Friday, May 24, 2013

It's a girl!

Well, I'm 19 weeks pregnant now, and we just had an ultrasound to check to make sure our baby was growing properly, and we were able to find out that "it" is in fact a "she"!  We're pretty excited!  Here are some notable things so far:

  • Because Type 1 diabetics are more at risk for having babies with birth defects, my OB did an extremely thorough ultrasound.  We got to see all kinds of crazy stuff. Four chambers of the heart, both femurs, feet, arms and hands and he counted all the fingers! He even checked to see how many bones she had in her pinky, because apparently if you only have 2 pinky bones instead of 3, that, among other things,  is a good indication that the baby could have Down Syndrome.  We saw her kidneys, her spine, and even her cerebellum! So crazy! But she was pretty good at hiding her face, so we didn't see that yet.  She was moving around like crazy, which was so strange to watch, since I'm not feeling her move at all yet.  We are going to have another ultrasound in a month. I think he wants to get a better look at her face, and to double check a few things she was hiding this time around.  We also have a fetal echo scheduled for next month, too, so that will be cool to see her heart!
  • Speaking of birth defects, I've started seeing the "high risk of high risk" OBs at the same office of OBs that I've been going to. He's been practicing for FOREVER and is actually really awesome. The other high risk OB I was seeing before will still be my doctor, but I think this guy is going to handle more stuff from now until I deliver, since he really knows his stuff. The only thing is, is that he can't deliver anymore because he recently was diagnosed with Parkinson's (I think?), so I'll have another person at the practice deliver me anyway. But he's doing all my ultrasounds now, and I really like him a lot.  Any way,  he told me that studies have shown that you start to really see a risk for birth defects when A1Cs are 8.3 or above.  Obviously you want to have an A1C as close to normal as possible, but knowing that my A1C was WELL under 8.3 put me at so much ease! 
  • Insulin resistance has kicked in finally, and it has been quite trying to keep up with all the changes. It's nice, because I'm not so freaking low all the time anymore, but it's rough to have to adjust things every couple of days. And, my insulin needs have already increased so much! Sheesh! My carb ratios are all down to 1:4 or 1:5, and my basal rates have all increased too. I end up having to change my pump about every 1.5-2 days instead of every 3, so that becomes annoying. And I'm starting to run out of real-estate on my stomach to rotate my infusion sites! This will be an adventure!
  • Speaking of changing insulin needs, I swear my little girl is already fickle.  I don't know if this is how the physiology works, and it probably is not like this at all, but I swear this little fetus just decides on a whim when she wants to suck all my calories from me, and when she doesn't.  Sometimes it's like she's making me constantly low and I can't eat enough food to keep both me AND my fickle fetus alive.  And sometimes it seems like she's saying "Naw, I don't want to eat today, so no thanks on the food, and, oh, here, have all this food back too." And then it's like she somehow dumped all the blood-sugar fuel she decided she didn't want anymore BACK into my blood stream and I'll randomly have highs.  I'm sure that's not how it works (anyone who knows anything more about how my blood sugar is used by her, feel free to pipe in), but it really feels like that sometimes!
  • And speaking of feelings, some days are just HARD! Overall things have gone really well, I've been so lucky so far, and I have an amazing medical team, and my blood sugars are in great control, so I can't really complain.  But, while that is true, it doesn't mean it's not terribly hard work.  What is just a number or set of numbers to most people (A1Cs and daily blood sugar logs), is actually just a small output of data representing hours and hours and hours of work on my part.  Or hours and hours and hours of feeling like crap on my part.  When I have marathon lows for 6 hours, and then my blood sugar suddenly jumps really randomly high, that's 6 hours of my life that I spend feeling like crap, lying in a heap on the floor sometimes, balancing a careful amount of carb intake vs insulin intake in hopes that it will meet the needs of my growing baby. It's exhaustion from lows, headaches from marathon lows or rebound highs, and random walks at 11pm at night because your blood sugar just won't come down no matter how much insulin you throw at it. not eating when you're starving, or shoving food in your face when your so full already you feel like you're going to explode. So, while in general, things have been a lot easier than I have thought, and Type 1 and pregnancy isn't like Steel Magnolias anymore, it is disingenuous to say that "everything is a-ok."  But, that's usually the sound-byte I give people, because how do you explain all that other junk to someone who doesn't really understand? And, I don't want to be "that guy" who keeps saying "Oh man, my pregnancy is the worst and it's so hard, and you couldn't possibly understand." Nobody likes "that guy"  (or "that girl," rather), and most people are just genuinely trying to show interest and are caring about you, so you don't want to burden them with a full medical report! But, this is a diabetes blog, and I'm writing this for the enlightenment of other potential diabetic parents, so there's the truth! It's hard, but doable and wonderful, all at the same time!

OK, whew! long, sorry! Just one last thing:  Why on EARTH do people think it's OK to touch someone else's stomach just because they are pregnant? Would you go up to some random person on the street as touch their stomach if they weren't pregnant? No! It's creepy, people. Keep your hands to yourself! I've decided that if people want to touch my stomach, I'm just going to start rubbing theirs right back, and see how much they like that. Seems like a good plan, right?  

Friday, May 3, 2013

Second Trimester Stuff Thus Far

Well, I was about 1 day into my second trimester when my insulin requirements started to increase.  Thankfully, I knew this could happen and was expecting it, so it wasn't too much of a shock. Also, it means the baby is growing, so that's good!  It's still a little hard to see my insulin requirements increase so much, since for so much of my life I've equated more insulin needs to a failure somehow on my part (i.e. not exercising enough, eating too many high glycemic carbs, etc).  Even though that's total bunk in regular, non-pregnant diabetes life, that nagging "you're not doing well enough" feeling still happens every time my insulin needs go up.  It's an antiquated way to view insulin needs, that I can logically understand is stupid, but for some reason it's so ingrained in my psyche that it's still hard to see.  I just have to remember, that, pregnant or not, my body needs the amount of insulin it needs, and that non-diabetics use insulin on a regular basis (their bodies just happen to  make it), so why is it so bad if I need to use it too?  It's not. Get over it, Erin.

Anyway, when my insulin needs rose, it took a few days to figure things out. I ended up having to take lots of walks at random times of the day (usually at like 9:00 at night) to help get my blood sugar to come down, but I think I finally adjusted dosing enough to make it better . . . for now.  Apparently, this is going to just be the status quo until October.  If I'm lucky, I'll only have to make adjustments every week or every few weeks, but I know my insulin needs could potentially change on a daily basis, and while that totally sucks, I am prepared for that. I give serious props to women who do this while working full time! I feel like it's just a full time job in and of itself eating, taking medicine, adjusting, etc., I don't know how people do this with a full time job!

Other things that are happening:
  • I'm getting larger.  I first noticed that, while my tummy wasn't growing bigger, my hips were expanding outwards, and I needed knew pants! My stomach is finally catching up to my hips a little bit, and while I haven't felt the baby move yet, it definitely feels like something is in there that isn't normally there. If I didn't know I was pregnant, I'd definitely think I had some kind of tumor going on.  Or a parasite family making a home in my stomach. (Shout out to La Famila Raul, C. Burns!) (that was an inside joke about parasites, just FYI) 
  • My endo is still the bomb dot com.  They email back and forth with me once or twice a week and help me make adjustments to my blood sugars  And I don't have to pay for it. And they are my heroes. I love my endo and her PA!
  • I had my first bout of morning sickness that ended really badly.  I was feeling a little nauseated, but knew if I ate breakfast, I'd feel better. So I proceeded to eat my oatmeal, only to throw it all back up again about 5 minutes later.  It was bad! I think it was a combination of things. I was having a really bad low (like in the 40s low) and going that low always makes me sick to my stomach anyway. Also (and this is gross) I was having some serious snot issues from spring allergies, and had massive amounts of mucous cascading down the back of my throat, making me feel gaggy, so that triple-threat combined equaled one yet-to-be-matched episode of upchucking. I feel for those who are constantly sick during pregnancy. Sheesh.

I just had both my monthly appointment with my endo, and my 16 week appointment with my OB.  My endo was absolutely ecstatic about how well things were going, which reassured me a lot.  I constantly feel like I'm killing my baby every time I have a low or a "high", but my endo said that I was doing perfectly and that I'm one of the best controlled Type 1s they had so far.  ( I should get some sort of award for that, or something, right?) My A1C was 5.1, which I guess is good, but to me it makes me wonder how can possibly still be alive and breathing with an A1C that low! When I told my dad he said "maybe you should be pregnant all the time, and that way it will be like you don't have diabetes!"  Um, not happening.  :)  My thyroid function is perfect for now, too, and they'll keep tabs on that monthly as well.  

My OB appointment was pretty low-key. We heard the baby's heart beat (156 bpm).  It totally freaked me out at first, because the medical assistant was having trouble locating it, but she found it and it was going strong.  She said she even thought our little fetus was moving around a bit, although I don't know how they tell that from just listening to the heart beat.  I have an appointment at 19 weeks when we will have an ultrasound.  While my OB is a high-risk OB, there is a doctor in the practice who is like the High Risk of High Risk OBs who's been practicing forever, so they are going to have him do my ultrasound just to make sure everything is OK so far. Hopefully we'll also be able to find out the gender at that appointment, too!

And then at about 24-28 weeks, I have to have a fetal echo done, where they will check out the little one's heart to make sure it formed properly.  With Type 1 diabetes, there's a chance that the baby's heart can be messed up, especially if you're uncontrolled, so I have to go get an ultrasound of the wee one's heart.  I'll get that done at the local children's hospital, which is where they have super special fetal echo equipment  apparently.  

And, that's about it so far! It's still a crazy ride, full of prescriptions and doctor's visits, and testing, testing, testing and more testing! And, I am actually looking forward to after this baby is born when I can neglect myself a little bit, and let me A1C run higher (and eat massive amounts of cereal--seriously you guys, cereal is all I'm going to eat after this kid is out of me!).  But, so far, so good! I'll keep you posted!