Week 37: Is This It?

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!

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.

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.

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!

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.

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.

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!

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.

The Fan Page Is Live/Hello, Low

Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby now has a fan page on Facebook.

Become a fan, won't you?

In other news, I'm on to the stim part of IVF, where I inject a drug that amps up the follicles on my ovaries to create some good eggs. I've gone for two blood and ultrasounds already, and things are progressing as they should, IVF-wise.

WTF? I just tested and my blood sugar is 41. This is after drinking two juice boxes because I felt a little off and noticed my CGM said I was 85.

Great.

This is where I want to eat the entire bag of goldfish that we buy in bulk for our kid.

But from past experience, those little golden cheesy fish taste OK going down but they will send me soaring into the 300s a few hours from now. And the irony is that I don't even like goldfish all that much.

My mom just bought me a bunch of holiday-themed Lifesavers in packs that went on sale immediately after Christmas. I haven't used Lifesavers to treat insulin reactions in awhile but since I have a fistful handy, I'm now chowing a bunch down.

I can't remember a recent post when I've blogged while low, so hopefully this will be intelligible later on after I've posted it.

But yes, back to the fan page. If you're on Facebook these days, do become a fan. For no other reason than to make me happy when I check to see who supports my book and my efforts to illuminate the world about what it takes to do pregnancy with type 1 or type 2 diabetes.

I just thought about that Flo Rida song Low and now wonder if that guy has diabetes. One of the lyrics in the song talks about "Shorty got low, low, low, low, low, low, low." I always thought he was talking about some illicit sexual activity on the floor of some dance club, but now I see clearly how it can apply to an insulin reaction. Get Shorty some Lifesavers! Or a juice box!

(See the brilliance that comes out when my blood sugar plummets?)

Now my CGM is merely reporting a LOW with an arrow pointing right, rather than straight down.

What I've consumed to treat this low:

--Two Fruitables fruit/vegatable juice boxes, 20 grams of carb.

--One handful of goldfish, no idea of the carb count since it comes from giant bag of the stuff we bought at a local warehouse club and I'm not in the mood to figure out how many carbs are in the handful.

--An entire roll of LifeSavers, approximately 11 candies, about 34 grams of carb.

This is way more than the recommended 15 grams of carb you're supposed to take when you first flirt with the low end of normal, which in my pre-pregnancy state is anywhere under 100 or so before bedtime.

Lemme test again....Ah, 66. On the way back up.

And I'm starting to feel somewhat normal again.

My CGM, on the other hand, just alerted me that I am LOW! BUZZ! BUZZ! VIBRATE!

Thanks for sharing.

Now I'll wonder if I'll go super high in an hour from that handful of pesky goldfish. Should I take a small hit of insulin now to counteract the extra carb? Even though I still don't feel quite right. I mean, am I going low again despite all the food?

Now my meter tells me I am 93.

The CGM? Still holding steady at 60.

Technology: why can't it be accurate? I'm only relying on all this stuff to KEEP. ME. ALIVE.

OK, the CGM is noting an upward trend of 91.

Off to bed. I'll hold off on the extra insulin for now.

(Though I just Googled it, and it doesn't appear, on first glance, that the rapper Flo Rida has diabetes. HOWEVER, he has some other song out called Sugar.)

Coincidence?

At What Cost?

My period's gonna come any day now, and that's when I start taking the drug that amps up my ovaries.

Until then, I almost feel like IVF hasn't really kicked off yet.

Oh, but it has.

I've been on the Lupron for about five nights now. As I've mentioned before, it's like injecting ten units of insulin. Been there, done that. I even need to time it to a certain hour or so each night, but other than that, I've sort of forgotten about it the rest of the day.

We have a stack of papers that I'm supposed to sign, along with Mister L., and send them off to our IVF clinic. In the past, I've been super on top of this and had everything in like a model patient.

This time, I've gotta go track down a notary to watch the Mister and I sign these things. My nurse tells me to get the paperwork in by the egg retrieval, which I know is more than a week away. (I'm too lazy to go and figure out what my estimated egg retrieval is right now, but I know I've got time).

I also wrote out another check to my secondary insurance plan--the one that pays for a majority of the infertility stuff since our primary insurance covers little. It may have been the Lupron working its hormonal magic, but seeing myself write out the amount of the check made me tear up.

Every other month, since last spring, I've written this check without a problem. Just like every other medical expense, I've told Mister L, it's been matter of fact.

Hundreds and hundreds of dollars in out-of-pocket expenses for diabetes medical supplies, doctor copayments and co-insurance until we hit the "catastrophic out of pocket maximum" our insurance says is the limit before they cover everything else? An amount we hit by April or so each year?

"It's just the way it is," I've told Mister L. Other people pay for their kids' braces, or their rehab stints, or their own health or money issues that may not be chronic like mine, but I know they're coming for everyone one day or another. We pay for health insurance and its assorted coverage for various medical expenses. (We also fund our retirement accounts as much as we can each year. Because although we may be poor by the time we actually make it to retirement age, fuck, yeah! we plan to live that long and enjoy life with whatever our dollars will buy by then.)

However, this week it hit me exactly how much I have paid for this secondary insurance. Along with other out-of-pocket things (parking at the doc's places, acupuncture before and after an embryo transfer, who-the-fuck-knows how much on juice boxes and sugary snacks and other crap to treat who-knows-how-many-insulin-reactions to keep my blood sugars in a tight range for pregnancy or potential pregnancy).

It struck me that all the money that's paid out for diabetes has a result: I am alive. My blood sugars are reasonable enough to get pregnant without worry. My eyes haven't fired up (too many) extra blood vessels and so my retinopathy isn't angry and my eye doctor and endocrinologist are fairly happy with me. Those dollars, to me, have been well spent.

The money for infertility insurance coverage, for genetic testing to figure out exactly what embryos will be viable, the acupuncture, for extra child care so I don't subject other people at the IVF clinic to my toddler running around in the waiting room, and more?

Gone with the wind, baby.

The Mister and I have heated discussions about expenses and where we can cut back and how I can bring in more freelance income. We've spent thousands. My bank account flirts with minimum balances.

So far, it's all been for nothing.

We spent a ton out-of-pocket to conceive our first child, and while it took more than a year from first-fertility-doc-appointment to Welcome-Baby-L!, there finally was an end. From today's vantage point, it was easily the best money we ever spent.

But here, in the midst of my third time trying to do all this again for a second kid, I worry that it might not end so well. Or maybe it will... but we'll have little to no money if and when we ever get there.

That (*&^* Sensor...

So I went all rebel with the new Dexcom sensor and used it for nine days instead of the company-recommended seven days. In part this was because I'd heard the sensors last longer than the company says it will, and in part because I was freaked out about putting a new sensor again.

Yesterday, my meter told me I was one reading while the Dexcom's reading was about seventy points lower. I figured it was time to (wo)man up and insert a new sensor.

So I gathered the new sensor, an alcohol swab, and the detailed directions that come from the manufacturer. I washed my hands. I read everything over.

And then I started to sweat.

I mean, this is a company I've never dealt with before, so all the terminology is new to me. Plus, I've been manually inserting my Silhouette infusion sets for nine years with my insulin pump. You'd think I'd be comfortable with something new to inject.

But the Dexcom inserter is this big plastic thing with "collars" and "pods". I can't just manually insert it; I have to push on this handle and because I typically do things slowly, I can feel the needle pierce my skin. There are plastic parts that are supposed to break off and then the part that actually sends information to the piece of technology that tells you what your sugars are is something separate that snaps into the part that's just pierced your skin.

I mean, it's a whole new way of doing things for me.

And yesterday afternoon, I was just scared of getting everything inserted properly.

So I swabbed my abdomen, choosing this time to pick the flabbiest part so that perhaps the sting would be cushioned. (Fat is definitely your friend when injecting or inserting something, I've learned). I scrutinized the directions.

I pushed the plunger to inject myself.

It hurt, but not quite as much as it did last week.

Then, oy, WTF. You have to break away all this extra plastic so that the sensor is lying flat against your skin. And when I looked down, part of the sensor wasn't lying flat against my skin. I can't even tell you what it's official name is, but when I saw it, I was like, "Great. I just wasted a brand new sensor."

I called the tech support number for Dexcom and quickly got a nice woman on the phone who assured me that everything was fine as I'd done it. I just needed to slide the transmitter into the part that was on skin. That took another five minutes of anguish when I seriously couldn't figure out why the transmitter was so effing hard to snap into place.

I thanked the woman and apologized for my angst, but seriously, is it this hard for everyone else when they first started injecting these sensors?

Juicy Eyes

When you tell most people your eyes need to be lasered, they think it's cool.

"I always wanted to try LASIK," they say.

Of course you did.

But that's not the treatment I'm getting.

On the same day I found out about my book deal, my eye doctor told me she thought the blood vessels in my left eye were looking a little juicy.

And that's not what someone with retinopathy wants to hear.

I tried not to think about this. I made an appointment for two weeks later when I could go back to the eye clinic (with the lame waiting rooms) and instead concentrated on the good things. The book excitement. Life. My happy son, Baby L. My supportive husband, Mister L. The tasty celebratory dinners out to celebrate the book news. (Mister L asked if I sold the book so I could get free meals from friends and family. Now that you mention it...)

But then the follow-up eye appointment arrived this past week.

This was my third laser experience. Lasering the leaking blood vessels that have developed in the back of my eyes after years of living with type 1 diabetes.

The first time, I cried in anticipation. I emailed bloggers and other diabetic friends asking about potential vision loss. I pondered. I worried.

The first time wasn't pleasant. But I made it through without any noticeable vision loss.

The second time, on my other eye, was tolerable. And again, I made it through.

This time, the Mister took a day off from work and came with me.

I've had so many eye doctor visits that they've become routine. Front of the eye optometry check: read letters on the wall. No wavy lines on the grid. Read tiny print in front of me. Maybe check my eyesight with different lenses and I'll tell you if it;s clearer with lens one or two. Squirt a few numbing drops in my eye. Watch the blue light come right up close to me and tell me the pressure in my eyes is below glaucoma level. Go sit in the waiting room for a half hour and watch things get blurry and my pupils dilate. And then I go see my Eye Doc and she looks deeply in my eyes and (usually) tells me everything looks fine

But this time, after all the front-of-the-eye acrobatics with lenses and wall letters, I went into a room and sat in front of yet another eye apparatus. The chin rest had paper to keep things sanitary.

I signed away a waiver explaining that I understood the risks of the procedure. Because only my left eye was getting treatment, I could see clearly out of my right eye and hadn't had any drops put in. I corrected three typos in the waiver form and noted them next to my signature.

Mister L. told the eye doctor I typically charged for my proofreading services but that these typos were on me.

Unlike the first two times I had laser, I don't remember any zaps during the procedure. Instead, the eye doc pushed a cold contact lens into my eye to keep it open. (Numbing drops made this experience awesome; as in, I didn't feel a thing). She shined bright light directly in my left eye many times. I occasionally felt eye strain, and told her so, but there was no real pain. (I'd taken two Tylenol before it started, just to make sure).

I keep thinking of a good word to describe this, but the best I can come up with is "unpleasant." Repeatedly, the eye doc told me to keep my chin down and my forehead pushed against the edge of the eye machine so she could get to the area she needed to get to. "You're doing great," she said repeatedly. "Excellent," she'd add.

I've noted in the past that my eye doc was a strictly-the-facts-ma'am kind of gal, but I really appreciated the praise. It made me think she realized how unpleasant this whole experience is.

Finally it was over. My forehead was sweaty and I now realize that the machine should have forehead paper along with the chin paper.

I noted immediately a pink tinge around my left eye, which went away soon after, but no peripheral vision loss. Eye Doc confirmed that if I didn't notice anything right now, I wouldn't notice anything else from this treatment from now on.

However, being the way she is, and heck, the way just about all doctors are, she couldn't tell my why the retinopathy had flared up again now. Was it because I pick up my 30-pound son all the time? Is it because I started running last year? She had no answers.

She did say that as a rule, she tells her patients with retinopathy not to do anything jarring. Or to lift up anything heavier than 15 pounds.

And as someone who has no intention to stop lifting my son, or pushing weights, or running because it makes me feel good and regulates my blood sugars, because there's been no published study that tells me to stop, I am respectfully ignoring her advice.

Driving a few days later, I noticed that when I waggled my fingers in the top peripheral part of my vision, I could see a tad more on my right side than my left, but the distinction is miniscule and my regular central vision is fine. I can drive without glasses. I can read without glasses. I can see at night without squinting.

I could get all riled up and emotional about having to go through all this. Having to sit in doctors' offices and wait in their waiting rooms and make small talk and sweat on machines and worry and have to take time off from working and all that.

But I don't.

After three decades with this disease, my vision--the vision that I use everyday with eyeballs that are now scarred with laser burns--is good. I can read and write and blog and surf the Internet. I'm writing a book--fulfilling one of my life's goals. I can and see the smiling faces of my family and the funny things my husband does and watch my son as he runs around and picks up lint from the floor and says "Yuck!" and swings at the playground and smiles and squeals with delight about going higher and faster.

I figure it's all a small price to pay.

Lame Waiting Rooms

Doctor's office waiting rooms—why aren’t they more customer friendly?

I see some of the best doctors in my area. They’re renowned for what they do.

So why are the waiting areas so ghetto?

Right now, I’m in a waiting room where people wait for their eyes to be dilated (yep, another retinopathy check). There's a bunch of chairs facing a big television screen where there’s always some earnest historical show or slow moving travelogue that’s mind-numbing. And with the eye dilation business, it's not like you can read while waiting for your pupils to expand.

I brought my laptop, as I do whenever I know I’ll have time to kill. And not for lack of trying, but there’s no free Internet connection for me to surf onto. And I’m sitting in the middle of a thriving metropolis.

Of course, there are password-protected networks, and heaven forbid I get the password of the office's network because you know I could wreak havoc with patient records. (Please. I've got such better things to do online.) I just want to be able to check my email, surf the Internet, and catch up on work while I sit and wait. And wait.

Mister Lyrehca is seeing a doctor this week and I will need to sit in the office’s waiting room for at least two hours while he’s seen. I just called ahead to try to find out if this location happens to be in an area where I can get to the Internet on my laptop while I wait.

The administrator who answered the phone clearly had no clue what to tell me and told me so. Her coworker overheard her talking and seemed to yell over that “sometimes you can connect, and sometimes you can’t.”

Great.

Why don’t offices like these have wireless free Internet access for those of us in the 21st century who want to work virtually?
Seriously, it's 2009. The Internet and email aren’t going anywhere. And I shouldn’t have to spend more of my hard-earned dollars for a Crackberry or some other mobile device for me to be able to connect wireless when I already have a great laptop and Internet capabitlity right at my fingertips?

Why are these doctor’s offices stuck on a virtual dirt road when it comes to waiting room services?

High Points and Low

Some days, there are just great highs and great lows. And for once, I'm not even talking about my blood sugars.

I was all set to blog about the fact that I cleaned out my closet today and for the first time in a few years, I fit into clothes I last wore before I was pregnant. Work ensembles fit me well. These great red and green and brown pants... all fit like a glove.

(And to be clear, I'm talking about three *separate* pairs of pants. Not one multicolored one).

So Woohoo! for losing the baby weight a mere 18 months after the kid came out. As I've said before, some women just nurse and their baby fat slips away. I have to train for a couple of triathlons to get pounds moving. Whatever works, right? 

Rock on.

I even thought about fashion philosophy as I tried on clothes this morning. How I've never been into fashion in the way that women's magazines showcase the topic, all because I've never been the size or shape that these magazines cater to. Plus, I tend to shop at TJMaxx and Ann Taylor Loft, rather than Burberry or Saks or Marc Jacobs (three stores that figured prominently in the fashion pages of the last magazine I worked at). But going through these clothes in my closet made me realize that it's not just skinny rich people who can enjoy style. Us larger gals who don't spend triple digits on one pair of pants are just as capable as dressing well and looking good. 

Then I wondered how long would this clothing euphoria last, anyway, if I'm trying to get pregnant and if history is any sign, I will likely balloon right out of those green pants a week or two after a positive pregnancy test? And how many years will it be before I can shoehorn my ass back into these clothes, anyway?

(Though can I just say how excited I was that I *did not* need a shoehorn to get into these pants this morning? Last fall, I did. Today, ne shoehorn pas.)

And then I thought, who am I kidding? It took me a year to get pregnant before. Who says it won't take a year, or longer, or never, to get there again?

While I last wrote about the Mister and I going to the doc's to get the go ahead to try conceiving again, there's already been a red flag. Apparently my thyroid meds aren't working hard enough, and my TSH levels are way out of line. Conceiving at this time wouldn't be good. So now I've upped my dose and need to wait another five weeks or so to see if they kick the TSH levels back to where they should be.

(And hello, what else is new? Something isn't working right in the body of Lyrehca. Ho hum. Is this even worth mentioning? But at least this particular ailment should be easily remedied.)

And this isn't even the low I was talking about earlier on. The low point of the day today was getting thrown up on. 

For the second time. 

Out of the mouths of babes. Or in particular, my Baby L. Who isn't even a baby anymore, but will be a year and half later this week. The kid has picked up some sort of stomach bug. Just a week after he finished taking penicillin for an ear infection. And just a week before the Mister and I planned to set him up with two days of day care so I can get some solid work done during the day. 

(And in my neurotic state, I have thought about how kids in day care tend to get sick more. Which makes me wonder if Baby L will get something bad that will stress his immune system, and have him develop Type 1. Which I don't even know if he's genetically inclined to get. Because I could find that information out, but if he is genetically inclined toward Type 1 diabetes, what am I going to do with that information, other than think about it all the time? And aren't I already doing something like that if I'm thinking that daycare may trigger a type 1 diagnosis?)

It's not like diabetes doesn't already permeate Baby L's life, in a way. He's never had a sip of juice, but he looks at me quizzically when I suck down a juice box to treat a low. ("It's Mama's medicine," I explain.) I keep a bottle of Ketostix by his changing table to try to see if he's ever spilling sugar in his urine (though every time I try to get some of his pee from a particularly full diaper onto one of those strips, I usually fail and the strip remains pretty dry.) And while maybe you know Metro Station's catchy "Shake It," I bet I'm the only person who sings it while waving the Ketostix bottle at her son to distract him during a diaper change. Baby L is at the point where he would rather squirm on the diaper pad than lie serenely as I work a Pamper onto his tush. So I grab the bottle and sing "Shake, shake, shake, shake the Ketostix!" 

Sometimes it works, sometimes it doesn't. But I always manage to get the diaper fastened.

Now if I could only figure out what to sing and shake so my Boy doesn't ralph all over me again. 

I'm Still Around

Many times I've wondered if I should keep blogging. Infertility and pregnancy tinged with diabetes provided a great momentum and I always had sufficient material.

Motherhood has given me another batch of experiences, but I haven't wanted to chronicle them in the same public way.

I'm still working on my proposal for my book about type 1 and pregnancy, which was the original reason I started blogging -- to build a platform.

I miss the feedback from people who looked to my blog for information about pregnancy, about diabetes, or just for whatever it is they found when they stopped by.

So here I am after several months of quiet here at Managing the Sweetness Within.

Baby L is doing great. So great that I always feel like knocking wood, crossing my fingers and wondering when the shoe is going to drop. Yet, it's that fear of what could go wrong that makes me appreciate how terrific my son is. He'll be nine months next week.

I've thought about what it would be like if he were diagnosed with diabetes. And while I wouldn't be happy, I keep telling myself that if he were, he'd have me as an advocate, someone who could relate to how it feels to prick one's finger, to inject oneself daily, to constantly count carbs and figure out insulin ratios. We'd be in it together. And while I honestly hope that never happens, I do feel at least I can honestly understand what he'd go through if it ever does.

After 8.5 months, I finally gave up pumping breast milk. Early on, I was committed to giving him as much as I could because of my (exaggerated? maybe) fears that any formula would eventually give him diabetes and make him less intelligent. But low supply, despite doing everything I could to jack it up, meant my kid's been eating (predigested) formula from early on. At the high point, he probably ate about half breast milk, half formula, and in the final days, he was lucky to get a bottle a week. And this is despite daily regular pump sessions with whatever herbs, drugs, water, or whatever I could do to up the ante.

I've come to realize that my kid eating a lot of formula has been fine for him. He's only had a few runny noses since birth, hasn't been really sick, and is now chowing down organic stage 2 foods by the spoonful. He seems bright and smart, and seriously, after reading this post by a blogger who's perspective I find refreshing, I'm more pleased that he's super sociable. I mean, he'll certainly do well in life being social, friendly and well-liked, just in case he's not the kid with the highest IQ.

Diabetes-wise, the numbers have been up and down, and my weight has continued to be about 40 pounds away from Yummy Mummy. I've started talking to a therapist who deals with diabetic issues to find out what my deal is about food. As in, why I can't seem to just eat smaller portions and be happy with them. Instead, I eat a lot of what I like, then cover for it with more insulin, and the weight never peels off. It's the opposite of the diabulimia trend I keep reading about. I'd never do that--I value my eyesight and kidney function far more than looking thin. Instead, I just keep eating and bolusing, and the weight doesn't budge. It's not rocket science--and I'm trying to figure out if it's just basic diabetes resentment about being told what and how much to eat, or something else.

I had a trigger thumb release about a week ago. Basically, my right thumb has been frozen since the summer, along with some other major wrist pain I chalked up to picking up a baby all the time. A trip to a hand surgeon brought me a few cortisone shots, which helped some, but my thumb didn't ever move. It was basically frozen straight, so I had what the doc called a minor outpatient procedure at my local hospital (where Baby L was born) to cut into the thumb and release a part of the thumb that helps the tendons move properly. I've had other diabetic pals have every single finger done, and my surgeon brother told me he'd have the procedure done himself in a second if it was happening to him, so I had no hesitation about having it done.

I still have stitches in my thumb that will come out next week, and taking a novocaine shot in the thumb definitely hurt, but I can now move my thumb again and am glad it's behind me. Chalk up yet another surgical procedure for a treatable, likely-related-to-diabetes-but-who-knows, issue. I'm just glad it was actually treatable.

In fact, when the nurse was taking my information before the procedure, the answers to the questions about drinking, smoking, and doing drugs were quick. When she asked about prior surgeries, I was like, you might want to sit down for this one.

I guess I don't mind having such a weird list of surgeries and other medical procedures (c-section, eyes lasered, thryoid removed, odd sarcoma removed from my abdomen) so long as they've all resulted in good things. I mean, the sarcoma was found to be mostly benign and hasn't returned. My vision was unaffected by the laser treatment. My thumb works fine now. And my fabulous napping son was worth any procedure (and there were certainly plenty of them) to get to this point.

Thirty Years In

Thirty years ago today, I was diagnosed with type 1 diabetes.

It's a day I remember every year, and a day I never know how to really commemorate.

This year, it's particularly special because I have my four month son keeping me company as I write this. A son who was born without any complications during my medically-intensive, but otherwise healthy pregnancy.

In fact, the first thing I thought this morning was, "I know I'm a diabetic parent when my infant son sleeps nine hours straight for the first time ever, and I'm up at 4am treating an insulin reaction."

But what else is new?

I wrote about this anniversary last year, and others in the blogosphere have written about it.

For a moment, briefly, I thought diabetes had robbed me of the chance to give birth vaginally. For those who follow, my eyes have had retinopathic issues and docs thought a vaginal birth would be too much pressure on them. The truth is, after having a scheduled c-section and an easy recovery, and hearing about long and involved vaginal births that went on and on, that will filled with pain, or became emergency c-sections anyway, I'm happier having given birth via scheduled C. Going vaginally sounds a lot scarier than what I did. And while breastfeeding was a challenge and milk supply continues to be, my non-diabetic mother had similar issues with me and my brother, so I now suspect genetics versus diabetes for my breastfeeding woes.

I don't have anything special planned for today, other than my usual Wednesday stuff. In fact, I've given more thought to a job interview I just had earlier this week. I'm going back in for a second interview, and was asked to do an editing test (standard procedure for senior-level editorial jobs), and I'm wondering more about whether I want to go back to full-time work when Baby L is four or five months, versus staying at home and freelancing and having my son stay at home, rather than at daycare.

I'll be pondering this over the next few days, and will try to update the blog sooner rather than waiting a month to do so.

But thirty years in, I'm feeling just fine today.

Just fine.

Birth Day

Good God, where to begin?

Baby L is ten days old, counting his birth day as day zero (as the hospital did) and we've been home since late last week.

I have barely had time to think, let alone blog or read other people's blogs. I'll make short statements about what's been going on.

1. The c-section birth went well. I walked confidently into the OR and asked if anyone ever walked out. "It'd be a miracle if anyone could walk out after the spinal/epidural," I was told. Getting a spinal/epidural injection in the back freaked me out in theory, but the reality was that I barely felt it going in, I did not know/see how long the needle was, and although I'd been warned about "the worst headache of your life" if the spinal didn't go well, that was thankfully not my issue. My legs and lower body felt really numb, really fast. So fast, that I felt like perhaps I was having a low blood sugar during the section, but I'd brought my meter into the operating room, had Mr. L. help me test, and I was 116, up from a steady 87-95 range all morning as we waited to be admitted to the OR.

2. Felt nauseous twice during the c-section, and both times the anesthesiologist waved an alcohol swab under my nose, which took the feeling away. The second time I felt like I would throw up, I asked "Can I get more alcohol over here?" My OB laughed (from the other side of the sheet that was held up by my chest so I didn't have to watch my own c-section occur) and said that was the first time she'd heard a patient ask for alcohol during a section.

3. Mr. L was in scrubs at my side during the whole thing, and brought a camera into the OR. I could feel pushing and pressing on my lower half during the section, and smelled something being cauterized, but when a nurse asked if I wanted to know what was being pushed, pulled, or cauterized during the procedure, I declined. Not typical for me, but I didn't need that much detail right then. However, the OB announced that I had "beautiful Fallopian tubes."

4. At one point, the OB yelled out "I see a head!" and I asked "Then why don't I hear any crying?" Within moments, we heard Baby L crying out loud. Healthy lungs, he has.

5. Someone held the baby up and showed the Mr. and I, but we'd requested that the baby be cleaned off before being handed over to Mr. L. The baby was weighed and measured, and given Apgar scores of 8 and 9. This made me proud. My boy did well on his Apgars! He's going to totally rock his SATs. You just watch.

6. Mr. L. held the baby and I took pictures as the OB reconstructed my nether regions ("We're putting the uterus back where it belongs!"). Near the end, two people in the OR (there were something like six or seven people in the room during the section) rolled me around and onto the bed that wheeled me out of the OR. Still felt numbness in my legs, but otherwise, I felt fine and lucid and good.

7. Looking at the baby, I saw immediately that he has my chin, big lips (that kid is going to be a great maker-outer, I said) and other characteristics that made me realize he looks a lot like me. I stopped worrying about whether I'd been carrying the wrong embryo post-IVF transfer at that point.

7. I don't want to say having a c-section was a piece of cake, but with morphine, torredol, two IVs and plenty of percoset and motrin afterwards, this procedure went (knock wood) fine for me. Having had a more extensive abodominal operation in the past gives me something to compare it to, and believe me, the section went very well.

8. In the recovery room, I called my mother from the bed as Mr. L called his mother and sister (all of whom were waiting in the hospital's lobby) and we simultaneously told our family about our newest arrival. My mother couldn't believe I was calling immediately after the section and started crying. She was very relieved that both the baby and I were doing just fine.

9. The baby was put under a warmer next to my bed because his temperature was a bit low, and I got to hold him on my chest and tried to breastfeed him (he latched but didn't get the hang of sucking. Much more on this to come in a future post). This is called skin-to-skin contact and it's really good for bonding with mom and baby. It's pretty fun--the baby chilling out on my skin is something I really enjoy.

10. Eventually, I was wheeled up to my hospital room, the Mister's parents and sister came to visit, and my parents visited after my mother went and bought many outfits for our newest arrival. My brother, who lives several states away, called all afternoon and at the end of the day, knocked and walked into my hospital room with a huge bouquet of flowers, having decided to make the four-hour drive to meet his new nephew. I was thrilled we had all this family around to meet our new boy.

11. Kept trying with the breast feeding thing. I'm still trying. In fact, feeding this kid has become my latest focus. Honestly, in the last week and a half, I feel like I've gone to college and become a scholar on the different techniques and tricks of feeding a newborn. One who needs to be supplemented because of too much weight loss. One who has a mother who overthinks and researches links between cow's milk and diabetes and wonders about nipple confusion and finger feeding and number of hours (minutes?) since the last feeding. Oh, and breast pumps. I've honestly never spent so much time topless as I have in the past ten days.

More to come, I promise.

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.

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?

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.