Type 1 Diabetes and Pregnancy: Baby is here!!

Today is my Diabetes Anniversary! I was diagnosed 14 years ago: March 14th, 2000. It seems so fitting to be posting about and reveling in the birth of my son today!!!

Our baby has arrived and is almost a six weeks old! WOW how time has flown by and how busy it has been.

I love being a mom. The exhaustion is definitely an adjustment and I couldn't be happier about having to deal with it for what I have in return.

I'm going to share a little about my labor/delivery process........

I went in on a Thursday night at 10pm to prepare for a Friday morning induction. The nursing staff did my intake and attached me to monitors for the baby's heart rate and contractions. I was administered Cervadil in order to soften and hopefully begin dilating the cervix.

 The hospital standards are that diabetics be placed on an insulin drip. I had strongly indicated that I was not keen on going on one at all. This topic became a constant conversation during my doctor appointments. She was very strongly working to persuade me that it would be difficult for me to not go on one. I finally agreed that I would be open to being on a drip once the IV was started on Friday and once I had the opportunity to discuss the administration of the insulin with the nursing staff. I'm quite a control freak about my diabetes and I've been the only one administering myself insulin for 14 years. I was not keen on the idea of handing over that control.

Friday morning at 830am my doctor checked in on me. I had only dilated to about another centimeter putting me at 2 centimeters. She gave the nursing staff the go ahead to start pitocin. My nurse recommended I eat breakfast and get up for a walk before starting. At 11am they started the IV of pitocin to induce contractions. I felt good for a few hours and got up to walk the halls to hopefully help move things along. This required a lot of help from my husband to drag along the IV and monitors attached to me.

My wonderful doctor must have put it in my charges that I was a control freak about my diabetes because my nurses were beyond respectful about my wishes. They even admitted IV drip protocols are written based on gestational and type 2 diabetes. They agreed to allow me to wear my pump as long as my blood sugars stayed below 120. This freaked me out because that's so difficult for a type 1 to pull off! I had amazing nurses, but I still felt they didn't readily grasp type 1 diabetes. For example, my blood sugar did spike to 140 after breakfast and right after they started the pitocin. The nurse let me take a correction bolus and said we'd start the IV if it wasn't down in an hour. Well she didn't check me for like an hour and a half and I was down to 70. Then she asked me why I thought it dropped so much!!! This is a completely typical change of numbers any day in the life of a type 1. As for "why?"...I took insulin...that's why...or because I'm in labor.....

 After that a diabetes miracle happened and my blood sugars stayed between 80-100. This may have been partly thanks to them not letting me eat! According to one of the nurses, "labor is the equivalent of your body running a marathon". Because I was being induced I was not allowed to eat due to increased risk of unplanned C-section. So a 15 hour marathon and no food. Awesome.

I was able to stay on my insulin pump thanks to my supportive nurses and great luck with blood sugars. The nurses even told me the rest of the staff thought they were crazy for not having me on a drip, again, I felt very thankful.

Around 4pm my contractions were a minute long and a minute apart. They were hurting to say the least and I was starting to have a hard time coping. I hadn't written a birth plan in order to keep an open mind. My doctor had checked in on me at 430pm and told the nurses I could have pain meds whenever I wanted. Around 6pm I decided I wanted them. My nurse gave me Fentanyl through my IV to take the edge off while we waited for the anesthesiologist. He arrived pretty quickly and the Epidural insertion didn't hurt due to the fact that I had the IV medicine. The Fentanyl only last about 40 minutes just enough time for the epidural to kick in. My legs were very numb and heavy feeling, but to my relief I could still FEEL them.

The nurse checked to see how far I was dilated and to my dismay I was still on 3.5 cm after a full day of pictocin. I was feeling a little stressed and worried that if things didn't progress I would have a c-section and my hope was for a vaginal birth. I relaxed, reminded myself to keep an open mind, and decided to try to get some much needed sleep.

Thanks to the epidural I was able to sleep about 5 hours and woke up right before midnight. The nurse checked in and I had dilated to 6-7cm, finally! My husband had finally fallen asleep himself. I decided to wait until I was closer to 10cm to wake him. He woke up around 130am and it was time to start pushing a little after that.

Our son was born at 3:14 am weighing 7lbs 8oz. They placed him on my chest immediately and I was able to hold him for at least 30 minutes until they needed to weigh him, check his blood sugar, and give him a bath. All this happened 5 feet from my bed in the newborn warmer.

My blood sugars initially skyrocketed after labor. Possibly from a variety of reasons: They finally let me eat so I stuffed my face with granola bars because that's all there was until breakfast, I had also been receiving dextrose through my IV in order to avoid spilling ketones (I had a few ketones before they gave me dextrose because of how hard my body was working and not receiving food), and my body had just been through labor so the stress could have spiked things too. 

My sugars stabilized after breakfast. They continued to check my son's blood sugars at intervals until he "graduated" from blood sugar checks after 12 hours. He had been borderline low for an infant and they gave him some formula to be on the safe side. (My son has a very low chance of developing type 1 diabetes. The blood sugar checks at the hospital are to look for lows. Babies born to diabetic mothers have usually been exposed to a sweeter environment prenatally, even with good control. After birth their own pancreas might be overcompensating and this can result in low blood sugars.)

My insulin amounts decreased steadily the days following delivery and I am actually now on smaller rates than pre-pregnancy. Breastfeeding has lowered my blood sugars and made me thirsty/hungry often. My endocrinologist called me after I was home to congratulate me, ask how things were going, and follow up with some prescriptions!! I happily told her how diabetes now appears "easy" compared to managing it when I was pregnant!! Haha! All about perspective.

Diabetes and pregnancy has been my greatest challenge with type 1 diabetes. I feel so thankful to have had a healthy pregnancy and blessed with a beautiful baby boy. My husband and healthcare team were above and beyond. The hard work has really only just begun, but the newborn challenges are so much more rewarding!

*What works for me might not work for you. If you have questions, concerns, or are thinking of making changes to your diabetes care always contact your doctor.

Type 1 Diabetes and Pregnancy: Final Weeks

I have finished up my final growth ultrasound. Baby is still showing up in the 50th percentile and I sure hope it's accurate (I've heard it's not!). I'm seeing my regular OBGYN for the weekly NST and checkups. In the next week if baby hasn't made his debut we will start discussing and scheduling an induction! My next update about diabetes and pregnancy will be post-baby! 

A few last pregnancy pictures (37 weeks)! We had time before we rushed off to a dinner date to snap these at a ranch by our house!! Finally a few non-gym clothes AND not taken on the iphone!

A sweet quote that my mom recently sent. Some good thoughts as I prepare for this new journey.(The more I read it the more I think this can be applied to any aspect of life, not just raising a child!)

If I had my child to raise over again,

I'd finger paint more, and point the finger less.

I'd do less correcting, and more connecting.

I'd take my eyes off my watch, and watch with my eyes.

I would care to know less, and know to care more.

I'd take more hikes and fly more kites.

I'd stop playing serious, and seriously play.

I'd run through more fields, and gaze at more stars.

I'd do more hugging, and less tugging.

I would be firm less often, and affirm much more.

I'd build self-esteem first, and the house later.

I'd teach less about the love of power,

And more about the power of love.

It matters not whether my child is big or small,

From this day forth, I'll cherish it all.

- Diana Loomans

Type 1 Diabetes and Pregnancy: Week 32-35

Almost nine months!! Starting to count down the days. Needless to say I'm ready to meet this baby soon! 

Doctor Appointments:  There are so many now I've lost track! 

• I go weekly for a Non-Stress-Test (NST) and check-up with my doctor. 
• I had another growth ultrasound at 34 weeks. Max was an estimated 5lbs and still in the 50th percentile. My high risk doctor said I was doing so well that he didn't need to see me again until right before delivery. Yay!!
• My high risk doctor did order an abdominal ultrasound of my right quadrant to look to see if I had gallstones that might be causing my persistent pain. It revealed nothing, which wasn't a surprise based on my symptoms and other testing. Also, the pain pretty much went away completely during the winter break. This points to it being muscle related and probably work/stress related! 
• I had another A1C completed for December which came back at 5.9, up from my last two at 5.5! My regular OBGYN was still very happy with it even though I was feeling a little bummed it went up so much. I had to remind myself 5.9 is still beyond stellar (heck anything under 6.5 is stellar). Also, I survived the winter holidays and still managed to stay below 6%, nice! 

Keeping baby in the 50th percentile hopefully and blood sugars in goal range!

How far along: 35 weeks

Gender: Boy

Maternity clothes: Everything is maternity! Refusing to buy anymore clothes so I'm doing laundry twice a week just to have gym pants!

Stretch marks: No.

Belly button in or out: Definitely out.

Sleep: Sleep requires massive amounts of pillows that I then have to climb over multiple times a night to visit the bathroom and drink more water. Naps needed!!

Best moment this week: Mini-vacation to the beach with my husband. Our last romantic getaway before becoming parents!

Worst moment this week: Right up until our mini-vacation my husband was very sick all week. Together we made one pathetic mess of trying to take care of each other!!

Miss anything: Holiday cocktails and being able to do my workouts in their entirety!

Movement: I think he has been practicing his kick boxing and soccer moves. We can see my belly moving now.

Cravings: More like splurges. On holiday food. Starting the New Year off with clean eating goals!

Queasy or sick: A little nauseous if I don't eat regular healthy meals. Mostly fatigue.

Looking forward to: Full term status around the corner and meeting this baby!

35 weeks and not in pajamas or gym clothes. Probably should have documented the moment by using a better camera!!

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!

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.