Saturday, February 15, 2014

Finally, four months later . . . a baby!

I've tried several times to sit down and write my baby's birth story for this blog, but up until now it's just been too hard. While, diabetes-ly speaking, I consider the birth of my daughter a total success, the rest of the experience was extremely traumatic for me, and it's going to take a while to get it all down in writing. So, let's start with the diabetes-specific stuff first, because it's not too painful for me, and I consider it one of my greatest accomplishments.

My final A1C before going in to have my baby was 5.6. My blood sugars throughout my entire pregnancy were immaculate.  My baby NEVER measured large during the entire pregnancy, and at my last check up, my doctor guessed that she would be in the range of 7 lbs.

I ended up being induced and 39 weeks, 1 day.  Looking back, there was absolutely no reason for my induction, other than my doctors were nervous and that "diabetics tend to have big babies." I was going in for non-stress tests twice a week, and my baby was never in any distress.  If I were to do it all over again, I would refuse an induction unless it was really medically necessary.

I'll write about the whole induction and labor later, I'm still too annoyed/upset/traumatized/sad about it all to write about it now.  But, to just detail the diabetes stuff, you need to know that I was induced, was in labor for 24 hours, my labor never progressed, and I ended up having a c-section.  Our baby was born at 7 lbs, 9 oz, 19" long. Perfect, and beautiful, Apgar of 9!

The entire time I was in the hospital, including during labor, the c-section and recovery I was allowed to manage my own diabetes with my own pump, my own glucometer and my own CGM.  I had an IV of dextrose/saline hooked up to me that they could start if my blood sugar dropped too low, but I rarely needed that, and if I started dropping a little low, I'd eat Popsicles (because that was the only thing they let me eat). Other than a few mild lows, my sugars were totally within normal range during the entire labor and c-section.  All the doctors and nurses were impressed with my management. One thing I will say, is that I was really shocked how little the hospital nurses, pharmacists, and doctors knew about diabetes management. It's like they are all still living in the 1980s when it comes to diabetes management. They kept asking me if I was using "Regular" insulin. Sheesh.

When my baby was born, her blood sugar was low and they fed her formula before letting me try to breast feed, which I was pretty ticked about. I'm still not sure why her blood sugars were low, since that's only supposed to happen if mine are high, right? And mine were perfect.  So, who knows? Also, right after delivery, my insulin needs plummeted dramatically.  I was low pretty much the entire time I was in the hospital recovering, and I had to cut my basal rates and I:C and sensitivity factor back to below my pre-pregnancy rates.

I ended up not being able to breast feed (another traumatic experience for me that I will detail later), so I didn't have to deal with any of the breast feeding lows that tend to happen.

C-section recovery was a total Bi*%$, but I don't think I would've recovered any quicker had I not had diabetes.  I think it would've been awful either way.

Our baby is perfect. She's had some minor heath problems (which I will also detail later), none of which have any relation to me having diabetes.

Since having our baby, one of the things that ticks me off so bad is all the "your baby is so big" crud I got and am still getting 4 months later.   My baby was normal at birth and she's normal now. I was on fluids for 30 hours before she was born, so I'm also pretty sure that she was actually some where in the neighborhood of a 6 lb something oz baby, because she was SO puffed up from the fluids. That is a totally normal sized baby, people! Also, how come when other women have 9 lb babies, people don't say a thing about it, but as soon as a diabetic has a normal sized baby, they make comments about how it's big? Grrrrr.

OK, I better stop writing now, because I'm just starting to get ticked off and angry again.  So, the diabetes take-away for me has been this: I can totally successfully manage my diabetes while pregnant.  Doctors kind of suck and will label you because you're diabetic and will try to make you have an induction, which will be awful and traumatic.  But, I'm still a diabetes rock star, and my baby was not affected by my diabetes.  And my baby is gorgeous. Seriously, people. I'm vain about how beautiful my daughter is. :)

Tuesday, September 24, 2013

Heading Down the Home Stretch!

So, I'm not really into sports metaphors, but "Heading Down the Home Stretch" seemed pretty fitting in this case. Actually, I'm not exactly certain if this is a baseball metaphor or a horse racing metaphor (that's how bad I am at sports metaphors), but suffice it to say, I'm smack dab in the middle of my last few weeks of pregnancy.

And thank goodness.

So, here's what's been going on:

  • I've still been having non-stress tests twice a week. These are still pretty stressful for me by the way.  Especially when the monitor they are using looks and acts like it's from the 1980s and is on the fritz all the time.  Sometimes it picks up my heart beat instead of the baby's and then I freak out thinking my kid's heartbeat is 70.  Sometimes the thing stops working completely and turns on and off at random and I swear it's possessed by angry spirits. But, in spite of how out-dated my OB's particular machine is, all the tests have shown that the Wee Carper is doing fine. 
  • At about week 34 I had what will likely be my last ultrasound, barring some complication or fetal distress.  The baby was positioned head down (which she has been for a lot of my pregnancy), and it was confirmed - yet again - that she is a girl.  My OB isn't very good at giving me nice ultra sound pictures. We don't get the normal, cute pictures of her profile, or feet or hands. This last time we got (yet another) picture of her female parts, and a picture of her femur.  Oh well.  I've had about 4 or 5 ( I lost count) ultrasounds over the course of this whole pregnancy (maybe 6 if you include the fetal echo), so I consider myself lucky to have been able to see our little one in utero so many times.
  • For most of my pregnancy the OBs have been telling me that they will probably induce me at 38.5 or 39 weeks, even if the baby isn't measuring big.  Theoretically, this is because there is a tiny bit greater than average chance of still-birth with diabetes (although no one has been able to tell me if this is diabetes in general, gestational, Type 2 or Type 1 specific . . . ).  But at my last appointment, everything was measuring so well, that the doctor said they will probably "let" me go until my exact due date, but no farther.  I still think it's rather presumptuous of them to tell me what they will "let" me do (as if they have control over my body), instead giving me my options, advising me with their expertise, and then asking me if that's what I want to do.  But, I do believe in modern medicine, and I trust my doctors, so even if I don't particularly like the semantics they use, I will take their advice on when it's time to get this kid out of me. Hopefully she'll be like both her mum and dad and arrive a few weeks early.
  • Diabetes-ly speaking, things got super insane from about week 30-35/36 with the amount of insulin I was taking. I ended up taking SO MUCH FREAKING INSULIN that I had to change my pump out once a day.  That's about 200 units a day, people.  Which I guess is not uncommon during pregnancy, but I still can't believe how much insulin I was using! Right at about week 36 I started having tons of lows, and needed to cut my insulin usage back a bit. That freaked me out a bit, but then I did some research and asked around and realized that this was pretty normal. I've said it before, and I'll say it again: It has been a great blessing that Apidra has been running their no-copay promotion this year! We sure timed this kid right.
  • Speaking of timing this kid right (like we really have any control over this . . . ), financially a diabetes pregnancy is a HUGE budget crusher.  We have been so incredibly lucky that this kid is arriving when she is, for the following reasons:
        • We have stellar insurance through my husband's work, for which I am grateful every day.  Don't get me wrong, we definitely pay our fair share of premiums for it, but compared to a lot of other people's insurance, it is SO good at covering diabetes stuff.
        • Apidra has been running their no-copay promotion.  With the increased insulin needs at the end of pregnancy, and our less than stellar coverage for insulin through our prescription plan, we would've been paying SO MUCH MONEY for my insulin.  As it stands, we haven't paid a dime. Thank you, Apidra.
        • We hit our deductible and out-of-pocket-max before the baby will be born.  This means we will not pay a cent for my hospital stay. Thank goodness she's being born before Jan 1st!
        • Again, with the timing of our baby, many parts of the ACA have been in effect. Much of my prenatal/well-woman screening was totally covered thanks to the ACA.  Also, I'm getting a breast pump for free because of the ACA, and the vaccines my husband has to get (TDAP, etc.) will be paid for because of the ACA.  And in a few months, when it's time, my birth control will be free because of the ACA.  Say what you will about that bill, and while admittedly it's not perfect, it's a damn good start and I'm already benefiting from it.
  • And, of course, all the annoying regular pregnancy stuff is happening too. At about week 30 my feet and ankles started to swell.  A couple weeks later my hands and fingers started to swell (I especially notice when I'm trying to play the piano or text!).  And, even though my husband says I'm not as bad as some women he's seen, I definitely have a more pronounced waddle when I walk. Think emperor penguin.  Oh, and the crazies have all come out of hiding and started commenting on the size of my belly, asking me when I'm due, and just looking at me and saying "Wow!".  Seriously, filters, people!  

So this, will most likely be my last entry until after Wee Baby Girl Carper has arrived.  And who knows how long it will be before I get around to blogging about that, but I will try my hardest to, because I know there will be a lot that goes down at the hospital that someone who is planning a pregnancy with diabetes will want to know! 

Thanks for sticking with me until the bitter end! If I get super bored in the next few weeks before this kid gets here, or if something significant happens that needs to be written about, I'll post again. But if not, see you on the other side of parenthood!

Thursday, August 29, 2013

Filters, Baby Showers & the Steel Magnolia Effect, Non-stress Tests: Or, things lately.

Yesterday was the first day all week that someone hasn't told me how big I am  Mostly, I think that's because I didn't see very many people yesterday. I only taught one family's worth of kids piano lessons yesterday, and those children are all extremely polite and well behaved. And also, it's never the kids that tell me I'm big, it's just adults! It's like people have never seen a pregnant woman out here before! Actually, I think that might be true for a lot of people, since there aren't a whole lot of people having babies in Columbus.  My personal perspective on how many women are having babies and how often they are having them is a little bit skewed because of The Church I belong to, and how valued children and families are in that church.  Also, my congregation is made up of a lot of young couples (because we live near a university), so when you put young couples together with a belief system that values children and families so highly, you get people who are breeding like freaking rabbits. All_the_time.  This is not a bad thing, it's just hard to remember that pregnancy is not quite as normal in the rest of my community as it is in my church community, so I need to learn to be more patient with people who may have actually never seen a largely pregnant woman, or who at least haven't seen one enough to not make it a novelty. Le sigh.

Baby Showers
I've been thrown two baby showers this summer.  The first was given by my sister-in-law and aunts when we were out west visiting family.  It was lovely! So many of my family members and best friends from college (who I still consider my closest friends, even though I don't live near them), were able to come. And it was awesome. It was so great to be around so many women who I admire and who have loved and mothered and sistered and friended me for so long!

I was also given a baby shower by some friends of mine from my church. I was blown away by how many people showed up and how generous they were with their time, talents, food making abilities, decorating abilities, and gift giving. I'm not a very emotional person on the outside, but if I looked like a deer in the headlights during that shower, it's because I was so overwhelmed with how cared for and loved I felt.

Another awesome thing about my baby showers was that no body, NOT ONE PERSON, told labor and delivery horror stories! I'm 31 years old, and like I said earlier, belong to a church where people are having kids all the time, so I've been to my fair share of baby showers in my life time. And let me tell you, people are REALLY awful about telling horror stories to soon-to-be moms about giving birth. I can't tell you how many stories I've heard about 3rd degree tears, the worst pain you've ever felt in your life, never having your nether regions be the same again, or what have you. Sometimes those stories were so bad that it made me never want to have kids.  So, I was fully preparing myself to hear all sorts of stories like these at my baby showers, but no one told them!

I kind of think it might be due to what I like to call the "Steel Magnolia Effect." If you've never seen Steel Magnolias, it's basically a movie starring Julia Roberts as a pregnant Type 1 diabetic who ends up dying after having a baby and it's really sad. Any way, that's pretty much most people's experience with anything diabetes and pregnancy related, but even when that movie came out, it was super out-dated. Pregnancy and Type 1 is much more common and much more safe these days. But, I think it might still be preventing people from telling me their birth horror stories, because they're worried that my birth is already going to be like Steel Magnolias.  Or, maybe people are just getting more considerate about those sorts of things? Either way, I'll take it!

Don't get me wrong, I'm still scared that things won't work out with this baby, too. And while at this point the biggest complication with a baby I could encounter would be something going wrong during the delivery (just like everyone else), and the chances of still birth for a baby of a Type 1 mom are only slightly above those of a "pancreas-typical" person, it still does scare me. And I won't stop being worried until this kid is out of me and she and I are home in one piece.  But, I think that is every pregnant woman's fear, so I think I'm pretty typical in that sense.  Any way, I'm just very grateful that no one told labor & delivery horror stories, because I worry about that stuff enough anyway.

Non-Stress Tests
I've started having non-stress tests twice a week. Basically they just slap a monitor on your belly, find the baby's heart beat, and record it for like 20 minutes. Or, if the baby is sleeping and doesn't move enough, then a really annoying nurse says, "Let's see if we can agitate the baby!" and proceeds to push hard on your stomach to try to wake the baby up and get it to move around. Sheesh. Next time she's going to get ninja slapped. But, all the tests (I've had 3 so far) have been fine. It totally freaks me out to have to listen to the baby's heart beat for that long, because it varies up and down so much, but I'm told this is normal.  Also, one time I heard (and felt) her having hiccups while listening to her heart beat, and that was pretty fun.

And that's basically it! We're just in a holding pattern now with diabetes stuff.  My insulin needs have increased a bit more (what's new there?), and I just had a three-week long fight with my medical supply company to get them to actually do their job and ship me some infusion sets for my insulin pump, but any diabetic person, pregnant or not, knows what that's like, so that's not really news. :)

Thanks for sticking with this super long post, friends! I'll keep you updated as more interesting things happen!