Tuesday, 5 June 2012

He's Arrived!

He's here! 
Arthur James arrived on 29th May 2012 at 05.12am at 35 weeks + 4 via forceps delivery. Arthur was taken straight to neonatal after his birth and is still in special care at the moment but doing very well and hopefully home with us very soon. He is a week old today! More details to follow, but I may take a blog break for a short while!

Friday, 25 May 2012

Hospital Life

As I said last time I am settling into the hospital life routine, however there are three things that I wanted to share with you about what I don't like about hospital life and what you should prepare for should you be in a similar situation!

1. The food! This is getting quite funny now because they just can't seem to bring me what I ordered. Every day (up until today actually) I have asked for a sandwich on brown bread. I have circled 'BROWN BREAD' in capital letters, underlined it, double circled it and underlined it at the same time and every day they bring a white bread sandwich. Today when I got back to my bed guess what - I had brown bread!! But not Ham & Tomato like I ordered, it was Chicken Mayonnaise! Evening meals are pretty much the same, you ask for one thing and get given the complete opposite. Last night I asked for an omelette and a yoghurt  and I ended up having chicken curry and ice cream! Breakfast seems to be the easiest to accomplish.

2. The stockings! I knew I would have to wear stockings to prevent blood clots if I was to have a c-section but I didn't realise I would have to wear them ALL the time. Even in  this heat! They are very fetching white knee hot socks. They're on it too, you can't fool them, if you take your stockings off they are on you like a shot! However it seems you can take them off for outings, thankfully I don't have to sit here typing this in Starbucks with them on.

3. The heat! This is only an issue at the moment because of the heat wave we are having but it is like a greenhouse on our ward. What a week to be in labour! Add point two to point three and the result is not good.

Now that I have moaned about all that I feel like I should say something positive. So on the plus side everyone has been lovely and the midwives are fantastic, which is the main point over the food, stockings and temperature!

Just a couple more days to go till my induction, I will try and squeeze one more post in before then!

Wednesday, 23 May 2012

34 weeks + 5 update...Plan C?

The plan for his release has changed!

Yesterday I saw the obs in my appointment and the plan was the same – induction to start Friday but he warned me the baby might not be here before Monday, we would have to see how things went and possibly stop for a little break mid-process, don’t worry I don’t think we would be looking at a constant four day labour or I might be asking the c-section question once again. I spoke with my diabetes nurse and we discussed whether I was happy with it being over a weekend, final outcome was to stick to the original plan.

Anyway this morning they had their weekly meeting (which I mentioned before) where they discuss all their in-patients and they have decided to wait till Sunday before they get the ball rolling. That way when things start to progress my diabetes team will on hand and also my usual obs on call, that's anticipating that he won't pop out on Sunday! As long as all the heart traces stay normal (as they have been) this is the new plan, what are we on now Plan C I think? I’m still allowed out for a few hours at a time so if this good weather lasts I will hopefully be able to enjoy some of it this weekend.

So it looks like he will still be a May baby, but which date?! For those who don’t know already I have a thing that I would like him to be born on a nice round, even date. But the month of May has messed that up already! Will it be Monday 28th, Tuesday 29th, Wednesday 30th? Monday or Wednesday would be my preference, I may have a different view if I am in labour a long time, I doubt I will be worried about hanging on for the 30th!

Tuesday, 22 May 2012

Sliding Scales

All is good here. I am settling into hospital life and routine and Friday when my induction is scheduled is fast approaching! I'm getting used to the daily routine of monitoring - see above!

I mentioned in my last post that I went onto a sliding scale whilst I was being given steroid injections to help develop the baby's lungs, apparently this is because the steroid injections can send your blood sugars all over the place. I came off my pump on Tuesday afternoon before my first steroid injection and stayed on the sliding scale until Thursday afternoon after my final injection. At first I was just on insulin then they added a drip that was a mix of saline, potassium and glucose.

Basically how it works is they/you measure your BG hourly and then the slide is adjusted depending on the result. I was on rates between 1-5. One when my blood sugar was at it's lowest (i.e. normal levels) and five when it was at its highest.  

Each time I ate my BGs rocketed and I was on a scale of 5, with it taking a few hours for my BG to come down. After breakfast one day it hit 17mmol/l and I kept questioning them about the sliding scale and how it was obvious that every time I ate I needed more insulin and wasn't being given it quick enough. (For example I could eat at 1.10pm but the sliding scale wouldn't be adjusted till 2pm). Some of the doctors/midwives were saying it was fine it was the steroids etc. but I knew there just wasn't enough insulin being given to me to cope with eating. I spoke with my diabetes nurse and she said that sometimes people gave an additional bolus when they ate but seeing as though I wouldn't be on the scale for long it was probably okay, we would also have to work out how much bolus to give and that could be difficult.

I was getting quite stressed and annoyed about it, after all I had been putting all my effort into not getting BGS of 17 mmol/l and here I was in hospital running higher than I had in weeks. Also apparently it is protocol to give the glucose/potassium/saline mix - although I have since found out that this really should only be given if you are not eating and I was eating! Clearly some confusion along the way...

It was Thursday morning when I spoke my diabetes nurse again and she told me that one of my diabetes doctor (I have two - one more focused on the baby side, one more focused on the diabetes side) had said she never wanted me to go on the sliding scale, she had wanted me to stay on my pump. It was the other doctor who said I should be on the sliding scale. I came off the sliding scale that afternoon based on this and guess what by evening time my BGs were down to normal and an hour after my evening meal I was 7.6 mmol/l. 

So now I am anti the sliding scale! I have said that when I get induced on Friday there is no way I am automatically going onto the sliding scale. I would like to be given the opportunity to self manage for as long as possible. If I get to the point where I can't eat, start vomiting or am completely our of it and can't manage then I will give in and go on the sliding scale but until then it is me and my pump! I have been told my diabetes doctor will fully support me on this. 

Tomorrow I have an appointment with the obs so will be bring this up with him and I will be flagging up the fact the sliding scale was useless. We may have a fight on our hands! 

Friday, 18 May 2012

34 week + 0 update

Can you guess where I am then?

Lots has happened since my last post as you can probably tell from the picture. I had a couple of half written posts and each time I went back to them they were now out of date as things had moved on so much. This could become quite an essay but I will try and summarise and come back to the details another time.

I’ll tell you the outcome first and then work backwards so as not to leave you all in suspense! At the moment the baby plan is to induce me next Friday 25th May  (I never expected a May baby!) when I will be 35 weeks pregnant. The reason being is that as well as the concerns over the baby’s growth they are also worried that a drop in my insulin requirements recently could indicate that my placenta might be starting to fail. So best to get him out but it’s all about timings, not too early and not too late – a bit like a nice joint of roast beef.

I came to the hospital on Tuesday for my regular appointment with the obstetrics team and also for another growth scan. The scan results weren’t too alarming, when I looked at the graph relating to his tummy size of course it had increased but it hadn’t gone steeply vertical it had progressed along on an upward curve. Estimated fetal weight was 6lb 9oz, I had in my head between 6-7lbs, so just under 2lbs weight gain since the last scan nearly four weeks ago.

In my obstetrics appointment I explained that over the last five days I had reduced my basal doses by 40% across the board as my BGs just seemed to be dropping and I was having to eat quite a few extra sweets and snacks without insulin to maintain normal levels. I hadn’t thought in depth about this to be honest, I had thought it was a little early for my requirements to be leveling off and had a fleeting thought as to whether I could actually be further along in my pregnancy than I thought. They said I wouldn't be that far ahead, a few days maybe but not a few weeks. There were a few discussions about my blood sugars etc and then the words I knew may come before I even reached 36 weeks ‘we’re going to admit you’. I savoured my last hour and went and got a coffee and made some calls before heading up to the maternity ward. Even though I know my hospital quite well I had never ventured up to here before and it felt very much like when you arrive at a hotel and need to work out where everything is. What was ironic was that we were booked to do our maternity ward tour later that day, I didn't need one now I was going to experience it for real! Within a few hours I had been passed from pillar to post and finally settled in the third bed they put me in and it was there I stayed until this morning.

On Tuesday afternoon I was given my first dose of steroids via injection in order to speed up the baby’s lung development. I was also put onto a sliding scale of insulin (I think I will probably do a whole post or should I say vent on sliding scales later!) and taken off my pump, my BGs were then monitored every hour and the sliding scale adjusted accordingly. Nothing else really happened on Tuesday in terms of finalising the plan for birth etc. but on Wednesday morning I was the hot topic (well that’s what I like to think) in the morning meeting between the doctors, paediatricians and who knows who else. The report came back to me that they wanted to hold off another week if possible and induce when I reached 35 weeks. In the meantime I was to stay in hospital to be observed and for the baby to be monitored three times a day to check he was okay. When I pushed them to ask if it really was necessary for me to stay in between now and the birth they said that it was a recommendation and that they wouldn’t keep me here unwillingly but if anything happened whilst I was away from the hospital they wouldn’t take responsibility. It was just like the Australia saga all over again…
Being type 1 there is a chance of still birth and they threw it at me that if anything happened when I was here I could be in theatre within minutes, at home the outcome could be much worse so what was one week in hospital putting it all in perspective? That doesn’t make it easy though for some reason I long to go home even though I am only a couple of miles down the road!

There’s loads more to tell and lots of updates for those interested in all the diabetes details but I’ll leave it there for now and let you digest. Blogging from hospital isn’t impossible but with no wi-fi I will now venture off to find myself a little wi-fi spot so I can post this online. One week from today it should all be happening and unless anything changes I will keep you well posted in the meantime.

P.S. This photo is already out of date they have moved me again since I took this, now on bed no. 5!

Thursday, 26 April 2012

Growth Update

Following my post at the weekend about my 30 week scan I thought I would post an update on what happened in my follow up appointment.

It turns out the increase in baby's tummy measurement is a little extreme, it's unusual for it to get so big so quickly and is likely to be due to the difficulties with my control over the last few weeks. Although they did say this could of happened if I wasn't on holiday I can't help but think that it wouldn't of as at home I would of been following my normal routine and foods and also probably had an antenatal or pump clinic appointment too.

Anyway, the goal now is to stop it increasing upwards sharply and for it to increase steadily. My doctor discussed the scan results with the obstetrician whilst I was at the hospital and he has confirmed delivery is likely to be at 36-37 weeks, so 1st-8th June - not long! I will now be monitored on a weekly basis and have another appointment with the obstetrician on Tuesday.

I have a whole heap of questions for my next appointment on Tuesday as it suddenly seems so near! At the moment they are saying I will either be induced or perhaps go straight to a c-section, it depends, apparently the baby is in a very good position if I do get induced. When the midwife examined me she said the head was VERY far down and asked could I not feel it? Well I can feel something but being my first pregnancy I don't know what to expect! I am pretty sure she said he was two fifths engaged and she said that was good because he is in position softening the cervix and ideally with me it would be good if he was ready to come early. Just not too early I hope!

So in my efforts to curb this little ones growth I am now back onto weighing everything that passes my mouth, filling in my monitoring diary religiously and studying the results and making changes every couple of days as needed. My basal doses have increased dramatically and for every meal I am now bolusing 1 unit for 5g of carbs. I seem to be getting back on track so hopefully can continue in this way.

More reports to follow as the clock continues to count down!

Sunday, 22 April 2012

Sweet Dreams?

I'm really looking forward to my bed tonight as today I treated myself to a pregnancy pillow! 

Sleeping in several different beds over the last few weeks has produced varying results and it has been nice to be back in my own bed. However despite being home getting a really good nights sleep is getting harder because of my growing bump and increasing back ache. I have been using a pillow between my knees but most nights I wake to find I have thrown it out onto the bedroom floor or I am suddenly lying on my back. Turning over is another mission, the first step being to find my pump and put that on the side I am moving onto, then I start to manoeuvre myself, it's very much like a three point turn! Often I find the other side isn't as comfy as I thought and I have to complete the whole process again to get back to my other side!

So today I decided to splash out on a treat for myself and buy a dream genii pregnancy pillow from Mothercare, which if you read all the marketing bumph comes highly recommended not only from mums-to-be but also by midwives and is also certified as a Class One Medical Device. I'm coming to the end of my pregnancy almost but as this also doubles up as a feeding pillow I thought I would make the investment. The RRP is £45.99 but Mothercare's price match meant that we only paid £36.99 - the price on Amazon which we showed them in store on my iphone. It's such a good deal, nearly everything we have bought so far in Mothercare has found us price matching!

So far I have tried it out in the car on the way home from the shops and it has been on the sofa with since. It promises a 'magical night's sleep', with my return to work tomorrow I think that is what I need, I'm off to give it a try!

Saturday, 21 April 2012

30 Week Scan

I had my 30 week growth scan yesterday. As I mentioned in my last post my control was a little up and down during my recent travels and I had hoped this wouldn't of had too much of an effect on the baby.

Well he has certainly piled on the holiday pounds! I can't believe how much he has grown in just 4 weeks. It looks like he is heading towards big baby syndrome...his tummy and overall weight are now measuring at 36 weeks, whereas all his other measurements are spot on for my 30 weeks pregnancy. Exactly what I didn't want to happen. His abdominal circumference is 319.0mm and his overall estimated fetal weight is 4lb 13ozs. Although the sonographer told me not to worry as this is completely common in those with diabetes I can't help but feel a little concerned and disappointed at this stage.

Speaking to a couple of people there are a lot of stories of inaccurate growth scans, people being told their babies are 10lb+ only to be born and they are well under. But I am sure there are also a lot of growth scans that are accurate too!

My next antenatal appointment is on Tuesday so I will be able to discuss the results of the growth scan with them then and get their thoughts. In the meantime I am on super control mode now that I am back on home soil. The lovely sonographer did a sneaky 3D scan for me, he looks sounds asleep but really he couldn't keep still, it seems there is still plenty of room left for kicks and turns!

Wednesday, 18 April 2012

Fun in the sun...

Lots has happened since my last post and I must admit I got into holiday mode therefore so did my blogging! We are now in Bangkok on the last leg of our trip and very nearly time to head home. Just a quick post for now and more travelling stories will be shared when I am back.

One thing that has changed dramatically during our holiday are my insulin requirements - I am definitely noticing the third trimester insulin intolerance now! My record so far for my total daily dose is 63 units (about double of what I took pre-pregnancy). I have had to increase the maximum daily bolus dose setting on my pump twice since we have been away. I had completely forgotten there was even a setting for this as I have never used it the whole time I have had my pump! It's now set at 70 units but I am sure that will increase again in the next few weeks.

I've also noticed that this increase in insulin means I need to change my pump more often, so it now only lasts about 2 and a half days rather than 3 plus. Another change I was pre-warned about so I have lots of extra supplies with me. The thing I have found most difficult about being away has been not only managing my changing blood glucose levels because of my pregnancy but also the changes due to different activity, temperature and of course food (I have treated myself to the occasional mocktail by the pool - see above!)

I had considered all these elements before we came away but perhaps not to the extent they have made an impact. It has been really hard and there have been times when I have felt like my blood glucose wouldn't shift from a high reading despite my attempts. I have had a good amount of high readings over the last couple of weeks but also a fair few good results so I hope things will balance out. My next growth scan (30 weeks) is on Friday so at least I won't have long to wait to see how baby fared on his first travelling experience!

So for now just one flight remains and then we will be back on home soil. It's been an amazing trip, although I must say I will breathe a slight sigh of relief as we near home knowing my home comforts and of course my hospital are back on hand.

Tuesday, 3 April 2012

Flight Number One - Tick!

Greetings from Hong Kong!

So we survived the first flight with little news to report. It actually didn't feel too long (it was about 11 hours) and I didn't get too uncomfortable, although there is no way I could of done another flight straight away, I am so glad we decided to split up the journey with a few nights in Hong Kong. We were sitting in standard class and as I boarded the plane the air steward commented that they were choca-block today and that they couldn't move me (I had decided to try the approach of not asking to be upgraded in the hope it might happen!) However we did get fairly decent seats, two seats right at the back of the plane on their own so we had extra floor space where the third seat should of been so I could stretch out. I set myself up a nice little seat with blankets for extra padding.

I had been advised to try a temporary basal rate for the flight so I set this when we got given our lunch, however I then decided to cancel it as I thought my basal is pretty much set for me to be inactive anyway (I sit at a desk all day) and I am glad I did as I don't think I needed it. A couple of hours after lunch I ate a chocolate bar without any insulin and my BGs were pretty steady. They crept up a bit later on, I just kept testing and then adjusting as needed. Which is pretty much what I have been doing since we arrived. It's hard to get it right - carb counting random Chinese food is not my forte and a three course hotel breakfast generally doesn't help when it comes to pre-breakfast spikes. Also on the flight they wanted to try and get us into the Hong Kong time frame so we were only given lunch and then breakfast before we landed. Luckily I had taken some snacks with me (always good to do for flights in case you get delayed) and I made friends with the air steward who gave us extra bottles of water and I was allowed to raid their tuck box!

I mentioned in my last post about all my liquids and medication I was taking - in their own little suitcase as you can see from the pic above. The picture isn't that clear but in here I had:
26 Clexane syringes
12 infusion sets
10 cartridges
2 insulin pens
5 Novorapid penfills
3 Levemir penfills
3 Novorapid Vials
Test Strips (about 250)
2 small sharps bins
Needles for pens and finger pricking
Spare blood testing kit
1 bag of jelly babies
Think that's it!....

There was no problem with taking these through security. I just had to get them all out of my suitcase and then they went through the scanner. For the first time though my pump set off the metal detector when I went through security. The lady searching me said it was very unusual (she seems them all the time apparently!) so they had to do a swab of that, but that was pretty much it really. Just three more security checks to go through!

When we landed I immediately changed my pump to local time - for me it was midnight but in Hong Kong it was breakfast time. Our next flight is to Melbourne and is an overnight flight with only a three hour time difference so shouldn't send my basals and insulin into a spin as much.

Baby was doing his usual kicks and spins practically the whole way here, he was probably wondering what all the noise was. Oh and I nearly forgot...the toilet break count! I think I counted 8 trips in total, let's see if I can break that record on Thursday!

Saturday, 31 March 2012

Leaving on a jet plane...

I have mentioned in passing about an impending holiday but have kept tight lipped about it till now, think I have been too busy blogging about other bits and bobs but here it finally is, in true last minute style!

Tomorrow me and dad-to-be are off to Australia via Hong Kong and then Bangkok on our return. Some people don't blink an eyelid when I tell them this, others things we're mad! We honestly wouldn't be going if this was just a jaunt we felt like having for the hell of it before we become parents. It doesn't really mix with the fact I am 6 months pregnant and that for the next year or so we will be on a dramatically reduced income. The reason for this escapade is because my brother-in-law is getting married and we would very much like to be there, all three of us.

We haven't really known for definite if we would go until this week and I guess we won't know for definite until we are on that plane tomorrow! Although I shouldn't need any permission letter to fly out of the UK being just under 28 weeks (after this time you need a letter from your doctor/midwife to confirm you are healthy, have an uncomplicated pregnancy and confirming your due date) I still may be questioned about how pregnant I will be on my return. I have a letter by the way!

It feels like we have been planning and thinking about this for so long, I have been putting things aside - infusion sets, test strips, jaffa cakes - for weeks and preparing much more in advance than I would normally do for a holiday. I ordered a double prescription of insulin (both for my pump and for pens incase my pump plays up) aswell as test strips - 10 boxes in all. I've worked out if I tested on average about 14 times per day I would need about 242 for our trip, I know I have probably over estimated here but you never know, if for example I fell ill I might need to be testing this much.

My doctor has also prescribed blood thinning injections. I need to inject one of these the day before each flight, the day we fly and then for five days afterwards. So with four flights on our whole trip that's pretty much most of the holiday. Flight tights were also on my shopping list, I could probably write a whole post about those, perhaps another time...There is so much medical equipment that I need to take on board that it has its own designated suitcase. I don't think security will know what's hit them with all these liquids and needles!

When I am actually on holiday it will be all about trying to keep as healthy and relaxed as possible. Getting ill abroad is what I need to avoid as that could potentially mean I can't fly and therefore affect our whole trip and whether we can get back home.

I'm ready for a holiday now and by the time we return (hopefully with baby still in my tummy) we will be on proper countdown with just over 8 weeks to go! I'm hoping to do a couple of posts whilst I am away, if my good intentions fail there will be plenty of stories to tell when I get back...until then...

Monday, 26 March 2012

Wedding memories

Two years ago today I married my fantastic and handsome husband (otherwise affectionally know as dad-to-be on here!) I thought this deserved a little post and a chance to share a couple of my wedding pics.

My diabetes thankfully didn't get in the way (too much) on our big day. My pump securely sitting in my big cycling short pants underneath my dress and my blood tester in my handbag along with some jelly babies . My blood sugars were fine throughout the day, I think I ran a little higher at times to ere on the side of caution (like 10 mmol/L) and I remember this picture of me being taken testing blood sugar just before we left the hotel for the ceremony.

I was on target before we sat down to eat our delicious wedding breakfast - tomato soup in bread for me (leek and potato for everyone else), sausage & mash followed by strawberry jelly and ice cream. The only problem I had and thankfully this happened right at the end of the night was my infusion set came off when I went to the toilet, it got caught on my dress and I just saw blood coming from my tummy. Blood and an ivory dress! Luckily no damage was done, my blood sugar was actually a little low at that point (probably all that dancing!) and so it wasn't a problem that I had to wait till we got back to the hotel to put a new set in. I am so thankful that this didn't happen in my last minute dash to the toilet at the ceremony.
My blood sugar was still a little low the next morning and I didn't feel too great, I then over compensated and it went too high which left me feeling pretty rubbish the rest of the day.

But to be honest I don't even think about those things when I look back now, I remember what a great day we had with all our family and friends and how I am lucky to have found my best friend for life.

(All photos copyright of the talented Jodie Chapman)

I 'heart' my pump...

Last night I had to get out an old acquaintance...my insulin pen. Every now and again I forget something to do with my diabetes, for example the other week I got five minutes down the road and I remembered I meant to put a box of test strips in my bag as I only had a few left. Then on Saturday I remembered I hadn't taken my insulin with my lunch until about 20 minutes after I had finished. I don't think I can blame baby brain, I'm convinced it happens to us all with diabetes as there is just so much to think about.

As I went to tuck into my dinner last night I reached down to get out my pump and remembered I only had a couple of units left in it, four in fact. I was frustrated and resigned to the fact my dinner would go cold as I filled my pump and changed my infusion set. Then I had a lightbulb moment, I could just inject. So I got out my insulin pen which has seen little if any action in the last couple of years, I loaded a cartridge and needle and then took my injection. My husband commented that he hadn't seen me do that in years and I agreed, it felt weird, I had to think about what I was doing to make sure I was doing it properly. It felt, let's say, old fashioned. I still used my technology and I inputted into my pump the amount of carbs I was about to eat and my blood glucose and then injected the amount my pump told me to take. As I mentioned in a post last week my doses have been rising therefore I am running out of insulin quicker so need to fill up my pump with more units (I only used to fill a cartridge with just over 100 units for 3 days).

The only problem I had following injecting rather than pumping was when I went to bed last night, my blood glucose was 5.6 mmol/L which was great but lower than I have been recenty before bed. Normally I would check how much insulin I had left in my system and decide if I needed to have a snack before bed. I couldn't do this so I had to take a guess and ate about 12g of carbs. This morning I was still on track at 5.9 mmol/L. It's features like this that make being on a pump so good, I used to 'suffer' from stacking a fair bit (giving more insulin before the previous dose is out of your system) and so being able to see my insulin on board on my pump was a big help for me.

I do love my pump, there is no way around it, I couldn't live without it now. I heart my pump!! My dad asked me last night what I would do if my pump stopped working whilst I was on holiday, I guess after a good cry and a period of devastation I would inject. But it wouldn't be a fun situation to be in, pregnant and on holiday. So please don't let me down pump, this is your big moment!

Friday, 23 March 2012

26 week scan

I had my 26 week growth scan today and I am glad to announce that all still looks normal! No huge head, extra long legs or bulging tummy. It was nice to see him on screen again, it had been too long! However he wasn't up for his starring role and I couldn't really get a good view never mind pictures to add to my collection (well, I did get some but I haven't got a clue what they are and I'm afraid they're not worth posting!)

As he has been constantly wriggling, kicking, tossing and turning lately I was intrigued to see what kind of position he was in. His head was near my cervix on the left hand side and then he was lying diagonally across my tummy with his feet higher up on my right hand side. Plus he was lying face inwards, so no smiling for the camera.

For those interested in the minute detail here are some of the measurements taken:

Biparietal Diameter: 68.5mm
Head Circumference: 248.5mm
Abdominal Circumference: 221.8mm
Femur Length: 49.8mm
Est. fetal weight: 982g / 2lb 3ozs

I've just discovered that the Biparietal Diameter is the head diameter so at the moment it is still pretty tiny at less than 7cms and weighing less than a bag of sugar. Still some serious growing to be done, let's hope he cooks in there a bit longer!

Wednesday, 21 March 2012

Insulin on the up...

It's been a busy few days and my blog love has been neglected! The next ten days or so are likely to be the same as we count down to our impending holiday - more on that in the next day or so, I promise.

I wanted to do a quick update on how I am finding my blood sugars and insulin requirements as I approach my third trimester. As expected I am starting to notice that my blood sugars have been creeping up and therefore my doses have needed a lot more adjusting. I must admit I haven't been as quick on it as I probably should of been. Things had been ticking along okay recently, although my last hba1c had risen from 6.5% to 6.8% and a few weeks ago I was struggling to remember the last time I had a good feast on some jelly babies, which is great to be avoiding hypos but I also knew this meant things were rising.

It's only when I write everything down and assess a week that I can see where things might be creeping a little out. But life has been getting in the way slightly as it does and all of a sudden a few days have gone by and my monitoring diary is looking sparse.

I'm trying to regain that control and today I have adjusted my doses again in preparation for tomorrow's after lunch peak. My insulin to carbohydrate ratio is now set to 1 unit = 5g for lunch, it used to be 10g then 8g then 7g and more recently 6g. I have also increased my basal slightly for the afternoon from 0.500 to 0.550. I could be heading for disaster making these two changes at the same time but I am fed up of getting sugars of 12..11...10 mmol/l two hours after lunch and then it not coming down any further despite knowing that my carb counting at lunch was correct. Something isn't right!

My other ratios have also increased and I know this will happen more and more over the coming weeks. I was taking part in an online diabetes survey yesterday and one of the questions asked how many units I took a day, I was surprised to see I am now on about 44 per day, which has increased from around 32 per day. So it's clear to see my demand for insulin is increasing. It will be interesting to see what tomorrow afternoon holds.

My other motivation for getting things back on track will come on Friday when I have my 26 week growth scan and I can see how things are going size wise. The thumps are getting stronger and I sense it's getting more cramped in there not to mention my ever visible growing bump. I'm intrigued to know if he is normal size or whether we are now on the road to big baby syndrome! Will report back on that front too....

Monday, 12 March 2012

My Diamond Ring

This weekend I met up with some of the girls I used to work with on Slimming World Magazine and we had a lovely afternoon tea. Before you try and guess, no this blog post isn't about the efforts of carb counting afternoon tea, although it could well have been!

One of my friends is also pregnant and one has just very recently had a baby so we were very much on the baby talk all afternoon, we haven't all met as a group since we both fell pregnant so it was a good chance to tell the stories of how we discovered we were about to become mummies, amongst many other natterings. Our accounts couldn't be more different - me knowing practically from day one whereas my friend didn't know she was pregnant till she was 8 weeks. It also highlighted to me again the need to be super organised and 'on it' when it comes to pregnancy and diabetes, if I had gone 8 weeks without knowing I was pregnant I don't know if my baby would be in as good shape as he seems to be now.

We found out I was pregnant last October after trying for what couldn't of been more than six months. I had done a couple of pregnancy tests in the months before and this time I tried to hold off for as long as possible before I did one, as it's disappointing (and a waste of money) when you do one too early to then see a negative result. It was a Monday morning and one of my other friends was staying with us for a few days, only the day before I had told her that we had started trying for a baby, she was very excited, little did I know I already had one inside me!

That morning I went to have a shower and did a test straight away. Seeing a blue line appear immediately, I left the test on the side of the bath and went to the sink and continued with my routine, pretty much thinking that was it till next month. Until I went back to the test and saw a cross. Eek! I then had my shower as normal and hid the test in a wash bag and took it back to the bedroom.

Once my husband started to surface I told him what had happened in the bathroom, knowing how hard things could be and the chances of problems in the first few months he didn't whoop with joy but simply told me not to get too excited. All in hushed voices of course as we weren't alone in the house! (In fact we couldn't really discuss it on our own till a few days later). Then we went about our normal day, well kind of, I don't normally do pregnancy tests in the tube station toilets - I had to do another one just to make sure!

It was very surreal for the first few weeks and it was hard to imagine that I was really pregnant. Then at 6 weeks+4 I went for an internal scan at the early pregnancy assessment unit so they could see what was happening (due to me having diabetes). I was convinced there wouldn't be anything there or what was there might not be growing as it should, but to my amazement there was a little tiny dot with a little heartbeat. It was a like a diamond ring - the diamond being the baby - so very tiny. It's amazing to look at now and think that was how he started and to compare to the more recent scan pictures.

My friend also had an internal scan, but hers was to try and get to the bottom of her stomach pains but led to her finding out she was 8 weeks pregnant! Again planned but still a shock all the same. I was incredibly envious that she had got to 8 weeks without any hideous nausea and sickness!

Having this early scan really helped as it would have been a long wait if I would of had to wait till I was 12 weeks pregnant and I would definitely ask for one if you have diabetes. Again another perk of diabetes, all the extra scans! I will be able to fill a photo album of all the pictures soon!

Monday, 5 March 2012

Fizz, Bang, Whallop!

One of the most exciting parts of my pregnancy so far has been feeling our little baby's first movements. I've been debating the best words to describe it other than amazing and exciting as it's also weird, surreal and strange to feel something actually moving inside you.

For me it wasn't completely obvious when I started to feel him move, it was more of a gradual process that started when I was around 18 weeks pregnant. This being my first baby there were plenty of moments of doubt whether it really was him moving or was it just gas in my tummy. Sorry for the detail but this is what it feels like!! At times like gas passing through your tummy and also like someone doing little flicks on your tummy from the inside. The movements gradually got stronger and more frequent to the point were I knew that it really was him moving without a doubt! And when I had my 20 week scan the sonographer was practically chasing him around my uterus to try and check his measurements. Which admittedly even led me to Google whether an active baby inside meant a hyperactive baby when born!

I can now see my tummy flinch when he does a big move but unfortunately so far daddy-to-be hasnt been able to capture the action as it happens. It's like he knows when Daddy's hand is there or when I expose my belly to try and get a clearer look. The usual tricks you hear about do help - cold drinks, fizzy drinks, the latter definitely sending him to a flurry of somersaults!

My midwife has mentioned about starting to count the movements soon, I should be looking for at least 10 movements a day and recommended I try the tricks above first if I was worried about him not moving (don't think I have to worry about that just at the moment, he can't keep still most of the time!) She also stressed that if I was worried about a sudden lack of movement to call or come into the hospital and mention I have diabetes. I've also just come across this website which seems to have lots of advice and links to useful apps to keep track of movements:

He definitely gets more active when there are voices, it seems particularly those of Mummy & Daddy-to-be. The other week I was working at home and so the house was very quiet and I wasn't having the usual conversations with my colleagues, meetings etc. But then as soon as my husband came home and we started chatting he went for it, spinning, kicking....whatever he gets up to in there!

I will miss his little kicks as he begins to get too cramped to perform his daily gymnastics routine. But I have a fair few weeks to go yet before that happens, I'm sure (and I hope) I have plenty of kicks and thumps and prodding to come yet!

Pic sourced from:http://www.flickr.com/photos/georgieporge/3283174816/

Thursday, 1 March 2012

Time flies when you're having fun!

Time is going way too quickly. I can't believe I will be 23 weeks pregnant tomorrow, if you take into account it's unlikely I will go full term due to being type 1 then I probably only have in the region of 13-16 weeks left to go! It's not that I had forgotten that this probably wouldn't be a 40 week pregnancy, I was just reminded of it on Tuesday when I was at the hospital and saw a different midwife who reiterated to be prepared for things to start happening at 36 weeks. I know that doctors prefer to wait as long as possible (if safe) and that 38 weeks was probably the average. But then I started thinking 36 weeks will be 1st June, I don't plan on finishing work till 8th June!

I like the fact that I know I won't go overdue (must add that to the benefits of diabetes list) as at least I can be slightly prepared and I won't have that endless uncomfortable wait at the end of my pregnancy. But I guess now I pretty much should be prepared for any time in June. Cue slight mild panic. Though I am sure I am not the only pregnant woman to fall asleep thinking of what needs to be done before the baby arrives, how many days I have left at work to finish all my projects, what else we need to buy, how many pay packets will come in before my maternity leave etc etc. I also haven't mentioned that I am off to Australia for 3 weeks in a months time (plenty more posts to come on that later) so my head is now gearing up to that too.

So I need to relish my pregnancy and enjoy it whilst it lasts, it's not quite coming to an end but it's well underway. I should enjoy the sleeplessness just me and my thoughts because soon enough it will be a whole other type of sleeplessness I'm facing!

Friday, 24 February 2012

The Naming Game

Now we know we're having a boy we have been able to do some focused thinking about what we are going to name him. The girls names have been shelved, although I haven't wanted to tell anyone what our top list was in case we ever have a girl, I don't want anyone to nab them in the meantime!

We didn't have that many boys names to choose from (compared to the list we had for girls) despite thinking about it for the last couple of months, we only really have one strong option at the moment. We think we'll go with said name, well we're about 90% sure, or should I say I am, Dad-to-be is 100% SURE. We've made a pact that we will change our minds if any big celebrities call their babies this or if suddenly in the next few months it becomes really common, or perhaps we will just get bored of it. If we still like it come June then it must be the name for him! Dad-to-be is already calling him by said name at every opportunity. So much so that we have had to come up with a pseudonym for him for when we are out with friends and family -we want to keep it a secret so nobody can say 'ugh, I don't like that!'

So we call him Batman. It works quite well, when people are around he is batman when we're on our own he is '-------' [insert your guess here]. Our own little superhero. It seems to be sticking and his sister-in-law is keen to get him his own little outfit when he grows up, funnily enough look what we saw on Saturday when we were shopping...

Saturday, 11 February 2012

It's a....boy!

Well all has been revealed and we are expecting a little boy! The anomaly scan went really well with no problems to report at all. The little monkey wouldn't keep still and the sonographer had a lot of fun chasing him round my tummy to try and take all the measurements.

It suddenly seems a lot more real and even more exciting than it was before. Plus a huge relief to know everything is as it should be, all organs are in place, no deformities and our little baby is healthy and happy in there.

We're officially half way through now - eek! I thought I would post some scan pics. I love the pic clearly stating we are having a boy and pointing to it's boy area, just in case we forget!

Thursday, 9 February 2012

Appointments and more appointments!

This week has been an appointment filled week! I knew that having diabetes would mean I would have my fair share of appointments compared to a 'non-d'. I thought I would be at the hospital every week but it hasn't been that bad I am glad to report.

Tuesday saw me at my diabetes antenatal clinic. I'm having my baby at Chelsea and Westminster hospital who have managed my diabetes with me since I moved to London in 2007. There are designated diabetes pregnancy clinics, mine always being on a Tuesday morning. Normally there is little wait but this Tuesday I waited a good hour to then be seen by three people I had never seen before in my life and who were obviously in quite a hurry because of the backlog of patients. It was very disappointing, all the questions I had written down ready to ask were shelved and I found it really frustrating. The doctor asked me when I had my pump 'fitted' and then told me he wasn't concerned about my high blood sugars just the hypos (of which there was none). The only thing that rectified it not being a complete waste of time was that the obstetrician had a feel if my tummy and we has a quick look at baby. I have my 20 week scan later this week so I really didn't want to see too much! I thought I saw a little something in that area and then decided I am useless with scans and for all I know it could of been anything!

Wednesday afternoon and I was off to Charing Cross hospital this time. In my last retinopathy check up there was a slight change that had been detected and they decided to refer me to a specialist just to make sure everything was okay. I was pretty prepared that this appointment would involve some intense waiting, after all the letter had told me to keep the rest of the afternoon free! The wait was another hour. Luckily everything was completely fine and I felt like a bit of a fraud being there. The doctor couldn't see any problems and said my eyes looked very healthy considering how long I have had diabetes (since Jan 1998).

So two down and just one more to go...my anomaly scan. The most important appointment of all! Really looking forward to seeing if baby is developing okay, hopefully everything will be healthy and as it should. Not to mention we will find out if we are having a boy or a girl. I'm so excited - it's like waiting for Christmas Day!! Next time I post all will be revealed...

Monday, 6 February 2012

Loadsa Money...I Mean Test Strips!

I test my blood sugars quite frequently, I always have done, but even more so now I am pregnant.

I've read the reports and heard the stories about GPs who refuse to prescribe a large amount of test strips and I used to not only think how ridiculous that was but also how thankful I was that my GP had never restricted how many (or the type of) test strips I could have. I went to see my GP when I was about 8 weeks pregnant and I asked whether he could up my prescription of test strips (Abbott Optium Freestyle, 50 strips per box) from 5 boxes to 6 or 7 boxes whilst I was pregnant. He asked me why I needed more and I told him that I was currently testing about 15 times a day, to which he was quite shocked even though I explained that this was what I had been told I might need to do by my DSN in order to maintain good control. This meant that a box was only lasting me about 4 days rather than a week. He was completely puzzled 'What do you do with the results?' he queried. 'Well I act on the result depending on what it is and I write down the results so I can see any patterns' I said. He didn't get it. He said he couldn't increase my prescription as I was already getting a substantial amount and there were people who simply didn't use their medicines, left them at the back of the cupboard and then they went out of date (I would think it was my lucky day if I found a box of test strips at the back of my cupboard!) He said I would just have to order them more often. I left feeling quite frustrated, I understood the cost issue for the NHS but what I couldn't quite fathom was his lack of understanding that I was merely trying to keep my blood sugar under control to try and protect my unborn baby - isn't that what every other doctor was telling me I needed to do??

The next time I went to collect another prescription of strips a few weeks later there was a note attached saying they hadn't prescribed the test strips as I had recently had an order. I was so angry and luckily the receptionist got me a prescription, after all I only had a few left, what was I supposed to do? Now whenever I order any I write in big bold letters that I am pregnant and therefore use more test strips at the moment, it's worked so far and hopefully will continue to do so.

Rant over, I cannot get anywhere near as annoyed with the lovely pharmacy staff who are completely the opposite when it comes to being flexible with prescriptions and my diabetes needs. This was what me led to post about test strips this week. I was worried I might run out of test strips this weekend (seeing as though I can't keep a spare box at home and need to wait till I have nearly used them all before I can ask for any more!) So I went into my local Boots on Friday evening and asked could they sub me a box till I brought my prescription in this week, it wasn't a problem, easy as that. It is this understanding and flexibility that goes a long way, it's hard enough and time consuming enough managing diabetes at times so every little helps. Thank you Boots, if only my GP was as understanding. Grrr.....