Third Trimester and Explosives: Type 1 Diabetes and Pregnancy: Weeks 26-31

Then end of my 2nd trimester was full of good energy and a great break from having too many doctor appointments. Then, during week 28 I had four doctor appointments and from here on out I'm there once to twice a week. 

EYE DOCTOR
The first during week 28 was an eye doctor appointment for the "floaters" I'd been seeing. This was a long appointment because my eyes had to be dilated. They took some extra precautions to minimize absorption because I'm pregnant. Everything looked good on my retina and I felt a huge relief!

OBGYN
My next appointment was a standard OBGYN appointment. I had blood work ran for my iron levels and another A1C. Despite STILL feeling like my levels were harder to control and averages spiking, my A1C came back at 5.5 again. I'm still taking 3x my pre-pregnancy insulin levels and for a few weeks even more. It has stabilized a bit recently. 

PEDIATRICIAN CONSULT
My husband and I consulted with a pediatrician for our next appointment. Did you know YELP has reviews for doctors? We read everything we could beforehand and I expected we'd love him. He answered all our questions before we asked them. I know many parents to shop around and "interview" a few pediatricians before choosing. We didn't really have time for that and felt lucky we loved our first choice.

GROWTH ULTRASOUND/ABDOMINAL PAIN
Finally, late on a Friday afternoon I had my first growth ultrasound. They measured baby's head, abdomen, heart, leg bones, and I don't even know what else. His weight came out at an estimated 2lbs 15 ounces and all measurements placed him in the 53rd percentile. So far on track! Not too big, not too small. Of course, I have no idea how accurate it is or how they calculate those measurements! The tech also was kind enough to give us some extra views of baby's profile and did some 3D imaging. As I've stated before, I've always thought these look kind of creepy. They still do, but I cannot stop staring at ours, oohing and aahing over it, and gushing that he looks just like my husband! Cannot wait to kiss those cheeks!

During this appointment I explained to the doctor that I'd been experiencing some abdominal pain. Because of the location of the pain she had me complete blood work to check my liver. Again, tests returned normal. Yay! We decided it seems muscle related as heat packs seem to help and sitting too long makes it worse. Actually sitting longer than 10 minutes sometimes is painful. I bought a heat pack specially for work that I can put around my belly so I can sit and get work done. I also got one of those belly support bands which has helped a little, but more with my posture when up and about. Ugh! Bring it on 3rd trimester!

FLYING IN THE 3RD TRIMESTER
After the onslaught of doctor appointments, we had a nice Thanksgiving weekend visiting family. We flew to Oregon from California and even though it's a short flight it was pretty uncomfortable. My doctor gave me a note for travel, but no one asked me for it. I also got sick for the 3rd time this fall during the holiday! We came back with an extra day off to rest, which was much needed because I'm feeling the fatigue come back!

On the way home I had to get the "female assist pat down" because I refuse to go through those new machines while pregnant. I've gotten really use to these and the sweet TSA lady and I were flying through it. I'm complicated because not only am I pregnant, but also wearing multiple medical devices right now. I have to touch my CGM and insulin pump, then they wipe my hands and stick it in the machine to test for explosives. Well I have no idea what could have been on me, but the machine alerts in red EXPLOSIVES DETECTED. I freaked out a little. The TSA woman was more like "oh jez, now we have to take you back to the private room and do more screening". All I could think is I hope I get to keep my clothes on! Thankfully I was calmed that my husband could come with me. He was carrying all my stuff from the security line. They redid the pat down exactly how they'd done it by security and then they tested everything in both my carry ons. It went pretty fast and before we knew it we were out of there laughing about it. Definitely a first!!!

EXERCISE
During week 30 I committed to getting back to the gym. I had dropped to 1-2 times a week with supplementing walking and my prenatal workout DVD. Between being tired, in pain, and on vacation it was difficulty to get my workouts done. I am glad to be back because my body needs it. I have made a lot of modifications but I still try to do weights 2-3 times a week and cardio (or at least "light cardio") 4-5 times a week.

NST
I had my first non-stress test at week 30. I will be doing these weekly now, along with growth ultrasounds every 4 weeks, it means I'm at the doctor 1-2 times per week. They hooked me up to a machine with two monitors. One tracked the baby's heart rate and the other if I was having contractions. I sit there for about 20-30 minutes. 

My understanding is that this helps monitor if the placenta is keeping the baby healthy and whether or not I'm showing early labor signs. Again, everything looked normal!

Lots of little potential scares these last few weeks and I'm glad none of my googling "eye floaters" or "upper abdominal pain" led me to freak out too much. Also, glad the airport didn't arrest me for "explosives detected!!" Good grief! Feeling very thankful for lots of "just another pregnancy symptom" moments. Can't wait for the "just another part of motherhood" moments! 

Since I know I'm being induced by 39 weeks, we've only got 8 weeks to go!

Last "selfie" of my bump I've taken back at 28 weeks. Since I feel like I've swallowed a baby whale since then I haven't taken a more recent one!!! I will remedy that this weekend I hope!!

National Diabetes Month: Life With Diabetes

November is National Diabetes Month and Today is National Diabetes Day!

The American Recall Center is asking, "What Do You Want People to Know About Diabetes"
This is challenging to answer because at first I want people to know "everything" so I don't have to go into any long explanations! Second, I want people to understand that type 1 and type 2 diabetes are very different when it comes to treatment. Finally, I want people to know that having diabetes does not have to be devastating. It never goes away, there is never a break, and all that hard work should be a constant reminder of gratitude for being able to be healthy.

"I don't love the challenges and hardships from diabetes. I love to overcome diabetes and defy odds every hour of the day. I love what I learn from diabetes and the characteristics those lessons teach me."

This strong and positive attitude is not always easy to find. I've been struggle with it a bit this week as I face seeing the eye doctor tomorrow! Pregnancy and tight control can lead to changes in the eyes of a person with pre-exsisting diabetes. (Awful how better blood sugars can cause problems too huh? Diabetes is just rude!!!). I've been seeing "eye floaters" and have to go get checked out. It could be a normal pregnancy symptom or a sign of a serious eye problem. I've been so thankful to not have any diabetes related complications so far in life. Trying to keep that positive attitude and remember I can handle anything that is thrown at me! Today or tomorrow....

Managing my type 1 diabetes every day (especially during pregnancy) is a constant reminder of the blessing of modern medicine and that good health is worth hard work!

Type 1 Diabetes and Pregnancy: Weeks 20-26

The last few weeks have had consisted of the following highlights:

 

22 weeks

• Spiking blood sugars. Happened right at 18 weeks for me, and even worse after 20 weeks. I fought two different head colds during the last 5 weeks which didn't help. I had an appointment with the CDE dietician and have had to make weekly to daily insulin amount adjustments. My complete daily dosage has gone from 15-22 units pre-pregnancy to 40-50 units currently. Pretty crazy climb. Also a very natural part of any pregnancy, but the different is I can SEE my insulin needs change.
• While feeling down about a few crazy days with high blood sugar spikes I also got back another A1C.......5.5! Keeping it there will be another story, but thankfully I'm mid-pregnancy with a great average. Time to keep fighting the good fight.
• I began feeling baby more and at the start of week 25 my husband felt him too!
• I had a follow up ultrasound to look at the baby's heart and spine (again)!
• We took our childbirth classes during this time. Four Fridays talking about labor and delivery from 630pm-930pm was torturous. The highlight was that it turned out we were sitting right next to another mommy to be with type 1 diabetes! The instructor said she'd never had one type1 in a class let alone two! They were a great couple to relate with and swap stories. During introductions we all had to say something we liked about pregnancy for most moms it was "feeling the baby" followed by "getting to eat whatever". We were both quick to point out that we didn't have the option of "getting to eat whatever" and in fact we found ourselves having the opposite experience of "strictest diet ever". The instructor was super sweet and the information pretty good, but meeting the other type1 was the best part of the class for us. Because of our jobs and backgrounds the class moved slow for us and we felt the one day seminar would have been the smarter choice! (My husband is trained in emergency medicine and therefore to deliver babies/pediatric life support. I have education/clinical experience with being a nursing assistant in college, medical speech pathology, and early childhood development.) 

Accidental 24 week photo while testing out the video baby monitor. Kept it, because check out the growth spurt!

How far along: 26 weeks

Gender: Boy

Maternity clothes: Maternity jeans from Motherhood. Pregnancy Halloween baby skeleton shirt from Amazon.com

Stretch marks: None, but belly is getting itchy and I'm worried! Using Nivea cream and coconut oil like crazy!

Belly button in or out: In....questionable if it is staying there.

Sleep: Good!

Best moment this week: Halloween! Seeing my students in costume! Also, my doctor appointment was a highlight, hearing the heartbeat, and seeing my sweet OBGYN!

Worst moment this week: Upper back sore tight muscles. This happens to me when not pregnant though! Husband, heat pack, and tiger balm helping!

Miss anything: October has been a stressful month at work, so a shot of whiskey would be nice. I also hit another growth spurt and miss my pre-pregnancy wardrobe!

Movement: Lots of kicking and pretty sure hiccups!

Cravings: Biscuits. Made some gluten free low carb ones!

Queasy or sick: Feeling good! A little tired and cranky sometimes.

Looking forward to: Growth ultrasound at 29 weeks and Thanksgiving Break!

 

25 weeks 

 26 weeks

Type One Diabetes and Pregnancy Weeks 13-20....Gender Reveal

It has been a month since I've updated! Yikes time flew bye! This post will cover the last 6 weeks of pregnancy and catch up to the current moment in time!

It has been relatively un-eventful. I've enjoyed the return of energy and reduced nausea that everyone said would come with the second trimester. Although I'm still very tired all the time and my workouts exhaust me much faster, I do not sleep 12-16 hours a day anymore!

I got pretty lazy about taking "bump" pictures and have way too many of myself in gym clothes working out in our garage!!

I had a check up during week 15 with Dr. A, my regular OBGYN. This was a short appointment to listen to the heartbeat and measure my fundal height. I did blood work the same day for further prenatal screenings and to get my A1C. My A1C was still 5.7, which was unbelievably amazing. 

Enjoying a friend's wedding celebration around 16 weeks!! Somewhat still able to "hide" the bump.

My next appointment was with my endocrinologist during week 18. This turned out to be great timing because the insulin resistance that sets in around half way through pregnancy and gets worse until the end was just starting to show that week! We were able to make some small adjustments and my blood sugar averages came back down that same week. We planned for me to send my logs in to her via email, meet with the CDE (certified diabetes educator) dietician with my food and blood sugar logs, and then again with my endo in the weeks ahead. 

My superstar husband also went out and picked me up a used treadmill. This helps immensely with getting down high blood sugars! Thus far 10-15 minutes of walking and drinking a lot of water can help correct numbers like 240 to 140 and 178 to 70. As I've stated before, this works for my body and maybe not all type 1s. I also often wind up low, but I'd rather quickly correct a low than have hours of high blood sugars for baby's sake. The treadmill allows me to exercise at any time day or night if my blood sugar creeps up too high!

20 weeks=5months=OMGhalfwaythere!!!!

During week 19 we had our anatomy ultrasound. They spent almost 30 minutes taking pictures of every structure they could. My regular high risk doctor could not see me as he was held up with another patient. Another doctor covered for him and reviewed the pictures with us. She review my second trimester blood work. We also finally found out the baby's gender!!! IT'S A BOY......!!

We had a small gender reveal celebration and took some better than in-the-garage-working-out "bump" pictures!

Type 1 Diabetes and Pregnancy Weeks 12-13: First Trimester Doctor Appts and Ultrasound

Doctor Appointments (This is long, sorry!):

The day we returned from vacation I had a doctor appointment with my OB-GYN (Dr. A). My husband had to miss this one because of a work commitment. Dr. A asked how I was feeling and if there had been any bleeding or severe symptoms. She then used a "Doppler" machine to try to hear the baby's heartbeat. My heartbeat came on the machine and she said we were listening for something twice as fast. She heard it briefly but then lost it, I wasn't hearing anything. I was okay with this because I knew she was going to get the ultrasound machine out if she couldn't pick up on it! Sure enough I got to SEE baby instead. The heartbeat was there and heart rate was good!

It was exciting how much bigger baby was now! Baby looked like a baby and no longer like a peanut! Turns out the doctor had so much difficulty finding the heartbeat because baby was very active! Arms failing and legs kicking! Baby turned towards the ultrasound and I saw baby's skull bones/skeletal face!! It was cool, my poor husband really missed out. Thankfully, I had a nuchal translucency (NT) ultrasound scheduled the following week that he would definitely be attending!

Baby's Profile

The purpose of the NT ultrasound to my understanding is primarily to measure part of the back of the neck of the baby. This helps determine risk for down syndrome. The technician took pictures of every structure she could see; legs, arms, stomach, heart, and brain to name a few. We were able to watch the baby on the screen for a long time while she took these pictures. She even turned on the 4D images and we saw what looked like a claymation image of our baby. It was very fascinating.

Crazy weird 4D clay looking baby

Then a specialized OB-GYN high risk/maternal fetal medicine doctor (let's call him Dr. R) at this clinic reviewed my blood work and the images. I have been very blessed with brilliant doctors. This one was equally impressive. He reviewed practically my whole medical history with me asking very good background questions especially about my type 1 diabetes. He spoke with the same knowledge as my endocrinologist. He went into even further details than my regular OB-GYN (Dr. A) regarding upcoming specialized testing because of my type 1 diabetes. For example, he wanted to go ahead and do extra screenings of my eyes and kidneys just to have as baseline information. He was doing this he said as a precaution because with my history and blood sugars he was not concerned, just thorough. He definitely won me over with his praise of my A1Cs and in depth expertise with diabetes.

Dr. R stated that at week 20 we would come in for our anatomy ultrasound where we would find out the baby's gender. At week 22 they would check the baby's heart with a fetal echocardiogram. Starting at week 32 I will need to do "non-stress tests" where I sit for 20-30 minutes a week while they monitor the baby's heart. Dr. R said he actually wants his patients going twice a week. He reviewed the risk of preeclampsia, a pregnancy condition characterized by high blood pressure and common in women with diabetes. If I develop this I will likely be hospitalized and stabilized as long as possible to carry the baby as close to term as possible. Also, he stated that assuming everything goes wonderfully I will still be induced, because I am a diabetic, at 38 or 39 weeks.

I really appreciate his diligence and his brilliance, but doesn't change that this is going to be a very daunting and busy process. I knew this going into it though. On my own and with my husband we had consulted with many high risk OBGYNs and done our research. So none of this was new information. Very much still overwhelming.

Then we met with the genetic counselor. Typically women my age do not complete either of these appointments, these were done because I have diabetes. I have to be honest, the genetic appointment felt informative yet pointless for us. We reviewed family and medical histories on both sides. She recommended further testing for certain conditions based on some of my heritage. My husband and I decided against it. We both felt that I am undergoing enough testing and appointments already. This appointment caused extra anxiety and stress. High risk pregnancy involves a lot of talking about everything that can go wrong. Afterwards, my husband and I went out for a nice lunch and focused our minds to more positive thoughts!

Next I met with my endocrinologist. This appointment was pretty standard. We reviewed my logs and talked about how things were going. I mentioned to her about my eating habits and how I'd already gained 10lbs because I was eating to keep away the nausea. She was so sweet and told me she had the exact same experience her first pregnancy and then gained less later on. Thankfully none of my doctors were concerned about the weight gain at all, my endo had said her doctor during her pregnancy gave her a hard time. I've heard many stories about doctors telling expecting moms they are gaining too little or too much. My OBGYN seems more focused on checking the baby's growth than mine, for that I'm grateful!

Remembering our relaxing vacation after having almost 4 hours of doctor appointments in one day!

Type 1 Diabetes and Pregnancy Weeks 10-11: Babymoon and Symptoms

Diabetes:

My blood sugars continued to drop weeks 9-10. I lowered my basal rates even more, they were lower than my baselines. My bolus rates also dropped a little to 1:12 and then needed to be adjusted at week 12 to 1:10. I had a few crazy highs of mid 200s and almost 300 that left me feeling guilty. They continued to come down quickly with walking. I had my A1C done again around week 12 and thankfully came back as 5.7. This put my mind at ease because my averages were not affected.

Symptoms:

I continued to have severe fatigue, some days sleeping up to 16 hours. I noticed improvements when I exercised and started making more of an effort. The fatigue made it hard to be motivated. I also had nausea, although not really full "morning sickness". Mostly it felt like being massively hungover everyday. The symptoms made me want hangover/comfort foods with grease and carbs. Eating would curb the nausea so I was eating a lot and it was showing on the scale.

I started fighting the grease/carb urges, but still needed to eat often or felt sick. In fact, the only time I threw up is when I was so tired I slept in too long and didn't get something in my stomach soon enough. As long as I kept my stomach full I felt better, so I gave in to that. I still didn't have die hard cravings but wanted mango and lemonade pretty frequently.

Hawaii:

During week 11 we were on vacation or our "babymoon" to Kauai, Hawaii. It was romantic, beautiful, and relaxing. However, as I still had many first trimester symptoms, I can see why many women put off a vacation like that until the second trimester. It was fun to be in Hawaii before growing too much, yet I had a few days where I needed to take long naps or go to bed early because of fatigue and nausea. We tried to balance indulging in yummy meals with healthy meal cooking in our little condo we rented.

Despite the preggo symptoms, we had an amazing vacation. I got some last minute adventuring such as surfing! We were able to snorkel, hike, kayak, and sight-see. Kauai was gorgeous and we plan to return there when we can!

Type 1 Diabetes And Pregnancy: Weeks 7-9

I had my first doctor appointment with the OBGYN on June 20th, 2013. My husband attended the appointment with me and we both agreed the doctor was amazing. She was experienced and reasonable about my blood sugars. Many doctors will hold type 1s to the ranges of non-diabetics with out acknowledging the difficulty of the condition. She initially referred to my A1C of 6.3 as "a little high". I responded that I understood what she was saying/comparing it to, but that this number was outstanding for a type 1. After that, she definitely referred to my blood sugars as excellent. I felt that we understood each others perspectives while agreeing I was in great health. My doctor (Dr. A) was not a high risk OBGYN, but we would be able to consult with the high risk team at our hospital throughout the pregnancy.

The appointment started with Dr. A reviewing all the upcoming expected doctor appointments and tests I would need to complete each trimester. She asked about family health history and my work environment/schedule. Because I work with young children she ordered extra testing for exposure to certain viruses. She gave recommendations for books, classes, and handed us schedules.

The doctor reviewed type 1 diabetes related complications and extra precautions we'd be taking. She talked about my A1Cs and asked type 1 diabetes questions that gave me confidence in her knowledge of type 1 diabetes (this is sometimes very hard to find!). She covered all my questions about exercise, food, and travel before I could even ask them. She encouraged me to email her in between appointments.

Finally, after all the very important information, she set me up to for the ultrasound. Everything she'd said and every thought in my head was gone as I looked at the tiny peanut on the screen. She pointed out and explained that the tiny "flutter" we could barely see was the heart beating!! Then said we'd probably be able to hear it with the type of ultrasound she was using. Sure enough she hit a button and there was the "lub/dub" of little baby's heart! I had goose bumps, was shaking, and crying! She printed us our photos and then it was time to go to the lab for blood work.

I complete blood work often as a type 1 diabetic. They took a bit more than usual and I became very light headed. The tech was on the last vial and I told him I was beginning to feel worse. I had to be laid down, legs elevated, and given orange juice. This is the closest I've come to fainting in my life and it felt awful. They promised me this would be the only panel with that many vials!

That round of blood work included testing for blood type, RH factor, STDs, immunity/existence of viruses, a cystic fibrosis screening, and an A1C test. Over the next week I received the results and was able to look at them online. My doctor emailed me a nice note saying everything was looking good, and that my A1C was down even more to 5.8!!! I couldn't believe this especially after almost two weeks of stubborn highs before finding out I was pregnant. The hard work was paying off! Checking blood sugar up to 14 times a day, using a pump, CGM, daily intense logs, and those awful 11pm walks/jumping jacks for high blood sugars. Totally worth it.

The next day I met with another dietician who worked closely with the first one I saw, both Certified Diabetes Educators (CDEs). We reviewed foods to help with pregnancy and diabetes. We looked over my logs and discussed changes to my insulin regimen needed. My husband attended this appointment with me and was able to ask questions. The next week I followed up with my endocrinologist to review blood sugar logs. The doctor and I were able to address a lot of the low blood sugars that had been occurring.

Between weeks 7-8 my husband's family visited. We told my husband's parents by handing them wrapped picture frames saying "Promoted to Grandparents".

My husband is from a big close family and I very much feel that they are my own. They became very involved in my care and diabetes as I was very open with sharing how intense this process would become. They asked good questions and really understood the answers. I was able to have long meaningful conversations with the whole family about type 1 diabetes. My mother in law bought the "Balancing Pregnancy and Pre-Existing Diabetes" book on her kindle while visiting, began reading it immediately, and discussing it with me. I have never felt so loved in my life. I cannot believe the amazing support network I'm receiving. I am beyond blessed with good family and friends!!!

 

Using "A Beautiful Mess" app to create the bump photos. Even though you can't see it at this point (I feel like it's there), still capturing the moments. Wanted to do the chalkboard photos, but never got around to making one and my handwriting is horrible anyways! This is easier!

Pregnancy Early Stages: Weeks 5-6

My pregnancy symptoms started immediately and I felt lucky that comparatively they were mild. I was moody, tired, and having tummy aches. My most persistent symptom was fatigue. I felt like I could sleep 12 hours a day or more.(Sometimes it was 16, yay for teacher schedule and summer vacation)

The biggest thing these few weeks, and the months ahead,  would be micro-managing my type 1 diabetes.

I adjusted my insulin pump basal* settings the night I found out I was pregnant. I began using a "super bolus" where I would take insulin for my meal but also my next two hours of a basal rate. I then set my pump to a temporary basal of 0-10% for those two hours. I learned about this method from another diabetic and believe she found in the book "Pumping with Insulin" and she also stated that she saw it on Diabetes Sisters Website.

After some consistent low blood sugars I stopped using the super bolus* and changed my bolus rates instead. I will likely need to super bolus after week 20 or so of the pregnancy as insulin needs will start to increase drastically. I was a bit too aggressive with adjusting my rates initially because I was anxious about having good blood sugars.

(*A basal rate is the rate of insulin that I take throughout the day in order to maintain blood sugars even without eating. A bolus is when I take insulin for a meal.)

I began eating more carbohydrates as recommended by my Dietician, a CDE (Certified Diabetes Educator). I needed to eat 150-175 carbs per day, which was a lot for me. I tried to bulk up on healthy carbs; whole wheat bread, brown rice, quinoa, potatoes, fruit, coconut yogurt, whole grain tortillas, and almond butter cookies! I began eating more protein, mostly chicken and some fish. Tofu in moderation and dairy in moderation. In order to get enough calcium I started eating more greens, coconut yogurt, and taking a supplement. This became really hard on days I felt nauseous or when we were traveling. There was more than one day that I survived on saltines, diet ginger ale, a piece of fruit, and miraculously could handle a cheeseburger (so unhealthy, so delicious!). I was often in the mood for things like fruit and kid friendly foods that I don't normally eat including mac n' cheese, grilled cheese sandwiches with tomato soup, and PB&J.

I had made a diabetes log template on excel. It is based off of one my doctor uses and I formatted it to highlight the numbers a certain color based on my blood sugar range goals! I started carrying around a hardcopy of my logs to write in. This meant using a bigger purse. 

I walked when my blood sugar started spiking. At night I would set alarms to wake me up if my blood sugar was going up or if I wanted to make sure that it went down. Nothing like jumping jacks at 11pm when my blood sugar is 240 and I'm exhausted/cranky from hormones. It worked though and that 240 dropped to 130 in 15 minutes, I took 0.5 units of insulin to help it. (Please note I am EXTREMELY insulin and exercise sensitive, not everyone's body reacts the same way). Of course then woke up low in the middle of the night and had to have a snack. Diabetes+Pregnancy is testing my strength is all kinds of new, exciting, and of course very frustrating ways!

Finding Out I Was Pregnant: Weeks 1-4

I entered a Monday morning in May with persistent stubborn high blood sugars in a way similar to when I'm fighting certain infections. I could not get these numbers down all day. I was confused because I didn't feel like I was getting sick. After googling if other type 1s had sudden change in blood sugars as an initial symptom, I took a home test anyways. Results were negative and I thought nothing more of it. I was however, really upset with my blood sugars and decided it was just a "bad day".

That week, I adjusted my insulin rates but everything I ate spiked my blood sugar and it was hard to fix. Looking back I realize I was moody and emotional. The following Thursday May 30th I was tired during my morning workout. This had been happening all week, but that day I also felt fatigued and awful at work. I left work early and slept as soon as I got home. I constantly felt symptoms of body aches, fatigue, headaches, and weakness.

My period was due the next day and I almost didn't test thanking it was definitely just an illness that had been coming on all week. I decided to go ahead and use the only pregnancy test I thought was left. It was positive. In shock, I began frantically reading over the little insert in the "First Response" box. Then, I tore my bathroom apart looking for another test, found one, and drank a whole bottle of water. It was also positive.

(In hindsight I would have left the preggo test out of the photo, even though it was clean!!)

My husband wouldn't be home until the next day. I couldn't tell him over the phone and here I was very excited/freaking out. Also, at this point I was suppose to meet a friend for dinner. I pulled myself together my mind racing and left home. It was so hard not to scream "omg you won't believe what just happened" through the entire meal. 

I left dinner and went to the pharmacy to buy a fancy digital test (set of 2) and more water. Note: turns out when they say 99.9% accurate they mean it! I didn't need to test FOUR times. I had an idea of how I wanted to tell my husband in mind and ran to Baby's R Us and grabbed some items to put in a box. Once home, I took the fancy digital test and the extra that came with it. Both positive of course. I wrote my husband a note and placed it all in the box.  

(I use baby mittens around my insulin pump when it is against my skin for comfort, hence the joke on the sticky note)

Sitting at home in shock and with insomnia, I emailed my doctors; my endo and my primary care physician. My emails were completely neurotic. They both responded with congratulations and a "you are definitely pregnant". My endo gave me a run down of what my next steps would need to be.

I had my husband text me when he was on his way home and I left work early to beat him home. I immediately had him sit down on the couch with him and handed him the box I'd made. He opened it reading the letter without yet looking at what was inside. He got through the first sentence and with the most wonderful look I've ever seen that words cannot describe, all he said was "WHAT, REALLY?!!". He may have gone a little pale too. He immediately grabbed me, hugged me, and kissed me saying "wow our lives just changed". This has become one of my favorite memories of all time!

After telling him!

I had called the OBGYN office that day to set up an appointment. They won't see you until you are about 7 weeks which for me was June 20th. However, arranged for me to come in to get my HCG (pregnancy hormone) levels tested. She stated that having type 1 diabetes means I am more likely to have a miscarriage so it would be a good idea to check my levels. You have to do this blood work two times 48 hours apart so they can see that the HCG levels are doubling every 48 hours. My blood work came back typical of a normal progressing pregnancy. My doctor emailed me that Monday saying she would see me June 20th! Which felt like it would be forever. 

Pre-Pregnancy and Planning With Type 1 Diabetes

At the beginning of 2013 my husband and I decided that we were ready to start a family. This prompted some pre-planning because I have type 1 diabetes. Type 1 diabetes is a condition that I did not cause by my diet or lifestyle. It is the rare version of diabetes and is very different from the more common "Type 2 diabetes". Type 1 or "juvenile diabetes" is caused by an auto-immune attack on insulin producing cells killing them all off. I cannot use pills or special diet to control it. Type 1 diabetics do not fall under most of the stereotypes about diabetes, they are typically slender, did not have abnormally poor diets, and were likely diagnosed young. I am and must always be insulin dependent. This complicates life a good deal. Pregnancy complicates diabetes and diabetes complicates pregnancy, so much planning was going to be needed!

In order to start the process towards a health pregnancy; I changed to a better health insurance, saw new doctors, and move my prescriptions to mail order. I became involved in the diabetes community and attended a "Take Control Of Your Diabetes" TCYOD conference. I met and talked at length to other type 1s who had children and had experienced pregnancy with type 1 diabetes.

I have had "in control" A1Cs over the last few years. They range sometimes in the 6s, but mostly low 7s. In December 2012 my A1C was 7.3. I knew that this number needed to be lower, but my previous endocrinologist (diabetes doctor) always told me I was doing great. This was part of why I switched my insurance, I needed to be able to find a doctor with higher standards and more in depth knowledge/experience working with type 1 and pregnancy. I searched HOURS on the internet reading reviews and backgrounds for endocrinologists trying to choose. This was a long process and it made me nervous.

The endocrinologist I found went above and beyond my high expectations. I met with both her and an OBGYN on the same date in March. This was unplanned, it just worked out that way. The OBGYN was not based out of the same clinic. I received an overwhelming amount of information that day all about planning for pregnancy and that I could not start trying until my A1C came back lower than 6.5 and as close to 6.0 or lower as possible. I had known this, however, it still felt like a daunting task. Type 1 diabetes takes constant attention every hour of the day and I had not been putting it first.

I felt great about my endocrinologist, she had been so sympathetic, understanding, and it was like talking to a friend as much as a doctor! She also provided me the guidance and motivation I needed. She was able to give me tons of information on diabetes and pregnancy. She shared stories of other type 1s she had worked with, giving me extreme confidence in her experience as well as motivated me to accomplish my health goals. The OBGYN I saw that day was helpful, but I was less impressed with her knowledge/experience with type 1 diabetes and decided after that I would not be seeing her again. I would be finding a OBGYN through my current endocrinologist's same clinic/health group.

I felt very overwhelmed after these doctor appointments. To get personal, I came home and basically cried my eyes out for a week. This was the most difficult grieving for my diabetes that I had every experienced. I took my diagnosis like a champ. I have always felt blessed by the lessons diabetes gives me and the pride I have in taking care of myself. That doesn't mean it is easy, but I work hard at making the most out of the negative situation. Well, March 2013 was a different story. I cried over diabetes at work, in the car, and at home. It was because it was the first time I felt different, scared, overwhelmed, and that it didn't just affect me anymore but my future, the health of my child, and my ability to live a normal life. It felt unfair that pregnancy would be so much harder for me than for most of my peers. Especially when I felt like a normal health 27 year old, despite the occasional annoyance of diabetes.

How did I pick myself off the floor? Finding supportive and knowledgeable doctors was the first step. The second was getting my blood sugars down. I had been on an extended "break" from my insulin pump. I was taking shots of NPH and humalog instead. After a long conversation with my doctor I finally agreed that I shouldn't wait until I found out I was pregnant to switch back over. Switching back and forth has always been easy for me. This was tested when my pump broke just a month later!!

Third step for me was finding the book, Balancing Pregnancy with Pre-existing Diabetes by Cheryl Alkon. I discovered this book online the day after my doctor appointments, ordered it, and had it by the end of the week. This was a turning point for me. The first few pages were exactly what I needed to hear! It was like picking up the phone and having an instant friend with type 1 who was telling me everything I was feeling and saying, "It's going to be okay, you can do this". I started highlighting and reading excerpts to my husband.

Fourth, I established my support network. My friends were amazing and listen to me whine and complain more than I ever have (or so I think). I didn't hold back, I shared with the people closest to me what I was feeling. I began explaining diabetes more often and the things I was doing to take care of myself on daily basis. My husband and I talked at length about things I was concerned about and how he would be a part of the team in managing my diabetes.

Fifth, I attended the TCOYD conference. I needed this conference more than I knew. My husband went with me and we both felt such a great connection to everyone there. He turned to me and said what I was thinking, that it was so nice to feel like you could instantly relate. We were surrounded by type 1s all day, which was nice because I can't always relate to type 2 diabetes despite some similarities. We met a young husband and wife with a new baby. The wife had type 1 and we were able to stay in touch with them. She gave me great advice such as how to curb after meal high blood sugars by "super bolusing".

Sixth, I got a continuous glucose monitor (CGM) after meeting with the reps from Dexcom at the TCOYD conference. Seventh, armed with all these tools, some crazy blood sugar logging charts, and help from training for a half marathon... I got my blood sugars down. At my endo appointment on May 6th my A1C was down to 6.3!! I told my doctor that with her approval I would like to start trying for a baby in July with possibly an even better A1C (6.3 is pretty crazy good, I was hoping to hit "normal" territory of just under 6.0). She said that sounded great but that she also felt if it happened sooner, it was fine. She said many endocrinologists would say to be 6.0 or below for pregnancy. However, she said understood how difficult this is for type 1s (amen to that) and that she was more than comfortable with us trying with an A1C below 6.5!!

Eigth, following my doctor appointment I made an appointment to meet with a Dietician who also was a Certified Diabetes Educator. This appointment gave me the ground work for understanding what foods to eat during pregnancy as well as helped me with my non-pregnancy meal choices! I started following her advice immediately and began snacking less and feeling more full!

Thank goodness my doctor said "no worries if it happens before July", because that same month, not 4 weeks after my endo appointment I was already pregnant!!

28th Birthday: Celebrating Where I've Been and Where I'm Going!!

I love birthdays. It's "my day" whether I spend it relaxing or doing something big! I love celebrating the start of another year of life and reflecting on the last one. I think age should boosted about! (I also hope to always feel this way beyond 28!! I hope to celebrate 40, 50, 60 and "better"). Getting older is a blessing, feeling "older" is a choice. 

This past year has been adventurous.

At age 27 ......

I underwent my most challenging year working as a Speech Pathologist yet and survived!

Traveled to Guam to visit my dad 

Wine tasted locally (and on some wine walks!)

Got TWO ipads to implement with my students

Attended my first San Francisco Broadway Show...The Lion King

Had my mom visit me in California

Spent Christmas in Oregon with family

Traveled to Vegas with my husband

Got snowed in at my aunt's in Mt. Shasta....TWICE

Found new hiking spots! 

Ran my first half marathon with friends in Eugene, Oregon

Bought a new car. First car we've owned not from the 90s!

Got a Dexcom Continuous Glucose Monitor

Attended a "Take Control Of Your Diabetes" Conference and made new friends

Took my students to Great America

Celebrated our 9th family reunion in Iowa

Moved in to a home!

AND went on a "babymoon" to Kauai, Hawaii BECAUSE on a special day in May I found out that my husband and I are expecting our first baby!!! I'm currently 13.5 weeks pregnant. Baby Barrett is due February 7th, 2014!! Here comes the best adventure and life challenge yet! 

A huge part of starting this blog was actually to be able to share this experience when it happened. I looked frequently for blogs about type 1 diabetes and pregnancy when I decided I was ready to start preparing. Now that I've been information loading for months I have lots of resources. I want to share my experience as well. The updates will be very type 1 related! I have been drafting posts about pre-planning for pregnancy and my experience the first trimester. I will be posting them soon!