34 Weeks Pregnant – Damn Diabetes…

Remember all my talk last week about how frustrating it was to see Baby B’s growth jump to 75th percentile in spite of all my hard work and uber-tight diabetes management?  Well, brace yourself for some more.

This past Friday I had another Fetal Assessment and another appointment with Dr. Awesome (my OB).  I’m glad they were in that order.

The Fetal Assessment showed a healthy, active and gorgeous little girl again.  No issues there!  But what it also showed is that Baby B has taken another size jump to the 90th percentile.

*Insert frustrated screams and curses here*

According to my pregnancy journal from The Kid, the jump to 90th percentile happened sometime between 32 and 34 weeks…maybe a tad earlier than this time, but really at pretty much the same point.  The good news is that The Kid still managed to stay put in her uterine oven until 36 weeks, and the decision to take her out then was based on my health (i.e. pre-eclampsia and retinal bleeds) rather than on hers.  So if we continue to follow the same trajectory as last time, given the stability with my BP and my eyes (so far), we should be able to make it to at least 36 weeks this time.  I’m crossing my fingers that this will be the case.

According to the Fetal Assessment nurse, if she takes another large jump in size by my next appointment (Friday), they’d probably call me back for an amnio early the following week to check lung maturity and then do a c-section if/when she’s good to go.  The Kid held stable at 90th for a few weeks, so hopefully Baby B will too…

I was told a number of times not to worry, that she’s fine, and that they just want to monitor.  But I still get so SO frustrated when I see the exact same trend in size as last time, given the fact that my diabetes control has been so much tighter!!  I just don’t understand why doing everything better isn’t leading to better results with respect to this.  It really kind of makes me want to beat my head against a wall.

Thankfully the nurse was quite encouraging, and acknowledged that I really do have excellent control.  She said that they often see this rapid fetal growth with Type 1 diabetes no matter how tight the control.  I’m still not sure if that makes me feel better or worse about it.

In between appointments, I met my husband for lunch and we discussed adjustments to our schedule for the next couple of weeks to make sure we’re ready if Baby B should make an earlier-than-expected appearance.  In the plan is a lot of prioritizing, as well as moving up my last day of work by two days to this coming Tuesday instead of Thursday.  I’m continually reminded by friends, family, co-workers and medical professionals to try to relax and take it easy, but it’s proving to be difficult to fit that into what remains of my schedule!  *sigh*

At my OB appointment, the nurse came into the office to fill out some paperwork with me until Dr. Awesome arrived.  The first thing he said (to the nurse) when he walked in was, “You know, this woman here is one of the hardest-working women I know.”  (In case it’s not obvious, that was in reference to my D-Management.)  With no idea of the emotional struggle I was currently dealing with, he said exactly what I needed to hear.  So, of course, I started to cry.  Dr. Awesome gets it – he totally gets it…and that (among other things) is what makes him so Awesome.

He did his usual examination and found everything to be A-OK, including my BP which was still only 120/70.  He felt the baby’s size and said he really wasn’t concerned – that she was likely 90th percentile at most, and not massively huge (to be redundant).  We talked a bit about the cause of the growth, because I didn’t really understand why it mattered.  At this point she’s still just in the 6 lb range (by my calculations…this is not official) and I’m having a c-section.  People have babies who are much bigger, so I didn’t understand why her size really matters.

According to Dr. Awesome, it’s not actually the size that is so much the concern, but the fact that the size is an indicator of other things that may be going wrong with the placenta – nasty things that can cause sudden nasty problems for the baby (see also: stillbirth) and that can creep up with few indicators of a problem…except for growth rate.  Apparently these nasty things are thanks to increased sugar levels and increased insulin levels – even if only slightly increased.  Damn diabetes.

So his approach, much like that of the folks at Fetal Assessment, is to keep a very close eye on Baby B.  Currently my c-section is scheduled for April 13th (38 weeks), but his best guess is sometime around 36 1/2 or 37 weeks.  That puts us at the week of April 2nd.  I can handle that.  In fact, I’m going to hope for that.

So we have a plan.  But I’m still stuck feeling like I should have been able to do more.  I should still be able to do more.  But what?  And with what energy?  Particularly without causing my stress to escalate and my BP to rise.  Don’t get me wrong – I do understand that my hard work has paid off in many ways including my own health and numerous other nasty things that could have gone wrong with Baby B.  I get that.  But to work this hard and then run into that same old wall again….

It’s frustrating.  Just frustrating.

Damn diabetes.

6 responses to this post.

  1. Be thankful for Dr. Awesome (I know you are) — he seems to know what’s going on and knows just the right way to say it. Just remember — and I know it’s hard to believe it — but diabetes isn’t the cause of everything. Some babies are just larger than others. My first son was born at 6 1/2 pounds, my second at 8. (I have diabetes, not my wife, but she was right at the threshold for gestational D with both). I think second children just tend to be larger for reasons that have absolutely nothing to do with D. Either way, I believe you’re in good hands with Dr. A.

    Reply

  2. You are amazing and you are so so strong. Your baby will be healthy, beautiful and so healthy because you worked so hard to make it so. I wish you positive thoughts and strength in the coming weeks and I know you will be great! You are my inspiration! :) Keep going! Baby 2 is coming soon!

    Reply

  3. Posted by Sarah on March 19, 2012 at 7:16 pm

    I’m praying for you both, but I have every faith that you will be able to make it! I know how it can really get you down. I had news of potentially starting retinopathy this past week. I have worked so hard to keep this tight (I’m running below 5.0, and it has been endless work), and I lost it in the doctor’s office too and a few times after. It makes it worse when you are trying so hard. Here’s to a couple more great weeks for you. When you make it, enjoy that giant bowl of cereal for all of us!

    Reply

  4. Posted by Sylvie on March 19, 2012 at 7:30 pm

    I know how frustrating it is to work hard (and you have worked EXTREMELY hard before and during this pregnancy) and not get the the exact results you worked your butt off for. I get the “damn diabetes” factor. Regardless of her time of arrival you have given her the best possible safe arrival and long term health that you possibly could–something to be “damned” proud of. Soon you will see the fruits of your labour (no punt intended)!! I too am proud of you, and see you as an inspiration.

    Reply

  5. Thanks Sarah and Sylvie! :)

    Reply

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