Friday, October 31, 2014

Sunday, October 12, 2014

GW is 5!!

I can't even believe it... my little boy is 5 years old.  Part of me feels like this is absolutely normal and nothing strange to wrap my head around as the reality is that I can hardly remember (nor do I want to) what life was like before him.  A bigger part of me, however, is completely floored that the little 7 pounds 14 ounces baby I held for the first time on Columbus Day in 2009 is now 50 pounds, the size of an average 6.5 year old (he's just shy of 3 feet 11 inches) and full of a whole-adult's worth of energy.

Left: age minutes.  Right: age 5 years. 
This kid astounds me.  I'm sure pretty much all parents say that about their children, but getting a front row seat for his development is like watching an unedited version of my favorite show - nothing is censored, nothing is primped and everything is so genuine that I can honestly say I envy his star-eyed perception of the world.  I'll admit that I am sometimes shocked by the things that he does and says, for better and for worse, but to have such freedom and joy of expression is flat out beautiful... even if sometimes embarrassing.

For much of this past year, GW was suffering from a serious case of the "I can'ts" - stubbornly unwilling to identify letters, play structured games by the rules or even wash his hair just because.   Attempting to break this through encouragement and attention, HB and I have been pushing GW to just try things... and, go figure, it's working: 

Reluctantly beginning speech therapy at the end of the summer to help correct his annunciation (for example, replacing the "f" sound for "th"), he appears to have surprised himself with how much progress he can make with just a little bit of effort.  Over the past four months, the number of comments we receive as a family for how much easier it is to understand what he says seems to be directly impacting his confidence and, as a result, his willingness to expand his sentence structure.  Using longer, more complicated sentences to express himself, he wants to talk and ask questions about everything - particularly what new words mean and when he should use them.   His latest words of interest are "wisdom," "convenient" and "immersion blender" (yes, I do think the budding chef in him is interested in the combination of those three... bam!)

For those of you who knew me as a child, you may remember the struggle I had learning how to read due to an ocular-motor disfunction that caused my eyes to operate independently.  Worried this might be an issue our kids will need to address, HB and I decided to have GW's eyes checked and the optometrist found that, unfortunately, he's in the same boat as me and is currently struggling with similar eye teaming issues.  As the correction for this is to strengthen his eye muscles through eye exercises, GW is about ten weeks into his first 24 week session of vision therapy. I remember the process being long and painful as a child, but with GW starting much younger than I did and with his enjoyment of anything exercise-related, I'm relieved that he's breezing through his sessions like it's flat out no big deal. He's still not a huge fan of the glasses he needs to wear for reading and doing school work, but the carrot of not using them after he "graduates" from vision therapy has him motivated to get "big strong eyes" and learn how to read.  Hopefully this will result in a much easier learning curve for him during elementary school than the steep wall I ran straight into and eventually fought my way over.  Fingers seriously crossed!

For the second year, GW is taking music lessons at the local piano school. Starting out last year in a music appreciation course, this year he's moved up to actual piano lessons - something, I'll admit, I wasn't sure he was ready for when the year began back in September.  But much to my surprise, he's taken to music and the piano like a fish to water (Lord knows he's nothing like a fish in actual water, sorry HB).  Able to sight-read the g clef staff in key of c and to use the right fingers on the correct keys, he can play all of the songs from his lessons without looking down at his hands... sometimes he even plays melodies from memory with his body turned away from the piano entirely!  His latest accomplishment was to perform in his first recital during the school open house for the community - he played "Hot Crossed Buns" and "Mary Had a Little Lamb" and bowed very nicely at the end.  I'm ridiculously proud. 

Another thing that made HB and I glow with pride was GW's running in and finishing his first ever one mile road race (no official time, but oh well, that doesn't matter at age 5 anyway).  He's been along for the stroller ride for most of our races thus far, but this time he wanted his very own bib and he wanted to compete!  It was an after dark, glow run that looped the local mall, which meant that the majority of the race was wind sheltered except for the last quarter mile... when we turned that corner and the wind hit GW face-on he whined to me "the wind is pushing me back!" to which I responded "are you going to let it stop you?" and - get this - he yells "NO!" as he started to sprint to the end.   That moment was the first time in his life that he hasn't responded to a challenge by saying "I can't" before even trying... my Mama heart just welled with pride and I waddled (yeah, Baby bump isn't so helpful with a smooth stride any more...) my way after him.  Crossing the finish line with a big smile, he promptly turned around and wanted to give high-fives to all of the runners still coming in...  Doesn't. Get. Better. Than. That.  #EagleEthos

Granted, I can't say that every moment this year has been rainbows and pop tarts, but even with the bumping of heads and the random sticky-yucky-gross moments of childhood it's been an experience I wouldn't change in the slightest.  I am so glad I quit my job to stay home with him and his siblings.  I am so glad that he's still willing to hug and kiss me at school (even if sometimes only in the hall way when no one is looking).  I am so glad that he's my boy and I'm his Mama.   

Happy birthday my silly billy goat gruff, we love you very, very much. 

Monday, October 6, 2014

Week 20: Fetal Echo

One of the challenges I'm finding about having a baby when you already have a child, or two in my case, is that working the baby's fetal schedule into the already complicated, busy family day is actually harder than it sounds.  With 19 weeks to go until baby #3 truly requires his own car seat, planned dinner and established bath routine (remember, I'm not allowed to go past week 39 without induction), his doctor appointments are already clashing with GW's school hours and GV's nap schedule.  Granted, it's pre-school for big brother and nap time can still happen pretty much any where for little miss, but the fact that I'm starting to get a taste of what juggling activities is going to be like and baby bump isn't even baby yet is somewhat comical

As the pre-ramble suggests, I had to move some things around today to get up to a doctors appointment in NOVA.  Due to the elevated AFP levels that we've been seeing over the last several weeks, my MFM is requiring that I see a pediatric cardiologist to examine baby's heart thoroughly with a fetal echo to rule out heart defects as the source of the abnormal numbers.  Given that diabetics with poor glucose control during the first trimester, notably the first seven weeks of gestation, can directly impact the formation of the baby's heart as a result of untreated hyperglycemia it is a logical concern of theirs (and, rightly so, one of mine) that is easily confirmed or ruled out with this exam.  So, taking the first availability we could to see the MFM's  preferred fetal cardiologist, we scrambled our selves and our typical Monday schedule to find out what we could: HB took the morning off of work, GW forfeited his morning school and romp session, GV resigned herself to a reclined rather than prone daily siesta and I held my breath for the ride north in extreme hope that the morning would prove an exercise in multi-child parenting, aka flaming-hoop jumping, rather than necessity.

We arrived at the Child Cardiologist Associates office with just enough time to fill out all necessary forms and initiate a sibling fight over the best child sized chair and waiting room toy before we were directed back to an exam room.  Finding the room to be exactly what you'd expect of a cardiologist, HB immediately began to field four-year old questions about "what's this?""can I touch that?" "do I have one of those?" about the various posters, replicas and kid-friendly props scattered about the counters adjacent to the table on which I impatiently perched.  Showing the kids the "foramen ovale" and various chambers of the heart from his inexplicable daddy-memory, HB kept the kids occupied just long enough for the doctor to come in, squirt the goo on my belly and begin our exam.

whub-whub-whub-whub... click, click, click, click... whub-whub-whub... click...

If you didn't know this already, it's torture watching someone who knows what they are looking at look at something important, like your baby, without commenting about it is they are seeing.  Giving the medical student with him a chance to drive the echocardiogram, two two white coats began to quietly discuss what parts are what, why they conduct sonograms in particular ways and how to check for this, that and the other malformation...  all of which, I then found out, were fortunately not present in my belly and therefore very ho-hum vanilla as teaching-aids.  I would have apologized to the poor student if I actually felt such disappointment were warranted, but frankly my boring belly and I were more than happy to be a non-noteworthy case study and deprive her for one more appointment of something to call home about. THANK GOD!

So, wiping my belly off, bundling the feisty siblings in their coats and scooting HB towards the door, we emerged from this high-stress, directly relevant to my self-/baby-care appointment with a sense of relief.   We're pretty much up-a-creek with the high AFP levels at this point as we've ruled out the main complications it could be leaving it as a likely indication of a prematurely aging placenta, but as I went through this process with GV I at least know what this could imply and the knock on affects we could see with baby #3s development.  The MFM will keep a very close eye on the placenta from this point forward to check for calcification and will monitor baby's growth to ensure we aren't seeing significant growth restriction due to inadequate function of the placenta, neither of which I can change or impact out of sheer will power.

All in all, it was a hectic morning that'll take the remainder of the day to recover from, but I'm happy we were all there.  I know we'll each need to sacrifice things as the kids get bigger to be there for each other's big moments - soccer games, piano recitals, science fairs - so the fact that we're starting it now is kind of nice.  We care about you, baby #3, and wish you nothing but congratulations on your big win today - just keep in mind that I'd prefer your next family togetherness moment be for something far less pressure filled than an fetal echo... like birth! Well, maybe not the labor process, but the clean baby snuggling right after doesn't sound half shabby to me.

Friday, October 3, 2014

Accessorize your Triceps!

With the littlest man growing and making my formerly soft-squishy belly the taut, thin skinned home to exclusively my uterus I've had to start moving my infusion sites and my CGM away from my go-to, formerly pain-free spots on my abdomen to both old-reliable locations and new, um, more revealing sites.  With my pump cannula pushing upwards of 55 units of insulin into my body a day (30.7 of which is now basal - which is holy cow high!), I'm swapping my infusion sites from hip to hip every few days as it's one of the few spots left around my middle with enough subcutaneous fat to avoid searing pain upon insertion.  Struggling to work up the gumption to shoot that huge needle into my skin is hard enough with that nerve-wracking claaaaaaaaang the spring makes upon release, let alone with the anxious knowledge that if I get the spot selection wrong, it'll sting not only now, but five minutes from now and - if thoroughly wrong - until I change the site all together.

As I've narrowed my go-to site options from four alternating spots (near my belly button and on my hips) down to two (hips only), the reality that my CGM transmitter and my pump cannula cannot be within three inches of each other for accuracy purposes creates the necessity to use previously avoided site locations.  As I only change the CGM once per week, I can't place it on one side and my cannula on the other because of the rate at which my cannula needs to be changed and the requirement that it be placed in a "fresh" spot every time I change.  Requiring more creativity and, well, diabetic confidence than I've previously been willing to display, I'm quite clearly wearing this inconvenience on my sleeve.


Both the CGM and the pump cannula are required to be inserted in a sight that will not only appropriately transfer insulin to my blood stream but to also accurately read the current glucose levels circulating through my system.  These locations, while seemingly everywhere, are actually pretty limited: the abdomen, the hips/glutes, the thighs and the triceps.  Having long since lost my comfort with my cannulas in my thighs due to running (OW!!), the options for my new CGM sites were pretty limited.. either a pain in the butt or the back of my arm.

Cannula and CGM location options

Not finding this first option at all appealing (who wants to sit on a lump all day?), I've had to swallow my insecurity to a large extent and be okay with the possibility of my CGM being visible to the world with my short sleeves shirts.  Knowing this will cause a lot more weird looks from strangers and probably several many pointed questions from curious kids, I wiped down the spot, adhered the tape to my skin and, due to the awkward angle, asked my Mother to push in the needle.  Both of us wincing at the mere idea of this new experience, it actually turned out to be much, much more pleasant a location than my abdomen had been previously.  Barely feeling the pinch of the needle, it seems that I am trading comfort for concealment...

Not quite as trendy as a bracelet or watch,
but, hey! It works! 
Fortunately, in the few days that I've been rocking this new look (note the implied confidence) I've seen more accurate readings popping up on my CGM receiver screen for my calibration tests and it showed in my endocrinology appointment this week.  Meeting with Dr. Rogacz to adjust my pump settings, get a grasp on appropriate symlin usage and run a new HgA1C I'm thrilled to report that all is looking tight and tidy.  My A1C is down to 5.6, my symlin dosages have been increased from 15 units once a day to 30 units up to two times daily and my settings are as accurate as they can be for the next five minutes.  So thank you for that, Dexcom!

Long story short, as this is my first pregnancy with a CGM, this new equipment is forcing me to actually have new experiences with my diabetes and my body.  Feeling like this whole disease is pretty much old-hat now and that there isn't much it can throw my way that I haven't already figured out, it's oddly refreshing to have to learn something new and different for a change... course I probably just tempted Murphy there (knock on wood) and will come back to redact these words in a few weeks, but for the time being, I am learning how to work my new arm-accessory and, fingers crossed, I wont ram it into too many walls or rip it out accidentally.  That would NOT be fun.

All for now.  Fetal Echo on Monday.  Keep your fingers crossed!