I’m back! It’s been longer than I’d hoped, but I’m finally getting a chance to sit down and write about the birth of Baby B!
As planned, I went in for my c-section first thing in the morning on Friday, April 6th. I had been a bit worried about my ability to fast prior to the surgery, because I’d been going low at night relatively frequently in the days prior. Thankfully everything fell into place the night before, and I didn’t have to worry about making the decision between breaking my fast (with clear fluids) and going low. Whew!
In spite of having had a c-section previously, I was pretty nervous (hey, it’s surgery!), but the nurse (who I knew from rotations at Dr. Awesome’s office) and the anesthesiologist put my mind at ease significantly…with one small wrinkle in the plan:
With my previous c-section I had been put on an insulin sage rather than leaving my pump running during the procedure. My endo had requested this, and the hospital folks had agreed with her assessment that it was better not to have my diabetes control in my hands in case something happened during the procedure (e.g. if I ended up having to be put under entirely). I anticipated the same approach this time, and had figured out how much insulin to recommend they give me on the sage (it’s IV, not subcutaneous, so a bit tricky), but this anesthesiologist wanted me to stay on my own pump and manage my own insulin. I was totally happy to do so (after giving him my advice re: rates to use for a sage if one became necessary during the procedure), but I hadn’t determined what pumping rates I’d want to use during surgery, so I had to scramble a bit with that prior to going into the OR.
It worked as well as it could have, I guess. My bloodsugar was pretty much perfect going in, but the stress of the procedure (it’s surgery, remember?) raised my bloodsugar to just above where I wanted it. Because a c-section is so quick, I actually didn’t bother with testing and correcting during the surgery. By the time a bolus would have taken effect, Baby B would have been out anyway. I’m not sure that’s the strategy I’d recommend, but it was the approach I used. Baby B did have low bloodsugar for a while after delivery as a result, and had to be put on IV, but it corrected quite quickly.
The surgery itself went very smoothly. I had a mini freak-out during the spinal and felt a little pass-out-ish (call me crazy, but I have a “thing” about having needles in my spine), but it passed before long. Thanks in part to lovely drugs, I was able to make it through the rest of the c-section pretty calmly with no nausea and minimal shakes. The OR staff (and Dr. Awesome, of course) were all so friendly that I actually spent most of the time chatting and joking around with them while they did their thing.
Baby B was hauled out and tested and wrapped up and my husband had a chance to hold her. She was gorgeous, and looked almost exactly like The Kid did at birth – only less purple. At a whopping 9 lbs, 4 oz, it’s no wonder I had been so uncomfortable by the end of the pregnancy! Then she was taken away to be put on monitors and an IV. Not only did she have low bloodsugar, but she also had some fluid on her lungs (common with c-section babies, apparently, since they don’t get the big squeeze that natural birth babies get). My husband went with her, and I took advantage of being cut open by having Dr. Awesome tie up my tubes so that this will be the last diabetic pregnancy I do! (Is it wrong to be a bit giddy about that?)
Because of her bloodsugar and the fluid in her lungs, Baby B had to spend a bit of time in the NICU (neo-natal ICU), but by noon the next day I had her in my room with me! Thanks to my parents staying with The Kid, my husband was able to stay in my private hospital room with us until we all came home together on Monday, April 9th! What a different experience from our last one!
Since we’ve been home, we’ve had some struggles with feeding Baby B. Because of being pre-term, and also a bit jaundiced, she’s been very very sleepy. It’s very difficult to feed a sleeping baby, and even more difficult to breastfeed one. Thankfully my milk came in within a couple of days, so she’s been getting solely breastmilk (with the exception of those first few days), but the combination of breastfeeding attempts, pumping, and bottle feeding has been time consuming and challenging. I’m lucky to have such a supportive husband! As of last weekend, though, she’s been more awake and finally got the hang of latching, so we’re breastfeeding fairly smoothly by now. That’s another relief and a difference from our last experience!
Initially she had a bit of trouble gaining weight, but her doctor was very pleased with her weight by our last visit on Wednesday, and we’re now able to loosen up on tracking feeds and waking her to eat. The side-effect of all of this is that we’re actually starting to be able to sleep for longer stretches at night. (I had grown to find 2 hours of consecutive sleep a luxury.) Baby B is (so far) proving to be a reasonably good sleeper (albeit a noisy one, thanks to some reflux that makes her grunty and gurgly), a good eater, and a pretty content baby when she’s awake! Here’s hoping that all of those (except the reflux) continue!
My own healing process has been largely uneventful, which is good. The first few days were pretty uncomfortable any time I had to move, but it’s been uphill quickly since then. I’m feeling like I can do things fairly normally by now, but I’m still supposed to be careful for the next 3 weeks. Unfortunately that means I can’t lift her carseat or stroller in/out of the van, so getting around is a bit more challenging than I’d like, but I have a baby carrier that I really like and it’s coming in handy to allow us to get out of the house. (In fact, as soon as she wakes up and eats, we’ll be on our way for our first grocery trip together!)
My bloodsugars, though, have been waaaacky! I needed virtually no insulin for the first few days post-partum. Then things stabilized briefly. Then when my milk came in my bloodsugars crashed again. My basal rates and bolus ratios are crazy low. I’m also crazy hungry! I’m currently not even close to low-carbing, as I try to keep up with my body’s milk-production needs, and also as I attempt to eat anything and everything that I missed eating while pregnant. :P Unfortunately my bloodsugars are starting to be less forgiving and I’m falling back into the spike-then-crash pattern after meals. My grocery list for today includes some moderate carb, but lower GI, foods to attempt to combat this while still supporting my body’s new needs. I’m losing weight very quickly (only about 10 lbs to go, actually), so I’m concerned that lowering my carbs too much more is going to leave me dropping to a weight that’s lower than I should be at this point. I guess we’ll see what happens. Either way, it’s time to put away the cookies and chocolate in favour of some healthier options. I see my endo next week, so I guess that’s some additional incentive. :)
The other stubborn issue has been my blood pressure. It was hanging out around 135/85 for a while post partum, and that makes both me and Dr. Awesome nervous because of the potential implications for my retinopathy. So he put me on meds. It’s improving already and I’ve been able to reduce them, but for now I’m still on them.
We’ve been hit with a couple of other unexpected challenges in the past few weeks, including a respiratory illness in The Kid and her father which had the doctor strongly recommending that Baby B and I leave the house until they were better, as it would have been very risky for her to get it. (We stayed with my parents for a few days.) As well, my pump died…off warranty. (More about that in a separate post.)
Other than that, things are going quite smoothly! Yay!
And now I have a hungry, poopy baby to attend to. I leave you with a few pictures…