Wednesday, August 25, 2010

Backblogging week 13: new CGM and why people should think before they speak~

Or at least they could start by asking questions. :)

So we made it to our 13th week, Littlebird. Actually, I'm in my 14th week as I type this, so we're really, really starting to move along now, aren't we?! Soooooo excited to meet you!!!! Truly, you are the best gift in my life (besides MAC, your dad.) :)

So anyway, back to what I was er, complaining about. So I'm finally starting to tell people, and gals weren't kidding when they said that people absolutely love to give unsolicited advice. I don't even know if I'd call it advice. Sometimes it just feels like commentary. Everything from diabetes-related (no, you actually don't know what the hell you're talking about, random person) to breastfeeding and diapering. I have thought about all of this for a very long time, thank you very much. I know where to get my questions answered and certainly have no intention of listening to snobby know-it-alls. You'd think people might give a gal at least a little bit of credit. We planned this baby so carefully, took care of my type 1 so carefully, had so many conversations with each other and mentors and those we's not like we have no clue what's going on here, people! Yeesh! Sorry, I just had to get this off my chest. Better now than later, eh? Of course, it's never going to stop. People even do this when your kids are grown! ;)
On the diabetes front, I got my CGM! (You can see it poking a bit into the pic there.) Whew! It's really interesting. It is a lot to deal with, I won't lie. Yet one.more.thing plugged into me. But I'm so very grateful I'm on the Revel now and the CGM transmitter just sends the data to the pump and another menu opens to use the CGMing aspect. I just hate the site. It's really gawky and feels large...but I'm getting used to it. The tegaderm is pretty itchy. But I'll talk about what happened when I didn't wear the tegaderm in my next post. :)
The whole trending aspect takes a little getting used to. Part of it is I've been on it only a few days and am still titrating my numbers to more closely match my fingersticks, but also just learning not to jump the gun and mess with it too much. I know people who freak out about their diabetes way too literally creates a vicious cycle of freaking out about your numbers, only to make them worse, then you freak out some more and surprise! they only get worse. So, like the CGM trainer said, you don't want to just keep staring at the screen all the time. Sometimes we just need to calm the hell down with this disease, do our best and go take a walk. I refuse to let this disease ever own me.
Case in point: we went to the in-laws for my mother-in-law's birthday this past weekend. I always get a little nervous at parties. Because, let's be honest: parties center around food. Good food. Carby food. Untimed, munchy, grazy food. Now, I must say my in-laws are just fabulous about my diabetes. They always let me know what we're eating, when we're eating and if they added a little sugar to a recipe I would've otherwise assumed had none (read: 3-bean salad). My sister-in-law is so cute too, and even makes whole-grain pasta instead of white when she makes this awesome pasta salad with things like black olives, artichokes, sauteed mushrooms and some wonderful dressing she concocts. Yum.
So I was in charge of making the cake (I know, I know: ironic and hysterical). I made a vanilla layer cake with strawberries and whipped cream...kinda looked like this (only I sweeten my baking with agave nectar). Nevermind my dog ate half of each layer cake the morning of the party, forcing me to bake two more [insert wildly hysterical laughter here]. The point is, it all worked out and everyone liked everyone's food. The bigger point is that my blood sugars are always excellent when I just let myself have fun in food-heavy social situations. Instead of stressing about the food, I just do my best...often finding that it's enough. I honestly don't know what it is, but it works like a charm every time. Good times, good sugars. Who knows why, but I think it has to do with something called relaxing and having a good time. ;)
I really want this pregnancy to work out. I want this baby to be so happy and healthy, not under the influence of uncontrolled diabetes and emotional stress surrounding it for the next 6 months. So it's been great so far to see all of my diabetes-related out, and my trying to just let things go whenever I'm worried...about this disease or not. Ya, sometimes I'm still bummed about the how-the-heck-did-I-get-type-1 question, but most of the time, I'm really amazed at how interesting and different my life has become, what I've learned, what makes me laugh, what gets me excited now. And right now, let me tell you, this baby is pretty darn exciting.

Friday, August 20, 2010

Backblogging week 12: the lows got the last word~

August 13th, 2010

(Look at that baby pooch!) !!!!!!!

This week, whew! I spoke too soon back there in a previous post about "what is everyone talking about with the lows?!"
To eat everything under the sun and still wake up with blood sugars of 50 at 2am and then again at 7 am...yeesh!! What the heck?! Kinda scaweeeey.
My CDE has to keep turning my night basals down. Oh, and she turned my afternoon basals down, too. She also increased my insulin to carb ratio and insulin sensitivity factor. To think all of this is gonna change to accommodate for greater resistance in a few months is mind-boggling to me. Because frankly right now, I'm amazed at the amount of food I can ingest without insulin. Sometimes it literally freaks me out. It's like, ohmygoshijustgotcureishouldremainperpetuallyinthefirsttrimesterinordertokeepdoingthis.
Uh, not.
So on the appointment front this week:
I had my 2nd ultrasound (yes, I know, it's nuts I have to do them so early.) But I did get to check out small fry from the 4-D approach this time. Wow, so weird to see his/her little face! Because I love to laugh, I started laughing of course (with tears in my eyes) and the tech was like, "um, well now. Can't get a really good picture here with all that jiggling around..." But it was so darn exciting! They did the nuchal measurement, which is an indicator for Down's syndrome. So far, baby looks ok. They also looked to see if all of Littlebird's limbs were intact (so far, so good, oh and uh, no wings) and the heartbeat (nice and strong at 160).
On the lab front:
My last A1c came back at 5.8% (I promise that's not me bragging, imagine chasing all those lows!) and all of my other blood tests like Total Protein and 24 hour protein came back fine. I also opted to do the first phase of contingency screening; which is solely blood-based genetic screening for Down's and another chromosomal defect. You can go on for amniotic fluid testing if the blood tests come back iffy, but this increases your risk for miscarriage and is only done (well, it's not required) if you're really high risk (ie, over 40) and worried. I get my results next week. Hopefully, being only 29-going-on-30, my risk is low. But *phew* always a little scary. So far, things have been turning out ok.
As you can see, my wee belly is starting to truly have a tiny bulge. I can't tell you how excited I am to finally *see* this. For me, a skinny gal all my life, gaining a belly---albeit one that makes me temporarily look like I drank too much beer (I kid, I kid)---is pretty darn exciting.
Next week:
I get my CGM (because I'm using the Medtronic Revel now instead of the Ping) next week. Thank god. Because if I'm chasing lows right now, I can't imagine the heinous stress of chasing highs in a couple of months. Wow, I'd be a total.nervous.wreck. Actually, without a CGM at this point, let's make that a capitalized Total Nervous Wreck.
I'll also begin to go through my clothes to decide which ones can fit over this strangely shaped bulge: too small for maternity wear, too big for what I own. Oy! A very interesting situation indeed, and one I am determined not be solved by running gear---as tempting as that is right now, haha. :)

Thursday, August 19, 2010

Backblogging week 11: new pumps and yucky bugs~

August 7th, 2010

Well, well, well. Week 11 was certainly exciting. No, I'm not being sarcastic---what ever made you think I'm like that?! :)

I'm finally getting a real baby pooch. Kinda kangaroo like. It's funny how you expand from the base, up. When you think of pregnancy, you think of how gosh darn big those bellies get and forget they don't just happen! It's been fascinating to me, being a science nerd and all, to watch this process happening in my normally wee body. Wow! I'm pregnant!!!
Ok, enough of that blubby-blub, sorry. :)

As I said very early on, my pregnancy CDE and Perinatologist wanted me to switch to the Medtronic Revel system for comfort's sake (combined CGM and pump, but still two don't get too excited. It's not an artificial pancreas.) So while there's two sites, it's certainly more comfortable than I would've been had I had to wear both pump and CGM devices. (Hi, my name is Emily! I'm just your regular robotic pregnant diabetic!)
Having said that, I had my pump training on my new Revel. I need to post a pic of my new pump. I got the purple one. I must say, it's pretty hip.
The pump training was pretty easy for me considering I was already on a pump (the Animas Ping). They all do the same things (thank god) and so the verbage and screen scrolling is just a little different. I.e, "insulin on board" on the Ping is "active insulin" on the Medtronic. As I get to know things about this pump, there are definitely pros and cons. I'll do a post on that after this. However, they're both excellent pumps and I don't think you can go too wrong with either one. I may like this one a tiny bit more, though. Except for the fact that it's not water proof like the Ping, which bothers me a lot for some reason. Maybe because a pump is like an extra appendage when you have type 1, and if it can't get wet it's kinda like being told you can't stick your foot in the water. Then again, wearing a pump might make my bathing suit fall down. :)
Towards the end of the week I contracted some very strange 48 hour bug. OH MY GOD. It was so awful. I am not a sickly person. The last time I got sick was when I got diagnosed with type 1 in 2008. So when I got this awful headache Tuesday that blew up into a combined headache with tummy cramps and well, you know, I was not a happy bird. I'm just glad I wasn't vomiting. So I was forced to just lay still. Everytime I tried to move around the house I was met with more stomach cramping. YUCK. So I just ate chicken noodle soup and drank raspberry leaf tea. This helped a lot and I was able to kick whatever yucky bug made its way into my body by Sunday.
*Raspberry Leaf is so wonderful!!
Here's why:
It's an herb that is useful in treating diarrhea as it is very astringent. It tones the digestive tract, essentially cleaning it up. It is also the premiere pregnancy herb, tonifying and strengthening the uterus for the course of the pregnancy, labor and birth.
*You just buy the loose-leaf tea preferably from an ethically-wildcrafted herbalist like Mountain Rose Herbs and put about 2 Tbs into boiling hot water, steeping for a few minutes. I like using a tea-straw to drink my loose-leaf teas, but you can also use a tea-ball. You can drink this wonderfully-easy-tasting tea all throughout the day when you have a bout of diarrhea or stomach problems, and at least twice a day when you're pregnant.

Well, we've made it through week 11, Littlebird. I hope you're doing ok in there. We have our 2nd ultrasound next week. Let's hope we get good news about your heartbeat and growth.

Wednesday, August 18, 2010

Backblogging week 10: chocolate pudding and the lows~

July 29th, 2010

As you can see, still not much of a bulgy bulge. Just an Emily-did-you-gain-a-few-pounds?-look. In fact, because week 9's photo is more close-up, I'm wondering now if this photo's more accurate in that it shows...absolutely nothing. Ha! But this bird still finds that little bulge quite exciting. :)
The lows have been really, really (did I mention really?) fun this week. Wow, amazing. Gals weren't kidding when they said it sometimes seems like you've got a bit of mini-D-cure going on in the first trimester just because of all the damn lows.
But they're not fun. oh no, they are not.
At times this week it was like I could eat things I could never eat (pasta! bagels! potato chips [all organic mind you :)] and I still could barely keep my blood sugar up. Constantly chasing. Because I've only had type 1 for a couple of years, I think my hypoglycemic awareness is still good and I really, really (wow, really is really my go-to word for this particular post, eh?) try to catch lows around 70 to keep myself sensitive. However...[voice trails off] that has not been so easy lately. Gosh, one day this week it was like, ew, I feel a little bit odd and BAM! 34 on my meter. Just like that. No warning. No reason. And I don't know about you, but when I'm that low, I just feel sick. Drinking juice is not refreshing, but actually gross. But a girl's gotta do what a girl's gotta do.
Then, I had the joy of doing a 24-hour urine test. This checks for protein spilling into your urine (protein in your urine is a sign that your kidneys are not functioning properly). Well, trying to pick a day where you're going to be at home more than out was hard enough, but just the whole, oh wait, the jug! it's in the fridge! next to juice! experience was beyond laughable. That night, I of course had to pee twice. Thank god I remembered to put the little pee-catcher-thingy on the seat. Then you have to take it into the lab right away the next day, where you feel like they're inspecting it for drugs or something as they take it from you. Let's just say the whole process is a bit degrading. Hi! I'm uh, here to drop off my...pee.
The only comfort this week was in making chocolate pudding. Super tasty. Didn't save me from the lows, but homemade chocolate pudding certainly saves the day. Hell, it saved my week. With a dollop of homemade whipped cream, it was the well, cream on top.

Tuesday, August 17, 2010

Backblogging week 9: the waves of nausea are so fun!

23 July 2010:

This week I finally met my new friend named Nausea.
Before, I was fine.
Then, I was just queasy.
Now, pure nausea. pure.
The worst part (haha, I know, laugh) is that sometimes I wish I'd just get it over with and barf.
But no, oh no. Not me. I get the joys of that awful feeling in your stomach FUN!
So MAC and I thought we'd use the "polarize it" app on the iPhone for our weekly pics. I haven't taken any before this because well, as you can see, there's [still] not much to see. I kinda just look bloated, if you ask me. ;)
But do you see that teeny-tiny pooch sticking out right above my pantline? Ya, that wasn't there before. I've been the same weight since forever...give or take a couple pounds. So let me tell you: this is so darn exciting to see a little pooch of ANY kind on me!
This week according to we have organs kicking into full gear and an almost-complete heart (good job, baby!) I'm also ecstatic to read about tiny eyeballs and earlobes being near-completion. Because as everyone knows, I like to talk. So of course I can't wait to talk to my little one!
As for diabetes. The lows are getting a bit crazy. And yet, I'm struggling to keep my numbers in control after breakfast. The CDE said that it's the pregnancy hormones causing the more difficult-to-control highs after breakfast. I'm now eating hard boiled eggs and corn for breakfast (don't ask: next up, the post on cravings!) :) This combination seems to be working for me right now, though: animal protein seems key along with a more whole-food based carb. Even spelt toast with peanut butter (my go to for the longest time after my diagnosis in 2008) no longer works. That's ok, the idea of peanut butter right now makes me wanna puke. So let's please stop talking about it. ;)
Exciting news though! My CDE and perinatologist really wanted me to be able to use the CGM. Because I'm on the Animas Ping pump, I would've had to get either the Dexcom (which was not covered, but is partnered with Animas) and is a completely separate device worn, or the Medtronic pump's CGM. Wearing a pump, a CGM and its monitor, and then the two sites would've been really fun you can imagine:
Random person I am sure to meet: Hey, look over there! It's a pregnant robot!
Me: Back off, bub! Anything for a healthy baby!
But really, it would not have been a fun experience to be 8 months pregnant wearing all of those....electronics.
However, Medtronic's latest pump is an integrated system called the Revel: yes, you still have to wear the CGM sensor and your regular insertion site, but the sensor on the CGM sends the BG data to the pump!! So I only have to wear one device! I just got approved to switch to the Medtronic Revel system and will go on the pump (I got the purple one! It's so cute! Yes, I'm weirdly excited about the color of my pump technology!) the first week of August. I'll start integrating the CGM in a couple of weeks after that. Kind of annoying since I'll already be in my 2nd trimester, but hey, better late than never. And honestly, as the numbers become harder to control in the highs department, I think I'll be more worried about catching that. My hypoglycemic awareness is still quite good (only having type 1 for about 2 years). It's still freaky though! I check my blood sugar about 12 times a day just to stay on top of everything, high or low.
So far, so good! My last a1C was 5.8% (mostly due to lows, let's be honest) while my others were more steady at 6% when I was planning the pregnancy and when we finally got pregnant.
I can't wait to post these posts! I wish I could, but I'm still so nervous about being in the 1st trimester and all its vulnerability. *Yikes* I just keep focusing on the positive and my deep gratitude just for the entire experience so far...oh my god, I'm a mama!

Monday, August 16, 2010

"Backblogging" week 8: the truth is...!

July 15th, 2010

Well, I'm 8 weeks pregnant.
I can't tell you how utterly excited and crazed with joy I am!
But, in classic fear of getting too sentimental and attached, I'm not announcing the pregnancy until I know it's safely after the first trimester.
I've wanted to write draft posts since I found out (at about 5 weeks) but to be honest, it all felt so strange and unreal still. It was like, noooooooo this isn't really finally happening! After all that planning and working and planning and working for the past year with Endocrinologists, meeting with OBs, talking with Maternal-Fetal Specialists and Diabetes Educators---we now have a baby on the way. And I hope it stays that way. ;)

It's all exciting, but funny sometimes too, because I haven't felt that wonderful. Oh, it's not like I've been vomiting all day long. Just the generalized queasiness. Ugh. It's awful. It's like that nauseated feeling you have after getting over the flu: you want to eat, but are kinda feel just a bit too sensitive still to be sure. Oy. Sometimes it's made better by eating, and other times I just want to run and hide from the looming refrigerator begging me to make dinner for MAC (my honey) and I.
I also found this fun website that tracks your pregnancy (after you've entered your dates to get the due date). It sends you an email each week to read about how baby's growing. So fun! I'd like to start taking belly shots because that'll be just :)

I haven't been struggling with too many lows, as most women have told me I would...gosh, everyone had me so worked up about getting a CGM for fear of dying. Well, but I can't say it's been easy. My BG's only stable if I eat just so but I haven't had hypoglycemic unawareness. You have to remember though, I've only had type 1 since 2008. I am hoping to get a CGM though. We did a 5 day "silent" reading (I didn't wear the actual device, only the sensor) through my hospital last week (in order to get a long term one approved) and guess what? the stupid sensor failed. 5 hours into it. Ya, I was pretty flippin' mad. I wore that darn thing for 5 days and it wasn't even working 5 hours into it. nice. So we're doing a second trial this week. I'll post about the results.
One frustrating but interesting tidbit is that I was switched to Humalog from Novolog right when I found out I was pregnant because a couple of studies showed it to be ever so slightly safer for pregnant women, as far as fetal development goes. Unfortunately, it threw my sugars so way off I had to switch back. Thank goodness I've met plenty of type 1's who used Novolog with perfectly healthy baby results, or I would've been having a cow (well, no, I'm not having a cow in 9 months!) about what to do. Maybe I spoke too soon about not having lows. I struggled so much to keep my BG in check that terrible week I was on Hellish Humalog, maybe now the "regular" pattern many women report of lows in the first trimester will begin to happen. Let's try and not jinx me here. :)
No specific cravings, although I am completely and utterly grossed out at the idea of a cup of coffee right now, which I used to covet every morning. I literally start gagging at the thought. Oh, and there was one evening MAC watched me work through an entire jar of pickles. So I guess I lied. ;) I was reading in Aviva Romm's fabulous book "The Natural Pregnancy Book" that the craving for vinegary foods "encourages our bodies to release calcium into the bloodstream" (a good thing for a growing baby who needs strong bones!) She tells us that usually when you "improve [your] intake of protein and calcium, no more cravings [for vinegary foods] happen." So interesting!
So this is where I'm at. So far so good. I'm saving these until-after-the-1st-trimester-posts as drafts because of the risk of miscarriage. But I'm feeling blessed and healthy so let's hope this baby---we'll call him/her Littlebird--- can stick around for an extended visit. ;)

Wednesday, August 11, 2010

the intimacy of food, part 2~

Wow, I seem to have a pasta theme going on lately with this whole "sometimes I just wish I could eat" topic.

The reason this blog post is broken into two is because the first time around I was just thinking about the most essential ingredient to type 1 frustration: the desire to just eat. Like normal again. To just, you know, get on with it.
But the second part involves something so much more external. It's hard enough having a somewhat, shall we say, strained relationship with food. But what can be even harder is when other people get involved.
Oh, you type 1's all know what I'm talking about:
the good old Diabetes Police.
When I'm in a situation with what we folks from Pittsburgh call "nebby" (aka, "nosy") people, I sometimes feel strangely obligated to eat something overly healthy. Or, to not join in on the shared lava cake for dessert. Now, with understanding people and close friends, I don't feel that way. But every once in a while, when I'm at a party, some loud mouth's gotta say, "Emily, get your hand out of the cookie jar." No joke.
But what can be more difficult is when you have to go to the Endo or the CDE---as nice as mine are, they're only human---and sometimes when they're looking through my logs and spy a day I had a real problem meal, comments like, "My god, what did you eat?!" can come flying.
Ouch. There has got to be a different way to say that, Doc.
What makes this hard is that in the first place, I have to talk about my food. Talk about feeling like you have an "eating disorder." That we have to even do this; show "food logs". So.Darn.Weird. But don't get me wrong, I willingly hand over my logs and am anxious to learn and perfect this sometimes extremely unkind disease. So all in all, things work out. But every once in a while, when I'm hit with the comment, "What happened here?!" there is a rush of guilt.
No, anger.
No, embarrassment.
No, shame. That's it. Like I have the ability to control every outcome of this disease. Like I should be able to predict and determine every meal's perfect 100 ending. Sometimes, diabetes really is like being in the flippin' Olympics. You try ice-skating while serving drinks to the judges and audience, then land a triple axle on one foot.
The bottom line is that again, the intimate relationship we should be able to have with our food as human beings---as snackers, munchers, decadent chefs, sense-blowing souffle indulgers, is not so easy with diabetes. It can be so hard to eat certain meals when you're thinking, "if this goes wrong, my CDE might say, what on earth did you eat?!"
A lot of this might still be due to the fact that I've only had type 1 for a little over 2 years. I'm still learning about certain foods....even the healthy ones, like beans. Beans can be tricky for me (all that fiber combined also as a carb and a protein). However, I wouldn't trade the discussions I have with my CDE and my Endo. I learn so much from pouring over my logs together. And, as my very first Endo said (and I still really believe this is what defines a good Endo; one that is gentle and does not judge):

You own this disease and understand it in a way I never will.
My job's just to help you see the forest from the trees.

Monday, August 2, 2010

the intimacy of food, part 1~

Sometimes I just wanna eat.
I don't want to think about it. I don't want to count carbs. I don't want to worry about if I should or shouldn't be eating a certain thing.
Sometimes I look around and I see all of these gross people mindlessly stuffing themselves full of french fries and pasta and cake and triple mochaccinos with an extra shot of "carb" and I just wanna be them.
Of course, I'd be sick to my stomach at the end of a day of eating like that, but still. You get my point.
Heck, it's even just the wanting to eat some soup and salad for lunch and hoping the bolus goes ok (too much? too little? too EVERYTHING?)
Now, I know that doctors and diabetes educators tell us we can *technically* eat whatever we want (especially someone like me, who tends to be underweight) but we all know that's not a healthy way to live. And honestly, I like eating healthy. But sometimes I just want some damn french fries. And why do I not eat french fries, you ask?

1) They are a carb count I will never figure out. What is 15 grams of french fry? Do you count them, one by one? Do you just grab a handful?
2) They require a combo bolus (dual wave, to medtronic users) that I simply can't get right. I already have a hard time with this type of bolus, but I really don't wanna mess my cards up doing it on flippin' french fries. Let's just say hours of painful work ensue.
3) I actually don't like french fries that much (honestly). But man, when I want some....
*Please insert the word "pasta" into the above numerical discussion. Now you see why there are just certain foods that make me wanna cry. Especially because I technically *can* grab a handful of french fries in an attempt to measure them, but with pasta? C'mon on. That's just not a dining experience you'd want to share with anybody.

What I'm talking about here is intimacy. With food. My food. But it becomes more than just "my food". Sometimes it feels like it really isn't my food. I look around at a picnic or a restaurant or a dinner party sometimes and it seems like everybody's got their own food but me. Like me and food need to go outside and have a little chat; make an agreement: now you be nice this time. I told you about how what you did last time was
There is so much that goes into eating a meal when you're a type 1 diabetic that you simply cannot plan for...the pre-meal number. The type of food. What you're doing after you eat. The random person who comes up to you to say hi right as you are calculating a bolus, causing you to forget you wanted to do a combo bolus instead of a straight shot. Oops. Life happens.
It takes away the ability to savor your food sometimes. Don't get me wrong, I also think type 1 diabetics are some of the most savor-your-food type people on the planet. But there's always a twinge of anxiety as you check that post-meal number, hoping the calculations and planning and timing and...conversations all.went.right.
So sometimes I just wish I really owned it. Food, I mean. Like we had this intimate relationship. An understanding...the way it should be when your immune system isn't busy attacking your pancreas (what the heck are you doing down there! Get back to your real job, ya lazy...SYSTEM!) Then, you just eat. Mindlessly sometimes. But in my [mostly] healthy world of living and eating, mindlessly simply means I'm focusing on the conversation with my honey. Or my friend. Or my book. Or whatever got stuck in my tooth.