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!

Sweet Stuff

A fellow teacher and I took two students to California's Great America this week. We had as much fun as the kids! We were so proud of their behavior and our own ability to keep up. We had a healthy lunch at the car and got plenty of walking done. Had we known that it included a miniature waterpark we would have also done plenty of swimming! Now we just need to go back!!

A Monarch butterfly let me get very close to her!

Hansen's Junior Water Organic- I've been running my blood sugar tighter lately and this stuff is perfect for the lows! 8 grams of quick carbs! My other go-to low blood sugar snacks include natural fruit strips!

A1C- The Diabetes Report Card

For those who are not familiar with the term "A1C", it is not a new fangled bbq sauce. An A1C is a snapshot of the last 2-3 months of blood sugars. As a type 1 diabetic, this is blood work I have done every 3 months. It takes a look at how my sugars have been overall. A certain amount of sugar remains in the blood stream attached to red blood cells and this test measures that percentage. A percentage of 4.0-6.0 is considered the "non-diabetic" range, 6.0-8.0 is typically considered an "in-control diabetic" range (at least for type 1s and typically less that 7.0 is best). Higher than 8.0 is considered at risk for further complications and not in great control. When I was diagnosed with diabetes my A1C was 14.8!!! It should go without saying that I was very sick.

 

After being diagnosed, I stayed in the 6.0-7.0 range for many years. In the most recent years, I've been hanging around 7.0, my last A1C was 7.3. This March, I found the BEST....can't stress this enough, BEST endocrinologist (diabetes doctor) I have ever had. I've had so many doctors over the years and some have been pretty good, but this woman shows them all up! She is understanding, knowledgeable, experienced, and personable. Her support and guidance has helped me get back down to 6.3, and looking forward to staying as close to that "non-diabetic" range as I can. Please note that even if my A1C goes below 6.0 I still will be and will always be a type 1 diabetic, it just would means I'm probably losing my mind every hour of the day to accomplish those numbers without causing myself more problems with lows!

All the half-marathon training, 5am workouts, walks at lunch, blood sugar logging, carb counting/logging, doctor emailing, Dexcom use, and insulin calculating pays off! (The above picture is from Type 1 Diabetes Memes site on Facebook.)

Sweet Stuff

I've been sick this week with a nasty head cold and sinus infection. Took Monday off of work to hang out in bed with lots of DayQuil! On the positive side:

1. I ordered a new pump clip! My last one is 5 years old now. After my insulin pump broke and I needed a replacement, I've been paranoid of other things breaking! I use my clip almost everyday and lately it has been feeling a little flimsy.  Now I have a new pretty clear one!

2. I've woke up at 5am for the last 4 days to go to the gym. Working out with a friend and texting each other in the mornings has been seriously the best! I have always had better blood sugars all day if I start my day with exercise. Exercising in the evenings is usually easier, but I have a harder time sleeping and am more prone to overnight lows. 
 
My friend recently heard that working in the mornings means you burn more calories overall! Makes sense to me, my blood sugars are better when my metabolism is higher! Win-win all around. However, as you can see I'm not super excited to be up at 5am. 


3. It has been 4 years since we rescued our baby Luka!! Always a puppy.


 

4. The administrators at my school have been bringing us breakfast for the last two weeks because of the state testing going on. Waffles, egg dishes, tortilla casserole, sausages, yogurt, boiled eggs, fruit, and coffee. Seriously feeling spoiled and going to miss it!


 



5. HAPPY MOTHER'S DAY!! I am blessed to be surrounded by amazing moms, grandmas, mother-in-love, foster moms, stepmoms, and even aunties!!!

And MY MOM!!! Happy Mother's Day!! Found this cute picture my mom took of us in a photo booth when I was scanning pictures this summer. I just love it!! Love her!

Sweet Stuff: Eugene Half Marathon

I flew to Portland this past weekend and drove to Eugene in order to visit some college friends! Ran my first half marathon (13.1 miles!) last weekend! For the record, this was not my idea. This was my college roommate's idea and the "purpose" of our trip. Which was really to just see friends and eat at our favorite restaurants. It was successful in that we more than made up for the calories burned during the half marathon. 

Some highlights:
1. Traveling. This was my most productive airport experience ever. I discovered that the San Jose Airport has a meditation room, yet I skipped it and splurged for a massage chair and margarita instead. 
2. My bag of cucumbers at the dinner table. I had no time to spend in Portland so my mom and brother met me at the airport for dinner. I didn't want to carb load on chips with my dip so I ordered a side of jicama and pulled out the cucumber snack I had packed instead. (This was after eating chocolate on the airplane of course). I spend my carbs like I spend my money, get the most out of it! So.... chocolate>chips!
3. Arrived in Eugene and greeted by the adorable "Wadsworth"!! The pet of the amazing friends who hosted us in Eugene!    

 

4. We went to Florence for the day, a coastal town. It was amazing weather for Oregon spring. The beach was actually warm!!

5. We enjoyed a small jaunt down to the coast called "Hobbit's Trail" and played some frisbee on the beach. I cannot throw a frisbee, but it was still awesome.

6. Dutch Bros Chai Latte! It says "I missed you". I missed you too, Soy Chai latte!

7. With friends along the river.

8. My training for the half marathon was exhausting and I was discouraged, but turns out I must have done it right because I beat my goal time. I still came in last of my group of friends though. However, they've all run half marathons before so I had that excuse to make me feel better.

9. My friend Erin was doing the race as well and joined me. Since she has done this BUNCHES she basically paced me the whole way, I would not have finished nearly as quickly on my own!

 

10. The hosts of the weekend ready for the race!! 7am and bright-eyed!

11. Puddles was there for photo-ops! I flew to Portland, drove to Eugene, and ran 13 miles....picture with the Oregon Duck? Um YEA!!

The whole trip was a fabulous escape, so thankful for such great friends and company!

Diabetes note: I was very careful with my blood sugars during training and the race. I run with a Camelback backpack which holds: water, blood sugar meter, back-up sugar, emergency glucagon shot, Dexcom CGM clipped on where I can constantly look at it, and I keep my insulin pump on. I reduce the rate of my pump usually before exercise, sometimes more during, and remove it if I know I can after much trial and error. I check my patterns using the Dexcom and check my blood sugar at least once during a long workout or if I feel low. During the race I ate a fruit strip, piece of banana, and drank one of the cups of gatorade they hand you to keep blood sugars stable. 

Seven Days of Dexcom

My Dexcom CGM (device that monitors my blood sugar patterns) has software where you can upload the data to your computer. Unfortunately, your computer needs to be a PC. My husband and I find ourselves in a world of nothing but Apple these days. I'm slowly going to think of a way to get a hold of a PC or Windows in order to upload eventually. If you have one I can borrow....let's talk. :) 

I wouldn't need it so bad if my receiver would show more than just the last 24 hours of blood sugars. I want to keep track of the patterns over the days

So I'm waiting for them to develop a web based system overnight just for me. In the meantime, I've been trying to remember to take a picture of my Dexcom trend graph every night so I can look at it later. Humoring my geekiness, here are my charts over a weeks time. 

Friday: A normal diabetic day. That little arrow means my blood sugar is slowly rising. I kept an eye on it.

Saturday: "Bubble tea" day. My husband and I had a craving for bubble tea and drove across town to get some. I carefully studied the nutritional facts online and made a choice based on the carb count. Turns out this did not include the tapioca balls. We could not for the life of us figure out how much was in them. I have had bubble tea a million times, but it's been awhile, and this one really shot up my sugar. Lesson learned; no more bubble tea until I figure out the carb count. I'll probably just be skipping it in the future, so not worth the almost 5 hours of high blood sugar. Well, not this time. I might change my mind on that during my next craving.

Sunday: This one shows the nasty low overnight after I finally came down from my bubble tea high ("bubble tea high" ...ya I'm chuckling too). My blood sugar was finally looking good and I fell asleep on the couch while my husband was on the computer. He woke me up letting me know my receiver was alarming and to check my blood sugar. I haven't had a high of 300 for at least two months and then on the SAME day a low of ....46, I haven't been that low in even longer. Your typical diabetes roller-coaster. I probably should have seen it coming. Seriously though, no more bubble tea.

Monday: This day was all in range and well earned! Notice the little blank space? I had to replace the sensor, it takes about 2 hours before it starts detecting blood sugars and then all set for the next 7 days after that.

Tuesday: This day was actually all in range. The dexcom was off by a little bit. For the most part I've felt like it is very close. Some days it matches almost perfectly.

Wednesday/Thursday morning: I forgot to take a picture of the Dexcom Wednesday night because that was the day our car went up in smoke and then came home to a backed up sink. When it rains it pours! So I took this Thursday morning. 

Friday: Definitely a trend of post dinner highs. I've made some adjustments already.

These graph may look a little crazy and maybe even scary to a non-diabetic. For a type 1 these are very typical and those ups and downs very normal. A non-diabetics blood sugars vary in this fashion in a smaller range throughout the day as well. 

My husband and I attended an event over the weekend where we heard another type 1 diabetic joke, "The perfect blood sugars would be a flat line...but we all know what a flat line means in the medical world." I immediately turned to my husband and said, "that's not funny". It's still not funny, but I appreciated her pointing out the impossibility of perfect blood sugar graphs.

 A zoomed in version makes it look much different. Oh, and I treated the low. 

Sweet Stuff

It's Friday and no better time like reflecting on the highlights from the week and embracing another well deserved weekend!

1. I had an amazing Easter with my husband's family (sans my working husband). Full of good Filipino food (hello lumpia!) and the best family! I had so much fun I completely forgot to take any photos so hopefully Aunt Ev doesn't mind that I stole one of hers. 

2. Easter also came with it's type 1 diabetes mayhem. My 5 year old insulin pump broke. It got a little wet during a morning run because my Camelback leaked on it. Thankfully it was working up until dessert. Then I became quite the entertainment for a few minutes with my alarming insulin pump. My pump company has the most awesome customer service. One great phone call and two days later, replacement pump in my hands! Thank you Kenya from Medtronic! Also, I didn't mind a few days doing the insulin shot thing. It was a nice reminder that switching back and forth is not so hard. 

3. The pump broke just in time for my new Dexcom Continuous Glucose Monitor (CGM) to get here. I was able to learn how to start using with only the tutorial videos and my paramedic husband supervising. I watched TONS of youtube videos including this cutie: Superhero CGM. In case you don't know, this amazing piece of technology measures my blood sugars from the tissue under my skin and sends the information to a receiver I carry with me. The receiver graphs the blood glucose trends. I can see if my blood sugar is rising, falling, or stable. I can track changes and make well informed adjustments.  

In the picture below, it shows a low blood sugar in the red zone in the middle of the night. The receiver's alarm woke me up and I treated the low with carbs. However, you can also see that I actually over-treated the low and immediately had a high blood sugar right after. I would not have woken up so soon for the low or had known that I'd over-treated it because my blood sugar was back to normal in the morning! Just awesome. Maybe a whole post on this life changer in the future, but if you're curious now learn what CGM is here or visit Dexcom's website.

4. Found the best almond butter brand at Whole Foods this week. I don't care for almond butter by itself because it is usually chunky and tastes bland to me. I usually just use almond butter in baking recipes and put it in smoothies. However, this stuff I could eat by the spoonful. Hoping this "Barney Butter" will help wean me off of my peanut butter addiction. Unfortunately it costs almost twice as much as regular almond or peanut butter. I find this brand to be much more satisfying and therefore I haven't been tempted to eat the entire jar or even half as much of it as I normally would. Hoping it slows down my consumption enough to be worth the cost!  

5. Last and best of all, not only is it Friday, it's SPRING BREAK!! Looking forward to relaxing and soaking in some good weather. Waiting patiently this favorite California flower to start blooming, Lily of the Nile. They look like giant dandelions/pom poms.