was born over 5 pounds at just 34 weeks. Baby girl isn't too far ahead of that. But maybe I should have contacted my endo sooner when I was noticing some periods of high blood sugar. Maybe I should have bolused earlier to prevent some after meal spikes. Maybe I should never have looked at Doritos during this pregnancy. Maybe, maybe, maybe... the truth is, it's impossible to know. All I can do is my best, and that's what I've been doing all along. But I still feel like I've let her down, as if I haven't given my daughter the best environment to grow and develop.
Many bloggers including myself have said before that diabetes comes with a lot of guilt. Guilt about what you eat or don't eat, guilt about how much insulin you might require compared to someone else, guilt over complications that arise. This pregnancy is no exception. The guilt is intensified because not only do my actions affect me, they directly affect my baby. I only want the best for her.
I know having a bigger baby isn't the worst thing that could happen. Compared to all the other risks, it doesn't even sound like it should be an adverse outcome. Only this time when someone assumes her size is "because of my diabetes," I might have to agree. And in that, I feel like diabetes won this round.
Her size will continue to be monitored. If she stays on this trend, she will likely need to be born at 37 weeks. Like many other things, we will just watch and wait. Hopefully seeing her chubby little cheeks when she gets here will melt the guilt away.
Baby Girl also passed her BPP with 8 out of 8 points again. Amniotic fluid looks good, placenta seems ok, baby is moving around in there doing her baby yoga while staying head down. And she is doing her practice breathing consistently. Aside from my new found discomfort this week in my lower pelvis and my inability to get a good night's rest, everything has been moving along pretty swimmingly.
Until the doctor came in and we started talking about her measurements. Just three weeks ago she was measuring 3 pounds 6 ounces, ranking her in the 68th percentile. This week she is measuring 5 pounds 7 ounces, shooting her into the 82nd percentile. Not what I wanted to hear. Also her abdominal measurement is slightly ahead of that at the 91st percentile. I felt disappointment. Guilt. Failure.
I was hoping I would have the exemplary pregnancy with type 1 diabetes. I was hoping I would not have a "big baby"associated with poor diabetes control. My control has been fantastic throughout my pregnancy, but others will still attribute her size to something I did. And I did do a lot... right. I've stalked my blood sugar into compliance most of the time. But it doesn't seem to be enough. I feel exactly like Kim in this post.
Maybe I would have had a larger baby even without diabetes in the picture. I was born over 5 pounds at just 34 weeks. Baby girl isn't too far ahead of that. But maybe I should have contacted my endo sooner when I was noticing some periods of high blood sugar. Maybe I should have bolused earlier to prevent some after meal spikes. Maybe I should never have looked at Doritos during this pregnancy. Maybe, maybe, maybe... the truth is, it's impossible to know. All I can do is my best, and that's what I've been doing all along. But I still feel like I've let her down, as if I haven't given my daughter the best environment to grow and develop.
Many bloggers including myself have said before that diabetes comes with a lot of guilt. Guilt about what you eat or don't eat, guilt about how much insulin you might require compared to someone else, guilt over complications that arise. This pregnancy is no exception. The guilt is intensified because not only do my actions affect me, they directly affect my baby. I only want the best for her.
I know having a bigger baby isn't the worst thing that could happen. Compared to all the other risks, it doesn't even sound like it should be an adverse outcome. Only this time when someone assumes her size is "because of my diabetes," I might have to agree. And in that, I feel like diabetes won this round.
Her size will continue to be monitored. If she stays on this trend, she will likely need to be born at 37 weeks. Like many other things, we will just watch and wait. Hopefully seeing her chubby little cheeks when she gets here will melt the guilt away.
Saturday, October 5, 2013
Week 32 Bumpdate
Pregnancy Symptoms- Minor swelling in my ankles after working one day. First time that's happened. Some heartburn. Trouble sleeping. It's usually my bladder or my brain. Or back/hip pain from sleeping on a side for a couple hours at a time. I can't wait until I can sleep on my back and stomach again.
Diabetes- Numbers seem to be compliant. Slight highs are usually because I miscounted carbs. I consider a slight high over 150. Lows are not too frequent. My endo cut back on some overnight basals because I was waking up low at night some and having to eat or drink juice. I had a 50 one night after I already drank a juice, so it was probably lower than that to begin with. Sometimes I don't feel the low until I'm on my way back up. That's how this one was because after I ate glucose tablets and half a granola bar I felt like I was sweating to death after running a marathon. My heart was pounding. You would think your body would try to "slow down" to conserve sugar but it seems to be the opposite. My endo was ecstatic this week after looking at my CGM data collectively. He said he wanted to make it a slide because it was so awesome! Hourly averages were all in range and my standard deviation was less than 25, which is amazing! Insulin to carb ratios were kept the same for now which translates to 1 unit of insulin per 1.5 grams of carbohydrate. I try to keep meals to under 45 grams of carbs because taking that much insulin still scares me, even though I really have not had any post prandial lows. I was told to keep emailing my data every 3 days or so, but could wait two weeks til my next endo appointment because I am doing such a great job.
Baby Status- Still cooking! This week I had my routine non stress test on Tuesday and passed with flying colors. Baby was moving like a rock star and her heart rate was accelerating appropriately. Then I had a routine BPP Thursday. No growth measurements this time, but she got 8 out of 8 points for everything they assess and we were done in 30 minutes. At the last one I had, she was not doing her practice breathing so I had to have another NST after the BPP. I also found out she has hair! It's probably peach fuzz, but still...
Eye Follow Up- The retinologist dilated my eyes again to see if there was any progression of my retinopathy. Everything looked stable from last time, so that was great news. He wants another follow up in 5 weeks and if everything is still stable, my eyes should have no impact on the method of delivery. He did say that at my first visit, my retinopathy would have been classified as mild to moderate nonproliferative. Now it is severe nonproliferative, most likely due to the pregnancy. But usually only proliferative retinopathy would dictate a c-section or not. Again, he talked about probable regression after delivery but also said that postpartum hormones can also cause progression. It will be another wait and see if I will need further testing or treatment after baby girl arrives.
Labor Plan- Delivery at 39 weeks. The current plan is to attempt a vaginal delivery if baby girl wants out any time before 39 weeks. But if she needs to be coaxed, I want a c-section rather than an induction. I don't like the idea of chemically inducing my body to give birth. I don't like the potential side effects of Pitocin. I know surgery is surgery and involves longer recovery time, but I just find it to be the more practical option, especially with my diabetes. It's interesting because each doctor I've seen has a different opinion about it. My regular OB was on board with my plan, but said he may still try to twist my arm for an induction at the end if my cervix is very favorable. One high risk OB from MFM said it is totally my decision as long as I was educated about all of the options. She did not feel my controlled diabetes would have any severe effects on my healing if I chose to have a c-section any more than the average person. Another MFM physician said she recommended induction if there was any way I could have a vaginal delivery since there are more potential complications with c-sections. My endo said he prefers all his type 1's have c-sections because it's quick and controlled and probably the easiest option to manage blood sugar control. Talk about confusing. But I've realized that ultimately it is my decision. I feel if my body is ready to deliver spontaneously, we'll roll with it. If not, it's surgery. I just want what's best for my baby, me, and my diabetes.
Labor Worries- If I labor, I am nervous about controlling my blood sugar. My endo suggests I keep my pump on under his orders. MFM suggests I do an insulin and glucose IV because they don't know what do with pumps in case an emergency situation arises. Plus IV insulin is instant in action. Subcutaneous insulin from the pump can have absorption issues. I talked to my endo about this. He said he is willing to give orders for either options. They are like apples and bananas...both fruits. (Are we sensing a little My Big, Fat, Greek Wedding in here?) He is just biased towards the pump, but I should make a decision based on my comfort level. Can someone please just tell me what to do!? How am I supposed to know what I'm comfortable with? I've never given birth with diabetes before!
I will keep my CGM on my arm, for my own peace of mind. I know there is lag time on that as well but I would feel better with it on, tracking trends while laboring in between the hourly blood sugar testing that will occur.
I worry about epidurals or spinals gone wrong. I worry about when I should get the epidural if I am laboring. Should I try and wait it out as long as possible so as not to slow labor or decrease the intensity of the contractions? I worry about recovery after surgery if that's the route we go. I am nervous that my choices will be wrong. I need to let it go!
7 More weeks, at most. I can't wait to see her pretty face.
Diabetes- Numbers seem to be compliant. Slight highs are usually because I miscounted carbs. I consider a slight high over 150. Lows are not too frequent. My endo cut back on some overnight basals because I was waking up low at night some and having to eat or drink juice. I had a 50 one night after I already drank a juice, so it was probably lower than that to begin with. Sometimes I don't feel the low until I'm on my way back up. That's how this one was because after I ate glucose tablets and half a granola bar I felt like I was sweating to death after running a marathon. My heart was pounding. You would think your body would try to "slow down" to conserve sugar but it seems to be the opposite. My endo was ecstatic this week after looking at my CGM data collectively. He said he wanted to make it a slide because it was so awesome! Hourly averages were all in range and my standard deviation was less than 25, which is amazing! Insulin to carb ratios were kept the same for now which translates to 1 unit of insulin per 1.5 grams of carbohydrate. I try to keep meals to under 45 grams of carbs because taking that much insulin still scares me, even though I really have not had any post prandial lows. I was told to keep emailing my data every 3 days or so, but could wait two weeks til my next endo appointment because I am doing such a great job.
Baby Status- Still cooking! This week I had my routine non stress test on Tuesday and passed with flying colors. Baby was moving like a rock star and her heart rate was accelerating appropriately. Then I had a routine BPP Thursday. No growth measurements this time, but she got 8 out of 8 points for everything they assess and we were done in 30 minutes. At the last one I had, she was not doing her practice breathing so I had to have another NST after the BPP. I also found out she has hair! It's probably peach fuzz, but still...
Eye Follow Up- The retinologist dilated my eyes again to see if there was any progression of my retinopathy. Everything looked stable from last time, so that was great news. He wants another follow up in 5 weeks and if everything is still stable, my eyes should have no impact on the method of delivery. He did say that at my first visit, my retinopathy would have been classified as mild to moderate nonproliferative. Now it is severe nonproliferative, most likely due to the pregnancy. But usually only proliferative retinopathy would dictate a c-section or not. Again, he talked about probable regression after delivery but also said that postpartum hormones can also cause progression. It will be another wait and see if I will need further testing or treatment after baby girl arrives.
Labor Plan- Delivery at 39 weeks. The current plan is to attempt a vaginal delivery if baby girl wants out any time before 39 weeks. But if she needs to be coaxed, I want a c-section rather than an induction. I don't like the idea of chemically inducing my body to give birth. I don't like the potential side effects of Pitocin. I know surgery is surgery and involves longer recovery time, but I just find it to be the more practical option, especially with my diabetes. It's interesting because each doctor I've seen has a different opinion about it. My regular OB was on board with my plan, but said he may still try to twist my arm for an induction at the end if my cervix is very favorable. One high risk OB from MFM said it is totally my decision as long as I was educated about all of the options. She did not feel my controlled diabetes would have any severe effects on my healing if I chose to have a c-section any more than the average person. Another MFM physician said she recommended induction if there was any way I could have a vaginal delivery since there are more potential complications with c-sections. My endo said he prefers all his type 1's have c-sections because it's quick and controlled and probably the easiest option to manage blood sugar control. Talk about confusing. But I've realized that ultimately it is my decision. I feel if my body is ready to deliver spontaneously, we'll roll with it. If not, it's surgery. I just want what's best for my baby, me, and my diabetes.
Labor Worries- If I labor, I am nervous about controlling my blood sugar. My endo suggests I keep my pump on under his orders. MFM suggests I do an insulin and glucose IV because they don't know what do with pumps in case an emergency situation arises. Plus IV insulin is instant in action. Subcutaneous insulin from the pump can have absorption issues. I talked to my endo about this. He said he is willing to give orders for either options. They are like apples and bananas...both fruits. (Are we sensing a little My Big, Fat, Greek Wedding in here?) He is just biased towards the pump, but I should make a decision based on my comfort level. Can someone please just tell me what to do!? How am I supposed to know what I'm comfortable with? I've never given birth with diabetes before!
I will keep my CGM on my arm, for my own peace of mind. I know there is lag time on that as well but I would feel better with it on, tracking trends while laboring in between the hourly blood sugar testing that will occur.
I worry about epidurals or spinals gone wrong. I worry about when I should get the epidural if I am laboring. Should I try and wait it out as long as possible so as not to slow labor or decrease the intensity of the contractions? I worry about recovery after surgery if that's the route we go. I am nervous that my choices will be wrong. I need to let it go!
7 More weeks, at most. I can't wait to see her pretty face.
Tuesday, October 1, 2013
Random Reflections
I can't believe this week will be 32 weeks! Only 7 more to go, at most! This pregnancy has flown by and I'm not sure if it's because my day to day diabetes management takes up so much brain space, or the little lady has sucked out some brain cells that control my perception of time. Either way it is amazing and exciting.
She is moving A LOT now, and she flipped to the head down position as she must be preparing for her landing. I have also noticed lots of hiccups which feel like little rhythmic twitches inside of me. The wiggles and movements are what I will miss the most about being pregnant. They are constant reminders that my body is miraculously building a whole new human. For me, there is no greater accomplishment.
Sometimes I still can't believe that I will be a mother. It will be a whole new identity to relish. Like my mom has said (and like I've admittedly done so many times) she will only see me as her mother for many many years. She won't think of me as a whole person who had a life before her. She won't really believe that I was just like her with dreams and fears and insecurities and hobbies and good days and bad days...she will only know that I can and will take care of her and that I love her. For that, she'll call me mom.
She won't really be able to process how I met her father and how it has been an emotional journey into marriage and beyond. Or that her father and I were really just two strangers that met and became a family and one day hoped for a little one to title us parents. She will think we were born parents like everyone else thinks of their own mother and father until they reach a certain age.
She won't know that I love sitting on my porch on a Sunday morning with the sunshine glinting on the leaves and the sounds of the birds and the crickets filling up an empty sky. It is my quiet time to reflect or sometimes write. For me, it is a spiritual time. It's my church.
Funny how the happiest and most joyous occasions in life are usually marked by the tiniest slivers of mourning. I suppose it's the juxtaposition of the two that really makes the joy that much more heartfelt. I am in NO WAY regretful or sad about becoming a mother, but I recognize that this life as I know it will simply not exist anymore once she is here. There will be small glimpses of it that I will miss, even though I know Baby Girl's arrival will undoubtedly be the happiest and most emotional moment in my life. It is a change for the better but still a major change. An unceremonious closing of the previous chapter while ringing in a new one. Change, good or bad, always makes me anxious.
I'm the kind of person who likes to know what's coming. I'm a planner, a "lister", a comparison chart maker...I like doing anything where I can look at the facts and analyze them to see an outcome. Momentous occasions just don't come with those kinds of charts. And babies don't come with instructions. I hope I can handle it!
She is moving A LOT now, and she flipped to the head down position as she must be preparing for her landing. I have also noticed lots of hiccups which feel like little rhythmic twitches inside of me. The wiggles and movements are what I will miss the most about being pregnant. They are constant reminders that my body is miraculously building a whole new human. For me, there is no greater accomplishment.
Sometimes I still can't believe that I will be a mother. It will be a whole new identity to relish. Like my mom has said (and like I've admittedly done so many times) she will only see me as her mother for many many years. She won't think of me as a whole person who had a life before her. She won't really believe that I was just like her with dreams and fears and insecurities and hobbies and good days and bad days...she will only know that I can and will take care of her and that I love her. For that, she'll call me mom.
She won't really be able to process how I met her father and how it has been an emotional journey into marriage and beyond. Or that her father and I were really just two strangers that met and became a family and one day hoped for a little one to title us parents. She will think we were born parents like everyone else thinks of their own mother and father until they reach a certain age.
She won't know that I love sitting on my porch on a Sunday morning with the sunshine glinting on the leaves and the sounds of the birds and the crickets filling up an empty sky. It is my quiet time to reflect or sometimes write. For me, it is a spiritual time. It's my church.
Funny how the happiest and most joyous occasions in life are usually marked by the tiniest slivers of mourning. I suppose it's the juxtaposition of the two that really makes the joy that much more heartfelt. I am in NO WAY regretful or sad about becoming a mother, but I recognize that this life as I know it will simply not exist anymore once she is here. There will be small glimpses of it that I will miss, even though I know Baby Girl's arrival will undoubtedly be the happiest and most emotional moment in my life. It is a change for the better but still a major change. An unceremonious closing of the previous chapter while ringing in a new one. Change, good or bad, always makes me anxious.
I'm the kind of person who likes to know what's coming. I'm a planner, a "lister", a comparison chart maker...I like doing anything where I can look at the facts and analyze them to see an outcome. Momentous occasions just don't come with those kinds of charts. And babies don't come with instructions. I hope I can handle it!
Tuesday, September 24, 2013
31 Weeks: What free time?
.JPG) |
| This is my calendar for the next 4 weeks. That makes 16 appointments. There are 3 on the third...so many that I couldn't even fit them all in one day slot! High risk pregnancies are major time commitments! |
Monday, September 23, 2013
Looking Back: Second Trimester Notables
Weight Gain- At 15 weeks I had only gained 1 pound, but after that steadily put on about 1 to 2 pounds per week. In the early weeks I really craved citrus fruits like pineapple and grapefruit and oranges. In the second trimester it was more like potato chips and ice cream.
Insulin Needs- Gradually increased. Not basal rates so much as I:C ratios for bolusing in the beginning, but both increasing at the end. Totally normal for pregnancy. It happens in normal people's bodies, they just don't know it. The more hormones that placenta makes, the more insulin required. Pump sites needed to be changed more frequently because of the increase in insulin. That was definitely one of the most annoying things for me. Why is changing a pump site and refilling a reservoir such a chore? The change from every 3 days to every 2 days seemed like so much more!
Blood Sugars- Not too low anymore, but seemed to be fairly stable and within range most of the time until about 26 weeks. A1c somehow held steady around 5.8 despite more 200's creeping in to the rotation. If I had any readings over 240 however, I would give an insulin injection with a syringe for faster absorption to get the sugar down quicker. Most of the highs would happen overnight and would take multiple corrections or an injection to bring them down. After emailing my endo and changing basals and a dinner bolus ratio, things were back on track for awhile.
Sex of the Baby- 18 weeks was the big week. I was ok waiting or finding out, but B really wanted to know...A GIRL! Of course I would have welcomed a little boy, but the thought of a little girl made my heart swell and my eyes tear. And then I thought of all the things I had experienced growing up and wished her at least the same moments of happiness and less of the moments of hurt. B had thought all along it was a girl. He said he was destined to be wrapped around her finger. The rest of the ultrasound was great. Baby Girl was measuring in the 35th percentile, so she wasn't bulking up yet due to my diabetes. All the organs looked normal.
Fetal Echo- My high risk OB(otherwise known as a specialist in MFM) recommended Baby Girl have an echocardiogram of her heart around 22-25 weeks since babies of women with T1D are at a slightly greater risk of having a heart defect. She cooperated and everything checked out ok without any real concerns.
Shower Plans- My mother in law was planning a shower at a tearoom with family and friends. My mom was planning on having one 2 weeks later at a hall, also with family and friends. I started registering for all kinds of things that I didn't think would fit in the house.
Eye Update- Another exam, dilation, and fancy pictures. I was definitely disappointed to find out that my eyes had worsened since the first visit, but not to the point of needing treatment. New microaneurysms. More watching and waiting and following up. As to be expected with diabetes and lots of growth hormones flying around during pregnancy, but I still felt defeated, hoping I would be in the small percent of cases where things remained stable. The retinologist reiterated that these things usually regressed after delivery.
New Worries- Hoping I could breastfeed, investigating breast pumps and how to order one through insurance, thinking about changes in insurance plans.
New Excitements- Feeling Baby Girl kick around 18 weeks! And sporting a serious baby bump. Also, B worked on painting and setting up the crib and moved furniture to transform our office into a nursery.
 |
| That's me half-way through! |
Blood Sugars- Not too low anymore, but seemed to be fairly stable and within range most of the time until about 26 weeks. A1c somehow held steady around 5.8 despite more 200's creeping in to the rotation. If I had any readings over 240 however, I would give an insulin injection with a syringe for faster absorption to get the sugar down quicker. Most of the highs would happen overnight and would take multiple corrections or an injection to bring them down. After emailing my endo and changing basals and a dinner bolus ratio, things were back on track for awhile.
Sex of the Baby- 18 weeks was the big week. I was ok waiting or finding out, but B really wanted to know...A GIRL! Of course I would have welcomed a little boy, but the thought of a little girl made my heart swell and my eyes tear. And then I thought of all the things I had experienced growing up and wished her at least the same moments of happiness and less of the moments of hurt. B had thought all along it was a girl. He said he was destined to be wrapped around her finger. The rest of the ultrasound was great. Baby Girl was measuring in the 35th percentile, so she wasn't bulking up yet due to my diabetes. All the organs looked normal.
Fetal Echo- My high risk OB(otherwise known as a specialist in MFM) recommended Baby Girl have an echocardiogram of her heart around 22-25 weeks since babies of women with T1D are at a slightly greater risk of having a heart defect. She cooperated and everything checked out ok without any real concerns.
Shower Plans- My mother in law was planning a shower at a tearoom with family and friends. My mom was planning on having one 2 weeks later at a hall, also with family and friends. I started registering for all kinds of things that I didn't think would fit in the house.
Eye Update- Another exam, dilation, and fancy pictures. I was definitely disappointed to find out that my eyes had worsened since the first visit, but not to the point of needing treatment. New microaneurysms. More watching and waiting and following up. As to be expected with diabetes and lots of growth hormones flying around during pregnancy, but I still felt defeated, hoping I would be in the small percent of cases where things remained stable. The retinologist reiterated that these things usually regressed after delivery.
New Worries- Hoping I could breastfeed, investigating breast pumps and how to order one through insurance, thinking about changes in insurance plans.
New Excitements- Feeling Baby Girl kick around 18 weeks! And sporting a serious baby bump. Also, B worked on painting and setting up the crib and moved furniture to transform our office into a nursery.
 |
| Picture my mom painted |
.JPG) |
| Baby Girl's pretty butterfly mobile |
Saturday, September 21, 2013
Looking Back: The First Trimester
I would have to say I was pretty lucky in the way of pregnancy symptoms at first, as in I barely had any! I was really worried about morning sickness. I had read of scary scenarios where people bolused insulin to cover a meal and then couldn't eat, or they couldn't keep it down and then had spirals of hypoglycemia while trying to choke down juice or glucose tabs. Not a problem of mine! I was eating like a champ and downing more carbs than I normally would have because my body required the energy most of the time to avoid a low. My thoughtful hubby did get me a food scale for my birthday which made it much easier to count carbs and measure portions in conjunction with Calorie King. Most "normal" (non-diabetic) people would probably have been a little upset with the gift, but my type 1 self was pretty pumped about it. Around week 7 my appetite plummeted and I had a strange aversion to meat and vegetables that lasted about a week. Then it was back to eating as normal.
As far as my insulin requirements, my basals were scaled back to prevent me from going low in between meals but my bolus ratios were almost immediately increased to prevent the after meal glucose spikes. I felt like I was taking much larger boluses than I was used to, but in order to stay under 120 1 hour after eating my endo knew it was necessary. Another big difference was that my endo team said in order to keep my blood sugar that low 1 hour after eating but to avoid a hypo at 2 hours, I should eat a small snack without bolusing about an hour and half after eating my meal. In other words, we know we are overdosing you with insulin to keep the postprandial readings down so then you need to eat more to even out. After a few days it was clear that it was working well. Almost too well! I had not seen numbers this smooth in years! My next hemoglobin A1C reflected the efforts. It was in the 5's which I had never seen since managing my own diabetes.
I had biweekly meetings with my endo during this critical period of organ formation. This really helped me stay on track along with stalking and logging my blood sugars by testing upwards of 15 times a day and using my CGM data. I found that after breakfast blood sugars were the hardest to control, so I started eating the same breakfast EVERY day. Greek yogurt with fruit and almonds. This seemed to keep me pretty stable and full from the protein and fat. My overnight readings remained awesome and mostly stable according to my CGM, landing me under 100 each morning for fasting readings which is the goal during pregnancy. I did have a good number of nights during the first trimester where my CGM would alarm me that I was low, so I would wake up and have a few sips of juice or a literal bite of a granola bar. My endo loved those comments on my log sheet... he said he's never seen anyone be so specific.
All in all, we were off to a great start. No icky pregnancy symptoms, no blood sugars running rampant, nothing too bizarre aside from the frequent need to eat to avoid a low. (What's a pregnant woman to do?!) I did get some disappointing news after visiting my opthamologist in the first trimester also mandated by my endo. He nearly flipped when I said I had not scheduled an appointment yet and I was only around 9 weeks at that point. I went to my appointment expecting the usual exam of the front of the eyes, dilating drops, and then an exam of my retinas to make sure there wasn't any retinopathy present. The last year my eyes had been clean with no evidence of diabetes. My doctor examined my eyes and said she didn't want to alarm me, but she did want me to see a retinologist because she thought she saw a few microaneurysms. Nothing to freak out about, right? It's only possible bleeding in my eyes!
I made an appointment with a specialist and went in very nervous. This time they took very fancy digital pictures of my retinas using a special machine and examined my eyes like usual. The good news was that my eyes were in good shape for someone with diabetes for 27 years, but the bad news was that indeed there were a few microaneurysms in each eye. No bleeding or leaking which is good. Non-proliferative retinopathy is what he called it. I was told that because of all the hormones and extra fluids in pregnancy that sometimes it could drastically worsen, but then usually regresses after delivery. It could play a role in how my baby would be delivered. If it did progress, there was a chance that a c-section would be recommended to save my eyes from the strain of pushing and ultimately rupturing a vessel. But it could also stay at baseline. All I could do was schedule a follow up appointment during the second trimester and see.
I felt a little defeated. Did I fail myself? Was I going to fail my baby? Was it something I did or all the things I didn't do? I was scared and uncomfortable to admit that this was a complication of diabetes. Why is that uncomfortable for people in this community? Because it usually assigns blame to the person for not handling things appropriately instead of to the disease that causes it. People are judged unfairly when they say they have complications whether or not they are controlled. Control alone isn't always enough.
I went home feeling some anxiety, but still happy that the baby was healthy so far. I tried to concentrate on my small miracle and keep my blood sugars happy without letting worry interfere.
As far as my insulin requirements, my basals were scaled back to prevent me from going low in between meals but my bolus ratios were almost immediately increased to prevent the after meal glucose spikes. I felt like I was taking much larger boluses than I was used to, but in order to stay under 120 1 hour after eating my endo knew it was necessary. Another big difference was that my endo team said in order to keep my blood sugar that low 1 hour after eating but to avoid a hypo at 2 hours, I should eat a small snack without bolusing about an hour and half after eating my meal. In other words, we know we are overdosing you with insulin to keep the postprandial readings down so then you need to eat more to even out. After a few days it was clear that it was working well. Almost too well! I had not seen numbers this smooth in years! My next hemoglobin A1C reflected the efforts. It was in the 5's which I had never seen since managing my own diabetes.
I had biweekly meetings with my endo during this critical period of organ formation. This really helped me stay on track along with stalking and logging my blood sugars by testing upwards of 15 times a day and using my CGM data. I found that after breakfast blood sugars were the hardest to control, so I started eating the same breakfast EVERY day. Greek yogurt with fruit and almonds. This seemed to keep me pretty stable and full from the protein and fat. My overnight readings remained awesome and mostly stable according to my CGM, landing me under 100 each morning for fasting readings which is the goal during pregnancy. I did have a good number of nights during the first trimester where my CGM would alarm me that I was low, so I would wake up and have a few sips of juice or a literal bite of a granola bar. My endo loved those comments on my log sheet... he said he's never seen anyone be so specific.
All in all, we were off to a great start. No icky pregnancy symptoms, no blood sugars running rampant, nothing too bizarre aside from the frequent need to eat to avoid a low. (What's a pregnant woman to do?!) I did get some disappointing news after visiting my opthamologist in the first trimester also mandated by my endo. He nearly flipped when I said I had not scheduled an appointment yet and I was only around 9 weeks at that point. I went to my appointment expecting the usual exam of the front of the eyes, dilating drops, and then an exam of my retinas to make sure there wasn't any retinopathy present. The last year my eyes had been clean with no evidence of diabetes. My doctor examined my eyes and said she didn't want to alarm me, but she did want me to see a retinologist because she thought she saw a few microaneurysms. Nothing to freak out about, right? It's only possible bleeding in my eyes!
I made an appointment with a specialist and went in very nervous. This time they took very fancy digital pictures of my retinas using a special machine and examined my eyes like usual. The good news was that my eyes were in good shape for someone with diabetes for 27 years, but the bad news was that indeed there were a few microaneurysms in each eye. No bleeding or leaking which is good. Non-proliferative retinopathy is what he called it. I was told that because of all the hormones and extra fluids in pregnancy that sometimes it could drastically worsen, but then usually regresses after delivery. It could play a role in how my baby would be delivered. If it did progress, there was a chance that a c-section would be recommended to save my eyes from the strain of pushing and ultimately rupturing a vessel. But it could also stay at baseline. All I could do was schedule a follow up appointment during the second trimester and see.
I felt a little defeated. Did I fail myself? Was I going to fail my baby? Was it something I did or all the things I didn't do? I was scared and uncomfortable to admit that this was a complication of diabetes. Why is that uncomfortable for people in this community? Because it usually assigns blame to the person for not handling things appropriately instead of to the disease that causes it. People are judged unfairly when they say they have complications whether or not they are controlled. Control alone isn't always enough.
I went home feeling some anxiety, but still happy that the baby was healthy so far. I tried to concentrate on my small miracle and keep my blood sugars happy without letting worry interfere.
Thursday, September 19, 2013
Looking Back: Baby on Board!
When my husband B and I found out I was pregnant I think we were both in shock despite knowing that this could actually happen. For almost my entire adult life, I never really believed that I would be able to conceive. (I probably attributed this to diabetes even though it's not a proven factor to inhibit fertility. But everything in the world has a warning sticker on it that says, "If you are diabetic, please consult your physician before using this, doing this, eating this, etc." Not to mention many uneducated people attribute random negative things that happen to you to diabetes. I find this humorous. More on this in another post). But there it was, a gleaming blue plus sign that said I most certainly was pregnant.
Cue a dance of joy in my head. At that very moment, I was building a new tiny life inside of me despite doubtful thoughts and despite years of diabetes. THIS WAS HAPPENING and diabetes wasn't stopping me. Then I immediately became nervous. I AM TYPE 1 DIABETIC AND PREGNANT! How am I going to manage this so that my baby is healthy?
About a year before this I told myself I was going to get in shape and make my body a healthy environment for a possible little babe. We joined a gym and used it regularly. I switched to a lower carbohydrate diet. We bought lots of organic food. For months I had been wrangling in blood sugars that were higher than recommended for conception. Then I got a CGM. This is my holy grail of diabetes management. I wasn't afraid to run on the lower side anymore, because it would alert me if I was too low. I could go to bed without worrying that I would be hypoglycemic in the night and not wake up at all. I could track the trends of my blood sugar and concentrate on areas that needed improvement. My first A1C after starting the CGM was nearly a full point lower than the last test. Success!
I absolutely love my endo team. My doctor is a straight shooter and someone I can be real with. He also has an awesome CDE who not only makes suggestions at a pace with which I'm comfortable, but allows me to have input in the decisions about my health. A few more months of tweaking basals and boluses on my insulin pump settings and my A1C was nearly there. Then finally we got the green light.
We found out I was pregnant a week or so before my next regularly scheduled endo appointment. So after freaking out for a minute after seeing the plus sign, I took a breath and reminded myself that I would have a lot of guidance. At that first appointment I found out my A1C was 6.0 when we conceived which was right on target! My endo asked if I had noticed any changes in my management yet. The only thing I could tell so far was that I was getting low much more often. We scaled back on some of my basal rates which is par for the course of a diabetic pregnancy in the early stages. Your body is so busy trying to build every little cell of the baby so perfectly that it uses a lot of energy! I made an appointment for 2 weeks later and I was on my way! It was a great feeling knowing that I was in control of all I could be and our little baby was taking up residence.
Wednesday, September 18, 2013
That's What it's All About
My name is Jill and I've been a diabetic for 27 years. Sounds like I am making a confession and in a way, I guess I am. There have been many periods in my life when I've chosen to ignore diabetes and other times when I acknowledged it but didn't own it. Then there were times when I felt I really held the reigns of this disease. Despite my relationship with diabetes through the tumult, this life has been full of wonderful, emotional, affirming, and terrifying experiences alongside hundreds of thousands of needle sticks, pokes, and proddings.
Two years ago I was in a dark place and diabetes was the main culprit. I had a lot of anxiety about lows and sometimes I felt completely helpless. I was also experiencing signs of early complications and the stress was negatively affecting my diabetes even more. I was afraid of living a life marked by poor diabetes control and ultimately of dying too young to experience all that I wanted. My husband was a great source of support, but I needed something more. I also felt like I did not want to burden my family with my worries and I needed to find others who really understood these feelings.
After doing some google searches I came across a diabetes blog called Six Until Me written by Kerri Sparling. Reading her words made me feel as if someone else was out there who understood. I continued reading and researching and pretty soon I was fully immersed in the DOC, getting daily subscriptions to my favorite bloggers and laughing and crying along with them about all things diabetes.
Fast forward to now and you will find me 7 months pregnant with my first baby while experiencing the best diabetes control I have ever seen since diagnosis. It was through the online community that I found the support of strangers with whom I shared so much just by reading their words. This type of social connection significantly impacted my outlook on this ever- enduring disease, and I realized I could still learn a thing or two despite living with diabetes for more than 2 decades.
So while my initial reasons for getting involved in the DOC were sort of dark and self-centered, it's because of the DOC that I am living the healthy life I wanted and also starting a new one. This blog is dedicated to all the people who live with diabetes directly or indirectly and need a place to come to laugh about it, cry about it, and just be real about it. It's about living a healthy life despite an angry and unyielding disease. It's about support and focusing on the finer points of life, not the sharper ones. :)
Two years ago I was in a dark place and diabetes was the main culprit. I had a lot of anxiety about lows and sometimes I felt completely helpless. I was also experiencing signs of early complications and the stress was negatively affecting my diabetes even more. I was afraid of living a life marked by poor diabetes control and ultimately of dying too young to experience all that I wanted. My husband was a great source of support, but I needed something more. I also felt like I did not want to burden my family with my worries and I needed to find others who really understood these feelings.
After doing some google searches I came across a diabetes blog called Six Until Me written by Kerri Sparling. Reading her words made me feel as if someone else was out there who understood. I continued reading and researching and pretty soon I was fully immersed in the DOC, getting daily subscriptions to my favorite bloggers and laughing and crying along with them about all things diabetes.
Fast forward to now and you will find me 7 months pregnant with my first baby while experiencing the best diabetes control I have ever seen since diagnosis. It was through the online community that I found the support of strangers with whom I shared so much just by reading their words. This type of social connection significantly impacted my outlook on this ever- enduring disease, and I realized I could still learn a thing or two despite living with diabetes for more than 2 decades.
So while my initial reasons for getting involved in the DOC were sort of dark and self-centered, it's because of the DOC that I am living the healthy life I wanted and also starting a new one. This blog is dedicated to all the people who live with diabetes directly or indirectly and need a place to come to laugh about it, cry about it, and just be real about it. It's about living a healthy life despite an angry and unyielding disease. It's about support and focusing on the finer points of life, not the sharper ones. :)
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