Posts Tagged ‘Pregnancy’

Baby B

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.  😛  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…

Alright Baby, Let’s Do This

As of this time tomorrow, I will no longer be pregnant!  Yay!  C-section is scheduled for 9:00 tomorrow morning!

On Tuesday my OB (Dr. Awesome) confirmed that he was able to get me in for the first-thing-in-the-morning slot on Friday.  He did ask, though, that I keep my Fetal Assessment appointment for this week (i.e. Wednesday) just to be sure Baby B was still doing alright.

Fetal Assessment yesterday confirmed that she was, in fact, doing great!  Her growth even stabilized a bit (instead of continuing its rapid climb), so there were definitely no concerns.  I also saw a colleague of Dr. Awesome yesterday (as Dr. Awesome couldn’t squeeze me in), who did some last checks on me and gave me some last info.

Interestingly, my BP is now on the rise.  At the OB’s office yesterday I was 145/85!  Holy moly!  To be fair, I had just struggled out of my chair and onto the table, and was in the middle of discussing the process of being cut open when he slapped the cuff on me, but still…that’s a far cry from the 120/70 that I’ve been seeing as recently as last week.  I actually checked it again at home today and was 138/78, so not really a lot better – but my stress levels today aren’t exactly better either.  (I don’t relish the thought of being sliced open, in case that hasn’t been clear.)  Regardless, it seems to be a good thing that this pregnancy will be over tomorrow.

Tomorrow will be the 37 week mark.  That’s a full week longer than Baby B’s sister lasted in utero, and a week is a long time for a baby!  I’m pretty excited to have made it this far!  According to last week’s amnio, Baby B’s lungs should be sufficiently mature by the time they take their first breath of air tomorrow (what a shock that must be for a little one…), so I’m hoping we can just deal quickly with any bloodsugar issues that she might have at delivery and then get to keep her with us – and take her home with us – instead of enduring the 3-week hospital stay that we dealt with when The Kid was born.  But I guess we’ll see…

I’d be lying if I said I wasn’t stressing about this c-section.  My last one went really smoothly, and I really have no reason to believe that this one will be any different.  If anything it should be better, as last time I was highly swollen (thanks to pre-eclampsia) and had just experienced my first retinal haemorrhage (thanks to retinopathy)…and then had my baby hospitalized for three weeks.  Truly, all signs point to this being a better experience.  But it’s still surgery, and I’m still nervous.  Given the option, I’d prefer to remain in one piece tomorrow if there was another way to do this.  But there isn’t – at least not for me.

It would be a lot easier, I think, if I wasn’t dealing with all of the diabetes-management stress that goes with this.  For example:

– Will I be able to manage fasting tonight, or will I go low and need to treat?  (I’ve been told clear fluids are okay if necessary, but the literature I’ve been provided says they’re officially a “no-no”, so I’ll be trying to avoid them.)

– Will my bloodsugar spike in the morning thanks to my liver’s response to the stress and my lack of food?

– Will the insulin drip throw my bloodsugar out of whack?  Will someone be monitoring me closely enough to make changes if it does?

– Will I be able to keep my bloodsugar in range when Baby B is delivered so as to keep her as safe as possible and avoid low bloodsugar for her?  Will I plummet during surgery in trying to do so?

– How long after surgery will I be able to reconnect to my pump?  To eat?

– Are my planned post-partum basals and bolus ratios right?  Will I struggle with major highs and lows while I’m trying to recover and heal and rest and take care of my new little one, including breastfeeding?

– Will diabetes make me more prone to infection while I’m trying to heal?

As if it wasn’t enough to just deal with the surgery itself, right?

Anyway, at this time tomorrow I should be much more relaxed (not to mention more medicated).  It’s just the getting from here to there, I guess.

But in spite of the nervousness, I’m so ready for this.  I’m ready to be done with this crazy task of managing a diabetic pregnancy, to be done with carrying this huge belly (see below) on my puffy feet, and to meet my sweet Baby B.

Let’s do this!

36 Weeks Pregnant and A Tentative Plan

I was hoping for a solid plan (re: Baby B’s arrival) by the end of today, but it appears I’ll have to settle for a tentative one.  I’ll take it.

This morning I had another Fetal Assessment.  Baby B is still growing like a weed whose mother has Type 1 Diabetes.  This past week I was running such tight bloodsugars that I could have been mistaken for a non-diabetic some days, yet her growth rate has continued on it’s (too) steep path.  They estimate that she’s 8 lbs 10 oz by now (her sister was 8 lbs 9 oz when delivered at 36 weeks and 1 day), but there’s a fair bit of room for error in that estimate (I’m told it’s a pound in either direction).

So…I was “treated” to an amniocentesis to check for lung maturity.  For those who don’t know, an amnio involves a long needle being inserted into the abdomen to take a sample amniotic fluid.  Honestly, it sounds nastier than it is.  The procedure itself wasn’t bad.  But I could have done without the pinching and cramping that carried on for the remainder of the day as my uterus reminded me how it feels about being stabbed.  (Just wait until next week, uterus….)

By the end of the day I had the results of the amnio.  The options were “absent” (i.e. indicators of lung maturity weren’t there – wait a bit and come back for another amnio), “present” (i.e. lungs are mature, baby’s good to go, get her out) or “trace” (i.e. indicators of lung maturity are starting to show, wait a week and take her out).  Baby B ranked as “trace”, so she’s getting there!

With that in mind, my OB is aiming to schedule me for a c-section in a week, which is next Friday, April 6th (yep, that’s Good Friday).  If he can’t get me in on Friday, it’ll be on Thursday, but then he’s unavailable to do it himself, so I really really hope he can make Friday work.  He’s planning on scheduling me for first thing in the morning so that I can do the fasting thing overnight and then get it over with.  The actual scheduling with the hospital will take place on Tuesday, so until then Friday is only tentative.  My OB was pretty optimistic about Friday working out, but then again, Dr. Awesome is optimistic about everything, so I guess we’ll see.

So this is good news in a number of ways:

1. I have another few days next week to wrap up the last things I wanted to do before Baby B’s arrival.

2. I will still be done being pregnant by the end of next week.  (Because seriously, this diabetes and pregnancy thing is something I am ready to put behind me for good.)

3. Baby B’s lungs should be sufficiently mature by the time she’s born, greatly increasing her chances of coming home from the hospital when I’m discharged, rather than having an extended stay like her older sister did.

So I’m happy!  🙂

 

Quick Pregnancy Update – 35 Week Appointments

I’m scrambling to get pre-baby stuff done today, so this update is going to be a quick one in point form.

Friday’s Endo Appointment:

– All’s well still, but we’ll have to see what changes need to be made as I adjust to my new schedule of being on mat leave, but also being super busy running errands, cleaning up and prepping for the baby!  Could mean lots of rate/ratio tweaking.

– BP was 130/70, which is the highest I’ve had so far, but I’m still getting readings under 120/80 at home, so I’m attributing the higher number at the endo’s to the fact that I was feeling stressed out while I was there.  She wasn’t worried.  I’m definitely keeping a close eye on it, though.

– We worked on a post-baby insulin plan (i.e. basals and bolus ratios) based on my post-baby rates from after The Kid was born.  It still needs a few adjustments and I’ll be discussing it with my CDE this week.

– She asked to see me again in 6 weeks rather than trying to fit in another one before the c-section.

 Friday’s Fetal Assessment:

– Baby B is now over 90th percentile.  Her growth is consistent and her growth rate is consistent, but both are consistently too high.  I won’t go into how I feel about that, since you’ll already know if you read my last pregnancy post.  (Incidentally, bloodsugars are still tight.  If anything, they’ve been lower and better this past week than previously.  So I’m still at least as frustrated as the last time I wrote about it.)

– I have another Fetal Assessment scheduled for this coming Friday, when I’ll be 36 weeks.  I don’t see my OB again until Friday, but after that appointment.

– I’ll be talking to my OB early this week to find out if I should be getting an amniocentesis at Friday’s Fetal Assessment (i.e. to determine if Baby B’s lungs are sufficiently mature).  It sounds like it’s it’s up to him whether or not I get one, but that if he’s indifferent, the Fetal Assessment doctor will likely request one.  (My OB is never indifferent about things like this.)

– If I don’t get an amnio this coming Friday, I would almost definitely get one sometime the following week.

– Once I get an amnio, if Baby B’s lungs are mature enough, my OB moves up the c-section date to as early as he’s able.  If Baby B’s lungs aren’t mature enough, we wait up to another week and do another amnio… rinse and repeat.

– In the case that we’re “a go”, my c-section will most likely be during the week of April 2nd – whenever my OB and the OR can make their schedules match.

– While I’m “waiting” for amnio/c-section/lung maturity/etc., I need to watch for two things: (a) a decrease in baby movement, which so far is not an issue – this kid is busy, and (b) an unexplained drop in insulin requirements which could mean my placenta is starting to fail (also not an issue so far).  If either of these were to happen, I’d be getting a c-section with some degree of urgency/emergency.  As long as those two things aren’t happening, and her lungs aren’t ready – we just wait and monitor.

So that’s our current status.  When I was pregnant with The Kid, she started to grow too fast around the same time, but we never made it to lung maturity with her because my pre-eclampsia and retinal bleeding made the c-section timing an issue of my health rather than hers.  So, with my BP and eyes under control this time, we’re entering some new territory now. The Kid was at 36 weeks and 1 day when she came out, and her lungs were not yet mature.  With better diabetes control this time around, maybe Baby B’s lungs will be mature earlier, but who knows…

I’ll keep you posted as I’m able.  For more timely (but much briefer) updates, friend me on Facebook or follow me on Twitter!

3rd Trimester Ophtho Appointment – A Sigh of Relief

This afternoon I had an appointment with Dr. Ophtho.  We had scheduled it for this point in my pregnancy specifically because this was the point at which he noticed new proliferation in my left eye during my last pregnancy.  With the baby’s recent growth, I was a bit nervous that I’d be seeing growth in my retinal blood vessels as well.

So I was very relieved to hear the “no changes” verdict.  YAY!  Unlike my last pregnancy, I can probably safely say at this point that this pregnancy will not have advanced my retinopathy!  This is absolutely wonderful news!

And considering that I’m still not having any blood pressure problems, hopefully I’ll be free from any pregnancy-related retinal bleeds as well!  *fingers crossed*

The icing on the cake was when I asked him when he wanted to see me next.  His answer:  6 months!  I’m sure those of you with annual ophtho appointments are wondering why this is good news, so let me tell you.  Ever since The Kid was born and I had The First Bleed, he’s been requesting to see me in 4 months.  For him to ask me to come back in 6 means that he feels my eyes are stable – or as stable as can be expected given their recent history.

Yep, the icing on the cake. 🙂

Trying to be Uncommon

This morning I had my third fetal assessment.  Baby is doing great and everyone was happy…yet I still left the hospital feeling a bit dejected.  Here’s why…

At my first fetal assessment – 3 weeks ago – Baby was at the 45th percentile for size.  Perfectly normally average.  Loved it.

At my second fetal assessment – 1 week ago – the “percentile chart” was shown to me with no specific numbers given.

“Here.”  The nurse said, and stabbed her pen at two little x’s on the graph.  “Here’s where she was last time” (pointing at the x just below the mid-line) “and here’s where she is this time” (pointing at the x slightly higher above the mid-line).  “Everything looks great!”  And we left.

At today’s fetal assessment, the nurse said, “She looks great!  75th percentile, just like last time.”

Wait, what?  I had been led to understand that she was only a tad above that mid-line (i.e. 50th percentile) last time…1 week ago.

In my last pregnancy, right around 33-34 weeks (for comparison, we’re 33 weeks now) The Kid jumped from 60th percentile to a point above 90th, in spite of tight control of my diabetes, and at that point we started talking about risks and early c-sections and all that fun stuff.  I’ve been really really hoping to avoid going down that path this time.  My control is even tighter with this pregnancy (A1C hovering right around 6.0% this time as compared to 6.5% last time), and I’m rarely having highs to speak of.  I see a few numbers around 8-9 mmol/l (145-160 mg/dl) every day, but rarely higher, and I correct them uber-fast!  So I’ve been convincing myself that Baby B is not going to have the same growth spike that The Kid did.

The nurse didn’t seem nearly as worried as me.  She pulled out the chart again and showed me the little floating x’s.  She showed me the “slight” jump that occurred in the two weeks between F.A. #1 and F.A. #2, and she showed me that the growth was nice and consistent now.  She also showed me that all three x’s were well inside of the “safe” zone  – the upper and lower lines that set off alarm bells when you creep over them (or so I assume).  She also reminded me of the 15% error rate, meaning my 45th percentile could have been 60th, and these 75th percentiles…well, they also could have been 60th.

In other words, she wasn’t worried.  Nor should I be.  And I suppose I’m not…not totally, anyway.

But then she said to me – very pleasantly and totally non-accusatory…

“Growth at the end is common with Type 1 diabetes.  It’s why we watch you so closely.”

Clearly she doesn’t know me.

Clearly she doesn’t know my spreadsheets, my carb control, my self-control, my obsessive blood-testing or my wakeful nights of correcting levels that are only slightly too high.  Clearly she doesn’t know that every ounce of my energy is being poured into be uncommon when it comes to Type 1 diabetes in pregnancy.

Clearly she doesn’t know that this explanation is not one that will make me feel better.

I’m hoping we hold fast to this 75th percentile.  I only have 4-5 weeks left now, and I’m awfully tired – physically and mentally.  I’m doing all that I can – literally everything that I can muster – to trick this Baby into thinking she’s living in a non-diabetic environment.  So far I’ve seen great results of all this work – happy healthcare professionals, gorgeous A1C, and (so far) none of the same nasty complications that I had last time around.

But the ultimate result that I’m looking for – the main goal of all of this hard work – is for Baby to be unaffected by my diabetes.  Normal size, normal development, normal timing of delivery (or as close to it as possible – I’ll settle for 37-38 weeks).

And so that she can experience normal, I’m determined not to settle for common.

Pregnancy Update – 32 Weeks

It seems that blogging during this pregnancy has been easier said than done.  I was really hoping to keep on top of things and keep everyone up to date, but clearly I’m failing to do so.  Bad, busy, pregnant me.  Anyway, today I do have an update – complete with pictures (which you may have already seen if you’re Facebook friends with me).

Maybe I’ll start with the pictures.

First of all, this one is me, taken yesterday at 32 weeks, in the classic “bathroom mirror phone photo” (thanks to having nobody around to take it for me).

Next, these two shots are from our first Fetal Assessment ultrasound three weeks ago (i.e. at 29 weeks) – one of her profile, and one of her face.

And finally, this is a close-up of the lower portion of her face (nose/mouth/chin) from this past Thursday – one day short of 32 weeks.  We can hardly believe the resemblance to her older sister already!

And now to bring you up to speed…

1. Doctors Appointments

They are ramping up big time.  I’ve been seeing the endo every three weeks (but expecting to go to every two after this coming week’s appointment), and the OB every two.  I have had two Fetal Assessments that were three weeks apart, but I’ve now been asked to come every week.  I haven’t had any recent visits with the ophtho – only two so far during pregnancy – but I have one coming up in about two weeks.  I also have phone appointments with my diabetes nurse every 3 weeks to do some more detailed problem-solving than what we have time for at my endo appointments.  So it’s busy.

The good news is that everything is going great and everyone on my medical team is really pleased!  Yay!  My A1C has been hovering just above and just below 6.0% (which I am thrilled with!), my BP is consistently under 120/80 (last one was 118/73), my weight gain is approximately 23lbs (perfect at this point), no thyroid issues, very little swelling (only a bit every few days in my ankles), and generally no sign of any problems.  The baby is hovering right around the 50th percentile size-wise, so I can’t complain about that either.  My left eye bleeds a little from time to time, but always from the same spot it did pre-pregnancy, and never very much.

All in all, I’m almost the picture of diabetic-pregnancy health!  It’s been so much work, but so worth it to have come this far already.  We don’t have a c-section scheduled yet, but my OB is still aiming for the week of April 9th-13th (i.e between 37 and 38 weeks…hopefully closer to 38).  The more confident he sounds in those dates, the more confident I’m feeling that this pregnancy is on the right track!

2. Missing Out on Important Things

No, this isn’t about “important things” like donuts, burgers and Snickers bars.  This is about the fact that, in spite of all the good stuff in #1 above, my OB asked (read: begged) me not to take a trip to Victoria, British Columbia at my 31-week mark.  The “important thing” in Victoria: my best friend from childhood.  The “important event”: her wedding.  There are few things in this world that could have kept me from watching this woman I love so dearly marry her soul mate (who I also love dearly, by virtue of how dearly I know he loves her), but this was one of those things.

While there was nothing to indicate any current health problems, my OB was worried that any additional stress of travel, etc, could start to cause that dreaded increase in blood pressure that could start the downward spiral we saw last go around.  Since my health, and the health of my baby (including the amount of time she gets to bake in my womb) is the highest priority for me right now, and since I trust my OB immeasurably (he is a very reasonable doctor, and an expert at what he does…not to mention a saint, but that’s another story), I had no choice but to heed his advice and stay home.  It was the right thing to do, but it seriously sucked.  Seriously.

3. Comparing Pregnancies

When I was pregnant with The Kid (i.e. the first one), I kept a pregnancy journal, so it’s been really interesting to look back and see the similarities and the differences.  On the side of differences, last time at this point I was having major swelling in my feet (read: compression socks and an inability to tie my shoes), and quickly rising blood pressure.  I was also significantly heavier by this point.  (For comparison, last time I gained 50lbs during the entire pregnancy and this time it’s looking like I’ll come in around 30lbs total weight gain, unless something drastic happens between now and my c-section.)

On the side of similarities, I was having some major insulin resistance (check), bad infusion site absorption (check) and was waking up every 2 hours at night to pee and/or check my bloodsugar (double check).  I was also entering “indigestion mode” again (seems to be a 1st and 3rd trimester thing), which is pretty much right on target again this time around.

It’s interesting how two pregnancies really can be so different, yet have some very distinct similarities.  I’m not complaining about any of the “similarities” though when I see how lucky I am to have the “differences”.

4. Insulin Resistance

I mentioned it above, but I’m mentioning it again.  Insulin resistance is huge in 3rd trimester!!  My bolus requirements at meals are more than double what they were pre-pregnancy.  I’m moderating my carbs a lot more with this pregnancy than I was with the last one so as to avoid massive insulin doses with the still-unavoidable (for me) bloodsugar spike-and-drop combo.  It’s really making a difference and it makes me wonder how I managed last time on a carby diet!  I’ve learned so much about my diabetes since then…  Last time it wasn’t abnormal for me to have highs in the high teens and low 20s (that’s the 300-400 mg/dl range) – not every day and not even every week, but every now and then when things weren’t working right.  This time my bloodsugar ceiling has been 17 mmol/l (~300 mg/dl), and I’m happy to say that I’ve only been that high twice in the last 7 months (making me a much less guilt-ridden Mommy than last time).  I’m at the point now where I feel high (and talk in terms of being high) when I’m above 9.0 mmol/l (~160 mg/dl).  It’s nowhere near perfect, but I feel like I’m giving this baby a much better growing environment this time than I was able to with Baby A last time, and that feels very satisfying.

Anyway, away from that tangent and back to insulin resistance.  I have it bad.  And it’s mostly around meals.  In fact, with my superbolus strategy (i.e. borrow basal insulin to add to meal boluses, and then follow it up with a 2-3 hour significant drop in basals), I’m seeing my basals drop significantly because of how much insulin I’m having to take when I eat.  So it’s this weird balancing act these days – add to the bolus, drop the basal, add a bit more to the bolus, drop the basal even more.  I find I’m pretty much assessing and re-assessing trends every 3-4 days now.  I’ve said it before and I’ll say it again – how anyone who is not an analytical Type A personality does this is beyond me.  I’m the kind of person who thrives on numbers and analysis and control and even I’m burning out!

5. Looking Ahead

Now that the end is in sight (hopefully still in as close to 6 weeks as possible and not sooner), I’m starting to think more about the time after Baby B comes, including my diabetes/diet management and my maternity leave.  I’ve realized two things:

a) There are going to be some days where I eat what I want to in spite of what I know it will do to my bloodsugar.  I don’t even mean donuts, etc.  I mean a bowl of cereal with milk, a real sandwich (on something other than skinny slices of high-fibre Weight Watchers bread), chicken fingers and french fries…things like that.  And I don’t mean on a regular basis.  I do still plan to go back to the low(ish) carb way of eating that I followed pre-pregnancy (and that I’ve only slightly modified during pregnancy), but I also plan on giving myself the leeway to have some exceptions – something I’m not really allowing myself in any major capacity these days.

b) I’m hoping I can get myself a bit further immersed in the D.O.C. while I’m on mat leave.  I see so much good stuff out there that I’d love to participate in more fully, but it’s so hard to find the time when I’m juggling work and my family and the rest of my life.  If I have a relatively happy baby (which I didn’t last time, so I’m still crossing my fingers about this for Baby B), I’m hoping to be able to participate more in online chats, diabetes blog memes, and a LOT more reading of blogs by my fellow D-bloggers.

And hopefully it will also mean more frequent blog updates here!

New A1C – 30 Weeks Pregnant

I got my new A1C result yesterday (from a bloodtest done on Wednesday).  The result?

5.9!!

I’m back in the 5s!  Yay!

The timing is perfect because I’ve been so frustrated with insulin resistance lately and highs that just don’t make sense and just don’t come down.  (By “high”, I mean 10s and 11s in mmol/l, or 180 – 215 in mg/dl – so not brutally high, just too high for pregnancy.)  The old guilt was starting to settle in, even though I knew I was doing everything I could.  So this result was an absolutely fantastic reminder that I’m still kicking ass at being pregnant with diabetes!

On another note, I apologize profusely for my absence of late.  I’ve been lacking the technology to post properly, but we finally have a new computer, so I’m hoping for a longer post in the near future…

Stay tuned!

My Obstetrician is the Best!

Yesterday on the way home from work my cell phone rang.  It was my obstetrician’s office.

I answered the phone, and his assistant said this:

“Dr. Awesome [not really his name] asked me to phone and tell you that your A1C is great!”

I kid you not.

He is always carbon-copied on the results of my bloodwork for my endo, so I guess the results of the last test showed up in his office yesterday.  This busy, but terribly kind, man then took it upon himself to make sure I was congratulated.

My obstetrician is the best!

(PS – 12 of 12 should be up tomorrow sometime.  No time today.)

 

New A1C – 24 Weeks Pregnant

As promised, I’m sharing my most recent A1C result (taken last Thursday).

6.1

As I suspected, it’s crept back into the 6s from my rockin’ 5.9 (largely thanks to the Christmas holidays).  Still, not too shabby.  Not too shabby at all.

🙂