Tuesday, September 25, 2012

Non-Stress Stress Relief

The NST was no biggie and the little man passed with flying colors. It still sucks donkey nuts that I have to do this weekly until the baby is born (so, 5-8 more weeks....that's both incredibly CLOSE and impossible FAR away). We'll do a growth scan in about 4 weeks or so to see if he's normal size or mutant. If mutant, then we'll schedule an induction or C-section (I guess that depends on just how mutant, and/or his position) at 39 weeks. I asked if we could move it up one week, if it's required at all, in consideration of the one and only silver lining: convenience in scheduling. See, I went into labor with Jackson in the 38th week. And we're all fairly well convinced that is likely to happen again. But if the C-section in particular is deemed necessary, I would prefer to know the day and time to make arranging childcare for Jackson much simpler. Otherwise, if I go into labor spontaneously before 39 weeks, we'd have an unscheduled C-section and lose that one and only benefit. Plus, who the hell wants an unscheduled C-section if a scheduled one can be arranged (when medically necessary, mind you). But alas, our hospital does not permit scheduling such procedures prior to 39 weeks as a matter of policy. Boo. I'm not trying to pull a celebrity trick here, just trying to make the best of a potential, undesirable situation. But there is a reasonably good chance that the wombfruit will not grow too big or ripen too fast, and we can just wait for natural labor to kick in and be on our merry, unscheduled way. So I'm working on devising Plans A, B, and C for lining up minders for Jackson when it's go-time. Fun.

 

Monday, September 24, 2012

So Now You Are Two

Both KB and I were a little sentimental when we got up with Jackson Sunday morning. He woke up not too early (for once) and in good spirits (not always true) and when we reminded him it was his birthday, he answered back that he was "two!" *one pointer finger on each hand held up* and clapped and we melted a little. He helped around the house and at the grocery store all day long, and was hysterically happy (in an adorable, involuntarily-make-you-laugh kind of way) when his friends showed up for his party. He shared his toys and ate his taco and chowed on cake and it was good.

I ate cake and ice cream and still had normal blood sugars. (So go fuck yourself, diabetes!)

Here is his cake, y'all:
And some cookies I made (bear paws! acorns!):
And cookies I bought as back-ups in case my cookies sucked (which they didn't, so more cookies!):
And party decorations (the crappier the thing, the more likely I made it; everything else was from Etsy):
                                               
And homemade play-dough for the kiddies:
A good day.

 

Saturday, September 22, 2012

I Win at Diabetes

The doubled dose of glyburide did the trick. In fact, my blood sugars have bordered on low after breakfast and dinner, which just means I have to eat more snacks. Eat more snacks! So problem solved, for now. Knock on wood. Praise the lawd. Etc. Etc.

Now to throw a 2-year-old's birthday party tomorrow and then pass the first NST on Tuesday. The fun never stops. (And dare I say, the low-ish blood sugars bode well for my unabashed plans to eat CAKE.) I shall will myself into a happy place this week. I think I can, I think I can.

 

Thursday, September 20, 2012

Double, Double, Toil and Trouble

Glyburide once-daily hasn't done jack shit to consistently lower my blood sugar. So we are doubling the dose (same 2.5-mg dose but taken twice-daily instead of once). What it has done is make me feel sick every morning, despite the disappointing effect on insulin production. It's like first (and second) trimester all over again. If the new dose/regimen doesn't work over the next few days then I will have to start seeing a fetal/maternal specialist (yay! double the appointments! officially high-risk!) and would be started on insulin. Oh for shit's sake. (At least my IVF veteran status makes me a pro at self-injection, so no classes or instruction required. And good thing I kept a sharps container under the sink, how's that for fucked up serendipity?) So fingers crossed the double-dose of oral meds is good enough. Here's hoping the universe can throw this dog a bone.

I'm still eating birthday cake this Sunday. Because fuck it. Two layers, Tahitian vanilla bean cake with honey and green tea meringue buttercream filling vs. salted caramel. Right?

 

Tuesday, September 18, 2012

When Life Gives You Lemons...

...forget about making lemonade because that's a sugary drink and you are diabetic now, moron.

I start glyburide 2.5 mg once daily today and we'll monitor sugars to adjust the dosage and timing as needed. And I start weekly NSTs next week at my 32-week appointment. I argued (gently) against doing these, since it only tells you how baby is doing right now. But I was countered with some flimsy suggestion that the data provide predictive information for a week out. (I suspect the only predictive info one would obtain from a less than stellar NST is "we're going to do more frequent NSTs.") What am I going to do, tell my OB that I'm okay with putting the baby at some immeasurable risk?

The two main things I feel right now are 1) anger, that my body can't give me or this baby a break and 2) defeat, that there's nothing I can do about any of this but play along and cross my fingers. If I don't go into spontaneous labor by 40 weeks they will induce. If he measures too big (I don't know how growth scans factor into this yet, but it seems inevitable I will get one or more) at any point then we will plan for either an induction or C-section by 39 weeks. Anger and defeat. The dynamic duo.

For grins, here's a gratuitously cute video of the child I did not endanger in utero with diabetes.

video

 

Monday, September 17, 2012

Whatever and Ever Amen

My blood sugars have been erratic over the past week despite cutting out processed sugars and adhering to a meal schedule. I get one normal value per day, plus three abnormal values that range from a few "points" above normal (say, 130 mg/dL, just over the 2-hr postprandial cutoff of 120 mg/dL) to occasionally way out of range (over 200 mg/dL). And the variance can occur from eating the same food at the same mealtime. Huh. So basically, pregnancy hormones have fucked my pancreas hard and my beta islet cells are just curled up in a ball whimpering, but definitely not cranking out enough insulin. My follow-up appointment is tomorrow and I will just walk in with my hand outstretched for an oral antidiabetic med script and ask a bunch of questions about where we go from here. I don't really want to know the answers, but I need data, people. Knowledge is power or whatever.

In much better news, Jackson's birthday is this coming Sunday and I have next to no (paid consulting) work to do this week so I am spending my time making decorations and treats for our family and friends. It will be a super small party, just immediate family and a couple of Jackson's friends and their parents. I wish we do could something a little bigger, maybe invite more kids, since he's about to take a backseat to a newborn who will rock all of our worlds, but we're just physically wiped and need to keep this low-key. I don't think a 2-year-old will care too much. Wait. Is he going to be a TWO-YEAR-OLD? Shit. When did that happen?

I completely stole another blogger's idea from her munchkin's first birthday theme (thanks, R) and went with "woodland creatures." Doesn't that sound enchanted? Nicer than "baby wild feral animals." I ordered a cake from the same bakery that made his sock monkey cake last year and can't wait to see what they've made for us this time. (I gave them some basics, like flavors -- one layer each of green tea/vanilla and salted caramel -- and told them go nuts with the artsy stuffs and surprise me). And I made a little pennant and door hanger with woodsy fabric. And I just got home from buying ingredients to make acorn cookies and bear paw cookies. (I feel like I have to put in some kind of effort to make something, since we're leaning toward ordering pizzas for the party). If I had known when I picked this theme how obsessed Jackson would be right now with Elmo and Cookie Monster, I would have gone that route -- I just found an awesome youtube tutorial for making Cookie Monster or Elmo cupcakes -- but there's always next year. Unless he's moved on to something else by then. Likely.

I'm super annoyed that my sister, who is not working nor actively looking for work at present, isn't coming. And I had to ask her; she didn't bother volunteering this info to RSVP even out of basic respect and manners. If she had an interview lined up Monday morning or something, or was concerned about the cost of driving from Chicago, I would understand. But no. She has random plans with friends and that's more important than her only nephew's birthday. On the one hand, it's a relief because she is a pain in the ass. Especially about food. She asked me a few questions when she was here last week about what we would have for dinner and cake flavors and such and wrinkled her nose at it (she claims to be allergic to tomatoes, vinegar [but not wine, mind you], soy, citrus, wheat, and other random things, and makes a huge stink out of it in public. Exhibit A: at Qdoba, when ordering nachos, she began her order with, "This is going to be a VERY complicated order due to my food allergies..." and her order was nachos, meat, and cheese.) I also tire of biting my tongue as she talks about, most recently, how she's planning to live on unemployment for a while and potentially cash in her 401K to avoid taking anything but the "perfect" job. I doubt she realizes that the unemployment offices in Illinois are not going to be impressed nor moved by her soul-searching plan and will kick her off the rolls if she doesn't take some sort of job within a reasonable amount of time. She also thinks COBRA insurance will only cost her around $200/month. (BWAHAHAHAHA.) I don't know where she got this info, but when I left my full-time job last year, my COBRA packet indicated that continuing my same policy would be around $1000/month. There goes the unemployment check. (And keep in mind, she's a hypochondriac who ends up in the ER at least once a month and spends hundreds of dollars per month on various prescription and OTC meds and even more on alternative therapies since, as she sees it, traditional medicine has "turned its back on her" for failing to recognize her totally legitimate and not at all made up ailments that no test can seem to diagnose and no proven therapy can seem to mend). My disappointment and concern is more of a big picture issue, since dealing with this brand of Crazy™ is exhausting and that's precisely why I don't do it anymore with other family members. If they can't make an effort to pull their act together when they're around me and my family (KB and my kids [HOLY SHIT, PLURAL!]) then why should I keep bending over backwards to validate, even if only passively (by not calling them out on their bullshit), this unhealthy behavior? It's a fine question I am asking myself more seriously these days, since my attention and energy is going to be fully devoted to the raising of 2 (TWO!) small children soon. I don't have the time or inclination to try and raise batshit crazy adults who should know better. She says she wants to visit in November, after her vacation (a super wise idea when you're out of work!) and presumably after the baby is born, but I find myself not caring if she does or not. And if so, I hope it's a brief visit. I pretty much have no family left at this point. They are all so royally fucked up I can barely stand to joke about it anymore. My sister seemed to be aimed toward Normal® for a while, but is now doubling down on Crazy™. Oh well.

And back to happy news again, my paid work is slowly trailing off into nearly nothing as clients keep pushing back their project timelines, meaning that I will have little to do in the coming 4-6 weeks and instead will just hand it over to someone else at the end of October. Sweet. Of course, I don't get paid for what I don't end up doing, but I don't care at this point. I'm happy to have the time to wash baby clothes and help assemble the crib and re-sterilize all my pump parts and find a part-time nanny and all that. (I have this plan that I'll write about another time to keep the baby home with me until around 6 months or so, since I'm only working part-time and from home, so I don't have to pump much and to soak up my last ever dose of newbornness. Just need to find a nanny. Zoiks.) I am finally hitting a tipping point at which, despite my physical misery, I am feeling excited for the baby to come. I wonder if he'll look like his brother or if he'll take after the more swarthy Italians in KB's family. I wonder if he'll be gigantic (thank you, gestational diabetes) or small. I wonder how Jackson will react to meeting him. (I'm trying to teach Jackson how to hold a baby by making a game of it, and asking him questions like, "Would you like to help cover the baby with a blanket? Will you help change the baby's diaper?" which are all met with a curious, "Okay?!?"). It's starting to sink in that I will soon be the mother of TWO children. Well. Who'd have thunk it.

More Diabetes News You Can Use after tomorrow's appointment (as you wait on the edge of your seat) and then birthday party pictures....because a little dose of happy is in order.

 

Wednesday, September 12, 2012

Pour Some Sugar on Me

My blood glucose (and normal reference cutoff values) yesterday:
  • 8am, morning fasting: 126 mg/dL (95)
  • 11am, 2 hrs post breakfast (oatmeal): 183 mg/dL (120)
  • 2pm, 2 hrs post lunch (PB&J on wheat): 130 (120)
  • 8pm, 2 hrs post dinner (chicken burrito): 99 (120)
Not looking too good. (And for those of you with experience, yes, I ate morning and afternoon snacks and everything was complex carb-no processed sugar and as much protein as I could work in). Rather than jumping straight to insulin, my OB suggested we can try oral meds first (glyburide and metformin have been shown to be as effective as insulin at lowering and stabilizing blood sugar, and actually present lower risk to the baby for hypoglycemia at L&D vs insulin). I have to keep up with the dietary control (for what it's apparently worth) and record blood sugar values until next week, and then we'll go over the results and decide how to proceed. I am really hoping we don't need to escalate the OB visit schedule and/or add a bunch of NSTs or ultrasounds. I don't need more to worry about. I'm also bummed by the prospect of me having to be closely monitored for blood sugar during delivery (read: more intervention) and the baby being poked numerous times after birth (they all get tested, so hopefully his first result will be good). I explained all this to my OB and she gets it. She told me what I already know: one step at a time. Sure.

 

Monday, September 10, 2012

(Epic) Fail

I took the 3-hr glucose tolerance test last week and it was torture. I laid on a cot in the clinic for over 3 hrs fighting the urge to vomit up the horrendous 100-g glucose orange sludge. And then this morning I got word that I failed spectacularly. Only my fasting and 3-hr levels were normal; it only takes 2 out of 4 abnormal values to declare gestational diabetes. And my 2 abnormals were out-of-the-park abnormal. So the kind nurse instructed me to sign up for some all-day class on how to eat whole grains and how to poke your finger to test blood sugars and what diabetes is or whatever and the thought of sweating through such a thing that is beneath even my first-year biology course education made me stabby. So I pulled rank and informed her that I hold a biomedical doctorate from a top-10 medical school and worked my way through college as a nurse aide drawing blood and doing finger sticks (in addition to taking blood pressures and emptying bed pans) and now consult for a major pharma company on, among other things, diabetes therapy protocols and health outcomes. Therefore I will be taking no such class and instead just want to know if there's a specific glucometer they want me to use, how many hours postprandial they want me to test, what reference values they want me to use, and when/whom to call for abnormal results. I also politely reminded her that we drew thyroid labs weeks ago and if they indicate that the synthroid my RE put me on during IVF cycling is still suppressing my TSH, then I can stop taking that annoying little pill every day. I want a paycheck for my own advocacy 'cause it appears I'm the only one working hard at it.

So I'm depressed about this, since it means mandatory OCD over every meal and every snack (when nausea is STILL a goddamned problem for me, not to mention the chronic bowel obstruction I have to contend with every day -- thanks, progresterone! hcg! estrogen!). It means stabbing my fingers a minimum of three times daily to check blood glucose levels. It means higher risk of induction and/or C-section. Fuck me sideways, y'all. Just when I thought the universe was done laughing at me, here we are. I also need to plan for rapid weight loss after I'm cleared at my 6-wk postpartum check since GD increases risk (through correlation, not necessarily mechanism of action) for a later diagnosis of type 2 diabetes. I will probably have to go through rounds of postpartum testing to rule this out. Fucking YAY!

And KB has been gone on his man-trip to Vegas since Friday, so all this great news comes when I am already on edge. My sister is here but being a colossal pain the ass. It's just crushing to her to not be the center of attention or to win the Who Has the Worst Ailments game, so she has suddenly developed some kind of generalized malaise and just can't be bothered to help much these last couple of days. Like, back of the hand to the forehead, damsel-in-distress, in need of smelling salts, Oscar-worthy acting. She lays in bed (which is an air mattress in the family room) awake, listening to me struggle to get Jackson up and ready in the morning with him crying and me doubled over. And just lays there. Because she's so ill, everybody. Woe. So I've been contending with a cranky toddler who's asking where Daddy is every day and wants to be held all the time and I'm not sleeping more than 2-3 hrs per night and just wishing this week was over. The end.

Although, I do have a therapy appointment Wednesday that should help. Sometimes it's refreshing to cry your fucking eyes out to a sympathetic person, even if you're paying them. And I booked a day of haircut and pedicure and in-room dining at a downtown hotel for Thursday night and Friday morning, because fuck it. I probably won't get any better sleep but at least I can have solitude. And some low-carb bullshit meal from the menu.

Pregnancy is so beautiful. *snort* But thankfully almost over. Just 7 weeks until I'm full-term. Please let spontaneous labor and a non-giant baby come through in the clutch.