Pregnancy & Motherhood

Pregnancy & Motherhood

Labor, Delivery, Diabetes and More

Pregnancy and Diabetes Blog

March 6, 2011

We are so excited to welcome our daughter Kendall Elaine on Feb. 17 at 12:57 am. She weighed in at 7lbs 8oz and she was 19 ¾ inches long, and she is absolutely perfect in every way. We are slowly adjusting to life with a newborn which equates to very little sleep and lots of diaper changes, but our hearts are filled with so much joy and excitement to finally hold her in our arms.

So much has happened since my last blog post, but I thought I would start with my labor and delivery experience and how I managed my diabetes throughout the entire process.  So here goes …

I was originally scheduled to check into the hospital on Mon. Feb. 14 around 6:00 pm for a scheduled induction.  As I mentioned before, my healthcare team decided that it was best to induce me as close to my due date as possible to prevent me from going beyond 40 weeks.  I was a ball of nerves the entire day just waiting to go the hospital because I just wanted to get the show on the road.  Around 4:00 pm I received a call from the hospital saying that they were too full and that I needed to wait until the next morning to be admitted.  ARGH – the waiting was killing me.

I did check in on Tues. Feb. 15 at 6:00 am and was quickly admitted to a room. I met with my OB and we discussed the plan for the induction. I was cautioned that the induction process could take a long time (i.e. maybe even 2 days) since I had only dilated about 1 cm when I got the hospital.   We talked about how I would manage my diabetes throughout the process and if and when I would be able to eat something.  The plan for Tues. was to use a cervical ripening agent for about 12 hours to get my cervix to dilate so they could officially start the induction on Wed. morning.  So Tues. was spent just visiting with family and friends and waiting for my body to respond to the medication.  As far as diabetes goes – I had a few low blood sugars throughout the day that I treated with juice and small snacks. I was able to eat small amounts throughout the day and for the most part my blood sugar stayed below 120.

By the end of the day on Tues. I was only dilated about 3cm so they decided to let me eat dinner (thankfully) and take a break until the next morning when they started Pitocin to help move labor along.  They started me on Pitocin in Wed. morning, and as the day progressed so did my labor.  I remained on my insulin pump, but as my labor progressed I started decreasing my basal rates by about .05 units every couple of hours with the goal of getting back to my pre-pregnancy basal rates by the time I delivered.  Trust me this method is not based on any kind of scientific findings, but rather just a “hunch” I had about how to manage my diabetes and how my body responds to physical exercise (i.e. labor).

Around 7:30 in the evening my contractions were getting closer together and more intense so I asked for an epidural.  Unfortunately three other people asked for an epidural at the same time so I had to wait about an hour for the anesthesiologist to get there.  By the time he arrived around 8:30pm, I had experienced several low blood sugars in a row that I decided to reduce my basal rate by 60%. Again this is not a scientific decision, but rather my personal approach to how I manage my blood sugars. Over time I’ve learned that I can reduce my basal rate by 60% about an hour before exercise and for an hour during exercise (essentially this equates to no basal rate insulin) in order to maintain “good” blood sugars during physical activity.

My memory of the next few hours is kind of “cloudy,” because my labor really picked up after I received the epidural. In all honesty I was pretty much done with diabetes, and if it weren’t for husband checking for me every hour or so I probably would have just let it go.  He was so helpful in that he would check my blood sugar and then ask me what to do on my pump based on my blood sugar.  I do recall my blood sugar being fairly “normal” for these last few hours of labor that I just decided to disconnect my pump completely.  Again I’m not sure how I made this decision, but it just felt like the right thing to do.  Maybe I just got a little too confident because my blood sugars had cooperated throughout the entire induction process.

Finally after hours of labor, the doctor came in and said it was time to push.  My husband checked my blood sugar one last time and it was a little low. Since I didn’t know how long I would have to push I decided to drink some juice to get me through the pushing phase.   Luckily I only had to push a few times, and then our daughter was born healthy and strong.  The entire room was filled with so much joy and the doctors and nurses (and me too) were all so happy that she was here.  Honestly I think we were all holding our breath a little because we all knew how hard we had all worked to get her here without any complications.  I worked hard throughout the pregnancy to manage my blood sugars. My OB worked hard to make sure there were no signs of distress in the baby before she was born. My endocrinologist worked hard to keep me sane and helped me realize that a few “bad” blood sugars along the way weren’t going to have a negative impact on my baby.

For the first few minutes after delivery we were all elated and sharing in the miracle of a new life.  I didn’t even think about my blood sugar or my pump for the matter. I was still disconnected and had probably been without basal rate insulin for about 4 hours.  Suddenly everything changed when the OB said that I was having a slight complication and would need to go to the operating room. In short I had something called a “retained placenta” that required the OB to manually/surgically remove the placenta because it would not deliver on its own.  Immediately I was carted off to the operating room, and I have very little recollection of the next few hours.

My only memory is getting back to my room and my husband checking my blood sugar for me and noticing that it was around 260. I shouldn’t have been surprised because I had been disconnected from my pump for so long. Also I did get sick toward the end of labor and during the surgical procedure that I started vomiting.  As we all know vomiting can cause high blood sugars, so I think it was just a combination of all the factors that caused me to be a little on the high side.  I was literally still so out of it from the minor surgery that I probably would have just crawled in bed and left my insulin pump disconnected and drifted off to sleep.  Luckily my husband was still on top of things and he worked his way through my pump and gave me a correction bolus.  By the time I moved to the post partum room the next morning, I was back in the low 100s.

So, this is my story of how I managed my blood sugars throughout the induction process.  For months I wrestled with the decision of whether I should manage my blood sugars on my own or if I should go on an insulin drip. In the end I am so grateful that I was able to have a successful labor and delivery and a healthy baby and that I was able to manage my diabetes.

I’m still not sure what caused me to have the “retained placenta.” I asked if it was diabetes-related, and the answer I received was “maybe.”  Typically, I would research the heck out of it until I found some research study that indicated that there is in fact some scientific correlation between diabetes and the retained placenta.  But I’ve been way too busy with a newborn to try to uncover that minute detail.

In the end, we have a healthy baby girl, and she has already filled our lives with so much joy.

Still Waiting

Pregnancy and Diabetes Blog

February 8, 2011

So I’m rounding the corner into my 39th week, and I am officially only one week away from meeting our daughter. As of right now I am scheduled to be induced next Tues. Feb. 15 unless she decides to come on her own.  In all honesty I am tired of waiting and I am kind of at a loss as to what to post.

I feel like I have gone the distance with managing diabetes throughout this pregnancy. My blood sugars have by no means been perfect, but for the most part I feel like I’ve done the best I can.  I have tried very hard not to judge myself too harshly for a number that’s “too high or too low” but to roll with the punches and try to get back on track as soon as possible.  At this point all signs point to a healthy baby girl and that is my only concern.

In another week I will be presented with a new set of challenges including learning how to take care of a newborn while also taking care of myself and my diabetes.  I’ve heard from other women that the post-partum phase can be more challenging than the pregnancy itself.

I will continue to blog for another couple of weeks, and I will share my labor and delivery story and my experiences with being a new mom and how diabetes fits into the picture.  I know the next few days, weeks and months are going to be a whirlwind, but I’m looking forward to the most amazing ride of my life.

 

Running Out of Steam

Pregnancy and Diabetes Blog

February 1, 2011

Ok – it’s official – I feel like I have a high risk pregnancy.  Over the last week I have been to the doctor three times and spoken with both my endocrinologist and my OB by phone. Everything is ok, but my entire medical team is just being cautious to make sure that Baby Williams is healthy when she makes her big debut.

My schedule for the remainder of the pregnancy is that I go to the OB on Tues. and Fri. On Tuesdays I have an ultrasound and a fetal non-stress test and on Fridays I have another non-stress test. The non-stress test consists of hooking me up to a monitor for about 20 minutes while they monitor the baby’s heart rate.  Last Friday they were unable to get a good reading so the doctor scheduled another ultrasound on the spot.  With each ultrasound they are measuring the amniotic fluid level, measuring the baby’s growth, making sure that the baby is practicing breathing, monitoring the heart rate, and checking the placenta.

I am trying not to get too stressed about all the ultrasounds because I’ve read that repeated ultrasounds may pose some risk to the baby. On the bright side I get to see her moving around and I’ve even seen a couple of great full face shots.  Another great thing about the frequent ultrasounds is that I get confirmation that the baby is on track and everything is ok.

This schedule will continue until Feb. 15 when I will be induced or the baby is born. I’m crossing my fingers that she comes before the 15th because I am getting increasingly more uncomfortable, but at least I know I only have two weeks remaining.

All this monitoring has me hyper vigilant with my diabetes management.  I am trying so hard to stay on top of my blood sugars, but I must admit that I am getting burned out with such careful monitoring.  I know that there are no breaks from diabetes management, but I feel extra pressure to have tight control because I feel like I owe it to my daughter to do the best I can.  I know it will all pay off in the long run, but the frequent doctor’s visits serve as a constant reminder of just how important it is to maintain “good control.”

Last week there was some discussion around when to induce me, and I received a call from the doctor’s office saying they were moving the scheduled induction to Feb. 15.  Initially I was little concerned because my OB indicated that she wanted to induce by 39 weeks.  However several of the OBs in my practice conferred and they agreed that it was ok to push it back to closer to my actual due date since I have not had any problems so far.  In the beginning I was told that protocol was to induce/deliver at 37 weeks for women with diabetes, so I was a little anxious when they decided to push it back. Luckily I have a great medical team, and I called my endocrinologist to get his opinion. He was on board with waiting until Feb. 15, but he did say he didn’t want me to go past my due date.

So needless to say the constant feedback, frequent doctor’s appointments and close attention to all things pregnancy and diabetes has me feeling a little burned out. I’m so ready to move onto the next stage and finally meet this baby girl that I’ve been working so hard to make sure she is ok.  I know it is all going to be ok in the end, and thankfully the end is in sight.

 

37 weeks and Counting

Pregnancy and Diabetes Blog

January 25, 2011

I am officially nearing the end of this pregnancy, and my doctors are on top of all the last minute preparations. I went back to the doctor today and had yet another ultrasound called a Biophysical Profile. This type of ultrasound is a test that is done in the later stages of pregnancy to determine fetal well-being. My understanding is that they are looking at the health of the baby and making sure everything is normal from muscle tone, to breathing to heart rate.  The good news is that Baby Girl Williams is still completely “normal” and if it weren’t for this pesky little thing called diabetes then they would probably just let me ride this thing out until I go into labor on my own.

However, diabetes does exist and my health care team is being very cautious and following protocol till the end.  So as of Friday I will start going to the OB twice a week to make sure everything is ok. Each Tuesday they will do a biophysical profile and then on Fridays I will be hooked up to a fetal monitor for about 20 minutes so they can monitor her movements and her heart rate. I haven’t been hooked up to the fetal monitor yet, so more details to come once I go through that.

I will continue this schedule until one of two things happen: 1) I go into labor on my own or 2) Feb. 11 rolls around in which case they will start to induce labor.  I learned today that women with diabetes have a higher incidence of negative vascular changes in the placenta in the later stages of pregnancy (I’m not sure if that is all medically correct, but you get the gist). So the standard protocol of my practice is that they prefer women with diabetes to deliver before 40 weeks.   I discussed the protocol with my doctor today, and even though we both agree that it is unlikely that there will be any issues in the last few weeks I prefer to err on the safe side and go with the recommended guidelines.

While I feel like I’ve done a good job accepting the fact that I have diabetes, there is a part of me that kind of lives in denial of the reality of the situation.  Typically I get upset when I feel like I am being treated “differently” because I have diabetes, but today I felt completely at ease when talking with my doctor. Instead of just being treated like a statistic or with the attitude that all women with diabetes have poor control I felt like I was an informed participant in my own health care.  Don’t get me wrong I have always felt this way with my endocrinologist, but I was worried about finding an OB that treated me with the same respect.  I feel really lucky that I found this practice and they are committed to making sure we deliver a healthy baby girl.

 

Last Minute Preparations

Pregnancy and Diabetes Blog

January 19, 2011

I am definitely on the home stretch now, and I had a doctor’s appointment on Monday that confirmed that our baby girl will be here soon.  One positive thing about pregnancy and diabetes is that I have had more ultrasounds to keep an eye on the baby’s growth and development.  I had an ultrasound on Mon. and my OB was very pleased with her growth and development.  I feel like I have really ballooned over the last few weeks so I was starting to worry that the baby was getting too big.

Well the good news is that she is completely “average” coming in at the 48th percentile for size. In fact my doctor said it couldn’t be more average than that and she was very pleased.  She did say that she does not want me to go the full 40 weeks so she hopes I go into labor on my own sometime in the next 3 weeks. If not she said she will probably want me to be induced.  I’m hoping that nature can run its course, and I will go into labor on my own because I would really like to avoid an induction and/or C-section.  However I must say I am not a martyr and if it becomes medically necessary for either case then I am on board

We also talked in length about the pump vs. insulin drip issue.  Those of you that have been reading along know that I’ve been mulling this issue over in my mind for weeks now. I have asked for opinions from endocrinologists, OBs, nurses, friends, other women with diabetes, and even just random people on the street, and it seems that the opinions are split right down the middle. For each person that recommends the drip I meet another person that recommends the staying on the pump.  So as of today I am going to stay on my pump for as long as I can, and if I feel that it is too difficult then I’m going to switch to the drip.  Stay posted because I’m subject to change my mind.

Apparently the pump vs. drip issue has worked its way into my subconscious because I woke up last night in a panic that I was about to go into labor and I didn’t have enough insulin in my pump to make it through half a day (I planned to change my site this morning).  Intellectually I know I will probably be able to change my pump site during early labor, but the panic just reminded me that it’s probably time to gather up all the diabetes supplies to take the hospital.

I also called the doctor this week to get my pre-pregnancy basal rates so I can turn my pump down once labor begins.  As I mentioned before I am probably taking double the amount of insulin I was taking before I got pregnant, and I couldn’t remember my settings.  Since I tend to go low during physical activity (i.e. labor) and because insulin needs drop off precipitously after delivery then I am planning to return to my pre-pregnancy settings once labor begins.  I think I’d rather treat a slightly high blood sugar than try to chase a low blood sugar.  We’ll just see how it goes.

Also as I mentioned before we are banking the cord blood because there is some evidence that autologous (i.e. the baby’s own cord blood) may be useful in “resetting” the immune system by facilitating pancreatic recovery.  That’s a fancy way of saying if she develops Type 1 diabetes then there is a chance that her cord blood can help prevent the progression of the disease.  I can’t say enough nice things about the Carolinas Cord Blood Bank because they have prepped me with all the information I need to make sure they are there to collect the cord blood.  I have their pager number in my phone so I can call them when we leave for the hospital. I am very excited that this program exists, but I hope that we NEVER need it.

So there are a lot of last minute preparations in the works.I just hope I remember everything when I leave for the hospital.

The Home Stretch

Pregnancy and Diabetes Blog

January 11, 2011

We are definitely on the home stretch now, and I am getting excited to welcome our baby girl. In fact I feel like this next month may drag by because I am so ready to meet her in person and to finish being pregnant.  Don’t get me wrong – this pregnancy has been amazing in so many ways, but I am running out of energy to manage all the pregnancy symptoms and my diabetes.

On the diabetes front my overall average blood glucose is ok (I think), but I am having a bit of trouble getting my post prandial numbers back in range.  Maybe it’s bolus fear (i.e. scared to bolus too much for fear of going low), or bolus amnesia (i.e. forgetting how to carb count) or perhaps it is the pregnancy and the anticipated fluctuations in insulin needs or maybe it’s the fact that I have barely broken a sweat in a few weeks due to decreased exercise intensity. Or heck maybe it’s just the Doritos! Who knows?  In any case I’ve had to administer more correction boluses over the last few weeks.

In any case I am running out of steam when it comes to tightly managing my blood sugars. I recently read that a person can only exert so much self control before he/she starts to look for loopholes and can rationalize nearly every behavior or decision. I thought about how this information relates to diabetes control and I can definitely see the parallels (hence the Doritos). I know in my case sometimes I just run out of steam when it comes to all the day to day nuances of dealing with it and kind of experience self-control fatigue. Sometimes I get sick of carb counting, sometimes I get sick of changing out my infusion set, and sometimes I get sick of pre-planning everything from meals to exercise and everything in between.  Let’s face it – it takes a lot of self-control to manage diabetes on a daily basis.

Managing diabetes and pregnancy simultaneously is definitely starting to push me over the edge. As I mentioned last week I am dealing with some pretty unpleasant symptoms.  Let’s just say I ditched the compression hose after only one day of wear.  Honestly a person can only take so much and it didn’t take long for me to rationalize that one away. (My logic is that I don’t have any blood pressure issues that are leading to the swelling in my feet and ankles and I can just try to stay off my feet a little more).  I definitely think this decision falls into the self-control fatigue category because I just couldn’t manage to put those stupid hose on for a second day in a row.

The other day I tried to express this idea of self-control fatigue to my husband (let’s just state for the record that he rarely multi-tasks – a trait I both admire and abhor at the same time).  I rambled off a litany of things that I had to manage down to the day the day aspects of living (i.e. fixing myself breakfast, going to work, managing a business, managing diabetes, wearing my seatbelt and flossing).  He looked at my quizzically and asked, “What does flossing have to do with anything?”  And I told him it’s this idea that I just don’t have enough self control to follow all the rules all the time and sometimes I just have to let something go and just do the best I can.

What can I say when I decide to let things slip off my plate sometimes it’s the diabetes management (i.e. no thought to eating ½ a bag of Doritos) and sometimes it’s the little things like flossing.  A couple days after our conversation about multi-tasking and self-control I came home to a “somewhat” flustered husband who claimed he was doing four things at one time – laundry, cleaning bathrooms, feeding the dogs and playing a video game (hey he’s not perfect).  First of all I thought to myself, “welcome to a glimpse of being a woman” and secondly I suggested he stop flossing before he gave up any of the other things.

As women with diabetes we have to manage a lot of different things, and I believe it’s normal to experience self-control fatigue.  My philosophy on the whole thing is to not beat yourself up too much and to just keep doing the best you can.  As for me I am motivated by this incredible baby girl to do the best I can during these last few weeks of pregnancy and take good care of myself.

 

 

 

A Bit of a Rant

Pregnancy and Diabetes Blog

January 4, 2011

Today I’m feeling like I need to go on a bit of rant so please excuse me for not having my normal upbeat, positive outlook on this whole pregnancy and diabetes thing.  I’m not sure if it’s the pregnancy hormones or the fact that I’m officially huge or the fact that HOLY crap the baby will be here in just a few short weeks.  Ok so here we go in no particular order . . .

1)   Pump site change – Typically I like to change my pump site with plenty of time to spare so I can account for any issues that may arise.  In the midst of trying to manage umpteen things and get out the door ASAP I realized that I did not have enough insulin to make it through the day due to my increased insulin needs.  Normally this type of realization is a minor annoyance and I just change my site as quickly as possible and move on with the day.  But I just wasn’t in the mood for it this morning and somehow this “normal” part of managing diabetes caused a minor meltdown.  I blurted out, “I’m sick of this pump.”  Husband innocently and politely replies, “Do you want to go back to the shots.”  Me, “some days because I can’t find a comfortable place to put this silly pump with this giant belly.” Husband with pragmatism and innocence in his voice, “I think you would be more annoyed with the shots than you are with the pump.” Me, “Perhaps but to be real honest I’m just kind of sick of dealing with diabetes in general.”   Husband responds with a gentle knowing nod and appropriately just says, “I know.”  ARGH

2)   

Long list of “things” to do before baby arrives – I consider myself a very organized person, but there are just some things that you have to handle at the end of pregnancy.  Again in no particular order:

a.   

Bank cord blood –Typically there are two choices for parents that decide to bank their baby’s cord blood:  1) donate to a public bank or 2) pay an annual fee to bank the cord blood for your child’s use.  So there is one silver lining with this whole diabetes thing and that is my local cord blood bank will bank the baby’s cord blood for FREE for our use if we need it in the future.  Hopefully we NEVER need it, but if our child ever develops Type 1 diabetes we can use her own cord blood to potentially help restart her immune system and reduce the severity of the disease.  I tried to arrange this detail back when I was 20 weeks pregnant and life was kind sailing along, but I was told to call back when I was around 32 weeks and get all the information.  Quite naturally they are “busy” and will give me a call back soon.  ARGH

b.   

Establish a pediatrician – So I’ve been asking around for recommendations, and I’m trying to be relaxed about choosing a pediatrician.  But based on my own experience with finding the “right” doctor I feel like it is important to at least interview the practice and get some information before I take my newborn for her first appointment.  I called around today and apparently spoke to someone that was at her first day on the job.  After much ado I was able to schedule a prenatal visit in a few weeks to meet the pediatrician.  At least it’s a start!

c.   

Find a daycare – Ok this is a tricky one because I have always known that I am going back to work, but needless to say it is going to be very hard to take my 10 week old to a daycare facility.  The rational side of me is completely on board with this process, but I am terrified of making the wrong decision. I spent some time researching day care centers months ago, but now it is time to put down a deposit and make a decision.  This one is really inching me up on the stress scale.

d.   

Organize the baby’s room and all the gear – Ok this doesn’t really matter, but find me a woman at 33 ½ weeks pregnant that doesn’t feel a strong nesting desire.  I think it’s all the hormones.

3)   

Higher average blood sugars and rapidly growing belly – I went to the doctor last week and based on my fundal measurement and my weight the baby should be a “normal” size, but I can’t help but worry that my higher blood sugars are growing a baby giant in there and somehow she is getting too big.  My friends all tell me that it’s all in my belly and I don’t look that big.  Apparently they haven’t seen me try to get off of the couch.  My next ultrasound is Jan. 17, and I can’t wait to take a sneak peek at her and make sure everything is ok.

4)   

CRAZY work schedule – Despite my best efforts to sail into these final weeks of pregnancy in a fully relaxed state there is this little thing called a career.  I am co-owner of a health and fitness studio and you can only imagine a fitness center during the first week of Jan.  Enough said!

5)   

Compression Hose – Ok last, but not least I upped my sexiness factor by about 10 today when I picked up my thigh high compression hose. I can’t believe I am posting this on the internet, but a huge belly, thigh high compression hose and an insulin pump does not present a pretty picture.  I’ve started having a lot of swelling in my ankles and legs, and I was fully prepared to just suck it up until the end of pregnancy.  But my doctor urged me to get the compression hose, and I can honestly say my legs felt much better after just a few hours of wear.  I have to laugh to keep from crying about this one because it is quite a chore to get them on and off.  In fact I had to solicit the help of my dear husband this evening just to get them off.  I’m not sure how I’m going to get them back on, but I’ll figure that out in the morning.

Thank you for reading the rant. I know it’s not about me right now and all my hard work and attention to good self care will pay off in a few weeks when we have a new little girl in our family.  I can’t wait to meet her!

 

Changing Basal Rates

Pregnancy and Diabetes Blog

December 28, 2010

Merry Christmas and Happy Holidays to everyone!  I missed blogging last week because my schedule was so busy with all the pre-holiday parties, shopping and general craziness of the holiday season.  We had a great Christmas and it was great to take some much needed time off work and visit with family and friends.

While I love the holiday season, I often get anxious about how all the yummy treats and the change in routine will affect my blood sugar.  This year has been no different, but I’ve tried to be extra cautious about making sure I eat well and don’t overdo it on the high fat/high carbohydrate foods.

However no matter how closely I monitor my blood sugars and how careful I am in counting carbs, I have watched my blood sugars creep up over the last few weeks. I saw my endocrinologist at the beginning of last week, and my A1C confirmed my suspicions. He was very patient and he helped me go through my pump settings and make some adjustments to my basal rates…. which worked for approximately 24 hours before I had to make more adjustments to my basal rates.  Since last Monday I have inched up my basal rates practically every other day, and I’m finding that it’s kind of hard to notice trends when the trend is just that my blood sugar is higher than it was the day before.  I’m trying not to worry about it too much and thankfully I have been mentally preparing myself for the need for more insulin since the beginning of my pregnancy.  At this point I have officially doubled my pre-pregnancy total daily dose of insulin.

My endocrinologist and I also discussed the “home stretch” of pregnancy and what to expect over the next few weeks. He said, “This increased need for insulin may level off around 36 weeks or then again maybe it will not.”  Don’t you just love the predictability of diabetes? So I guess I’ll just have to wait and see.  We also discussed the actual labor and delivery and how I can anticipate a rapid decrease in insulin needs almost immediately after delivery.  One mistake I made was that I never wrote down my pre-pregnancy basal rates so my endo looked through my chart and gave them to me.  He encouraged me to turn my pump settings back when I get to the hospital in preparation for this rapid change.  We also discussed the drip vs. pump issue again, and the only thing I can say is that the jury is still out.  I am planning to ask for a consult with the diabetes management team when I arrive and make my decision from there.  Who knows if I’ll have enough time, but that’s my plan for now.

On a completely unrelated to diabetes note – I am starting to get very excited about welcoming our baby girl into the world. She was super active over the holiday weekend, and our family members took turns rubbing my belly trying to determine if we were feeling a “butt” or a “knee” or a “foot.”  Time is going to fly over the next few weeks so I know it will be here before I know it.  I can’t wait to meet her!

 

 

 

The Amazing Race

Pregnancy and Diabetes Blog

December 14, 2010

From the day I was diagnosed with diabetes I made a commitment to myself to never, ever let this disease stand in my way of accomplishing my goals and dreams. I am always impressed when I learn of another strong woman with diabetes that is living life to the fullest in spite of the day to day hassles of managing the disease.

I don’t watch a lot of reality TV, but I am huge fan of The Amazing Race. In fact, my husband and I tried out for the show a few years ago when we were dating. I was so certain that they would choose us because I had diabetes and it seems like it would make the race more interesting. For those of you that are unfamiliar with the show you can learn more about it by visiting http://www.cbs.com/primetime/amazing_race/. Basically the premise of the show is that teams of two, who have some type of preexisting relationship, race around the world in competition with other teams. The schedule is grueling because each team is trying to make it the next pit stop before the other teams to avoid being eliminated from the show by coming in last. Over the course of about 30 days the teams travel over 30,000 miles via every form of transportation imaginable and complete various challenges along the way. The tasks can be mental and/or physical in nature and oftentimes relate to some indigenous part of the local country’s culture. Sometimes the challenges include eating a local dish. There is no set schedule and the contestants have very little time at each pit stop. They often sleep on planes and cross many time zones in a short amount of time. The first team to cross the finish line wins one million dollars.

This schedule can be grueling for anybody, but think about managing all these variables while also managing diabetes. This Sunday as I watched the season finale I was on the edge of my seat as the top three teams raced to the finish line. One of the women (Nat Strand) in the top three teams has Type 1 diabetes and she and her partner were on the verge of winning the entire race.

The show did not make a huge deal about the fact that she had diabetes, but early on I noticed that she tested her blood sugar while driving down the street in England (mind you that they drive on the other side of the road so I imagine it was pretty tricky to keep driving and test her blood sugar.) I was so excited that the show had casted a woman with diabetes and she was hanging tight in the competition. I am so happy to report that Nat and her partner Kat won the race and the million dollar prize.

She was so humble about the entire experience and it was not until they won the race that the show’s host asked her about her diabetes. She replied that managing diabetes did complicate matters, but that it’s just part of her daily life. She also said that she wanted to show the world that a woman with diabetes can do anything she wants. She also said that she was going to use some of the money she won to donate to diabetes research.

Here’s a link to an interview with Nat and Kat (http://www.thedeadbolt.com/news/109465/nat_kat_amazing_race_17_winners_interview.php). Scroll about halfway down the page and you can see what she had to say about managing diabetes while running the race.

So from one woman with diabetes to another – I encourage you to chase down your dreams. Take an active role in managing your diabetes and never ever let it stand in your way of anything you want to do. Right now I’m taking my own advice and working hard to have a healthy pregnancy and a healthy baby. It may take a little more work than someone without diabetes, but it’s not insurmountable.

The Third Trimester

Pregnancy and Diabetes Blog

December 7, 2010

As of this Friday I will be 30 weeks, and it suddenly occurred to me that in just a few weeks this baby may literally make her big debut. Technically I still have 10 weeks left to be full term, but I am just trying to mentally prepare myself in case she makes an early arrival. Time has flown by so I know these next few weeks are going to be extremely fast especially with all the excitement of the holidays.

My husband and I are in the process of getting the nursery together and despite his better judgment he is working on my task list to appease me. We have totally different personalities in that he doesn’t see why we need to do all these things right now since we technically have until February, but I like to just get things done so I can minimize stress. (I’ve always had that personality trait, but something tells me it may be exacerbated by a life lived with diabetes – who knows).

I also had another ultrasound last week to check her growth and development, and we got great reports all around. The baby is in the 32nd percentile for height and weight which according to the OB is just fine and on the small side of normal. Needless to say this made me feel good because one of my biggest fears is that I am going to have a very large baby. Hopefully we can stay at this pace and she will continue to grow and develop normally.

Another indicator that the baby will be here soon is that I now have to go to the OB every two weeks. While each appointment is relatively quick I do like the frequent checks just to make sure everything is ok. One big issue that is still looming in my mind is whether I should go with the insulin drip or stay hooked up to my pump during labor and delivery. I have polled my endocrinologist, my OB, read a bunch of blogs and other information on the internet and asked a few other medical professionals their personal opinion. Well the only constant is that everyone seems to have a different opinion. My endocrinologist definitely recommends going on the insulin drip once I’m admitted. My OB said that most Type 1s manage their diabetes with their pump during labor and delivery, the blogs are split down the middle and my friends and acquaintances in the medical profession can make a case for either path.

So I’m left to decide what to do. I finally received some good advice that has made me feel a lot better. One of my clients and friends recommended that I just wait until I get to the hospital and ask for a consult with the diabetes management team. Then I can decide if I feel like they share my same philosophy and will be able to control my blood sugars during labor and delivery. Now the reality is that I may not have time to have a consult, but just having a plan makes me feel less anxious about the situation. Also it kind of buys me some time and opens the door for either scenario.

In a perfect world I would arrive at the hospital and have time to talk to the diabetes management team, set a plan, sip on some ice chips while my husband rubs my back and tells me how wonderful I am, my blood sugar is managed perfectly and then I give birth to a healthy baby girl. BUT – once again this is one of those things in life that I just can’t control so I have to be ok with knowing that I have done a great job taking care of myself and the baby both before and during pregnancy and that everyone (the OBs, the nurses, my endocrinologist) are all on the same team and we all have the same goal in mind – A HEALTHY BABY and a HEALTHY MOMMY!

Wonder how I learned to take a roll with the punches attitude towards things beyond my control? I can tell you I definitely wasn’t born that way because I am as Type A as a person can get. Maybe it’s that whole diabetes thing!