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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

Update

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.