Archive for June 2010

Introducing Baby NoName

June 22, 2010

Just twelve days ago, he was still safe and warm inside of me.

37 Weeks

We were all ready to bring him home.

Nursery

And when his cries pierced the silence in the operating room, our lives changed forever.

Operating Room - Just Born

And today he  is sleeping in the next room!

Sleeping In  My Arms

Sleeping on Boppy

Sleeping in Carseat

Born: June 10, 2010 at 8:16 pm

Weight: 5 lbs 15 oz.

Length: 18 ½ inches

BG: 87

It took over 48 hours of labor and ended in a cesarean section, but Lukas finally joined our family twelve days ago.

Naturally, he is the most beautiful baby to ever grace the planet … would you expect any less? 🙂

He is the poster child for newborn health. His BG at birth was 87 and remained constant from that point forward. Just like the textbooks say, he lost 10% of his body weight in the first two to three days, and then gained it all back by the end of the first week. We are so proud of him!

Obviously, Lukas is doing great. Mom is hanging in there. Between mastering breastfeeding and recovering from major abdominal surgery, I am pretty well spent most of the time. Yesterday I had my one week check up with the OB. He says my level of pain is higher than most. That is, most women are off of the major pain medicines in a week and just taking occasional ibuprofen. I am still hitting the Vicodin every six hours and the ibuprofen every six hours, too.

I also met with the lactation consultant yesterday, who helped a bit with our latch. Hopefully this will be the kick we need to beat mom’s soreness and move forward with breast feeding. Lukas is stubbornly attached to mom and her breast milk. He resists the bottle and the pacifier. I wonder where he gets his stubborn streak ? 🙂

My blood sugars have been erratic to say the least, but mostly on the low side. Thank goodness for my insulin pump so that I can make quick adjustments to my basal and bolus rates.

Sorry that this post is so short, but Lukas is finally sleeping and I really need a nap. Stay tuned for posts about my failed induction, my c-section, our experience in the postpartum unit and our first few weeks as mom and son.

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One final update before the big day

June 4, 2010

We’re down to just a weekend before the big amnio. If all goes as planned, this might be my last post for a little while. I’ll do my best to at least post a couple of pictures once Baby NoName finally makes his big debut, though.

In the meantime, here is an update on my and baby’s health over the course of the last couple of weeks.

As has been the case throughout this pregnancy, Baby NoName and I are healthy. Neither of us has an diabetic complications to speak of, although I continue to struggle with “real people” pregnancy symptoms like swelling, heartburn, and round ligament pain. These have mostly improved now that I am on my “staycation” and resting more.

For the last three weeks, though, I have really struggled with my BGs. I’ve averaged about 100 throughout the entire pregnancy until these last couple of weeks. Now my average is up to 120. I’m seeing an alarming number of post-prandial readings in the 170-180 range and an occasional number in the 200s. Of course, I do my best to bring these numbers right back down, but they are alarming after all of the great numbers I saw up until this point. I have no idea how much of an effect this new development will have on baby’s BG when he is born, but you can be sure I am worrying about it. Hopefully all of the good numbers I’ve managed to accumulate throughout the pregnancy will offset some of these higher ones.

It seems that my basal and bolus rates are increasing every two to three days. And the needs are not consistent. One day this week, I used a 140% temp basal all day, and the next day, my numbers dropped back down into the normal range.

My average daily insulin intake is up to 82 units, up from 35 units pre-pregnancy and up from 75 units a couple of weeks ago.

I’ve gained about 17 pounds over the course of this whole journey. Given that I came into this at a less than ideal weight, I was hoping to keep my weight gain to about 20 pounds or so, so I am pretty happy with this number. Still, I am not exactly thrilled with my new, flabby and water-logged figure. I do my best to avoid seeing my rear end. It has widened considerably. And my arms and legs look increasingly like stuffed sausages. Yikes.

Psychologically, I am a bit of a mixed bag. I am so excited to finally meet this little guy. But I am scared and nervous, too. Can I actually do this? Childbirth? Breastfeeding? Childcare? What if it turns out that I am not “mom material?” I’m sure we’ll figure it all out as we go along, but that doesn’t mean that these thoughts don’t keep running through my head.

Spending the last couple of days at home has not helped. When I was always running to work and appointments, I didn’t really have time to think about what was coming up next. But now that I’ve had a chance to relax and regroup, it’s given me time to think about these types of things.

Tip of the week: Avoid the TLC channel and the shows Baby Story and Bringing Home Baby during the last couple of weeks of your pregnancy. I’ve seen all sorts of births on TV this week: c-sections, at-home births, natural births, medicated births. In one episode, the mom was in so much distress that the doctor asked the camera crew to turn off the cameras so that they could deliver the baby. My mind made up all kinds of scenarios for what happened while the cameras were off.

My life is about to change in ways I can’t even begin to imagine. And this is something that I’ve always dreamed about. The journey has been long and stressful but oh so worth it. But I realize now more than ever that this journey is not even close to over. In fact, you might say that it’s just beginning.

Maternity Leave: The Ins and Outs

June 2, 2010

So I am officially on maternity leave now. Technically, it is a sort of pre-maternity-leave vacation. You see, my company requires that I use any remaining vacation during the first days of my actual FMLA/short term disability leave. That is, all types of leave, including vacation and sick time run concurrently, or at the same time. So you can’t use your vacation and then use your FMLA and then use your short term disability. The clock starts ticking on all of them on the day you begin your leave. In my case, this is the day the baby is born.

The really crappy part about this is that my HR department did no clarify this requirement with me until I was already in my third trimester. Too late to travel to an exotic location for a “baby moon.”

So I am on a “staycation” now. At home. With swollen ankles, sore hips, and heartburn. I’m trying to put the time to good use, though. I am preparing the house for our little one’s arrival. It is slow going, though, because I am tired, swollen, and sore. I spend more time on the couch resting my fat ankles than I do actually preparing. Today our new mattress is being delivered, so I am here to manage that, and then it is off to Target for some last minute baby items. I’m also on the lookout for a seamstress who can sew up the cushion covers for my deal-of-the century, hand-me-down rocker/glider.

You might remember that my struggle with my company over maternity leave was a bit emotional for me. I work for a small company where only one other co-worker has ever been pregnant. So the company has no written policy on maternity leave, and it seems that the policy changes pretty regularly to suit the whims of a few select people in charge. I was really hoping to avoid that kind of battle. I just didn’t need it on top of all of the appointments and tests and emotional ups and downs I was already facing.

In the end, though, probably because I am so darn stubborn, I was able to negotiate what I consider to be a reasonable amount of time, but it is not without risk. And, of course, none of the time is paid except for the 6-8 weeks of short term disability which are paid at 60% of my normal wage.

This is what I was able to cobble together:

  • 4 days of personal leave and 4 vacation days before my leave actually starts. I structured the leave so that the first day of my actual leave will fall roughly on the day the baby is delivered.
  • 6 weeks of short term disability starting on the day the baby is born. I am using 5 days of vacation to cover the elimination period. If I have a c-section, I will get 8 weeks of short term disability leave. The amount of time you get under short term disability is based on the amount of time your doctor says you are unable to work. Typically, your doctor will allow 6 weeks for a vaginal delivery or eight weeks for a c-section. Your leave might be extended if you have complications. If your doctor requires you to be off of work longer than your short term disability coverage lasts, you might then get long term disability. Not all companies offer short term disability leave and the benefits under it differ depending on your plan. Some states require that the company provide a certain amount of short term disability leave, but mine does not. Another important note about short term disability: Many plans have an “elimination period” in which you do not receive benefits. In my case, this is the first week. You can use vacation time to cover this financial shortfall. This is what I decided to do, but only because my company did not give me enough notice to use that vacation for a proper “baby moon.” I would have preferred to have the extra time off and sacrificed the pay during the elimination period.
  • 12 weeks of FMLA (Family Medical Leave Act.) This also starts on the day the baby is born. So basically, I’m losing the first six weeks of FMLA leave because they run concurrently with the short term disability leave and the five days of vacation. Also, you can typically use FMLA time intermittently, as opposed to using it all in one block. Unfortunately, there is a clause in the law that allows companies to force you to take all of your FMLA time in one block if you are taking it for the birth or adoption of a child. A total crock, right?
  • A leave of absence totaling four weeks. This leave is not required by law; it is an extra leave benefit at my company that is approved on a case-by-case basis. Thankfully, this leave does not run concurrently with my other leaves, so it extends my total maternity leave time to four months. Unfortunately, since I will no longer be protected by FMLA, the company is not required by law to hold my job for me during this leave.
  • When I return to work, I will return part time. One surprising perk at my company is that if you maintain 25 hours per week, you can keep your insurance benefits. So I will return to work three days a week starting in October. I will continue on this part-time schedule until the end of the year. I’m losing some vacation and my bonus is going to be pro-rated as a result of the drop in my hours.
  • At the first of the year, I will return to my normal full-time schedule. However, the company is completely within their right to deny me full-time status if they do not have enough work to warrant my return.
  • One other benefit I managed to squeeze into the plan was for my company to cover my tuition for my final MS class which just started last week. This is huge for me, because that class costs over $2,000. The way I understand it, the company does not have to cover the class by law; the only benefit that FMLA requires them to offer me while on leave is health insurance. I argued that, because of the repayment clause in out tuition reimbursement policy, if I decided not to return after my leave, they would get their money back. If I do return after my leave, as is my intention, then they get the same benefit they would have gotten if I was not on leave (a more educated employee.) I think that argument helped.

Anyway, that is the low-down on how my maternity leave panned out. I learned a lot more than I ever wanted to know about the laws surrounding maternity leave, disability, and discrimination during this process. I hope I never need to know these things again, but it is good information to have in my back pocket should the need arise.

Finally, an Update

June 1, 2010

First, let me thank the couple of readers I have who have hung on with me through my most recent hiatus. Things are getting kind of crazy in my little world now and blogging has definitely taken a back seat. Without further adieu, here is an update on what’s going on and how things are going.

I am officially 36 weeks pregnant today. Baby NoName is still passing his non stress tests with flying colors. I was scheduled for one yesterday, Memorial Day, and the Fetal Eval Department was closed, so I had to go to Labor and Delivery for the appointment. It was kind of nice to get a sort of dry run for finding L&D and where to park again. The maternity ward was pretty quiet. I’m hoping for the same environment on the big day.

Luckily, when we arrived at the reception desk, I recognized the L&D nurse from the Fetal Eval Department. She fills in there from time to time. Along with Baby NoName’s regular kicks and heart beats, she also recorded two contractions. She says this is normal at 36 weeks. They are just “practice” contractions. They were so weak that I didn’t even realize that they were contractions. They felt kind of like Baby NoName was stretching inside my uterus and just pushing his little walls to their limits. If I have more than six in an hour, I should call my high risk OB.

We officially have a plan for the birth now. Seeing as both baby and I are healthy, we have planned a tentative induction for 37 weeks. That’s next week! I think that if I had resisted and tried to wait this out until closer to 40 weeks, my doctor would have agreed, but the truth is I am tired and grumpy. The testing and prodding and doctor appointments are really starting to get to me. I’m not sure how much longer I can take this routine. Couple that with an increased risk of fetal death in the last month for type 1 diabetic moms, and I am more than ready to get this show on the road.

So the plan is that we have an amniocentesis scheduled for next Monday. The amnio is used to check the maturity of Baby NoName’s lungs. Apparently, the only real risk with an amnio is contractions. When you get an elective amnio in the earlier stages of pregnancy this is more of a risk because it can lead to miscarriage, but at this late stage, the risk is much less because the baby is much more likely to survive if you go into early labor. Basically, contractions at this stage are OK because we are more or less ready to deliver the baby anyway.

If the amnio shows healthy, fully-mature lungs, then we are ready for the induction. If my cervix is not yet dilated, I will be admitted to Labor and Delivery the same evening for Cervidil. This is a prostaglandin gel that they apply to the cervix to soften and thin it. Then they will start the Pitocin through an IV in the morning. Pitocin is an artificial version of oxytocin, the hormone that my body would make naturally during labor to cause contractions.

If I am already starting to dilate on my own, then we will just wait until the next morning, skip the Cervidil, and start with the Pitocin.

I am a little freaked out about the whole induction process. I’m reading that Cervidil can cause painful but non-progressive contractions. And Pitocin can cause contractions to be more painful, but ultimately not work well enough to progress the labor. I have heard horror stories of inductions that last three agonizing and exhausting days and then result in c-sections anyway. It seems that sometimes induction works and sometimes it doesn’t. I expressed my concerns to my doctor who told me that these scenarios are all possible, but that there is no way to know if induction will work until we try it.

He is strongly in favor of induction over a straight c-section given that Baby NoName and I don’t have any of the standard diabetic complications. It is hard for me to believe, but my eyes, my kidneys, my blood pressure, baby’s heart, baby’s weight, and baby’s spine are all perfect. I guess all of those late-night BG checks and the never-ending appointments are finally paying off.

So I made a deal with him. We will try induction for one day (24 hours if we have to use the Cervidil the night before.) If I am not progressing and am not at least semi-comfortable, we will move forward with the c-section rather than waiting another day or two as is his standard procedure.

In the end, I think it just comes down to me freaking out about the whole labor and delivery thing. No matter what route he takes to get out here, it is not going to be a walk in the park,. So ultimately, it doesn’t really matter which avenue he chooses as long as he is healthy.