Tuesday, January 26, 2010

31w4d- nearly 4 pounds

C and I went in for an ultrasound yesterday to get an estimated fetal weight, primarily to make sure the GD isn't affecting Ishkabibble's size, but also just to get another look at our little one. The official estimate was 3 pounds 15 ounces, so we're perfectly on-target with no size issues so far. But the big news is... we saw Ishka's FACE! Not a profile, "oh, look at that lovely jaw-line" kind of image. This was a full frontal face shot, and the u/s tech was kind enough to print that one out for us to take home, along with an image of Ishka's right foot (I think) and a few classic profiles. All are a wonder to behold, but the FACE... wow. If our home computer were working, I'd scan the image and share it, but the harddrive bit the dust a couple of weeks ago and since we're relying on the generosity of friends to retrieve all our files, it's taking a while to fix it. I will be sure to scan it as soon as we have a working computer at home again.

Mind you, it's the low-tech 2-D image, not the fancy-shmancy 3- or 4-D version. Had we oodles of money to burn (or maybe if C hadn't been laid off so early last Fall), I might have splurged on a 4-D u/s photo-shoot. Apparently, that's becoming quite the business- you can buy a CD with a full 10 minutes' or more worth of your baby's still and motion ultrasound images set to music for some amount of money. I love the idea, but I think it would end up stashed away along with our wedding photos... rarely looked at and kind of neglected. I'm holding out for the real deal... the huggable, squeezable baby I can wrap in my arms. Soon. Just over 8 weeks left to go, and all is still well.

Wednesday, January 20, 2010

a sweet A at 30w6d

Today, I met again with the Doc in charge of the OB practice. She wanted to follow up with me when I had another week or so of blood sugar numbers to report. Once again, I had a few that were a little high, but I've discovered a simple way to deal with them. Upon seeing my first 150+, I took off for a brisk 45 minute walk then tested again at 2 hours post-meal. I could hardly believe it when the meter indicated my blood sugar had dropped more than 65 points. I've had only 2 more 150+ readings since then (one brought on by a breakfast of unprocessed, no-sugar cooked oats with 6 cranberries, a sprinkle of Splenda and a splash of unsweetened almond milk), and each time my glucose dropped below 90 by the 2-hour mark thanks to a short (only 10 minutes) walk. My short walk solution also preceeded the testing on one occasion when I ate a little more pizza than I should have. The result? A very satisfying 112 at one hour post-meal.

I'm amazed that something so simple as a walk, and a short one at that, can have such a dramatic impact on my blood sugar. I'm now walking for at least 10 minutes every day, usually after whichever meal seems least GD-friendly. The Doc gave me an "A" for this appointment thanks to my "overall healthy numbers (sugars-wise)," my good blood pressure (117/62 or something like that), the absence of any bad stuff in my urine, Ishkabibble's healthy heart rate (always in the 140's), and the fact that my weight has held steady for the last few appointments.

My next visit will be with a **gasp** male doctor in the practice. They rotate on-call duties, so there's no way to know ahead of time who'll be on when Ishka decides to enter the world. I want to be familiar with each of them before that day comes, so my next couple of appointments are with "new" doctors. I'll go back to "my" midwife for the last few weeks. Appointments are every 2 weeks now, and it sounds like the off weeks will be filled with ultrasounds and non-stress tests. I hope juggling all these appointments doesn't speed up time. I'm very happy with Ishka where he is for now, and in no hurry for her to come out.

Tuesday, January 19, 2010

more, please

Kate is as lovely in person as she is on her blog. More so, in fact. I was a little concerned that our conversation would be forced or would focus solely on IF, but needn't have worried. Time flew by and I was truly surprised by the hour on my watch when we eventually got up to leave. I'm looking forward to meeting again.

Tuesday, January 12, 2010

when URL becomes IRL

Hi All,

meKate (of ICantWhistle) and I are meeting this Saturday, January 16th, in Leominster, MA. This blogging thing is great, but 3-dimensional people are so much more wonderful. If anyone out there would like to join us, please leave a comment with your email address and we'll let you know the details.

We'd love to meet you!

worry? Why worry?

Today is my sixth full day of blood sugar testing. I had some relatively high numbers over the weekend, so I contacted the nutritionist who told me to see my OB/MW. I managed to squeeze in an appointment yesterday afternoon, where I met the OB in charge of the office where my MW practices. She's a bit brusque, but seemed open to questions and discussion in a quick, no-nonsense sort of way. She claims that the "acceptable" glucose numbers provided by the nutritionist are on the low side, and that anything under 140 mg/dL is perfectly fine at one hour past mealtime. And she thinks the ketone testing is frivolous as long as I'm eating something shortly after waking each day. I'll continue testing, but won't worry unless I get a result higher than "trace."

So, I was worried yesterday, but now I'm semi-convinced that I have nothing to worry about. And we have an u/s scheduled for the 25th the estimate fetal weight. Hurray for another look at Ishkabibble! Even C is excited. And I made up a delicious, super healthy sourdough bread recipe over the weekend that cooperates nicely with my glucose meter- C's fear that bread would be banished from our house has been put to rest. The whole GD thing seems to be going well, although I'm hesitant to go out to eat because who-knows-what's in those delicious, professionally-prepared meals. A weekend trip to Panera will be preceeded by a little net-searching and menu planning. But staying on-track isn't all that tough. I just pay more attention than I used to. This will pay off post-pregnancy, when I want to lose the weight I've accumulated, and then some.

Speaking of weight, I did not gain a thing since my last MW appointment 3 weeks ago. Nor did I lose. It wasn't intentional, and I'm certainly not starving myself, so I'm happy with it.

Thank you for the thoughts and prayers for my college friend and her baby, born a full 2 months early (15 1/2 inches long; 2-pounds 13 ounces) last Friday. Both are doing well. It looks like her little boy has some jaundice but is otherwise doing very well for making such an early appearance. His proud papa even got to change his first messy diaper.

Of course, that has me thinking that I could find myself in labor at any moment, too. One of the other couples in my childbirth class mentioned laboring in a jacuzzi, and suggested renting one when I said how jealous I was (we have no jacuzzi or large tub). I looked online and found that I can buy a birthing tub for just $125! It's essentially a heavy-duty inflatable wading pool, but a little deeper than the kiddie pools you find in the toy store. I really like the idea of laboring at home (as long as I can) in a warm tub. We're only 15 minutes from the hospital, so as long as labor doesn't start until Ishka is truly ready to be born, this is our plan. There are tubs at the hospital, but they're only a little bigger than my own bathtub, and an inflatable wall/floor will be so much more cushy than whatever bathtubs are made of.

So, just about 10 weeks to go. Feeling great, worried about next-to-nothing. It's time to nest.

Friday, January 8, 2010

How many needle sticks does it take to have a baby?

It's really not that bad. I mean, pricking your finger is nothing compared to a lupron injection, let alone HCG or the dreaded PIO (which, thankfully, I did not have to experience). But from 28w6d through the end of this pregnancy, I will be pricking my fingers 4 times each day to test my blood sugar levels. If the numbers cooperate, that's all I'll be doing. So far, I can't tell if they're cooperating or not. I've had two readings in two days that were above the "acceptable" maximum, but not by much.

I met with the nutritionist on Wednesday afternoon for my "diabetes education" session. I have a nifty meter to use 4 times each day to test my blood glucose level when I first wake in the morning and again one hour after each meal. It's essentially painless, just requires that I remember to do it on time and to bring the meter and test strips with me everywhere.

For those of you unfamiliar with the 3-hour glucose test, I'll provide some background. After fasting for 10 hours, a blood sample is drawn then the patient drinks a very sweet, sugary drink (I'm guessing it was about 16 ounces of the stuff). Additional blood draws occur 1, 2 and 3 hours after the beverage is consumed. The glucose content of each blood sample is measured and compared with acceptable standards. If any one number is significantly high, or if two or more are above "normal," then the patient is considered to have developed gestational diabetes (obviously, I am talking about pregnant patients here).

The acceptable results for each step are:
fasting < 95 mg/dL
1-hour < 180 mg/dL
2-hour < 155 mg/dL
3-hour < 140 mg/dL

My results were high for three of the four time periods.

The nutritionist explained to me that pregnancy hormones can make a woman insulin-resistant, so gestational diabetes isn't entirely dependent on weight or diet, although being overweight and eating a high-carb diet can contribute. The concern with GD is that the extra sugar in the mother's blood will pass to the growing baby and be stored as fat. When the baby is born and no longer receiving massive doses of sugar from the mom's blood, the insulin that the baby is used to making will cause hypoglycemia. Also, an overly-large baby can cause problems with the delivery.

The first step is to monitor blood sugar as I've been instructed, to pay close attention to my diet, and to continue exercising (I've taken to walking the local mall... the sidewalks are too choked with snow right now, and it gets dark far too early for me to feel safe walking my neighborhood streets) on a regular basis. The nutritionist emphasized that babies NEED carbs, so under no circumstances am I to adopt an excessively low- or no-carb diet. My daily menu should include:
Breakfast of approximately 30g carbohydrates;
Morning snack of ~15g carbs;
Lunch of ~45g carbs;
Afternoon snack of ~15g carbs;
Dinner of ~45

These numbers were given to me as MINIMUMS- much less, and there's a danger that the baby will not be receiving all that s/he needs. I was also told to test my urine (more pee-sticks!) each morning before eating to check for the presence of ketones. Ketones would indicate that I waited too long between meals, in which case I should have an evening snack, including about 15g of carbs and some protein, before bed each night.

So far, my glucose has been a bit high on two occasions in the last 2 days, but not excessively so. I'm hoping that I can maintain the right balance to avoid having to add insulin to the equation. Most of all, I want this baby to be healthy, and hopefully of a size that's conducive to a natural birth. C and I attended our first hypnobirthing class last night, and I'd love to come out of this with a healthy baby and something that approcahes my ideal birth experience. Top priority, though, is the healthy baby.

Eyes on the prize!

While we're thinking of healthy babies, please say a prayer or send positive vibes or whatever is your thing to do to my college friend who is having her baby delivered via c-section as we speak at 31 1/2 weeks. Getting to this point was not easy for her, and she and her DH will be incredible parents. I wish them all the best of outcomes.

Tuesday, January 5, 2010

sugary sweet

I just called to check on my 3-hour glucose test results. I failed 3 of the 4 time-frames, and even my fasting level was elevated. Next step- schedule an appointment with a nutritionist for diabetes education where I'll learn what foods to avoid and how to test my blood sugar. I guess I'll be testing twice each morning for a while, both before and after breakfast, to see if diet keeps things under control. I don't know if I'll stop testing once that proves sufficient, or if I'll test for the rest of the pregnancy regardless of the results. I haven't had the chance to consult with Dr. Google yet, and I'm not jumping to any hasty conclusions.

On the plus side (there's that reluctant optimist in me again), I think this means we'll have an extra u/s or two to see if Ishka is getting too big.

I'm still not overly worried. This is something to deal with, and not entirely unexpected. I am, after all, over 40 and a little overweight. I can deal with this.

Monday, January 4, 2010

28w4d- oh, fudge!

I rang out the old year by taking the 1-hour glucose tolerance test and getting my rhogam shot. Do I know how to celebrate or what? Anyhow, neither was a big deal. The sugary drink was essentially slightly concentrated orange gatorade. It wasn't nearly the volume that I'd feared, and easily went down in two big gulps. The rhogam shot was a piece of cake- it was an IM shot, in the upper arm, and I didn't feel a thing. Then I had to sit around for 15 minutes, presumably to make sure I suffered no ill effects.

Because of the holiday, I was not able to get the GTT results until today. I failed. A "normal" result is below 140, and I was 170. I haven't consulted with Dr. Google yet to see if anything can be surmised from this number, but I've been asked to call the hospital's lab this afternoon to schedule the 3-hour test. According to my research, only about a third of the women who "fail" the 1-hour test actually develop gestational diabetes, so I'm taking some comfort from that. I refuse to worry until I have something to worry about. I'm wondering if all the cookies and fudge and other yummy treats that have been amply available during the holidays contributed to my elevated number.

Ishkabibble is doing well, as far as I can tell. Each time I settle in for a movement counting session, Ishka seems to drift off to sleep but reliably wakes up after a 30-45 minute nap to jab and kick and roll all over the place. My MW told me to expect ten in under 2 hours, but I've never had to wait more than an hour to count ten movements. Of course, whenever C is nearby, Ishka dozes. As soon as he walks away, the wild rumpus resumes.

Third trimester issues have begun to set in- I sleep only 4-5 hours at a stretch (I'll think that's heavenly in a few more months) before waking up with a back ache or sore knees and hips, or the need to pee. Getting back to sleep is sometimes impossible, sometimes a breeze. I suspect afternoon naps will soon become a regular feature of my days. Ishka has found my bladder twice in the last several days and either danced on it and used it as a punching bag (I wish I could tell the difference). Bladder capacity is at an all-time low, while mid-winter dry-air thirst is up. I'm getting quite round, and it looks to me like 95% of this pregnant shape is in front of me. I may have gotten a little wider, but most of my expansion is front and center.

Note to folks who'll reach this stage after me... Your doc or MW will ask you to pee in a (ridiculously small) cup at the beginning of each visit. At first, it's easy. By about week 27, I could no longer see what I was aiming for. From here on out, I am bringing a bigger target, a paper cup from home. You may want to consider doing the same. I think those doctors' office pee cups were designed by men.

So, it's a new year. I hope THIS is the year that BFPs abound and dreams are fulfilled. I hope we all manage to learn from the past, but look forward to the blank slate that is 2010. The possibilities are endless!