Saturday, November 12, 2011

starting from scratch~

I had my monthly appointment with my CDE the other day. I told her I felt like a complete mess. Yes, I am a perfectionist about a disease that the word perfection has no ability to even sit in the same room with, but still. I'm trying to keep my a1C under control (it's creeping up) and after my seizure this summer, I need to be extra careful not to let low blood sugar sneak up on me so…well, scarily, again. But it's creeping up partly due to that paranoia and also all these breastfeeding hormones and well...life as a new mum.

I sometimes feel like I'm taking care of two babies, to be thoroughly honest.

It can be hard to eat normal meals when I feel so on the run lately. My boy (aka, Littlebird) is literally on the run now, since he started crawling. I'm just trying to keep him out of the potted norfolk pine we have in our living room. He sticks his chubby little hands in the soil and then proceeds to pull on Norf's branches until he rips off a sample to test. Yum.

So I've found myself tending towards the good old "3 Meals a Day" habit. Not a good one. For anyone, diabetes or not. 4-6 small meals really is the way to go as far as regulating blood sugar and only giving your body a bit to process at one time. But there I am, day after day for the last 3 months, eating 60 grams of carbohydrate in one sitting. Which to most people is not a lot, but that's really hard for your body to metabolize all at once.

At my appointment, we talked about 'starting from scratch'. I'm trying to take it easy on my body again, especially because a woman's body is never the same after having a baby. Especially a type 1 diabetic's, ah! The irony of the situation is that I really, truly need to eat more carbohydrate in order not to lose too much weight since my boy is exclusively breastfeeding still (here we are, nearly 9 months in; more on my take on all of that later) and I'm already my pre-pregnancy weight. Controlling my blood sugar before I had my son was a challenge but it didn't feel as impossible as it does sometimes now. Let's just call it what it is: Hormone Hell. I feel like as I attempt to maintain my weight (it's always been hard for me to keep weight on) and do so by eating more carbohydrate) I end up in this high/low to low/rebound high battle with my BG---as you can imagine: a vicious cycle ensues...

Oh, what a situation to be faced with! But I know this isn't really a situation...it's a condition of my life and I just need to learn to make it work for me as much as possible as hard as that might be. I know some type 1 mamas I've talked to have said it gets easier and I think that's because children get more independent as they get older---a good thing! But for now, I'm literally dealing with what feels like the same thing over and over and over again: Littlebird gets into the Norfolk Pine pot, Littlebird gets into the unable-to-be-moved office computer cords, Littlebird is having a major meltdown right when I'm having low blood sugar. Oy. And as you know, I can't let that go. No discussion.

So I end up dealing with a lot of "diabetes guilt" for so many other reasons than the common ones discussed in the DOC (diabetes online community). The kind of guilt that stems from the fact that I deal with a disease that has very little leeway in certain situations when my son is overwhelmed and needing me---feeling like there is very little leeway for that, haha! As I look down at him sitting on the floor, red-faced and screaming while I chug a juice box, his eyes demanding WHY ARE YOU IGNORING ME?! I find myself looking forward to the day I can explain it to him and he can actually, truly understand. But for now, we struggle in our communications at times; it's all a learning process I know. And yes, yes: I know he doesn't 'hold it against me', but well, it doesn't change my feelings of frustration and anger and guilt surrounding this godawful disease.

So I'll end this post with things I am thankful for because there is always a 'real' reason to look up:

-I am thankful he is so strong and healthy and happy---oh my gosh is my son HAPPY!

-I am thankful for my own health. I have access to everything I need and more and considering my frustration, I'm doing just fine. There's always room for improvement, but hey: that's just life.

-I am thankful for the amazing support system I have in my family and "friend-family". My partner, Matthew, has really done nothing short of amazing in learning my disease-process right along side me, and my close friends are like my family in that they've reached out and been compassionate and understanding without being pitying or condescending. They trust me to know myself, but know I trust them to be there for me in case I need them in a pinch with this beast of a burden!

All in all, it's a wonder, really, isn't it? All of us doing as well as we do, making positive little changes each and every day, whenever we can. Knowledge is power. And we do have a lot of power.

Wednesday, October 19, 2011

i miss granola~


I used to eat freely. Before March 2008, that is.

Now, I know some of you reading this are saying, "Here we go again. She's complaining about how she wishes she could just eat."
Bear with me.
Am I technically venting? Well, yes. So please bear with me because maybe I'll make all you non-diabetics hungry and you can go out after reading this and buy yourself some of the snackies I so wish I could freely eat without complication. Things like granola.
Why granola?
Because it's damn tasty, that's why!
Granola is made of:
oats (carbs), fruit (carbs), nuts (protein-fat-carb), [often] honey (carbs). Then of you course you must have milk with it (carbs-protein).
As you can see, granola is a high-carb food. Off the top of my head I can tell you a 1/2 cup (that's right, 1/2 cup!) has 56 grams (!) of carbohydrate (and this can go higher depending on the type of granola) in and of itself. This does not include the tasty milk that mustmustmust go with it.
I am abnormally educated in nutrition. No joke. Every type 1 diabetic (I believe I mentioned this a loooong time ago in one of my posts how we are your [free] source of information on food) who is even slightly attempting good blood sugar control knows so much about food it's almost enough to make you lose your appetite. So really, just ask away.
Everything from what type a food is and why, how it metabolizes in your body when you eat it, and the best part: how it metabolizes in combination with other types of food.
I am simultaneously getting hungry and irritated as I write this, believe it or not. And this is mostly because I'm craving granola.
I would say though that the hardest foods to process are not just 'pure' carbohydrate---like granola. You get quite the spike in blood sugar from a purely high carb food just because it takes a lot of work for your pancreas to spill enough insulin in time to keep up with that amount of carb floating around. The problem therein lies in that combination issue I mentioned above. So do yourself a favor and take it easy on purely sugary foods. This is why it's so important for everyone (not just diabetics) to combine proteins with carbs; it helps slow the carbohydrate release down so that you you burn food more like the "normal" function part of this graph than the "diabetic" function image part. Oh, the struggle.
But as you can see, I'm also not saying what a lot of people like to say to diabetics Oh, you can't eat sugar!
They're trying to talk about straight sugar, like we all crave sitting around downing restaurant sugar packets or something. Um, no. As a side note though, I did see this guy at a coffee shop last week who pouuuuuured (I say pouuuuured because he did not just 'add' some, he pouuuuuured) white sugar and then pouuuuured honey into his coffee for nearly 5 seconds a pouuuuur. Kid you not. Just because his pancreas works doesn't mean it wasn't giving him the finger for that.
So the hardest foods to keep up with as far as diabetes goes (at least as far as I know) are those that are equally high in fat as they are carbs. And of course, they are often the most comforting and tastiest foods:
Icecream
Pizza
Mashed potatoes
Fries
Mousse
Yoghurt
Nutella. Oh, deardeardear Nutella---you are a post in yourself.
Why so difficult? Because when you eat a carby-fatty food (or a fatty-carby food, depending on your view, I guess, haha) the fat literally slows the carb's release and then later, as the carbohydrate finally begins to make its way through for metabolizing, your pancreas has to do one helluva job to keep up with all that carbohydrate suddenly entering your bloodstream. This is why type 1 diabetics have major issues when they take a huge dose of insulin for say, pizza. They crash an hour later (the fat in the cheese is holding the carb back so now you have all this insulin floating around and no glucose to attach to) you treat the awful low, but then 4 hours later (sometimes up to 7!) you have this HUMUNGOUS spike because now there's no more insulin to help the carbs now ready for processing. Nice. And so fun to deal with, right? Low, high, high, high, looooow. So thanks be to god for pump technology; that's what "combo bolusing" and "dual wave" bolus functions are for---they break up your insulin dose into a percentage over a period of time that you decide on so you don't get this boatload of insulin all at once. Kinda like the way everybody else's pancreas functions. Well, the way our pancreas is supposed to be functioning. Hooray! Let's all go eat pizza.
(Hmm, it has just occurred to me that I think I'm writing this post because it's basically a pep talk for me not to raid my snack cabinet of all its granola.)
But it's also a pep talk to all of you out there who are perhaps reading this. Well, obviously you're not 'perhaps' reading this if you're reading this. ;)
Our health is so worth it, though; all this annoying-but-oh-so-important figuring it out. And some foods that are advertised as healthy snacks can be sneaky---like granola. So I've learned to take it easy on my pancreas (Peabody). He did his best and now my insulin pump (Peabody Jr.) does his best, but let's not push it.
So I am now going to go have some granola. Strawberry Almond Hemp, my fave. A small bowl, not like the bowl in that picture up there. That's gotta be like 115 grams of carbohydrate, easy. And while it frustrates and embarrasses me to no end that whenever I want certain things like this I actually need to use a food scale which then makes me appear to be on a diet (I guess I am, kind of) it only helps me to learn how to eyeball foods better in public when I um, do not have my food scale with me. (Can you imagine?! Just call me Type 1 Mary Poppins; I'll be pulling lamps out of my bag before you know it!) Hey, it's better than counting out 23 pretzels, haha. But please note the food scale's not for restricting food so I can restrict my weight. It's the food scale's fault: it's actually restricting me from eating an entire bag of potato chips (the way I'd really like to sometimes!) Honestly, it's helped a lot in doing correct measurements for my carbs so my insulin dose is correct, too.
I've also found this reallyreallyreally great vanilla almond milk to go in my granola and to eat cookies with. It's only 2 grams of carb per cup and quite creamy and is absolutely awesome chilled. Oh, but it's yucky in coffee, though, just a warning. :)


Thursday, September 1, 2011

seize the day, literally.

In July, I had a seizure. Ya, seizure. Let me start off by first just saying yowza.
Now, maybe some of you have had one already. Or maybe you haven't. Maybe you're thinking ohmygoshyoumustbeareallybaddiabetic.

Well, what's a Really Bad Diabetic, anyway?!
Is it someone who doesn't 'do what their told'?
Someone who doesn't check their blood sugar?
Someone who refuses to take insulin if they need it?
And these are just the basics.

What about all of the complicating factors that go into being a person with diabetes---and a person who cares about their disease a lot, at that. I honestly believe that the people who engage and deal with this disease every day and keep it under relative control are those who see how complicating it is to their lives and those around them the most. You find yourself trying so hard to own it, control it, tell it how it's gonna be, that you end up being the person that sometimes feels like they can't take anymore. Of course, as with anything else you've given the finger to---whether from burn-out or just plain apathy--- if you've stopped caring, you're trying not to think about it. This works. For a time.
But I care. I really do. That's what bothers me about the seizure the most. It wasn't a result of my being reckless with insulin or checking my BG or any other diabetic-related matter.
Do I sound sensitive?
Well, I am about this situation, I've realized. Because I work so hard at keeping this disease balanced. Trying to control it, you know? Well, sometimes, diabetes just feels like it's got control over you no matter what you're doing so right.

Having said that first, now let me get into what happened:

I had just finished breakfast and nursing my son (I am a full-time breastfeeding mama to my superhealthy son right now) and our family was headed to the local farmer's market, like we do every Saturday during the growing season. I checked my BG in the car right before we got out and headed over to shop and stroll. I was in the mid-80s with about a unit on board. Not too shabby, so I drank a juice, planning on buying a delectable little snack (like we normally do) when we got there. As we were getting ready to walk over, I asked Matthew, my partner, if I should just wear our son (I'm big into babywearing). He said, "Na, I'll just carry him today". By the way, they both have the same outdoorsy hat and it's so.freaking.cute. I think he just wanted to show Littlebird off, haha.
Good thing.
Looking back now, as we did our initial shopping, I was starting to lose my mind. I was buying things without even thinking about why (3 tiny tomatoes? what the heck was I planning on doing with those exactly?) I usually have a good idea of what I want to buy to make for dinners that week and man, was I off. As we made our way around the bend (almost to the snacky-food area!) I saw an old friend and simply said, "heyhow'sitgoing?" and kept walking past her (she later told me it was as if I didn't recognize her). The last thing I remember is thinking I was tripping and going. "Oh, wow". Scary.
Of course I wasn't exactly present while I was having the seizure, but from what I was told, this is what happened: I started to fall in that "tripping" way like I said, but kind of on a woman (poor woman and my dead weight!) and she kindly attempted to break my fall. But I just fell. When I hit the ground, clearly seizing, not just passing out, people made some space for me. Serendipitously enough, an ER doctor was doing his shopping for the week too and just so happened to be passing by (I'm always amazed at how lucky I've been in life, yeesh!) so he stopped to assist. He said I only seized for about 2 minutes, which is a safe-from-damage number, neurologically speaking. When I came to, the crowd dispersed (good lord, how embarrassing) and because we were next to the stand selling pies, the man behind it starting shouting "hey, you wanna buy my pie?!" Um, no. We don't. want.pie.right.now. Sir.

It really was the perfect place for such an er, incident. The paramedics were already there and just helped me up and they decided to transport me because it was my first seizure ever. Even though they realized I had type 1. To be honest, it's all still blurry from after I woke up all the way to being put into an ER exam room. I'm not sure how well I would've been able to walk to the car, etc---had they decided not to transport. The rest of that day and the next two were all pretty foggy and dream-like, actually.
It took an hour or so for my BG to actually come up and stay up. They gave me good old Tang in the ER and even made me eat half a sandwich and my BG was still in the 70's! So it probably was the safest bet to not just 'sit up, relax, head home'. I was pretty bummed we had to cancel our brunch plans with awesome friends, though. :(
One of the hardest things about it all was the post-muscle-aches. My whole jaw was sore from clenching (every muscle in your body contracts during a seizure. Nice.) and I had a lot of back pain. Even my legs hurt; like I'd been running and out of shape or something. But it eased up in the next day or so. Phew. Thank god for epsom salt baths.
So I know you're wondering, How did this happen?!
Apparently, type 1 diabetic nursing moms are particularly at-risk for seizures. The risk combo of going low from nursing, constant change in how the body processes food, and of course all our fave: female hormone interactions can create what my CDE called so eloquently "a perfect storm of events". Boy, was she right. That day, I'd just eaten breakfast, nursed, used my brain at the farmer's market (which always causes me to burn glucose like crazy) and all the walking, too---yeesh, it's no wonder I just went ahead and passed out.
I just wish someone would've um, you know, WARNED ME.
Even a little bit. About the whole "type 1 diabetic nursing mothers are at high risk for seizures" thing. Ya, that particular warning would've been a real help, I think. I dunno, maybe that's just me. ;)
But, there are so many warnings given to those of us living with this disease. I think good CDEs find themselves not wanting to become that person. You know the one. The person always warning you about being a diabetic. How a 'good' diabetic is, was, and always shall be. Ya, that one. Riiiiight.
So I'm getting back on track. I have a whole new respect for low blood sugar I didn't think possible because I never let a low go (hey, that sounds kinda cool) and have tons of kiddie juice boxes all over the place. However, that blasted day, I only had one and didn't follow it up immediately like I usually do with some carb with protein type snack I keep in my handbag to keep from dropping again too quickly. Oy.
The following week I rode a bit high on my numbers because, frankly, I was terrified out of my mind of it happening again. Like when I'm driving with my little one in the car. :/
Then, my CDE and I started to slowly work our way back to a more normal glucose range safely. I'm still struggling with the lows, but that may now be due to my breastmilk changing. Ya, no one tells you that, either. Breastmilk changes in its nutrient content throughout that first year depending on the baby's needs: sometimes it's higher in fat, sometimes its water content is high for greater hydration purposes, etc.
But I want to make it very clear that I'm happy with my decision to do what is called in the U.S "extended breastfeeding" [insert cackle here because in other cultures it's just called, er, feeding your baby]. It's always been really important to me to provide the wonderful nutrients and immune-regulating properties in breastmilk to my child[ren] for as long as their bodies needed/wanted it (aka, baby-led weaning/solids) and so far, so good. Did you know the immune-regulating properties in breastmilk actually increase after baby's first year? Good enough incentive for me, being a person with an auto-immune disease trying to do the best I can to regulate my kiddo's immune system---um, thanks!
So here I am, doing my best, but sometimes, if this disease was a psycho ex-boyfriend (er, none of mine are psychos, just boring, mostly) I'd like to go after it all knuckle-busting-style and beat the royal crap out of it. But I can't. I just can't. As close as it is to me, every.single.flippin'.day---I can't beat the crap out of it. I can only work my arse off at a friendship that is, at best, 1 and 3/4 sided. And that's on a good day.
But...have I mentioned how so dang worth it all the craptasticness of it is, because my little guy is healthy and happy---and mostly, short of a couple of bruises from falling, so am I?


Thursday, June 2, 2011

sometimes we just need a little reminder~

He is so worth it.
There are days where I'm so overwhelmed dealing with not only the emotional roller coaster of having just had our first child (well, 3 1/2 months ago) but also literally the hormone-hell that is messing with my body in general being a type 1 diabetic.
And then, I need a place to put Littlebird while I do laundry and he looks up at me like... that. My heart melts and I know, no matter what, he makes it all worth it. He motivates me endlessly. He fills my heart up with so much love, it's overflowing.
MAC (his dad) and I really worked for our baby. We had to plan so much because of my Type 1 Diabetes that it started feeling like the romance was being taken out of babymaking! ;) But I'm so glad we did. Our little guy is not only a bundle of joy, he's super healthy and happy (as you can see.) We're both pretty sappy, I guess. Maybe all new parents are. We actually still get tears in our eyes, though, like all googoogaga, you know? ;)
What I'm trying to say is that while my body still adjusts constantly it seems while I'm breastfeeding, I often beat myself up for all the pendulum swinging I can do. Highs to lows, lows to rebound highs. I'm so grateful for having a good pregnancy CDE. She's been my lifesaver! Each week still, it seems I'm needing to get some slight adjustments to my basal rates as my body comes out of pregnancy fog. It's a wonder to even ponder what nondiabetic women's bodies are going through to readjust. No wonder everyone feels crazy for a while. I know I...still do! ;)
Food is (as always, when will it not be?) still a struggle. I'm trying to navigate that fine line between foods that won't make me spike and foods that will sustain me through nursing so that I don't go low. While I've got the nighttime basal rates down (20% reduction after nursing to prevent bottoming out) I'm still trying to figure out the window during the daytime to prevent delayed hypoglycemia but still provide enough of a baseline for daily life. Ugh, what a complicated mess it can be. But we're getting there. Oh wait, where is "there"? Right. We're constantly figuring the ever-changing "there" out.
The thing about type 1 diabetes is that it's one of the realest lessons in learning to go with the flow. It's one of the greatest lessons in learning to be compassionate with yourself. It's one of the worst things to deal with---counting every gram of carbohydrate that enters your body (let alone how it interacts with everything it's combined with) but it's also one of the best ways to learn about good health. Because health is not just a number on the scale. Health is wholeness: it's how you view yourself. Your mind, your body. Your food and where it comes from. How you savor it, if you savor it. Health is wholeness. It's about wholly enjoying life and all that it should truly be about. We talk a lot about learning to love ourselves in this culture, but how many people look like they're the walking manifestation of self-loathing? Why don't we stop to slow down and take it all in...I mean it all in: the good, the bad, the ugly. If we could do this for ourselves, we could certainly do it for others. But instead, we're hard on others and even harder on ourselves.
Maybe that's why when you get diagnosed with a chronic disease it's easy to start the self-loathing cycle.
Well, I promised myself to try to make the 'enemy' part of this disease (re: my immune system up and deciding to attack my poor little pancreas) my friend. I sometimes wish I could say things like, there are no compromises! I shall conquer and WIN! but unfortunately, this battle's not going to be 'won' like that. This battle (like most conflicts in life, if we'd all just wake up and realize this fact, globally) takes negotiation. It takes compromise. It takes discussion. And it takes a helluva lot of work.
It'd be a lot easier to just get up and run away screaming from our disease. But that's just it: it's too easy to burn out. Oh, we all have our burn-outs. But I'm talking about people who completely and utterly give up. They're done. So over it. Their eyes are going. Their kidneys are going. They're just like...Eff it. And when it's really frustrating...who can blame them?
But we've gotta keep going. You have to find that something that makes it worth it.
I know I have.

Monday, April 25, 2011

It's a damn wrecking ball~


Frankly, this is how I feel regarding this bloody disease lately.

To continue on with the 'building' metaphors, I feel like I built such a strong foundation in my body last year as I prepared for pregnancy. And ya, the building went up, strong as granite, built to protect my sweet Littlebird. He grew and grew and I stayed healthy all throughout.

Then he was born.

I can barely begin to describe the havoc that post-pregnancy hormones wreak upon a type 1 diabetic woman's body.
Sigh. Guys have it so much easier.
Combining all of the pregnancy regulating hormones still processing out of the body, on top of the ones it needs to produce all this milk, let alone the mess type 1 creates in and of itself on a daily basis...I'm a wreck. I feel like a wreck.
Then I got my bloodwork back last week. I was honestly really freaked out about my thyroid panel results. I know that type 1 and autoimmune thyroid disease often go hand in hand (nice) and that women's thyroids often get wonky after pregnancy in general...so I feared the worst. But I kept talking to my body (I'm really into mind-body medicine) and kept saying to myself how I rejected getting another autoimmune disease (go ahead and laugh). Maybe it worked. Or maybe I was just lucky this time around, but my results came back fine.
And my A1c was 5.6%
Good? You readers might be jealous, but I'm honestly not sure how to take it. I know that number is due to a lot of post-breastfeeding lows that I'm still trying to work out. I've found that if I do a temp-basal of 80% for 2 hours after each feeding at night, it prevents the impending low. My CDE wanted me to just snack, but I was like, "um, all I'm thinking about is sleep, not eating at 2 a.m." So that's how I tinkered that temp basal right. But during the day I make sure I snack because otherwise I'll not be replacing the calories I lose through feeding him. I'm already starting to lose weight a bit too fast (I only have a few pounds to go until I'm my pre-pregnancy weight....not exactly a good thing considering I'm such a small gal, ugh!) So I'm trying to monitor this issue closely so I don't become like er, 1995 Kate Moss.
Then last week, I started having more post-partum bleeding. Not heavy, but it upset me because immediately my blood sugars started to go NUTSY. We're talking insulin resistance that caused my numbers to skyrocket. I even hit a 400. So I changed out my site and did a major pump and dump session of breastmilk. Talk about waste. And diabetes guilt. I was so mad. I was so tired. I felt so....disgusted.
Are you getting the picture? I'm up, down, up, down. Like one of those freakin' circus hammer bell games.
The most frustrating thing is that I'm generally a healthy eater. (Point: we went out to eat with a friend Friday night and I ordered Beet Loaf. You read that right: BEET LOAF. Why? Because I happen to like the damn stuff!) and I ended up with BGs in the near-300's. (Yes, it was a balanced meal. And yes, it had protein.)
Then, just as I was thinking about this stupid post and possibly freaking out more about this stupid freakin' disease...my blood sugars stabilized. Interesting that it happened right as that extra postpartum bleeding I'd started having stopped. That's why I hate hormones. Pregnancy was hard, but this....this is sometimes just pure insanity.
Why?
Because I'm caring for another little human being. And the irony of it is that I'm no good at caring for him if I don't take care of myself first. There's no healthy Littlebird if there's no healthy Mamabird to take care of him.
So I'm trying to refocus. To stay calm when things skyrocket or bottom out. To keep positive because I'm actually not doing that bad (read: it's not like every blood sugar's been 300). It just takes time. My superwonderful OB told me at my postpartum check up, "it's kind of a lie to tell women that they're fully postpartum and ready to 'move on' at the 6 week mark. Like it's this magic number where your body's just back to normal. It's more like 3-6 months!" So as my body recovers, I need to remember the process is not just from the physical act of giving birth, but all of the complex, chemical, internal processes that had to occur to make a baby, let alone feed one now. With my own body, (yeah that's amazing, right?!)
I'm just trying to stop judging myself so harshly. I've always been my worst critic. Not a good disease to have with perfectionism, I'll admit. :) The ways I've been easing things now are just by keeping my foods really, really simple (whole foods like yogurt, almonds, wild rice, cheese, dark greens, eggs, apples...and keeping a lot of snacks on board to prevent those breastfeeding lows and also so I can keep my meals small to prevent any spikes.) I've also promised myself a 30 minute walk each day during the week just to clear the babyfog. It's nice because I get to listen to my Ipod while the tinyman sleeps in his stroller. A good time for headspace.
As my CDE said, "we're getting there" and she's right. It's a journey, not a destination. I need to remember that. This is a day-to-day thing. I made it through one of the toughest scenarios with this wrecking ball of a disease (a pregnancy) and managed to build a damn palace out of it (my son) so I think I deserve a little credit after that week of pure hormone hell that I had last week. So my CDE's gonna be saying 'we're getting there' as long as I'm alive with this disease.
And I plan on being alive with it for my little birdy for a very, very long time.

Monday, April 11, 2011

guidance for planning a type 1 diabetic birth (just my 2 cents) ~

I wanted to write this post because now that littlebird and I are settling in, I know there are still a lot of unanswered questions and/or thoughts regarding my pregnancy and birth. There were certain things (especially towards the end) that were very, very helpful that I think gals can take advantage of and try doing in an attempt to have as healthy and natural a labor and delivery as possible. Of course, as you can read from my birth story below, not everything always goes as planned (ie, I ended up getting an epidural and some pitocin assistance even though I went into active labor on my own). As far as getting my body into natural labor though....hmmm, well, you can leave that up to the "experts" if you like, but I truly believe that many of the things I was doing during my pregnancy and especially those couple of weeks before littlebird's delivery (weeks 37-39) assisted in essentially opening my body up for his arrival (ie, going into natural labor rather than being induced).

[Added later: I just thought of this, but feel it's really important and helpful. If you can, please buy Cheryl Alkon's book "Balancing Pregnancy with Preexisting Diabetes". No, she didn't pay me to say that. :) It's really just the most informative book out there on the subject and you won't regret her guidance.]

Things I think are essential to a healthy Type 1 diabetic pregnancy:

Plan it. Don't ignore the things you need to work on.
Yes, it's that easy. And that hard. Give yourself at least 6 months to do this. Whether you need to get your weight under control, your BG in better control, or your emotional state...just plan it. Go after it with fire and fight if you have to. If you want a healthy kid, the best thing you can do for them and yourself is go into it with your best state of physical and emotional health. If you don't do this and just "wing it" (like my CDE told me some gals do because they're just so frustrated and drained and just want a baby---can I hear a collective W.T.F?!) you will end up being extremely stressed out that first trimester. As if you won't be enough. Don't add fuel to the fire! Not only will you be nervous from knowing this is the window most common for 'regular' miscarriage---a fear every woman has---but also all the fears your diabetes brings up. Increasing diabetes-induced stress is a big no-no, in my humble opinion. Don't do that to yourself. It's not worth it. I was so nervous when I got pregnant but....I knew my body and mind were healthy and doing well. I knew my type 1 was in control when we got pregnant. I knew it wasn't an issue. I was better equipped to handle those common 1st trimester lows. I was also not sitting there royally freaking out during those early 1st trimester ultrasounds wondering if his brain, heart, and spine (those most affected by out of control blood sugar during conception) were ok. Deep down, I knew my kiddo was ok and if not, it was most likely not due to my type 1 and we'd just deal with all that from there.

Pick your OB and pregnancy CDE (and if you can, Perinatologist) before you conceive.
The OB is most important, I think, because they make the final calls on how and when you deliver...and will actually be delivering your baby. Trust me, you need to love them. Not just be "ok" with them. You need to really respect and be comfortable with your OB---and feel they give you the same. These are, most often, the 3 you will see---depending upon your state of health, you may have other specialists assigned to assist you. I just saw these 3 providers. Also, your CDE absolutely needs to know pregnancy and diabetes inside and out. If not, you're going to have a very hard time. While I loved my OB, he also didn't know the ins and outs of how to deal with my type 1. You will, with a good CDE, be talking to them weekly (or moreso) to make adjustments...especially when you hit that insulin-resistant phase during the 2nd trimester and literally might need changes every few days.
*A note on perinatologists: I met several before I got pregnant in my planning phase the year before littlebird was even conceived. Now, if any perinatologists are reading this, please don't be offended. :) Honestly, I felt that many of them took the same approach. They all wanted to automatically induce me at 38 weeks and due to their training, obviously, they are not really around "natural" birth a lot. They're dealing with high-risk pregnancies all day long, after all. So what I'm saying is that you need to keep this in mind if you end up with someone a bit *ahem* high-strung. It's their job to worry a lot and make recommendations based on the reason you've been referred to their clinic, ie, your disease process[es] present. If you're not into natural birth, most of their suggestions and input will be welcome. In my case, I felt mine went overboard a bit; however all in all it went very well. My point: I think choosing your OB (the person who would actually deliver your wee one) is more important than the Peri---the doc making recommendations from your ultrasound and fetal monitor results.

Decide if you want to manage your Type 1 DM via your pump (yourself) or via IV insulin drip.
My recommendation is that you use your pump (if you have one). I never met resistance with this idea at the hospital I ended up choosing. Strangely enough, at the local University hospital when I was interviewing OBs there, they preferred IV insulin. The problem with IV insulin during labor is that, as we already know, insulin's pretty difficult to measure. It's got quite a window of error with syringe measurements. We also know that IVs aren't that accurate as far as giving you a dose (that really needs to be as accurate as insulin needs to be). Think of how it is when you try to give yourself a quarter of a unit via insulin syringe. Difficult, right? So, my point is that if you can get on a pump or use your own pump, do it. You'll be able to make small corrections as needed or even disconnect completely if you're so sensitive at the time---giving birth is like running the marathon of your life. You'll be under a lot of stress though, too, so that's why it's important to be able to give yourself those minute corrections, if need be. Also, just think of how nice it is to not be hooked up to an IV the entire time you're in active labor at the hospital....ugh.

Hire a Doula.
This is a woman who assists and advocates for you during birth. I don't care if you're having the most medically intensive birth you can imagine. It's helpful to both you and your partner to have someone there to qualm fears, tell you you're doing great, offer guidance---other than your partner. They're going through their own "labor and birth" in a way. They need just as much support as you do! If you give your partner a job (MAC's was to check my BG every 30 minutes+ and to also love me up as much as possible [believe me, you need positive reinforcement when in active labor!]) they will be a TON more helpful to you than if they just stand there and have the opportunity to freak out more. They need a job; it makes them feel a helluva a lot better about watching you in a situation they've never seen you in.

Pack your own snacks and juice boxes.
Then, if you have a low, you know the exact carb count on the juice box and snacks and don't over-treat because you just eat or gulp from some random cup the nurses hand you! I don't recommend your favorite low BG treatment, whatever it is, i.e., Skittles. If your nauseous (which you will most likely be) I suggest apple juice: it's neutral in flavor mostly and non-acidic. Don't bring orange-juice---way too acidic and most women will vomit from it. Sorry to be so graphic, but that was some good advice from my own doula---because when the time came to need juice in labor, I was so damn grateful for that plain apple juice!

Drink Raspberry Leaf Tea all throughout your pregnancy.
This herb is one of *the* women's herbs. It's specific to the uterus and while it does not bring on labor, it certainly makes it more efficient as far as contractions go. It also tones the uterus (as it is smooth muscle) and is just soothing in general. It is also astringent, so will assist
postpartum with your bleeding.

If you want to try to go into natural labor, use Evening Primrose Oil capsules.
You will insert 3 of these up by your cervix every night before bed starting at week 37. They'll just dissolve over night as you sleep. They release prostaglandins (which is also in semen; hence why doctors tell you to have sex to 'induce' labor if you can tolerate it) which essentially "ripens" your cervix. EPO (and prostaglandins in general) soften the cervix, which is essential for dilation and effacement. Think of your cervix as being hard during the pregnancy (keeping the baby inside) and needing to soften in order to open to allow the baby to come through. Only makes sense, right? I did this and truly believe it helped me to go into natural labor during week 39. Maybe it won't work for everyone, but from what I've read and researched, it seems to help most women. In the least, it helps with the softening and so if you need to be induced, will help things along so you are not having an induction on a hard, completely unready cervix.

Don't freak out, you're doing great.
Seriously. I can't tell you how many times my OB and my pregnancy CDEs told me this. And you cannot hear it enough. Keeping your eye on the target (a healthy you, a healthy baby) is the goal. Just remember that. You sometimes think you're going through hell and back because of the unpredictability of the situation, but with the right healthcare support team you will succeed! No matter what happens (and you need to be flexible with whatever "birth plan" you have in your head or create on paper because pregnancy is like the 'last frontier'---you simply cannot plan and predict its outcome) remember to be flexible. Your body and baby will thank you. Before you know it, you'll have a wee one of your own to take care of---and as all type 1 moms can tell you: that's a whole other ball game to learn how to play. ;)

Monday, March 7, 2011

a strange sort of tale of thanks~

I'm sitting here, a day after my 3 year type 1 "diaversary" as we call it in the DOC (diabetes on-line community), pondering my luck. Then it hit me that a lot of it's been my hard work, too. I need to give myself that credit. I often forget to.
When I got diagnosed on March 6th, 2008, I was terrified. I was angry. I felt cheated. I was such a healthy person. The thought actually flew through my mind (selfishly, I know) that a gal like me didn't *deserve* such a disease.
Yup, I said it. Deserved.
No one deserves disease. No one asks for it. And autoimmune diseases certainly have a funny way of entering our lives---unexpectedly. Automatically. Unfair, to say the least. Deserved; never. That's like telling someone with multiple sclerosis or lupus that they somehow brought their body's demise upon themselves. Type 1 diabetes is no different. No one asks for or deserves to have their blessed little pancreas to crap out on them. Ever.
So here I am. "Surviving and thriving" as my friend Mattie, another relatively new type 1 and new mama exclaimed to me yesterday when I posted about my *celebration* day.
We are all lucky to be alive. But more than that, we are blessed to not merely exist with this disease, but also do so well with it. We live in a time when we can not only eat well with it, be active with it---but also have children with it.
And 3 weeks ago, I did just that.
I gave birth to my beautiful little son, my first child, the apple of my eye, with no problems at all. He was unaffected by my type 1 so much so that in a hospital birth setting, they barely brought it up. They let me continue to manage my type 1 all throughout the birth and the biggest deal was checking his blood sugar when he was delivered just to make sure he didn't have neonatal hypoglycemia. But he didn't. He didn't even go near the range for it. He's a healthy, happy boy.
3 years ago I was not thinking about having my first child. I was so focused on graduate studies that I was the type of gal that was all about putting off having kids until, quite literally (I now realize) the last minute. Considering all that I plan on doing with my professional goals, I most certainly would've been about 40 by the time we started our family. Hmmm. Kinda risking not being able to have a family by doing that!
I'm going on and on about all this because...well, type 1 has brought me a lot of surprising and frustrating issues to deal with in my life. But strangely enough, it's also brought me a lot of good surprises. Amazing ones. Gifts, really. An opening up inside myself that I used to think was just one of those "learning to be flexible" things. It's so much more than that; this opening up that I'm talking about. My life has changed in so many ways: from the learning to let go of so many silly worries, to the ability to flip my life-plans around for a while in order to have both a family and the profession I've worked so hard towards, to the heart-wrenching realization that I've been truly lucky to have access to the things I need to take care of myself with this disease...all the way to this ultimate joy: the baby boy sleeping cosily on my chest in his little wrap as I write this.
Type 1, I'd give you back in a heartbeat. But you also brought out in me a new kind of courage. A courage I can't have without you being around. And so, strangely enough, I thank you for the darkness, but most of all...the light.

Monday, February 28, 2011

type 1 diabetic birth story~

I had a Pharmacology professor in college who described, quite perfectly I think, the difference between pain and suffering:

Pain and suffering are two very different things. A person suffers from cancer, scleroderma, chronic hepatitis. It brings up concerns of pain only for pain's sake. A woman labors with great pain, but little suffering, for the birth of her child. There's an anticipation there; a joy making it worth the pain.

I thought I understood that. I mean, I wrapped my head around it rationally, academically, logically. But I had no idea what it meant until I labored and delivered this amazing little person (I've so lovingly nicknamed here as "littlebird") that I now have the privilege of calling our son, on February 20th.

It all started that week honestly (week 39) when I had one of my (many) 'routine' ultrasounds and fetal monitoring sessions scheduled at the perinatology clinic. Everything was going just fine with littlebird and as they did the growth scan it showed that he was in the 90th percentile for size; ie, nearly 10lbs. Wow. That seemed...off. Even the ultrasound tech felt it was overestimated and admitted that ultrasound can be off when measuring weight in fetuses. She also reminded me that his past growth scans showed him to be quite lanky, not large (both his parents are lanky, and MAC, his dad, is especially tall at 6'4"). She comforted me and said to just show the info to my OB and CDE and let them decide if it was of concern. So that was the plan.
The next day, the perinatologist (a type A, not-so-nice woman throughout my entire pregnancy, I'll admit) called me and said:
Your baby is too big. He's past the max for vaginal birth and so I'm recommending c-section for tomorrow.
Wow. Just freak me out and drag me to the hospital and strap me down while you're at it, lady. I didn't even know I had a "max".
So I called my OB, pretty much in tears and told him what she relayed. He had worked with me to go to 40 weeks as long as all was well with the little one. He had supported me throughout the entire pregnancy to give my body the best chance to go into natural labor. So he understood completely why that conversation upset me so much and got pretty mad. He felt she was putting the patient in the middle of something without having a doctor-to-doctor discussion first. Besides, ultimately, it was his call when I got induced (since he'd be doing it, not her). He read the report and felt the weight was a "vast overestimation" and most likely the baby was merely long, not large. My CDE felt the same, stating also that my diabetes was not to even be a consideration in the matter, since my last A1c had been 6.1% with stable numbers at that, no major pendulum swings skewing the picture.
So my OB told me to relax, we'll stick with the plan unless something called for a change, and to just wait until my scheduled date of induction (my due date, February 24th---pretty much an entire week).
So that's what I did. I went to my appointments at the perinatologist's office the rest of the week where she wouldn't even look me in the eye as I went in for my ultrasound (wow, really mature---this isn't personal!) and baby still looked good on the scans and the fetal monitor. By Thursday, they just told me they'd see me at my usual Monday appointment.
I drove home that day, feeling something different. Was it hope? Something deep inside me told me not to worry. I really knew it was going to be alright. And not just because everything eventually is alright because it well, has to be...even when it's not how we want it, life always gets to its point, you know? There was a warmth, a freshness in the February air, an honesty, an openness. The Sandia Mountains where I live looked lovingly down at me during that drive home. I listened to the music of Beirut, one of my favorite bands, the sounds of their Balkan horns comforting me. The woman I worked with at the refugee resettlement center happened to call me out of the blue and said that she had to call because she gets these "feelings" about certain things and knows how they'll pan out. She said she "just knew" it was all going to be ok. Something in my gut knew to trust her. If you knew her, you'd know why.
My close friend Kalena (we're both massage therapists) called me that night (Thursday) and said she was thinking of me on this nearly-full-moon and that she had some time and thought we should do a session working on all of the acupressure points for labor induction. We met at her office, lit with lovely candles and opera playing in the background. Littlebird moved about happily and I felt contractions throughout the session. I believe with all my heart that her massage jump-started the entire process.
My water broke at 1:30 in the morning on Friday, February 18th---exactly when the moon became full. I'd been told recently there would be a full moon on the 18th and that babies often liked to come on the full moon. I didn't want to put all of my eggs in one basket, but being scheduled for induction on the 24th (exactly my 40 week mark), I laid in the tub at night that week before, talking to littlebird as usual, calling him by his real name, gently weeping and asking him to come on the full moon if he could.
He heard me.
I woke up to wet pajamas, the scent of the ocean strong. I knew it was amniotic fluid slowly leaking from me. I checked my BG; it was 70-something. I had a small juice box. I could feel the excitement in my chest; my BG always drops when my brain in really on, coupled with excitement.
I didn't yet have any contractions, which is not surprising, considering this is my first pregnancy. Things don't move very quickly. I couldn't fall back asleep. Matthew, my partner, was so excited and nervous and half asleep; he started to put all of his things together like we were leaving right then. I told him to relax. So I paid some bills and we both tried to lay back down but kept softly chatting in bed.
I called my doula in the morning, an incredible friend, and told her I had an acupuncture appointment already scheduled for that morning to get things moving along, so we decided I should keep it. Diane, the DOM pulled up just as I was getting out of my car. I told her my water was breaking. She embraced me and said, "This is perfect! This session will really get him moving since your body's opening up as we speak." (Acupuncture works best to 'induce' labor if you are at least starting to dilate, efface, leaking amniotic fluid, or lightly contracting).
We did the session and all of the labor induction points felt deep and painful and different than anything I'd felt in the past doing acupuncture. I imagine those points were really open to being activated!
Later on, I still had no contractions and my BG remained stable all day. My doula came over in the afternoon and we all took a long walk with our dog who could tell something was up, and did lunges in the park. We took our last pictures of me pregnant. All I felt was the amniotic fluid leak.
I know to some people it seems odd (or even dangerous) to wait like I did. But I knew I wasn't in danger of what is called PROM (prolonged rupture of membranes) until past the 24 hour mark (because it increases the risk of infection in the baby), and that we'd certainly be going into the hospital before then. I merely wanted to wait and relax and try to let things get moving on their own at home. I truly believe that the more relaxed you are, the more relaxed your cervix will be and you can birth that baby in the hospital more efficiently (think Ina May Gaskin's 'sphincter law').
MAC told me he'd get me anything I wanted to eat for dinner. So we ordered chicken satay from the lovely little Thai place up the street. By 11pm, nothing was really happening and my doula said we should go into the hospital for the baby's safety at this point.
When we checked in, as expected, my OB was not on call. So we were given the option of birthing with a Nurse-Midwife or the on-staff OB. I chose the midwife, since I was wary of docs other than my OB (sorry) :)
They were very excited about my birth-plan because it stated what was *most* important to me and yet was flexible enough in case things didn't go as planned for a totally natural birth. I want to point out here that they all actually read it; kept checking in as the labor progressed about my input and my options available. You can see the birthplan I used here. I personally think some gals really overdo it on their birthplans. You can't truly "plan" birth. Especially with something like a first birth and type 1 diabetes (in the hospital at that). It seems to become a point of contention for some people. So I simply wrote on it any additional details I needed to add---such as all of my type 1 diabetes issues (using my pump and controlling my diabetes myself during the L&D with MAC's assistance, bringing my own food and treating any lows myself) and also added things like my desire to not be hooked up to anything but my pump, to birth in a position comfortable to me, and for the little one's vernix not to be washed off, no antibiotic eye ointment, no vitamin K shot, no circumcision. At the heart of the matter was me staying in control of my own type 1 DM and not jumping into a medically intensive birth too quickly, and littlebird being cared for with as little intervention as possible, unless necessary, of course.
The night was long. I started in on the contractions and while painful, I was managing them by laboring in the tub and moving around a lot. None of us slept. I couldn't eat at all. I was thankful I had such a high-protein, high-fiber meal for dinner, as it was all that sustained me for the next 24 hours. I was really nauseous and could only suck on ice chips to stay hydrated, despite bringing coconut water and juice and lots of delicious snacks. Haha, that's Murphy's Law for ya: if I didn't pack anything, I would've needed it!
By 8 a.m little was happening and the midwife I was assigned was about to end her shift. She came in and said, "Guess what? Your OB's on-staff today!" I nearly cried with joy! When he walked in he kinda laughed and said, "Well, I guess we can cancel that induction for next Thursday, huh?" He was going to be there all day and all night. I knew he'd be delivering my baby and that made such a difference in my anxiety about anything that might come up.
At this point, they just left us alone. At one point we realized that they weren't even following the "every hour you need to be on the fetal monitor" rule, since I was literally just in the room, laboring naturally. They just kept checking in and asking us how we were doing. So MAC, my doula, and I basically stayed in the room all day and labored *together*. They were amazing. They kept filling and draining the tub with warm water for my laboring. They kept getting ice chips. They kept cleaning up the floor when I had accidents (TMI, I know, but hey--- birthing a baby ain't pretty, folks.)
MAC kept checking my BG and helping me to make corrections. Strangely enough, I struggled not with lows, but keeping it below 140. I was anxious about it because I knew I wasn't eating, but I just couldn't. I was feeling so sensitive that at one point MAC put on chapstick and I exclaimed, "I smell peppermint! What's that peppermint smell?! I think I'm gonna barf!" :) We focused on hydration and just constant monitoring, which the staff was happy to accommodate since they all said they preferred the better control of pumps and made it clear they didn't want to touch mine! :)
Saturday "day" is where everything truly becomes a blur. I entered a different world. A different time span. Time flew by and yet felt eternal. I've never been in so much pain in my life but with so much excitement. The wind was howling like a wolf. The room felt hot, cold, hot, cold. I couldn't be naked enough, but couldn't put on enough clothes. You are a different person when you give birth. You are your internal self turned outward and back again.
I didn't want them checking and rechecking my cervix too often for fear of the increase in chance of infection since my water had broken. I let my OB check once and I was at 9 1/2cm.
Finally, around 5, my body began to collapse. MAC tells me my eyes started rolling into the back of my head. I hadn't slept since those couple of hours Thursday night, basically. The only position I was comfortable in for the contractions was squats and my knees were giving out even though I kept trying. My OB finally asked me if he could check me. I was still at 9 1/2cm. What a blow that was. He said there was a small lip of cervix still there so he tried to lift it over for me. That nearly made me jump off the bed and plaster myself to the ceiling. I screamed Oh my god, I can't! Please stop, Dr. Teicher!" MAC told me he said, "Well, that's good because I'm done. And wow, you're always so polite, I've been called much worse!" :)
He let me labor for about an hour or so longer but when he checked me again, I was still at 9 1/2cm. I started to feel upset. Dr. Teicher gently asked me to consider some help for my pain. He told me he thought I was getting wound up after so long and that was why I couldn't dilate further. I got teary eyed. He said I'd gone on so long and that it was incredible; everyone on the floor was amazed. I don't know if he was just saying that, but I knew he was right in a lot of ways. He seems like he can read your mind sometimes because the next thing he said was, This doesn't mean you've failed, Emily.
When the Nurse-Anesthetist was putting in the epidural, I was at my lowest point. I felt so defeated. All that work and no baby coming. They could see his head a little, but that was it, no more progress. Dr. Teicher told me he thought if I could just sleep for a couple of hours pain free, I would fully dilate, relax and could push him out. So I slept. We all did.
By 8 or 9pm, I was fully dilated and effaced. I started pushing, but my contractions were now not strong or efficient enough and littlebird's heart rate started to decelerate a bit (thanks, epidural, argh!) so my OB turned the Pitocin on to the lowest amount possible. This seemed to do the trick because they guided me in pushing (since I could no longer feel the contractions but thank heaven could still feel "pressure" and certain sensations, unlike some gals I've heard about going completely numb in every way on Epi's).
The room started to feel very dim; almost candle-lit. Quiet and sacred. I was determined to push him out. Caesarean was not on my list of lifetime things to do; especially with my first child, and I knew if all of this failed, I'd be in the OR in just a little while. With just a few contractions, I could feel littlebird coming down the birth canal. Dr. Teicher asked me if I wanted to touch his head as he crowned. I did, and it motivated me knowing he was literally right there. When he got a bit stuck, the OB had some nurses there to help pull him out, although they did need the vacuum on him, which bummed me out. Also, his arm apparently got a bit stuck at the moment he slid out (pretty common, I'm told) and so this caused me to tear quite badly (which, by the way, is healing nicely with Arnica Montana 6x homeopathic and epsom salt baths...) :)
But let me tell you---when I felt littlebird slide out of my body and the collective sigh of relief and excitement, I cried. It just came washing over me that he was out and we were both ok. The entire time, MAC had been checking my BG and it was staying stable in the 120's and 130's. When they checked littlebird's BG, it was about 60. Perfect. So they put him to my breast almost immediately after the birth and he latched beautifully to get some of that wonderful-antibody-nutrient-dense colostrum. Because neonatal hypoglycemia can occur as a delay, IDMs ("infants of diabetic mothers", nice acronym, eh?) are required to have their BG checked for a few hours---at least 3 times. He passed every time and was never even close to needing assistance. This was because my BG stayed stable and also because he latched quickly enough to get that good colostrum.
My OB said, "Are the bets still going on his weight?" People chimed in with their final estimations. The final number: 8lbs, 10 oz.
And he was long and lanky---21 1/2"!
A good size, a normal size; within range of vaginal delivery. And certainly not "almost 10lbs". Yeesh, thank god I always question things. ;)
After the delivery, the sensations in my body changed immediately. First, I went from nauseas to famished. So I ate a granola bar and didn't bolus, fearing the post-birth lows I'd been warned about. Wrong move. I skyrocketed to about 200. All those hormones competing with my insulin, I'd imagine. I got stressed-out towards the end too, knowing I was kind of under a time crunch headed toward c-section, so we all know what stress does to BG---usually increases it. That, and the Epidural and Pitocin change a lot of things I didn't *exactly* plan for as far as how my type 1 would react.
The next day I ended up struggling to keep my BG under control---even as I began to breastfeed. Again, I think it had to do with all those competing hormones, my not eating for over 24 hours, and stress (hello cortisol!) I just drank a ton of water (necessary to counteract the swelling from the epidural anyway) and ate good meals. Things started to decrease and balance out nicely, with no lows, surprisingly. I just kept checking religiously and correcting anything. It's hard to figure out how to change basal and bolus patterns, but I just increased or decreased settings one day at a time. Don't change too much at once or else you'll crash.

All in all, I got what was most important out of my first-birth experience, in a hospital at that, since t1dm makes me ineligible for homebirth (sad face). I always reminded myself throughout the pregnancy that "I worked this hard for a baby, not a birth". That's an important thing to stay focused on, because those of us who value natural birth so highly can easily get sucked into what I call the 'natural-birth-nazi' focus: where the only healthy mamas and babies are born via homebirth with no interventions, and that's just not true. You can use the best of both worlds--western and naturopathic principles because you might very well need them and still have a healthy pregnancy and birth outcome. For some of us, that's the only choice we've got anyway, so one of the best things you can do is find a healthcare team that supports that philosophy with you. So, the most important thing is that both littlebird and I are healthy and happy, and he had no major interventions, like needing to be in the NICU for low BG. He was also only given colostrum and is now breastfeeding beautifully full-time...growing big and strong!

I'll post next on some of the things that I feel made this birth work out well enough and why. For now, I hope my birth story was informative and somewhat helpful to any women out there reading this trying to plan a pregnancy with diabetes. It is possible. Just take it one day at a time---and literally one moment at a time if you need to. Don't let this disease control your personal goals. It isn't an easy one to manage, but it is manageable and you can accomplish anything you want to do with it if you keep it close to you, rather than pushing it away or ignoring it.

Thursday, February 3, 2011

so i deserve the Bad Blogger of the Year award~

I'm finally sitting here, on my couch (actually it's a very uncomfortable futon) to blog.
You read that right.
To blog.
Oh dear god, I feel so bad that it's been not only a couple of months since my last pregnancy post, but that I fell off the wagon just as things were getting interesting. :)
So onto the juicy stuff, right?
As you can see from this picture, I AM HUGE NOW.
And loving it!
(Not really, haha. I'm kind of like those dolls that roll around at the base; I can't remember what they're called?)
This pic is from 36 weeks. I am now at the end of week 37. Whew! Officially full-term!
We made it littlebird! As much as I want and plan for a natural birth, I know that if anything starts to go wrong, needing to get my baby out now, he would be fine. From the ultrasounds, he appears to be a little over 6lbs. There can be inaccuracies in these measurements, so we can't be too sure. However, we do know that littlebird's dad is 6'4", so he might come out on the 'larger' scale (ie, 7 or 8lbs, still completely in normal range) just because he might be quite loooooooong not so much BIG. haha. As my friend and doula said, "considering the lanky genes he's getting from both of you, it should come as no surprise!" (we're both kinda skinny people).
As a minor comfort to any readers who are bumming that I literally failed in my job as a Type 1 Diabetic Pregnancy Blogger, you can catch this little interview I did with Sysy Morales over at the amazingwonderfulstupendousincredible Girl's Guide to Diabetes. You have to scroll down a tiny bit due to the ads, etc, but it's there. And hopefully helpful. I think it covers, in a general way, what you go through when you're pregnant with type 1. I'd like to think this can reassure any women out there who really want to have a healthy pregnancy with this often mind-boggling disease that they can truly accomplish their dream.
As for my state-of-late, all is well. Really, it's kinda crazy. As you can read in that interview I hyperlinked above, it's the 2nd trimester that just blows you away. Everything you thought you knew about insulin resistance, stress, growth hormone, bolusing, and basals changes. Completely. But the important thing to remember is that you are not alone. If you are seeing a perinatologist, they should be in a center or can refer you to someone that offers diabetes education specifically for women who are pregnant. And as far as I know, most people see CDEs in these places who know their stuff well. I can't tell you how often I'm amazed at the suggestions and changes my "pregnancy " CDEs make. It makes a world of difference---life savers, really! Without them, this whole pregnancy would've been a mess (to me, at least). Things change quite fast in that 2nd trimester due to exponential growth of the fetus---a difficult feat to keep up with. By the 3rd trimester, there seem to be more patterns and plateauing in my bolus and basal rate changes needed; it seems more gradual.
But so far, littlebird and I have succeeded! And you can too, if you're reading this wondering what the heck to do. :)
Hmmm, not too much else to say right now except that little update. I'm headed into week 38 next week and will definitely have more to post about my hopes for my birth and what I'm doing to encourage him to come before 40 weeks. Remember, my superwonderful OB is willing to allow me to go to 40 weeks, but not past. Then I get induced. Ugh. But, he was the only doc I interviewed who was even willing to talk about this.
But, so far, so good. More on "why" later. :)