Due to ongoing leakage and my Awesome OB's conscientiousness, I'm going into the hospital tomorrow for one last test to see if what's been leaking for weeks is not merely urine, but somehow amniotic fluid that has sneakily eluded several past tests.
I'll be 37 weeks and 2 days, just two weeks shy of my scheduled c-section, and also full term.
Tomorrow's test includes an amnio, where they'll inject blue dye into my uterus (awesome--not), I'll put in a tampon and walk around for an hour, then pull out the tampon to see if it turns blue. The amnio will also determine if the baby's lungs are fully developed. All past ultrasounds (I get them twice-weekly now) have all shown the baby is doing great--active, kicky, breathing, and all things good.
So we'll see how it goes. My next post might be as a mother of two. Or not.
UPDATED ON MONDAY, 11/22: Yep, the kid is coming today; baby looks good, but apparently, I AM leaking fluid (and they figured this out before the amnio, thankfully.) Stay tuned for some news!
Showing posts with label Finally Pregnant. Show all posts
Showing posts with label Finally Pregnant. Show all posts
Sunday, November 21, 2010
Monday, November 01, 2010
Week 34 Update
I've been terrible about blogging this pregnancy.
The truth is, my existing kid has kept me busy. The whole pregnancy has been sort of back burner as the 3.5 year old has demanded attention.
Without getting into details, Preschooler L has required a lot of focus this summer and fall, and as a result, I was pretty preoccupied getting him what he needed and needs. Now that things have calmed down with him (and the weather has cooled down), he has actually started asking about when the new baby is coming, and how he is excited to play with him/her.
In the meantime, my scheduled c-section date is for Dec. 6, just five mere weeks away from today.
Not that that means anything--I had a bit of a scare this past Friday night when I thought my water broke, prematurely, at 34 weeks and 6 days. I went to the hospital and after several tests, was told that no, my amniotic fluid was intact.
I was just (continuing to) pee on myself.
Awesome.
Urinary incontinence has been a hallmark of this pregnancy, along with some other common but frankly totally annoying below the belt issues. "It's what happens when you have a basketball sitting on your nether regions," was a paraphrase of the insight from my SuperAwesome OB.
While I did NOT want to welcome a newborn just before 34 weeks, and while I hope this kid will remain in place until the c-section at week 39, I will say that I cannot wait to have my bladder and other parts back where they belong and functioning properly (as is, within my control.)
Speaking of control, the diabetes numbers have been up and down. I'm told this is common with a subsequent pregnancy, and that it's just that much harder to reach target numbers when you are also telling someone for the umpteenth time to get his shoes on and to say "excuse me" instead of giggle when he passes gas.
But my A1cs have all been stellar, and since I'm now up to weekly fetal monitoring (hello, week 34!), I am told repeatedly that the baby looks fine, measures fine, and that for whatever reason, my daily highs haven't seemed to pack weight on to the baby's frame.
Of course, I am now mainlining insulin, but that's all par for the course.
In the beginning months, I sweated every high number, and overtreated lows, and just worried more. Now, I feel like, it is what it is. I've done the best I can. I've eaten the best I could. My older kid can put his own shoes on now, my bladder leaks every so often, and the next kid is on its way.
All I can do is wait for the arrival.
The truth is, my existing kid has kept me busy. The whole pregnancy has been sort of back burner as the 3.5 year old has demanded attention.
Without getting into details, Preschooler L has required a lot of focus this summer and fall, and as a result, I was pretty preoccupied getting him what he needed and needs. Now that things have calmed down with him (and the weather has cooled down), he has actually started asking about when the new baby is coming, and how he is excited to play with him/her.
In the meantime, my scheduled c-section date is for Dec. 6, just five mere weeks away from today.
Not that that means anything--I had a bit of a scare this past Friday night when I thought my water broke, prematurely, at 34 weeks and 6 days. I went to the hospital and after several tests, was told that no, my amniotic fluid was intact.
I was just (continuing to) pee on myself.
Awesome.
Urinary incontinence has been a hallmark of this pregnancy, along with some other common but frankly totally annoying below the belt issues. "It's what happens when you have a basketball sitting on your nether regions," was a paraphrase of the insight from my SuperAwesome OB.
While I did NOT want to welcome a newborn just before 34 weeks, and while I hope this kid will remain in place until the c-section at week 39, I will say that I cannot wait to have my bladder and other parts back where they belong and functioning properly (as is, within my control.)
Speaking of control, the diabetes numbers have been up and down. I'm told this is common with a subsequent pregnancy, and that it's just that much harder to reach target numbers when you are also telling someone for the umpteenth time to get his shoes on and to say "excuse me" instead of giggle when he passes gas.
But my A1cs have all been stellar, and since I'm now up to weekly fetal monitoring (hello, week 34!), I am told repeatedly that the baby looks fine, measures fine, and that for whatever reason, my daily highs haven't seemed to pack weight on to the baby's frame.
Of course, I am now mainlining insulin, but that's all par for the course.
In the beginning months, I sweated every high number, and overtreated lows, and just worried more. Now, I feel like, it is what it is. I've done the best I can. I've eaten the best I could. My older kid can put his own shoes on now, my bladder leaks every so often, and the next kid is on its way.
All I can do is wait for the arrival.
Thursday, September 30, 2010
The Big Reveal
June 22
We told our families this weekend about the pregnancy.
Mister L. wanted to wait ‘til after all the test results were in: the CVS, the nuchal fold, the first major ultrasound. I am 15 weeks this week, a bit later than when we told them with the first pregnancy.
The final CVS results came back and they were all negative: no increased risk for a variety of chromosomal problems and rare but terrible-sounding diseases that we Jews are more likely to carry. (The best question I was asked before giving blood for these tests: “Is there any way you and your husband are related?” I guffawed and said a hearty No.)
We told Preschooler L on the morning of a Father’s Day barbecue we hosted. I thought it was important to tell him first, before we told everyone else, because his reaction was more important than anyone’s. He came into bed with us early that morning, snuggled between us, and we told him that like his cousins (who each are two-sibling families), he was going to be a big brother. We’d have a new baby for the family, that the baby would be his baby, and that we’d be very excited for our new addition.
He sort of got it, said he was excited (this is a new phrase for him, telling us sometimes that he’s “so excited” to go to a birthday party, or to go swimming), but it was sort of in one ear and out the other. He is three, after all.
Later that afternoon, we had my parents, Mr. L’s father and wife, our siblings and their families over for Father’s Day. Mr. L. had this idea about printing up a photo of a cute baby from off the Internet, telling everyone I had an early Father’s Day gift for him, but that he’d have to wait for the delivery, and then showing the picture to everyone. I’d just thought we could have Preschooler L tell people brightly, “I’m going to be a big brother!”
So the Mister told everyone his story, and held up the picture wordlessly to the crowd.
“Is that (Preschooler L)?” one person asked.
“No! It’s the baby on the cover of your book, right?”
Finally one person was like, “Lyrehca is pregnant!”
After much coaxing, I then prompted Preschooler L to say “I’m going to be a big brother!”
I pointed out that I thought it was obvious, as I have very few maternity clothes for warm weather this time. I borrowed a lot of clothes the last time around, which I’ve since passed on to other people, and I was showing in the colder months last time. So I have plenty of maternity heavy sweaters and winter pants, but maybe one maternity tank top. I have a number of oversized non-maternity tops and elastic waist shorts (fat: it is my reality), but those haven’t been fooling some people over the past few weeks.
As mentioned earlier, my mom’s friend noticed my expanding ass way back around week five and asked if I was pregnant.
Around week 11, a little boy on the playground pointed to my oversize (non-maternity) sleeveless top and asked if I had a baby in there. “No, it’s just fat,” I told him. In the last week or two, close friends have either asked Mister L. out of my hearing if I was pregnant, or have revealed that they suspected it. I’m a good ten pounds heavier than I was before pregnancy, thanks to ongoing juice box consumption to treat low blood sugars, and to me it’s obvious I’m fleshier than usual. My own mother told me last week that, when she saw me in an empire-waisted-but-not-maternity-dress, that she couldn’t tell if I was pregnant or not, but that I was definitely putting on weight.
(Though in a nice twist for me, at my last doctor’s appointment on Friday, the day before when we announced our news, I learned I’d dropped three pounds in three weeks. Apparently, my weight gain is slowing down. Or perhaps I’m retaining less fluid. Either way, I still have plenty of weight on me, so there’s nothing to worry about, pregnancy-wise. The heft continues.)
Being out of the closet, finally, my mother insisted on taking me maternity clothes shopping for summer clothes. We went to one store and I tried on some stuff, but honestly, just because I’m pregnant doesn’t mean I want to look lame.
One dress was a floor-length sundress totally open on the top so my top half heaved out. “It’s the style to have your bra straps showing these days,” my mother said. “It’s not the style if I feel like I belong in a trailer park,” I retorted. I bought one dress that I hope to wear to my book reading this week, but it’s got three-quarter-length sleeves, so if it’s hot that evening, I’ll have to pray for intense air conditioning. I’m hitting a few other stores today, without my mother but with Preschooler L, so we’ll see how successful today’s efforts turn out to be.
We told our families this weekend about the pregnancy.
Mister L. wanted to wait ‘til after all the test results were in: the CVS, the nuchal fold, the first major ultrasound. I am 15 weeks this week, a bit later than when we told them with the first pregnancy.
The final CVS results came back and they were all negative: no increased risk for a variety of chromosomal problems and rare but terrible-sounding diseases that we Jews are more likely to carry. (The best question I was asked before giving blood for these tests: “Is there any way you and your husband are related?” I guffawed and said a hearty No.)
We told Preschooler L on the morning of a Father’s Day barbecue we hosted. I thought it was important to tell him first, before we told everyone else, because his reaction was more important than anyone’s. He came into bed with us early that morning, snuggled between us, and we told him that like his cousins (who each are two-sibling families), he was going to be a big brother. We’d have a new baby for the family, that the baby would be his baby, and that we’d be very excited for our new addition.
He sort of got it, said he was excited (this is a new phrase for him, telling us sometimes that he’s “so excited” to go to a birthday party, or to go swimming), but it was sort of in one ear and out the other. He is three, after all.
Later that afternoon, we had my parents, Mr. L’s father and wife, our siblings and their families over for Father’s Day. Mr. L. had this idea about printing up a photo of a cute baby from off the Internet, telling everyone I had an early Father’s Day gift for him, but that he’d have to wait for the delivery, and then showing the picture to everyone. I’d just thought we could have Preschooler L tell people brightly, “I’m going to be a big brother!”
So the Mister told everyone his story, and held up the picture wordlessly to the crowd.
“Is that (Preschooler L)?” one person asked.
“No! It’s the baby on the cover of your book, right?”
Finally one person was like, “Lyrehca is pregnant!”
After much coaxing, I then prompted Preschooler L to say “I’m going to be a big brother!”
I pointed out that I thought it was obvious, as I have very few maternity clothes for warm weather this time. I borrowed a lot of clothes the last time around, which I’ve since passed on to other people, and I was showing in the colder months last time. So I have plenty of maternity heavy sweaters and winter pants, but maybe one maternity tank top. I have a number of oversized non-maternity tops and elastic waist shorts (fat: it is my reality), but those haven’t been fooling some people over the past few weeks.
As mentioned earlier, my mom’s friend noticed my expanding ass way back around week five and asked if I was pregnant.
Around week 11, a little boy on the playground pointed to my oversize (non-maternity) sleeveless top and asked if I had a baby in there. “No, it’s just fat,” I told him. In the last week or two, close friends have either asked Mister L. out of my hearing if I was pregnant, or have revealed that they suspected it. I’m a good ten pounds heavier than I was before pregnancy, thanks to ongoing juice box consumption to treat low blood sugars, and to me it’s obvious I’m fleshier than usual. My own mother told me last week that, when she saw me in an empire-waisted-but-not-maternity-dress, that she couldn’t tell if I was pregnant or not, but that I was definitely putting on weight.
(Though in a nice twist for me, at my last doctor’s appointment on Friday, the day before when we announced our news, I learned I’d dropped three pounds in three weeks. Apparently, my weight gain is slowing down. Or perhaps I’m retaining less fluid. Either way, I still have plenty of weight on me, so there’s nothing to worry about, pregnancy-wise. The heft continues.)
Being out of the closet, finally, my mother insisted on taking me maternity clothes shopping for summer clothes. We went to one store and I tried on some stuff, but honestly, just because I’m pregnant doesn’t mean I want to look lame.
One dress was a floor-length sundress totally open on the top so my top half heaved out. “It’s the style to have your bra straps showing these days,” my mother said. “It’s not the style if I feel like I belong in a trailer park,” I retorted. I bought one dress that I hope to wear to my book reading this week, but it’s got three-quarter-length sleeves, so if it’s hot that evening, I’ll have to pray for intense air conditioning. I’m hitting a few other stores today, without my mother but with Preschooler L, so we’ll see how successful today’s efforts turn out to be.
Monday, August 16, 2010
Genetic Test Results
June 9, 2010
The last batch of doc visits have been different from what I did the first time I was pregnant. This time, the bloodwork and nuchal fold test, a screen that measures the amount of a certain hormone in the blood along with the measurement of the back of the fetus’ neck, came back not so great.
These tests show the risk of having a baby with Down’s Syndrome or two other chromosomal defects called trisomy 13 or trisomy 18. My risk, as a 40 year old, is 1 in 75 for Down’s. The baby neck measurement came back within a non-risky range, but combined with the low hormones in my blood and again, my age, my risk decreased a bit to 1 in 72 for Down’s.
“I know this is disappointing, Mister L.,” said our awesome OB. “You asked for everything to be the same as when you were pregnant with Toddler L, and this isn’t.”
When I had that test before, the same doc congratulated me when she got the results, saying my risks were the same as a 20 year old’s. That is to say, miniscule.
With this higher result, we decided to do an earlier invasive test that would definitively tell us if the fetus has Down’s Syndrome or one of these trisomies (which I had a very low risk for developing). If I wanted to wait a few more weeks, I could have had an amniocentesis, which takes a bit of amniotic fluid from the uterus through a needle in the belly.
But since we wanted to know right away, I ended up having a Chorionic Villus Sampling, or a CVS, which takes a piece of tissue from the placenta. The options are to take it through the cervix, or through the abdomen if the placenta is in an area that can’t easily be reached.
We were told the Down’s risk on a Friday, and by the following Thursday, I was in to have the CVS. Throughout the week, Mr. L and I would say “good thoughts” and we do this ritual where we rub a clay and ceramic painted pomegranate in our bedroom (a symbol of fertility) and say “Woo, woo, Go Lima.” (This is leftover from our first round of IVF, where we bought the pomegranate at an art fair because, hey, why not?)
(Our working name for the fetus right now is Lima, as in, it’s the size of a lima bean. Mr. L. sometimes calls it Lima, as in the capital of Peru. “It’s not Peruvian, unless there’s something you haven’t told me,” I’ve said.”)
We’ve done a lot of pomegranate rubbing recently.
The day of the test, Preschooler L was at school early and the Mister and I went to the hospital. There’s no anesthesia, but I took a couple of extra strength Tylenol as a pre-emptive measure. (Some past vaginal tests have been excruciating.) At the same time, being an infertility vet, I told the doc about my tipped uterus, my raised cervix, the advice past IVF docs have told us about “going in at 7 o’clock,” and my plea to please use the smallest speculum possible, as again, past experience has been excruciating.
The doc did as directed, and was pretty nice about our type A explanations and questions. This doc happens to do a lot of these CVS procedures, which means his experience hopefully will translate into no miscarriage. (The rate of miscarriage following a CVS is about 1 percent, something weighing heavily on our minds. But the truth boiled down to that if the fetus was found to have a chromosomal problem, we’d be much more inclined to terminate, as tough and painful as that would be, and it’s easier to do that at 13-15 weeks with the results of a CVS versus a 18-20 weeks if we’d waited until the right time to do an amnio (which has a lower miscarriage rate, but again, can be tougher to terminate after your belly is swelling a bit more and you are more likely to feel movement.
Shockingly for me, the speculum was the toughest part of the procedure. Once that was in, the doc somehow got where he needed to go past my cervix and got the right amount of tissue from the right place… without me feeling a thing. At the same time, I was breathing deeply and staring at the ceiling (at these ceiling tiles that had the texture, of ice cream, of all things) and clutching Mr. L’s hand.
A day later, I got a call from a genetics counselor (which, I’d forgotten, I’d met an hour before the CVS. She had explained all the details of the test and when we’d get the results.). Initial results come about a day or two later, but the full chromosomal analysis is done in two weeks. From what the genetics counselor told us, the initial results are about 95 percent accurate, and are 100 percent accurate with the full result report. Of course, there could still be some chromosomal problem that the test doesn’t measure, but the results, when good, seemed as reassuring as they could be.
The initial results were… all normal for Down’s and for the trisomies, thank God. We’re still waiting for the final results, which should come right before Father’s Day, and once we know they look good, we plan to tell our families as they are having a meal at our house in honor of Father’s Day.
Hopefully things will go well.
I actually went back to the OB’s office where a nurse practitioner did a heartbeat check. They did one immediately after the CVS and confirmed the heartbeat was good and strong, and the heartbeat check yesterday (five days later) also showed a strong heartbeat. So thankfully, I did not miscarry as a result of the CVS.
The NP asked how the pregnancy was going, and the truth is, I’m so focused on my blood sugars and which was my Dexcom is trending that I sometimes feel like the actual pregnancy is on the back burner. It isn’t, of course, but I’ve thought about my diabetes and my current kid a lot more than I’m thinking about the progeny of this pregnancy. Pregnancy the second time around, for me, has been more worries about high blood sugar excursions despite my admirable and recommended-for-pregnancy A1cs. I haven’t even glanced at one of those “what is your fetus doing this week” emails or websites. All I care about is if my sugars are in range and if I’m eating relatively properly.
So far, the rest is taking care of itself.
The last batch of doc visits have been different from what I did the first time I was pregnant. This time, the bloodwork and nuchal fold test, a screen that measures the amount of a certain hormone in the blood along with the measurement of the back of the fetus’ neck, came back not so great.
These tests show the risk of having a baby with Down’s Syndrome or two other chromosomal defects called trisomy 13 or trisomy 18. My risk, as a 40 year old, is 1 in 75 for Down’s. The baby neck measurement came back within a non-risky range, but combined with the low hormones in my blood and again, my age, my risk decreased a bit to 1 in 72 for Down’s.
“I know this is disappointing, Mister L.,” said our awesome OB. “You asked for everything to be the same as when you were pregnant with Toddler L, and this isn’t.”
When I had that test before, the same doc congratulated me when she got the results, saying my risks were the same as a 20 year old’s. That is to say, miniscule.
With this higher result, we decided to do an earlier invasive test that would definitively tell us if the fetus has Down’s Syndrome or one of these trisomies (which I had a very low risk for developing). If I wanted to wait a few more weeks, I could have had an amniocentesis, which takes a bit of amniotic fluid from the uterus through a needle in the belly.
But since we wanted to know right away, I ended up having a Chorionic Villus Sampling, or a CVS, which takes a piece of tissue from the placenta. The options are to take it through the cervix, or through the abdomen if the placenta is in an area that can’t easily be reached.
We were told the Down’s risk on a Friday, and by the following Thursday, I was in to have the CVS. Throughout the week, Mr. L and I would say “good thoughts” and we do this ritual where we rub a clay and ceramic painted pomegranate in our bedroom (a symbol of fertility) and say “Woo, woo, Go Lima.” (This is leftover from our first round of IVF, where we bought the pomegranate at an art fair because, hey, why not?)
(Our working name for the fetus right now is Lima, as in, it’s the size of a lima bean. Mr. L. sometimes calls it Lima, as in the capital of Peru. “It’s not Peruvian, unless there’s something you haven’t told me,” I’ve said.”)
We’ve done a lot of pomegranate rubbing recently.
The day of the test, Preschooler L was at school early and the Mister and I went to the hospital. There’s no anesthesia, but I took a couple of extra strength Tylenol as a pre-emptive measure. (Some past vaginal tests have been excruciating.) At the same time, being an infertility vet, I told the doc about my tipped uterus, my raised cervix, the advice past IVF docs have told us about “going in at 7 o’clock,” and my plea to please use the smallest speculum possible, as again, past experience has been excruciating.
The doc did as directed, and was pretty nice about our type A explanations and questions. This doc happens to do a lot of these CVS procedures, which means his experience hopefully will translate into no miscarriage. (The rate of miscarriage following a CVS is about 1 percent, something weighing heavily on our minds. But the truth boiled down to that if the fetus was found to have a chromosomal problem, we’d be much more inclined to terminate, as tough and painful as that would be, and it’s easier to do that at 13-15 weeks with the results of a CVS versus a 18-20 weeks if we’d waited until the right time to do an amnio (which has a lower miscarriage rate, but again, can be tougher to terminate after your belly is swelling a bit more and you are more likely to feel movement.
Shockingly for me, the speculum was the toughest part of the procedure. Once that was in, the doc somehow got where he needed to go past my cervix and got the right amount of tissue from the right place… without me feeling a thing. At the same time, I was breathing deeply and staring at the ceiling (at these ceiling tiles that had the texture, of ice cream, of all things) and clutching Mr. L’s hand.
A day later, I got a call from a genetics counselor (which, I’d forgotten, I’d met an hour before the CVS. She had explained all the details of the test and when we’d get the results.). Initial results come about a day or two later, but the full chromosomal analysis is done in two weeks. From what the genetics counselor told us, the initial results are about 95 percent accurate, and are 100 percent accurate with the full result report. Of course, there could still be some chromosomal problem that the test doesn’t measure, but the results, when good, seemed as reassuring as they could be.
The initial results were… all normal for Down’s and for the trisomies, thank God. We’re still waiting for the final results, which should come right before Father’s Day, and once we know they look good, we plan to tell our families as they are having a meal at our house in honor of Father’s Day.
Hopefully things will go well.
I actually went back to the OB’s office where a nurse practitioner did a heartbeat check. They did one immediately after the CVS and confirmed the heartbeat was good and strong, and the heartbeat check yesterday (five days later) also showed a strong heartbeat. So thankfully, I did not miscarry as a result of the CVS.
The NP asked how the pregnancy was going, and the truth is, I’m so focused on my blood sugars and which was my Dexcom is trending that I sometimes feel like the actual pregnancy is on the back burner. It isn’t, of course, but I’ve thought about my diabetes and my current kid a lot more than I’m thinking about the progeny of this pregnancy. Pregnancy the second time around, for me, has been more worries about high blood sugar excursions despite my admirable and recommended-for-pregnancy A1cs. I haven’t even glanced at one of those “what is your fetus doing this week” emails or websites. All I care about is if my sugars are in range and if I’m eating relatively properly.
So far, the rest is taking care of itself.
Tuesday, August 03, 2010
Pupils: Waiting to Dilate
May 26
So I have my first eye appointment of this pregnancy, though it’s not the first time I’ve had to call the Eye Doc. Back around week 5 or so, my right eye (and only the right eye) began tearing up. It was annoying. Particularly so because of the pregnancy, I was advised not to take a standard antihistimine because of the potential pregnancy interaction. So my eye doc recommended artificial tears. Which seemed to be beside the point; I mean, my eye was *already tearing*, so why add more tears to the mix?
Regardless, thankfully the eye thing cleared up after three days, but my eye doc insisted, several times, that I needed to see her within six weeks. I’d already had an appointment scheduled for today prior, so I just kept my appointment (at 6 weeks), and here I am.
The front of the eye was unremarkable, as usual. The optometrist, a short woman with towering heels who I’ve seen before, but she clearly didn’t remember me, was pleasant asking me questions about my son based on the notes in my file. I told her I was pregnant, so that yielded a number of other questions about medications and how far along I am and all that. Otherwise, my eyes—the visit itself, the pressure as a glaucoma check, wavy lines, peripheral vision—it all came back fine.
Amd here I am, sitting in the dilation waiting area, annoyed as always that there’s no Internet access here, and I can’t text because I need to really see the keys I’m pressing to type on my phone and I just can’t see well enough. There was some high school girl here with her mom, wearing the same pump as me, who said she wants to be a “diabetes endocrinologist” when she grows up. Good for her. I told her to stick with it, as type 1 endocrinologists are so much better than those who don’t know what they’re talking about. I would have liked to have talked to her more, but neither she nor her mother were all that chatty.
Mister Lyrehca has called and texted a few times to tell me to call him if I need him to drive me home, which I am sure is not going to be the case. Even if my doc tells me she needs to do laser right away, I’ll tell her that I’ll come back next week or whenever, when I don’t have to drive myself home. So we’ll see.
The irony is that my blood glucose meter’s averages, this morning, were crazy impressive. Like, my average over the past 7 days was 90. I have never seen that kind of number as an average before. I think it’s skewed, though, because my CGM clearly shows spikes, and I don’t test every hour because of the CGM, so I suspect there are more lows factored into that average than not. I’ll be interested to see what my next A1c is, though.
But beyond all that….well, I feel like there’s not much else to report about this pregnancy beyond what my blood sugars are and how my eyes are. Honestly, why would I focus beyond that? I have had no morning sickness, haven’t felt bad at all, have noticed my stomach getting bigger and my bras getting a little tighter, and again, weight gain has happened.
I’ve also had… I don’t know if I can call them cravings because, are they? But I’ve bought and devoured big chunks of (Pasterurized! Not moldy! Perfectly acceptable for pregnancy!) cheese: fontina, gouda (unsmoked) and havarti, and devoured them. I mean, really, is that a craving? I’d devour big blocks of cheese anytime, but most of the time prior to this pregnancy, I’ve refrained. I figure that’s what’s helped my belly to balloon. I’ve also eaten, throughout the last week or so, big bags of chips and, at one point, a bunch of homemade chocolate chip cookies. The irony is that I can take giant (and when I saw giant, I needed to increase the upper limit of the amount of insulin I could take at one time) and sometimes, my sugars are really just fine. Other times, I eat the shell of a whole wheat bagel (with all the soft inner parts ripped out) and butter, bolus a good 60 grams worth of insulin, and see myself soar up to 300 and I get pissed. Last week, I thought to myself that it would be a miracle if this baby was born without any health problems. And then, my meter is telling me my last week’s readings average was 90 and that my A1c is going down.
So you can understand why I’m pissed and hardly think of pregnancy as something magical. I thnk it’ll be a real neat trick if this baby is born healthy and happy.
Wow, I just got myself into a cynical and cranky state.
Where is my damn eye doctor????
To top it all off, my sugar was lounging in the low 70s and 60s for a good half hour, and I dutifully treated with ten grams of carbs (doctor office packets of graham crackers) three times in a row… with the blood sugar not budging. And yes, I both watched my CGM and tested my blood sugar three times. Now, 45 minutes later, my CGM tells me I’m shooting upward at 104, with my arrow going straight up. Who knows how high that’ll climb to? Plus, my pump battery is low, and while I’ve been a rebel and gone up to a day or two and ignoring the battery alarm to see how long it would last, I’d rather change it out right now , but don’t have the right kind of battery on me.
Finally! My name was just called and into the retinology doc's office I go!
So I have my first eye appointment of this pregnancy, though it’s not the first time I’ve had to call the Eye Doc. Back around week 5 or so, my right eye (and only the right eye) began tearing up. It was annoying. Particularly so because of the pregnancy, I was advised not to take a standard antihistimine because of the potential pregnancy interaction. So my eye doc recommended artificial tears. Which seemed to be beside the point; I mean, my eye was *already tearing*, so why add more tears to the mix?
Regardless, thankfully the eye thing cleared up after three days, but my eye doc insisted, several times, that I needed to see her within six weeks. I’d already had an appointment scheduled for today prior, so I just kept my appointment (at 6 weeks), and here I am.
The front of the eye was unremarkable, as usual. The optometrist, a short woman with towering heels who I’ve seen before, but she clearly didn’t remember me, was pleasant asking me questions about my son based on the notes in my file. I told her I was pregnant, so that yielded a number of other questions about medications and how far along I am and all that. Otherwise, my eyes—the visit itself, the pressure as a glaucoma check, wavy lines, peripheral vision—it all came back fine.
Amd here I am, sitting in the dilation waiting area, annoyed as always that there’s no Internet access here, and I can’t text because I need to really see the keys I’m pressing to type on my phone and I just can’t see well enough. There was some high school girl here with her mom, wearing the same pump as me, who said she wants to be a “diabetes endocrinologist” when she grows up. Good for her. I told her to stick with it, as type 1 endocrinologists are so much better than those who don’t know what they’re talking about. I would have liked to have talked to her more, but neither she nor her mother were all that chatty.
Mister Lyrehca has called and texted a few times to tell me to call him if I need him to drive me home, which I am sure is not going to be the case. Even if my doc tells me she needs to do laser right away, I’ll tell her that I’ll come back next week or whenever, when I don’t have to drive myself home. So we’ll see.
The irony is that my blood glucose meter’s averages, this morning, were crazy impressive. Like, my average over the past 7 days was 90. I have never seen that kind of number as an average before. I think it’s skewed, though, because my CGM clearly shows spikes, and I don’t test every hour because of the CGM, so I suspect there are more lows factored into that average than not. I’ll be interested to see what my next A1c is, though.
But beyond all that….well, I feel like there’s not much else to report about this pregnancy beyond what my blood sugars are and how my eyes are. Honestly, why would I focus beyond that? I have had no morning sickness, haven’t felt bad at all, have noticed my stomach getting bigger and my bras getting a little tighter, and again, weight gain has happened.
I’ve also had… I don’t know if I can call them cravings because, are they? But I’ve bought and devoured big chunks of (Pasterurized! Not moldy! Perfectly acceptable for pregnancy!) cheese: fontina, gouda (unsmoked) and havarti, and devoured them. I mean, really, is that a craving? I’d devour big blocks of cheese anytime, but most of the time prior to this pregnancy, I’ve refrained. I figure that’s what’s helped my belly to balloon. I’ve also eaten, throughout the last week or so, big bags of chips and, at one point, a bunch of homemade chocolate chip cookies. The irony is that I can take giant (and when I saw giant, I needed to increase the upper limit of the amount of insulin I could take at one time) and sometimes, my sugars are really just fine. Other times, I eat the shell of a whole wheat bagel (with all the soft inner parts ripped out) and butter, bolus a good 60 grams worth of insulin, and see myself soar up to 300 and I get pissed. Last week, I thought to myself that it would be a miracle if this baby was born without any health problems. And then, my meter is telling me my last week’s readings average was 90 and that my A1c is going down.
So you can understand why I’m pissed and hardly think of pregnancy as something magical. I thnk it’ll be a real neat trick if this baby is born healthy and happy.
Wow, I just got myself into a cynical and cranky state.
Where is my damn eye doctor????
To top it all off, my sugar was lounging in the low 70s and 60s for a good half hour, and I dutifully treated with ten grams of carbs (doctor office packets of graham crackers) three times in a row… with the blood sugar not budging. And yes, I both watched my CGM and tested my blood sugar three times. Now, 45 minutes later, my CGM tells me I’m shooting upward at 104, with my arrow going straight up. Who knows how high that’ll climb to? Plus, my pump battery is low, and while I’ve been a rebel and gone up to a day or two and ignoring the battery alarm to see how long it would last, I’d rather change it out right now , but don’t have the right kind of battery on me.
Finally! My name was just called and into the retinology doc's office I go!
Tuesday, July 27, 2010
Pregnancy and Chronic Illness: Discuss.
Late July
Pregnancy and Chronic Illness Webinar August 2
Laurie Edwards, of the excellent blog A Chronic Dose and terrific book Life Disrupted, and I will host a webinar on Pregnancy and Chronic Illness at WEGO Health next Monday night, August 2, from 8-9 pm eastern time. Thinking at all about pregnancy with a chronic condition like diabetes, or heck, anything else, and want to hear more perspectives than just mine? Definitely RSVP and check us out!
May 18
Weight, Weight--Don't Tell Me
I met with my endo and the nurse practitioner who works with my high risk OB on Friday.
Two weeks after my last appointment.
The NP was someone I’d never met before, though I suspect I will get to know her very well over the rest of this pregnancy. The first thing I learned, going in to see her, was that I’d gained three pounds in the last two weeks. Bringing this pregnancy’s total to five pounds in ten weeks.
Is that some kind of new record?
I’ll admit that last week, I ate a bunch, and covered for it with ginormous amounts of insulin. I’ve also started eating a LOT of cheese. In part, because cheese doesn’t really wreck my sugars the way many other foods can. I also treat at least one, if not more, insulin reactions a day, with some amount of juice.
So the weight gain isn’t really surprising.
I pointed this out to the NP, and she was all, “are you concerned about your weight?” I replied that it seemed like a lot, and that while I’d lost all my pregnancy weight the first time, I’d put on a good ten pounds or more since starting with actively trying to conceive and taking copious amounts of infertility drugs a few times over the past year. I told her I’d gained 40 pounds with the first pregnancy.
“So do you want to gain 30 this time?” she asked.
“I want to deliver a baby that’s healthy, happy and alive,” I responded. “If I put on more weight, so be it. I need to do what I can to maintain my blood sugars.”
She said she sympathized, that type 1 pregnancies were so hard. Yep. Weight gain is really the least of it.
No one even blinked when I stepped on the scale anytime during my first pregnancy, and that was from a starting point of about 30 pounds over where a height-weight chart says I should be.
The rest of the NP visit was uneventful, because she tried to listen to the baby’s heartbeat through my stomach. I was nine weeks six days that day, and she told me she typically doesn’t hear a heartbeat until 12 weeks. Nothing happened, so she sent me to my endo appointment and told me to return to her office after the endo visit, where she’d do a regular ultrasound to check on things.
You Say 90, I Say 80
I then saw my fabulous Kind Endo, who was pleased that I’d actually brought not just weekly and daily Dexcom readings, but actual logs of insulin rates and boluses and carb counts written out for a few days. Looking at the Dexcom readings, particularly the weekly ones, have scared me. I see a lot of peaks and some valleys, but the valleys don’t freak me out the way the peaks do.
Kind Endo was nonplussed, telling me that I need to just let the insulin do its job and not to worry about short bursts of high blood sugars. She thought I was overcorrecting, and worried that I was running too low at times.
“But I feel fine at 60. And I work from home, so it’s not like I’m driving much with such lows. And I always treat them.”
We have also battled about the target blood sugar I should set on my pump to correct to. I have set it to 80, with the reasoning that you’re suggested to be between 60-99 before a meal, so 80 is in the middle. She argues that’s too low, and that she typically tells people to correct to 100, but that I should correct to 90. We went back and forth on this point.
“Surely I’m not the only patient who fights you on this, right?” I asked. (I end up saying something like this to a lot of people)
“Well," she conceded. "You're a journalist.”
The Downside of Writing A Book
Because my A1c dropped recently, from 6.1 to 5.7, Kind Endo really thinks I’m doing fine, despite the highs I see more frequently due to the CGM. “You really don’t think this baby is going to be deformed because of these highs?” I asked.
“Absolutely not,” she said.
I feel like I overthink everything these days. Mr. Lyrehca, who is just now reading my book, will quote it back to me when I tell him I’m worried. “The book says …. That highs will happen. The book says… that you need to take care of yourself,” he reads.
Whoever thought my published words would be used to taunt?
The irony is that Mr. Lyrehca rarely reads for fun, so he’s s-l-o-w-l-y making his way through the book itself. Which gives him all the more time to find sentences to read back, sometimes citing page numbers as well.
I also think maybe the Dexcom CGM is adding to my fears. Before, I tested regularly, sometimes every hour, but not always. Now, the Dexcom shows me a sharp incline immediately after some meals. Sometimes I can counteract the climb by immediately hopping on the elliptical and doing a 20-30 minute workout, but I can’t always exercise within the hour after a meal. Sometimes I have to work. Or drive. Or do something that makes exercise impractical. And while I can and sometimes do bolus a hit of insulin, the damn stuff doesn’t start working for an hour or two. It is beyond frustrating to see my sugar spiraling upUpUP and know I can’t do anything but sulk and wait for the insulin to kick in and then I watch the spiral reverse and come back down.
Moving Forward
So after Kind Endo, I went back to the NP, who tried to do an abdominal ultrasound (cold gel on my belly), but again didn’t find a great view of the uterine activity. “Would a vaginal ultrasound do it?” I asked. It would, so once again, the Tam Cam did its job and voila! There’s finally a clear shot of what’s going on, and hold-my-breath… all is good.
The NP found the gestational sac, the fetal pole, and look at that--the heartbeat. “It’s in the 150s, 160s,” NP said. “Totally normal.”
The funniest thing was that both she and I could see things moving, as tiny as they are.
“The arms and legs are waving, see?”
And what do you know—I could see tiny limbs all akimbo, dancing around.
Unbelievable.
Afterward, I went to have blood work drawn so that we can learn some early chances of whether this baby has higher chances of carrying some chromosomal concerns. Three years ago, the nuchal fold test was done on the same day as the blood draw, so the full results came after a week or so after the blood was analyzed. This time, they draw the blood first, then we go back in two weeks and see the nuchal fold test. This is where they measure the fold of the back of the fetus’s neck to see if its chances of having Down’s Syndrome are high. Last time, the result came back great, but this time, I’m three years older and officially an old lady being pregnant at 40.
I hope it’ll be all good.
Despite the highs.
Pregnancy and Chronic Illness Webinar August 2
Laurie Edwards, of the excellent blog A Chronic Dose and terrific book Life Disrupted, and I will host a webinar on Pregnancy and Chronic Illness at WEGO Health next Monday night, August 2, from 8-9 pm eastern time. Thinking at all about pregnancy with a chronic condition like diabetes, or heck, anything else, and want to hear more perspectives than just mine? Definitely RSVP and check us out!
May 18
Weight, Weight--Don't Tell Me
I met with my endo and the nurse practitioner who works with my high risk OB on Friday.
Two weeks after my last appointment.
The NP was someone I’d never met before, though I suspect I will get to know her very well over the rest of this pregnancy. The first thing I learned, going in to see her, was that I’d gained three pounds in the last two weeks. Bringing this pregnancy’s total to five pounds in ten weeks.
Is that some kind of new record?
I’ll admit that last week, I ate a bunch, and covered for it with ginormous amounts of insulin. I’ve also started eating a LOT of cheese. In part, because cheese doesn’t really wreck my sugars the way many other foods can. I also treat at least one, if not more, insulin reactions a day, with some amount of juice.
So the weight gain isn’t really surprising.
I pointed this out to the NP, and she was all, “are you concerned about your weight?” I replied that it seemed like a lot, and that while I’d lost all my pregnancy weight the first time, I’d put on a good ten pounds or more since starting with actively trying to conceive and taking copious amounts of infertility drugs a few times over the past year. I told her I’d gained 40 pounds with the first pregnancy.
“So do you want to gain 30 this time?” she asked.
“I want to deliver a baby that’s healthy, happy and alive,” I responded. “If I put on more weight, so be it. I need to do what I can to maintain my blood sugars.”
She said she sympathized, that type 1 pregnancies were so hard. Yep. Weight gain is really the least of it.
No one even blinked when I stepped on the scale anytime during my first pregnancy, and that was from a starting point of about 30 pounds over where a height-weight chart says I should be.
The rest of the NP visit was uneventful, because she tried to listen to the baby’s heartbeat through my stomach. I was nine weeks six days that day, and she told me she typically doesn’t hear a heartbeat until 12 weeks. Nothing happened, so she sent me to my endo appointment and told me to return to her office after the endo visit, where she’d do a regular ultrasound to check on things.
You Say 90, I Say 80
I then saw my fabulous Kind Endo, who was pleased that I’d actually brought not just weekly and daily Dexcom readings, but actual logs of insulin rates and boluses and carb counts written out for a few days. Looking at the Dexcom readings, particularly the weekly ones, have scared me. I see a lot of peaks and some valleys, but the valleys don’t freak me out the way the peaks do.
Kind Endo was nonplussed, telling me that I need to just let the insulin do its job and not to worry about short bursts of high blood sugars. She thought I was overcorrecting, and worried that I was running too low at times.
“But I feel fine at 60. And I work from home, so it’s not like I’m driving much with such lows. And I always treat them.”
We have also battled about the target blood sugar I should set on my pump to correct to. I have set it to 80, with the reasoning that you’re suggested to be between 60-99 before a meal, so 80 is in the middle. She argues that’s too low, and that she typically tells people to correct to 100, but that I should correct to 90. We went back and forth on this point.
“Surely I’m not the only patient who fights you on this, right?” I asked. (I end up saying something like this to a lot of people)
“Well," she conceded. "You're a journalist.”
The Downside of Writing A Book
Because my A1c dropped recently, from 6.1 to 5.7, Kind Endo really thinks I’m doing fine, despite the highs I see more frequently due to the CGM. “You really don’t think this baby is going to be deformed because of these highs?” I asked.
“Absolutely not,” she said.
I feel like I overthink everything these days. Mr. Lyrehca, who is just now reading my book, will quote it back to me when I tell him I’m worried. “The book says …. That highs will happen. The book says… that you need to take care of yourself,” he reads.
Whoever thought my published words would be used to taunt?
The irony is that Mr. Lyrehca rarely reads for fun, so he’s s-l-o-w-l-y making his way through the book itself. Which gives him all the more time to find sentences to read back, sometimes citing page numbers as well.
I also think maybe the Dexcom CGM is adding to my fears. Before, I tested regularly, sometimes every hour, but not always. Now, the Dexcom shows me a sharp incline immediately after some meals. Sometimes I can counteract the climb by immediately hopping on the elliptical and doing a 20-30 minute workout, but I can’t always exercise within the hour after a meal. Sometimes I have to work. Or drive. Or do something that makes exercise impractical. And while I can and sometimes do bolus a hit of insulin, the damn stuff doesn’t start working for an hour or two. It is beyond frustrating to see my sugar spiraling upUpUP and know I can’t do anything but sulk and wait for the insulin to kick in and then I watch the spiral reverse and come back down.
Moving Forward
So after Kind Endo, I went back to the NP, who tried to do an abdominal ultrasound (cold gel on my belly), but again didn’t find a great view of the uterine activity. “Would a vaginal ultrasound do it?” I asked. It would, so once again, the Tam Cam did its job and voila! There’s finally a clear shot of what’s going on, and hold-my-breath… all is good.
The NP found the gestational sac, the fetal pole, and look at that--the heartbeat. “It’s in the 150s, 160s,” NP said. “Totally normal.”
The funniest thing was that both she and I could see things moving, as tiny as they are.
“The arms and legs are waving, see?”
And what do you know—I could see tiny limbs all akimbo, dancing around.
Unbelievable.
Afterward, I went to have blood work drawn so that we can learn some early chances of whether this baby has higher chances of carrying some chromosomal concerns. Three years ago, the nuchal fold test was done on the same day as the blood draw, so the full results came after a week or so after the blood was analyzed. This time, they draw the blood first, then we go back in two weeks and see the nuchal fold test. This is where they measure the fold of the back of the fetus’s neck to see if its chances of having Down’s Syndrome are high. Last time, the result came back great, but this time, I’m three years older and officially an old lady being pregnant at 40.
I hope it’ll be all good.
Despite the highs.
Monday, July 19, 2010
Where'd My "Get Up And Go" Go?
May 7, 2010
I don’t know if it’s all in my head, or because of my old ladyness, or what, but I just haven’t felt motivated the way I did two weeks ago.
Two weeks ago I went to New York, my former homeland, and spoke about the book and saw a ton of pals and went to the terrific ASJA writing conference. While there, I was excited, psyched, bubbling with ideas for new writing opportunities, and, of course, pumped to see old pals and meet new ones at the book event.
I came home with laryngitis, a sore throat, and three days after I got home, my right eye began tearing. It was effing annoying, all of it. We also had our first kid birthday for Preschooler L, complete with a rented gym and pizza and birthday cake, party favors, the whole shebang. Less than 24 hours after I drove myself home from New York.
Did I also mention I’d been up til 5am for the two nights before I went to New York, just because I had deadlines I needed to meet before I left town?
So for two weeks since, I’ve been completely unmotivated to follow up on most of the editors or story ideas I came up with at the conference. I haven’t felt like de-cluttering the many corners of our house that need it. For a day or two, I’ve just flopped on the couch and caught up on a lot of DVR’d television.
I never do this. During the week, when Preschooler L is in school, I consider it terrific and precious crucal time to Get. Stuff. Done.
I will say that the week we got back, we had to bring Preschooler L in for an EEG for some weird moments when he seemed to be off somewhere else. The episodes haven’t happened again, and the EEG came back entirely normal, but we had to keep him up late one night and then wake him up early the next day (sleep deprivation is a crucial part of the EEG) and honestly, who do you think helped deprive him? Which only added to my own feeling of health deprivation.
Almost two weeks later, my eye finally stopped tearing up and itching, which means it is no longer swollen. It also means I can stop wondering if a good antihistamine would help me feel better, even though the eye doc says “I’d skip it during pregnancy.” Oy, pregnancy.
And my voice is basically OK now, and I finally don’t have a trace of a sore throat. The laryngitis business used to happen every time I went back to college after a semester’s break. I’d get excited to see people, I’d talk up a storm, and sure enough, I’d lose my voice.
But these days, it’s really annoying to be sick, with a kid, with another one on the way (eight weeks and five days today) and not be able to network at a conference or do a phone interview or even follow up on things via phone (email doesn’t work for everyone) because my voice is shot and my throat is sore and my damn eye is leaking all over the place.
Ugh.
Hooray for being past that whole mess. I always think people who write about how sick they are are being completely boring, and I find the question “how are you?” to be a mere pleasantry, not a real probe on the state of anyone’s health, but damn, it is annoying to be sick.
I don’t know if it’s all in my head, or because of my old ladyness, or what, but I just haven’t felt motivated the way I did two weeks ago.
Two weeks ago I went to New York, my former homeland, and spoke about the book and saw a ton of pals and went to the terrific ASJA writing conference. While there, I was excited, psyched, bubbling with ideas for new writing opportunities, and, of course, pumped to see old pals and meet new ones at the book event.
I came home with laryngitis, a sore throat, and three days after I got home, my right eye began tearing. It was effing annoying, all of it. We also had our first kid birthday for Preschooler L, complete with a rented gym and pizza and birthday cake, party favors, the whole shebang. Less than 24 hours after I drove myself home from New York.
Did I also mention I’d been up til 5am for the two nights before I went to New York, just because I had deadlines I needed to meet before I left town?
So for two weeks since, I’ve been completely unmotivated to follow up on most of the editors or story ideas I came up with at the conference. I haven’t felt like de-cluttering the many corners of our house that need it. For a day or two, I’ve just flopped on the couch and caught up on a lot of DVR’d television.
I never do this. During the week, when Preschooler L is in school, I consider it terrific and precious crucal time to Get. Stuff. Done.
I will say that the week we got back, we had to bring Preschooler L in for an EEG for some weird moments when he seemed to be off somewhere else. The episodes haven’t happened again, and the EEG came back entirely normal, but we had to keep him up late one night and then wake him up early the next day (sleep deprivation is a crucial part of the EEG) and honestly, who do you think helped deprive him? Which only added to my own feeling of health deprivation.
Almost two weeks later, my eye finally stopped tearing up and itching, which means it is no longer swollen. It also means I can stop wondering if a good antihistamine would help me feel better, even though the eye doc says “I’d skip it during pregnancy.” Oy, pregnancy.
And my voice is basically OK now, and I finally don’t have a trace of a sore throat. The laryngitis business used to happen every time I went back to college after a semester’s break. I’d get excited to see people, I’d talk up a storm, and sure enough, I’d lose my voice.
But these days, it’s really annoying to be sick, with a kid, with another one on the way (eight weeks and five days today) and not be able to network at a conference or do a phone interview or even follow up on things via phone (email doesn’t work for everyone) because my voice is shot and my throat is sore and my damn eye is leaking all over the place.
Ugh.
Hooray for being past that whole mess. I always think people who write about how sick they are are being completely boring, and I find the question “how are you?” to be a mere pleasantry, not a real probe on the state of anyone’s health, but damn, it is annoying to be sick.
Sunday, July 11, 2010
Feeling Low About Highs
May 4
Despite writing the effing book on pregnancy and diabetes, my blood sugars have still soared throughout the last eight weeks.
I just saw my Kind Endo and high risk OB on Friday, the first visit of this pregnancy. The OB did her ultrasounds, said I was measuring right on time (7 weeks, 6 days), and both she and the endo took a lot of bloodwork.
That morning, I printed out six weeks worth of Dexcom readings, and a day-by-day printout of the last week.
Things looked OK, but you could clearly see excursions. I tend to bolus now and bottom out later, so I’ve become more acquainted with juice boxes and such. I’ve started buying big jugs of juice to have on hand when I just don’t want to futz with poking the puny straw in the right place on the top of the juice box while I feel like my knees aren't going to support me.
This weekend, Kind Endo told me to stop bolusing before three hours were up, to religiously test my sugar before a meal, an hour after, and to NOT CORRECT A HIGH until three and half hours after that first (15-minutes-pre-meal) bolus.
Ugh.
I hated it.
My sugars soared and while they were in line a few hours later, I hated sitting there watching my CGM sit in the 200s, or the 300s, for more than an hour at a time.
Just now, I heard back from Kind Endo, and she wants me to reduce my breakfast and lunch insulin-to-carb ratios by one. Frankly, I will probably continue to correct post-meal highs, if they continue, immediately after a meal.
Despite my angst, my A1c dropped .4. It’s well in the fives now.
I don’t say that to brag, though, but to point out the obvious: what does it matter what your longterm averages are if you clearly see potentially-damaging highs at least once a day? Wearing a CGM has pointed this out even more obviously than pricking my finger 15 times a day ever did before. I've recommended the Dexcom to several others, but it certainly has added to my anxiety during this pregnancy as well.
I constantly think of the stat I cited in my book: conceiving with a high A1c means your chances of having birth defects are 30 percent. That means 70 percent of those people will deliver healthy babies. The irony is that my A1c was exactly where it should be, but I still have these daily highs.
I also think about one woman I tried to interview for the book. She carried several children at once and delivered all of them, but she told me diabetes was the least of her concerns while carrying that many kids inside. She did what she could, but she was very lucky because her sugars were crazy and her kids were all born healthy, so that she probably wasn’t the best person to interview for a book about healthy pregnancy and diabetes.
It’s not right to focus on this, but it comforts me when I see a high blood sugar that isn’t budging fast enough.
[Added on July 11 after I wrote this original post: It's also possible to get my sugars to drop faster when I can jump on the elliptical trainer we have at home immediately after I see a post-meal sugar rise. But that isn't always practical, and I usually need to stay on it for a good 30 minutes to see a drop. (Again, the reality of wearing a CGM.) Sometimes I'm driving in my car immediately after a meal, or have to deal with my kid, or have to do some work. Or something.
It makes me angry that insulin isn't instantaneous. This should be a much bigger issue, in my opinion, than other issues that diabetes advocates talk about. Where is insulin that works immediately? As in, doesn't need to be injected early to mimic the absorption of a meal with carbohydrates? Doesn't need three hours to bring a high down? Who out there is with me?]
ON the other hand, I think how awful it would be to have an unhealthy baby after I’ve just written this go-girl pregnancy guide.
Just by writing that makes me think I might be tempting fate.
I really, really hope I am not.
Despite writing the effing book on pregnancy and diabetes, my blood sugars have still soared throughout the last eight weeks.
I just saw my Kind Endo and high risk OB on Friday, the first visit of this pregnancy. The OB did her ultrasounds, said I was measuring right on time (7 weeks, 6 days), and both she and the endo took a lot of bloodwork.
That morning, I printed out six weeks worth of Dexcom readings, and a day-by-day printout of the last week.
Things looked OK, but you could clearly see excursions. I tend to bolus now and bottom out later, so I’ve become more acquainted with juice boxes and such. I’ve started buying big jugs of juice to have on hand when I just don’t want to futz with poking the puny straw in the right place on the top of the juice box while I feel like my knees aren't going to support me.
This weekend, Kind Endo told me to stop bolusing before three hours were up, to religiously test my sugar before a meal, an hour after, and to NOT CORRECT A HIGH until three and half hours after that first (15-minutes-pre-meal) bolus.
Ugh.
I hated it.
My sugars soared and while they were in line a few hours later, I hated sitting there watching my CGM sit in the 200s, or the 300s, for more than an hour at a time.
Just now, I heard back from Kind Endo, and she wants me to reduce my breakfast and lunch insulin-to-carb ratios by one. Frankly, I will probably continue to correct post-meal highs, if they continue, immediately after a meal.
Despite my angst, my A1c dropped .4. It’s well in the fives now.
I don’t say that to brag, though, but to point out the obvious: what does it matter what your longterm averages are if you clearly see potentially-damaging highs at least once a day? Wearing a CGM has pointed this out even more obviously than pricking my finger 15 times a day ever did before. I've recommended the Dexcom to several others, but it certainly has added to my anxiety during this pregnancy as well.
I constantly think of the stat I cited in my book: conceiving with a high A1c means your chances of having birth defects are 30 percent. That means 70 percent of those people will deliver healthy babies. The irony is that my A1c was exactly where it should be, but I still have these daily highs.
I also think about one woman I tried to interview for the book. She carried several children at once and delivered all of them, but she told me diabetes was the least of her concerns while carrying that many kids inside. She did what she could, but she was very lucky because her sugars were crazy and her kids were all born healthy, so that she probably wasn’t the best person to interview for a book about healthy pregnancy and diabetes.
It’s not right to focus on this, but it comforts me when I see a high blood sugar that isn’t budging fast enough.
[Added on July 11 after I wrote this original post: It's also possible to get my sugars to drop faster when I can jump on the elliptical trainer we have at home immediately after I see a post-meal sugar rise. But that isn't always practical, and I usually need to stay on it for a good 30 minutes to see a drop. (Again, the reality of wearing a CGM.) Sometimes I'm driving in my car immediately after a meal, or have to deal with my kid, or have to do some work. Or something.
It makes me angry that insulin isn't instantaneous. This should be a much bigger issue, in my opinion, than other issues that diabetes advocates talk about. Where is insulin that works immediately? As in, doesn't need to be injected early to mimic the absorption of a meal with carbohydrates? Doesn't need three hours to bring a high down? Who out there is with me?]
ON the other hand, I think how awful it would be to have an unhealthy baby after I’ve just written this go-girl pregnancy guide.
Just by writing that makes me think I might be tempting fate.
I really, really hope I am not.
Sunday, July 04, 2010
Rear View
April 28
According to the calendar, I am seven weeks, three days pregnant.
According to my blood sugars, I am requiring more insulin all the time. My insulin ratios pretty much dropped to 1:5 across the board as soon as they told me I was pregnant. I monitor my sugars like a hawk. I give myself giant correction boluses post dinner, sort of off the cuff, and nowadays, they are typically keeping my overnight blood sugars steady.
Last week, we went to our infertility office for a vaginal ultrasound, which is standard even for those of us who didn’t conceive (i.e. without IVF) the way we thought we would (i.e., with IVF).
The tech congratulated me for conceiving unexpectedly, and asked when my last menstrual period was, since that’s how they date pregnancies that don’t have an official embryo transfer date.
“Oh, I have that date, but I also have the dates for when I took Clomid, when we actually had sex, and when I had obvious egg white cervical mucous,” I replied confidently. Who are these people who don’t know exactly when they conceive? Clearly I--a veteran of infertility treatments and a woman who keeps track of carb counts and insulin-to-carb ratios—can’t allow that anything can simply “just happen.”
Based on all my conception info, I said that the embryo should be six weeks and three days along.
Based on the ultrasound, the tech told me the embryo—the embryo that she found easily and clearly saw a heart beating strongly—measured six weeks and two days, give or take a day.
Who called it?
The heartbeat was strong at 122, too. And I am NOT carrying twins.
Similar to my pregnancy with Preschooler L, I don’t feel any different. I’ve had no morning sickness, save for one afternoon episode mentioned earlier. I don’t think my boobs are sore. I’ve had no cramps. Except for my new rigor for drinking water and milk instead of diet Coke, and thinking a bit more about dumping Splenda into tea as I treat my current talking-myself-silent-bout of laryngitis, I don’t feel all that different. I ate a mozzarella with capers sandwich last week and only wondered if it was OK halfway through my devouring.
There has only been one obvious outward sign (besides the blood sugar nuttiness) that perhaps I am pregnant after all:
My mom’s friend C., who I saw two weeks ago (i.e., in week five), casually asked my mother if I was pregnant a day after she came to a party at my house.
“Not that I’m aware of,” my mother said. “Why?”
“I can tell from her behind,” C told her.
Uncannily, C. predicted my first pregnancy back in 2006, weeks before we spilled the news to my parents, merely because of what my ass looked like.
I quickly and vehemently told my mother to tell C. to stop the scrutiny.
However, maybe C. is on to some kind of new money-making venture: early pregnancy prediction by tush size.
According to the calendar, I am seven weeks, three days pregnant.
According to my blood sugars, I am requiring more insulin all the time. My insulin ratios pretty much dropped to 1:5 across the board as soon as they told me I was pregnant. I monitor my sugars like a hawk. I give myself giant correction boluses post dinner, sort of off the cuff, and nowadays, they are typically keeping my overnight blood sugars steady.
Last week, we went to our infertility office for a vaginal ultrasound, which is standard even for those of us who didn’t conceive (i.e. without IVF) the way we thought we would (i.e., with IVF).
The tech congratulated me for conceiving unexpectedly, and asked when my last menstrual period was, since that’s how they date pregnancies that don’t have an official embryo transfer date.
“Oh, I have that date, but I also have the dates for when I took Clomid, when we actually had sex, and when I had obvious egg white cervical mucous,” I replied confidently. Who are these people who don’t know exactly when they conceive? Clearly I--a veteran of infertility treatments and a woman who keeps track of carb counts and insulin-to-carb ratios—can’t allow that anything can simply “just happen.”
Based on all my conception info, I said that the embryo should be six weeks and three days along.
Based on the ultrasound, the tech told me the embryo—the embryo that she found easily and clearly saw a heart beating strongly—measured six weeks and two days, give or take a day.
Who called it?
The heartbeat was strong at 122, too. And I am NOT carrying twins.
Similar to my pregnancy with Preschooler L, I don’t feel any different. I’ve had no morning sickness, save for one afternoon episode mentioned earlier. I don’t think my boobs are sore. I’ve had no cramps. Except for my new rigor for drinking water and milk instead of diet Coke, and thinking a bit more about dumping Splenda into tea as I treat my current talking-myself-silent-bout of laryngitis, I don’t feel all that different. I ate a mozzarella with capers sandwich last week and only wondered if it was OK halfway through my devouring.
There has only been one obvious outward sign (besides the blood sugar nuttiness) that perhaps I am pregnant after all:
My mom’s friend C., who I saw two weeks ago (i.e., in week five), casually asked my mother if I was pregnant a day after she came to a party at my house.
“Not that I’m aware of,” my mother said. “Why?”
“I can tell from her behind,” C told her.
Uncannily, C. predicted my first pregnancy back in 2006, weeks before we spilled the news to my parents, merely because of what my ass looked like.
I quickly and vehemently told my mother to tell C. to stop the scrutiny.
However, maybe C. is on to some kind of new money-making venture: early pregnancy prediction by tush size.
Sunday, June 27, 2010
Happy Birthday
April 9, 2010
Today is my son’s third birthday. It’s also the day my publisher starts shipping copies of my book to people who have pre-ordered them.
It’s also the day I am four weeks and five days pregnant.
I had another blood test yesterday to see if my HCG levels are doubling. This is a common way to know if the pregnancy is sticking and your body is doing what it is supposed to do while nurturing an embryo. Once again, I drove myself to my infertility clinic and dragged myself into the waiting room. The place has excellent wireless Internet access, so I always bring my laptop and fire it up while I’m sitting there. When the phlebotomist called my name, she smiled.
“You are always working while you’re here,” she noted.
I have had this woman draw my blood countless times over the last year or so. Having done two fresh IVF cycles, as well as other tests to try to figure out why those cycles weren’t successful, this woman knows my face, if not my entire story.
As she swabbed the crook of my arm with alcohol, she told me I should make a recommendation to the staff of the infertility clinic that they should set up study carrels in the lobby. For people like me, as well as for all the husbands and partners who sit there and wait while their wives or girlfriends are in some lab having blood drawn.
They should listen to me—I’ve been there enough times to have my own parking space. (Even though the parking in this particular clinic is free, thanks to the joy of a suburban location).
Because who am I if not always working? If I’m not trying to get something done so I can bill the time and meet a client’s deadline, I am always wondering where my blood sugar is, what time I last ate, and calculating what I ate and how many carbs was in it. Yesterday was no exception.
I’ve started to keep daily logs of what I eat and how much insulin I take, despite having a CGM. My overnight sugars, while steady, are consistently above where they should be. I bolus correction factors all night long, and nothing budges. I’ve noticed this for three days and changed the correction factor so that I get more insulin, but no dice. I need to email my doc and ask her WTF? And instead of writing this up at 5am, I am supposed to be on the elliptical we have at our house so I can jumpstart my sluggish blood sugar to start dropping back to where it should be. The slowness of insulin is one of my biggest complaints: If I am high now, why should I have to wait two hours before I start coming down? Knowing I am high and that a correction insulin hit will take a few hours before I am down, annoys me.
(Just checked the CGM, and apparently the hit of insulin I took 30 minutes ago is starting to work. So do I still go on the elliptical, even though I might come down quicker, but them bottom out? Should I try it for ten minutes?) Usually, if I eat and go straight up before an hour after a meal (the joys of a CGM with the trend arrows), I can go on the elliptical and, after about 20-30 minutes, reverse the sharp increase. Now that I am apparently trending downward, slowly, would a burst of exercise help me trend down a little faster?
Let’s see—will be right back. Ten minutes is all I’ll do, promise!
Okay, I’m back. My CGM says I’m still trending down gently. In the meantime, I watched the local news and just got angry about some dumbass flasher in the kids’ room of the library where I grew up—a place I happened to visit this week to return a book. What is the matter with people?!
Focus, focus.
So yesterday, I got the call in the afternoon about the results of my blood work:
HCG level was 556, more than double my result on Monday.
Progesterone was greater than 40, which is good.
My TSH level, something that had been low when I saw my endo about a month ago, has jumped up into the normal range, at 0.579.
Since the HCG level was so strong, I asked if I could be carrying twins. The nurse said I had to wait until the first ultrasound, but that a high number didn’t necessarily mean multiples. But wouldn’t that be the ultimate irony, huh?
But the HCG levels of my last two fresh cycles have always started out low or near normal but never doubled right. So the fact that this round had a strong starting number (comparable to what it was when I conceived Toddler L, who, let’s face it, should now be called Preschooler L) and has more than doubled makes me hopeful.
Now if I could only wrangle these overnight blood sugars down.
We’re off to celebrate my son’s birthday today: annual family portrait, a trip to the local kids’ museum to see Curious George, and tonight, dinner at an Italian restaurant near the Boy’s daycare program. Every morning when we drive by, Preschooler L asks if we can go to the restaurant and get “a kids’ menu.”
“Dude, we just finished breakfast,” I tell him. “Plus, the restaurant isn’t open this early.”
“I want to go to the (NAME OF THE RESTAURANT REDACTED) and get a kid’s menu!” he insists. He doesn’t want a hot dog or grilled cheese at that hour. He only wants to look at the menu that is all his own. Just before the preschool dropoff, though, I can usually divert his attention once we pull into school parking lot.
But tonight, my son shall have the kid’s menu of his dreams. Happy 3rd Birthday, Fabulous Boy!
Today is my son’s third birthday. It’s also the day my publisher starts shipping copies of my book to people who have pre-ordered them.
It’s also the day I am four weeks and five days pregnant.
I had another blood test yesterday to see if my HCG levels are doubling. This is a common way to know if the pregnancy is sticking and your body is doing what it is supposed to do while nurturing an embryo. Once again, I drove myself to my infertility clinic and dragged myself into the waiting room. The place has excellent wireless Internet access, so I always bring my laptop and fire it up while I’m sitting there. When the phlebotomist called my name, she smiled.
“You are always working while you’re here,” she noted.
I have had this woman draw my blood countless times over the last year or so. Having done two fresh IVF cycles, as well as other tests to try to figure out why those cycles weren’t successful, this woman knows my face, if not my entire story.
As she swabbed the crook of my arm with alcohol, she told me I should make a recommendation to the staff of the infertility clinic that they should set up study carrels in the lobby. For people like me, as well as for all the husbands and partners who sit there and wait while their wives or girlfriends are in some lab having blood drawn.
They should listen to me—I’ve been there enough times to have my own parking space. (Even though the parking in this particular clinic is free, thanks to the joy of a suburban location).
Because who am I if not always working? If I’m not trying to get something done so I can bill the time and meet a client’s deadline, I am always wondering where my blood sugar is, what time I last ate, and calculating what I ate and how many carbs was in it. Yesterday was no exception.
I’ve started to keep daily logs of what I eat and how much insulin I take, despite having a CGM. My overnight sugars, while steady, are consistently above where they should be. I bolus correction factors all night long, and nothing budges. I’ve noticed this for three days and changed the correction factor so that I get more insulin, but no dice. I need to email my doc and ask her WTF? And instead of writing this up at 5am, I am supposed to be on the elliptical we have at our house so I can jumpstart my sluggish blood sugar to start dropping back to where it should be. The slowness of insulin is one of my biggest complaints: If I am high now, why should I have to wait two hours before I start coming down? Knowing I am high and that a correction insulin hit will take a few hours before I am down, annoys me.
(Just checked the CGM, and apparently the hit of insulin I took 30 minutes ago is starting to work. So do I still go on the elliptical, even though I might come down quicker, but them bottom out? Should I try it for ten minutes?) Usually, if I eat and go straight up before an hour after a meal (the joys of a CGM with the trend arrows), I can go on the elliptical and, after about 20-30 minutes, reverse the sharp increase. Now that I am apparently trending downward, slowly, would a burst of exercise help me trend down a little faster?
Let’s see—will be right back. Ten minutes is all I’ll do, promise!
Okay, I’m back. My CGM says I’m still trending down gently. In the meantime, I watched the local news and just got angry about some dumbass flasher in the kids’ room of the library where I grew up—a place I happened to visit this week to return a book. What is the matter with people?!
Focus, focus.
So yesterday, I got the call in the afternoon about the results of my blood work:
HCG level was 556, more than double my result on Monday.
Progesterone was greater than 40, which is good.
My TSH level, something that had been low when I saw my endo about a month ago, has jumped up into the normal range, at 0.579.
Since the HCG level was so strong, I asked if I could be carrying twins. The nurse said I had to wait until the first ultrasound, but that a high number didn’t necessarily mean multiples. But wouldn’t that be the ultimate irony, huh?
But the HCG levels of my last two fresh cycles have always started out low or near normal but never doubled right. So the fact that this round had a strong starting number (comparable to what it was when I conceived Toddler L, who, let’s face it, should now be called Preschooler L) and has more than doubled makes me hopeful.
Now if I could only wrangle these overnight blood sugars down.
We’re off to celebrate my son’s birthday today: annual family portrait, a trip to the local kids’ museum to see Curious George, and tonight, dinner at an Italian restaurant near the Boy’s daycare program. Every morning when we drive by, Preschooler L asks if we can go to the restaurant and get “a kids’ menu.”
“Dude, we just finished breakfast,” I tell him. “Plus, the restaurant isn’t open this early.”
“I want to go to the (NAME OF THE RESTAURANT REDACTED) and get a kid’s menu!” he insists. He doesn’t want a hot dog or grilled cheese at that hour. He only wants to look at the menu that is all his own. Just before the preschool dropoff, though, I can usually divert his attention once we pull into school parking lot.
But tonight, my son shall have the kid’s menu of his dreams. Happy 3rd Birthday, Fabulous Boy!
Monday, June 21, 2010
Urban Legend
April 5, 2010
In some ways, 2009 was kind of a rough year. I pulled together all our tax paperwork last week for our accountant, and I noticed, over and over again, all the bills for our medical expenses.
A large chunk of those expenses were for infertility coverage. There was extra insurance to cover the costs of fertility treatments in our state. There were extra procedures to figure out if we can have a girl without chromosomal defects. And sometimes there were extra costs on top of those procedures that aren’t always reimbursed.
That’s a bunch of extras.
And that doesn’t include the ongoing costs: parking and routine lab-work, co-payments and babysitters so we don’t have to schlep our son to these appointments. More to pay to get additional coverage at daycare and nursery school. More excuses. More guarded explanations.
Our three-year-old knows what it means when I say I have to go to an appointment. “What’s the doctor’s name?” he’ll ask. He hasn’t yet figured out which name signifies what medical issue is being examined.
So what exactly did we do in 2009?
* One fresh IVF cycle over the summer, that ended in an early miscarriage and D&E. (transfer July 4th. Try explaining to your friends who have come to your neighborhood to watch the parade in front of your house about why you are leaving your son with a babysitter while you and your husband are trying to sneak out of the driveway. To get to a clinic. That no one knows you are visiting. At 9 in the morning, no less.)
* One frozen embryo transfer in the fall that didn’t develop into anything. (Circa Columbus Day Weekend).
* One vaginal procedure to figure out if there was any scarring obscuring anything en route to the uterus. (The week of Thanksgiving. Some minor scarring, but only enough to direct future people to enter with their assorted medical tools and whatnot “at 7 o’clock.”
* Another fresh IVF cycle that started around MLK weekend, 2010, but ended in an even earlier miscarriage by Valentine’s Day.
We honestly didn’t plan any of this around holidays. It just worked out that way.
For my 40th birthday this spring, the insurance company gifted me with yet another test. To prove that my old lady ovaries were still working properly (and therefore, worth insuring for another round of IVF), I had to do a Clomid challenge. This entailed yet more blood tests, several days of taking Clomid to help amp up my ovaries, and then a vaginal exam to determine my uterus was still clean and clear.
The nurse who did the exam remembered me from an appointment last summer, when she confirmed that I’d need a D&E for a miscarriage/failed IVF. “How are you doing,” she asked mournfully. “Still trying to have a baby,” I replied, all matter-of-fact, with advice: “By the way, go in at 7 o’clock and use a tiny speculum.”
She did and she did. “I see one follicle in here,” she noted. “I’ve been taking Clomid,” I reported. When not being mandated by one’s insurance company to prove ovaries are still working right, Clomid is the first line of treatment when you aren’t conceiving. I’d taken it many cycles before, long before the IVFs and the IUIs, the workups and the endless bloodwork. It had never done much for me, honestly.
But maybe could it work now?
I went home with a new mission.
“Let’s have sex!” I told Mr. L. What did we have to lose? A follicle was in sight. Never mind that we’d been here many times before, so many times that actually having sex for recreational fun was something I’d nearly forgotten how to do. As I had many times before, I bought an ovulation predictor kit and dutifully peed on a week’s worth of sticks.
The ovulation predictor tests were never entirely conclusive, but the egg white mucous pouring out of me one day suggested it was all systems go. Once again, we tried to do what most of the rest of the world does to conceive.
How shocking—we were in a bed, just the two of us! For once, I was not draped in a hospital gown and a paper shower cap, my feet up in stirrups, Mr. L sitting at my side, both of us freezing in a clinical exam room, our eyes glued to a monitor as a pipette with fresh or frozen embryos were gently, carefully, guided through my cervix and into my uterus, as my full bladder threatened to leak all over the doctor doing the transfer, the nurse assisting, and the embryologist who was always there telling us which embryos looked the best for the procedure.
Romantic, no?
But this time, things were a bit more ordinary. The typical way the majority of people conceive.
Again, since I’ve been here many times before and have never gotten pregnant with just sex, without a round of fresh IVF, both the Mister and I carried on with the rest of our lives. My day-to-day blood sugars were okay, but not stellar. My thyroid levels were a bit low. The only minor change this time: I was taking Metformin, a drug my infertility doc recommended, not because my sugars were out of line or because I’ve ever shown any sign of having polycystic ovaries, but because it might “help my hormones,” whatever that meant. I continued to eat deli meat and drink diet Coke.
One week later, at a party, I ate a smidge of Brie cheese. Weirdly, after we were on our way home an hour or two later, I felt sick to my stomach. Mr. L had to pull off the highway so I could find a bathroom. I couldn’t tell if I had to vomit or sit on the toilet for a long time. Thankfully, I didn’t vomit.
“Maybe you’re pregnant,” Mr. L said, after I left the Gas and Go’s public bathroom, shuddering.
“Maybe. Wouldn’t that be something?” I said.
I didn’t have a lot of faith.
In the meantime, we met with a few other doctors. This included another infertility specialist to get a second opinion. She told us she would keep doing what we’re doing, but to stop using PGD, an expensive procedure that tells you the chromosomal makeup (and gender) of embryos before you they are transferred via IVF. We didn't have any history of chromosomal abnormalities, and the procedure might even damage healthy embryos, so it wasn’t worth doing, she told us. A nutritionist said I was on the right track. My endo told me my A1c was 6.1 and that my bloodwork, for the most part, looked fine.
“We did try this month, but I’d be shocked if it meant anything,” I told them all. “Good luck,” they all said. One medical assistant, who waited with me as I waited to see my diabetes endocrinologist, regaled me with stories of patients she’s seen who get pregnant on their own after years of infertility treatment. A friend I haven’t seen in ages told me a distant mutual friend, one I’d lost touch with over the past year, recently delivered her healthy son. The new mom was a woman who’s done as much if not more fertility treatment than me, and had conceived her toddler daughter after a lot of IVF. Her newborn son? Conceived naturally.
I’d always thought these stories were urban legends. You hear about them, but do they really happen?
We had our follow-up appointment with our reproductive endocrinologist on a Friday in April, about two months after the last IVF ended in another early miscarriage. We’d waited the appropriate amount of time. We’d had more bloodwork to see if there were chromosomal or genetic reasons why my last two pregnancies ended so prematurely. Nothing showed up. All we had to do was wait for my period to start and we were geared up to start the next fresh IVF cycle. I was all set to order the drugs the day my period started.
That weekend, my period never showed.
I bought a pricey digital pregnancy test that promised results in three minutes.
In less than one, we had our answer:
We’ve never been here. We don’t know the embryo cell count, the potential for implantation, exactly how many days post-transfer I am. How many were transferred?
That Monday, I went to the infertility clinic for a blood test. The nurse left her message on my cell.
Beta count: 165. “Very good. We want it to be anything over 100.”
Progesterone level, that indicates the uterus is prepping to support an embryo: 40. “It doesn’t get much better than that,” the nurse said.
How did I get here? The Mister and I actually had sex and get pregnant? And me at age 40, no less?
I honestly have no idea.
In some ways, 2009 was kind of a rough year. I pulled together all our tax paperwork last week for our accountant, and I noticed, over and over again, all the bills for our medical expenses.
A large chunk of those expenses were for infertility coverage. There was extra insurance to cover the costs of fertility treatments in our state. There were extra procedures to figure out if we can have a girl without chromosomal defects. And sometimes there were extra costs on top of those procedures that aren’t always reimbursed.
That’s a bunch of extras.
And that doesn’t include the ongoing costs: parking and routine lab-work, co-payments and babysitters so we don’t have to schlep our son to these appointments. More to pay to get additional coverage at daycare and nursery school. More excuses. More guarded explanations.
Our three-year-old knows what it means when I say I have to go to an appointment. “What’s the doctor’s name?” he’ll ask. He hasn’t yet figured out which name signifies what medical issue is being examined.
So what exactly did we do in 2009?
* One fresh IVF cycle over the summer, that ended in an early miscarriage and D&E. (transfer July 4th. Try explaining to your friends who have come to your neighborhood to watch the parade in front of your house about why you are leaving your son with a babysitter while you and your husband are trying to sneak out of the driveway. To get to a clinic. That no one knows you are visiting. At 9 in the morning, no less.)
* One frozen embryo transfer in the fall that didn’t develop into anything. (Circa Columbus Day Weekend).
* One vaginal procedure to figure out if there was any scarring obscuring anything en route to the uterus. (The week of Thanksgiving. Some minor scarring, but only enough to direct future people to enter with their assorted medical tools and whatnot “at 7 o’clock.”
* Another fresh IVF cycle that started around MLK weekend, 2010, but ended in an even earlier miscarriage by Valentine’s Day.
We honestly didn’t plan any of this around holidays. It just worked out that way.
For my 40th birthday this spring, the insurance company gifted me with yet another test. To prove that my old lady ovaries were still working properly (and therefore, worth insuring for another round of IVF), I had to do a Clomid challenge. This entailed yet more blood tests, several days of taking Clomid to help amp up my ovaries, and then a vaginal exam to determine my uterus was still clean and clear.
The nurse who did the exam remembered me from an appointment last summer, when she confirmed that I’d need a D&E for a miscarriage/failed IVF. “How are you doing,” she asked mournfully. “Still trying to have a baby,” I replied, all matter-of-fact, with advice: “By the way, go in at 7 o’clock and use a tiny speculum.”
She did and she did. “I see one follicle in here,” she noted. “I’ve been taking Clomid,” I reported. When not being mandated by one’s insurance company to prove ovaries are still working right, Clomid is the first line of treatment when you aren’t conceiving. I’d taken it many cycles before, long before the IVFs and the IUIs, the workups and the endless bloodwork. It had never done much for me, honestly.
But maybe could it work now?
I went home with a new mission.
“Let’s have sex!” I told Mr. L. What did we have to lose? A follicle was in sight. Never mind that we’d been here many times before, so many times that actually having sex for recreational fun was something I’d nearly forgotten how to do. As I had many times before, I bought an ovulation predictor kit and dutifully peed on a week’s worth of sticks.
The ovulation predictor tests were never entirely conclusive, but the egg white mucous pouring out of me one day suggested it was all systems go. Once again, we tried to do what most of the rest of the world does to conceive.
How shocking—we were in a bed, just the two of us! For once, I was not draped in a hospital gown and a paper shower cap, my feet up in stirrups, Mr. L sitting at my side, both of us freezing in a clinical exam room, our eyes glued to a monitor as a pipette with fresh or frozen embryos were gently, carefully, guided through my cervix and into my uterus, as my full bladder threatened to leak all over the doctor doing the transfer, the nurse assisting, and the embryologist who was always there telling us which embryos looked the best for the procedure.
Romantic, no?
But this time, things were a bit more ordinary. The typical way the majority of people conceive.
Again, since I’ve been here many times before and have never gotten pregnant with just sex, without a round of fresh IVF, both the Mister and I carried on with the rest of our lives. My day-to-day blood sugars were okay, but not stellar. My thyroid levels were a bit low. The only minor change this time: I was taking Metformin, a drug my infertility doc recommended, not because my sugars were out of line or because I’ve ever shown any sign of having polycystic ovaries, but because it might “help my hormones,” whatever that meant. I continued to eat deli meat and drink diet Coke.
One week later, at a party, I ate a smidge of Brie cheese. Weirdly, after we were on our way home an hour or two later, I felt sick to my stomach. Mr. L had to pull off the highway so I could find a bathroom. I couldn’t tell if I had to vomit or sit on the toilet for a long time. Thankfully, I didn’t vomit.
“Maybe you’re pregnant,” Mr. L said, after I left the Gas and Go’s public bathroom, shuddering.
“Maybe. Wouldn’t that be something?” I said.
I didn’t have a lot of faith.
In the meantime, we met with a few other doctors. This included another infertility specialist to get a second opinion. She told us she would keep doing what we’re doing, but to stop using PGD, an expensive procedure that tells you the chromosomal makeup (and gender) of embryos before you they are transferred via IVF. We didn't have any history of chromosomal abnormalities, and the procedure might even damage healthy embryos, so it wasn’t worth doing, she told us. A nutritionist said I was on the right track. My endo told me my A1c was 6.1 and that my bloodwork, for the most part, looked fine.
“We did try this month, but I’d be shocked if it meant anything,” I told them all. “Good luck,” they all said. One medical assistant, who waited with me as I waited to see my diabetes endocrinologist, regaled me with stories of patients she’s seen who get pregnant on their own after years of infertility treatment. A friend I haven’t seen in ages told me a distant mutual friend, one I’d lost touch with over the past year, recently delivered her healthy son. The new mom was a woman who’s done as much if not more fertility treatment than me, and had conceived her toddler daughter after a lot of IVF. Her newborn son? Conceived naturally.
I’d always thought these stories were urban legends. You hear about them, but do they really happen?
We had our follow-up appointment with our reproductive endocrinologist on a Friday in April, about two months after the last IVF ended in another early miscarriage. We’d waited the appropriate amount of time. We’d had more bloodwork to see if there were chromosomal or genetic reasons why my last two pregnancies ended so prematurely. Nothing showed up. All we had to do was wait for my period to start and we were geared up to start the next fresh IVF cycle. I was all set to order the drugs the day my period started.
That weekend, my period never showed.
I bought a pricey digital pregnancy test that promised results in three minutes.
In less than one, we had our answer:
We’ve never been here. We don’t know the embryo cell count, the potential for implantation, exactly how many days post-transfer I am. How many were transferred?
That Monday, I went to the infertility clinic for a blood test. The nurse left her message on my cell.
Beta count: 165. “Very good. We want it to be anything over 100.”
Progesterone level, that indicates the uterus is prepping to support an embryo: 40. “It doesn’t get much better than that,” the nurse said.
How did I get here? The Mister and I actually had sex and get pregnant? And me at age 40, no less?
I honestly have no idea.
Sunday, April 08, 2007
Erev C-Section
In a mere 12 hours, I'm scheduled for a c-section.
I spent all day today filing baby stuff, assorted doctor's notes and paraphernalia, and nesting at home with Mr. L.
People called or emailed all weekend to wish us luck.
I got a little teary tonight. What if something goes wrong? This is the last night the Mister and I will be just two. What if I ate too much chocolate, and therefore too much caffeine, throughout this pregnancy and it affects the baby's mental state?
(I was going to write up a post about everything I've learned being pregnant and type 1 and dealing with infertility, but didn't get around to it. It'll come in the future.)
And yet, coming home on Friday from my last day of work, I allowed myself to think "What if everything is really wonderful and the baby is perfect and everything is really great?"
It made me really happy and teary in a good way.
We likely won't have any access to a laptop in the hospital, and while we have a big email list of people to announce our news to (via a friend of Mr. L's) tomorrow, I just don't know when I'll get to update again. A few of you are on the big email list, so you may know our news before I can update here. If Mr. L leaves the hospital for a quick visit home midweek, I may ask him to update things.
In any case, I'll update when I can. Stay tuned.
I spent all day today filing baby stuff, assorted doctor's notes and paraphernalia, and nesting at home with Mr. L.
People called or emailed all weekend to wish us luck.
I got a little teary tonight. What if something goes wrong? This is the last night the Mister and I will be just two. What if I ate too much chocolate, and therefore too much caffeine, throughout this pregnancy and it affects the baby's mental state?
(I was going to write up a post about everything I've learned being pregnant and type 1 and dealing with infertility, but didn't get around to it. It'll come in the future.)
And yet, coming home on Friday from my last day of work, I allowed myself to think "What if everything is really wonderful and the baby is perfect and everything is really great?"
It made me really happy and teary in a good way.
We likely won't have any access to a laptop in the hospital, and while we have a big email list of people to announce our news to (via a friend of Mr. L's) tomorrow, I just don't know when I'll get to update again. A few of you are on the big email list, so you may know our news before I can update here. If Mr. L leaves the hospital for a quick visit home midweek, I may ask him to update things.
In any case, I'll update when I can. Stay tuned.
Thursday, April 05, 2007
Week 37: 37 Thoughts
1. The women in my office had a shower-like lunch for me yesterday. It was low-key, but they bought the baby some duck-themed books and bath stuff. Seeing as I haven't had a shower at all, I was touched by it.
2. The Mister came to work the other day and helped me clean out my desk. I have a lot of books and personal items on my desk that I wanted to bring home.
3. Am trying to get some work done (I'm actually leaving the office just before the next busy period) and float between trying to be productive so I can get through the day, and cleaning out years of old emails and files on my computer to make sure I can access what I need after I'm no longer working at that computer/desk every day.
4. Yesterday, after the nice shower, I got a few go-Lyrehca emails. One was from a former freelancer I trained and who left my publication to move to New York and picked up a lot of freelance work right away. She told me that working for me was like being in a Master's program and that she quickly got promoted because of the quality of her work.
5. The second was from one of the magazines I freelance for and recently told I was going on a hiatus to have the kid. The magazine has a new section editor who was told by the editor I had worked for that I was a great worker, and that whenever I was ready to get back into freelancing for them after the baby's arrival, to please get in touch.
6. I love getting emails or getting praise like that.
7. At work itself, one of my coworkers told me she was going to really miss me while I was out, since she considered me the glue of the magazine.
8. Honestly, I don't hear a lot of stuff like that, particularly from the top boss at the place. Our priorities (mine and the top boss's) are pretty far apart, and as a result, we don't interact all that much. Plus, I sense that our styles are pretty different.
9. Beyond work glory, I've determined, perhaps weeks or months later than most, that pregnancy can be really hard on the body. Particularly in the final weeks.
10. As Mr. Lyrehca pointed out, some women vomit for three months straight, and I didn't have any of that.
11. But in the last week alone, my ankles and legs have gotten bigger, I've dealt with the sheer annoyance and pain of a hemorrhoid, and two days ago, my left kneecap developed this sharp arthritis-like pain (I suspect this is what arthritis feels like).
12. It hurts to go up and down stairs, and it's only on one knee, in the front. (Knee pain in the back would indicate a scary blood clot, and I'm told this isn't a clot).
13. One the first day, two Tylenol did nothing for the knee pain, but yesterday and today, it seems to have lessened in intensity a bit.
14. Due to Passover, I've eaten more of carb-heavy foods over the past few days.
15. My blood sugars have reflected this, despite my efforts to take more boluses to cover them.
16. I fear this is packing weight on the kid for the last week in utero.
17. Sigh.
18. Today I've scheduled the last of my prenatal massages at lunchtime. I'm deeply looking forward to this.
19. Friday is my last day at work.
20. We still need to buy a bassinet mattress for next week.
21. My home office is still cluttered, and it's hard to get motivated to declutter it before next week.
22. I've been up for a few hours (it's nearly 6am) even though my blood sugar was 89 when I went to bed and 94 when I awoke around 4ish.
23. It took several days, after weeks of prodding from Mr. L., but I finally pulled together a huge list of email addresses for everyone we want to announce our baby news to next week.
24. I try not to think about what we'll do should something (knock wood) not go anything but well.
25. I wonder what the baby is going to look like.
26. I wonder if I'll ever feel well-rested again over the next year.
26. I wonder if my assorted health complaints will somehow disappear next week, or if I'm living with cankles, hemorrhoids and left knee pain for the duration.
27. I have thought that despite all my worrying about the baby's potential for health problems (diabetes! autism! ADHD! Something else I haven't thought of yet), that having the baby in utero has kept things limited. Once the baby is here, the reality will be staring me (crying, hungry, tired, in need of a diaper change) straight in the face.
28. It was snowing here yesterday. On April 4.
29. All the clothes I've bought for Baby L. aren't snow-ready.
30. Once the baby arrives, I suspect my mother will go into baby overload and buy the kid whatever cold-weather gear it may still need by the second week in April.
31. I lay in bed earlier tonight and noted the lack of abdominal pain I was feeling, to try to remember how it feels next week when I'm recovering from another abdominal scar and more pain.
32. I totally forgot about this and this deserves a post of its own, but Laurie at A Chronic Dose mentioned me on her blog last week as someone who always makes her think. I need to write more about this at length, particuarly because this post isn't much more than a brain dump, but thanks (again!) to Laurie.
33. I turned 37 last week. It was sort of a low-key birthday in light of where I am in the pregnancy.
34. I just felt the baby kick.
35. It's very reassuring when this happens.
36. I have another hour before I need to start readying for work.
37. I think I'll head back to bed while I still can.
2. The Mister came to work the other day and helped me clean out my desk. I have a lot of books and personal items on my desk that I wanted to bring home.
3. Am trying to get some work done (I'm actually leaving the office just before the next busy period) and float between trying to be productive so I can get through the day, and cleaning out years of old emails and files on my computer to make sure I can access what I need after I'm no longer working at that computer/desk every day.
4. Yesterday, after the nice shower, I got a few go-Lyrehca emails. One was from a former freelancer I trained and who left my publication to move to New York and picked up a lot of freelance work right away. She told me that working for me was like being in a Master's program and that she quickly got promoted because of the quality of her work.
5. The second was from one of the magazines I freelance for and recently told I was going on a hiatus to have the kid. The magazine has a new section editor who was told by the editor I had worked for that I was a great worker, and that whenever I was ready to get back into freelancing for them after the baby's arrival, to please get in touch.
6. I love getting emails or getting praise like that.
7. At work itself, one of my coworkers told me she was going to really miss me while I was out, since she considered me the glue of the magazine.
8. Honestly, I don't hear a lot of stuff like that, particularly from the top boss at the place. Our priorities (mine and the top boss's) are pretty far apart, and as a result, we don't interact all that much. Plus, I sense that our styles are pretty different.
9. Beyond work glory, I've determined, perhaps weeks or months later than most, that pregnancy can be really hard on the body. Particularly in the final weeks.
10. As Mr. Lyrehca pointed out, some women vomit for three months straight, and I didn't have any of that.
11. But in the last week alone, my ankles and legs have gotten bigger, I've dealt with the sheer annoyance and pain of a hemorrhoid, and two days ago, my left kneecap developed this sharp arthritis-like pain (I suspect this is what arthritis feels like).
12. It hurts to go up and down stairs, and it's only on one knee, in the front. (Knee pain in the back would indicate a scary blood clot, and I'm told this isn't a clot).
13. One the first day, two Tylenol did nothing for the knee pain, but yesterday and today, it seems to have lessened in intensity a bit.
14. Due to Passover, I've eaten more of carb-heavy foods over the past few days.
15. My blood sugars have reflected this, despite my efforts to take more boluses to cover them.
16. I fear this is packing weight on the kid for the last week in utero.
17. Sigh.
18. Today I've scheduled the last of my prenatal massages at lunchtime. I'm deeply looking forward to this.
19. Friday is my last day at work.
20. We still need to buy a bassinet mattress for next week.
21. My home office is still cluttered, and it's hard to get motivated to declutter it before next week.
22. I've been up for a few hours (it's nearly 6am) even though my blood sugar was 89 when I went to bed and 94 when I awoke around 4ish.
23. It took several days, after weeks of prodding from Mr. L., but I finally pulled together a huge list of email addresses for everyone we want to announce our baby news to next week.
24. I try not to think about what we'll do should something (knock wood) not go anything but well.
25. I wonder what the baby is going to look like.
26. I wonder if I'll ever feel well-rested again over the next year.
26. I wonder if my assorted health complaints will somehow disappear next week, or if I'm living with cankles, hemorrhoids and left knee pain for the duration.
27. I have thought that despite all my worrying about the baby's potential for health problems (diabetes! autism! ADHD! Something else I haven't thought of yet), that having the baby in utero has kept things limited. Once the baby is here, the reality will be staring me (crying, hungry, tired, in need of a diaper change) straight in the face.
28. It was snowing here yesterday. On April 4.
29. All the clothes I've bought for Baby L. aren't snow-ready.
30. Once the baby arrives, I suspect my mother will go into baby overload and buy the kid whatever cold-weather gear it may still need by the second week in April.
31. I lay in bed earlier tonight and noted the lack of abdominal pain I was feeling, to try to remember how it feels next week when I'm recovering from another abdominal scar and more pain.
32. I totally forgot about this and this deserves a post of its own, but Laurie at A Chronic Dose mentioned me on her blog last week as someone who always makes her think. I need to write more about this at length, particuarly because this post isn't much more than a brain dump, but thanks (again!) to Laurie.
33. I turned 37 last week. It was sort of a low-key birthday in light of where I am in the pregnancy.
34. I just felt the baby kick.
35. It's very reassuring when this happens.
36. I have another hour before I need to start readying for work.
37. I think I'll head back to bed while I still can.
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 diabeticmommy.com'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.
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 diabeticmommy.com'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.
Thursday, March 29, 2007
Cord Blood Conundrum
Many things to write about, but the latest is the conundrum over whether to have our kid's cord blood saved when the kid is born.
The deal is this: docs can collect cord blood and save the cells to use down the road to fight against catastrophic health conditions. There are a handful of very obscure conditions that cord blood cells currently help, but the idea is that down the road, conditions I'm more familiar with, like type 1 diabetes, may get helped with the cells collected from cord blood.
Problem is, it's expensive up front to collect the cells, approx. $1500-2000 to collect it, and about $125 a year to store it.
The bigger issue, in my mind, is that there are plenty of cord blood banks out there, and I've talked to three this week. They are all very strong with the marketing blather and make me wonder why they're all such hard sellers.
With the diabetes and the cancer scare a few years ago, I have the kind of medical history that makes me want to do this. The Mister agrees.
Then again, there's the argument that if your kid has, say, leukemia, the kid wouldn't be best treated with its own cord blood, because those cells may have the same leukemia-producing genes that caused the problem in the first place. But if a sibiling has banked cells, the leukemia child could use the cells of the sibling's banked cord blood to try to fix the problem.
The American Academy of Pediatrics recommends banking with a public bank, where there's no cost and like any blood bank, you don't get your own blood back if you need it. But I don't know much about public cord blood banking, and I don't know if it's necessarily available where we are right now. Another take on the situation is here.
But how do we pick one place over another? Cost? Well, the cheapest place we found is in Florida, where the sales rep I talked to told me how secure their facility is in light of natural disasters like hurricanes. Do we go closer to home? Well, the instate place near us brags about how their facility is in state, but does that really matter in this electronic, courier-driven age? And the third place that our doctor friends recommend is the most expensive, but also does research on site. But it's not like they wouldn't share the results of that research if they stumble on the cure for diabetes, right? So why would I care who is doing the most research on it?
Does it matter if a company is publicly-owned or not? Been in business the longest?
Oy. And I do research for a living.
Of course, of these three, two have discounts that extend til tomorrow, because it's the end of the month, and like buying a car, I suspect these places have monthly quotas to fill.
And our OB and the two pediatricians we met with weren't much help. All told us they think it's a lot of money and nothing's really been proven yet. We're willing to pay the money (Dude, we just spent thousands last year on health care and infertility costs. What's another two grand?), but how to pick where to spend it?
SO ANYONE who's decided to bank their kid's cord blood--tell me your thoughts. How'd you pick the place you went with?
The deal is this: docs can collect cord blood and save the cells to use down the road to fight against catastrophic health conditions. There are a handful of very obscure conditions that cord blood cells currently help, but the idea is that down the road, conditions I'm more familiar with, like type 1 diabetes, may get helped with the cells collected from cord blood.
Problem is, it's expensive up front to collect the cells, approx. $1500-2000 to collect it, and about $125 a year to store it.
The bigger issue, in my mind, is that there are plenty of cord blood banks out there, and I've talked to three this week. They are all very strong with the marketing blather and make me wonder why they're all such hard sellers.
With the diabetes and the cancer scare a few years ago, I have the kind of medical history that makes me want to do this. The Mister agrees.
Then again, there's the argument that if your kid has, say, leukemia, the kid wouldn't be best treated with its own cord blood, because those cells may have the same leukemia-producing genes that caused the problem in the first place. But if a sibiling has banked cells, the leukemia child could use the cells of the sibling's banked cord blood to try to fix the problem.
The American Academy of Pediatrics recommends banking with a public bank, where there's no cost and like any blood bank, you don't get your own blood back if you need it. But I don't know much about public cord blood banking, and I don't know if it's necessarily available where we are right now. Another take on the situation is here.
But how do we pick one place over another? Cost? Well, the cheapest place we found is in Florida, where the sales rep I talked to told me how secure their facility is in light of natural disasters like hurricanes. Do we go closer to home? Well, the instate place near us brags about how their facility is in state, but does that really matter in this electronic, courier-driven age? And the third place that our doctor friends recommend is the most expensive, but also does research on site. But it's not like they wouldn't share the results of that research if they stumble on the cure for diabetes, right? So why would I care who is doing the most research on it?
Does it matter if a company is publicly-owned or not? Been in business the longest?
Oy. And I do research for a living.
Of course, of these three, two have discounts that extend til tomorrow, because it's the end of the month, and like buying a car, I suspect these places have monthly quotas to fill.
And our OB and the two pediatricians we met with weren't much help. All told us they think it's a lot of money and nothing's really been proven yet. We're willing to pay the money (Dude, we just spent thousands last year on health care and infertility costs. What's another two grand?), but how to pick where to spend it?
SO ANYONE who's decided to bank their kid's cord blood--tell me your thoughts. How'd you pick the place you went with?
Thursday, March 22, 2007
Good God, It's Week 35
I have the rest of the week off from work because I supposedly didn't use a few vacation days from 2006 that need to be used by the end of March. (Um, OK, I'd bet that's incorrect, but who am I to argue with the HR woman at work? Enforced days off--sign me up!).
As a result, I spent yesterday doing some nice things:
1. Got a pedicure so my feet finally are worth baring in public. (The pedicurist took pity on me as I contorted around my belly to take my socks off. It was like running a marathon. She gave me a fancy smoothing serum on my callouses-of-death heels without charging me extra.)
2. Got a prenatal massage that felt terrific. I highly recommend these if you are pregnant and achy. The therapist was sweet, did a hardcore Swedish, and knew her way around the pregnant form. ("God bless you, honey, you weren't kidding when you said your ankles and legs were swollen.")
3. Bought some baby clothes.
That last one actually felt the most indulgent. All along, people have asked if I'm excited, if the Mister is excited, about the baby's arrival. Honestly, excitement isn't the word I'd use. Cautious is much more like it.
"We're taking everything one day at a time," I say. "Knock wood, the baby will be healthy and happy."
The whole religious tradition of not tempting fate, not having any baby showers, heck, being casual about where we registered, has really seeped into my being. The one time I mentioned to Mister Lyrehca, "Oh, it should be a quick 20 minute visit" was the heart rate scan a few weeks back where I was sent to Labor & Delivery for two more hours of fetal heart rate monitoring.
Truly, I'm trying to not take anything for granted.
But I had time to shop a bit yesterday, and was close to some baby apparel stores. So I figured I'd scan the sales racks and see what was there. Besides, as of yesterday, the baby had only two items of clothing, and both were gift onesies that would be too big for a newborn to come home from the hospital in. (Unless the kid comes out of the hospital the size of a three-to-six month old. But I digress).
God, baby clothes are cute.
Two credit card charges later, Baby Lyrehca is set to be a very well-dressed kid. Onesies. T-shirts. Socks. A soft hat. All in colorful shades and hip patterns.
I came home and showed Mister Lyrehca, who typically balks at updating his wardrobe from high school. (He proudly wore a Members Only jacket in recent years despite my taunting him; thankfully, friends of ours also mocked him and he finally got rid of it). Even he thought the items were cute and fun. I'm trying not to think of what it'll be like to have to change these clothes because they're covered with spit up and other bodily fluids. Instead, I'm trying to picture the oohs and ahs Baby L will get for being just so fashionable. So baby-stylish. So great.
But you know I can't just relax. I asked both stores what their return policies were. Just in case.
Also saw my Eye Doc yesterday for a follow-up visit.
Apparently, the part of my eyes could be considered "severe non-proliferative retinopathy" while other parts are plain old "proliferative retinopathy." However, since last October's laser treatments, they've been "quiescent" or "quiet." This means that while there is new blood vessel growth in the back of my eyes leftover from whenever, the laser stopped some of it in its tracks. The laser did not stop all of it, because I only had limited laser treatment. The idea is that the limited laser treatment may stop everything forever from growing, but if it doesn't, I'd need more.
"Why didn't you just laser everything you saw?" I asked.
Because that may have affected your vision, Eye Doc said. The idea is to do as little treatment as possible to minimize vision changes while getting the desired effect of stopping the new blood vessel growth in its tracks. The whole time, I might add, my actual eyesight has remained unchanged (i.e., I see things just fine) and the optometrist who analyzes the vision in the front of my eyes told me yesterday that everything looked "brilliant." (I liked her immediately.)
I was more annoyed at being told I was "proliferative" versus "severe non-proliferative." These are semantics most people don't even understand, and even Eye Doc seemed to think the difference was a casual one, but I said that should I ever actually qualify to get life insurance, the difference in my eye damage might make me uninsurable.
"Actually, you're less likely to have eye problems because you've had the laser," Eye Doc said. "That makes you a better candidate."
That seemed like a glib way to summarize things. Eye Doc, who I used to enjoy chatting with during my visits, and I are becoming a bit less chatty. I still have to go back there in three months for a follow-up, though she tells me I can aspire to have visits every four months, then every five, and then maybe taper them back to twice a year.
Mister Lyrehca and I are are pulling together our tax paperwork and receipts to get things filed before the baby's scheduled arrival. I save every single receipt and itemize whatever I can because I freelance on the side. Our medical expenses, we've figured out, amounted to more than ten percent of our combined income last year. According to our accountant, anything more than two percent of your total income is deductible. While this past year included fertility expenses that are not a typical year for us, hearing that my eye doc appointments may cut back from four to two a year didn't exactly thrill me. It's still way more than the general population pays to have its eyes checked.
And frankly, eye appointments are just one of a myriad of things. Parking at the hospitals where I get checked out. Gas for those trips. Filling prescriptions. Mileage. The time spent waiting.
Although I passed a milestone on Tuesday that should hopefully keep us from racking up another round of medical bills: babies born after week 35 don't automatically go to the hospital's Neonatal Intensive Care Unit. I hope Baby L. never needs to see the inside of a NICU ever.
But if it does, my kid will be the best-dressed one there.
As a result, I spent yesterday doing some nice things:
1. Got a pedicure so my feet finally are worth baring in public. (The pedicurist took pity on me as I contorted around my belly to take my socks off. It was like running a marathon. She gave me a fancy smoothing serum on my callouses-of-death heels without charging me extra.)
2. Got a prenatal massage that felt terrific. I highly recommend these if you are pregnant and achy. The therapist was sweet, did a hardcore Swedish, and knew her way around the pregnant form. ("God bless you, honey, you weren't kidding when you said your ankles and legs were swollen.")
3. Bought some baby clothes.
That last one actually felt the most indulgent. All along, people have asked if I'm excited, if the Mister is excited, about the baby's arrival. Honestly, excitement isn't the word I'd use. Cautious is much more like it.
"We're taking everything one day at a time," I say. "Knock wood, the baby will be healthy and happy."
The whole religious tradition of not tempting fate, not having any baby showers, heck, being casual about where we registered, has really seeped into my being. The one time I mentioned to Mister Lyrehca, "Oh, it should be a quick 20 minute visit" was the heart rate scan a few weeks back where I was sent to Labor & Delivery for two more hours of fetal heart rate monitoring.
Truly, I'm trying to not take anything for granted.
But I had time to shop a bit yesterday, and was close to some baby apparel stores. So I figured I'd scan the sales racks and see what was there. Besides, as of yesterday, the baby had only two items of clothing, and both were gift onesies that would be too big for a newborn to come home from the hospital in. (Unless the kid comes out of the hospital the size of a three-to-six month old. But I digress).
God, baby clothes are cute.
Two credit card charges later, Baby Lyrehca is set to be a very well-dressed kid. Onesies. T-shirts. Socks. A soft hat. All in colorful shades and hip patterns.
I came home and showed Mister Lyrehca, who typically balks at updating his wardrobe from high school. (He proudly wore a Members Only jacket in recent years despite my taunting him; thankfully, friends of ours also mocked him and he finally got rid of it). Even he thought the items were cute and fun. I'm trying not to think of what it'll be like to have to change these clothes because they're covered with spit up and other bodily fluids. Instead, I'm trying to picture the oohs and ahs Baby L will get for being just so fashionable. So baby-stylish. So great.
But you know I can't just relax. I asked both stores what their return policies were. Just in case.
Also saw my Eye Doc yesterday for a follow-up visit.
Apparently, the part of my eyes could be considered "severe non-proliferative retinopathy" while other parts are plain old "proliferative retinopathy." However, since last October's laser treatments, they've been "quiescent" or "quiet." This means that while there is new blood vessel growth in the back of my eyes leftover from whenever, the laser stopped some of it in its tracks. The laser did not stop all of it, because I only had limited laser treatment. The idea is that the limited laser treatment may stop everything forever from growing, but if it doesn't, I'd need more.
"Why didn't you just laser everything you saw?" I asked.
Because that may have affected your vision, Eye Doc said. The idea is to do as little treatment as possible to minimize vision changes while getting the desired effect of stopping the new blood vessel growth in its tracks. The whole time, I might add, my actual eyesight has remained unchanged (i.e., I see things just fine) and the optometrist who analyzes the vision in the front of my eyes told me yesterday that everything looked "brilliant." (I liked her immediately.)
I was more annoyed at being told I was "proliferative" versus "severe non-proliferative." These are semantics most people don't even understand, and even Eye Doc seemed to think the difference was a casual one, but I said that should I ever actually qualify to get life insurance, the difference in my eye damage might make me uninsurable.
"Actually, you're less likely to have eye problems because you've had the laser," Eye Doc said. "That makes you a better candidate."
That seemed like a glib way to summarize things. Eye Doc, who I used to enjoy chatting with during my visits, and I are becoming a bit less chatty. I still have to go back there in three months for a follow-up, though she tells me I can aspire to have visits every four months, then every five, and then maybe taper them back to twice a year.
Mister Lyrehca and I are are pulling together our tax paperwork and receipts to get things filed before the baby's scheduled arrival. I save every single receipt and itemize whatever I can because I freelance on the side. Our medical expenses, we've figured out, amounted to more than ten percent of our combined income last year. According to our accountant, anything more than two percent of your total income is deductible. While this past year included fertility expenses that are not a typical year for us, hearing that my eye doc appointments may cut back from four to two a year didn't exactly thrill me. It's still way more than the general population pays to have its eyes checked.
And frankly, eye appointments are just one of a myriad of things. Parking at the hospitals where I get checked out. Gas for those trips. Filling prescriptions. Mileage. The time spent waiting.
Although I passed a milestone on Tuesday that should hopefully keep us from racking up another round of medical bills: babies born after week 35 don't automatically go to the hospital's Neonatal Intensive Care Unit. I hope Baby L. never needs to see the inside of a NICU ever.
But if it does, my kid will be the best-dressed one there.
Sunday, March 18, 2007
Week 34: Time's Marching On
Back with the appointments on Friday. Another baby heart rate check, along with visits to Kind Endo and High Risk OB.
All were uneventful, thankfully.
The kid's heart rate ebbed and flowed, but no one blinked when there was another slight drop (around 110 this time) but bounced right up. Kind Endo looked at my meter's blood sugar numbers and declared them "actually quite good." (Although waking up with a 110 and being told it's "high" annoys me. I just think about the women who gave birth pre-pump, pre-Humulog, and pre-blood sugar testing and think, 110 ain't so bad.) I've been amazed myself at how great my blood sugars have been (yesterday's 7-day meter average was 107, for God's sake. Kind Endo told me that the insulin resistance seen during late pregnancy somehow prevents the bouncing highs after meals. Of course, I regularly take more than 100 units of insulin a day, but hey, who's counting? My numbers look great!
High Risk OB's nurse met with me afterward, and we're sort of at the point where I don't have any serious questions, I've gotten used to the odd side effects of pregnancy like insomnia and cankles and left side rib pain (the kid's leg keeps poking me there) and we're just sort of waiting this thing out.
Had lunch with the fabulous Serenity late last week, which was great.
Work's finally slowed to a crawl, so I'm taking the time to clean out years of emails and to compile the list of people we want to announce our baby news to. This, sadly, is taking up a ton of time (the email clearing, not the list compiling).
Going through a year of receipts this weekend to figure out how much to do f0r freelancer tax deductions. Every year I wonder why we don't just do this on some online tax program and every year I think "I need to upgrade my laptop so I can keep these files on my own computer and not on the work-provided laptop Mr. Lyrehca uses at home." But buying a laptop is another round of details I just don't want to get into right now. The same thing with upgrading my six-year-old Minimed 508 pump--too many details to figure out, and since the pump is still essentially working fine (save for the fast clock and the batteries that wear out more frequently than they ever did before), I figure I can wait til after the kid's arrival to upgrade.
Note to anyone: got any suggestions for either a new laptop or a new pump model I should consider? For the laptop, I've been on a PC for years, but like the idea of a Mac if I knew I could transfer files and have software available without any hassles. And for the pump, I like a good solid belt clip (like the 508) and since I still calculate my boluses manually (i.e., I do the math in my head and don't care about the whole Insulin On Board element), I just want something that my insurance will cover, isn't going to break down regularly, and is as easy to use as the 508.
I did meet with pump reps from Minimed and Animas last summer, pre-getting-pregnant, and actually liked the food database on the latest Animas (the 1250, maybe?), but realized the Animas had more buttons to push and got sort of lazy about upgrading, since the IVF cycle took up a lot of brainspace, and I figured, "hey, the 508 still works, why bother upgrading now?"
At the same time, I find Minimed's insistence on using a proprietary reservoir arrogant, and still have plenty of 508 reservoirs that would work in an Animas or Cozmo. I didn't look into the Cozmo because I erroneously thought I'd have to change meters (I use a One Touch Ultra and ain't giving it up) and thought it was bulkier than my current 508.
So let your opinions be known, either for laptop or insulin pump suggestions. It'll help pass the time as I wait for the kid's arrival.
All were uneventful, thankfully.
The kid's heart rate ebbed and flowed, but no one blinked when there was another slight drop (around 110 this time) but bounced right up. Kind Endo looked at my meter's blood sugar numbers and declared them "actually quite good." (Although waking up with a 110 and being told it's "high" annoys me. I just think about the women who gave birth pre-pump, pre-Humulog, and pre-blood sugar testing and think, 110 ain't so bad.) I've been amazed myself at how great my blood sugars have been (yesterday's 7-day meter average was 107, for God's sake. Kind Endo told me that the insulin resistance seen during late pregnancy somehow prevents the bouncing highs after meals. Of course, I regularly take more than 100 units of insulin a day, but hey, who's counting? My numbers look great!
High Risk OB's nurse met with me afterward, and we're sort of at the point where I don't have any serious questions, I've gotten used to the odd side effects of pregnancy like insomnia and cankles and left side rib pain (the kid's leg keeps poking me there) and we're just sort of waiting this thing out.
Had lunch with the fabulous Serenity late last week, which was great.
Work's finally slowed to a crawl, so I'm taking the time to clean out years of emails and to compile the list of people we want to announce our baby news to. This, sadly, is taking up a ton of time (the email clearing, not the list compiling).
Going through a year of receipts this weekend to figure out how much to do f0r freelancer tax deductions. Every year I wonder why we don't just do this on some online tax program and every year I think "I need to upgrade my laptop so I can keep these files on my own computer and not on the work-provided laptop Mr. Lyrehca uses at home." But buying a laptop is another round of details I just don't want to get into right now. The same thing with upgrading my six-year-old Minimed 508 pump--too many details to figure out, and since the pump is still essentially working fine (save for the fast clock and the batteries that wear out more frequently than they ever did before), I figure I can wait til after the kid's arrival to upgrade.
Note to anyone: got any suggestions for either a new laptop or a new pump model I should consider? For the laptop, I've been on a PC for years, but like the idea of a Mac if I knew I could transfer files and have software available without any hassles. And for the pump, I like a good solid belt clip (like the 508) and since I still calculate my boluses manually (i.e., I do the math in my head and don't care about the whole Insulin On Board element), I just want something that my insurance will cover, isn't going to break down regularly, and is as easy to use as the 508.
I did meet with pump reps from Minimed and Animas last summer, pre-getting-pregnant, and actually liked the food database on the latest Animas (the 1250, maybe?), but realized the Animas had more buttons to push and got sort of lazy about upgrading, since the IVF cycle took up a lot of brainspace, and I figured, "hey, the 508 still works, why bother upgrading now?"
At the same time, I find Minimed's insistence on using a proprietary reservoir arrogant, and still have plenty of 508 reservoirs that would work in an Animas or Cozmo. I didn't look into the Cozmo because I erroneously thought I'd have to change meters (I use a One Touch Ultra and ain't giving it up) and thought it was bulkier than my current 508.
So let your opinions be known, either for laptop or insulin pump suggestions. It'll help pass the time as I wait for the kid's arrival.
Wednesday, March 14, 2007
Random Thoughts on Health and Money
Just coming out of a busy work period, my last deadline week before I leave to have the kid.
Even writing that makes me wonder if I'm jinxing myself. What if something happens to the baby and there is no baby? What if the kid comes early and I spend weeks in a NICU?
I started going through all my email at work and home yesterday to figure out who should get the announcement we'll send out when the kid will be born (knock wood, that all goes well). And I thought, I know a lot of people. Mr. L. knows a lot of people. We would have to tell a lot of people some terrible news if there's a problem with the baby.
Since last Friday's events, at first I was surprised by the comments I was getting, saying how calm I was during something I thought was an overreaction on some doctors' parts. But then I thought, "I'm no doctor. What do I know about infant heart rates? Am I too blase for my own good?"
As I explained to the Mister, I'm so used to hearing about health catastrophes and things not working right in my own body that I'm not so worried when I hear about something else. When I was first told I had an avocado-sized tumor growing in my abdomen, my first reaction was, "Oh, I'm sure you're just feeling scar tissue from years of taking shots in my stomach." My current Kind Endo, who first felt something odd during my first visit with her a few years ago, told me later she was scared by what she felt, and was amazed that I seemed to take the news in stride. But here I am, years later, wondering how I'll deal with a problem if there's a problem with Baby L.
Baby L. has continued to kick me on a regular basis, and kicky=active=good in the minds of my docs and the techs who give me ultrasounds weekly. But does active mean the kid will have ADHD? Could the kid become autistic? If I feed the kid a bit of formula because I hear breastfeeding is tough, despite my intention to breastfeed the kid as much as I can because it's supposed to be healthier, will that doom the kid to developing type 1 or type 2 down the road?
And again, will the kid be as large as the last reading said it would be, and will that be OK?
Besides the general fear about the kid's happiness and health, I look around and think, I'm supposed to get all this done before April 9? Still reorganizing after the painters left last week, still trying to figure out what bedding to buy for the crib, what to do about cord blood banking (important for the kid's future health needs, or an untested, unproven, expensive waste of time?), and wondering if the current insomnia I have (only got up at 5am today, so things are getting a bit better) will be welcome in a few weeks when I'm up hearing someone scream and cry and moan (and no, not Mister L, though it very easily could be) and I can't figure out how to calm the yeller down.
And unrelated, yesterday I talked to a coworker about a new project she's launching at work. She wanted feedback on how the people in my department would play into her project, and I instinctively thought, "Oh, I could totally do that work freelance from home." I told her as such, but knew to say, "Listen, let me get back in touch with you after my maternity leave is up and maybe we can work something out." She just came back to work after a year off having twins, and has had some good insight about being a new mom and not going back to work and the financial element of that, and dealing with putting your kids in day care and returning to work for both personal and financial reasons. But as always, my instinct was to get excited about a new work project and think about how I might make extra cash doing it. And yet, I know the deadline hours and long commute make me think I'd be crazy to try to return to work full time, but being there full time makes me privy to new assignments and inside scoop. I always wonder about how my new role as a mom is going to interact with my longtime role as an employee and freelancer always looking for new work and income streams.
Even writing that makes me wonder if I'm jinxing myself. What if something happens to the baby and there is no baby? What if the kid comes early and I spend weeks in a NICU?
I started going through all my email at work and home yesterday to figure out who should get the announcement we'll send out when the kid will be born (knock wood, that all goes well). And I thought, I know a lot of people. Mr. L. knows a lot of people. We would have to tell a lot of people some terrible news if there's a problem with the baby.
Since last Friday's events, at first I was surprised by the comments I was getting, saying how calm I was during something I thought was an overreaction on some doctors' parts. But then I thought, "I'm no doctor. What do I know about infant heart rates? Am I too blase for my own good?"
As I explained to the Mister, I'm so used to hearing about health catastrophes and things not working right in my own body that I'm not so worried when I hear about something else. When I was first told I had an avocado-sized tumor growing in my abdomen, my first reaction was, "Oh, I'm sure you're just feeling scar tissue from years of taking shots in my stomach." My current Kind Endo, who first felt something odd during my first visit with her a few years ago, told me later she was scared by what she felt, and was amazed that I seemed to take the news in stride. But here I am, years later, wondering how I'll deal with a problem if there's a problem with Baby L.
Baby L. has continued to kick me on a regular basis, and kicky=active=good in the minds of my docs and the techs who give me ultrasounds weekly. But does active mean the kid will have ADHD? Could the kid become autistic? If I feed the kid a bit of formula because I hear breastfeeding is tough, despite my intention to breastfeed the kid as much as I can because it's supposed to be healthier, will that doom the kid to developing type 1 or type 2 down the road?
And again, will the kid be as large as the last reading said it would be, and will that be OK?
Besides the general fear about the kid's happiness and health, I look around and think, I'm supposed to get all this done before April 9? Still reorganizing after the painters left last week, still trying to figure out what bedding to buy for the crib, what to do about cord blood banking (important for the kid's future health needs, or an untested, unproven, expensive waste of time?), and wondering if the current insomnia I have (only got up at 5am today, so things are getting a bit better) will be welcome in a few weeks when I'm up hearing someone scream and cry and moan (and no, not Mister L, though it very easily could be) and I can't figure out how to calm the yeller down.
And unrelated, yesterday I talked to a coworker about a new project she's launching at work. She wanted feedback on how the people in my department would play into her project, and I instinctively thought, "Oh, I could totally do that work freelance from home." I told her as such, but knew to say, "Listen, let me get back in touch with you after my maternity leave is up and maybe we can work something out." She just came back to work after a year off having twins, and has had some good insight about being a new mom and not going back to work and the financial element of that, and dealing with putting your kids in day care and returning to work for both personal and financial reasons. But as always, my instinct was to get excited about a new work project and think about how I might make extra cash doing it. And yet, I know the deadline hours and long commute make me think I'd be crazy to try to return to work full time, but being there full time makes me privy to new assignments and inside scoop. I always wonder about how my new role as a mom is going to interact with my longtime role as an employee and freelancer always looking for new work and income streams.
Sunday, March 11, 2007
Weeks 33.5 Update
A lot and yet not a lot has happened in the last week and a half.
Had another ATU (monitoring) appointment on Friday, where I go to the hospital and the kid is checked out for a heartbeat, amniotic fluid update, and that sort of thing. A bio-physical profile.
I'd thought this would be a quick-ish visit, as the last two I've had have been. Mr. L. didn't come with me to this appointment (and I'm now having them weekly). I was hooked up to a machine that checked the kid's heart rate and lay back for 20 minutes, watching the monitor as I'd forgotten to bring something to read (and the tech seemed to "forget" that I requested a magazine from the waiting room to tide me over.)
The kid's heartrate started out in the 140s, bounced up to the 150s, and I even saw 170 here and there. "These are all normal," Tech said before she left the room.
At one point, I'd started to doze off, and noticed the kid's heart rate dropped some. 115. 98. 110. Maybe the kid is dozing off, too, I thought. The numbers jumped back up to the 140 range again.
Thirty-five minutes later, I'm wondering why no one has come in to disconnect me after twenty minutes. Since I'm wearing a monitor strapped to my belly that's connected to the machine, I can't really get up myself.
I didn't see a call button anywhere, nor did I remember the number of the main ATU office. I saw a phone, and reached over as best I could to grab it. I called my OB's assistant, who is in the same hospital in a different office, and who made all the ATU appointments for me.
"Hi, it's (Lyrehca) calling from the ATU unit," I told Assistant. "I'm here alone and I've been in a room for almost 40 minutes and they seem to have forgotten about me. Would you call the office and let them know?"
"Oh my God, I'll call them right now," she said.
I watched the clock, and thought, "if no one comes in in five minutes, I'll just disconnect myself from the machine. The heartrate numbers have been printing out on a sheet of paper, so it's not like I'll lose data if I disconnect myself."
Three minutes later, a different tech walked in.
"I thought you forgot about me," I told her.
"We didn't forget about you," she said. "We're down the hall watching your numbers and sometimes we get backed up with other patients."
"OK," I said. "Can I get back to work now?" This Friday was nearing the end of my deadline week and while I went into work early that day to get some stuff done before the 10am appointment, I wanted to get back.
"Oh, no, you're not going to work," she said. "The baby had a deceleration and we need to send you to Labor and Delivery for a few hours."
"What?"
Apparently, the drop in the baby's heart rate, down to 98, is called a deceleration. It means that the kid's heart rate slowed down, and while it could mean something relatively harmless that the kid swam over and touched its own umbilical cord, it could also mean there was some other reason that was less than harmless. They wanted to watch me for a longer period of time in a bed in Labor and Delivery, where they had more beds, and that if they saw something distressing, they could delivery the baby early if they had to.
Um, huh?
"Are you kidding me? I might have to have the baby today?"
"It's possible, but it's also possible this is just a one-time thing. But we need to monitor you more closely to see if more decels are occuring."
I was a bit annoyed with this tech's matter of factness about this totally unexpected thing. I honestly felt like I was missing something.
"I don't even know where Labor and Delivery is. And does my OB know?"
"We just got off the phone with her. She's the one who is sending you there. It's on the tenth floor."
So I pulled out my cell and called both the OB and Mr. Lyrecha. The OB's assistant said she'd get the OB to call me right back, and called the Mister. He was alarmed.
"Should I come down to the hospital? Are you OK? Is the baby OK? What's happening?"
"Everything is fine," I said. "I'm just going to go to the Labor and Delivery floor and get checked out for another two hours or so. I feel fine, the baby is kicking a lot, and I will call you every hour with an update," I promised.
The the OB called me back, and explained that since I'm getting all this testing (weekly), that it's not uncommon to see something like this and that it could just be a one-time thing, but since I'm there, it was important to get further monitored for a few more hours. I mentioned my surprise again about expecting to just go back to work.
"You can return to work if you really want to, but you really should get checked out just to see what is going on."
So after I called my boss and told her what was going on (and she was very cool about saying "What can I do to make things move smoothly while you're out?" which I plan to say if I'm ever in a similar situation but reversed), I made my way up to the Labor and Delivery floor, where I'd never been before. (We have a hospital tour skedded in a few weeks). I was checked in, given a bracelet ("Are you admitting me?" I asked. "Not just yet, but this is standard procedure," I was told. "Do you have a pediatrician," I was asked. The Mister and I had just decided which of the two we interviewed we'll go with, so I gave that doc's name and practice. No idea what her phone number is.)
A nice calm nurse with curly blond hair came into the lobby to get me. Labor and Delivery has heavy locked doors and you have to be approved to even get past them. This reassured me for security reasons.
"I'm a little surprised I'm here," I told Calm Nurse. "I thought I'd be here for a quick 20 minute visit downstairs.
Calm Nurse repeated a lot of what I'd already heard, and led me to a hospital bed in the Recovery area. As in, the woman in the bed next to me had had a c-section that morning and was the proud mom of a new son.
I gave a urine sample, asked if I had to wear a Johnnie (thankfully, no), and got strapped to another heart rate machine. Calm Nurse told me she'd stay with me for a bit as she asked me medical history questions. Tonsils out? Yep. Wisdom teeth pulled? Yep, two. A few surgeries here and there, yes. Diabetes for 29 years, check. "Oh, you're type 1," she said. Oh yeah.
"But so far, the pregnancy's been uneventful, except for swollen ankles," I said. (My blood pressure both in the ATU and in L&D was normal, so still no sign of danger with the cankles.)
Calm Nurse was able to get me a stack of magazines to read (the new Marie Claire, nice) and when I tested my blood sugar and found it a bit low, she brought me some graham crackers and peanut butter and a nice big glass of ice water. It was just what I needed.
"It's like a restaurant here," I said. "A bit more like camping," she said, showing me a styrofoam cup filled with a scoop of peanut butter and a plastic spoon. I had two of the four packs graham crackers (20 grams of carbs) with a bit of peanut butter to treat a 64. A half hour later, when the 64 hadn't budged, I ate two more packs of grahams and left the unit around 120, which is a bit higher than I wanted to be, but at least out of a lowish zone.
And I alternated between skimming Marie Claire and keeping an eye on the monitor. Again, 150s and 160s on the heart rate. A jump up to 200 or so when I hoisted myself up to eat the graham crackers. Whenever I moved, the monitor would move slightly and sometimes it lost contact with the baby's heart rate for a few seconds. Always, a green, yellow or red light would indicate how strong a signal the machine would get from the baby. If the baby swam out of the way, it would lose contact with the machine and the numbers would disappear from the screen. This happened at one point and the number than came back was a 94. Oy.
After about an hour, the Calm Nurse came back and said she didn't see anything that was worrisome to her, and that the OB on call, who was in touch with my own OB, said I was free to go.
What about the 200 and the 94 reading?
"The 200, like the 94, was momentary, and likely happened when you reached for the food," she said. "This baby likes graham crackers and peanut butter. It was very active while you were eating."
"Good," I said. "I plan to eat a lot of both of them in my time." (I eat peanut butter every day for breakfast, and will miss it if I have to avoid giving it to the kid while breastfeeding. Not sure how that will play out.)
The 94 was accompanied by a time on the monitor where the numbers stopped recording for a few seconds, and the nurse told me she thought it was just because the baby had been moving around. A more gradual and longer drop in the heart rate would have indicated a more serious problem, but there was no sign of that.
I called Mr. L. and reported things. He was nervous, he told me. "The nurse I have here is very reassuring," I promised. "Do you want to talk to her?"
He declined, but continued to ask questions. After I hung up, Calm Nurse told me it was sweet he was asking so many questions. "He sounds like a great guy," she said. "He is," I said.
"You're free to go," she said again, and since I felt fine and the baby felt fine, I said I was going back to work. And after a lunch at the hospital and calling my mother (since Mr. L told me he'd told his sister about what happened, who then told her mother, which annoyed me, but I figured I'd need to let my mother know since we're nothing but not a worrisome bunch).
By then, I was calm and feeling like there was a lot of excitement over something that turned out to be nothing unusual. I can understand wanting to be safe rather than sorry, but honestly, how often do these decelerations happen in a non-diabetic pregnancy?
While that was probably the biggest news of the past week and a half, the previous week's ATU visit showed that the kid, at 32 weeks, was measuring about two weeks ahead, at around a 73 percentile. I was alarmed, since the kid had been closer to a 60th percentile four weeks before and wasn't quite so ahead.
"Is this because of the diabetes," I asked. "Am I dooming the kid to having a large abdomen and a lifetime of type 2 itself?"
I was reassured that a two-week ahead gain was considered normal, and if the kid was measuring ten weeks ahead at week 30, that was something to be more concerned about. Besides, the Mister and I are both tall, and as much as I hate it, we both have our share of abdomnal fat. The Mister is definitely apple-shaped, and the only time I've had a flat stomach was when I was five, prediagnosis with type 1. Still, it annoys me that the kid is measuring a few weeks ahead on a growth chart.
And in completely other yet still-baby-related news, we had several rooms in our house painted over the last week. This meant that I moved out to my parents' place for a week, which I must admit was a much closer commute to work, calmer (the phone never rang for me, I had a bathroom and bedroom all to myself, and would read a lot at night instead of dealing with the TV, the Mister's favorite leisuretime activity), and sort of mellow. While I saw the Mister on the weekend when we all went out for dinner, and talked to him several times a day, it was a bit like being on a working vacation.
Now I'm back home and while we have some great colors in a number of rooms now, we still need to put all the paraphernalia like bills and papers and tchotckes all back where they belong. Not quite as restful as it was being at my parents place.
And to top things off, some late-assigned freelance work means I need to do work (from home, but still work) later on today to get it all done by Monday. This is likely the last bit of freelance I'll take on for awhile, as I'd like to chill as much as possible at home before the kid's arrival. Decluttering papers on my own time, despite the lack of payment for it, is more appealing than freelance work. It's like the calm before the impending storm.
Oh, nearly forgot, but Scott at Scott's Web Log had tagged me for a meme about seven things. I've got a bit of Meme Fatigue, and frankly barely have time to post updates like this as it is. So while I'm always honored when someone cites me on their blog, forgive me for passing on it right now.
Had another ATU (monitoring) appointment on Friday, where I go to the hospital and the kid is checked out for a heartbeat, amniotic fluid update, and that sort of thing. A bio-physical profile.
I'd thought this would be a quick-ish visit, as the last two I've had have been. Mr. L. didn't come with me to this appointment (and I'm now having them weekly). I was hooked up to a machine that checked the kid's heart rate and lay back for 20 minutes, watching the monitor as I'd forgotten to bring something to read (and the tech seemed to "forget" that I requested a magazine from the waiting room to tide me over.)
The kid's heartrate started out in the 140s, bounced up to the 150s, and I even saw 170 here and there. "These are all normal," Tech said before she left the room.
At one point, I'd started to doze off, and noticed the kid's heart rate dropped some. 115. 98. 110. Maybe the kid is dozing off, too, I thought. The numbers jumped back up to the 140 range again.
Thirty-five minutes later, I'm wondering why no one has come in to disconnect me after twenty minutes. Since I'm wearing a monitor strapped to my belly that's connected to the machine, I can't really get up myself.
I didn't see a call button anywhere, nor did I remember the number of the main ATU office. I saw a phone, and reached over as best I could to grab it. I called my OB's assistant, who is in the same hospital in a different office, and who made all the ATU appointments for me.
"Hi, it's (Lyrehca) calling from the ATU unit," I told Assistant. "I'm here alone and I've been in a room for almost 40 minutes and they seem to have forgotten about me. Would you call the office and let them know?"
"Oh my God, I'll call them right now," she said.
I watched the clock, and thought, "if no one comes in in five minutes, I'll just disconnect myself from the machine. The heartrate numbers have been printing out on a sheet of paper, so it's not like I'll lose data if I disconnect myself."
Three minutes later, a different tech walked in.
"I thought you forgot about me," I told her.
"We didn't forget about you," she said. "We're down the hall watching your numbers and sometimes we get backed up with other patients."
"OK," I said. "Can I get back to work now?" This Friday was nearing the end of my deadline week and while I went into work early that day to get some stuff done before the 10am appointment, I wanted to get back.
"Oh, no, you're not going to work," she said. "The baby had a deceleration and we need to send you to Labor and Delivery for a few hours."
"What?"
Apparently, the drop in the baby's heart rate, down to 98, is called a deceleration. It means that the kid's heart rate slowed down, and while it could mean something relatively harmless that the kid swam over and touched its own umbilical cord, it could also mean there was some other reason that was less than harmless. They wanted to watch me for a longer period of time in a bed in Labor and Delivery, where they had more beds, and that if they saw something distressing, they could delivery the baby early if they had to.
Um, huh?
"Are you kidding me? I might have to have the baby today?"
"It's possible, but it's also possible this is just a one-time thing. But we need to monitor you more closely to see if more decels are occuring."
I was a bit annoyed with this tech's matter of factness about this totally unexpected thing. I honestly felt like I was missing something.
"I don't even know where Labor and Delivery is. And does my OB know?"
"We just got off the phone with her. She's the one who is sending you there. It's on the tenth floor."
So I pulled out my cell and called both the OB and Mr. Lyrecha. The OB's assistant said she'd get the OB to call me right back, and called the Mister. He was alarmed.
"Should I come down to the hospital? Are you OK? Is the baby OK? What's happening?"
"Everything is fine," I said. "I'm just going to go to the Labor and Delivery floor and get checked out for another two hours or so. I feel fine, the baby is kicking a lot, and I will call you every hour with an update," I promised.
The the OB called me back, and explained that since I'm getting all this testing (weekly), that it's not uncommon to see something like this and that it could just be a one-time thing, but since I'm there, it was important to get further monitored for a few more hours. I mentioned my surprise again about expecting to just go back to work.
"You can return to work if you really want to, but you really should get checked out just to see what is going on."
So after I called my boss and told her what was going on (and she was very cool about saying "What can I do to make things move smoothly while you're out?" which I plan to say if I'm ever in a similar situation but reversed), I made my way up to the Labor and Delivery floor, where I'd never been before. (We have a hospital tour skedded in a few weeks). I was checked in, given a bracelet ("Are you admitting me?" I asked. "Not just yet, but this is standard procedure," I was told. "Do you have a pediatrician," I was asked. The Mister and I had just decided which of the two we interviewed we'll go with, so I gave that doc's name and practice. No idea what her phone number is.)
A nice calm nurse with curly blond hair came into the lobby to get me. Labor and Delivery has heavy locked doors and you have to be approved to even get past them. This reassured me for security reasons.
"I'm a little surprised I'm here," I told Calm Nurse. "I thought I'd be here for a quick 20 minute visit downstairs.
Calm Nurse repeated a lot of what I'd already heard, and led me to a hospital bed in the Recovery area. As in, the woman in the bed next to me had had a c-section that morning and was the proud mom of a new son.
I gave a urine sample, asked if I had to wear a Johnnie (thankfully, no), and got strapped to another heart rate machine. Calm Nurse told me she'd stay with me for a bit as she asked me medical history questions. Tonsils out? Yep. Wisdom teeth pulled? Yep, two. A few surgeries here and there, yes. Diabetes for 29 years, check. "Oh, you're type 1," she said. Oh yeah.
"But so far, the pregnancy's been uneventful, except for swollen ankles," I said. (My blood pressure both in the ATU and in L&D was normal, so still no sign of danger with the cankles.)
Calm Nurse was able to get me a stack of magazines to read (the new Marie Claire, nice) and when I tested my blood sugar and found it a bit low, she brought me some graham crackers and peanut butter and a nice big glass of ice water. It was just what I needed.
"It's like a restaurant here," I said. "A bit more like camping," she said, showing me a styrofoam cup filled with a scoop of peanut butter and a plastic spoon. I had two of the four packs graham crackers (20 grams of carbs) with a bit of peanut butter to treat a 64. A half hour later, when the 64 hadn't budged, I ate two more packs of grahams and left the unit around 120, which is a bit higher than I wanted to be, but at least out of a lowish zone.
And I alternated between skimming Marie Claire and keeping an eye on the monitor. Again, 150s and 160s on the heart rate. A jump up to 200 or so when I hoisted myself up to eat the graham crackers. Whenever I moved, the monitor would move slightly and sometimes it lost contact with the baby's heart rate for a few seconds. Always, a green, yellow or red light would indicate how strong a signal the machine would get from the baby. If the baby swam out of the way, it would lose contact with the machine and the numbers would disappear from the screen. This happened at one point and the number than came back was a 94. Oy.
After about an hour, the Calm Nurse came back and said she didn't see anything that was worrisome to her, and that the OB on call, who was in touch with my own OB, said I was free to go.
What about the 200 and the 94 reading?
"The 200, like the 94, was momentary, and likely happened when you reached for the food," she said. "This baby likes graham crackers and peanut butter. It was very active while you were eating."
"Good," I said. "I plan to eat a lot of both of them in my time." (I eat peanut butter every day for breakfast, and will miss it if I have to avoid giving it to the kid while breastfeeding. Not sure how that will play out.)
The 94 was accompanied by a time on the monitor where the numbers stopped recording for a few seconds, and the nurse told me she thought it was just because the baby had been moving around. A more gradual and longer drop in the heart rate would have indicated a more serious problem, but there was no sign of that.
I called Mr. L. and reported things. He was nervous, he told me. "The nurse I have here is very reassuring," I promised. "Do you want to talk to her?"
He declined, but continued to ask questions. After I hung up, Calm Nurse told me it was sweet he was asking so many questions. "He sounds like a great guy," she said. "He is," I said.
"You're free to go," she said again, and since I felt fine and the baby felt fine, I said I was going back to work. And after a lunch at the hospital and calling my mother (since Mr. L told me he'd told his sister about what happened, who then told her mother, which annoyed me, but I figured I'd need to let my mother know since we're nothing but not a worrisome bunch).
By then, I was calm and feeling like there was a lot of excitement over something that turned out to be nothing unusual. I can understand wanting to be safe rather than sorry, but honestly, how often do these decelerations happen in a non-diabetic pregnancy?
While that was probably the biggest news of the past week and a half, the previous week's ATU visit showed that the kid, at 32 weeks, was measuring about two weeks ahead, at around a 73 percentile. I was alarmed, since the kid had been closer to a 60th percentile four weeks before and wasn't quite so ahead.
"Is this because of the diabetes," I asked. "Am I dooming the kid to having a large abdomen and a lifetime of type 2 itself?"
I was reassured that a two-week ahead gain was considered normal, and if the kid was measuring ten weeks ahead at week 30, that was something to be more concerned about. Besides, the Mister and I are both tall, and as much as I hate it, we both have our share of abdomnal fat. The Mister is definitely apple-shaped, and the only time I've had a flat stomach was when I was five, prediagnosis with type 1. Still, it annoys me that the kid is measuring a few weeks ahead on a growth chart.
And in completely other yet still-baby-related news, we had several rooms in our house painted over the last week. This meant that I moved out to my parents' place for a week, which I must admit was a much closer commute to work, calmer (the phone never rang for me, I had a bathroom and bedroom all to myself, and would read a lot at night instead of dealing with the TV, the Mister's favorite leisuretime activity), and sort of mellow. While I saw the Mister on the weekend when we all went out for dinner, and talked to him several times a day, it was a bit like being on a working vacation.
Now I'm back home and while we have some great colors in a number of rooms now, we still need to put all the paraphernalia like bills and papers and tchotckes all back where they belong. Not quite as restful as it was being at my parents place.
And to top things off, some late-assigned freelance work means I need to do work (from home, but still work) later on today to get it all done by Monday. This is likely the last bit of freelance I'll take on for awhile, as I'd like to chill as much as possible at home before the kid's arrival. Decluttering papers on my own time, despite the lack of payment for it, is more appealing than freelance work. It's like the calm before the impending storm.
Oh, nearly forgot, but Scott at Scott's Web Log had tagged me for a meme about seven things. I've got a bit of Meme Fatigue, and frankly barely have time to post updates like this as it is. So while I'm always honored when someone cites me on their blog, forgive me for passing on it right now.
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