Bear's Arrival.

Say hello to Vlasnik kiddo #2, who shall on the internet be referred to as "Bear":

Naaaaaaaaps. #babybear

A photo posted by Kim (@textingmypancreas) on Mar 10, 2016 at 8:54am PST

I'm a mom of two. That's... wow.

Easter!

A photo posted by Kim (@textingmypancreas) on Mar 27, 2016 at 8:19pm PDT

As it turns out, I didn't get the seven more days of pregnancy that I was hoping for. I got two.

The last biophysical profile ("BPP" if you like acronyms) I received suggested that my amniotic fluid level had gone slightly north of the normal range. I found out this is not cool because that means that when your pregnancy is already technically full-term and you are dealing with crazy insulin resistance and trying to keep your blood pressure down, your delivering OB leaves you a voicemail after consulting with your high-risk one which essentially says "hey, just wondering what you thought about having a baby today" and then you frantically find childcare for your toddler, grab your bags, and go have a c-section that very night even though you weren't mentally prepared for it just yet.

Or, you know, that was my experience.

With Rabbit, we tried inducing labor. When that didn't work, we went the route of emergency c-section. I think the hours of labor prior to surgery were a large part of why that surgery was so hard for me to recover from, so I wasn't really looking to relive that scenario this time around. I knew that the result would likely be the same - this baby was measuring larger than my first had been, plus I was one more week pregnant when I delivered. I'm not a big risk-taker on matters like these, so I was totally fine with scheduling a c-section (and so were my doctors).

New evening plans: it's baby time.

A photo posted by Kim (@textingmypancreas) on Feb 11, 2016 at 4:25pm PST

The whole process was way less stressful than the first time - I guess because it wasn't an "emergency"? It helps to know how the whole thing goes down already.

As for diabetes, I opted to keep my insulin pump connected to me, rather than have an IV for insulin. I did the insulin IV option with Rabbit since we didn't know how long labor would last and I didn't want to be worrying about pump settings while having contractions - but with a scheduled surgery, I knew I'd be back "on" in a few hours and didn't want to hassle with an extra IV line. I wish I could say that I stayed totally in range throughout the whole procedure, but that's a big ol' bucket of nope. We had to administer a couple of partial doses of IV glucose as we prepped me for surgery - the last delivered a few minutes before my son was.

There have been lots of good things:

• I didn't throw up after surgery this time! ::high fives self::
• Bear didn't have the low blood sugar issues in the first 24 hours of life that his sister did. His BG was low right after delivery, but resolved itself within a few hours.
• I was somehow able to stand up within 24 hours of surgery and was walking around within 48 hours, which, what, how.
• I didn't need to take pain meds for as long after this surgery, as I did with the first. And most importantly, to me:
• This recovery has been SO MUCH BETTER than my first. It has not taken nearly as long to be able to move around without pain, and I actually feel about 80% of the way to the "normal" I felt prior to this pregnancy, now that I'm two months out. Again, what.

I hope you'll forgive me that I'll continue to write less here. I'm not disappearing, but I am absolutely reallocating my time. Diabetes continues to challenge me, but it isn't my focus in my life right now.

You can probably guess what is.

(FYI, my diabetes turns 30 years old this month. I can't think of a better way to celebrate it than to, instead, spend that time with my kids.)  :)

38 Weeks.

Hi. I'm probably having a baby in 7 days.

Before the chaos of life with a newborn hits again, I wanted to note a few things that have been different about Pregnancy #2 vs. Pregnancy #1 for me:

• First pregnancy: relentless lows. Second pregnancy: "wtf is even happening right now" highs and insulin resistance. All the time, even in the beginning. Current insulin pump infusion speed can best be described as "fire hose", but at least things have evened out significantly. My current insulin needs are very similar to what I experienced with Rabbit at the end of the third trimester; the ratios and rates are RIDICULOUS (like, you guys, my insulin-to-carb ratio during part of the day is 1:1 and that is not a typo), but they work, so do what you gotta do right?
• First pregnancy: mild pre-eclampsia showed up during week 36, putting me on modified bedrest for the last week and a half of my pregnancy. Second pregnancy: no sign of it. I've had a few errant BP readings, but when they recheck me I've been "back in range", so maybe they should just let me sit and breathe for a second, instead of strapping the BP cuff on as soon as I sit down? I've never understood the logic of that strategy. "I know you just told me that you get short of breath with any kind of activity and I just had you walk down a couple of hallways after several minutes of hospital navigating, but let's go ahead and check your blood pressure right now and be surprised when it reads higher than normal".
• First pregnancy: blogged a lot. Second pregnancy: mostly just Instagrammed because it's a much quicker/lazier solution for wanting to document things. :)
• First pregnancy: my doctor offices were all over the literal map, with some appointments requiring a couple of hours of drive time to attend. Second pregnancy: every doctor is in the SAME HOSPITAL BUILDING HALLELUJAH THANK YOU JESUS. Now I just drive to the same place for everything and it's so freaking easy I could cry.
• Speaking of locations, we also moved last November to a new house that could better accommodate our growing family. I was around 6 months pregnant and apparently still had energy and could move around like a normal human being... I hardly remember feeling that way now, but it seems to have worked out.
• First pregnancy: delivered at 37 weeks, 4 days. Second pregnancy: still hanging on at 38 weeks, and unless the little dude has other ideas, we'll make it to 39 weeks. Fingers crossed.

Well little dude, we've made it. Today marks the most pregnant I've ever been. (Rabbit had to be delivered early because of mild pre eclampsia... but no sign of it this time around.) As long as we both stay healthy, you get another 10 days. Also, I am not good at taking selfies in this house yet. #37weeks #pregnancy #T1D

A photo posted by Kim (@textingmypancreas) on Feb 7, 2016 at 1:34pm PST

Round Two.

::blows dust off of blog::

I've been taking a bit of a bloggy hiatus. Although it felt weird at first to not be blogging every day/week, it's actually become pretty freeing. I've been able to spend more time with family, focus more at work, and the nights I would have stayed up late to write on my own site or keep up on other blogs, I've been going to bed earlier. All of those are pluses for me, sitting squarely in the "good for my health" column.

But...

I do miss connecting with this community in the ways I used to. I miss knowing what my friends are up to. I miss the random connections and uplifting camaraderie. I miss being up-to-date on every FDA filing and approval; every piece of diabetes legislation; every #dsma conversation. I miss the impromptu, softly spoken calls to action that morphed into something much bigger. I miss you guys, period.

But...

I don't think I'll be returning to my former participation level; at least not soon. I'm juggling a lot of responsibilities at the moment, and this part of my life is where I can "opt out" for a while. I want to especially blog during these next six months, but we'll see what time and energy allows.

Why the next six months?

Our superhero is getting a sidekick.

A video posted by Kim (@textingmypancreas) on Aug 8, 2015 at 12:33pm PDT

Baby Vlasnik #2 is due in February.

:D

Letting The Dust Settle.

I once heard someone note that when you have a baby, "your life just kind of explodes". I'd like to add to that thought and remark that when you have a baby AND you have diabetes, your life just kind of explodes but then all of those fragments proceed to land on their self-destruct buttons. Life post-baby seems to resemble some sort of Michael Bay-directed cinematic adventure (with the addition of an adorable infant).

The total takeover of mind, energy and heart that a child brings has been... intense. But after a few months, I'm feeling that we're adjusting okay to this new version of normal. Our mornings look a little different, and not just because we're up waaaay earlier now - there exists a whole new set of activities that run in tandem with ours in order to get another human ready for the day. But I'm finding that I don't even mind all that, because that first grin of the morning - the one where the dimple in her right cheek surfaces; where her eyes widen, then light up with recognition when we lock stares; where she kicks her legs jubilantly and, with clenched fists, swings her chubby arms around - sets the tone for everything else. No matter what else may happen throughout the day, this daily treat remains the highlight. The joy in that moment fills up my heart, and I continue to be astounded at how this perfect little person could have been made by me.

Sorry, I'm baby gushing. I do that now.

While I may be adjusting to the shift in schedules and priorities, my relationship with my health has become more tumultuous. Diabetes is running alongside me like the child, arms flailing with panic, whose school bus drove right by them but never slowed down: "Hey! HEY!!! Stop the bus! You forgot me!!" I see you, diabetes - I just don't have the time to come to a complete stop for you. Don't throw yourself in front of me, okay? And no angry calls from your parents.

Where I once might have seen patterns and predictability, I now just see a jumbled mess... but maybe it's not as bad as I think it is, because I'm comparing it to the super-intensive routine I had during pregnancy. I saw my endocrinologist a few weeks back and after studying my CGM and insulin pump downloads for a bit, the corners of her mouth began to turn up.

"You know...." she paused, shuffling papers twice, and then three times, looking back to double (and triple) check herself, still smirking. "I'm actually really happy with where you're at." The tone of her voice indicated that even she couldn't believe she was saying that.

Pause. "I'm sorry... you're what?"

Laughter. "I mean, with most new moms, the baby comes and diabetes goes out the window. But I can see that you're still testing. And you're bolusing! I mean you're not entering carbs most of the time, but you're remembering to take insulin... at all. I can be happy with that if you are."

Well, that was true. And when we checked my A1C, she and I were both pleasantly surprised when I clocked in at 6.5.

"If you're okay with it, I really don't think we should make any changes yet. Let's let the dust settle a bit more before we start changing things - you already have enough to adjust to right now."

I'm okay with it.

I think.

Pregnancy And Type 1 Diabetes.

One of the most excerrifying (that's being excited and terrified at the same time, if you're unfamiliar) times of my life was being pregnant with my daughter. As a woman who has lived with type 1 diabetes since the dawn of time she was six years old, I'm familiar with the notion that pregnancies with pre-existing diabetes are complicated. Even when you're managing your diabetes perfectly well thankyouverymuch, pregnancy puts us in the "high risk" category and everyone freaks the heck out.

While it's true that balancing pregnancy and pre-existing T1D is a major challenge, what I wish someone would have told me way back when is that not only is it possible for someone like me to create a brand new human being who is totally healthy - there are perks to being pregnant and diabetic!

In that spirit, I'd like to balance out all of the "aaaaaah everything will go wrong!" with a little of what will go right.

Rabbit's Arrival: Part Two.

(Part One can be found by clicking here.)

It's a little surreal to be wheeled into an operating room for the first time. What I remember thinking as the nurses glided me and my wheely bed down the hall: "I'm about to have surgery. She's about to be born. I hope she's okay. Do I still have legs?"

The doors flew open, and Justin Timberlake greeted me in song.

"Are you kidding me? I really get to listen to JT during this? BEST OPERATION EVER."

The nurses laughed. "We're happy to leave the radio on for you, or turn it off - whatever you prefer." "No, no, this is great - it will help relax me a bit." I hadn't realized until that moment that I couldn't stop myself from shaking. I couldn't tell if it was the drugs, the nerves, or all of it.

My bed and I were glided to the middle of the room. One, two, three, LIFT! All of a sudden I was on the operating table/bed in the middle of the brightly lit, all-white room. A blue cloth was draped from my shoulders up to a height that obviously I wouldn't be able to see over (I remember thinking, is this really necessary? It's not like I'm going to try and sit up to see what you're doing...), and an anesthesiologist/nice man in glasses greeted me.

"Hi Kim, do you know what we're here to do?" (I imagine this is a litmus test of some sort to see how "with it" I was; that or someone didn't get the day's agenda ahead of time.) The drugs were definitely doing their work on my body, but my mind was still lucid. "I'm having a c-section so we can get this baby born!"

The doctor grinned at me. "Good, good, good." He spoke with a kind voice and told me what we were doing, what I should expect, and who was in the room. He tested how high up in my body the anesthesia was working and electrodes were placed on my chest.  Aaron joined us, and took a seat by my head. I couldn't exactly tell at what point the procedure started, which I guess is a very good thing, but soon I could feel some light pressure on my stomach, moving from left to right. I felt more pressure. Bruno Mars took his turn at the microphone. A few minutes passed.

"There you are! It won't be long now!", my OB enthusiastically called out. Aaron and I looked at each other, or rather I tried to twist my head in a way that would allow me to make eye contact with him. He rubbed my hair through the surgical cap.

A few moments later: "She's here!"

I looked to Aaron, whose attention focused past the drape. "Go; go see her; take pictures", I told him. The room was a flurry - me being sewn up; the baby being attended to.

All I wanted then was to hear the sound of her being "okay"; the sound that would let me know her lungs were more than just intermediate. I needed to hear her cry. Ten seconds, twenty, thirty... I'm not sure I breathed while waiting to know if she could.

It was only a few more moments (though they seemed so much longer), and then I heard her. It was the most beautiful whimper I've ever heard, and the crescendoing sound seemed to be directly connected to my tear ducts. I teared up immediately, thankful to have gotten to that place in time where I knew that she and I had made it.

She was here, and she was okay.

* * * * *

A few other here-and-theres:

The anesthesia had me feeling quite fuzzy by the time Rabbit arrived, so much so that I had to struggle to keep my eyes open while they cleaned her off and got her stabilized, and I also threw up in the recovery room. Like you do.

Rabbit experienced some low blood sugars in her first 24 hours in the world - immediately after birth being one of those times. Soon after I had ralphed, they alerted Aaron and I to this and asked if we'd prefer to feed her a bottle of formula or to have her hooked up to an IV; we opted for the bottle route. (I'm still surprised they let me hold her right after getting sick, but I really did feel much better afterwards. Maybe that's normal "I Just Had Surgery" stuff.) By the next day she was pancreasin' just fine.

As for me, I'm still amazed at how well things went diabetically during my hospital stay:

How I thought to take a picture of my CGM graph right in the middle of labor is beyond me.

My Dexcom graph, the day after Rabbit's arrival.

Not being able to eat anything once we started the medications Monday night helped my Dexcom graph stay steady, as well as the insulin IV drip we had me hooked up to. It also became apparent to me that nursing has a huge impact on blood sugars, as I didn't have to bolus for food the entire time I was in the hospital. (What?!) I've been adjusting my basal rates now that we're home so things are a little more back to what I'm used to, but man, was that nice.

I had planned ahead for the "just in case" option, knowing from Kerri's posts about her daughter's birth story that a Dexcom sensor on my lower body would likely be removed in the case of a c-section. When I checked into the hospital, I had both my Dexcom sensor and my insulin pump site in my left arm. It worked beautifully.

And as for Billy, he seems to have found his calling as a baby alert dog:

He goes where she goes, comes running when she cries, and sometimes whimpers when her diaper need changing. They share tummy time, and though we are careful to keep him at a bit of a distance (he is a dog, after all), he would love to snuggle up to her if we'd only let him:

In short: things are pretty great around here.

Rabbit's Arrival: Part One.

Every time I have sat down to write a post about the baby bunny's birth story ("I should really get this written down before I start forgetting stuff"), I get distracted by the thought: "....oooor, I could just cuddle with my daughter some more", and guess which option usually wins?

My daughter. Wow.

She arrived two weeks ago (about halfway through week 37 of pregnancy) at 9 lbs. 2 oz., 20 inches long, with a full mop of hair and the most kissable cheeks I've ever seen. There were many surprises for me throughout the delivery process, but I like to think that she and I handled it pretty well. After all, she's sleeping in her bassinet right next to me as I type this (and I'm listening to my favorite sounds in the world, which are the contented sighs/hums she often makes while sleeping or eating), and getting her here safely and in good health was the only thing that really mattered. Mission accomplished.

Or "touchdown", if you're so inclined.

Be warned that there will be a great deal of TMI in these posts, so read at your own risk. I don't feel the need to censor much of the story, as it involves me personally - childbirth really does erase a lot of one's modesty.

Aaron and I visited my doctor's office one last time before delivery in order to have an amniocentesis performed; a procedure recommended by the high-risk OB to determine how developed her lung function was. I laid on the familiar ultrasound bed and with the wand we searched around for a "good pocket" to poke into. Upon finding one, that part of my stomach was injected with a numbing agent and then was stuck with a giant needle that I tried really hard to not look at too closely - all the while watching the little bunny baby on the ultrasound monitor. She did a very good job of staying put during the procedure (too much movement could have resulted in her getting jabbed by the needle, thereby necessitating an immediate delivery - and yes, we had our bags packed and in the car before this appointment, just in case), and we got the amount of amniotic fluid needed to get the testing done. 

We were relocated to a monitoring room where I sat in a surprisingly comfortable medical-grade recliner while hooked up to a machine that took note of my contractions and her heartbeat, in addition to recording the baby kicks I was tracking with a button press (indicated on the chart by a musical note) for each movement. We were there for about an hour to make sure that the Rabbit was going to be okay post-procedure, and when we were all confident that she would be, Aaron and I headed home for our last few hours as Free People Who Do Not Have Kids. 

The test results took a few hours to come back, and they showed that her lung development was in the "intermediate" zone. My doctor and I talked through the options, and mutually decided that keeping our plan to begin induction that night made the most sense for our particular circumstances.

And so, at 7:00 pm that Monday night, we checked into the hospital. The only other time I'd been admitted to the hospital was for my diabetes diagnosis 27 years ago, so that was a little weird.

We were shown to our room, and after changing into some glamorous (no) hospital gowns, the labor-inducing circus got underway. Blood was drawn, and two IV lines were put in place for later - one in my left forearm, and one on top of my right hand. The left would be in charge of labor-related medications, while the right would be reserved for my insulin drip once labor began. (I was given the option of keeping my insulin pump on and being in charge of my own diabetes management during labor, and I'm very glad I went the route of the IV insulin drip. Not only did I not have to think or do much about diabetes for several hours, but it also worked beautifully. Proof coming in a future post.)

The medication I was given that night and into the morning was to help get my cervix in a baby-expelling state of mind, and other than the very uncomfortable manner in which it was delivered every few hours, that part of the process was pretty uneventful.

That is, until 6:15 am the next morning, when surprise! My water broke. (We hadn't begun the actual labor meds yet, so this was taken as a good sign that my body was ready to do this.) You know how in movies it's this huge gush of water, and then everyone tells you that in real life, it's not like that at all?

It was exactly like that. Perhaps the most embarrassing part was that I couldn't tell if I was peeing or bleeding or what the hell was going on, so my reaction was something like, "Oh. OH. Aaron! Something is happening! Something is definitely happening...", while I simultaneously pounded the "someone please come help me right effing now" button on the side of my bed.

Stuff began to get real pretty quickly. A catheter was inserted (yay, no more wheeling IV bags with me to the toilet!), and doses of pitocin began coming my way via IV. Labor contractions began as small, intermittent discomforts, eventually snowballing into horrific pain on a 90-second continuous loop. I remember thinking, wow, people are not exaggerating one bit when they talk about how painful labor is. I would have gladly signed over my house for even a small dose of something to quell the pain.

Somewhere around 11:00 am, the anesthesiologist/angel appeared and after a few minutes, we had an epidural set up in my back. I can tell you that I have never felt such grateful relief in all my life. Holy hell, what a difference. The epidural allowed me to tolerate (read: mostly not feel) the increasingly intense contractions, and for the next few hours I was even able to take some short naps (!). Everything was progressing as my medical team hoped it would.

It was, that is, until around 3:00 pm. Progress in terms of dilation began to stall, and baby Rabbit wasn't giving any indications that she was ready to budge (meaning, she hadn't "dropped" any lower). In addition, the fetal monitors were indicating that with each growing contraction, her heart rate was dropping.

That's not good.

And so, at 3:17 pm, my OB came into our room to tell us what the new plan was. "She was tolerating labor just fine up until now, but we don't want to take any chances so we'll be doing a c-section. Aaron, here are some scrubs for you to put over your clothes. Kim, we're going to wheel you into the operating room now and Aaron will join you in about ten minutes."

Aaron started sending the "get here now!" texts to family, and I was given the numb-the-bottom-half-of-your-body drugs, while my hair was shoved into one of those meshy shower caps. I began to feel tingles, then the strange feeling of dead weight throughout my legs, hips, stomach, and eventually even out to my arms and hands. I also began to accept that, once again, I really had no control in how this all would play out.

My doctor looked from me to Aaron, then back again. She smiled.

"You're going to have a baby within the hour."

And all I could think was:

(To continue to Part Two, click here.)

Wordless Wednesday: Ta Da!

Week Thirty Seven.

After some testing this afternoon, the plan is confirmed: we're checking into the hospital tonight. The little Rabbit should be joining us tomorrow sometime! I can't guarantee when I'll get a post up here again, so keep an eye on the Twitters if you're looking for the first "she's here!" announcement.

Let's do this!!!!

Week Thirty Six: The Upsides.

Last week's post was sort of a bummer so this is my attempt at cosmically realigning my pregnancy mojo, or something of that nature.

Good Things:

• I made it through 36 weeks of pregnancy before the inability to get a wedding ring on struck
• Not being able to easily reach my feet has meant more pedicures, and I am very okay with this
• Every so often I catch Aaron holding back a laugh (typically during a time where my belly is in my way to some degree), and when I ask, "Are you laughing at me?", and he responds, "Yes, but it's because you're cute", it then makes me smile so everyone wins
• The hospital we'll be at has some delivery rooms with jacuzzis in them, which when it comes down to it I may not even use or care about, but for now it helps me think of this "getting baby out" process as a wonderful spa-like vacation
• I can really fool myself into believing things like "infant care is a vacation"
• They have a margarita machine at the hospital right
• Okay back to topic
• I have a straight A student in there - six BPP tests, all passed with flying colors
• Speaking of colors, there's some debate over what color her enormous mop of hair will be - I vote brown (the ultrasound tech did a measurement on her hair last week [does insurance cover that?] and claims it is over an inch long)
• People smile at very pregnant ladies more than I expected
• While I may have momentarily given up on proper nutrition last week (three Oatmeal Creme Pies in one day - go ahead and judge because I don't care because pregnancy - and the second and third ones tasted like delicious, delicious guilt anyway), I'm pretty sure all the previous weeks of almonds, blueberries, and soy milk negates most of the grossness
• The Oatmeal Creme Pies are no longer in our house, so I'm once again safe
• It sounds as though ours and the royal baby will be sharing a birth month, so obvsly they will be BFF penpals
• ONE WEEK LEFT!

Pure evil, in every possible way

The Plan (Week Thirty Five).

I'm beginning to believe there must have been some under-the-radar meeting involving secret handshakes and passwords wherein every pregnancy symptom that I've experienced thusfar has decided to band together for one last "let's make this really miserable" hurrah. Instead of confetti, there are sporatic stabs of back pain. Instead of an inflatable bouncy house, I have inflated feet and ankles. Instead of cake, there's my inability to avoid low blood sugars every mid-afternoon, and sometimes after dinner, and often in the middle of the night (essentially overdosing myself for meals as that's all I can seem to do to negate food spikes, with the expectation of a low later on that can be avoided - assuming I remember to expect it - with a snack). (See also: not medical advice in any way please don't do this I am not a doctor.)

Wait, so maybe there can be cake.

Last week had me seeing both the high-risk OB (also known as a maternal-fetal medicine specialist) and my regular OB. This was our last visit with the high-risk dude, and we once again got to see our little Rabbit on a 4D ultrasound scan. The good news is that she seems raring to go - all major organs look good, she's "breathing" like a boss, and the amniotic fluid levels look great. The BPP scan we did at my regular OB's office also produced another perfect score; 8 out of 8.

This is all very good news. But unfortunately, not all of the news was ideal.

Remember how I mentioned that while her size was creeping up, no one was freaking out about it yet? She now is being estimated above the 90th percentile in weight, and both my hope and my bladder are feeling a little crushed. And "crushed' compounds when I realize that I shouldn't feel badly about feeling badly, but yet I do. (What?) Let me explain.

If I'm being completely honest with myself, my disappointment stems from now being an example of the incorrect assumption that "oh, you have diabetes, so of course your baby was big". I have worked so, so hard to keep this body a healthy environment for her (on top of all the normal pregnancy requirements); poked my fingers more than I ever have in my life; lost sleep so that I could check BGs during the night and eat a little something to keep the morning fasting ketones at bay; injected and waited, waited, waited until it seemed safe to consume some carbohydrates; participated in the frequent monitoring, doctor visits, blood draws and urine collections recommended; kept my A1Cs in "baby range" as soon as I was able to do so.

I've done everything I'm able to do to keep her healthy. So why do I still feel defeated? (And if she comes out otherwise-healthy, who cares?)

It's possible that, even if I didn't have type 1 diabetes (or even if somehow I could have been hooked up to an artificial pancreas that could keep my BGs in those impossible ranges at all times), I still would have grown a baby her size. It's possible that she was going to be larger no matter what I did. But we'll never know, and I fear that the biggest thing that will stand out to some about this journey is that, judging by her size, I must have been "uncontrolled". That I didn't work hard enough. That it's my fault. Once again I have to release myself to the conclusion that I ultimately can't control what happens here - I can try hard, and I can enlist the most competent medical team, and I can count every freaking carb and unit of insulin until it all starts blurring together, but at this point the whole thing's on a version of auto-pilot where what I do doesn't directly affect the outcome. And while delivering at 37 vs. 39 weeks would relieve me of the misery party I mentioned earlier, it wasn't what I was genuinely hoping would happen.

And then I feel bad about feeling this way, because I sincerely hope that it doesn't come off as thinking that delivering early, for anyone, is a failure. I know that it's not. Everyone's situation is different, and 37 weeks is considered "full term" anyway. I only assign this feeling to my own personal situation, because that's the only situation I know all of the details and inside information into. My own journey with pregnancy is the only one I can judge, because it's the only one I truly know.

Though I know this is the plan that is probably best for her, I can't shake the feeling that I didn't do the best for her along this journey somewhere, somehow. (But again, what could I have done differently?) I know that so many others with T1D have delivered very healthy babies during week 37, and I hope that our story is no different, no matter how I may feel about it in this moment. (And if you're one of those who did deliver early and shared your story with me, thank you- it is helping me in ways I can't now articulate to accept what's coming.) Much in the same way that removing most of my pre-pregnancy clothing from my closet helped me feel better about how I was growing, I've packed up the newborn-sized clothing the little Rabbit will probably never get to wear as a way to help me accept what will be. I keep telling myself that if she is healthy when she's born, it shouldn't matter how (or when) we get there. I keep telling myself that, but I can't say I believe it with my whole heart just yet.

I hope that can change in the next two weeks.

Due to her estimated chunkiness, we won't be giving her the 39 weeks I had hoped for. We're scheduled for an amniocentesis in a couple of weeks (which is during week 37 of pregnancy for me), where I'll hang around my OB's office for monitoring a couple of hours after the test as we wait for results. If the test results indicate that her lungs are fully developed, we'll be checking into the hospital that night to start induction.

Until then, I'm working on packing the rest of our hospital bags, while unpacking the disappointment and guilt I'm feeling.

It's the kind of baggage that's best left on the curb.

The Nerve.

I like to think I have a pretty high threshold for pain.

When I was in high school I belonged to a Tae Kwon Do studio, working my way up to black belt over the course of about a year and a half. I had never had a big interest in martial arts before, but their huge sign in the window of the studio that offered "SELF DEFENSE CLASSES" reeled me in - and the more I learned, the more I loved it. My decade of dance classes combined with cheerleading experience proved a formidable foundation of strength and flexibility that allowed me to excel at this new (to me) sport. It felt totally empowering, and I miss practicing it.

But onto the pain stuff.

I can recall one class where a younger instructor was teaching us a sort of submission move that involved grabbing the fist of your attacker and bending their thumb (utilizing a pressure point, I'm sure) inward in a way that was supposed to prove them incapacitated. I volunteered to be the proverbial "attacker" in this situation; the instructor taking my hand and showing, step by step, how to position his. He then looked to me, a slight grin on his face, and said, "This only hurt little bit. Okay?" Um, sure. Okay. His chubby fingers began to exert pressure on my thumb. I didn't even flinch.

He pressed harder, and harder again. Still nothing. (I vaguely remember smiling at him at this point.)

The look on his face was priceless - this was supposed to cause me to double over in pain, yet there I stood smiling at him. Did he realize all of the injections, finger sticks, and blood draws I'd had up until that point? This was nothing!

The point of this recollection is that I've, up to now, been under an assumption that I can tolerate quite a bit of pain with some amount of grace.

I've known that late pregnancy sometimes causes back pain; it's one of the multitude of symptoms that gets rattled off when you're learning "what to expect". What I hadn't anticipated was that it would be the sort of debilitating back pain that leaves you involuntarily whimpering every time it shoots down your back. Maybe I thought it was going to be some mild soreness that hangs around, or at least the kind that while uncomfortable, could be manageable.

I certainly didn't expect it to strike during my drive home from work on Friday, leaving me wondering if the facial expressions I was making would cause my fellow drivers to believe I had gone into labor, and more importantly wondering if I could make it home without veering off into a ditch somewhere.

But I did somehow make it home, and as I limped into our house strung together in one, high-pitched sentence "MYBACKISKILLINGMECANYOUPLEASEGETTHESTUFFOUTOFMYCARINEEDTOLAYDOWN" to Aaron. A call to my doctor confirmed: it's sciatic nerve pain, and it's the most painful thing I can remember feeling ever in my life. I spent Friday night and most of the day Saturday trying all of the things you can try to relieve the pain: lying on your opposite side, Tylenol (which, to my delight, didn't seem to interfere with my Dexcom G4 results in the way it would have with the 7+), Icy Hot patches, a maternity belt, and good old-fashioned cursing. Some of it helps, some of it doesn't. This morning I can feel the pain creeping back into my lower left side, and I'm willing the Tylenol I swallowed at breakfast to ward off the worst of it.

I think this is why Mother Nature designed human pregnancy to be so long - if all of these symptoms came on at once instead of the gradual manner in which I've experienced them, I'd be losing my damn mind.

Week Thirty Three.

I feel as though I've regressed to the state of a four-year-old on a road trip: "Are we there yet?"

(If you were looking for a "I love being pregnant!" post, keep your seatbelt fastened. This isn't your stop.)

One early morning, I noticed that my rings weren't quite sliding on like they used to, and I bristled. Glaring sternly at my ring finger, I used my mental telepathy to express that "no, there's been a mistake, surely. I haven't had any salt yet today. (I wasn't sleep-eating potato chips, right?)". I had hoped I could reason with myself, but shockingly, it didn't work. I'm just swelling up in all extremities now, at any given time apparently.

Things that used to be easy before, like oh, I don't know, walking or going up one flight of stairs or not running into things stomach-first have become significant challenges as of late. Did you know being super pregnant also makes you burp all the time? Yeah, me either. Awesome. Super.

I'm on my third iteration of Palmer's Slather This All Over Your Belly False Hope Cream®, but my stripes are still pretty bright. I'm told that stretchmarks fade after the baby's out... right? I hope that's true, otherwise my kid is going to grow up believing I'm half-tiger and I don't want to explain in a few years to some nice stranger at a grocery store why my adorable daughter is roaring at me.

Baby Girl is still moving around frequently, but not as much in the same enthusiastic, Thumper-esque ways of her youth. I'd imagine she's feeling pretty cramped in there by now, so her dance moves are now less Cupid Shuffle and more Mom Dancing. She'll sometimes stretch a foot out, leaving the angle of my stomach so off-kilter that I press back on her because tummies aren't supposed to look like this so stop it. You can do your stretches next month, after you move.

As for the medically-related whatnot, we're still doing well. My blood pressure actually measured lower than it has been last week, which is great, and the little rabbit has now passed three of the BPP tests with perfect scores. As for measurements/weight estimations, I'm starting to wonder if I really am growing a large Muppet in there, because the percentile her weight falls in has steadily crept up. Is she just having a long growth spurt? Is it because her dad was a large baby, too, or because I'm tall? Is it because of the spikes in blood sugar I wasn't able to tame? Maybe all of the above. She still has a few weeks to bake, so no one is freaking out yet in relation to her size, but it's enough to make me wonder if 39 weeks is still a realistic goal.

The diabetes part of the equation has been... well, it's actually given me a break for a couple weeks. I don't mean that it's gotten easier, or that I'm not taking the hugest amounts of insulin I've ever heard of, or that those food boluses don't happen several minutes or sometimes a full hour before eating, but the results of those efforts have been more visible. My endo was actually really pleased last week with how I'd handled the previous several days, and made adjustments based on the speculative temporary basal rates I'd tried.

(Sidebar for the newly-pregnant or planning-to-be ladies out there, because at some point I wanted to be sure to pass on these gems: there are a couple of websites/newsletters that have been super helpful for me. If you haven't yet, check out Lucie's List - the site and weekly newsletter based on your due date - for some real talk on what to expect throughout the whole ordeal, what you're actually going to need gear-wise for baby, and reassurance that whatever weirdness you might encounter is probably a normal pregnancy thing. Also for good advice and information, but also for some of the funniest writing you'll encounter, do the same with Pregnant Chicken. Her weekly emails make my... week. Seriously, she's wonderful.)

Four to six weeks left, and while I'm not sure Aaron or I will ever feel "ready", we're feeling pretty close to that. Which will have to do!

Reasons I Love My Healthcare Team.

1. My OB and my endocrinologist are not only located in the same building, but on the same floor and two doors away from each other, as if they anticipated hugely pregnant T1 ladies such as myself needing to jog between the two
2. They use careful and thoughtful wording when something isn't up to snuff; careful to not place blame where it isn't due or to make me feel any more badly than I already do when goals aren't quite acheived
3. My endo's exam rooms each have a "Carb Drawer" full of juice boxes, peanut butter crackers, and glucose tabs for in-office lows, which I had to dig into at my visit yesterday
4. When my endo's nurse whisks away my Dexcom receiver in order to download my data from it, she circles back within seconds after seeing the current graph: "You know you're low, right? And you're going to eat something?"
5. Pedicures and pool time are doctor's orders (actual wording from OB: "You're going to be pretty uncomfortable for the next several weeks, so make sure to do things that can distract you and make you feel good: go get pedicures! Go find a pool to lounge in!")
6. When I describe my unconventional method for dosing as of late (I'm doing injections for the larger amounts instead of bolusing from my pump*, which helps my pump sites last longer - and saves me money by not needing to order pump supplies again so soon - but does eliminate that handy IOB feature on the Ping. It works for me, right now. YDMV.), my endo pauses, then replies "Oh, that totally makes sense! I'm absolutely fine with that. Do you need (Humalog) pens or needles?"
7. I get to tell her that no, I actually don't right now because my internist gave me a small village of sample pens last week ("I want that baby to be healthy! She needs insulin!"), and I nearly wept with joy
8. Sidebar: who else but a pregnant diabetic would shed tears of joy over free digestive hormones
9. My last two A1Cs have been some of the lowest I've had, and while a lot of that is due to what I'm doing when I'm on my own, it doesn't hurt that we've been meeting bi-weekly to adjust all of my rates  (and now, it will be every week)
10. While visits to an endocrinologist have, in the past, resulted in me being in tears, I feel nothing but uplifted every time I meet with my current doctors, and that is exactly what I need right now

New basal rates = new fasting BG swagger

*Another reason that bolusing doesn't work well right now: the Animas pumps have a bottom threshold I:C ratio of 1:2, so for those of us who need something more aggressive than that, the bolus calculator is useless. I can do the calculations myself and then dial up the proper amount, but I really miss the pump figuring it all out for me.

Week Thirty One.

Last week began the phase of pregnant-while-awesome diabetic where I'm at my regular OB's office every week, for the main purpose of doing an ultrasound that checks out Baby Girl's development in several areas - a biophysical profile (or "BPP", for short). This test involves the ultrasound tech measuring things like the amount of water in the swimming pool (amniotic fluid), looks for "practice breathing" (and she's been doing that with gusto both times), and measures all parts of the baby's rapidly growing body, including heart rate and muscle tone. I think that non-diabetic people get these too, but later on in pregnancy, and not nearly as often.

A BPP is also where they estimate her current weight, and though her weight has been creeping up a bit, I'm happy that she's remaining in a normal range. So what if she ends up being a little chubbles? (And, really, with Aaron and I as her tall, non-skinny parents, the likelihood of her being a small baby was preeeeetty tiny.)

I'm also happy to say that Baby Girl has received perfect scores on both BPPs so far. Yahtzee!

As for me, everything still looks pretty good. We continue to keep an eye on my blood pressure, and I continue to wish that the nurses would give me more than 30 seconds after we've entered the exam room to check it, as the readings are always consistently higher than the ones I see at home. Heartburn has been less frequent, and while the belly has gotten more uncomfortable to lug around, I haven't let it be too much of an excuse to sit out of possible fun. (I even made it through seven innings of a College World Series game this past weekend!) While my weight gain is following a good pace, I found out at my most recent appointment that the actual belly is measuring five weeks ahead. FIVE. What?

The toughest part for me now, mentally, is that for at least another month I have no idea what The Plan To Get Her Out is. There are too many variables; too many things that can change for better or worse between now and go-time. Decisions like when, the manner of delivery; all of it rides on what happens in the coming weeks, and there's no way to really know how it will all shake out, yet. Her estimated weight, how many (and how large) the fluctuations in my blood sugar are, and many other factors will determine how we proceed. No pressure though, right?

At least I can say that the temp basal I started running last night has made some significant impact:

And sometimes, too much.

Just keep moving forward - that's what I'm telling myself. 

(Even though the mere thought of moving in any way makes me out of breath - no room for the ol' lungs anymore!)

My #DayOfDiabetes.

Yesterday found me participating in #dayofdiabetes, where I tweeted the majority of my day as someone who is both pregnant and lives with type 1 diabetes. Sorry about cloggin' up your feedz, but I wanted to be honest in what was happening, how I make decisions, and how I felt about the results of those decisions, and that takes a lot of words.

And in the spirit of honesty, I also shared what could possibly be the most facepalm-y moment in my diabetes life so far.

Well of course it's on the day I decide to tweet everything diabetes-related that I drop my pump in the (clean) toilet. #dayofdiabetes

— Kim / Diabetes (@txtngmypancreas) June 17, 2013

I saved all of my tweets through Storify, so if you'd like to go back and relive my exhilarating (not really) day, here's the link. (Tweets are organized with the newest on top, so you'll have to scroll to the bottom of the story to go chronologically. I know.)

If you'd like to explore the #dayofdiabetes events that others have contributed too, head to the Tumblr site.

I don't know that this could be called a typical day with diabetes, but seeing as how no two days are ever the same, perhaps it was.

What Helps.

Being pregnant while trying to wrangle blood sugars, blood pressure levels, morning ketones, food, boluses that seem too huge to be right, and everything else that comes with diabetes-while-gestating can feel really overwhelming sometimes.

But you know what helps me a whole lot?

(click image to enlarge, if you can't read the text)

My online friends who have either been down this road before, are going through it right now, or have supportive and wonderfully encouraging things to say (derived from compassion, not necessarily personal experience) when I post pictures like this.

They help the scary seem not quite so very.

(By the way, that bolus was for 64 carbs. Third trimester insulin requirements are no joke.)

Week Thirty.

Let's start with a bumpdate, shall we?

I'm simultaneously starting to feel quite uncomfortable in my own body, yet pretty good about how that body looks. While my rib cage misses all of that luxurious room it used to have, things like random ankle swelling seem to have been a one-trick pony who has now wandered off to Montana or somewhere. The pregnancy hormones that graced me with the skin of a fifteen year-old are letting up a bit, and my inclination to care about those leg blotches seems to be inversely proportional to the temperature outside. Want to stare? Don't care.

Last night marked the first time that a stranger asked with full confidence when I was due. Yay?

Our recent visit back at the high-risk OB this week yielded several notable outcomes:

• Baby Girl finally stopped moving long enough for the doctor to look more thoroughly at her heart, which appears to have developed normally - the screening he did ruled out "about 85% of possible heart defects"
• She apparently experienced a growth spurt, as her weight is now in the 69th percentile
• Everything still looks GREAT development-wise
• She's decided that laying across my belly is obviously the most comfortable position, with her head on my right side (just under my rib cage) and her feet so thoughtfully using my bladder as an kickable ottoman
• The doctor took more time to explain his stance on the 37 weeks comment from last month, and it would require certain results from testing we'll do next time before he'd push for a 37 week delivery (which means he's respecting my preference to go 39 weeks, even if he doesn't understand it: "most women just want to not be pregnant anymore at that point")
• He and his staff give really good restaurant recommendations

So, overall, it was a good appointment. Probably the best one we've had with him so far.

I managed to spill some small ketones this morning - a during-pregnancy first - that can be attributed mostly to the fact that, what was I thinking, I actually slept through the night. Breakfast and a large amount of water intake cleared them up within a couple of hours.

And as for the non-diabetes stuff, everything's coming along there, too. I'm totally amped about the upcoming baby showers our friends and family have been so kind to plan for us, and I'm swiftly becoming addicted to the smell of Dreft as I wash the baby outfits, toys, and accessories we're storing up. Packing a hospital bag (okay, two) is a thing I've started, mostly because at least having it started makes me feel calmer.

And while I had originally planned to never post an ultrasound photo online (because somehow that just felt too private), I'm breaking my own rule. Her cheeks made me do it.

Two months to go!

Really? Okay.

Have you ever had to crank up a basal rate so high that you wondered, "How am I not dying right now"?

And have you ever, then, seen a line so steady on your CGM graph that you could swear this was a dream/nightmare/did breakfast make me hallucinate?

That.

(Not complaining - just a bit in awe that something that colossal is producing results like this right now.)

Puff, The Magic Cankle.

I looked down at my feet last night after I was home from work and though, "Hmm, that's not normal."

One does not have time to pretty their feet up for the camera
when there is swelling involved.

Whoooaaaa, there, left foot. What are you doing, buddy?

Up until now, my feet/ankles/anything else hasn't shown any signs of swelling, and I was really digging that. When I saw my endocrinologist on Tuesday, she examined just my feet (well, actually, now that I think about it - she physically examined just my left foot) and had said, "Well, just a little bit puffy." I frowned, and when I came back home asked Aaron to assess my foot size. Second opinion!

We both agreed that my feet didn't really look that different than normal.

Fast forward to last night.

Because calling my doctor would make too much sense, I snapped a picture and sent it to a few friends. "Is this normal? It looks way puffier than the right foot, right? Not just me?" When responses came back in the vein of, "Um, you should probably call your doctor right now", I did. (And for what it's worth, that advice matches up with what the internet says, too.) Being after hours (and in the middle of some severe weather) I spoke to the doctor on call that night, describing my situation (28 weeks, type 1 diabetes, blood pressure has been fine) (except for the first time they checked it at my appointment on Tuesday when it read 154/82, but then they checked it again and it was 122/78) and telling her about this new symptom.

"Does it hurt at all? Does it hurt to walk on?" Nope, feels just like my other foot, except for the part where I can tell that it's puffy.

"If you press your thumb down, does it leave an indention?" Hmm, I hadn't tried that (nor was I completely confident that I could reach my foot). However, I was successful. Indention made, and it stayed put for a second or so.

She ran through a couple other questions, telling me that just one swollen foot or ankle can indicate a blood clot, but since I wasn't exhibiting any of the other symptoms, it perhaps wasn't that. She recommended I keep my feet elevated for the rest of the night, laying on my left side if I could (something about taking the pressure of the uterus off of some veins and stuff), so I happily handed the dinner-assembling reins to Aaron (who made killer sandwiches, btw) and planted myself in our recliner.

Sure enough, the elevation + increased water intake + necessary dog cuddling (severe weather = shaking, scared, cuddly dog) seemed to do the trick. And this morning? My foot looks totally normal to me.

I'll be following up with my doctor this morning by phone, and hoping this is some sort of fluke whereby my left foot is just being a jerk-and-a-half.

Pregnancy! Good times!