Showing posts with label pregnancy. Show all posts
Showing posts with label pregnancy. Show all posts

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!


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.

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!

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.

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.  :)