September 23, 2014

MaMaMaMaMa

Sooooo.... I had a baby.
Kinda obvious, eh? Also extremely typical that it would take me 7 months to write about it.

It = Her.

Yup. Her. Like fate laughing in my face. I have videos of her doing super kung fu moves in my stomach while I exclaim about how he is beating the living shit out of my ribs. Gawd, you should've seen the 'I told you so' grin on Mr. Right's face when he failed to find a pair of balls on his icky, slimy red daughter.

Remember it, honey. It's the first and only time I'll ever be wrong.

Hannah Grace was born on February 13, 2014 at 11:09 pm. Yup, I kept her from being a Hallmark Card Birthday baby by a whopping 51 minutes! My first Big Parenting Success!!! I'd love to sit and tell the whole painful birth story, but frankly it would probably take me hours and it's 12:30 am and I'm tired and I have a pile of laundry to fold before I hit the sack.

So, without further ado, here's the short and sweet version of the birth of Hannah Grace:

Monday: Weekly growth scan. Baby's gone off her growth curve significantly. Major panic ensues, seeing as I'd had the evil baby-killing flu from hell just a few weeks before. My induction is scheduled.

Wednesday (crack-of-WTF-early-am): Get the call from the hospital. Call Mr. Right at work, who rushes home and drives us in, where some gel is shoved up my hoo-haw to get things going. I'm not dilated at all and barely a fingertip effaced.

I walk. And walk. And walk some more. More gel. Our Doula comes in. The on-call Dr. decides to break my water (boy oh boy, the things I know now that I wish I'd known then!!!), clock starts ticking. Did I mention I'm GBS positive? Contractions of EPIC proportion, helped only by either walkingwalkingwalking or bouncing on the ball. Walk, bounce, walk, bounce. I face off with an Endo and 3 Perinatologists after informing the nurse that I will not be removing my Insulin Pump, thank you very much. Sign their 'We Are Not Responsible' form. (Definitely more detail for later, here) I'm only dilated 3 cm, so the synthetic oxytocin is fed into my veins. Finally moved to the delivery room, where they expect me to sit on a bed so they can attach a fetal monitor. Dudes, BACK LABOUR. {OK, back labour is worse than any labour, EVER. If you've had it, you'll know. If not, you have no idea} She's flipped back to back and  my only relief is this wonderful hip pressing thing my Doula does, and WALKING. I'm determined to go drug-free. I'm doing a pretty good job of it too, so long as the freaking medical staff will just Stop Trying To Get Me To Lay Down!

Then, they start double-dosing the synthetic oxytocin. So now not only do I have back labour, I've got continuous contractions. As in, 30 second contraction, 10 second break.

This is probably the only time in my life that I can actually distinctly remember the exact feeling of pain. While my wisdom teeth being pulled under local freezing was terrible, I just remember that it hurt. Back labour with huge amounts of synthetic oxytocin... I remember exactly how it felt. OUCH. FUCKING MOTHERFUCKING OWWWWIEEEEEEE!!!
{I never yelled once. Never screamed. According to my Doula, I did, however, mutter the f-bomb repeatedly. I was pretty ashamed when she told me that}

Unfortunately, the contractions were so intense that they started to affect baby, badly. I remember having 6 nurses in my room at one point, all of them - and even my beloved Doula - urging me to take something for the pain. ANYTHING. After I said no, somebody brought in my OB, a wonderful lady who I trust implicitly. She laid it on the table for me - get an epidural, or be prepared to be taken for an emergency c-section. She tells me unequivocally that the only c-sections she ever does are Absolutely Necessary.

I hadn't slept in almost 24 hours. I was harming my baby by being so damn stubborn. I was risking having my chance for a vaginal birth - hell, by that point I still hadn't even dilated enough to start pushing! So I gave in.

Epidurals suck. I mean, yeah it was awesome not to have the awful pain, but my body doesn't react right to drugs. I could feel and move my legs (wrong), but I couldn't feel a single contraction, not even a slight bit of pressure. Oh, and when you're having off-the-charts contractions continuously with only 10 second breaks... it takes WAY longer than ten seconds to get an epidural and you have to hold still the whole time. Thank gawd for my Doula, that's all I have to say.

Anyway, at some point we slipped into Thursday. I finally slept, for 2.5 hours. When I woke up, my awesome OB (who was actually in lieu of my normal OB, who was on holidays, which was fine with me because I ADORE Dr. T!!) decided it was time to try and turn baby. Now, Dr. T is a little Asian lady who doesn't have a practice here in Canada - instead, she fills in for my regular OB and travels overseas to help with obstetrics in third world countries. So she knows all the old-school tricks that OB's nowadays aren't taught. Like making me lay on my side for an hour with my left leg up on one of those bed trays that hospitals have. After which, Dr. T reached up into me and, using one hand under my breasts, turned the baby around so that she was in the proper birthing position. Super cool. Oh, and I felt that. I wasn't supposed to lol.

Fast forward and I've finally dilated to 7 cm... and I'm on the max dose of sythetic oxytocin and going nowhere. Baby is still doing the boot-and-scoot-boogy in my stomach, kicking and punching and generally having nothing to do with her eviction notice. They hook these electrodes into baby's head so they can better monitor her. Dr. T decides it's time to give it the old college try; she tells me that often, the simple labour process itself can help with the last stages of dilation. So, I start to push. And I push. I'm hacking and coughing the whole time - I'm not allowed to have any water because of the high chances of a c-section, but Mr. Right and my beloved Doula slip me ice chips on the side.

Oh, and I'm vomiting. I think I forgot to mention that - not only did I vomit through my entire pregnancy, but I continued to vomit all the way through labour. Push, puke, push, puke, push, puke. I continued to joke with the medical staff the whole time, though I can't for the life of me remember what I was saying that had them laughing so hard. When I remember it now, it's like watching myself from behind a fogged mirror; hazy but recognizable. I remember it all, but almost as though I was outside of my own body, a separate observer. I think it was those damn drugs.

On it goes: push, puke, push, puke. For 3.5 hours I try my hardest to push this kid out. Dr. T tells me that there's no physical reason for baby not to come vaginally. Hell, I was pushing so hard and so well that I blew the damn catheter right out! I'm doing everything right, we're all just waiting for baby to finally make her appearance...

And then I spike a Really. Bad. Fever. The talk turns to infection. I keep on pushing, willing baby to please just come out already... and then her heart rate drops badly. Everyone's looking at the monitor connected to those wires running into my va-jayjay, watching as with every contraction baby's distress gets worse and worse. My fever goes even higher. Dr. T looks at me with sympathy and says, "Tiffany, it's time."

Then everything gets foggy. I'm wheeled into the OR without Mr. Right, sheets are draped, I take out my continous glucose monitor, remove my engagement ring, and wait. The first cut is made without my fiance, and it HURTS.

"I can feel that and it HURTS," I say urgently to the Anesthesiologist.
"You can feel that or it hurts?" is his response. ARG.
"IT HURTS!"

He looks at me over his mask, bafflement in his eyes. What can I say, drugs and I don't mix. "Please hurry," I tell him. I can hear him muttering to himself, wondering what he can give me. He finally depresses a plunger on a needle, telling me the name of some narcotic that I forget now. Eventually I stop feeling Dr. T cutting open my stomach, and they let Mr. Right in. First thing he does: checks my blood sugar. Gawd I love that man.

I don't know how much time passed - when I asked to watch them pull my baby out, they told me they couldn't let the sheet down or the sterility would be compromised. So my first glimpse of her, after Mr. Right's shit eating grin when he told me "IT'S A GIRL!", was this long, scrawny red creature, all legs and arms and putting me in mind of a spider. They walked her past me, gave me a two-second look, checked her over, declared that her blood sugar was low, put her on my shoulder for 15 seconds, and then whisked her away to the NICU. Mr. Right, at my urging, followed.

So, I was alone. They put my parts back together, yanked all of my drugs and wheeled me into recovery where I spent the next 10 minutes practically begging the nurse for a tylenol, trying to relax my vibrating muscles, and asking for updates on how my daughter was. The pain was phenomenal - I felt EVERYthing. It was so intense that every muscle in my body tensed up in response, like fight or flight but heavy on the please-fly-me-the-FUCK-away-from-this-pain! C-sections are no fun, let me tell you. Eventually she gave me a shot and I was wheeled into our private room, which was the last place I wanted to be until a nurse that I will never forget walked into my room with a HUGE plastic cup of ice water in each hand. I burst into tears and told her that I would love her forever. Seriously.

It was almost 12 hours before I finally saw my daughter, and believe me, I'm not happy about it, nor were the NICU nurses. I cried to 2 different nurses - and I hardly ever cry - to just please take me to see my baby. The next morning (Valentine's Day), I was making threats if anyone else prevented me from getting to the NICU, so they finally helped me to get on my feet. Except I couldn't. My left leg was completely dead. So I got a wheeled bar for my catheter bag, and a kindly nurse found me a wheelchair, and Mr. Right took me to my baby.

That moment... it's indescribable. Wonderful. Beautiful. Sacred. Bittersweet because I'd been kept from having that moment for hours up until then. I stripped my gown off without a care and set her as close to my heart as I could, and I cried. In joy, and sadness, and the intensity of wanting her so badly and finally having her. In missing out on having that closeness when I should've, when she was mere seconds in this world or minutes in this world, when every baby needs the skin and touch and smell and warmth of the body that housed them for an eternity. Of all the things that I regret about Hannah's delivery, that's the biggest. I was wronged, Hannah was wronged, and it was just inhuman.

The NICU nurse came after an appropriate time and checked all of Hannah's vitals. I'll always remember her turning to me upon looking at the results, a big grin on her face, and saying "She just needed her Mama."

Instead of spending the usual week in the NICU, she spent only 2.5 days. We worked on breastfeeding (epic fail, though I pumped for 4 weeks) and just cuddled as often as I was allowed. I requested a walker to get my dead leg working again, and after 7 days in the hospital we were finally released to go home.

And now here we are, 7 months later, and I've been gifted with this wonderful, chatty little creature who defies all of the milestones (she started rolling over at 9 days old, talking at 4 months, and is, according to standard measurements, months ahead in terms of development). She's in the 90th percentile for height and the 50th percentile for weight, so tall and slender and beautiful and SMART. My little extrovert, not a shy bone in her body, loves nothing more than to be out and about meeting people and slaying everyone with her killer smile. I'm truly, irrevocably in love.

I'm a Mommy. And it's awesome.

{On a side note, my fight to stay on my pump kept my blood sugars between 4.5 and 6.0 for the entire time I was in labour. Not one single hypo- or hyperglycemic episode! The NICU nurses told me that they see low BG's often in babies whose Mom's have had long, hard labours augmented with a lot of drugs.}

January 19, 2014

35 Weeks!! I Can't Reach My Vag. Seriously.

Ok so technically we are two days away from the 35 week mark, but I figure I'm entitled a slight TARDIS trip for incubating a wiggly alien in my abdomen.

Because just when I think pregnancy really sucks, it snorts in my face and throws some new challenge my way.

Like the chest cold I caught 3 weeks ago from L~. The one that I still have, complete with hacking cough and painful throat. I never get colds - I can count on one hand the number of colds I've had in my life and still be able to flip the virus the goddamn bird. Fine. Bring it, I say.

And then I'm further mocked by a stomach flu, the likes of which I also haven't seen in years. It knocked me flat on my ass for two days last week; worse, it resulted in dehydration and ketones. Big, scary ketones (sans hyperglycemia, how's that for irony!) that had me calling two different hospitals in a panic that the almost-developed sea monkey would suffer a terrible and painful death. I barely avoided DKA and it's been a rough recovery but the little Ninja continues to kick the shit out of my right rib while simultaneously head-butting my bladder. Big. Fucking. PHEWF. 

I've gained 60 lbs, 45 of it legit baby belly. 15 lbs has taken up residence on my hips thanks to stress and the first 6 months of morning sickness and being a pregnant and barefoot housewife during winter. I lost 3 lbs last week which I'm sure I'll get shit for at my next Diabetic clinic appointment. I've become a chronic whiner and I groan a lot whilst trying to turn over in bed. I hate stairs. I have cankles for fucks sake!!! I don't sleep. It's 7:30 am right now and I haven't slept a wink at all. But I've peed about eighty-seven times. Seriously, I pee so much now that our water bill has actually increased. Oh, and my left boob??

It's leaking. 

And if all of that wasn't enough... my lovely Doula has me doing exercises to help prevent tearing during labour. I sit on a Palmolive dish soap bottle filled with warm water (bliss!) and bounce around on an exercise ball a few times a day. 

And I'm supposed to massage my perineum. As in, lube up a finger, and rub it in a 'U' shaped pattern at the bottom of my vag while stretching lightly in order to feel the burn. Okay, I'm very familiar with self-exploration, I can handle - - 

What. The. Fuck. 

Fingers coated in olive oil, ready to rock that hole... And I can't fucking reach it!!!! I twisted. I contorted. I sat on the toilet and tried, I even resorted to doggy-style! 

I can't touch my own goddamn vajayjay!!! My arms are not long enough to reach past the freaking planet at my midsection and actually hit gold. 

I have hit rock bottom. For all I know, there's mold growing down there and a freaking troll has moved in - after all, I've been sick for almost a week, so there's been a noticeable lack of getting bendy lately. 

My femininity dried up. And I cried.

Touché pregnancy, touché.

December 17, 2013

30 Weeks: Poor, Poor Me

I'm feeling a little sorry for myself today.

I've blogged about my Endo frustrations before. It wears me down, leaves me feeling almost helpless... not a feeling I'm used to. So at my last OB appointment, my doctor and I discussed my going to a different clinic, one that I've used in the past. Today was my first appointment with them, and it was both a huge improvement as well as a slight disappointment.

What I loved was the knowledge about insulin pumps. The prior Endo made me write my blood sugars out by hand on this terrible sheet he'd come up with. I'd asked him why I couldn't just download my pump in one of my first appointments: he told me that there was too much information and he couldn't see the forest for the trees. Umm, okaaay then... I used his sheet without complaint. This morning I brought my log book, unsure about the procedure at this new clinic. One if the first things that the CDE did was download my pump and print off all the reports. Then we spent almost an hour and a half reviewing the data. At one point, we talked about ketones and the CDE was shocked to hear that I was still using urine test strips - she proceeded to give me a blood ketone meter for free and reviewed with me the pregnancy procedures in event of ketones. She gave me a thorough check-up: my feet were poked and prodded, it was discovered that I have a decent case of pregnancy-induced edema, and I even peed in a cup! 

Then it was the dietician. One of the things that I didn't have a complaint about at the old clinic was the Dietician - she was helpful and supportive. So was her counterpart today. She gave me a list of very cool apps and websites that I could use for carb counting and estimation and I left her office maintaining the positive feelings the CDE had inspired.

And then it was the Endo. One of the first things she told me was that, because they operate out of a different hospital and are under a different health authority than the one I'm delivering at, they might not be able to see me. I was crushed, I won't lie. I hid it well but it took an immense amount of will power to stop myself from crying. The previous 3 hours had been so helpful, so supportive, and now I was being told that I might not be allowed to continue receiving that help. 

It makes me shake my head, even right this moment, to think that I may have to accept what I consider sub-standard diabetes care because of where I'm delivering. Do I not pay the taxes that support our healthcare system?? Am I not entitled to the very best resources available for a person in my condition with the technology that I have????

We had a few hitches after that; she wanted to know why I was having difficulties with the Endo/clinic, and I explained to her that I didn't feel that they had the tools and resources necessary to help ME. I let her know that I had discussed with the prior Endo my belief that we didn't communicate well, that we weren't an effective team, and told her about how when I'd gone to him with an issue he'd shrugged it off and essentially told me that it would happen and there's nothing I can do about it. I just wanted help, that's all I've ever asked for!! I don't need someone to manage every little detail of my disease - I'm perfectly capable of doing that myself and my A1c reflects my dedication. But when I'm struggling with something I want to feel comfortable addressing it and then feel satisfied that I was given something to even try and do to resolve it!! That's not too much to ask of a specialist, is it?!?

And that's where things went a little sour. She made this comment to me (not word for word but pretty darn close):

"I don't want to tell you to suck it up, but you have to think about what's best for the baby and just because you don't like someone - -" 

!!!!!!!!!!!!!!!

I interrupted her right there. I'm pretty sure that my blood pressure increased a good ten points, I was so angry! 

"It's got NOTHING to do with my liking or not liking someone. It's about my having ALL of the tools and resources available to me to manage this disease and keep this baby healthy! How is that not about me doing what's best for this baby??"

She acknowledged that she'd misstepped in saying that it had anything to do with my liking him or not (I frankly don't like or dislike the man, I just want to be able to trust and rely on the person in that position for crying out loud!!), but I saw the whole medical clique/politics thing come into play a few times afterward. She told me that she'd try to liase with the other clinic, which put me over the moon, but then told me that she'd 'talk to Eddie about it', that being the first name of the old Endo. Le sigh. I appreciate and respect that the man is well known in the area for his research and for being a part of the Edmonton Protocol, but that means nothing to my immediate situation if the assistance that I need hasn't been there!!!! Jeesh. So I ignored it and just addressed what I NEEDED from that visit, and I got suggestions. She was willing to compromise with me, showed understanding when I explained why, in my mind, loosening up control of my blood sugars was not an acceptable trade-off for not gaining any more weight. The communication was fantastic, in spite of the little hitches we had, and I did leave feeling 90% satisfied with the visit.

And they booked me for an appointment in two weeks. Freaking awesome. At the next appointment I'll see the Endo who originally put me on the pump, which I'm looking forward to, along with the CDE and dietician again. 

And then I guess all I can do is continue to be an advocate for myself and my baby and the level of care that we require, and hope for the best. I wouldn't be the least bit surprised if my file had been labelled with some big red sticker, letting everyone know that I'm a troublemaking upstart and a difficult patient... and I'm okay with that. So long as it gets me the level of care that I'm entitled to, I'll continue to fight the status quo.

Otherwise, I might as well just manage it all myself. And wouldn't that be a shame?? Because nobody should have to fight the system in order to access the resources available... and you know what? I shouldn't be judged for being willing to do that, either.

November 18, 2013

99 Days and Counting

We've broken the double digits! 25 weeks and 6 days in, and this baby will be born in 99 days. 

Well OK, most likely less than that since my OB typically induces around 39 weeks. He said he'll be okay with my going to 40 if everything looks good at that point... but only if I can continue to maintain the non-diabetic blood sugars that I've been kicking butt with. Challenge is on!

Did I mention that it's after 2 am in this lovely Minday morning? Ahhhh, pregnancy induced insomnia, my new BFF. (I hate you)

As of last weekend, L~ finally knows that he's going to be a big brother. While most 6 year old kids would probably have figured it out by now (especially considering the many slip-ups of our adult friends and family!), it took three other six year olds telling him point-blank what was going on before L~ caught on. Fortunately so far there doesn't seem to be any backlash and L~ is somewhat ambivalent about his forthcoming fall from Only Child Syndrome.

So far. Unfortunately L~, for all his sweetness, is a mass of medicated issues; developmentally, emotionally, physically. He's a ticking time bomb and I'm constantly waiting for the clock to hit zero. He has no physical drive and is quite simply the first and only lazy child I've ever in my life seen. He's having troubles in school - has been since the start of kindergarten last year. He doesn't understand the assignments. He doesn't pay attention and disrupts the class and has emotional breakdowns almost daily. He's at his fourth school in two years because Mr. Right and exnonwife keep beating around the bush instead of just acting and doing something proactive. It's the teachers fault, every time. Now they are putting him back into Kindergarten with the expectation that this will finally solve all their problems.

The thing is, he needs help. He doesn't need to be held back or switched into another school again - he needs one on one every day with a qualified educator who can teach him in a way that he will understand.

Because he's 6 years old and he cannot grasp simple concepts like the difference between a square and a rectangle.

Or letters of the alphabet.

I suggested Mr. Right have an assessment done. Unfortunately after the past two and a half months of his excuses and my frustration, we've come to the conclusion that this is an area where I cannot be involved. Because in his eyes I just think there's something wrong with L~, and in my eyes Mr. Right is so determined that his child is just perfect that he's not willing to get him the help he needs to succeed. 

So I wait for the next big issue; I wait for exnonwife to blame L~'s likely unsuccessful return to kindergarten on the fact that we're having a baby. (And believe me, I have every finger and toe crossed that I'm wrong and that he ends up excelling in kindergarten!) I wait for whatever medication they'll put him on next and the effect that that will have on his behavior (he's on thyroid and anti-seizure meds with the occasional steroidal inhaler or two thrown in for fun). And how that will affect our household and relationship every second weekend for the next... who even knows.

And how it's going to one day affect my child's environment. 

I worry too much, I know. But there's a little tiny part of me that screams in a very loud whisper: 'I REALLY DON'T WANT A CHILD LIKE L~!!' What I mean by that is, whatever gene that caused his impairments, whatever nature or nurture that influenced his delays and laziness: please do not make friends with my child. Mr. Right is average intelligence, and exnonwife seems to manage about the same. I have a high IQ; I taught myself to read when I was 3, resisted being advanced ahead two grades in school, understood concepts that the average person would find baffling. I'm not bragging, believe me. If anything I find that my intelligence hindered my childhood and has made being an adult somewhat frustrating. It even sometimes colours my relationship with Mr. Right and my immediate family, resulting in my having to suppress feelings and thoughts in order to relate to them.

But in spite of all that, I want everything for my child, including an innate keenness and intelligence. And the physical aptitude that runs in my family, as well as Mr. Right's. I hope that our little Sea Monkey is the exact opposite of the child that lives in our house every second weekend.

Is it terrible of me to feel that way?

October 30, 2013

23 Weeks: I Won't Give Up My Control

118 days to go.

Boy, where to start... ? The sea monkey is doing just fine - he's weighing in right on target, our fetal echocardiograms are great so far, he's constantly doing his kung-fu ninja moves, and his heartbeat measures perfect every time. He's perfect. And that's really all that matters.

In my opinion, anyway. Things are significantly more difficult for me, but I'm dealing and dealing well. But the frustration... gah. You see, I do not enjoy my Endocrinologist. He and I are like oil and water - I self-manage my Type 1 Diabetes to a degree that most Diabetic specialists are not used to. One would think that this would result in an Endo who is nothing but encouraging and pleased; alas, not mine. I had my monthly visit with him this morning and it went as it always seems to, resulting in my frustration and anger.

My A1c measured in at 5.5%. Freaking AWESOME. What's important to note here is that this A1c is based on a low number of hypoglycemic episodes, so it's not an issue of a lot of low BG's pulling the number down. No, it means that my blood sugar is averaging around 6.0 mmol/L. It means I'm maintaining non-diabetic BG's for the majority of each day, and doing every thing within MY power to ensure that this child will be born without any effects of my disease. If I continue to do this through the following 118 days, I minimize the risk of having a large baby due to high blood sugars. I minimize the risk of his lungs being underdeveloped or his own blood sugar going dangerously low after he's delivered, among many other potential issues. I also significantly increase the chance of a healthy, normal, natural labour and delivery rather than requiring medication and surgery! All of my sacrifices are worth that.

My Endo, however, is possibly on crack or just has his own control issues... you be the judge. Because today he told me that my control is good enough that I can sacrifice it in order to stop weight gain.
Say WHAT??

I've gained almost 50 lbs over the past 6 months. Believe me, I don't like it myself - I was about 25 lbs overweight when I got pregnant, and slowly working at losing that. But I liked my body... now, I hate it. I don't have the cute little baby bump - I have the planet-sized mountain on my abdomen that has everyone wondering if I'm possibly having twins. It's HUGE. I feel fat and icky and gross and I want my pre-baby body baaaaaaaaack!!!!

But there is no freaking way in Hell that I am going to let my blood sugars go UP and increase the potential risks to my innocent little baby to avoid gaining another 20 lbs.

And that's what I told him. I asked him how he can justify my baby's health against my weight and his response: he's aware of studies that suggest that excessive weight gain in the Mother can lead to future obesity in the child.

Okay, so in his opinion it's more important that my child not maybe get fat some day, than it is for us to have a healthy, safe labour and delivery of a child who will not have any heart or neural defects or be oversized due to my elevated blood sugars.

I told him that I plan on teaching my child good eating habits, just like my Mom did for me. My Mom, who is 56 years old and in better shape than most 20 year olds. Who gained 70 lbs during her pregnancy with my older sister, who I should note is not obese. I grew up at a healthy weight and maintained that until college, but I was never obese either, and that had nothing to do with genes.

I walk every day, usually twice a day. I eat balanced meals - in fact, if anything I could be accused of not eating Enough rather than eating too much. I'm in a weekly prenatal dance class and a weekly yoga class, and I dance around the house. A lot. I log the food that I eat and consistently maintain a caloric intake between 1900 - 2000 calories as suggested by my Dietician, who I also touch base with at least once a month.

So tell me, how exactly would it help for me to stop controlling my BG's so tightly???

I've also been dealing with the inevitable 2nd through 3rd trimester insulin insensitivity, which basically means that my normally overly-sensitive to insulin body is now struggling a bit in using injected insulin to manage the meals that I eat. I've started cutting carbs and walking after breakfast and dinner in order to alleviate this, but today I asked the Endo if he has any other suggestions for managing this issue. Nope... in fact, rather than encouraging me or offering me any sort of constructive advice, he instead told me that it's going to happen and there's nothing that I can do about it.
Bullshit. Don't EVER tell me I can't do something, particularly when it comes to this disease!!! I know better than anyone that there's always something that can be done, I just have to find the tools. 

I'm beginning to suspect that what's happening is that the Endo has nothing to do when he sees me. I don't look to him to make changes to any of my pump settings; he knows that I'll take his suggestions but probably won't use them (sadly, they're usually no good!). I'm perfect in every possible way... except for the weight gain. So he grabs on to it like the last raft off a sinking ship and just goes with it. Maybe he just wants to be right (I prove him wrong, a lot!), maybe that's what it is.

All I know is that today's visit and the comments he made were the last straw; I'm going to be asking to see a new Endocrinologist going forward.  Someone who is able to understand that I don't need to be controlled by my doctor - I do that better than any Endo ever could.

September 15, 2013

16 Weeks, 5 Days: Pregnancy & Type 1 Diabetes

I don't blog often about having Type 1 Diabetes here on the Spanx. Deliberately. You see, I used to be extremely involved in the online community of Diabetics; I had a formerly well-known blog several years ago, started an online support group, was published with the JDRF, and a few other notable things that really don't matter. Hell, I went to college for a healthcare diploma with the end goal of becoming a CDE some day (a few years later I ended up going back to school to become an accountant lol)! I became so deeply submerged in everything diabetes and insulin pump related, that I ended up spending entirely too much time sitting in front of a computer rather than living life, finding love; you know the old song and dance. So I turned around and, with the exception of a few areas, I walked completely away from Diabetes on the internet.

I spent the several years in between then and now focusing on losing the weight that I'd gained from being so sedentary, dating and kissing frogs, finding Mr. Right, jumping through hoops to buy my house, re-establishing relationships with my closest friends... the important things. The things that I blogged about here, while my relationship with my disease remained steady and true and not really worth talking about. Until now. Until pregnancy changed everything.

Pregnancy as a Type 1 Diabetic is freaking hard.

I've had this disease for almost 24 years and I'm exceptionally good at managing it, and all it took was a few weeks of being pregnant to truly humble me. One of the very first symptoms that I had before I even knew I was preggers was low blood sugars. All the time. For no good reason. That started around week 4 if I recall correctly, and it's lasted for the duration. Now, imagine knowing that if you don't drink that glass of orange juice you'll pass out and possibly go into a diabetic coma, potentially resulting in the Seamonkey's death... except you know that if you drink that orange juice you're going to spew. Everywhere. {OJ can be substituted with Ginger Ale/Apple Juice/Everything with the same results!} Welcome to pregnancy as a Type 1 Diabetic... with HG.

I've had record lows; Mr. Right called me one Sunday from work, waking me up from a sickness-induced nap:

"Did you check your blood sugar baby?"
I didn't feel low. At all. And I've always had great sensitivity for lows. "Oh, yeah, good idea."
5 - 4 - 3 - 2 - 1...
My contour meter beamed this scary reading over to my pump: 1.0 mmol.

One. Point FREAKING ZERO. For those of you not in the know, a low BG starts at 3.9 mmol (70 for my American brethren). The reality is that I was extremely lucky to have woken up to that phone call, and I knew it. Had Mr. Right not called me... well, I hate to even imagine. I choked down a cup of ginger ale and managed to keep it down, and ironically once I hit around the mid-2's I started to feel shaky and sweaty and the spaghetti-limbs showed up. Fortunately I've only had a few subsequent low's in the high 1's; the rest usually beep in at a 2-point-something, thanks to this pregnancy-induced degradation of my hypo-awareness.

I'm happy to report that, with intensive monitoring and adjustments of my basal/bolus ratios, I have been able to limit and better manage the lows, and last week's A1c was a lovely 6.1% with a standard deviation (SD) of 41% of MBG! Not perfect though - I'm shooting for 5.5% with an SD of <40% by mid-October at the latest. A lot of Diabetics use the A1c as a benchmark for control, without realizing that the measurement is imperfect simply because it's a weighted average. Sure, my A1c might be great... but if I dig into the numbers behind that A1c, what I might find is that I'm having 6 highs a day and 6 lows a day and those are resulting in what looks to be a great A1c... but what is, in reality, terrible control. By using SD in conjunction with my A1c, I get a much better idea of how good my blood sugar control really is.

To explain SD, I've copied a little explanation that I wrote elsewhere on the www's:
"Standard deviation in reference to BG represents the variation of blood glucose levels either in excess of or below the average. It measures the range of the values that affect the average; if the values are close to the mean, then the SD will be close to zero. If a lot of the values are far from the average then the SD will also be further from zero.
The lower your SD, the more consistent your BG's are. The higher your SD, the more erratic and inconsistent your BG's are. Basically, the SD is a good way to evaluate how tightly controlled your BG levels are.

On average case studies, a healthy, non-diabetic person will have a standard deviation in BG levels of < 1.7 mmol / 30 mg with a MBG (mean blood glucose) of 4.5 mmol / 80 mg. This is a SD of about < 40% of the MBG. Diabetics should set approximately this same target SD to improve overall control (and decrease the risk of complications and yadda yadda yadda). Starting with a goal of <50% SD is a great way to begin."
I'm lucky because my Minimed pump downloads into a program that uses all of the BG information - including when I have my CGMS hooked up - to calculate SD. But Excel has a function to do the same if necessary. 

The past week or so has brought about some pretty significant changes that are making managing my blood sugars a bit more difficult: I'm starting to see the typical decrease in insulin sensitivity that occurs in the second trimester, and my HG is finally getting better! I haven't vomited for 2 whole days. Which means I've been eating! Which means... I've been bolusing for actual meat-and-potato meals. And it's been having mixed results. Yesterday my BG's were perfect all day long. My 1 hour post-prandial's (PP's) were consistently under 7.5 mmol without trailing lows. The line on my CGMS didn't go above or below my target ranges for the entire day, and I only had one low BG overnight last night. Today... well, this morning after breakfast I chased an 8 around for a few hours, then again early this evening I was fighting with a 7. Neither were PP's and they scoffed at the extra over-corrections that I hit them with, and even the temp basal of 130% that I resorted to at one point! So, I walked. I walked and finally started to see the downward pointing arrow on my CGMS status screen.

But what am I going to do when it's -35 degrees outside and there's 3 feet of snow to contend with, and I can't shake those freaking 7's?!? And my belly is sticking out to there?? I plan to walk around and around my kitchen and living room if I have to. Maybe talk to my Obstetrician about what sort of exercises I can do right at the moment in the event that this happens again... and I know it's going to happen again.

In the meantime, all I can do is the best I can to ensure that I have a healthy baby, and a normal birth.
 

 

September 13, 2013

Ugliest Pillow. Ever.

In a consignment store last week, I happened upon the holy grail of pregnancy pillows:


The Snoogle.

It's this giant body pillow that's shaped in something of an "S" configuration, with one end for head support and the other intended to be placed between the knees. Though I fall asleep on my side, I always wake on my back, so this pillow has been a lifesaver in training myself to remain on my left side. I adore it.

Mr. Right, on the other hand, is not quite so fond of it. He jokingly complains about how he's been replaced; how we have what amounts to another full sized person in the bed. Who I would rather snuggle with then him.

So I started calling it my Snoogly. 

Which Mr. Right quickly adapted to Poo-gly. After a very bad night of pregnancy induced flatulence. 

The Poo-gly: every pregnant woman's best friend!



August 30, 2013

14 Weeks & 4 Days: Pregnancy SUCKS

I'm not a complainer by nature. I was raised to suck it up and go; one of my Mom's favourite phrases when we hurt ourselves as kids was to "walk it off". And self-pity was never tolerated. Period.

Pregnancy has broken me. Straight up. It's turned me into a vomiting machine from the moment I wake to - well, the moment I wake. And then there's the added suckage of having Type 1 Diabetes and being pregnant. So beyond one paragraph that a future post is to follow. Just trust me when I say that pregnancy is hard... and pregnancy with Type 1 Diabetes is a bazillion times harder. And scarier. 

I was hospitalized, and then I was laid off (and that's all I can say about that). It's been a very rough couple of months. I'm finally going to be a Mommy and that is mind-blowing and life-changing and freaking AWESOME! But gawd, I hate being pregnant.

Until I see this:

Hello World!
Hello, beautiful! He's insanely active; the aforementioned Type 1 has had one benefit: we've already had 6 ultrasounds. Every time we see him on the screen he's bouncing around with a ton of energy, stubbornly refusing to hold still for measurements and quality Kodak moments. Of all the u/s photos we have - and we have a lot! - this one is as good as it gets, thanks to a tech who had a unique ability to hit the button in the split second that he was between bounces. Waving at us. At least I like to think that's what he was doing.

{We aren't going to find out the sex before he's born... I just have this feeling that it's a boy.} 

So while I acknowledge every day how blessed I am, how lucky, how incredibly wonderful this little miracle is... I am also not ashamed to admit that pregnancy is freaking hard. I'm not glowing, unless you look at me in the right light and perhaps see a resemblance to a spotlit Kermit. A smelly, bloated, top-heavy, constantly puking frog who cries over African documentaries and loses her shit at annoying strangers. That's me, + pregnancy. 

I can't fucking Wait until it's over.

And I wouldn't trade it for anything. 

Thank gawd this pregnancy thing is temporary.


July 17, 2013

8 Weeks, 1 Day: The Flicker. And Poop.

Two weeks ago we went for our very first ultrasound. My former-Doctor had scheduled it in the small town lab connected to her clinic, so we got in quickly and didn't have to wait long in the waiting room. Though I'll tell you... When your pea-sized bladder is overflowing to the point if pain, even a ten minute wait feels like forever! When I was finally called in I sighed with relief... and asked when Mr. Right would be allowed in the small room. "Once I've taken all the measurements," I was told.

Except the little wand against my stomach at 6 weeks was apparently not good enough. Out came the vaginal ultrasound wand, which put me in mind of a dildo. A very expensive dildo, apparently, as the tech informed me when I asked if Mr. Right could please come in NOW?!

"I'm sorry, but we can't open the door when this device is in use because if anything ever happened to it we could not be able to replace it. It costs more than a car!"

I'd like to say that I was mad (afterwards when I walked back out to the waiting room I was extremely angry) but right then she turned the screen to me and there was my little sea monkey. 

"You see that flickering?" She asked, pointing to a little bulge in the middle of that c-shaped creature. "That's the heartbeat." 


Hello, Sea Monkey!

That moment was indescribable. I don't think there will ever be a comparable time in my life; everything just stood still. For five seconds I existed in everything, and everything existed in me. All because of a rapid flicker.

As for the rest of what this post title alludes to... well, first I'd like to say that I've been incredibly surprised by how early the symptoms start! I don't have morning sickness... I have ALLDAY sickness. My boobs are KILLING me. I'm so freaking bloated I could die. This past weekend I ended up hitting a Thyme Maternity sale because the slightest pressure on my stomach is intensely uncomfortable. I'm bloody exhausted. And I can't POOP. 

Now, imagine if you will (or remember, if you've been here!), having a crampy stomach and unbelievably rank flatulence because of digestion issues. Any cramps are scary so that's a ton of fun. But in this case, a sixth sense (and some medical reassurance haha) tells you that if you just have a bowel movement you'll feel so much better.

Except... nada. No pooping for you! It's there but it's HARD. So you bear down but WAIT! What if your painful need to poop causes something else to come out?!? Yes, logically I know that's not possible (my obstetrician also poo-pooed that) but I have suddenly found myself questioning logic and believing the Chinese Gender Horoscope when it tells me we're having a boy. So not only am I having a hard time pooping, I'm also worried about having a hard time pooping. 

Say what?!?

Oh and the best part? I now have little dark hairs growing around my gargantuan nipples. 

Totally worth it.

June 28, 2013

Don't Listen To Doctors

... as Mr. Right would say.

I think I'm not alone in being terrified of this pregnancy... For this pregnancy... About this pregnancy. Other women must worry that something will go wrong, right?

As a Type 1 Diabetic I have many, many additional worries and challenges and complications: my blood sugar needs to remain as stable as possible at all times, because extreme and extended highs and lows can harm the baby through every stage of my pregnancy. OK well I've been doing this for almost 24 years so easy peasy... except SO NOT. I could LIVE in the fridge right now, and I'm barely using any basal insulin. It's scary to realize, for the first time in a bazillion years, that I have NO idea what I'm doing.

So Thursday morning I went to see my GP in order to ease my fears, confirm the pregnancy, and be referred to a high-risk obstetrical clinic. When she came in the exam room my excitement and fear combined in a verbal jumble of 'ItooktwopregnancytestsandtheywerebothpositiveandI'msoHAPPYandEXCITEDbutOMGI'mTERRIFIED!!!!!!!!!'

She didn't laugh as she usually does at my behavior... nor did she congratulate me.

"Oh... well..." [insert some blah blah here that I can't remember because then she said:

"You need to be prepared to have a miscarriage."

"EXCUSE ME???" I practically yelled it at her. and then, in the middle of the exam room I started crying. Normally I would argue her opinions with her - we've debated in the past about religion and marriage. And yes, having children otside of wedlock. Prior intellectual and interesting conversations that should've been my first indication that she would not like my news. 

"Well if it's meant to be God will see it happen."

And that's when I blew up at her. This Doctor who had spent the last 17 years listening to me talk about how badly I wanted children; who told me to expect to have difficulties conceiving; who had gained my implicit trust and respect, not only betrayed me but also stepped over the line by shoving her unqualified opinion and religious beliefs in my face.

I may report her. Right now I'm trying to get past her words. Trying not to let the worry consume me. I always thought that this would be a time of happiness and anticipation... not these epic fears that now sneak up in me. 

I will NOT let her influence my feelings towards the sea monkey percolating inside of me. Que sera sera... And everything will be fine. I'm now on a whopping 5 mg Folic Acid (normal procedure for Type 1 Diabetics) along with extra D and Calcium supplements. 

Holy Vitamins, Batman!

And best of all, my initial lab tests showed that my HCG levels are exactly what they should be. I've already got an appointment at the high-risk obstetrical clinic tomorrow morning, and a 6 week ultrasound scheduled for Thursday afternoon. 

And Mr. Right and I will continue to talk about nursery colours (OK, I'll talk and he'll nod and smile!) and how beautiful this little sea monkey will be. We're having a baby. It chokes me!!!

Isn't life wonderful?