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.
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