Tuesday, February 21, 2012

The Check Up

So I went to my 6 week OB-GYN follow up today...while my mom babysat for me. Maneuvering the heavy infant carrier & a diaper bag etc. over a 1/2 mile of hospital terrain,etc. is not a feat I'm up to quite yet. And I was 15 min.late, which means that they couldn't fit me into their jampacked schedule for another hour. Since I've now reached the (advanced)age of 30(seriously,they said so) in addition to the scar check, they did the yearly check exam,etc. I didn't know that 30 was such a big deal(perhaps reproductively it is). The Csection scar is doing ok,still tender to the touch but these things take time to heal. And its been confirmed that,if I wanted to have any more kids it would have to be via Csection. (the reason for the C-Section dictates one's future in that regard) So really,you have to go through labor unsuccessfully before they'll "know" that said birth canal is too narrow,a concept I don't totally understand (why they can't predict that in some way,what with the probable trillions of births since the beginning of time). Some people have gone on to have vaginal births post C-Section, but it's my observations that many people just opt to have another C-Section. I've got nothing against C-Sections,as it pertains to the whole "Nature VS Medicine" thing...the point is,to get the child out,not to have some sort of religious experience,but it is true that docs really don't like you to have a vaginal birth after a section & will tell you that you have to have another C-Section unecessarily. Repeated C-Sections increase ones risk of uterine rupture(etc.) & at some number,(4?)hospitals refuse to do them,the risks are so high. I'll never be Michelle Duggar,but I don't like anyone telling me anything. And I don't think I'd want enough kids for that to even be an issue, but time will tell,in that regard.My problem with C-Sections are,they're painful/take very long to fully recover from,plus the baby doesn't get some "immunity" from the birth process. So what I don't quite understand is if it's physically impossible( I mean,the canal is supposed to accommodate &why it didn't I don't understand) or if the doc is just saying it because that's what OB-GYN's do. I need an impartial party to explain it to me, I guess.( like an L&D nurse)

As addicting as babies are,
I don't plan to repeat the experience for awIhile. Pregnancy was a time of great physical & mental stress & my brain needs healing,as well as my body. I ate,slept,& breathed guilt for 10 months & it didn't magically disappear the minute I delivered. I really appreciate the normal hum/drumness of being not pregnant now,& diabetes wise,my control got much better(funny how that happens,when you're supposed to be in great control DURING,not after). I am much more comfortable with taking huge amounts of insulin/prebolusing then I was pre-pregnancy,& I think that'll work to my advantage on the next a1c. I still have alot of conflicting feelings about said pregnancy..& I know that if I ever have any more,there are things that I'd do very differently. I think that having a baby in the NICU for even a minor reason makes you aware of how much worse things really could have been,& how grateful you are when they get out happy & healthy.And that's what it's all about,even at 3 am when they're crying to be fed & you're dead to the
world but then they smile at you & suddenly the night is not as dark anymore. He's the cutest thing since, well, Sep.1, 1981...

- Posted using BlogPress from my iPhone

Saturday, February 18, 2012


Almost three years to the day that thishappens. I don't think about it so much anymore but it's odd timing,that one week in January where tragedy & joy tangle each other in a complicated web of emotions.
- Posted using BlogPress from my iPhone

The Story of a Birth: Part 3

Dear JB,

NICU's can be scary places. And it does something to one's heart(read:take out,pulverize,put back into chest) to see one's baby in there. You were so little,(7 lbs is little, in my book)had an IV in one arm and a mass of heart leads under your sleeper tracking your heart rhythm and breathing rate. (both of which are pretty variable in a newborn) And by highly variable, I mean that the respirations can go from 20 to 70 over the course of 2 minutes.(it looked like a CGM on steroids) It took some getting used to, not freaking out over that monitor readout.(or the fact that it went off every 10 minutes just about) But your heartbeat is always steady, and true, (in contrast to some of the other babies, who would throw PVC's really frequently)and that was comforting, in that great time of uncertainty.

On Wednesday of that week, you had your IV removed..after it was clear that you didn't have an infection/blood glucose was holding steady. You didn't much like that,& I can't blame you(IV's aren't fun for anybody). You cried.(and I think I did too) Your two little heels had both been pricked(multiple times) for blood sugars,& I know it was necessary but seeing those little scars just made me hate diabetes all over again for putting you through it.

On Friday, your temperature finally began to come up...so they started turning the temperature down on the incubator/warmer. It was a long, long weekend full of advances/setbacks...to be able to turn the temp down by one degree,the underarm temperature had to measure at least 98.6. If it was 97.5 or below,they had to turn up the temp again.(they measured temp every 4 hours) Your temperature bounced up and down (despite wearing two layers,and 1-2 blankets) so the settings on the warmer simerally bounced up and down and I had doubts that you'd ever be warm enough. But you finally did,and by Monday afternoon you were all the way down to room temperature & ready for the 24 hour crib test (maintaining a 98.6 temp in an open crib for 24 hours).And by Tuesday afternoon,you could be discharged/come home. That was a little bit scary,bringing you home for the first time but the staff assured me that you would likely have no problem with future temp regulation, at that point.

So we took you home,and by that evening my feeling blah's had progressed to chest pain& an 103 degree fever.Fortuantly,my mom was there for the week (two babies to take care of) or I'm not sure I'd still be here. Whatever I had fortuantly wasn't contagious,(chest Xray was negative for pneumonia but the pulse oximetry reading was at 95%,earning me a round with the doctor's office nebulizer and a prescription for antibiotics and albuterol) but put me out of commission for the next 5 days. You,fortuantly, were unaffected...you continued to eat,sleep,poop,and grow. (as it should be) You had your first appointment with the pediatrician & clocked in another 9 oz weight gain. (and thumbs up on the pediatrician,I love her to death) And, as of 2 days ago...you now weigh over 9 lbs. I really hope you can stay healthy for a long,long time because the pediatrician also scared the socks off of me talking about what happens if a baby under 3 months old gets a fever (it is a huge deal),to that end,I've turned into the overprotective,do not want to take you out of the house at all,mother.(trying to protect you from all the nasty germs)

Parenthood is a work in progress...please be patient with us.


your Mommy

Thursday, February 09, 2012

The Story of a Birth: Part 2

Room #317 was seemingly like any other room on the post-partum floor, but with one large, noticeable difference.

Minus the baby. Because a half-hour after moving in, a rechecked blood sugar was a 32 (normal, for a baby, is above 40) and a formula feeding only resulted in a 28, so the baby was whisked off to the NICU for blood sugar observation. (and a subsequent Dextrose IV) I couldn't go anywhere, because I was tied to the bed (literally) with compression leg thingies and that urinary catheter (for the first 24 hours). In my mind, I didn't expect him to be there that long and it was somewhat relieving that they were monitoring him while I could get a few hours of sleep. And sleep was odd, because for the first time in 7 months, I could do it on my back & do so with the aid of painkillers that actually worked. Attempting any sort of movement was just as difficult as during the later part of pregnancy. I was plenty hungry but only got soft liquid-ish stuff for the first 24 hours(per protocol). In the afternoon, they took my IV out & I re-inserted my Ominipod system after another doctor showed up,poked around,and said that she trusted I knew what I was doing in that regard. (not really,but I could see that she didn't, so I figured strict blood sugar management was not a priority anymore) I cut my basals by about 66% across the board,and my bolus ratios by 50-75%. I didn't want to be either too aggressive or too passive,but clearly diabetes was still there, it hadn't gone anywhere.(some people are lucky enough not to need any insulin at all,after delivery) That worked well, for the most part.

The next morning, they removed the urinary catheter/compression thingies and told me to get out of bed. So I got out of bed,took a shower,and crawled right back into bed.(moving was very painful) My parents visited,and we went down to the NICU where they said that although the baby's blood glucose was now normal,his temperature was now too low so he'd have to stay in the NICU to be monitored for that.

Tuesday passed,and Wednesday as well.By Wednesday evening,it became obvious that I was going to be discharged & the baby wouldn't..his temperature just wasn't coming up. To add to this, his bilirubin levels rose (so they did about a day of photo therapy),and his platelet count dropped,so they were concerned about infection & started him on antibiotics. The blood culture from that was negative for infection.(but they tend to give antibiotics when there is any risk at all for infection)

Wednesday,my post-lunch bg was 276 and my OB nurse freaked out, calling in a CDE. This CDE was exceptionally short on bedside manners as well & the resulting conversation was a waste of both mine, and hers, time. I don't think she quite understood the concept of a POD (like an infusion set) going bad. And she sprinkled in too many examples of other patient's "brittle diabetes" horror stories. (I don't like that term,and I don't believe in it)Five minutes in, she answered a phone call from a doctor
(dealing with someone's very high bg)and neither one of them treated the patient with much respect.This lasted for about 15 minutes,during which time she didn't go off/handle it privately...it was all in front of me.
Fun times.(I needed another pain med dose after that conversation) I demonstrated to my nurse how to change a POD, she'd never seen one before.(just regular insulin pumps) And that was pretty neat, because she asked lots of questions/was genuinely interested in it all.(her husband is a type 2)

Thursday was a black,black morning..for I knew that my 4-day stay in Paradise was coming to a close, the insurance company sure wasn't going to let me stay anymore $2000+ days. Things were healing well,& I had no problem moving around/walking at this point, so it meant that I'd be discharged(probably before 10 AM). At 4:30 am, I woke up & started bawling..and that went on through the 5:30 AM vampire blood draw. At 6, Dr. Tired-OB-Of-the-Week-Before showed up.

"Why is your blood glucose so high?!" (my pre,and post lunch bgs had been hanging out in the mid-200's)

I shrugged,trying to hold it all in.

"Because you're eating Crap Food-what is that,Cheetos and Pepsi?" he poked at a lone bag on the bedside table.

Charming doctor.

"That's DIET Pepsi." (thank you very much!!!!and that's not Cheetos, that's a bag of candy, which I'm using for low blood sugars. Not that you care.)

"So how are you doing today?"

I burst into tears.

"What's wrong?"

"My baby's still in the NICU & I just can't go home today."

"He won't be there for long-he just needs a little extra time,the low blood sugars probably set off the temperature issues. He's not seriously ill,he'll be out soon."

(I knew that,but just the fact that he's in the NICU at all has made me a basket case & you're just not getting it, are you? And there's no "OUT" in sight.)

"I'll discharge you later today-not by 10 AM, so you can stay with him longer,ok?"

(yeah,thank goodness for that small favor)

Therapy time over, he moved on to the next victim/patient. And I resumed crying, until at 8:30 AM my nurse showed up, fed me painkillers and hot tea,and had a lovely 3 hour therapy-cry-a-thon session with my post-pregnancy hormones. After that,I was a bit more ready to deal with the situation as I could see that it wouldn't do my baby any good if I didn't get well myself. It still wasn't ok that he was still in the hospital, but I could at least walk out the door myself without constantly sobbing.I still felt like crying(at the drop of hat,and would do so,quite frequently) Other babies crying (on the floor) also made me feel that way. My job was to get better,and their's was to make him better.

At 4:30, I was discharged,my husband & I went down to the NICU...fed him,held him,etc. ate some dinner, and then went home, where I crashed into bed,exhausted beyond exhausted. Coming home (from the hospital) without your baby never feels right.

Wednesday, February 08, 2012

One Month: A Pictorial Odyssey

(working backwards in time...from today, to Day #1)

Saturday, February 04, 2012

Musings of the 3 AM Brain

What if everyone in the world had either type 1 (or type 2,etc.) diabetes?

Would life, as we know it, be easier or harder? (since the theories for managing diabetes are almost as plentiful as the number of cases) Would the Type 1: Type 2 ratio matter...since they are different,& can be treated thus. If there were more type 1 cases, would people get more education:be better informed? (and inform others)

Would we be healthier-would we take matters into our own hands,implement exercise programs, various incentives, etc...or would the vast majority of us continue to ignore what should be done & eat ourselves into a state of morbid obesity? And would insurance companies be any better about covering the supplies needed to TREAT and prevent complications from occuring? And would Congress/etc. get serious about funding various entities to make a cure happen sometime in this lifetime? I mean, we'd all be just one big happy D-family...all of us would want that cure.

And would we finally get rid of this stupid "diabetes blame game" where if you have diabetes (any type) you must have eaten too much sugar or not have exercised enough or been dropped on your head as an infant...etc. Would we stop blaming the patient,& would people stop blaming themselves enough to work towards a state of health?

(In conclusion, I don't think more people getting diabetes is going to improve either the public perception of it/chances of a cure/or anything else. It's just going to cause more suffering. And some days,you just feel like a paper towel against the flood of stupidity,ignorance, etc...nothing you say is making much of a difference)

Wednesday, February 01, 2012

Wordless Wednesday: Bottles

Mommy's and Babies. #rollon70mg/dl

- Posted using BlogPress from my iPhone