Wednesday, December 28, 2011
Yesterday morning, as I rolled out of bed, I was positive that this was the day. I don't think you really want to know precisely why I was so positive (let's just say that it had to do with gross body substances) & that, combined with rocking cramps, had me convinced that this, was it.
Well, it didn't quite work out that way. Husband took me to the OB-GYN (a normal appointment, all ready scheduled) and I'm not in labor...not yet. I am 2 cm dilated (seems to be progressing at the rate of 1 cm/week) but unless 6 cups of amniotic fluid exit the building, I'm not really "in labor". I am also GBS (group B streptococcal?) positive, so labor will involve antibiotics in my IV. And also, the hospital doesn't allow you to wear your own insulin pump, something that doesn't make me too happy because I've been planning on this for months (barring any emergencies). OB-GYN assured me that they have a team of internal medicine guys to "get my diabetes back on track with pump adjustments" after delivery. (yeah, right. NO offense, but my diabetes is never "on track") And then...the issue about blood sugars during actual delivery. He said they like to run them on the high side. (and by that, I'm guessing 100-120,which is kind of laughable to think about those numbers being on the high side! And that's perfectly alright, if that works out to be the case but I'm envisioning having to get ALOT of IV dextrose if they're the ones who actually run the D-show) My Endo doesn't have privileges there, so she doesn't have any say in the matter. I'm not sure that I can refuse to go off my pump (and not be admitted there), I've never been refused the use of my pump for an extended period of time.
And then, it was off to the NST/biophysical profile which went pretty routinely. I never pass the NST, but the biophysical profile always comes out ok. (8/10 is normal) Perinatologist doctor wanted to know what OB/GYN doctor had planned (in terms of delivery)...its kind of like the two offices never communicate. (the answer is:vaginal delivery, unless it hasn't happened by the 39th week, and then they will schedule an induction) I have to get a magnesium infusion (via IV) this week, to prepare for delivery & in the hospital, they'll be checking my electrolytes daily (and the babies electrolytes at birth, to screen for any problems). He also updated all the names/numbers of my Endo,the OBGYN group, the pediatrician that we chose, and my Nephrologist into the hospital computer system in preparation for that day.(suite at the hospital=booked,patient with zillion medical issues coming through)
The antibiotics will fortunately be penicillin (I'm allergic to doxycycline). I don't really know I'm really going to know if I'm in labor if the amniotic sac doesn't burst, because I have contractions (both painful, and not) already,but I'm guessing that if dilation continues at this rate at some point it will switch from "latent"(0-3 cm) to "active"(4+ cm)and things will steamroll from there. I've survived Christmas, so now I'm hoping I have a New Year's baby (you get a ton of free stuff if you've the first baby on Jan.1) & the baby is mature enough, so if he wishes to make his appearance on that date, I'm more then agreeable to that.
Wednesday, December 21, 2011
Sunday, December 18, 2011
Nope, it's likely not the "last week of pregnancy..." but, with any luck, my insulin requirements have hit their plateau and that makes me VERY HAPPY. Early next week, it will be considered a "full term" pregnancy...and that makes me happy as well. (in the words of the OB -GYN, the goal is 37 weeks, but if things can go 1-2 weeks longer that is "bonus time")
On schedule for the this week: Weekly appts. with the OBGYN, to start checking for dilation/effacement. And the Group B Strep swab, to determine if antibiotics will be needed during delivery. As well as the (2) mandatory NonStress tests, a final appointment with my Endo (I can't say things are really that great between us, but now is not the time to be looking for a new Endo. I need to iron out a final plan for my bgs/insulin/etc. for birth,and afterwords) It's not the hospital where she has privilages (and realistically, how much time am I going to have to do diabetes overhaul), so I think I really need to have this stuff figured out now. I do agree that my blood sugars should be under 120 the entire time (to minimize the chances of hypoglycemia for the baby) but never having been through this before, will they let me suck on hard candies(or ice) if I'm running low/in the throngs of nausea? I think this hospital prefers you to be on an insulin drip, which I'd prefer NOT to be, unless I need a C-Section. (if I can handle things myself, I'm going to) Basically, I need a natural delivery plan, a C-Section Delivery Plan, and a Post-Baby Delivery plan for my diabetes. We also have to tour the actual hospital ward....I have no idea where it is. (I didn't do my student rotation there) And then I think, I will feel "ready." (the car seat has been installed and all systems are GO) As to when it will actually happen, no one knows (but I rather hope it is prior to 2012) Lightening (whereby the baby drops into the pelvis) hasn't occurred, so my lungs are compressed to the size of golfballs (walking up a flight of stairs, or walking 10 feet both leave me winded). On the positive side, my back does not hurt as much as it did a few weeks ago...but I am grateful that diabetes is going to get me out of having to wait it out an extra 2-3 weeks (should labor not occur). At the most, it will be three more weeks. (and I'm having contractions on my NonStress tests, I don't think it will be that long)
Wednesday, December 14, 2011
YOU GUYS ROCK. (DON'T EVER FORGET THAT)
There were babes being born (both early, and late).
And I had just rolled, on my side, for a snooze
When my nose was soon greeted, by the strong smell of booze
For Santa was here, and cocoa n’ eggnog
Was not his forte’…from the strong whiff of grog.
I groaned, and I waddled, to the window, real slow
I guessed that I couldn’t avoid seeing this show.
And there, was St. Nick, all rosy with glee
He slurped, and he burped, and looked straight at me.
“Hey honey, I’ve brought you a bouncing bundle o’ joy
Today is the day for your baby boy!”
The contractions were strong, & it made me afraid
That this day in the books, a birth would be made.
“All I want for Christmas is just 14 (+) more days
I must decline, and request, that you put in a raise.”
Old Santa was miffed, as he’d wasted his time
On a house in the boonies, on the public dime
He sighed, and he climbed back into his old sleigh
His agenda had most clearly been upset that day
But I heard him exclaim, as he drove out at quite the rate
“Next time, I’ll make sure, to double-check the date!”
Saturday, December 10, 2011
(Photo: Creative Commons)
Today, you are a teenager. It seems as though a million years have passed...or at least a generation. (that five year old girl on the other side of your hospital room is now legally an ADULT. Yikers.) Do you remember that day...the pain, the worry, the fear that would soon cast it's long shadow over "all the days of your life?"
I do. But I also remember a remarkable CDE,
who,on that very next day (in fact, some of the first words out of her mouth) told me that I could still have kids. (Was I thinking about having children,heck no,it was about the furthest thing from my mind. I just wanted to live.)
That was then. And this, is now.(I trust I've grown up a bit since then)And in retrospect, I'm glad she said that.(its something every young person needs to hear at diagnosis,& I once talked to someone dx'd in the 1960's who didn't have kids because her doctors forbade it, which is incredibly sad. I think everyone deserves a doctor who will work with them to make their dream happen). It's impossible not to think of the rock n' rolling, hiccupping,rapidly growing life inside of me. I guess I think about babies more then I think about diabetes...which is saying alot.You really do still suck bucketloads, diabetes,and cause more pain then is ever warranted. Seemingly 95% of the other people getting NST's at the perinatologist also have diabetes.(and sugars that warrant "concern". My own sugars in the past week have moved beyond concern to warranted screaming of silent obscenities at the meter & the bolusing of huge corrections, to little avail.Another insulin spike from heck.) But there are things that are stronger then you are,things that in the end make you slick back into the corner,with your tail between your legs...whipped. And though I oscillate between despair & hope on a daily basis,I think that having a baby is the ultimate "sticking it to diabetes" act.I know it can be done.
So today, diabetes, I want you to know that you're not the most important thing on the agenda anymore. And that despite the passage of time,you still don't "know it all"...its a lifelong learning process (what works today, won't tomorrow). It almost seems like a new beginning, this 13th year...the dawning of the 2nd chapter of my life. (PreKid, PostKid) And you and me will have to figure out a working relationship for the next phase as well. (not that I was terribly successful in the first phase...but I want to do better. Pinky Swear It.)
Me. (13 years later)
Tuesday, December 06, 2011
Target, during the holiday season, is even more magical. Long lines,tantalizing treats to stuff into your mouth to offset any blood sugar discrepancies, etc.etc.etc. Target, seemingly,is the only thing that can drop a 34 week's pregnant, waddling women with diabetes' blood sugar. I think I spent about four hours there,and consumed 67 uncovered carbohydrates (to roll out a "110" by trip's end) It was my own private version of "Extreme Couponing"...
Time Spent: 4.5 hours
Number of receipts: 23 (and no, I did not conduct back-to-back transactions...I have too much respect for other shoppers to do that!)
Number of coupons used:20
Total saved with coupons: $183
Total brain cells left: 1
Blood Sugars taken:3
Carbohydrates consumed: 67
Shoppers Who Took pity & let me move ahead in line: 0
Status of back: Regretfully,Target didn't have any of those to buy or I totally
Status of Christmas List: Done,finished, taken care of.(as well as a few birthday & miscellanous odds and ends) And that's one good thing. I spent alot, but I was going to buy it anyway...so proportionally,it was still a win.
Happy Holidays! (I think they call it "Target" because that's exactly what your blood sugars are, while you're shopping there)Obviously, I love to shop but I can't do any of those marathon type sessions anymore...deal or no deal.My back,feet,and blood sugars all rebel.
Wednesday, November 30, 2011
I'm glad to see November go...it's been a long month. No more blogging daily for me!
Finally went to see "Breaking Dawn- Part 1" today. My husband doesn't have any interest in seeing it, & ultimately, the best time to go see it is on a weekday (when most of the masses of people are at work, not the mall) It was good, well as good as such things can be (most of the people reading this could probably care less about it). I'm not "in" to Harry Potter, I like Twilight much better. (but I don't fall into the fanatical stage about that either) There were approximently five people in the theater (all female, this is very much the "chick" series) all crying over their popcorn & salting their cokes with their tears. (a true sisterhood, as it were)
Without spoiling anything, between the wedding (beginning of the movie) and the emergency C-Section (end of the movie) it was really action-packed (deviating slightly from the book, to make more of a plot). Things got very, very graphic toward the end of the movie and one person went to the exit and just stood there, with their back to the movie. (for the rest of the movie, a good 20 minutes) I get that it was probably a little too much for them but if it were me, I'd go off and do something else, instead of just standing there. (what good is paying for a movie, if you're not watching it?) That was pretty odd. All I can say is, it wouldn't be the best of movies to watch if you had any sort of food aversions(or were in the first trimester of pregnancy). I've seen a real C-Section (and it wasn't nearly as bloody as the hack job in the movie),but it was still kind of disturbing seeing the effects on the heroine.(I would prefer NOT to end up as bad off as that) Probably not the greatest movie to watch when you're in the 3rd trimester either. At the end, I was getting ready to leave & the person up above my seat told me to stick around, there was one more scene after the credits. (which will lead to the next part)
The next two "parts" don't come out till a year/2 years from now...I've read the book already, so I know what happens but waiting is just too hard!
Tuesday, November 29, 2011
Monday, November 28, 2011
Captain's Log: Starda(y!) #229
Babies Weight: 4.6 lbs (it's mind boggling how much weight they gain from week 28 on!)
Weeks: Almost 33
Contractions: yes,but much fewer then last week,although my amniotic fluid index has jumped from 25 to 29. I really hope that that is the natural peak,& not the fact that my blood sugars went to pot last week over the irresistible pecan pie/potato/etc.holiday smorgasbord. 33 weeks is supposed to be the "peak"fluid week,& the babies weight is normal. Peri isn't worried.
Movement: not so much on my part,on his,constantly!!
Current complaint list: First Trimester Deja Vu all over again...you name it,I've got it. With the additional challenges of the Third Trimester.
Nursery Status: Ready,once the crib gets reassembled.
Next NST: Thursday...this baby is being well monitored!
Sunday, November 27, 2011
Saturday, November 26, 2011
That was before. Before D came along. Some of us have never really really known a "before", for others, there were many years spent with the "before." The thing about the "before",is,that for many of us, it may never come again (sorry for the downer opinion,yours may vary,& I certainly hope I'm not right). The years dull the memories of some things but for others, the diabetes stuff gets so hardwired into your psyche that you doubt it ever could get itself undone. It's all normal.
Fact: I'm ready to go back to the "just diabetes" phase of existence. I miss sleep, I miss my back muscles not hurting, I miss Chai Tea Lattes (and everything Starbucks),I miss having clothes that would fit, and I miss not having to bolus a unit every time I even look at a carbohydrate, I miss just worrying about the D-Stuff. Vaguely I recall those days where doctor appointments weren't every week,and I'm ready to go back to them. I guess just because something becomes "normal", it still doesn't mean that you particularly love it. I know there are people for whom pregnancy is a 10 month nightmare(bed rest, the whole 9 yards)but I can't even begin to explain what its like, with diabetes. Every day that ends (without disaster) is the best thing that happened that day. I guess when you go to the doc (and everything is a constant stream of negativity) that really doesn't put you in the mindframe of "enjoying your pregnancy." I'm not afraid of caring for a newborn anymore, for even the demands of that is the successful conclusion of the 3rd Trimester. And yeah, I'm nowhere NEAR 39 weeks. My patience has kind of run out (and I would really like to hop in a time machine & fast-forward to the end of December) & I want a healthy,bouncing, bundle o' joy to be here.(NOW) And if it sounds like I'm complaining, I guess I am..there's gotta be some place I can let it all out & it had just as well be here. (which very few folks go) It's my opinion that the people who enjoy their pregnancies don't have complicating medical conditions involved.
Friday, November 25, 2011
Thursday, November 24, 2011
Wednesday, November 23, 2011
(green bean casserole, muffins)
Tuesday, November 22, 2011
Better safe then sorry though (I'm glad I got it checked out). Hopefully it will fade.
No word on when I might expect an induction, the OB-GYN said around 39 weeks. (if it hasn't happened by then) I'm not quite getting how, if anytime after 37 weeks (considered: full-term) is considered just fine, why they would wait till 39 weeks to induce. I guess the womb is a nice,welcoming,nurturing place but 39 weeks just seems too long. I read in my nursing textbooks that diabetic placentas also age faster then non-diabetic placentas (aka, start degrading around 37-38 weeks). And if the baby is too large...that can certainly play a role? (according to the obgyn, that really didn't matter in terms of induction, maybe she meant that would be grounds for a C-Section)
We won't be going anywhere for Christmas, though. (that much is pretty clear) 37 weeks is just after Christmas. (and even 3.5 hours away with family is too far away) Or, it could be a New Year's Baby. Or, it could be a 2012 baby. Time will tell.
Monday, November 21, 2011
Today was my first non-stress test. That was a fairly uneventful event, (4 very pregnant people in lounge chairs hooked up to electrodes) until I noticed that the contractions graph was having ACTUAL JUMPS on it,& at this point in the process, I have no business having contractions. The nurse noticed and asked A. if I was feeling them and B. how far along I was. No, I'm not feeling them. (yes, they are actual contractions) What the Sam's Hill?? As far as the heartrate/variability/baby moving went, he is very active.
And then it was time for the ultrasound. I was feeling pretty bummed/on the point of tears over the contractions when the doctor came in and asked how I was (answer "overwhelmed") which he assured me was perfectly understandable on the verge of the beginning of the end. The placental blood flow & everything looked ok, the amniotic fluid index has actually gone down 2 points & the contractions are likely perfectly normal, given the increased amniotic fluid index. As long as the contractions aren't painful there is no need to be overly concerned. See you in a week.
With my nerves freshly shot from that, I got to schedule an emergency appointment with my eye doctor for the large black "floater" that has been swimming around in my right eye for the past 2 days. (the thing shows no signs of going away,initially I thought it was from a headache but nope) I had my eye appointment for the year in October (which showed things to be absolutely perfect, D-wise) but apparently my right eye didn't get the memo. (so here I go again this afternoon)
I think I'm falling apart.
Sunday, November 20, 2011
Saturday, November 19, 2011
I found this today...and I'm pretty sure it's the last one on Planet Earth. Long, long ago, Staples & Office Depot would actually give you vouchers for $3 off your next purchase, no minimum required (on the spot, when you turned in ink cartridges). They could be "stacked" (aka, used with 2 more vouchers) and combined with coupons & one's total Out of Pocket costs were very, very low. (and even more weird, the vouchers were all the same so there were no unique codes on the vouchers) It's not like that now, if you turn in ink cartridges it'll be 90+ days before you see the rewards in your "account" and you have to spend $$ at the store to even get the rewards.
But this beauty of these coupons are...that they never expire,so nostalgia aside, I'm going to spend it (one of these days). Maybe not even the manager will know what these were, its been so long since they were in vogue!
Friday, November 18, 2011
Thursday, November 17, 2011
Wednesday, November 16, 2011
I know it's controversial (and very much in the "experimental" stages)but stem cells already can treat/cure many types of cancers. And I believe that one day,they'll be able to "grow" parts of organs, etc. (from stem cells) Maybe even cure diabetes, or something else.(should they be unfortunate enough to inherit my screwed up genes) So we've made the decision to save our kid's cord blood. (kit goes to the hospital with me)
Tuesday, November 15, 2011
(does this infant carrier come with an infant? sadly, no,that takes 9+ months)
(the saga of the never ending blood sugar logs..)
Sam Talbot is an fiery chef with ecletic taste buds!
I got my flu shot today. I had to go to TWO CVS's to do so, because the first had an issue with my insurance (& I would have had to pay for the whole thing out of pocket) whereas the 2nd store would cover it (if it were under the guise of being a "Minute Clinic" appointment with a nurse practitioner). It wasn't that inconvenient,really, (there are quite a few CVS's in the area) but flu shots feel nothing like an insulin injection & really,please don't say that they do. And so that's done. (I will wake up tomorrow & feel like I've been hit by a bus, but it's better then being hit by the flu)
Monday, November 14, 2011
Today, like millions of people all over the world, I didn't get to have the day off from diabetes. (for good behavior) Whether you've lived with it 30 years or 30 days...it is simply there,and it will be there (likely) for some time to come. Today, I awoke (for the 2nd time) with the chalky flavor of glucose tablets still lingering on my taste buds. That is the price for being alive.
Today,there is still no cure. No cure for the millions who have been diagnosed (in the almost 90 years since the discovery of insulin). Babies, kids,teens,adults...we all owe our lives (or if T2...continued health) to the discovery of this one drug. For as much as I'm grateful for insulin,and as much as I realize that future life would not have existed (this baby sponsored by Sanofi-Aventis)..it's still diabetes,& I'd really,really,really like a cure.
Today, the flame of hope still burns...and will burn, until there's a cure.
Sunday, November 13, 2011
I love her illustrations. (toward the story line) I can't draw that well..but if I could, I'd love to do something like that on YouTube.
Saturday, November 12, 2011
I have to say, I love California beaches. Even if you feel like a great beached whale (and not up to the carefree frolicking of bikini-clad models & studly wetsuit surfer dudes) it does improve your mood. Even just for a few hours, it was nice.
And then, we came home to the East Coast blizzard...on the 6.5 hour flight to Philly, my Omnipod PDM died (two hours in), freaking me out. My "backup" syringe (brand new, in the package) proceeded to snap off as I removed it from the package & by that point,I really didn't see how I was going to avoid having to make a scene(4.5 more hours with no insulin (and an already skyrocketing bg) ? yeah, not happening) as I tried to patch the insulin syringe back into function-a-bility but it was impossible. Finally, I systematically searched through my purse and backpack (praying there would be at least one old syringe)...and there was. And it worked. And I took injections with that syringe, once every two hours as our 6.5 hour flight got pushed to a 7.5 hour hour flight as we circled the airport, as babies and toddlers screamed (and puked) filling the plane with lovely sounds (and smells) into the wee hours of the morning.(while their mothers did absolutely nothing,sans hold them. Did not attempt
to soothe,etc. or to tell them to be quiet) I could not WAIT to get off that plane, & meet up with my luggage.(hopefully) However...when we finally did get off the plane, our flight home had been cancelled(because of the East Coast blizzard) so no luggage was forthcoming.(they said it would be on a flight the next day). Well, by that point driving home had more appeal then spending the next 12 hours in the airport so we rented a car, and drove home.
In the rain. (but fortuanatly, not the snow)
Got home, inserted a new pod,and the PDM actually worked again..but the luggage didn't show up till the evening. I would venture to say that that was my most unpleasant flight,ever. (lesson learned: take at least five back-up syringes,because it was some sort of "communication error" and I doubt that it would have worked even if I'd have had a back-up pod)
Friday, November 11, 2011
Thursday, November 10, 2011
(4 years anniversary today-& I have to say, that he is all of this & more). I am very fortuanete, good guys do exist out there. (which,when you've been through the dating mill makes you quadruple-ly thankful)
The snap of the perinatologist's glove signified that the exam portion was, for all intents and purposes, over.
"How bad is it?"
(its bad, I know it's bad.The tech isn't saying anything, and if it were better, you'd be reassuring me by now. Just tell me, before I lose my mind.)
"About the same. Last time you were at a 26..now you're at a 27. It's the same."
Happy-happy-joy-joy. (NOT) So what does this mean?
"I think you're going to have to notify the NICU staff (etc.) about the possability of Bartter's Syndrome, so they'll be able to screen for that.(at birth) And you know better then anyone else about what all that means, you'll be doing some educating. (but you're probably used to that by now.) But it doesn't mean the baby has Bartters..your amniotic fluid levels aren't going up, & are not severely elevated, so it may not be that. You don't need an amnio, or any medication to reduce the levels .(at this point)"
"Will I need a C-Section?"
"Not necessarily. If everything else proceeds normally, you shouldn't."
"My blood sugars have been excellent."
"That's good-that can certainly play a role! The baby's weight is normal, & everything else looks good-have you had any contractions?"
(Confession: I'm not entirely sure what a contraction feels like, but I think that if I were having them, I'd likely know about it. Yeah, I get random abdominal pains occasionally but I think that with a contraction, your abdominal muscles tense up & that hasn't been the case)
"In a couple of weeks, you can begin Non-Stress tests/Biophysical Profiles(basically the NST plus the ultrasound). (1-2x a week?) "
Non-Stress tests= a whole new experience. As a nursing student, I actually got to explain to an anxious, laboring patient what the tracing meant. (all those peaks and dips and random blips) & knowing me, I'll form a conclusion about it long before the doctor enters the room because that's what nursing students do!
But for as much as I feel lost in the shuffle at the OB-GYN...at the high-risk office, I see the same perinatologist every time and I really like him. He is stellar. (about answering all my stupid questions & calming my fears)
Wednesday, November 09, 2011
Are YOU participating? (it's not that easy this year..I have no time to create a scrapbook page, and I don't feel like delving into said topic.) But I encourage you to not be like me. Really, if I'd have gotten my ducks in a row (1-2 months before this) , I'd probably be doing it. (it's enough to get my postcard project done for WDD!) I will say that online support (before there was a "DOC",) really helped me feel not so alone, in the early years of D. From the CWD chat I found out about insulin pumps (and rapid acting insulins), which changed my D-care for the better. If there weren't anything like that, I'd be floundering around alone & clueless with my diabetes management. (or who knows where I'd be) I'm so grateful for the fine D-folk I've met on the Internet...(and later, in real life) they have shaped my D-life in positive ways & some feel more like family, then friends. (I appreciate each & every one of you!!!!!!)
Tuesday, November 08, 2011
Surprise baby showers. And yes, it was a complete surprise because we get together with this group of friends ever so often..nothing out of the ordinary about that. Only this time,there was an ambush. (they had it all...food,cake,streamers,and presents!) We are so lucky to have a group of friends to put together something of this caliber for us.(any kind of shower just gives the recipient the warm fuzzies,though I wasn't expecting any since my family lives so far away) Despite the Ravens/Steelers jersey clashes, it was an otherwise amicable evening.
Now to get started writing thank you cards...
Monday, November 07, 2011
Stimulation of metabolism-sensing enzyme that can regulate crucial gene explains how free radicals generated during maternal hyperglycemia cause malformation of the neural tube
BOSTON – October 17, 2011 — In a paper published today in Diabetologia, a team at Joslin Diabetes Center, headed by Mary R. Loeken, PhD, has identified the enzyme AMP kinase (AMPK) as key to the molecular mechanism that significantly increases the risk of neural tube defects such as spina bifida and some heart defects among babies born to women with diabetes.
Even if women with diabetes—either type 1 or type 2— work vigilantly to control their blood sugar levels around the time of conception, the risk of a defect is still twice that of the general population. This finding could lead to strategies to interfere with the mechanism and reduce the chances of such birth defects occurring.
Previous studies published by Loeken's lab showed that maternal hyperglycemia (high blood sugar) causes oxidative stress in the embryo, and inhibits expression of the Pax3 gene. Pax3 is essential to the formation of the neural tube, which in the embryo is the precursor to the brain and spinal cord. Oxidative stress results when oxidized molecules – called free radicals – are created faster than they can be eliminated.
However, Loeken said, it was not known how the cells that express Pax3 could sense the oxidative stress and why oxidative stress, which occurs throughout the embryo, only damages selective structures such as the neural tube.
In the paper published today, Loeken’s team identifies the key to the process as AMP kinase, which is activated by oxidative stress and was found to signal the cell nucleus to block the expression of Pax3.
“The stimulation of a metabolism-sensing enzyme that can regulate specific genes explains how oxidative stress, which is generated throughout the embryo during maternal hyperglycemia, causes malformation of specific embryo structures,” Loeken said.
“We now know that we must do whatever we can to prevent AMPK from being stimulated,” said Loeken, who is a research investigator in Joslin’s Section on Islet Cell and Regenerative Biology.
Trying to keep the mother’s blood glucose levels under control is currently the only way to do that, she noted. “That’s the best we can do right now,” she said. But armed with the findings of this study, she noted, other researchers may be able to come up with drugs or other strategies to inhibit AMPK activity,
Dr. Loeken added, however, that formulating a strategy could be tricky because it is not known if interfering with AMPK activity -- while a good thing in preventing neural tube birth defects -- might also have negative effects on the embryo.
In their study Loeken and her group, including Yichao Wu, Marta Viana, and Shoba Thirumangalathu, used mice and cell lines to test their hypothesis that AMPK might be stimulated in the embryo and that stimulation of AMPK was responsible for blocking Pax3 expression and causing neural tube defects in response to high glucose.
“We found in this study that AMPK is stimulated in embryo by both high glucose and oxidative stress,” Loeken said.
The study used interventions including a drug that activates AMPK and another that blocks it. The paper showed that a drug that increased AMPK activity mimics the effects of oxidative stress to inhibit expression of Pax3, thus inducing neural tube defects.
This research was supported by a grant from the National Institutes of Health.
(moral of the story is...just another way diabetes contrives to complicate matters)
This product looks pretty cool. According to the JDRF "Discoveries" magazine,(fall 2010) preliminary research (at Yale) has been promising,showing increased insulin absorption time/peak levels/increased clearance. This is pretty cool, because with the Artificial Pancreas system that is being developed...faster acting insulins are a MUST. (it can't very well keep your blood sugar in a normal range with such slow-acting insulins) The system that's in place now...its an improvement,but it still has light years to go & I don't think that most people would consider it a "cure" in any sense of the word.(needs much better CGM technology/faster acting insulins) Take it from the person that has to pre-bolus cereal 30-40 minutes in advance...some foods are just glycemic murder. Insulins such as Apidra/Novolog/Humalog start working within 15-20 minutes, but it is very much YMMV. Such technology is years away from being approved (& perhaps decades, if the FDA is involved) but anything that gives that insulin a little extra "boost" start time is a good idea, in my book. (in the meantime,I guess we're stuck with taking hot showers/hot tubs)
Sunday, November 06, 2011
So yesterday, we had our carpets cleaned. This involved eviscerating the contents of the basement onto the outside deck,moving the dining room contents into the kitchen, etc. Project Nursery had to be stacked in the Junk Room (aka, the only room in the house with carpet that wasn't being cleaned)...basically, it was pretty chaotic. (beginning the evening before)
The next morning,(around 10 AM) they showed up and commenced to cleaning the house. As you're probably aware, carpet cleaning chemicals can be pretty nasty (read: lethal) stuff, & you're supposed to be out of the house while they're doing the treatments. Well, with this place (using nontoxic stuff) it wasn't quite that imperitive to be out of the house...you just had to be in a room that wasn't undergoing treatment. (that room would be the kitchen) We have two cats, a baby on the way,& the toxic crap they use to clean carpets is decidedly NON-APPEALING. (say what you may) And the cost, comparitively, was about what it would be with the traditional method.
I ran some errands, getting back about noon. The cleaning team they sent out was composed of two guys...one of whom did the actual work, the other one did the talking. (the instant I walked through the door, he started talking, and didn't "finish" until 2 solid hours later) It was like listening to a Billy Mays infomercial. What did he talk about? A little bit of everything...the evils of large carpet cleaning corporations (in particular, ChemDry, who was apparently resposible for the death of Jett Travolta), the physiology of cat puke/urine/etc. & how to treat such stains to GET THEM OUT FULLY, past horror stories of the houses they had cleaned,(that had gone the traditional cleaning route) the state of the economy, what products we needed to get(that were Au Natrale), how Gerber/Mott's is poisoning us (and the babies)with arsenic-laden apple juice from China(64 parts per million,vs the "safe" 3 per million) , Dr. Oz, how talc based powders will give you leukemia/etc., and on and on and on. In the meantime, it's not like we could go anywhere...the cleaning was still going on. So we sat in the kitchen, ate lunch,and listened to him talk. Two hours, people.
But they did a good job, I'll give them that much. The huge yellow splotch that resides in the future Baby Nursery has at least, significantly shrunk. They seemed to think it was from cat urine (and I was duly scolded never to treat such a stain with an OXY based product, but I didn't know what it was from) . I don't think that stain will ever come out fully, we'd have to "patch" swap it out if we ever sold the house. (it's not very large, 2" x 1", perhaps) I think I have permenatly leached the natural color out of the carpet.And they know what they're talking about...they know how to do their jobs. (as well as educate the masses about carpet care) I'm a firm believer in "going green" when it comes to cleaning your house (if possible). It's much safer for your pets. (and for human beings as well)
The carpets took awhile to dry (about 16 hours), so we had to put on plastic booties to walk around till this morning. (and then, we put everything back as it was) As per the carpet warranty, you actually have to have your carpets cleaned every 2 years (at least)...and if you have cats, you're probably going to be doing it 1-2x a year. (at the least) Our cats are getting older, but one of them still pees (not in the litter box) and the other one pukes, so heck yes the carpet is getting constant action. (I can only imagine what it will be like with a child in the mix)
Saturday, November 05, 2011
Have you met Hope?
Hope wears a medical alert, the latest Keds tennis shoes...and a smile that will melt your heart.
Hope is in the "All clear" from the eye doctor.
Hope travels thousands of miles to meet up with 40+ DOC'rs. (sight unseen)
Hope is a virus, & I wish everyone could catch it!
Hope beats strong on the fetal Doppler.(& in your own heart as well)
Hope is in the research labs...it's a fine time to be a mouse or a rat!!
Hope is painful,hope can't settle for status quo.
Hope gives up Saturdays to walk,bike,& walk for a cure.
Hope sells sugar-free lemonade(& Girl Scout Cookies) towards that cure.
Hope never dies..but it can disappear for weeks/months/years on end.
Hope & I are not best buds...but we need each other,more then words can say.(we are more then casual aquantinces)
Hope needs its own RX pad.
Hope savors each victory, & forgives past mistakes.
I hope you've met Hope...cure or not,we all need to believe things will get better.
Friday, November 04, 2011
Wow, 29 weeks? I barely remember those early weeks of bemoaning that it would never, ever,be obvious that you are in there...because in the past 5 weeks, its now become that(to the world). Ah, the joys of the third trimester.(most notably:back muscles turned to silly putty,heartburn,and random strikes of shortness of breath) As for low blood sugars,they aren't really much of a concern these days...I'm not going to say they're non-existent,but the likelihood of a serious one is slightly higher then the likelihood of getting hit by a random meteor. Daily TDD is 50 units and climbing. (it should continue to climb for the next 6-7 weeks)
And...the never ending doctor appointments. Now that it's the third trimester, I go to the OBGYN every two weeks. (starting around week 32,that will be switching to weekly with the OBGYN) As for the perinatologist, up to this point I've gone in every four weeks but depending on the results of next week's ultrasound I may be going in every week from that point onwards. (non-stress test, biophysical profile) The last ultrasound showed normal weight,etc.but the amniotic fluid index was elevated (which could be due to diabetes, and could be due to genetic diseases...such as Bartters Syndrome)I wasn't happy at all to find that out but the perinatologist told me it could be from many different reasons,(sometimes unknown)none of which could be determined at this point & the important thing was to monitor it closely. Sometimes it just goes away on its own,& if the levels greatly increase by the next ultrasound its most likely to be from a genetic cause.(he didn't seem to think that the cause was from diabetes.And I might beg to differ,given that I'm still no diabetes angel cc "results of last a1c" but still,the 'betes control is in the "fair" category) The important thing is to monitor the whole package(any signs of swelling,high blood pressure,contractions,movement etc)and to try not to freak out too much about this one finding. (and I don't have any of that...to date) Baby X is still pretty active in there. (he's always been active,which is comforting, in a world full of uncertainty)
There have been no references to the C word (CSection)...actually,there have been no references to labor, period. (I'm guessing that with diabetes,there's just no way to say "you'll likely be able to due this naturally" when the world can turn on a dime,& the most important thing is deliver the baby,ASAP. I guess that in the next few weeks that Csection word is going to become a reality if my amniotic fluid volume doesn't go down. Which, after you've actually been in an OR and seen all the gory details live is not a comforting thought.
But the most important thing is a healthy baby.
Thursday, November 03, 2011
Wednesday, November 02, 2011
And so,on Monday night (partially to avoid the roaming throngs of sugar-crazed Trick or Treaters, many of whom were adolescents(and not cute at all) my husband & I took a trip to Babies R' Us. (for the first time) It was a kind of "get your feet wet" trip, to see what was out there...but we ended up spending about 2.5 hours in there. The game plan was NOT to make any major purchases until we know what some friends are giving us.(rumor has it, a bassinet & they already did give us a stroller thingie,car seat,& several other odds and ends,which is really nice of them because my family members are still using all their baby stuff) But apparently, there isn't any separate infant carrier that snaps into the car seat...which presents a real problem,because every single one of the 3 aisles(and 200+ options) of infant carriers also had car seats attached. I guess we'll have to look up that particular model online(and see if you can even get the infant carrier separately) In the meantime, we roamed around putting various odds and ends on our registry (in a mostly deserted store...since all the other parents were out doing Halloween stuff with the kiddos(except the first-time parents-to-be) and got a few essentials that it was highly unlikely anyone would buy for us.(like a changing pad,which we'll put on my desk to convert into a changing table,& a baby bath mat to fit into the sink) When you go into Babies R' Us though,you're pretty much going to BLEED money (and find "essential" items that you absolutely cannot live without. (even with the best of intentions) I also intend to get a breast pump,but looking at all of those options put my brain into complete shutdown...all those options/prices/not having a clue what I'd need. I'm sure I wouldn't be the first person to have a mental breakdown in the middle of that store though. (or to spend too much) All in all, I think we controlled ourselves pretty well though. (on the spending) Even my husband,(your own spouse may vary...most of them would probably rather stay home and watch Monday Night Football)who is less-then-enthusiastic about shopping/spending money got into it.(and appeared to have fun)
And now I know how much I absolutely don't know about all of this...yet somehow,all of these "essential must-have" items that kids 40 years ago didn't have (and turned out just fine) that they encourage somehow turn up on the vast majority of parents-to-be lists. Of course, there are the basics...and the things that really,really,make it easier to keep your baby happy(like swings,etc) but deciphering what you really need is kind of difficult when it's your very first kid.(you could walk in there and blow a couple of grand, I'm sure)
Tuesday, November 01, 2011
Every year, I say I won't do/can't wait for NaPoBloMo to end..and yet every year,I feel suckered into doing it. Last year,I forgo it(due to arm surgery). But November is such an interesting month,chockful of significant diabetes related events,personal anniversaries,birthdays,holidays, etc. (if ever there was a month that I could pull off 30/30, this would be the one)I've yet to recount my experiences with the NYC trip "Simonpalooza" several weeks ago..and I'm sure the world really,really,really wants to hear about the never ending litany of medical appointments that I go to, these days.(as well as nursery pics) As well as last week's "pump failure at 32,000 feet" fiasco.
So, if you choose to stick around, I'm sure it won't be all boring. Because I certainly have plenty of blog fodder. (due to being severely delinquent in said posting duties)
Wednesday, October 19, 2011
Regardless of that fact, my a1c rang in at 6.5...a marked 0.4 improvement. (not that I expected my Endo to go all gaga over over it, because true to form, she didn't). But what happened next put the icing on the cake.
"Well, you knew what you were getting yourself into (suck it up)." (really lady? that's all you've got to say,& thank you very much,not that I regret said choice,but it's the first time in my life that I've been 27 weeks,hugely insulin resistant,25 excess lbs,and I don't really think anyone "knows" what they're getting into). And then she went on to tell me such additional goodies as how every day in this 9 month stretch mattered,you can never redo it,if you screw up the kid its permanant, blahblahblah at which point I completely lost it.
I burst into tears, which I don't think I've ever done in a doctor's office before. (not even being diagnosed with diabetes did that) There's only so much blame a person can take,and you can pretty much 1/2 that when you're pregnant. (and thank you very much, I have enough blame to last me every single day of my life, it doesn't need to be coming from you.) After that, she toned it down a little bit (remarking drily that my blood glucose, in office, was 296 (OF COURSE IT IS,YOU'VE JUST PUT IT THERE but no additional comments (and at that point, I would have walked out the door and not come back,I was that upset). Why is it that doctors feel the need to tell you what you already know? I'm not here because I've got this crap figured out, I'm here because I NEED HELP & SUPPORT. Which clearly I wasn't getting from her.
So yeah,that appt. was not the greatest. She did try to be slightly more sensitive after that,but the remarks she made left a permanant scar on my already tender psyche. I don't know if I can forgive her, much less go back to her, after that.
I then went forth, spent several hours getting it out of my system, complained on Twitter, took a nap, called a friend, and feel much better now.
Thank goodness for the D-Community,because no one else truly gets it.
Thursday, October 13, 2011
Sitting there in the Hopkins Peds Clinic waiting room,with all the babies (and the little kids)among pictures of yawning Poohs & smiling green dinosaurs, my mind took a turn back, to when (indeed) I was last considered a "pediatric patient."
Diabetes Clinic. Like clockwork, every three months. Getting up the nerve,somewhere around the age of 19 (yes, I was a late bloomer) to make the trip myself. Waiting room conversations with Parents of D. (somehow, I never ran into any other teens with diabetes) Sneaking out the back door (post-appt) & heading straight for the McDonalds across the street, to celebrate the start of the next "A1c Stretch" on a hot fudge sundae. The long, long, long wait for my a1c. Saying goodbye,(at the age of 19 years & 364 days) because I thought 20 was entirely too old to still be seeing a peds Endo. (it really isn't, if they're good, but I was entirely too selfconscious back in the day)
And here I am again, this time with a child in tow (albeit somewhat invisible to the naked eye, but at least I don't have to keep my child occupied, he seems perfectly content to play kickball with my intestines all day). Getting checked in, as a patient. Parents cast me curious looks,staff keeps asking "is this for yourself?" Just like that, it's time to waddle back to the exam room.
(genetics is located in with the pediatric diseases clinic)
"Hello, I'm Carolyn."
We discuss the genetics of Bartters Syndrome, the weird mess of a family tree I have. (they want blood from family members, but yeah, not so sure THAT is going to happen)She tells me people of Swedish & Italian descent are actually carriers 1/200 or 1/100% versus 1/1000 in the general population. (that's not so great,as my husband is 1/8 Swedish but yeah, what can you do) We talk about the research study from Yale, & what they're attempting to find. (testing for the most 7 common subtypes, & perhaps other testing on the types that don't "play by the rules." We review my medical file,& I sign more release forms.(for intial dx'ng records)
The Yale form is long, & geared very much toward the pediatric patient/and their parent, but it still applies. And I sign,my toes curling in anticipation at the thought that sometime soon,3 or so months from now, I'll learn what sub-type of Bartter's I've got. (probably on the day I deliver, when I could really care less)
I'm just surprised that there weren't any conditions that would keep one out of the research,like there generally is.
(start combining diseases, & researchers can't tell what is the effect of what)
And then I give blood, & wait...for something. (too long coming) What something is, I don't know, but it's better then the nothing I've got now. I'm grateful that the genetics counselor at the perinatologists has friends in high places..for somehow,this kind of stuff never just "finds its way" onto the Internet.3/4 of the studies I've been in,I've found out by word of mouth. (by the time it makes it to ClicalTrials.gov, they are desperate to find people,in my opinion, the truly great stuff (like the Artificial Pancreas Studies) go reallyyyy fast)
Tuesday, September 27, 2011
In a couple of weeks, my OB course will end...and the Medical/Surgical one is slated to begin. Now I know I'm going to sound like a total wuss, but I have my doubts as to whether or not I can hack it. A thousand questions are flooding my mind (is this going to put me in premature labor, could I have really stellar diabetes control & do better by the baby if I just didn't take this,this course is so difficult that NON-pregnant people frequently fail 1-2x, what if I manage to do well but still have some medical complication and have to drop out 3/4 of the way through(I don't want to take a course I'm just going to have to repeat anyway)...questions to which there are no answers,questions that float out there in the stratosphere.
Medical/Surgical is a demanding course, a full time course. (OB is a piece of cake, by comparison)And I'm going to be living fulltime in the doctor's office anyway, as the
third trimester brings with it increased monitoring/tests in the pregnancy. (just because things are going well now, does no mean that will be the case 10 weeks from now)
So, I have several options. I can drop out in several weeks(miss the 2nd class of the semester), start up again in March.(and be one semester behind) I can drop out in several weeks,take next semester off, and be 2 semesters behind. Or,heck,I could take the next two years off & still be eligable for readmission to the program. I don't want to do that,& I don't for see having to do that, but there are no answers out there...for either my advisor, or for me.
And LifeChange 101 is coming our way,& there's a part of me that needs time to get ready for that.(call it my "nesting" instinct)
I want to create the nursery, & get everything in order (and that includes my mountains of junk,let's hope this kid does not inherit my messiness traits) and 2-3 weeks at the end of the semester doesn't seem adequate. (especially not when you have grown so big that you don't want to move) This is what I want,& this is a decision that may never come my way again.(whereas, with nursing school, yes I could do this at age 42) This is the decision that is "best for me" as my advisor would so eloquantly put it, although no one can tell you what to do, the answer in this regard is becoming clearer.
Its admitting that I can't do everything which is a tad hard. People do this, people have emergencies/babies/circumstances routinely that they have to take time off...& get back into the program,graduate,become nurses.(it isn't some bad thing when you can't) I just really wanted to have completed the semester before I did that, it feels like a thorn in my flesh if I can't, like a task unfinished.
Time will tell, I guess. (whether or not I'm nuts enough to take on Med/Surg.)
Wednesday, September 21, 2011
The third trimester looms,& one thing I know...I still don't know much about birthing no babies. Or that much about caring for one. But I do know,that this nursing rotation has cut down by 80% the actual amount of classes we'll need to take.( Dad101 & BabyCare 101) as I've learned about what labor will be like,what preterm labor will be like,all the drugs that they might give,breast feeding vs.formula, a preemie is going to be different then a 38 weeker,all the maneuvers & monitoring tests that they do,under what indications they ship you off for a
C-Section,how diabetes doesn't just put the infant at a risk for hypoglycemia/being too large but also a risk for placental abruption/bleeding to death right there, etc.Some of it I wish I didn't know. Will it be the sort of pain that makes me want to throw up/die (kind of like the intusseption) or will it be more pressure then pain? It is nice to have a wealth of knowledge at my fingertips,because the OB doesn't have the time to educate you about all this stuff. Most of this stuff is geared toward the Mom(of course), but there seems to be a never-ending amount of childcare classes being offered at the local hospital. (I picked the two that might have relevance to either/both my husband & I) I just need the nitty-gritty hands on stuff,since I already know what labor/etc.will be like.(& my husband needs hands/on too,labor can be summarized with the words "long & painful."
Yes,this $1200 baby care class is well worth it. I feel a little more ready for what is coming our way.
- Posted using BlogPress from my iPhone
Saturday, September 17, 2011
1. The illness I live with is: Type 1 Diabetes
2. I was diagnosed with it in the year: Dec. 10, 1998.
3. But I had symptoms since: May 1998...I recall getting personally acquanted with every single water fountain/restroom on all 3 floors of the high school. (it was the summer of driver’s Ed)
4.The biggest adjustment I’ve had to make is: Snacks, Eating, and not being my own person anymore.
5. Most people assume: That I’ve got it together by now, & my blood sugars never go over 120 or below 70. (“Do you have it pretty well regulated, dear?”) Yeah, right. (I’d like some of whatever you’ve been smoking) Every day is a constant battle.
6. The hardest part about mornings are: That they exist. (period)
7.My favorite medical TV show is: The Duggars/Greys Anatomy/Private Practice/What Not to Wear/etc....I don’t think I’ve got an absolute favorite, per say.
8.A gadget I couldn’t live without is: You probably think I’d say my insulin pump, or my Dexcom...but I could probably live without those. My iphone is the love of my life, though.
9. The hardest part about nights are: Sleeping on my side...but that’s not diabetes related, that’s pregnancy related. I was a back sleeper for 29 years and suddenly, I had to go cold turkey. (no easy thing) No one ever told me about that little thing known as “Supine Hypotension.”
10.Each day I take (X) pills & 0 vitamins: Well, it depends. I take at least 1 pill, and I’m supposed to take a prenatal(very lax on that one though) & there are the random aches & pains & allergies that I’ll occasionally have to pop some more pills, but yes, one a daily basis, just one. I’m trying to keep the pill brigade to a bare minimum right now. I do pump insulin 24/7, though.
11.Regarding alternative treatments I: if it works for you,& it hasn’t been shown to be toxic/damaging/etc. I think “alternative” treatments may have additional benefits. But you can’t “replace” insulin altogether, & you need to keep your HCP in the loop. I have taken supplements/herbals in the past, but I don’t pretend to speak for the DOC at large.
12.If I had to choose between an invisible illness or visible I would choose: I’m going to go with the invisible illness. If I don’t want to share it, I don’t have to share it.
13.Regarding working and career: I dunno what I want to do exactly...I’m leaning towards something in either pediatrics or research. I’m still very much the naive, impressionable nursing student. I don’t think being a CDE is in my future, I’m not the teaching sort. At this point, I’m just crossing things off my list (of RN jobs I don’t think I could ever do).
14.People would be surprised to know: That “Yes, I can eat that!!!”
15.The hardest thing to accept about my new reality has been:
That the “Golden Years” probably won’t be so golden, unless there’s a major breakthrough/cure. I fear the impending complications.
16.Something I never thought I could do with my illness that I did was:
Every day, I wake up & discover something else that I can do that I never thought possible with diabetes. Fear Factor. Job(s). School. Pregnancy. The list grows as my life goes by, & sometimes I look back & think “I did what?” (in my wild and crazy youth) Diabetes certainly throws monkey wrenches into the above, but it doesn’t have to “stop” any of it.
17. The commercials about my illness: are interesting, I feel a sort of “bond” with some of them in question...but the meter ones make me feel like smashing something.
18.Something I really miss doing since I was diagnosed is: Drinking an extra-large, sugary Slurpee on a hot summer day. I’m sure its entirely possible, but I’ve never been brave enough to try to figure out the bolusing sequence on that one.
19. It was really hard to have to give up: I wanted to enter the military, & well that was obviously out.
20. A new hobby I have taken up since my diagnosis is: Cross-stitch. I enjoy stabbing things (that aren’t body parts) with needles. (a sort of diabetes voodoo)
21.If I could have one day of feeling normal again I would: I’d eat a zillion carbs, & wash it down with a couple of Daquiri’s & veg out in front of the tv for the rest of the day. (of course, “normal” in this case means no D, & the absence of pregnancy)
22. Want to know a secret? One thing people say that gets under my skin is: “Have you had it since you were a baby?” (I know its called juvenile D, but why don’t you just ask me WHEN I got it?)
23.But I love it when people: just listen, and don’t judge!!!
24.My favorite motto, scripture, quote that gets me through tough times is: You can do this!
25.When someone is diagnosed I’d like to tell them: It’s going to be ok, you can do this.
26.Something that has surprised me about living with an illness is: that most of the time, I deal with it fine. You get used to it.
27.The nicest thing someone did for me when I wasn’t feeling well was: Brought me soup/liquids & made sure I was doing ok. (& called the doctor for me)
28.I’m involved with Invisible Illness Week because: It’s going around the DOC!
29. The fact that you read this list makes me feel: Hopeful for humanity. Invisible or not, we all need to be more understanding of others.
30.My illness has taught me: To be prepared for most “disaster” scenarios. Diabetes doesn’t have as much power over you, if you’ve got the antidote to the whatever it throws at you. I try to stay one step ahead of the ballgame, so when that disaster comes, its not "as bad."
Monday, September 12, 2011
My first pump, a MiniMed 508,was named Code Blue.(it was always having one emergency or the other)
My Deltec Cozmo was Lambo,Jr. (named for an Australian acquaintance of mine)
My Animas was "The Green Hornet."(insulin stung going in)
And then along came the Omnipod, which was dropped into my lap(& after some time, I finally decided that yes,I'd keep). A year has passed,& I still have no clue what to name it. The two separate parts are referred to as "the pod" & "the PDM" & it really hasn't much more personality then that. I wish I could find a name for it,for all my other pumps have had actual names. Even the Dexcom name(s) came easily.("Dex" & "The Cockroach"(transmitter) I really would like the devices to meld into one system so I could just call it "Artie" (short for artificial pancreas),that won't be happening for quite awhile though. Such is life. I certainly would like to participate in future phases of the AP project,but again,that will likely be several more years down the road. It's exciting stuff & I believe in this project more then any other research out there.("curing" diabetes is a stretch,but giving individuals the power to live normal lives with mostly normal bgs isn't)
While the rest of life moves very quickly,the advances in the diabetes field move very,very slowly...& sometimes I wish I could just jump to the future & have it all NOW. I know that sounds selfish,but I've had more then enough years of diabetes & I need a break, I need some of the awesome burden to be lessened (for me & everyone else out there). Decades & decades & decades more with this disease just doesn't sound do-able.( I know others have done it,but there are days where the best I hope for is to finish the day alive)
Technology and diabetes care have become interwined, from the advent of blood glucose meters to the pump/CGM combo.(and for all it may drive you crazy,it's the future,it's (for most people) the best of diabetes care) (not everyone chooses one,for various financial & personal reasons).
But I & technology are joined at the hip...for better,or for worse.It makes my life a whole lot easier,a whole lot less "different" from the rest of humanity.My iPhone contains everything from diabetes management apps to recipes to Twitter/Facebook(essential for my coping mechanisms)...as well as it being the link to the pharmacy,doctors office,etc.(everything a PWD could ask for) And I realize I'm lucky,in a world where many people don't even have the means to buy insulin/test strips (lucky,yet "unlucky"....the great oxymoron of the 21st Century)..I don't dispute that. I do love my technology.(given the chance, I choose to utilize those opportunities)
- Posted using BlogPress from my iPhone
Tuesday, September 06, 2011
(and deserving of it's own blog post)
I think it was bacon encrusted,because wow,that thing was sooooo good! (I believe the "gotta have one" hype now)
- Posted using BlogPress from my iPhone
Sunday, September 04, 2011
The Placental Express has yet to hit with a bang,but my blood sugars are definatly creeping up. Especially overnight. (gone are the days of hanging out at 70-90 overnight) If I do nothing, they remain stable. (versus dropping multiple times per night, in the first trimester) If I treat a low, even 15 carbs will skyrocket me from 60 to 130 by the morning. Which, by this point, doesn't put me in a good mood. There was a time in my life where waking up to 130 on a persistent basis would have thrilled me to death. But now, it doesn't (I NEED under 100). It just makes me annoyed at diabetes, & the fact that it never plays by the rules. (you can't not treat a low) My total daily dose has increased by about 10 units, but some of that is just the fact that stellar control was not my thing pre-pregnancy. Most of this is in the way of basal increases...my ratios are still about the same. (although I just upped breakfast again,with a 1/8) As the day wears on, I get a whole lot more sensitive to insulin (ending at a 1:20 for supper)
So, what I don't quite understand is how much of the insulin increase is related to the placenta and how much of it is related to weight gain. (I'm aware that both just really go to town post 20 weeks) It's very much a YMMV process (as to both),but someone who gains 25 lbs versus 50 definatly has less of an insulin increase. Gaining too much (or too little) weight is not a good thing, you don't really need to "eat for two." (more like 1.1) That being said, I'm most definatly feeling pretty pudgy these days.
(I hope colder weather comes soon, because I've outgrown every single pair of non-sleepwear attired shorts that I own) I've gained about 12 lbs. I just wish I knew just how much of an insulin increase I'm due for, but there seems to be no real way to estimate that either. (other then 2-3x pre-pregnancy daily doses)
As I'm much hungrier, (for everything under the sun) avoiding junk food is impossible. Although I'm aware that such cravings are normal, and "some" is ok, I sometimes eat it 24/7 (especially during class days) and that's not good. I just can't seem to be satisfied on just "healthy" food.
I think that the days of daily basal changes are just around the corner,& that insulin resistance is here to stay.
Thursday, September 01, 2011
It is a far,far,better thing that I do then I have ever done before.-A Tale of Two Cities by Charles Dickens
You're worth the 3 AM check,the 12 AM check,& all the checks in between.
You're worth the 200+ kicks daily,mostly in the middle of OB class(a veritable Mexican Jumping Bean). As I learn about Leopold's Maneuvers and fetal monitoring strips,you don't want me to be too caught up in delivering other people's babies that I forget about my own.
You're worth the heartburn,nausea,caffeine/food deprivation,random joint aches,& back pain.
You're worth turning 30 for.(happy Birthday,& don't start falling apart twice as fast now,self)
You're worth the Endo gruel-downs.
You're even worth having diabetes for,although I don't suppose one has anything to do with the other. But diabetes defiantly influenced who I married,it influences so much.As much as I hate the circumstances,there is a silver lining to many a dark & dire cloud.I'm doing my best not to screw this up.
And we're halfway there.
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Thursday, August 25, 2011
So,after waiting about an hour,we were called back & the tech started the comprehensive ultrasound scan...looking at the heart,arms,legs,head,etc. (naming what she was looking at) As she was leaving the room,I asked what it was (she certainly wasn't volunteering that information) & in a voice as dry and uninterested as humanly possible said "It's a X" before making her escape. Seriously,we've waited 19 weeks for this moment and that's how you act? (I don't know if she was having an off day or harbored a personal prejudice against moms with diabetes,like they have no business being pregnant) Then the doctor came in,and he was much nicer with explaining everything. Took another look at the fetal heart & proclaimed everything to be right on track.(weightwise,about 8 oz and no abnormalities) And it's kind of nice that they're concerned that I have someone to help with the blood sugar rollarcoaster, as the regular GYN office really doesn't care(or ask)about diabetes stuff at all. But the high-risk group only does the monitoring,not the actual delivering of the babies.(its all very specialized) My Endo handles it,but they've offered the services of their diabetes educator should I ever need it.(emergency or otherwise)
After that,we saw the genetics counselor for an in-depth discussion regarding my medical conditions/chance of passing them on.(more specifically,about my Bartters Syndrome) Because most variants are autosomal recessive,that means that I won the genetics lottery and got it from both parents(while my five siblings got Nada). In the general population,the chance of being a carrier is 1/1,000 so the chance that the baby will have Bartters is 1/1000 but there is 100% chance that they'll be a carrier. That's if it's recessive linked,I could have the (extremely rare) dominant form and in that case,the child will have Bartters Syndrome. (if that were the case,it would be apparent at birth) Insurance,of course,doesn't cover gene testing and I don't see spending $6000 on it,it wouldn't change anything anyway.It would be nice to know at some point in the future though(if I could find a research facility that would test for free). My nephrologist says that since it doesn't change the treatment regimen,there's really no need (I guess the only thing one can do,is be alert & proactive with any changes,at birth).We talked about medical issues on both sides of the family tree,they drew more blood,and scheduled the next screening in 4 weeks.
And it's a boy!!!
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Monday, August 15, 2011
Thursday, August 11, 2011
Here,you can see my abdomen at 17 weeks,& yes,this is pretty much what it looked like 17 weeks ago.(mostly just blubber) It's hard to believe that I've packed on a good 11 lbs. (where on earth is it?oh,that's right,it shrinks other vital things in the lower abdomen to the size of a pea) I haven't been overweight in quite a while,but wow that 2nd trimester came in with a roar.(and the lbs as well,the scale is starting to groan everytime I step on it) It's a bizarre feeling,having your stomach measured with a tape measure.(as well)He/She
is already producing insulin from it's tiny itsy bitsy little pancreas(is it wrong to envy one's kid?because sometimes,I wish it could share,& I know that's bad because genetically I may have passed on my bad luck)& setting about to double in size in the 3 weeks.And speaking of weeks,in just 2 weeks we'll get to find out what it is. In the meantime,there are plenty of things to keep occupied(like school,which begins in less then 2 weeks) Gulp...
It is afternoon on December 31,2011. I am doing a POD change,when said water breaks & my husband immeadietly rushes me to the hospital,ahead of the New Year's Eve revelry.After 5 hours of labor,at precisely 10:46 pm,a healthy 7 lb,8 oz baby is born (with no complications)
And that's what will probably not happen (although as long as it's healthy,I don't care what they do to me)
I don't like hospitals. I don't like the way they smell,feel,or degrade a person of the basic rights of human dignity. Unless you're the one in the white coat, you'd really like to be anywhere else on the planet. But when it's your job to care for sick people,well, it's not that bad being in the hospital. Because mentally,you're not entrapped...you don't "have" to be there.You can leave at any time. But a patient can't do that.(unless they want to get sicker/die)
It's something that I have to start thinking about,that yes, I'll be headed back to that place at some point in the next 5 months.And the choices that have to be made...which hospital is it going to be at? There are no shortage of hospitals in this region,and my OBGYN contracts at two of them(the one nearest our house,however,is the one that has diabetes care straight out of 1955). And that's a problem,even if my Endo's office is right down the street.(this hospital doesn't give two beans if your blood sugar is 350,as long as you're still breathing & your pain is well managed) 2008 left a really bad taste in my mouth regarding that hospital.(they pretty much ignored my Endo's orders,because most of the time I was 300's & looped out on painkillers) The other option,is the hospital with all the major equipment to handle anything that might go wrong..NICU,& such. That's definitely the way I'd go if I needed a C-Section,but for now, I have no,no clue which one to pick.I need my diabetes care to be stellar,(more for the effects on the infant,then for me) & I don't know if I'll be in the position to handle that aspect myself. And I sure as heck cannot trust Local Hospital not to kill me(if they'd take over the diabetes care). Personally, I think keeping the pump on is the way to go but things can get pretty dicey afterwards & your insulin needs drop to practically zero while you hypo nonstop & therein lies most of the problem,if you're zoned out on painkillers you aren't going to be able to catch that low & a nurse who checks you 2-4x a day is sure not going to catch it. At the other hospital,they also employ nurses that teach at my college(& the perks of that are many...since you get to know them,when you're a patient you get waited on hand & foot). I kind of also think they might do better with the D-care over there since they are like Baby Hospital Central in the county.(level III NICU) I don't think my Endo has privileges there though,& that is a problem.(I'll need major help in the diabetes dept.) Those are uncharted waters...& I need all the help I can get.
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Thursday, August 04, 2011
and you could tell it was hot outside.(up by the Park entrance, it was in the 50's & everyone still had their coats on from that). On the reservation, they go by Daylight Savings Time so that put the actual timing of the trip back an hour. (the rest of Arizona does not go by that) They also put on a mandatory "Canyon" movie (which after 2.5 hours got extremily dull, I reckon I know more about every single person who has ever rafted the Colorado then I ever wanted to) but we finally arrived at the agency headquarters, where we got off, stretched legs, perused the gift shop,and sprayed liberal applications of SPF50 from head to toe. It was just 9 AM and 85 degrees. An hour later, another group of river goer's joined us, we all signed release forms, and this Marine-looking type gave us a briefing on what to expect. Boarded buses, took off for the "secured area" which is at the bottom of a dam. To get there, we passed through a two mile tunnel in utter pitch
blackness. (claustrophobic, much? You would be by mile 1.5, our bus seemed to be moving at about 20 mph) came out at the bottom, donned hard hats, (because we were at the bottom of a dam/bridge) and all trotted off towards the river,(provided)lunch boxes in hand.
At the river, we tossed all the hats in a bin & boarded boats. It became very obvious that when they said that it would be hot, they did indeed mean, hot. A blast of 105 degree heat greeted us the instant we stepped off the bus. I wasn't thinking it would be quite that hot... but I was grateful for one thing,that I hadn't brought any back-up vials of insulin with me. (I'm not sure even the Frio would have done any good in that heat) Of course,if my pod would have gone bad I would have been up the Colorado without a paddle(figuratively), and a 4 hour drive to the nearest pharmacy.(not really a good thing,but I was lucky,nothing happened)
There were 17 of us on that boat. Our tour guide was a young Navajo Native American named Ritchie. I was most immeadietly concerned with my blood sugar...it was already trending low & in the insane heat, there's no telling what it would do.But there was lots of sugar on board(both in the form of the lunch boxes,glucose tablets,and the "net" of MinuteMaid Lemonades being drug in the water so I felt safe, in that regard.Checked my blood sugar every hour (during the 4 hour trip),& it held pretty steady. My meter, however, went completely off the deep end & started issuing random Error Codes like crazy.
I had no clue what an error 3, or error 4, meant...it was initially pretty freaky & I envisioned my Omnipod/meter dying right there,it's electronics fried by the Arizona sun.But I could still test(didn't give any sort of "device outside temperature range" messages, and those blood sugars correlated well with what my Dexcom was telling me so I just trusted that whatever was going on,it wasn't screwing with the trusty-ness of those readings. It continued to self generate Error Messages (about 20, over the course of an hour and a half) & then stopped. I bolused once(for lunch),& the function of that also seemed to be working just fine, so I stopped worrying about it.
We made two stops during the boatride...to stretch legs,etc. The French Europeans on board took those oppurtunities to strip off as much clothing as humanly possible & go swimming/skinny dipping in the river.(why they bothered wearing anything is beyond me,since you could see more then you ever wanted/needed to) Fortuantly, they made a bit more of an effort to cover up
on the rest of the journey.
The river was as ice cold as the sun was hot...compliments of the mountain run-off.
After three seconds,you couldn't feel your feet anymore.(45-50 degrees) It certainly helped prevent heatstroke. (those are my frozen toes,FTR)
We had a cooler of water on board,& were encouraged to keep up the H20 intake (as well as wear protective gear,sunscreen) & that got everyone through the 4 hour trip. There was no shade on the Colorado though. (other then when we stopped a couple of times. More then once doubted the wisdom of taking such a trip (despite the guide's reassurances that this "was the best time of year to go"-he may be used to the heat,I was not) but things did work out & it was pretty much fun.
The sun was so hot that I didn't take that many pictures...much less videos (I couldn't see the screen, (hence the upside-downness of any videos,& I am currently tearing my hair out as how to insert those videos...may take a day or two,check back)
It takes between 10-14 days to fully "raft" the Colorado...& its all regulated by private industry, so you just can't go out there and do it on your own. The discoverer/conquoror of the Colorado (one John Wesley Powell) did it in a rowboat, and he only had one arm (they had to tie him to the boat during the really bad rapids...if the boat went down, he would have too. As with the Grand Canyon, alot of people have died (on this great national wonder) & it commands an awesome power.
(Obligatory stop at a reservation store on the way back,& the resulting "Oohhh I really need/want this!" gush (that is,until one viewed the five digit price tag. Probably not as comfortable as a Baby Bjorn,either)
Boarded the bus again,drove the 3 hours back to the car/hotel...and then my blood sugars crashed hard for the next 13 hours.(effects of the heat, perhaps,I certainly didn't do anything that might be considered "physical exercise"-much of that day was spent sitting) The SPF 50 was more then effective in preventing the dreaded "day after" sunburn,although since I reserved my left hand to be SPF free(in order to not mess up blood sugar results) that hand/arm did burn some. The next 24 hours were spent recooperating from the day/hypo night from heck. Despite not being white water rafting,it was still pretty grueling. (I am most definetly not the "diabetic adventurer" type..once in a while is ok,but being away from civilization for an extended period of time is nerve wracking stuff,and the blood sugars were every bit as crazy as I thought they'd be,although mostly after(not during) the trip.
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