Monday, April 02, 2007

Week 36: Never A Dull Moment

Thanks for all your comments about cord blood. Who knew I had so many anonymous readers? For the record, we were pretty much agreed on actually banking the blood, but just were overwhelmed with where to actually do so. I'm happy to report we went with the company that gave us the best deal, which has actually been in business the longest of the bigger cord blood banks, and got the stuff Fed Exed to us on Saturday so we're good to go. (In the interest of not giving anyone free publicity, if you ever want to know which bank we went with, feel free to email me).

You'd think this would have been the biggest news of week 36, but nope. I had a bunch of doc's appointments on Friday, where everything seemed to look fine, then trotted back to the hospital on Saturday just to get checked out again. Thankfully, all was fine, but it was a tense few hours there.

Friday, saw Kind Endo and High Risk Ob, and had the usual batch of scans (kid's heartrate, uterine contractions, amnio fluid check, etc.). The kid seemed a bit quieter than usual, the tech said. She had me turn on my side and sip cold water to try to perk the kid up, and after a bit of sipping and turning, declared the kid active and good. The heart rate zipped along where it usually does. All seemed fine.

Kind Endo told me that the few bad nights I've been having (woke up one night with a blood sugar of 30. THIRTY! Then went to the kitchen and ate three packs of LifeSavers and a good amount of Edy's ice cream. Then calculated how many extra carbs I'd consumed and took a huge bolus of insulin to bring it down. Then slept for two hours to test and see myself at 180, so I bolused again and actually woke up around 150, then bolused again, ate my oatmeal breakfast, and was 111 an hour post breakfast. Haven't had a night that bad since before I got pregnant) were likely the result of the placenta starting to break down (THIS IS NORMAL AND HAPPENS TO EVERY PREGNANT WOMAN, D OR NOT) and therefore I probably needed less insulin overnight. You're telling me! (In contrast, one of the past few nights I marveled how I slept through the night uninterrupted, and my blood sugars were 85 when I went to bed and 91 when I got up. A good night's sleep! Priceless! It nearly makes me want to pay full price for a continuous glucose monitor to ensure this happens all the time. But one major life change at a time.)

Back at the doc's office on Friday, High Risk OB told me the specifics of when to actually arrive at the hospital, what to do if I think I'm in labor before the official c-section date, and gave me a Hep B test. I forget the specifics of this, but essentially, all pregnant women are tested to see if they have the strep hep B virus in them (which is common) and if you do, and plan to give birth vaginally and closer to 40 weeks than I am, the docs give you some kind of medicine to prevent the baby to be born with the same strep Hep virus. I'm probably not getting the specifics of this correct, since the c-section next week pretty much rules out this will be a problem for Baby L, but I got the (vaginal swab) anyway. The test apparently also includes a rectal swab, but, as I pointed out to High Risk OB, I have had major tush pain this week with the appearance of a totally annoying hemmorhoid thanks to being swollen, in the final weeks of pregnancy, and just cranky all around. She saw what I was talking about ("Please don't touch it! This thing is a literal pain in the ass.") and agreed to forego the rectal swab. Woo hoo!

What else? The cankles are at an all-time high. I gained another six pounds over the past two weeks and it's clear to all the medical types I see that it's all fluid retention. Even one of the techs at the ATU who scans me and the kid weekly pointed out that my face was rounder than usual. The cankles include the full calf treatment, i.e., swollen all around. I'm pleased the recent weeks have been a bit warmer than usual, so I've been wearing fashionable sandals from Clarke's (they look like stylish Birkenstocks) just to give my feet a respite from the agony of pulling on socks. Both my doctor brother and my actual doctors recommended getting compression tights, or stockings, which are supposed to squeeze the fluid out of your ankles and back up into the veins (or is it the arteries?) of your legs where it belongs, but since I've been dealing with bloat for many weeks now, what's another week of fluid retention? Besides, the idea of pulling on tight knee high stockings, as helpful as they're supposed to be, just sounds awful. I can tough it out.

So on Saturday, I had that roller coaster blood sugar thing through the night, but woke up and had my usual oatmeal breakfast. After breakfast, though, I felt a litle queasy and nauseous, but we still went to Temple as we were being honored in the service that morning for our upcoming new arrival. This is not something we typically do on Saturday mornings, and the Mister really wanted to go, so we went. It was OK, but after Temple, we came home and I wanted to just lie on my side and rest. The Mister kept asking if I could feel the baby kick, and while I felt a few twinges while sitting in Temple, I didn't feel a lot more. I drank something and tried to feel some movement, but then picked up one of my pregnancy books and read that nausea and constipation were signs of possible early labor, and decided to call the High Risk OB's office to get a second opinion.

As it turns out, my own OB was on call that day, and thought things sounded like I'd had a bad night because of my up and down blood sugars the previous night and maybe that was making me feel queasy. However, since nothing's ever taken for granted with type 1 diabetic moms, she thought I should come to the hospital for monitoring, even though the monitoring I'd just had 24 hours before looked fine. So the Mister and I canceled our lunch plans for Saturday and I actually packed a hospital bag as if I might give birth that day, and we drove to the hospital.

(A shout out to formerly pregnant people, particularly the diabetics: What'd you bring to the hospital that was crucial? What was a waste of packing space?) I've been meaning for awhile to pre-pack the bag, particularly because I know the c-section date and all, but just did it as we were getting ready to go. I found a list of things to pack on's bulletin boards, so I just referred to that as I threw stuff in a bag. I had way more pharmaceutical-type stuff (i.e., my own pump supplies and peanut butter crackers for treating reactions and toiletries) than probably most women have (no CDs or calming music for the birthing room for me), but then again, I knew I might not use any of it today.

We drove to the hospital, went up to Labor & Delivery (where I've been before, and where Mister L. saw for the first time last week when we took baby classes and got a tour of the place), but it took some time for a nurse to finally come out and take us into a room for monitoring. We'd heard things were crowded in L&D, but sitting in the waiting area, there weren't a lot of people there at all. "What's the point of rushing in here to be monitored if we're just sitting here?" Mister L. griped. Finally, a nurse brought me in to the same room I'd been in a few weeks before when I got extra fetal monitoring during a routine visit.

This time, however, I was asked to strip down to a Johnny, take off my underwear, and I noticed that I was lying on a large bed-covered pad that I suspect would blot up any fluids that might come out of me (like amniotic) should I go into labor on the table. Oy. In the meantime, they hooked me up to the machine and wouldn't you know, Baby L's heartrate was totally fine and I felt the kid kick around and move like the acrobat it typically is. It seems to me that Baby L, like most of us, likes to sleep in, and was probably just chilling while I was wondering why I hadn't felt much movement all morning long.

So we hung out there for awhile, and I noticed that my blood sugar had been holding pretty steady at 68 since we left the house, despite my drinking juice. I told the nurse on call that if I had to have a c-section that day, 68 was a good number to be at, but after we saw the kid's heart rate and movement were fine on the monitor, I tested again at 51 and was given permission to treat my own blood sugar. Those peanut butter crackers never tasted so good. Finally, my own OB came in to tell us that the kid looked terrific, but since my cankles did not, she wanted to take some blood and test me for pre-eclampsia. Pre-e is a sign of super high blood pressure, but my numbers have always been totally normal (the day before, I rang in at 103 over 60, a personal favorite). So High Risk OB allowed us to go grab some lunch and then told us to come back to Labor and Delivery and she'd give us the blood results and if they were fine, we were free to go.

Which is pretty much what happened. About 90 minutes later, we were sitting back in the Labor & Delivery waiting room when High Risk OB came out and said "You have no sign of pre-eclampsia; your blood results were better than mine" and said we could finally leave. The Mister and I came home, called the appropriate family members to tell them everything was fine, and promptly napped for the rest of the afternoon.

You'd think I'd get a break on Sunday as a day of rest, but inexplicably, my pump gave me a weird error message in the middle of a bolus and reset itself back to the factory settings. Which is annoying, because 1., my basal rates are all over the map and 2., the pump's a few years out of warranty. When I called Minimed (which is what the company was called when I first got the pump, so that gives you diabetics a sense of how long this thing's been going), I was told the error message came from some electrical static and that I just needed to reset my settings myself. Pleased that my pump didn't appear to conk out an effing WEEK before giving birth, I pulled up my basal rates as best I could (since they change all the time, I don't keep a running list of what they are, but let me be the first to tell you this is a good idea) and will call the Endo's office as soon as it opens today to get the right basal amounts set ASAP. Since I had another night of highs, along with waking up all sweaty circa 5am, I suspect that the basals are still pretty wonky and will get things sorted out today.

And here we are back on Monday, with a week to go before the scheduled C. And yet, with the assorted medical events of this weekend behind me, I don't even feel annoyed or surprised that anything (the hosptial visit, the lack of fetal movement on Saturday morning, the pump resetting itself) actually happened. It's more like par for the course for me. React and move on. Just like treating a high or low blood sugar. Do what you have to do and move on. I am also not going to worry too much about my blood sugars creeping up with these overnights, and how the kid was measuring 6.5 pounds on Tuesday and how I was pleased that I hope the kid will be under nine pounds at birth, and that I hope these wonky nights won't pack more weight on the kid and make it larger than it needs to be. No, I'm not going to worry about that at all.

It's never a dull moment around here. And this is all BEFORE the kid even arrives.


Andrea said...

Ooooh. That was close. I'm glad your pump error was minor.

Packing for the hospital:

I can't remember what you're planning on doing for feeding, but if you're planning on nursing, forget the nursing bras until three or four days after the birth. I found that my bra size only went up for two days, then went right back to my pre-pregnancy size, and I'd spent a fair chunk of change on two nursing bras that I never needed to wear.

Frances was really, really touchy about things going over her head and touching her nose for a long time--I found the onesies that snapped up the tummy and between the legs a real life-saver, not just in the hospital, but for months afterward.

Swaddling blankets--swaddling is a wonderful thing.

Other than that I'd say keep it as minimal as possible. Kids come out with their own temperament and preferences right from the beginning, and it won't take long to figure out what you'll need.

Samantha said...

I just want to say that you are some calm and collected! I'm really impressed with how are taking things one step at a time. I think I would be a nervous wreck! One more week to go! Wow!

Kassie said...

Pump stuff - infusion sets, etc are obvious, but given that you use a 508 and those batteries are hard to find, I'd pack batteries. When my 508 died, it involved batteries being used up weekly.

Re Pre-e, you can have it and not have all the symptoms. I never had the headaches or high blood pressure but I had the extreme swelling, but had pre-e and HELLP syndrome. So it's good that, despite decent BP, they checked bloodwork.

Ottoette said...

Gosh, what a week! You sound very cool, calm and collected considering! That's the impending birth, I remember being unusally calm the last couple weeks - right up until I was on the surgery table, then I got a little nervous. The c-sect was a piece of cake though.
Socks - don't forget lots of socks. If you have some with the tread on the bottom - even better. My feet were freezing in the hospital.
Shampoo/conditioner/soap, for some reason I decided to use the hosp stuff, and I wished I'd had my own.
Reading material - light/fluffy/mindless type stuff. Baby sleeps a LOT those first couple days.

Dee said...

Delurking to offer you good luck as you count down these final weeks. I've been following your story quietly for a few months now and hoping all continues to go well.

As far as what to bring to the hospital with you, I found this helpful post/info over at Life and Times of a Labor Nurse:

Useful Shit, Part Deux
Seeing that I take requests, I best be fulfilling them. So here is what you should bring (or not bring) to the hospital with you:

1. Two outfits for baby, two blankets, two hats. Like I said before, these little machines poop, pee, and puke.
2. Something comfortable to go home in. Don't be thinking that means your size 6 prepregnancy Gap jeans either. Because that belly isn't going anywhere for a while.
3. Toiletries in travel sizes, and a cheap toothbrush. Do not, I REPEAT, do not bring in items you use in your home. Unless, of course, you want to bring home a world of hospital germs to inoculate your home with. So in other words, bring items that will have just enough to get you through up to 4 days, then throw it away. In the hospital. Throw it in the hospital garbage.
4. You may want to bring your comfy pillows and stuff from home, but only if you missed #3.
5. Don't bother bringing motrin, advil, or tylenol with you. Your nurses will give it to you when you need it, and it is not considered safe from a nurse standpoint for patients to be self administering. Yes, we know you know how to safely take some advil, but it's a legal thing.
6. If you take any prescription medication, bring it with you, but make sure you tell your nurse what you take. Most places will give you the medications during your stay, but it's always nice to have them in case you forget. But again, it goes back to #5.
7. Don't bring in the car seat until the day of discharge. Of course, it will be ready and installed, but just have Dad get it when needed.
8. Lip balm.
9. Mints for your support people. You won't want to be smelling dragon ass during a contraction. Trust me.
10. Most units have clear liquids like cranberry, apple, and grape juice, or ginger ale, but if there is a special drink that you want during labor, bring it. Keep in mind that it must be clear. I've had patients bring in flavored waters and the like.
11. Non-constricting shoes. Weird one, huh? But when your feet and ankles (cankles for some of you... and no I am not making fun... I'll be there with you) swell from post delivery it is mighty difficult squeezing those hooves into dainty Coach attire.
12. Full on sleeping clothes for the dad. This is an absolute must if he plans on spending the night with you and he is one to typically sleep bare assed. None of the nurses want to see penises attached to males older than, say, 4 days old. We only know what to do when there is naked vagina around anyway.
13. Snacks for later. Snack foods in hospitals consist of jello, toast, and crackers. Not exactly my idea of a snack...
14. Take out menus of area restaurants in case you absolutely hate the hospital food. Sometimes the nurses station may have some too.
15. A camera! With extra batteries!
16. Slippers. Don't you dare walk on those floor barefoot! Or even better, non-skid slipper socks. They are easier to wash when you get home.
17. Personal hand sanitizer for the guests who can't manage a sink, running water, and soap. Or point them to the Cal-Stat or Avaguard the nurses use in the room.
18. If your pediatrician or their partners do not round at your hospital, make sure to bring his/her info in with you. The nursery will still need to know.
19. A doula.
20. Flexibility... because it doesn't always go the way you expect.

Flmgodog said...

Glad to hear that you and Baby L are doing well and all is ok.
The end is very near for you and I am so excited!!!
Quick question: Are you going to wear your pump for the c-section. Just curious.
Trying to decide how I am going to work this all out.
Take care!

Lyrehca said...

Wow, everyone--thanks for all your comments. Dee and Flmgodog, I would have emailed you directly, but you don't have email enabled on either your comments or your blogs. Dee--thanks--these are all great. Flmodog--my hospital has a policy of putting all type 1s on an insulin drip and I've dealt with this in a prior surgery and it was fine. It wasn't my first choice, but my sugars were great during that prior surgery and with this one, I'll definitely test my own blood sugar regularly (hourly)and the docs claim that it's easier to bring down a high with an IV insulin drip than wait for a pump correction to happen. I'm doing all this in a topnotch hospital where I know my docs know what they're doing (and I don't say that lightly) so if there's a policy like this at your hospital, and you trust your docs, I'd think you're in good hands. If you have the choice to do so, though, I'd say keep your pump on and manage it yourself. Already emailed Kassie about the 508 battery shoutout, but everyone else, thanks for your good wishes!


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