Archive for March 2011

Discipline(d) breakdown

March 11, 2011

It’s Friday – my favorite day of the week because I get to spend it with my little guy. I usually take advantage of my day off by doing all of those little things around the house that just keep needing to be done … laundry, dishes, bathrooms,  kitchen … the list goes on forever.

But today I have been especially undisciplined. Lukas has been sleeping for a record-breaking two and a half hours now and I’ve spent the majority of that time reading blogs, watching TV, and listening to the never-ending rain. I even took a nap (gasp).

My diabetes care gets a little sloppy on days like this, too. This morning, I absent-mindedly munched away at a half a box of Dots while watching meaningless TV before I realized what I’d done. Afterwards, I quickly over-bolused, which resulted in a 219 an hour later and a 40 just a half hour ago.

I realize it’s not the end of the world that this happens every now and then, but I struggle to allow myself such luxuries. Because I fear that one day of indulgence will lead to a downward spiral of sloppy eating habits, poor testing routines, piles of dirty laundry, toothpaste-spattered bathrooms, and crusty kitchen countertops.

Hopefully tomorrow will be a more productive day. But in the meantime,  what do you do to stay motivated in the face of never-ending BG checks … or mounds of dirty laundry? I could use some advice.

I might go wash the dishes now. Or watch Ellen. We’ll just have to see how it goes.

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Postpartum: In the blink of an eye

March 4, 2011

This post is the final post in a series about my labor, delivery, and postpartum story. When we left off, the entire family had been delivered to my room in the postpartum unit to recover.

See the following posts for a recap:

Read on to find out what happened during our stay in the postpartum unit.

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It was late in the evening by the time we finally got settled in our postpartum room. I’m really not sure what time it was, because we had been inside the hospital for going on three days now. The flourescent lights were starting to really throw off my sense of time and place. I was disappointed to realize that my room only had a half bathroom (no shower!!!) and was right outside of the nurses’ station, so was quite loud. But I was so tired and elated and just so full of wonder and fear all at the same time that I didn’t even bother to ask if they could move us. We were all here, together, in one piece (or I guess you could say two pieces :)) and that was what really counted.

I was comfortable at this time because I still had plenty of pain killer from the epidural running through me and a catheter to keep up with my peeing needs. So I was anxious to try when the nurse suggested that I breastfeed. I did so, under the guidance of a gruff and less-than-sympathetic postpartum nurse who seemed bothered by my incessant questions. Lukas latched right on like a champ, and the pain was immediate for me. Too bad that epidural couldn’t have spread just a little further north!

Afterward, the nurse suggested that I pump to help bring in my milk. I complied, after observing her rudimentary lessons, but, looking back, I think this is where all of my trouble with breastfeeding started.
And now a sidetrack about breastfeeding:

It turns out that I really didn’t need any help bringing in my milk – It came in on day two with abundance. However, lacking good lactation advice, I continued to pump in an attempt to build up a “buffer” for when I couldn’t breastfeed. But by the time we were discharged, we already had several ounces of stored breast milk and two really engorged breasts. My totally uneducated opinion is that the pumping I did in the hospital set me up for the oversupply I dealt with later that eventually played a big role in my decision to quit breastfeeding.

So if you wondering about breastfeeding and pumping, here is my advice: listen to your body. If you have plenty of milk, DO NOT pump, not even to build up a “stockpile.” If you’re anything like me, you will end up with more milk than you can use and you will pay for it with sore, rock-hard, lumpy, leaky boobs. So much fun.

Instead, just feed your baby when he or she needs it, and let your body do what it’s built to do. And if you have to supplement with formula at night so that you can get some sleep, try not to agonize over it. A healthy mom is critical to the health of a new baby, and if you are a wreck, your baby will be too.

Of course, everybody is different, so take my advice with a grain of salt. If you don’t have plenty of milk, for example, than you have the complete opposite (and much more common) problem from me. In that case, my advice certainly does not apply.

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The next morning, the nurse stripped the bandages off of my incision, drug me out of bed, and showed me how to get to the toilet. Getting out of bed is a lot hard than it sounds when you have a belly full of stitches. But they had removed the catheter and my body was starting to flush out the swelling that the Pitocin had caused, so I got lots of practice getting to the toilet in short order.

We spent four days in the postpartum unit and it was just an absolute whirlwind. I fed Lukas every three hours and my husband changed all of the diapers. In between, we struggled with an allergic reaction to two of the three pain meds they tried on me, gas pains, general incision pain, constipation, insomnia, and the standard noise and interruptions that come along with a stay in the hospital. It turns out that I had more pain than most new moms, so this added another layer to my struggle to recover.

I had one nurse who was a real diabetes moron. She gave me a lot of trouble for not finishing my lunches and for treating my near-constant lows with orange soda pop. My doctor set her straight, though, and she laid off. Aside from that one nurse, the hospital staff went out of their way to be helpful, which was a godsend when I was struggling with all of that pain. And they did not try to impose on my diabetes management. Instead, they just wrote down my BGs in their logs and kept track of the changes I made with my pump and the food I was eating.

Speaking of the near constant lows, I was hardly taking any insulin at all during those first few days. I had entered my pre-pregnancy basal rates into a profile on my pump before we left for the hospital, but most of the time my pump was on suspend. My insulin needs increased slowly over the next several weeks, but I still had random lows, especially after breastfeeding.

Our days in the postpartum unit passed in what seemed like moments and I felt so helpless. I could hardly crawl out of bed. My husband had to help me shower and get dressed.

By the time we got home, it had been seven days since we had stepped foot outside of the hospital and I was so happy to see the light of day that I could have cried. It was late afternoon on a sunny day in June. As I walked toward the house, I felt the warm breeze on my cheek and noticed the sun glinting through the tall grass. I looked down to see Lukas asleep in his carrier. I just stood there for a moment, trying to take it all in. We were all here and we were all healthy. It was just incredible.

Day Three: The Delivery

March 3, 2011

This post is a continuation of my labor, delivery, and postpartum story. When we left off, the first 48 hours of labor had drawn to a close and I was only five centimeters dilated.

See Labor: Day One for a breakdown of the going-ons on the first day and Labor: Day Two for a review of what happened on the second day.  Read on to find out what happened on day three.

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Things happened quickly after my doctor made the decision to do a c-section. I watched everything as if I were floating outside of myself. I was scared and nervous. It just seemed like a dream. The anesthesiologist came back and injected a boatload of some sort of painkiller into my epidural and they rolled me into a sort of staging area outside of the operating room. Here we waited for our turn.

Once inside, I tried to take it all in, but it was just so much. There were like three or four nurses and two doctors standing at the foot of the table. The anesthesiologist stood behind me. Everything was stainless steel. A nurse asked me if I could move my feet. I tried, but could not, but was not convinced that I was numb. They strapped my arms down to the side of the table like you see on TV and they put up that crazy paper shield right in front of my face so that I couldn’t see anything. I was kind of freaking out.  My doctor was standing on my left and an assistant was standing on my right. Just before the surgery, my doctor leaned around the shield and showed me what looked like a pair of pliers. He says, “I just cut you several times with these and you did not feel it.” I think he was trying to put my mind at ease, but his comment only served to freak me out further.

During the actual event, I did not feel anything. Not even the tugging or pulling or pressure you sometimes here about. Before I new it, my doctor was saying, “He looks good.” He held my baby up over the curtain for just a moment, but I couldn’t really see him because the curtan was basically in my face. I was still pretty freaked out and I said nervously, “He’s not crying.”

They took little Lukas over to a bassinet in the corner of the OR where they had oxygen and all kinds of other treatments, but he didn’t really need them. Just like that, he let out a surprised yelp and then started to cry in earnest. Tears of relief pricked at the corners of my eyes.

Meanwhile, the doctors and nurses were working on putting me back together. They discovered that Lukas’ cord was in a full knot, which explained why his heart rate kept dropping. And they found a large fibroid (the reason for our ectopic pregnancy scare at six weeks), which they removed. As soon as they started to close me up, I felt pressure in my shoulders. Sort of under my collar bones. That and nausea. I mentioned this to the anesthesiologist, who assured me that both were normal (the pressure is a result of gas that is trapped in the abdominal cavity during the surgery) and gave me something that eased the gas pain and Phenergan for the nausea.

My husband took pictures of the baby, of my open belly, of the knot in Lukas’ cord, even of the fibroid. Kind of gross, but I was glad he did it, so that I could sort of relive the expereince later after I had calmed down. I was not able to hold Lukas in the operating room because the pain in my shoulders was too great, but my husband was and we have a great picture of him in his white jumpsuit and “shower cap” holding our little bundle.

It wasn’t long, though, before I was able to hold him. Out in the recovery room, the nurse tested my sugar (the only test that I or my husband didn’t do during this entire week-long event) and then they propped me up and let me hold him. I can’t even describe the feeling. It’s like a dream. It doesn’t seem real. After a little bit of bonding and a few visits from family, they took Lukas to the nursery for a quick checkup and took me and my husband to the postpartum unit. They rolled Lukas into the room just behind us, and reported that he was doing splendidly. His BG was near perfect and he showed no signs of distress. And with that our postpartum adventures began.

Check back soon for one more post about our experiences in the postpartum unit.

Labor: Day Two

March 2, 2011

This post is a continuation of my labor, delivery, and postpartum story. When we left off, the first 24 hours of labor had drawn to a close and I was still only one centimeter dilated!!

See Labor: Day One for a breakdown of the going-ons on the first day. Read on to find out what happened on day two.

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So my second evening in the hospital began similarly to the first evening. They nurse turned off the Pitocin and ordered me a tray from the cafeteria. I was allowed to take a shower and eat a little something before the foley ball would be inserted. Before I was able to shower, though, I started to get pretty significant contractions. This was a surprise to all of us because we had stopped the Pitocin. Luckily the hot shower helped to alleviate the pain and the contractions subsided before the foley ball insertion.

A foley ball is a balloon-like device that is inserted into the cervix through a catheter. Once inserted, the doctor fills it with water to expand the cervix. The expansion is relatively painless. But the insertion is less than pleasant. The doctor could not seem to get the damn thing in the right place. And it hurt. Bad.

The second night passed much like the first night. Testing and waiting and trying to nap between interruptions. Now that we were more familiar with our surroundings, we could make out the activities going on in the rooms around us. We could watch the contraction monitors by the bed and match them to the rooms where the deliveries were occurring. All around us, women were screaming, babies were coming, and families were celebrating. And we were still testing and treating and waiting. By morning, we were more than ready to get this show on the road.

When the doctor removed the foley ball, at least we had some good news. I had dilated to 5 centimeters. Yea! So the next step was to break my water. Which caused immediate, painful, full-on contractions. They came fast and furious. So fast that I hardly had time to catch my breath between them. It seemed like an eternity while I waited for the anesthesiologist to show up and administer the epidural.

So the lesson here? Request the epidural before they break your water. And require painkillers before they insert a foley-ball.

Once the epidural was in and I was comfortable, they started to push the Pitocin again. But every time they increased the level of Pitocin, the baby’s heart rate would drop. At one point it dropped so far and for so long that they started to prep me for an emergency c-section. My husband and I were both scared to death, because they don’t even tell you what’s going on until they have you half wheeled into the hallway. All we could hear was a lot of alarm bells ringing and people talking. There was absolute chaos in my room and a great deal of urgency. And then, just as fast it started, it stopped. The baby’s heart rate returned to normal, and the excitement was over. But as a result, I spent the rest of my labor wearing an oxygen mask and being turned from side to side. Which is especially hard to do when you can’t feel your legs.

At the end of day two, we were exhausted and beat down. The on-call doctor checked my progress and I was still at only five centimeters. Certainly not dilated enough to deliver a baby. So my doctor came in and said we’d be doing a c-section. I was so disappointed. So tired. This was exactly what I didn’t want. But there was no other option. I got a little teary, and started to stress out about what was coming. Major surgery. Yikes.

Check back tomorrow for the details of day three.

Labor: Day One (Finally!)

March 1, 2011

Scrolling through the archives of my blog the other day, I realized that I never really told you all about my labor, delivery, or postpartum experiences. I started a collection of posts on these topics some time ago, but never finished them.

It’s just so hard to explain the rush of activities and emotions that occurred over the course of those seven short days. I  kept trying, but was never satisfied with the results. And then my netbook died, taking those draft posts along with it.

So I thought I might try again. And this time I’ll be sure to back up my files.

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You might recall that the day before my induction, we had an amniocentesis which confirmed that BabyNoName was ready to be delivered. The office assistant gave us instructions to arrive at Labor and Delivery the next day at 5pm.

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We arrived at the hospital right on time at 5pm and the nurses were ready for us. I was surprised by the amount of paperwork to be completed and the details to be finalized. But I was comforted by the fact that the nurses seemed confident in their ability to deal with my “special” circumstances and their seeming interest and concern about my baby’s well-being.

It seemed to take forever, but it was probably only a couple of hours before we finally got started with the IV and then the Cervidil. As a reminder, Cervidil is a gel that is applied to the cervix by means of a tampon-like device that is placed in the vagina. It’s supposed to thin the cervix and, in some cases, can even dilate the cervix. As expected. It caused light cramping, but was not difficult to deal with. I was still allowed to get up, walk around, and use the bathroom on my own.

My husband and I fell into a routine of testing and logging my BG every hour. At one point, I was low and the nurse let us treat it with our own stash of supplies, so from there on out, we took care of my BG.

The Cervidil stayed in all night, and in the morning, the doctor on call checked my progress. Boy was I disappointed to hear that we’d only progressed to one centimeter. One! So next we started with Pitocin through the IV. The Pitocin increased the discomfort of the cramps, but they were still not debilitating. They gave me morphine every four hours or so to keep me comfortable. We also used the exercise ball to sort of massage away the pain and to try to take advantage of gravity.

The nurses really went out of their way to keep me as comfortable as possible, and they were very hands off with the whole BG control thing. They wrote down everything I did, from BG tests to basal adjustments, to low treatments, but really stayed at arm’s length. One nurse told me that as long as I was able to keep everything under good control, they would let my husband and I handle it. But if things got out of control, they would step in. And they kept their word. I was impressed.

So after a whole day of labor with low levels of Pitocin, another on-call doctor checked my progress. Still one centimeter. No, I’m not joking. Oh, how I wish I was! At this point I had been in “labor” for about 24 hours. My doctor stopped in and advised me that they would next try a “foley ball”. I’d never heard of this procedure before. Fair warning: if anybody ever suggests it, consider running in the opposite direction.

Stay tuned for “Labor: Day Two”