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Thursday, December 22, 2016

Postpartum adjustments. aka taking care of a baby... and diabetes too

If you scroll back a few posts (back to 39 weeks) you would see in my Dexcom report that I used to calibrate my Dex about 5 times a day while pregnant. I also tested about 10 times a day on top of checking Dexcom obsessively. In fact I made diabetes the biggest priority of my life (as in a bigger priority than my job or anything else). I would bolus down a BG of 110 or 120 while driving, I would stash my insulin pen in my back pocket for quick access during work lunches. I would check my BG and bolus in public if needed. I would eat one smartie at a time to treat a 55 BG to ensure I did not shoot up too high. I would eat the same two options of breakfast and lunch each an every day to ensure I met my targets. Not to mention the part where I would download my two-week Dexcom history in preparation for every prenatal appointment. As a result, I stayed in the non-diabetic BG range aout 90% of the time throughout my entire pregnancy, achiving non-diabetic A1Cs in the low 5% range consistently, and generally felt very accoplished about my management. The work was worthwhile. I delivered a healthy baby girl at full term and experienced exactly zero complications related to diabetes during my pregnancy. In fact, my diligence (or obsession) paid off so much so that I felt I had a relatively normal and overall quite easy pregnancy and I can't wait to do it again. Overall, it was a very positive experience. Also, if I can do it, anyone can - I really believe that.

Now, almost 4 weeks after giving birth, things are quite a bit different. Let's back up to the day of the surgery. Within a few hours of delivery my BG was registering in the 80s and 70s consistently, which prompted the gradual lowering of insulin infusion in the IV drip. This escalated, and the insulin was shut off altogether (while the Dextrose drip remained) and my BG stayed in the 70s for hours without additional insulin (as the Levemir from the previous day was still doing its work I presume). These developments prompted my decision to go to 5 and 5 units Levemir split for my initial "return" dose instead of the 7 and 7 I originally planned upon. I also set my I:C to be 1:15 at first. Within the next day and a half - promptly after surpassing a BG of 200 for the first time in months, I re-set my doses to be 6 and 6 for Levemir with a 1:10 I:C, which was where they remained for a few weeks. (Aside; the hospital staff was excellent - just excellent - at letting me do whatever I needed to do, including using my own meter [which as I learned reads about 20 points higher than theirs] and insulin pens.) Currently, I am doing 8 and 8 Levemir and a 1:8 I:C, although I am now planning to lower the evening Levemir dose back to 7. Whew.

In the past 4 weeks there were night-time low battles - the only pattern I can identify is that sometimes I drop low after baby cluster-feeds and my milk supply is being replenished. All I can do is eat Pizelles, drink Capri Suns, or (my favorite!) eat giant sour patch kids to fix these lows. There was one night where I consumed about 30g or 40g of carbs uncovered and did not go high. There was last night where I only had to consume about 15g overnight to stay stedy in the 80s and then wake up at 62, but 15g is still too much for me to keep my basal dose. Things do not have as much of a pattern as they did during the pregnancy, which is annoying. But another reason for this lack of tight control is that I am not as diligent as I was during pregnancy at identifying the patterns, perhaps. I no longer freak out about a BG of 140. I certaintly do not calibrate 5 times a day. Seriously, I am lucky if I test two times a day! I have not downloaded my Dexcom history since the week before delivery. Also, after the past year of excellent control I never thought that I would be so relaxed about bouncing between 60-180 on many days, but.. I am. My food choices are well... not as strict as they were during pregnancy. And to be honest, I am ok with that.. for now.

I am still happy that I am not really hitting 200s ever. I haven't had serious lows.. yet. I am pretty sure any endo on the planet would be happy with my A1C right now (even if I would personally consider it too high). So it's not like I have completely gone off the control train - in fact my control is still much much better than all the years leading up to preparing for pregnancy. I guess I have just come to expect a lot of myself if you know what I mean.

Now, when it comes to taking care of my baby girl, I am much more diligent. Sometimes I have to put her down to check BG or take my insulin, or eat when I haven't in hours, but let's be serious - she rules the show and I wouldn't have it any other way (have I mentioned that I lucked out and it seems she is an easy baby? that I actually am getting enough sleep? that I am probably jinxing myself by writing this? that I am so freaking happy she is in my life?) I also feel that re-assessing my food choices and becoming more stringent in my control goals again is on my radar in early 2017, because I want decades of health for myself and for my family (which I definitely plan on expanding on).

Happy holidays everyone - best wishes for a very happy new year!

Monday, December 5, 2016

The Birth Story

11/24 - Thanksgiving

I spend the evening at my sister-in-law's enjoying good food and (gasp) a half a glass of red wine for what I think was the second time all pregnancy. I declare that I have absolutely no signs of going into labor and that the baby would definitely arrive by scheduled C-section on the 30th.


It is the day of my last prenatal appointment and before driving into Boston for the 3pm BPP and prenatal I spend the morning at home trying to clean but dragging my feet. I feel an intermittent but painless tightening of my abdomen at seemingly regular intervals, and at one point I start using an app to time these "contractions" but quickly stop and laugh it off because while uncomfortable I did not consider them painful. But they were somewhat on my radar as they did not go away after drinking water and resting. Another new and intersting symptom was that every time I used the restroom (which was a lot of times at almost 40 weeks pregnant) I felt the baby drop. It was a sudden sensation that I can only equate to a sudden stop when you are on an elevator, experienced only in your pelvis. This was indeed interesting, and I wondered if I should bring up these developments to my medical team at my appointment...

As I drive in for my appointment (about an hour and a half drive), I experience probably six or eight of these "fake contractions", this time accompanied by some lower back discomfort (or dare I say mild pain), which I attribute to the discomfort of the driving position. As I drive, I enjoy what will be my last snack as a childless person (diet Pepsi, almonds, and pork rinds).

I arrive at Beth Israel and we pass the BPP with flying colors. Although Dr. H is not there the day after Thanksgiving, Dr. S is (I like him too). My blood pressure is actually OK and we discuss some details of the scheduled section. He asks about labor symtoms and I casually mention the baby dropping sensations and tell him that I have been experiencing "fake contractions all day". He asks how many and I estimate about 20. He seems slightly alarmed by this information and suggests (my first) cervical check (which sucks by the way) before sending me home to New Hampshire for the weekend. "I am sure I am not dilated - these contractions don't hurt at all!" I declare. (Famous last words). He determines that I am 2 cm dilated and I get hooked up to the monitor to see if I am contracting. After about 15 minutes, the nurse encourages me to drink water to check if the contractions they are detecting might be an artifact of dehydration.They are not. In fact they are coming at 3-5 minute intervals and are starting to feel very uncomfortable, especially in my lower back. An hour passes an my cervical check comes back at 3 cm dilated. I am not going anywhere.

At this point the doctor and nurse are laughing at me because apparently I both have a high pain tolerance and also I am apparently in severe denial of the fact that I am actually in labor. I feel like I am in a strange dream when Dr. S decrales that I should definitely make my phone calls, head to L&D, and we are having a baby today. I oblige. We discuss vaginal breech birth. It is not recommended for first time moms. "It is not a good time to test your pelvis Maria. If this was your third the conversation would be very different". He also tells me that it is actually more difficult to deliver a smaller baby breech than a larger one. I am ok with the section - I could never forgive myself if something went awry because I did not do what (as far as I can tell) is safest for *her. As I go to the garage for my hospital bag and to make phone calls before checking into the hospital, the contractions pick up. They feel exactly like strong period cramps, they come at regular intervals, and I feel OK about it as long as I am pacing. I am still in disbelief. I take half of my regular Levemir dose and correct the adrenaline-induced BG of 130 mg/dl with a unit of Humalog.

I check in and we wait out some hours for the food to clear my system and for the insulin/ D10 drip to get me to the "sweet zone" (no pun intended). It takes some time to stop flatlining at 130 and get BG under 110. As a result baby's birthday is delayed until early next morning. Labor progresses meanwhile. Strong/painful contractions (I feel them and the monitor shows as such), increasing in length and intensity, although from time to time becoming irregular, but also some as close as 2 minutes apart. A lot of blood in the toilet. It is a good thing I did not drive home today.

I have them check one last time that baby is breech. "Nothing but a butt down here". I am only slightly upset that I am having a c-section. It is what it is - baby's position is not in my control I tell myself as I take my last look in the mirror that day.


Midnight. I am led into the OR while B waits to be brought in after they set up. (I should mention that the plan was for B to sit by my head at all times so he doesn't have to see anything.) I am suddenly very anxious and terrified as I am brought into the OR and I take my position for the spinal. I verbalize this. Thankfully the anesthesiologist is a pro and gets it in on the first try. As I lay down I don't feel much at first, just a little numbness, but that quickly escalates. Like a wild trip, I feel out of control of my body. I tell myself that since I am talking, I am breathing. The catheter going in tickles like crazy and I can't stop laughing. And then I think I panicked but only for a little while. I remind myself, as I lose control of my body and feel a lot of pressure on my chest that this too shall pass and surrendering the need to control is best for now. I hear suctioning. "Have you started? Where is B?" B arrives and sits by my head. He walked past the whole picture as they were cutting me open. This small oversight is the last thing on my mind.

It is around 12:20 am now. I don't feel anything, just pressure (as promised) and it is freaking me out that my left side is much number than my right. The sensation of trying but not being able to move my leg freaks me out a lot (for the record, it felt like my left knee was bent, and I tried to straighten it because it felt so damn weird, as the doctors assured me that my left knee was not bent at all). Shit shit shit. I say that a few times at least. "What is my blood sugar? I feel low" (Aside: I did have to pull Dex after all because they wanted to make sure it didnt interfere with their machines). It is 81, then 105.

Finally they are close and the spunky anesthesiologist grabs B's phone and takes pictures of Audrey's arrival. "There is the first poop!" the doc announces. The moments between the "baby is here" and the crying take forever. B is encouraged to go see (not part of the plan people!) and after the seventh suggestion he obliges. (B was a champ throughout by the way and 9 days after our daughter's birth I am more in love with him than ever before).  He shows me photos of her as I lay there and all I can say is "Oh my God. She is so so little".

11/26/2016, 12:47 am, 6lbs 11oz, 19.25 inches

"How is my placenta? Does it look good?"
"Yes, it looks good."

She gets a 9 and a 9 on the Apgars... Her blood sugar is normal during all the checks. (She never leaves my side, during the entire stay at the hospital.)

"When can I hold her?"
"About a minute."

And then I do. And nothing will ever be the same again.

It is incredibly hard for me to describe how surreal it is to be awake during your own surgery. They say about long trips (whether literal or figurative) that it is not the destination but the journey. I feel so proud of myself for everything I did before and throughout the pregnancy to have such a happy outcome. I still can't believe I am here. But the journey is just beginning I am finding.

Wednesday, November 30, 2016

Wednesday, November 23, 2016

Week 39

Today I am 39 weeks and 2 days pregnant. And I made it through the last week of work (although it seems my boss thinks one should spend their vacation time and maternity leave working from home but that's another story!)

If it wasn't the home stretch before, it certaintly is now and this week is flying by already. Monday was spent doing some deep cleaning, yesterday I spent the whole day driving around - first to catch up with my mom and then into down-town Boston for a BPP appointment. I also got my car washed and my hospital bag is officially living in my car now (what?) Today - I have more cleaning and a little shopping (and some cooking and baby clothes washing) to do. And tomorow is Thanksgiving already! Crazy!

I am feeling pretty good. My BP is still normal at home (yay!). I have almost no swelling whatsoever (yay!). And the other day I downloaded 90 days of Dexcom history and was pretty thrilled to see this (double yay!):

Given that 90 days is a long time I was so happy to see the average as well as the standard deviation! I tend to give myself a hard time about the occasional 150 mg/dl or a stretch of a few hours out of range but it was nice to see that overall I am extremely consistent and have normal blood sugar about 90% of the time - which is a huge accomplishment for any type 1 diabetic and it is certainly a huge accomplishment for me. I complained a lot over the years about my lack of determination, consistency, inability to achieve this. Honestly, I did not know this was possible. While (certainly) pregnancy adds motivation and diligence, I know this would have been impossible for me to achieve if I hadn't jumped on the low carb train so to speak some 18 months ago. A flat line averaging low 100s would have been an unachievable feat for one day, not to mention 90. I am so so thankful I found this way of doing things and I am never going back. My quality of life has improved so drastically this past year and a half, and my stress levels about blood sugar management are almost non-existent (even during pregnancy). I will have to go back and post about this way of diabetes management some more in the future. It thrills me to know there are many people who are achieving such results and I am one of them (when two years ago my A1C was 8.6% and I thought it was impossible or if possible somehow detrimental to quality of life). Everyone must do what works best for them obviously. This is what works for me, so I do plan to talk about it in the future, as it has been the single most life-changing thing (for sure in my diabetes life, but perhaps in my whole life as well). Also - I have heard that many have success with the "sugar-surfing" approach. Alhough I have not read this book, I have heard quite a bit about it and it made me wonder - do I also use sugar-surfing techniques in addition to my low-carb lifestyle? I think so. I definitely watch the CGM like a hawk most of the time and make very quick adjustements with a lot of micro-boluses or glucose corrections. I am just so grateful for the technology that allows people with diabetes to be healthier, and also for the internet where we can connect with others - for technical and emotional support and well as simply to share our stories, all of which are so important :)

OK, so diabetes is going well. As I mentioned before I am apprehensive about the post-partum period but I will just have to handle it as it comes.

Exactly one week from today, I will be checking into the hospital for my scheduled C-section (unless something exciting happens sooner of course). Actually, my last BPP and prenatal appointment is this Friday and I am slightly apprehensive because it will not be with my regular doctor so I can see someone who doesn't know my white coat syndrome history panicking at my in-office BP (especially with diabetes at 39+4 weeks pregnant!) My doc did say that he would give the other doctor a heads up. In any case, I would like to just stick to the schedule and deliver on the 30th (because these things can always be planned, lol). I will be relinquishing control of my diabetes management while I am on the operating table as well as for a short time thereafter. But I had my 90 days of Dexcom history scanned into the hospital records (my ammunition for doing my own thing after I am able to stand up again). I also "won" the right to wear Dexcom during the surgery for peace of mind, as long as it is on my arm, so above the sterile surgical field. My doc keeps warning me that it may not be accurate because of all the extra fluids that will be administered but we shall see.

I am definitely nervous (but accepting) about having surgery. It is nothing I have done before but there is a first time for everything. (And yes, I am still trying to get her to flip head down but I have come to peace with the fact that it may not happen. I still am happy we are going past 40 weeks so at least I gave her a very good chance of flipping if she was going to do so on her own.) Aside: B's co-worker told him a story of her own experinece with the version, where the baby's rib was broken in the process and she had to have an emergency section on the spot. While I know that such complications of turning a baby are rare, it is these kinds of accounts that made me chicken out of having her turned.

I am going to list the specifics of what I am nervous about so I can get it off my chest because blog=therapy.

1. Seeing and hearing her for the first time. I just want to know that she is healthy and OK. I know that all the scans have always shown her to be nothing but a healthy baby but I guess it's a natural fear that I won't believe it until I see it? I just want to hear her cry and hear the doctor say that she looks perfect. I want all the newborn screening tests to come back normal and I want to hold her and actually know that this whole baby thing is happening for real. OK? OK.

2. Slightly nervous about the anesthesia. BUT I am quite confident they will do a great job. In the off-case that something alarming happens I have confidence that they are prepared to deal with it. Repeat after me: the anesthesia and surgical details are out of my control.

3. Healing from the surgery. The big thing here for me will be not over-doing it. I will have plenty of help, but I am stubboornly independent and have a very very high tolerance for pain so I will need to remind myself to take it easy. Also, I am worreid about giant excited dogs bumping my incision (their noses are perfectly lined up to do so). My solution for that one is walking around with a pillow in front of my belly for the first week or so...

Surprisingly, I am not very nervous about the whole caring for a newborn thing. I have read exactly one book: Pregnancy, Childbirth, and the Newborn. It seems to have covered the basics, I pretty much remember everything I read and if not there is always the internet so good enough! I hear people do this all the time.

In other news I chopped off my hair! I love it. The girls at the doc's office yesterday were commenting on how I must be close to delivering because apprently "that's what eveyrone does right before they have a baby".

Happy Thanksgiving Everyone!!!

Monday, November 14, 2016

38 Weeks.

This week can only be summarized as: I don’t want to do anything anymore.

After today, I have exactly 4 days of work left until I take a week of “vacation” (read: clean, cook, and get a haircut) before my “official” maternity leave will commence on my due date of 11/28.

I am dragging my feet to say the least – at work, at home, you name it. I feel heavy and tired and my feet definitely hurt on the days when I have to stand too long. And I gained yet more weight. Even. More. Weight.

I am trying to keep my emotions steady. About everything – the (very likely) C-section, and recovery from said surgery, the uncertainty of being at my house next week (over an hour and a half from my hospital when my husband is at work, also over an hour and a half away), the fact that my boss is driving me up the wall, and the fact that I still can’t seem to wrap my head around that in all likelihood by the end of this month (one way or another) I am going to deliver my daughter and become a mom. I think the emotions are exacerbated by hormones and a lack of peaceful sleep.

Although my blood pressure is still fine (in fact it was even ok at the doc’s office last week), and there is what I would call only very minimal swelling in my ankles at the end of the day, the need to urinate even more frequently (many times a night), and not being able to find a comfortable position at night that doesn’t result in leg cramps, numbness in my hands, back pain, or just random bouts of insomnia where I feel like I can’t shut off my brain has made me feel like I am suddenly succumbing to the end-of-pregnancy suck. What a difference between now and two weeks ago. Two weeks go I had to remind myself that I am not allowed (NOT allowed!) to run to try to catch the train. Now there is just now way (NO WAY!) I am coming close to running for anything. I think I am starting to understand all those women who complained a lot of the end. All the memes about feeling like a hippo and the last month of pregnancy feeling like it lasts 1623 days or so.

Don’t get me wrong – I am not ungrateful. I am grateful that the only “problem” I have had so far is a baby who is stubborn and won’t turn head down. I am grateful that I was able to do such a fantastic job maintaining normal A1Cs throughout the pregnancy.  I am grateful that I have an awesome husband and a very supportive (albeit sometimes slightly overbearing but very well-meaning!) family (all of whom will be there for me as I recover from childbirth and figure out the whole mom thing). Despite the discomforts of going to term, I am so very grateful that despite having type 1 diabetes, I as of now appear to be healthy enough to expect to continue with this pregnancy past my due date.

Sigh. Only four more days of work. And then (unless something exciting happens sooner or baby decides to flip) another 11 days until parenthood – but who is counting? And happy World Diabetes Day (once upon a time I entertained the idea that I may potentially deliver on WDD, but here I am – 38 weeks today, still very pregnant, with the end almost in sight though).

Friday, November 11, 2016

Eviction date

I officially have a C-section date: 11/30! I will be 40 weeks and two days pregnant. I think it is a good time as it gives her a few more weeks to make a decision to turn as well as finish growing up in there :) I can't wait to meet you in 18 days or less my girl <3

Tuesday, November 8, 2016


Aka the one where she chickened out.

I decided to cancel the version. Although risks are low I would hate to have something overloooked and be sent home.. I will discuss if they will attempt it if/once I go into labor (before the scheduled section). In any case, she still might turn on her own and if she does not I am sure Beth Israel can do a good C-section. In any case, I would rather take on the risks instead of having her take any.. also, Yes I am a flip-flipper and I hate making these decisions!

Week 37.

The end is in sight more than ever before. I am just over 37 weeks pregnant now with my due date just two weeks and some days away. I am still working. Yesterday, I announced to my boss that I would definitely be working this week and next (unless my water breaks or something), but I was not sure if I would work the week of Thanksgiving (at which point I will be over 39 weeks pregnant, if I am still pregnant then). I am vacillating about (potentially) having a few days at home before Thanksgiving/ baby/ etc. (which is an hour and a half away form the hospital) or being at work (a mere 5 minute walk from the hospital).

No end game has been finalized. I think a lot will be decided based on how this Friday goes – provided baby did not suddenly become a giant (doubtful), and that everything else still looks good (like the amount of amniotic fluid and her BPP scores), I will be having an External Cephalic Version (ECV) performed this Friday – a procedure to turn the baby from a butt down to a head down position. I am nervous about it – they book you in labor and delivery, complete with a hospital gown and an IV, standing by ready to preform an emergency C-section in case something goes wrong. Which is freaky. But watching YouTube videos of successful quick and seemingly painless ECVs has (somewhat) put my mind at ease. So we shall see how things go and hopefully I will have an update one way or the other by the end of the week.

My BP is steady, at about 120/80 at home. Systolic always spikes at the office but diastolic is fine – Dr. H says I am “vascularly excitable” (aka anxious?). Since the diastolic BP is in a good range, my urine is always negative for protein, and I have no swelling (or any other symptoms of Pre-E), I have managed to avoid a 24 hr. urine collection still (not complaining!) I do feel a bit like a whale but really it’s not so bad. I have small discomforts such as slight nausea after eating a good-size meal (thanks baby, for all the kicks into my stomach), I think pulled a ligament at the bottom of my foot but it’s only uncomfortable when I walk barefoot, getting up off the couch/ out of the car is not super easy, and also I hate standing on my tip-toes to reach things in the kitchen because it seems that involves leg cramps. Sleep. I miss sleep. I have to pee all the time and it’s not easy getting/ staying comfortable. But really it’s not too bad. I can’t complain much. I feel lucky.

Diabetes… is fine. Sometimes I will get a transient spike to 140-150ish but at this point I just shrug, correct and move on. I am not sure if my insulin needs are still increasing but they are definitely not decreasing! Dr. H. said I must have a super placenta – I’ll take it J I am dreading the post-partum adjustments – especially if I have C-section I want to make sure my blood sugar is in a normal range as much as possible but I am concerned it will be difficult with little rhyme or reason with all the hormonal swings. I will just have to cross that bridge when I come to it, and keep my Dexcom on for a while.

In other news baby has a name now - it’s Audrey. Things feel even more real now that we are referring to her by her name instead of calling her “the baby”.

Anyway, I am more excited than nervous, by a long shot. Bring it on.

Wednesday, November 2, 2016

36 weeks

This week can be described as a mad scramble to finish stuff that needs to get done - at work, at home, basically everywhere. Calling a pediatrician's office, daycares, setting up work plans for the next couple of month, and scrubbing the floors on all fours (which did not flip the baby, unfortunately) were all achieved.

I was a bit sad and annoyed yesterday at my bi-weekly BPP appointment, because the technician wasn't the greatest. She acted very surprised that I had no complications of diabetes, and then told me about her niece who had diabetes since she was 8, had difficulty managing it, bounced around into 800s all the time, and recently got a kidney and pancreas transplant. Then she added "She was a bit older than you though - 33." This made me really sad. Also the technician was very slow and kept (slowly) checking on things that I felt like didn't need to be checked on, like which side of the baby the stomach was on. We KNOW what side it's on - the correct one! I guess it's always good to be extra sure but after ALL THOSE SCANS I have already received I think we would know if something MAJOR like that was off... I guess my biggest annoyance was that she seemed to have this underlying assumption that "because I have diabetes something MUST be wrong"  - at least that was the impression that I got and I did not like it, not one bit. Then she tried to get an accurate measurement of amniotic fluid and failed to find the deep pocket of fluid, resulting in a low fluid measurement, at which point she told me to stay there and she was going to get the doctor who would "give me the results". After waiting for what seemed like an eternity and thinking that maybe this time something was actually concerning, *my doc came in and said "OK, let's find that fluid". And he did, within about 30 seconds of being in the room. "Everything looks perfectly normal Maria. Sorry about that, let's get you out of here." So yeah, we are still good (although still breech also).

I am coming into that home stretch and as I look at my baby apps that tell me "3 weeks and some odd days till due date" it excites me to to no end and also leaves me in a lot of disbelief. I still have a lot to get accomplished at work in the next several weeks (yes, I will be working full time until whenever the baby comes) and hopefully I can get it all done. I have been keeping tabs on my blood pressure, and it's still holding in the normal range at home most of the time, but given the spikes at the doctors office (which is always the case for me, pregnant or not) I fully expect a 24-hr urine collection coming my way at some point in the very near future. I am hoping that these next 3 (or 4? or less?!) weeks run smoothly. I am so excited to meet my daughter. I am still in awe of how time has flown by and that it is November already and I am going to be a mom so soon.

Also, can I just say that maternity leave policies in this country suck?! The reality of leaving my baby at 8 or 9 weeks in daycare, not seeing her for 10-11 hours a day M-F, pumping breast milk at work, etc. all make me want to throw up. I have been suppressing these feelings for some time (I have worked since I was 15, pretty much non-stop) but this week I stopped suppressing them. I will discuss all of my thoughts in a later post, after she is here. I have not made any final decisions yet, but  suffice it to say for now that the whole pregnancy experience did not play out the way I expected, in particular when it comes to my feelings on going back to work so soon. There is a very integral part of me that has been screaming inside: "I did not want to have a baby just so I could leave her in daycare for 50 or more hours per week at such a young age!!" "I am going to miss all the milestones!!" "My boss sucks kind of because I know she bothers people who are on maternity leave, expecting them to basically work from home" "I am fairly certain that can get a much better-paying job that is more convenient later next year!" Anyway. I am not one to rashly close doors, but allowing these feelings to emerge and discussing them with my family has left me feeling lighter and free this week.

More to come.

Tuesday, October 25, 2016

35 weeks...

I don’t know if I will be able to write every week but I figured I would give another brief update while I can (and post some pics). I am just past 35 weeks. The baby is still breech. Other than that things are well I think. I am going in for BPPs every Tuesday and Friday. I have also decided that if she does not turn in the next few weeks I will opt for the ECV if still on the table (e.g. if fluid levels remain high enough, etc.) I plan to push the procedure as late as they will allow in order to give her the best chance to turn on her own and avoid early delivery as much as possible in case something goes wrong. If she stays breech regardless, I will plan for a c-section right around her due date probably. I keep reading stories of babies turning at the last moment so I really want to give her all the chances in the world and definitely don’t want to rush into assuming she will stay breech and delivering early in case she does end up turning. It would be really nice if she would just turn and then I could just go into labor on my own, etc. I keep reminding myself that if a breech baby is the only problem I am having, that’s ok, and the most important thing is that she is healthy. My diabetes is so far out of the picture at the moment…

So here are some pics, as promised: In no particular order, there is baby stuff, curious dog, recent Dexcom report, and me (taken 6 months apart). Have I mentioned I gained like 30 lbs??? I am getting there.

Monday, October 17, 2016

34 weeks

Well I have made it to 34 weeks and things are going pretty well I think. The problem I am having still is that the baby is breech. I am doing all the exercises that may or may not help her flip head down short of standing on my head and scrubbing all my floors on all fours (next weekend, maybe). I also haven’t tried the icepack to her head advice, but I am thinking I might as well. (Aside: my dogs get pretty excited when I am doing my inversions with my elbows on the floor and my butt high up on the couch, or laying on the floor with my pelvis elevated. At least *they are amused)… If she doesn’t flip I will be offered a version at around 37 weeks, which is a decision I am dreading making because with an anterior placenta and being a first time mom the odds of success are lower and the risks (although unlikely) freak me out. I haven’t decided if a guaranteed scheduled c-section freaks me out more than attempting a version first in an effort to attempt vaginal delivery.

My doctor’s appointment last Friday went much better than the last one – I was more agreeable to ceding control of my diabetes management (whatever, if they mess it up it’s one them!)  and he seemed pleased that I was going along with hospital policy and also with the twice a week biophysical profiles (BPPs) starting this week. I hope they don’t take long – so far they haven’t – she is always very active, practice breathing, and my amniotic fluid is and always has been “average”, which is great. I also had my first growth scan in over a month last week, and was very pleased that babe was still consistently in the 30th percentile. I only get one more growth scan in 4 weeks and that’s it for that!

I am keeping an eye on my blood pressure at home and was pleased to find it at 110/65 this morning. I also have zero swelling. So far so good. My blood sugar management continues on its own curve of running averages in the very low 100s with a tight standard deviation (of less than 20 mg/dl), translating to a normal A1C in the low 5s. My morning I:C ratio is now up to 1:2 with other meals at 1:2.5, and I am up to 26 units of Levemir daily. Crazy! I am doing what needs to be done and also fearfully dreading the postpartum insulin adjustments to come. With lows under 60 mg/dl reported as less than 1% (according to Dexcom) I really can’t complain.

My baby shower/ B’s 30th birthday went great – we got so much stuff and it’s really starting to feel real. My living room was temporarily transformed into a fortress of cardboard boxes (again, more amusement for the canines).  I promise I will post some pictures soon. Gotta run, meeting calls …

Monday, October 3, 2016

32 weeks: let the crazy begin

Well, here we are: 32 weeks along and 8 to go (give or take).

While I have been very lucky with pregnancy symptoms overall (no serious pains, heartburn, nausea, exhaustion, swelling, etc. *In fact sometimes I forget I am pregnant until kicked), I have to say that the third trimester hormones have been messing with my emotions (sorry B).

Also, sorry Dr. H. What can I say – I have recently turned into a bit of a control freak. The 40-minute discussion about whether all those twice a week appointments are really necessary for me (although I was relieved to hear that they are recommended after 34 weeks and not 32) did not amuse him. Nor did my obsessively strong desire to manage my own insulin during labor and delivery (apparently that is against hospital policy). I must say the latest “discussion” was not so much heated but just kind of antagonistic and repetitive (on both of our parts). We came to some agreements without much discussion at all: no early induction unless actual complications present (including going past due date, within reasonable limits), scheduled C-section only if baby remains breech (actually he said they do have limits on estimated fetal weight when it comes to vaginal delivery in diabetic patients but he seems to think that is a moot point considering my level of control and that the baby has been tracking in the 30-comething percentile). Looking back, I think maybe I am just over-reacting about giving up my own blood glucose management in the hospital. I am sure they can do a good job, and he said I can move around for most of the delivery (until the end when they do the Dex10/insulin drip to “clamp” my BG in the normoglycemic range for delivery OR if I have pain management, whatever happens first.) I guess that’s OK. I hope they listen to me when I tell them what I have been doing to stay in the normoglycemic range (92% of the time, according to the latest Dexcom download, translating to a 5.2% A1C). I know I am over-reacting, but something about not having a say in my own management protocol (which has been working so well) makes me a crazy pregnant bitch (maybe it’s just that I expected this would be a non-issue, since I have heard of other women being allowed to do so in labor, but where I am it’s a “non-starter according to hospital policy”). And I understand that it is policy and this doctor is not just trying to piss me off for no reason. I really do. But it just wasn’t what I expected. I was also hoping she wouldn’t still be breech (but she was). They will offer an external cephalic version at 37ish weeks to try to turn her if she doesn’t comply on her own. If she stays breech, it will be a C-section. Some things are just out of my control – might as well get used to it, I hear parenthood is full of that shit (and worry).

The good news is her first biophysical profile (BPP) took all of two minutes. She was doing all the things she was supposed to, and the fluid level looked great. My at-home blood pressure readings remain excellent, and Dr. H is not concerned about the spikes at the office (I guess when your pulse is 120, one can deduce a systolic high reading is an artifact of anxiety J

So, where am I/ What’s the point of this post? Oh yeah, I have to give up some control (a good lesson for impatient control-freak me). Also, after talking to B (who is very laid back and the perfect balance to all my crazy), I have decided there is absolutely no reason to not just go to the routine monitoring appointments. I am stubborn but not that stubborn? (read: I would never forgive myself if I went all apeshit AMA and something bad happened).

Until next time.