12 Weeks

Baby says, "Hi"

Today was my 12 week OB appointment. The purpose of the appointment was twofold: To set me up as an “official” pregnancy patient and to start genetic testing.

The day started out with an ultrasound. Part of the 12 week genetic testing, called Nuchal Translucency, is to measure the amount of fluid in the baby’s neck. This measurement, coupled with some blood work, assesses the baby’s risk of having Down syndrome and some other chromosomal defects.

This whole genetic testing thing is complicated. As parents, you do not have to do the testing, it is just an option. Also, the tests are known for producing false positives, which can cause a lot of worry and heartache. It was hard for us to decide whether or not to do it, but we finally decided that we would rather know what the odds are, and to be prepared for the outcome at delivery.

The ultrasound was somewhat uncomfortable. Because the baby is so little at this stage (something like 2.5″ – 3″!,) you need to have a full bladder to push your uterus forward so that the ultrasound wand can pick up the sound waves. I dutifully drank my 20 ounces of liquid 1.5 hours before the exam. As anyone who has been pregnant before can probably tell you, there is a lot of pressure in the bladder area. Even when your bladder is not full, it sort of feels like somebody is trying to wring it out. I am in the habit of peeing every 1-2 hours, even when I have not had a whole lot to drink. So maybe you can start to understand the pain I was in when I walked into the doctor’s office.

Luckily, I did not have to wait long, and the ultrasound experience, as usual, was mesmerizing. Hearing that heartbeat (171 beats per minute this time!) and seeing a “real baby” in there is just amazing. This time it looks even more like a baby, less like a fish. Baby looked like s/he was posing for us, with his/her right hand in the air as if to wave “hello”. THe ultrasound tech also instructed me to leave a urine sample, which was not problem at all!

Afterwards, we spent several long minutes trying to draw my blood. They need something like 6 vials of it for this genetic testing, and my veins are apparently still weak from my dehydration and hospitalization. So we finally gave up on that. I have strict instructions to rest and drink tons of water. On Tuesday I have to go back for another try.

After that, the nurse practitioner recorded some of my genetic history, and then took some cultures. And then I was free to go.

All in all, a tiring visit, but I am so releived to hear that baby is healthy and growing as expected.

Morning Sickness Remedies: What Worked for Me

The name Morning sickness is such a misnomer. It lasts ALL DAY everyday, for weeks. And, at least for me, it was so much more than just a little queasiness. It was like nausea on steroids. And no matter what I did, it just won’t go away. It threw me into bed every night, exhausted and miserable, and greeted me first thing in the morning as soon as I woke up.

Luckily, I seem to be through the worst of it now. It still hits me now and then, but I am SO much better than I was three weeks ago.

One of my goals with this blog is to share what I’m learning on this journey with the rest of the Diabetes OC. So I thought I would dedicate this post to the things that worked for me (and those that didn’t work, too) when I was trying to survive the worst of my morning sickness.

Here they are, in no particular order:

Things that worked

• Jelly Belly Jelly Beans. I found that if I nibbled on these tasty little candies a few at a time throughout the day, they helped keep my stomach from gnawing a hole in itself. An added bonus: they also helped keep my plummeting blood sugars out of that dangerously low range.
• Macaroni and Cheese. You know, the good, old-fashioned Kraft version with powdered cheese mix. This  dinner time go-to turned out to be just bland enough to allow me to keep down a decent quantity, and calorie-dense enough to help inch my weight back up into its pre-pregnancy range.
• Apple Cider. I can’t explain it, but I tolerated and even craved this fall-time drink, which came in especially handy when trying to treat those late-night and early-morning lows.
• Saltine crackers. True to their reputation, these little gems turned out to be the best nausea reducer for first thing in the morning. Believe what you read in the books: keep the saltines on the nightstand and eat one or two before you even attempt to put your feet on the floor.
• Salty potato chips. I read somewhere that a handful of salty potato chips could settle morning sickness. I was doubtful, but was also desperate. This one turned out to work pretty well, but the limit is just about 15 chips, or one carb exchange. After that, they started contributing to that full tummy sensation.
• Almonds. A handful of almonds helped take the edge off when it was too soon to take another anti-nausea pill. An added bonus is that they do not affect my blood sugar.
• Ice Water. It had to be ice-cold, but a few sips would quell my queasiness at least enough to help me get ready for work in the morning. Of course, the additional fluid was also key to keeping me well hydrated.
• Phenergan. I don’t know why my doctor initially told me that the only anti-nausea drug I could take was Zofran. Once I switched to Phenergan, I could finally start to eat again. The side effects can be debilitating, though. It does make me feel tired and loopy in high doses. If I can manage with the lower dose, though, it works pretty well. An added bonus: it is available in generic form, so it is much more affordable than Zofran.
• IV Fluids. When all else failed, I checked myself into the hospital for some good old saline. Two days and three bags later, I felt like a new person. It sure was a nuisance, but it really did help me turn the corner.
• My husband. He did EVERYTHING while I was stuck in bed. From laundry, to dinner, to waking me up to test my sugar,he has really taken a lot of the burden in this new journey. Thank goodness for him. I don’t know how I would have made it this far without him.

Things that did not work

• Bananas. Forget the BRAT diet (Bananas, Rice, Applesauce, and Toast,) which the doctor suggested when I was in the hospital. Bananas contributed to my full and queasy feeling and added a new symptom: heartburn. Applesauce was not much better. Rice and toast worked out alright, though.
• Ginger and lemon. Whether in the form of tea, ale, or candy, these remedies just did not cut it.
• Scrambled eggs. Yuck. This sounded like a good idea, but just did not work out. I couldn’t even finish one egg. Ever since, the thought of any type of egg makes me a little queasy.
• Zofran. I can’t believe I paid so much for a drug that did so little. I could have been taking a sugar pill. Just to prove that everyone is different, I have a friend who is taking this right now and it is working like a charm.
• Reglan. This drug is supposed to help the stomach empty, which should help the full-tummy sensation. Unfortunately, its side effects contributed to my incredible fatigue and helped to make me feel loopy. It did not help much with that full feeling, either. THe good news is that this is available in generic form, which helped keep my drug costs down.

Do you have any secret weapons for morning sickness? What worked  (or didn’t work) for you?

The Endo is Growing on Me

Last week I had my second “pregnant” appointment with my Endo. If you are a regular reader, you will remember that we have had some … er .. communication issues in the past.

This visit went better than previous visits, though. I think maybe we are getting used to each other. We are, after all, seeing each other once a month now. Granted, he still does not respond when I send him my weekly BGs, and still complains when I send them a day or too late, but his pluses are starting to stack up and offset his minuses.

In particular, I was especially pleased with the way he handled the OB when I was admitted to the hospital for IV fluids. You see, I am still only seeing the “regular” OB, not the high risk one, because I am so early in this whole pregnancy journey. His office typically does not do much with type 1 diabetics and the hospital in our city does not even perform deliveries for  diabetics that are on insulin because they do not do IV insulin drips. So you can imagine their concern when I showed up in Labor and Delivery for a couple of liters of fluid.

The nurses were sort of out of their element with me in the beginning. I did my best to ease their worries, but they were simply not comfortable with my just-below-target-range BGs.

But then my OB called my Endo and he seemed to have all of the right words. Apparently the OB was concerned that my sugar might be too low. It was 72 at the time and I was testing hourly (!)

The Endo, now one of my favorite people, assured the OB that everything was fine and that I was doing very well. He instructed them to let me handle my diabetes and to contact him if there were any problems. Can you believe it?! And even more remarkably, the OB consented! This act earned my Endo my Hero of the Day award. If not for his kind words, the OB was considering transferring me to a neighboring hospital for the night where they would be “better equipped” to handle my diabetes. We diabetics know what that means: A total loss of control over our own care. What a relief that I would not have to deal with overbearing nurses, “diabetic diets,” and my own stealth blood-sugar tests in between the official ones that the hospital would perform.

Additionally, during this last appointment, I saw the lowest A1C I’ve ever seen. Are you ready for it? It was 5.3! Of course, this has a lot to do with the numbers I have been seeing in the 30’s and 40’s, but it also has to do with the 10-15 tests a day I’ve been doing and the almost complete lack of numbers in the 200’s. The 30 day average on my meter, computed from 360 total tests (12 per day,) is 112! Amazing. I guess maybe this guy knows what he’s doing.

The rest of the visit was also successful. Aside from a slap on the wrist for not testing for ketones while on vacation, he verified that my blood pressure was really good (104/70) and my feet still have plenty of feeling. He will check my Thyroid again next time. It is running a little low, but this is apparently normal in the first trimester.

All-in-all, the appointment was a relief. I spend a lot of time stressing over those couple of high numbers, and his reassurance has meant the world to me. He also reminded me that there is no evidence that BG spikes cause harm to the baby, only highs for extended periods of time. And I am also relieved to hear that the lows are only painful for me, not the baby. Apparently the baby takes whatever sugar it needs and leaves the rest for me.

With that appointment out of the way, I am now stressing about the 12 week appointment with the OB tomorrow.  If all goes well there, I might be able to relax (a little) for the holidays.

Back from the (Near) Dead

So the first trimester has turned out to be quite a roller coaster. After the initial tubal scare, and the relief of a peanut with a heartbeat, we received a third bit of good news … our fourth ultrasound showed a still growing peanut and a heartbeat that was over the 150 beat threshold. We could finally consider this peanut “viable”.

The relief was short-lived though. It was followed almost immediately by morning sickness that would not die. It laughed in the face of the $50 Zofran prescription I took religiously. I was miserable and actually starting to second guess this whole pregnancy thing. Would I actually live through this??

Around week nine, after three weeks of increasing sickness, I finally broke down and had myself admitted to the hospital for IV fluids. I received 3 bags of fluid over two days and a new prescription for the nausea, this one for generic Phenergan. For the first time in nearly a week I was able to eat, even if it was just toast and ginger ale. I started to feel better almost immediately.

The nausea is stubborn, though. It is still hanging around now in week 12, but I am feeling MUCH better than I did back in week nine.

The big D is also doing it’s best to kick my butt. I have never seen so many lows and they come on fast and hard. Despite all of my efforts with temp basal rates and the suspend feature, I still find myself sometimes hovering in the 50’s and 60’s with quick dips into the 30’s and 40’s I have even seen a few numbers in the 20’s … wow, that’s scary.

My low-blood-sugar-treaters-of-choice have become apple cider, Carnation instant breakfast, and Jelly Belly jelly beans. In fact, I am forcing a pint of apple cider into my over-full belly as we speak.

As the first trimester nears its end, I am preparing for my 12-week ultrasound, and feeling nervous yet optimistic. Sometimes it is still hard to believe that there is a baby in there, and I am still worried that the technician will find something on the ultrasound, but I am getting a little more used to the idea of being pregnant. At times, it seems like the time will never come when I will finally hold this baby in my arms, and at other times, it feels like the time is just whizzing by. 12 weeks already! And I spent most of it curled up in a ball in bed. There is so much to do and so little time!

Sick and Tired

Nothing new today. Just more of the same. Sick and tired.

Real (Pregnant) People Sick

I’m still struggling with nausea and the remnants of that stupid H1N1 flu shot.

Yesterday I called the OB to ask if there is anything else we can do besides the Zofran. It seems that my love affair with that little pill was very short-lived. It turns out the only other thing we can do is IV fluids … which I would have to receive at the ER. Yuck. So I am forcing the fluids and testing for ketones. Luckily I’ve only had negative to trace amounts so far.

I read Lee Ann’s post over at the Butter Compartment this morning about guilt and I could really relate. My husband had planned to stop at Walmart last night to pick up some things for his lunch this week. I asked if he would pick up some Ketostix, Pedialyte popsicles, and chicken broth. He went to three stores, never found the popsicles, and forgot his lunch items altogether. I am so glad to have him. What would I do without his help at a time like this? But it is definitely hard to let him accept some of my burden. The guilt is indescribable. I have been building a post about this topic in my mind for some time now, but I want to give it the time it deserves.

That’s all from here for now. It is taking all of my energy just to get out of bed this morning.

Zofran, I think I love you

Our visit with the OB was relatively positive yesterday. The heartbeat is up from 97 to 119. I still have to go back in a week to make sure everything is growing.

We got another ultrasound picture … a white blob with a blinking black center suspended from a white yolk sac. I’m sure that it doesn’t look like much to the outside world, but it is beautiful to us. We hung the picture on the refrigerator. I am getting less and less nervous with each visit.

One of the highlights of the visit was the prescription for anti-nausea medicine. The doctor prescribed Zofran and I am actually starting to feel human again. Don’t get me wrong, I don’t feel normal, but this stuff is definitely taking the edge off and I am preparing for a day at work (and out of bed) for the first time in almost a week.

Of course, it makes me a little leery that the drug is not actually approved for use during pregnancy, but there is a lot of good anecdotal evidence out there, so I am just hopeful that everything works out. And for the first time in five days, the scent of my own deodorant (powder fresh?) is not making me gag.

H1N1 Shot and Morning (and Noon and Night) Sickness

I got a H1N1 shot last Thursday afternoon. I waited in line for three hours at a clinic run by the county health department at the fairgrounds. It was just like what you see on the news. Gobs of “Tier One” people and small children waiting in long lines outside in the cold.

Don’t get me started about how broken our health care system is.

The bad news is that between the effects of the shot and my morning sickness-turned-all-day-sickness, I can hardly get out of bed. I have already missed three days of work. In a row.

Our appointment to check the heart rate is this afternoon. We are looking for a number higher than 100. Last week it was 97. After  the whole tubal pregnancy scare, this seems like just  a small concern, so I am not too worried about it. The doctor mentioned that he might be able to give me something for this nausea, too. I am definitely going to take him up on that.

A Peanut with a Heartbeat

I broke into tears of relief when the technician showed us the little blob on the screen. “There is definitely a baby in there,” she said “And there is the heartbeat. Do you see it?”

I nodded through blurry eyes. Yes, the little blob was blinking: in, out, in out.

Next she focused her attention on the mass. “This looks like a pedunculated fibroid. It is on the outside of the uterus near the ovary. It doesn’t look like it is bothering anything. I think it will be fine.”

More relief.

We saw a different doctor this time. She confirmed that the fibroid is nothing to be concerned about. We’ll just keep an eye on it to make sure it doesn’t grow into anything problematic. She was a little concerned about the heart rate, though. At 97 beats per minute, it was a little low, but she said this is not so unusual in such an early pregnancy. So I need to go back on Monday for another ultrasound to confirm that the heart rate  is increasing. She said the age is 6 weeks and 2 days and that my due date is June 29.

She was also mildly concerned about my HCG level. She thought it was slightly high for the age of the embryo. Nothing to be too concerned about now, but she suggested genetic testing when it’s time. We had planned to do that anyway.

So I finally got some sleep last night and life is returning to its normal rhythm.  A peanut. With a heartbeat. Inside me. Amazing.

Preparing for the Appointment

I am fasting and preparing an overnight bag. Just in case. I have no idea what to expect. Thankfully I will have my husband with me today. I’m not sure I could get through this without him.