Work, pregnancy, doctors, diabetes etc.

I am eager to write some more before I start working and enter the third trimester when I will officially have no time for anything!

Work
I start August 29th. I will be 27 weeks pregnant then. I left off last time mentioning that I wasn't sure if my new employer knew I was pregnant or not. Well, let me fill you in on how that went! Last Monday (at 24 weeks along) I went in to meet with the employee who was leaving and whose project I would be taking over. That same day, after we were done speaking, I went to my new boss' office and we headed upstairs to talk to HR and sign the offer letter. As the offer letter was being printed, she casually asked me "Are you planning to expand your family soon?". I said, "Yes. I plan to take off the least amount of time possible and return to work as soon as possible. I will arrange for childcare promptly and I have family in the area that can help so that will not affect my performance." She was very agreeable, at which point I said "I am happy you said something. I am due November 28th." I think she was a bit surprised it was so soon but she seemed happy, gave me a huge hug, congratulated me, and assured me that I should be able to take off as much time as I need (at least 8 weeks). So all in all, it went pretty well. I wanted to show you guys the difference between 22 weeks (when I interviewed, on the left), and 25 weeks (taken two days ago). If it seems like a pretty dramatic change, it is, and it's not just the difference in the fit of the shirts!

Pregnancy (& Doctors)
It's getting so real and suddenly so close to the end! I am less than 3 weeks away from the third trimester. This is the first piece of furniture we bought for our daughter ($20 at a flea market!). We bought it from a guy whose grandfather hand-made it in the 1920s, and while it could use a fresh coat of paint (something I may or may not get to accomplishing, along with all the sewing I have been meaning to get to lol) I thought it was a great deal!

I put together my registry for the new baby all in 1 day! My mother and mother-in-law are sweet enough to be throwing me a baby shower in early October. The funny part is it will be on my husband's 30th birthday! It just worked out that way because of people's travel schedules and so we are having a baby shower/ surprise party for him. Basically just a big family party to celebrate everything at once :) The main goals on my list currently are to find a daycare for her, as well as to find a name (we have had a short list for a while but I can't help but feel I am somehow cheating her by not thinking about it more). I am sure it will work out...

As far as pregnancy symptoms, the main one is weight gain. It seems so strange to just keep gaining weight. So far, I seem to have gained an appropriate amount but it's just so weird to me to have put on another 4 or 5 pounds in the last month! And more to go yet. Another not-so-fun symptom is sciatic pain, and I get that sometimes from driving too long or doing too much work around the house. Also, more recently (like this week) I have been having more trouble sitting up in bed or rolling from one side to the other - suddenly it requires a lot more effort than it used to, which is a little scary, because I have a ways to go and my belly is not getting any smaller! I am slightly concerned that my commute is almost 2 hrs (just over 1 hour of driving to the subway + 45 mins on the subway). It's temporary, as we will move closer next year at some point, but being pregnant makes me feel a little more annoyed about it (at least there is a public restroom at the train station - seriously, my least favorite pregnancy symptom is peeing. ALL. THE. TIME.) I will say the one really fun symptom is getting kicked. I have an anterior placenta (in the front) so it cushions a lot of her movements and it makes me nervous when she is having one of her less active days, but now that she is bigger I feel some good movements every day, which is great. Speaking of, I had my first apponintment at my new doctor's this Monday - let me tell you it was surreal to step into the Beth Israel Deaconness Medical Center and realize that my chld will be born in this building!

Last week, while waiting to meet with my new boss to sign my offer, I called Joslin and asked them who they would recommend I see (I was looking for someone flexible who would feel comfortable with a patient with type 1 diabetes, and would also be comfortable with that patient managing their own diabetes.) Joslin (and also Kerri) suggested Dr. O right away, but I ended up scheduling with someone else at the practice because Dr. O was so busy and it would be a while before I could see her. So two days ago I went in for my first appointment and it took 3 hours!!! Let's just say they were thorough lol. Although I have been receiving "high-risk" care in Ohio, they essentially repeated the entire anatomy ultrasound (four different people tried to scan everything, which took forever because baby girl was moving around so much and not cooperating at all!) They kept asking me if I was sure it was a girl, because she refused to reveal that to them for the duration of the appointment (she has been a girl twice now and they were sure both times lol). But at least they were able to finally find all the other important parts and were satisfied that everything looked great ("We just like to make sure for ourselves" they kept saying.) Everyone was very very nice and respectful to me. They said very nice things that almost made me cry, such as "Wow, your A1C is probably better than mine!", "Great job!", "You may be the lowest risk patient we have!". I have been working so hard and it was both nice and reassuring to hear those things. My daughter is tracking steady growth in the 30th% percentile still, so no changes there at all (we are not tall people, so that sounds about right!). My systolic blood pressure was high (but diastolic was 70). Of course, perfect at home, like always. They didn't care, and understood my stress of having to "prove myself to a new team of doctors". I had a small amount of ketones in my urine (low carb lunch of meat and zucchini that happened many many hours before the appontment) and of course noone was concerned because my blood sugar was perfect. "A little ketosis not ketoacidosis!" It was nice to be surrounded by such an educated team! And to have them appreciate the fact that I knew what I was talking about as well :)

Finally, they asked what they could do for me. I told them that I was looking for someone who would be comfortable individualizing my care. I understood that certain blanketed protocols exist for patients with diabetes, but I wanted things done my way lol. Actually, I said " I am not picky as long as I can dictate what happens" We laugh. "Seriously though, I understand that as the patient I can overrule whatever the physician suggests, but I would like to be with someone who will work together with me, instead of having to navigate an antagonistic relationship. For instance, I understand that there are complicatons that can necessitate, truly necessitate an early induction. However, simply having diabetes does not necessitate this in my opinion. I respect the medical degree but I also do not want blanketed protocols based on outdated research to be applied to me, barring actual comlications, including but not limited to pre-eclampsia, placental problems, macrosomnia, fetal distress, etc." They were agreeable and understanding that individualized care was best, and we all agreed that the best person for me to work together with would be Dr. O. And so my next appointment will be with her and we can work closely together to develop the best plans for the remainder of this journey. (If anything can be described as a long trip, it's moving cross-country with 3 dogs, and also pregnancy.) Amazingly, I will be almost 30 weeks pregnant by the time my next appointment rolls around (unless anything alarming happens), which is pretty crazy!

To be quite honest, starting to think about the end game has brought up a few natural fears. Mainly, it's the uncertainty. This pregnancy (knock on wood) has been going pretty smoothly. The most exciting/ crappy thing that happened so far was the food poisoning at 9 weeks. I know that things can change quickly. I know I could develop a complication, and I don't want to feel like a huge failure if that happens. I don't want my health issues to affect my daughter. I don't want my health issues to affect my ability to keep working right up until delivery. I don't want my health issues to burden my family. There - it's out there now. I can't help but be slightly apprehensive if not fearful about what's to come. I may have mentioned this but I have never done this before and I have no idea what I am doing. Or how well I will do once I am a parent. Or how good I will be at balancing family and work. And diabetes. And everything else.

Diabetes. 
Diabetes is still there and to be honest has been more difficult to control (than during the first half of the pregnancy). Overall, it is still going fairly well. But I can't help but feel like it could be going better. I always try to remind myself that treating a low is faster and easier than treating a high, and most of the time things are on track, but it feels like when things get off track they are difficult to fix in a timely manner. If I can't get to bed at a decent number, it seems the whole night is screwed (despite several correction boluses), which of course rolls into issues the following day. My plan is to remain vigilant and always make sure to: be in range before eating; pre-bolus, pre-bolus, pre-bolus; increase exercise consistency (which has been difficult, and perhaps is my biggest diabetes management "flaw" currently), and continue to be making changes when seeing a pattern (3 days) which warrants insulin increases. I should add "go easy on myself" but I guess that's not really my style. Boy, I never thought I would be this obsessed about my diabetes (to the point where my health care team seems to think I am doing as well as I possibly could be but I still seem to think I should/could be doing better...)

And now onwards.