Tuesday, January 27, 2015

Week 36 Update

Feeling like a rare treat after the last month of solo-trips to NOVA, HB came along with me to the Antenatal Testing Center yesterday since it seemed plausible that Baby's so called "any minute arrival" could prompt an early check in to my labor and delivery suite.  But instead of encountering baby-induced (harhar) excitement or the prompt test-test-doctor visit rhythm I've become accustom to over the past several weeks, this appointment was short on facts, long on time and unsettling in it's general execution.  

Waiting ages before starting the non-stress test, the nurses left Baby and me on the monitor for 38 minutes - almost double the time required for an accurate pass or fail assessment.  Granted, the machine kept mixing my heart rate in with the baby's and would drop from a fairly consistent level of 130 beats per minute into the low 60s for a half second here and there, but by and large the requisite five accelerations were appropriately high and lengthy to excuse me at the 20 minute mark.  So, although it was fun to watch the monitor together and listen to the whub-whub-whub of his heart for a little while, it was no surprise to me when I looked up from my book halfway through the NST to find HB asleep and snoring.   (If only I'd had my camera within reach... dang it!)

After finishing the exam and sounding the alarm that, once again, it's time to wake-up for the day, HB and I marched ourselves back out to the waiting room to do just that: wait.  A considerable amount of time later, a sonographer I didn't recognize called us back and instructed me on just how to lie down for an ultrasound... lady, this is the 15th sonogram I've had with this pregnancy alone, I believe I know what I'm doing and, if for some reason I don't, please hold my sign.  

Beginning with the scan, she did a quick biophysical profile (8/8), an amniotic fluid index check (28.6) and then announced that we'd be doing fetal measurements.  Having just done these last week and knowing that the doctors try to keep such measurements to at least two to three weeks apart at this stage, I was a bit surprised to hear this, but who am I to argue? More information is more information - go right ahead! 

Finding he'd barely put on a few ounces in the six days since my last appointment, I at the very least felt comfortable going into my doctors visit that I'd maintained the option of a scheduled induction for one more week rather than propelling myself forward as a volun-told c-section candidate.  Taking a minute (or twenty...) to breath a sigh of relief, we watched GW's favorite chef, Michael Symon, on The Chew as waited to see which doctor would eventually call us back... 

Shuffling out from his office with an air of exhaustion, the doctor looked at me with an expression of amused surprise and asked: "how are you still pregnant?" 

Feeling like maybe there was a reason for the extended testing for the morning and that maybe, just maybe, he was asking this because things were obviously progressing to the point that it might have been thoroughly fortuitous (as opposed to great planning) to have HB tag along today, I responded that "I'm not entirely sure."

Sitting down at his desk, he looks at my chart and says: "Oh! That's why! You're 33 weeks."

Wait, what? HB and I looked at each other in utter confusion and attempted to correct the situation stating that, no, I'm 36 weeks and my due date is February 21.

Adamantly arguing the facts listed before him, the doctor continued: "Yes, this says here that your due Feb 21 and that you're 33 weeks."

Attempting to read the upside-down ultrasound report from across the desk, HB craned his neck to look at the  information detailed on the paper.  Noting the date on the top line, he says, "um, that report is dated the beginning of January."

Reviewing that "minor" detail, the doctor responds with a simple "oh" as he began to shuffle papers and click through my electronic chart.


Promptly following this, um, reassuring remark with a series of yawns and additional confusion about what report details today's exams ("no, that's still the old one, Doc") we finally got down to the business of being 36 weeks along, a ways into the effacement process and presenting persistent elevated amniotic fluid levels:  "well, we'll see you next week if your membranes are still intact then."

Again, seriously? That was anticlimactic.

"And call the girls at the office to get your induction scheduled for mid-week 38."

At least that's progress.

(Half-heartedly) thanking the doctor for his time, HB and I shuffled out to the car with a sense of confused apprehension.  On one hand, we are glad that I didn't have an overly tired obstetrician attempting to pull a baby out of my ear yesterday, but the lack of more definitive answers just leaves us sitting at pre-stage one: labor could happen any time, or not.  I guess the best news to come out of the appointment - besides, of course, the fact that HB and I enjoyed some awesome one-on-one bantering time - is that we have an official eviction date to plan around:  February 11.  So, if he doesn't arrive before then (gee wiz, thanks for the perpetual "who knows" time frame!), we know that I'll head into the hospital on the evening of February 10 and go through a similar process to that with GV last go around.

I guess induction wouldn't be such a terrible thing - there wouldn't be a mad dash up I-95, the pitocin helps the uterus contract back to it's normal size quicker and we'd have the maximum amount of nesting time left on the clock - but my impatience (and that of GW, too, actually) to meet Baby is beginning to show.   I want my body back, sans swollen ankles and midnight contractions, and I want to really start bonding with this little guy...  ah well, it will be when it will be.

All until next week, maybe. 

Wednesday, January 21, 2015

Week 35: Right now, right now? Maybe later, later?

Well, my 35 week check up was yesterday morning and I can’t even begin to understand where my head is today as things are just all jumbled.  Going into the appointment, I was anticipating all sorts of doom and gloom due to my weight gain this past week, a four-day headache that acetaminophen just wouldn’t shake and the knowledge that we’d be repeating fetal measurements (in other words, just how huge are we talking? And is vaginal delivery even still an option?);  but having hopped in the car almost two hours early to learn that the inner-loop of the Capital Beltway was closed due to a turned over vehicle blocking both the two Hot Lanes as well as all four of the regular lanes, I began to think my pessimistic expectations of the morning’s happenings were a bit too cheery for what was actually in store…  

Taking just shy of those two hours to get to the hospital due to knock-on accidents and residual area-wise back ups, I arrived just on time to go straight from the ATC reception into the ultrasound room for my exam.   Running a biophysical profile, checking my amniotic fluid index levels and measuring Baby’s overall growth, Tamara - the wonderful sonographer I’ve worked with through both of my pregnancies with this doctor’s office - was comforting, yet frank about where things currently stand: 
Biophysical Profile: 8/8
Amniotic Fluid Index: 29.6 
Estimated baby weight:  7 lbs 3 oz (85% percentile)
Abdominal Circumference:  34.2 cm (+18 days)
Head Circumference: 34.1 cm (+19 days)

Showing me the 3D pictures of his (practically identical to GW and GV) face, Tamara and I couldn’t help but notice the chubby cherub cheeks that Baby’s acquired in the last few weeks.  Suggesting that I cut even more carbs than I already have (okay, I’ve been cheating on my protein only diet some, but not terribly excessively… I’m dreading the idea of three more weeks of omelets…) to ensure that Baby doesn’t continue to put on excessive weight and break through that magical 9 lb 4 oz threshold that would ensure a doctor mandated delivery by cesarian, she encouragingly said that things were by and large looking good before sending me down to another nurse, Kaye, for my weekly NST. 

Delivering me to my reclining blue chair with waiting goo, padded belly straps and monitor, Tamara provided a report summary of the ultrasound which I promptly scrutinized for the twenty minutes Baby's heart accelerations and movement were monitored.  Passing this go around with no-prompting (thank you!) I was relieved to hear that, in spite of his large size, the NST and ultrasound were exactly what the doctor would be glad to see.  Setting my pessimism aside, but not out of reach, my meeting with the perinatologist was all that remained of the morning's flaming hoop session. 

Surprised not to be seeing Doctor Bronsky as he's typically the go-to in office practitioner at the ATC on Tusesdays (apparently Doctor Nies, along with everyone else in NOVA, is down with the flu so he was off covering for her on the L&D floor), Doctor Khoury called me back to his office in a flourish of compliments: "look at that belly!" -- "you look wonderful!" -- "it's so great to see you, dear!" Having dreaded my next appointment with him since my early November given the zero tolerance, minimal wiggle room estimation he made of me, my weight and my macrocosmic baby I acknowledged his praise with a half-hearted "thank you" and began throwing up as many emotional barriers as possible to handle whatever read he'd make of my test results.  

Stating that he didn't feel like a c-section is required at this point, he began by stating that the issue with diabetics with large babies - regardless of previously successful delivery histories - is that even if the baby doesn't measure above the weight threshold requiring surgical assistance for delivery, there is a significant risk for shoulder dysplasia that we'll need to  address mindfully.  Moving on to look at my AFI numbers and wishing to alieviate his concern with the possibility of preterm labor, he called down to the nurse practitioner, Laura, to have her check for effacement and dilation before sending me on my way for the week.   Running the Group B Strep test while at it, Laura made the ambiguous comment "oh yeah, you're super soft" before returning to her other patients.  Knowing that this generally meant things were heading in the correct direction for delivery, I gathered my things and began to walk out to reception with the intent of asking "anything else?" when Doctor Khoury practically tackled me in the hallway preventing my hasty exit. 

"Sit, please!"   (Uh oh...)

"You're moving quite a long - 80% effaced, 1 CM dilated and baby is at -2 station - so really he could come at any time.  I want to see you sooner than seven days, come in next Monday for your next appointment and we'll check you again.  In the mean time, if things progress at all - even if you aren't sure - get to the hospital immediately... subsequent babies tend to come quickly, but with the higher risk his size presents for delivery, we really can't afford to have you have this baby in the car.  Okay, dear?" 

Knowing that the numbers he rattled off are definitely a sign delivery is coming (but not necessarily imminently - darn AFI levels making "any minute" something that could last from right now-right now through induction in February), all I could do was nod my head and attempt to process the morning's events.  So I am looking at a large baby.  I am looking at a large baby that may or may not be premature.  I am looking at a large baby that may or may not be premature and is potentially going to be ill effected by my diabetes (sugar level or lung development wise). I remember with GV we did the amniocentesis at week 37 to determine if she could be delivered that week or would require more time for lung maturity, so being mid-week 35 with a large baby that may or may not be premature and is potentially ill effected by my diabetes has me freaked by "what-ifs" of his sooner rather than later arrival.   I mean even with waiting for 38 weeks to induce her, GV still wound up in the grow-box for a few days due to her jaundice and she suffered from post-birth hypoglycemia even though my sugars were tighter than the jeans on any one of those Hollywood film stars (at least they're wearing jeans, right?).  

Feeling excited, anxious, nervous, terrified and completely unsure of what is to come, I am flat out overwhelmed by yesterday's appointment.  On one hand, GW was a 36 week 5 day baby and he was just fine with a mild case of home-treatable jaundice... but he was born well over a year before I became a diabetic.  On the other hand, GV was born over a year and a half after I went on the insulin pump and, despite all of the terrible placentra-related complications of that pregnancy, was considered a perfectly healthy, completely normal newborn within four or five days following delivery - no NICU or micro-management required by the pediatricians.  So, optimistically speaking, things could go well even if Baby decided to come early...  would things be better if he arrived following induction the week of February 9th?  Yeah!  He'd get more lung development time, he wouldn't run the risk of being delivered on the side of I-95 in a traffic jam and I'd have another few weeks to button up the house into the home it's supposed to be.   Of course, he'll likely be so huge by then that that adds more cons to the mix, but hey, there is no one perfect way to have a baby and only God knows what's actually in store. 

On that note, I'll end my weekly blathering and hope that the next update I have for you is a clear-headed one.  Fingers crossed. 

Wednesday, January 14, 2015

Asleep diabetics say the darnedest things. Apparently.

So early this morning, I feel a nudge from HB as he asks me the question: “are you going to correct your blood sugar?”

Marginally aware that an alarm is going off, I grunt in response: “that’s just my alarm clock.”  

Ironically not satisfied with this dismissive answer given his, um, professional ability to sleep through his alarm clocks, HB insists: “NO, that’s not your alarm clock. That’s your glucose monitor.  You need to fix your blood sugar.” 

Annoyed with his persistent inability to just let me sleep, I hit snooze as I conclusively state: “If I fix my blood sugar for it every time, it will never learn to fix it for itself.”

Gotta love a sleepy diabetic's hypoglycemic logic...  thanks for the looking out, HB!

Tuesday, January 13, 2015

Week 34: Not so much.

I am completely drained.  Yes, I have been staying up until well after midnight every night for the past few weeks.  Yes, I have been getting up early and fight the good fight to have two fully dressed children at the breakfast table by no later than 7:20 each morning.  Yes, I am eight and a half months pregnant and being tired is just a way of life.  But, no, these reasons have nothing whatsoever to do with the bottom of the barrel, running on empty, complete exhaustion that my day today introduced.

For the second week in a row, HB couldn't make it to my perinatal appointment at the hospital due to his looming work deadline.  Having overcome the oddity of this mommy-only situation last week, I pouted momentarily this morning when looking at the traffic reports before leaving just early enough to arrive twenty minutes prior to my "we don't actually have appointments available, but we'll schedule you for 8:45 and least know you'll be seen" time.   Skipping the waiting room in favor of the conveniently located bathroom at the nurses station, the nurse I bumped into on my way out decided to have me start my non-stress test immediately since I was already back in the exam room and it didn't matter scheduling wise where I was fit in so long as my NST occurred.  Reassured by my old-hand-at-this attitude toward the procedure, she quickly took my weight (down 1 lb from last week) and my blood pressure (118/79) before hooking my belly up to the various monitors and letting Baby, my book and me be for the twenty minutes of monitoring.

About 15 minutes later, she came in with a concerned look upon her face.  Looking at Baby's heart rate on the chart, she asked me to roll to my left side and down a large cup of ice chips to encourage him to show proper heart accelerations.   As I have previously explained with GV's pregnancy, a non-stress test is a way for a MFM to look at the fetal heart rate to see if it increases to a certain level for at least 15 seconds for a minimum of two times over the course of twenty minutes.   When this kind of acceleration is seen, the baby is considered to be "reactive" and in good health; but when this acceleration criteria isn't met within the appropriate time window, the baby presents "non-reactive" concerns that require additional testing.  Well, today, my coffee didn't rial him up, my movements didn't change his agenda and the ice bath I gave him must have been soothing because Baby wasn't having any of it.   Much to the concern of my nurse who continually went back and forth from my monitor to Doctor Bronsky's office, Baby showed marginal accelerations within a thirty minute window - reactive enough for Dr. Bronksy to take me off that particular monitor, but non-reactive enough to require a previously unplanned biophysical profile to be completed on Baby.

Sent back to the waiting room to fret over the "I guess you passed" (aka "I'm trying not to say you failed") results of the NST, it was only a brief moment before the extremely informative sonographer, Sandra, came out to collect me for my ultrasound.  Explaining every little thing she was looking at as she clicked with the mouse and slid across my swollen belly with the probe, Sandra went out of her way to praised the "precious/adorable/sweet baby" each step of the way through the 8 part biophysical exam as if trying to boost his ego and put my parental concerns at ease.  Stating that "it's no wonder why you guys failed the NST with how squirmy he is and how much fluid you have," my heart sank as she reported my amniotic fluid index levels had increased to 29.6 cm.  Reassuringly trying to indicate that this increase should be "no problem, as long as ..." she ended her pick-me-up speech with a rushed "but, the doctor will talk with you more about that...  Want to see the baby in 3D and color?" 

Nice try to distract me, honey, I'm still going to obsess about it. But, yes (duh), I want to see him in 3D and color.  

Left: 01/13/2015 Baby #3 at 34 weeks gestation.  Right:  10/31/2012 GV at 34 weeks gestation.
I think they'll likely look alike.  

Ushered directly from that non-sequitur into see Dr. Bronsky, I sat down and immediately noticed the oddly stiff straightness of my posture - there was absolutely no denying my concern about the changes from last weeks glowing reports to this week's failure to respond and abnormal AFI levels.  Looking over my chart - and once again not providing me with a take-home copy of the ultrasound report - he automatically launched down the "how are your sugars?" worm hole.  Explaining that my A1C is slightly elevated, but likely more as a result of fewer hypoglycemic episodes than otherwise, I braced myself for what I assumed would be a sink-hole of criticism to engulf my chair and self-esteem. 

Frankly stating that he wasn't pleased to see that my amniotic fluid levels increasing at this point, Dr. Bronsky used the magical word "however" when reviewing Baby's biophysical profile results: 8/8.   Indicating that this doesn't necessarily replace the non-responsive NST but provides him with significant more confidence that Baby is still looking good, he requested that I begin daily kick-counts and expect a more comprehensive work up next week rather than the week after. 

Feeling quite a bit battered around the head by the appointment, I took one final emotional blow as I left the hospital:  as I walked over the catwalk from the Women's & Children's Hospital to the parking garage a friendly hospital volunteer handed me a flier about the campus' new visitation policies.   Taking a gander over the bold face type as I approached the car, I stopped dead in my tracks and had to actively fight back tears as I read that "all children under the age of 16 (including siblings) are not permitted as visitors on hospital premises for the duration of flu season."  In other words, when baby comes and we're left in the maternity ward for hopefully a brief stay of two to three days, GW and GV will not be permitted to come see me or to meet their new baby brother as GW did when GV was only an hour old.  Granted, I understand the medical necessity of trying to decrease the spread of infection and control the rampant spread of the flu across the DC metro area, but they've had their flu shots and we know better than to take a sick child to a place full of depressed and/or brand new immune systems!  I just... I just was really looking forward to that moment when we could all share the newness of Baby together.   

What a freaking emotional roller coaster.  Let's just hope next week brings better news. 

Friday, January 9, 2015

Last Pre-Baby Endocrinology Exam

Going into day four with my CGM down and no estimated delivery time for my new transmitter battery, I went to my endocrinologist's office today for yet another pregnancy check-up with very little confidence that my sugars have been as tight as they ought to be this week.  Knowing full well that these few days won't have a huge effect on my HgA1C as it's a three month average of my blood glucose readings and since I'm getting measured more frequently than is typical, I could somewhat safely estimate that today's A1C reading would be relatively close to last month's of 5.5.  

Sans kids, Grandmama or HB (aka taunting the traffic Gods to let me get home from NOVA in anything resembling a reasonable amount of time), all of my attention was focused on the appointment and I cannot even begin to tell you how mystified I was by the ignorance of my nurse as she asked me questions about my diabetes. 

"Are you still taking Dexcom G4?"  she inquires.

"Yes, I still use it,"  I respond patiently. 

"How many units of that do you take a day?"

My internal monolog: "Seriously, are you freaking kidding me? It's my continuous glucose monitor, woman! It doesn't use or even measure units! And come on, there are only so many of them available on the market and used by this office! Are you seriously asking me this as if it were a prescription drug?!"

My answer: "It's my glucose monitor."

"Oh.  Are you still taking Medtronic Minimed?"

"Yes..." I said in attempts to mask my skepticism of what was to come next. 

"Is that a pill or something?"

My internal monolog:  "O. M. G.  You have got to be kidding me!"

My answer: "It's my insulin pump.  I use it with humalog." 

"Oh.  I'm new to this diabetes thing."

My answer:  "You're lucky."

Scurrying out of the room after checking my blood pressure (98/80 - um, shouldn't that have been of concern?) and taking a sample of blood for my A1C, she skips several of the typically routine pregnant-diabetic questions and leaves me to wait for the significantly more competent and well trained Doctor.  

Surprised to see me without entourage, Dr. Rogacz dives right into my chart and the CGM trends I've provided for her covering the previous week.  Reporting that my HgA1C is up to 5.9, she theorized that this increase - while in the wrong direction - is likely as a result of less prevalent overnight hypoglycemia and an apparent growing trend in mid-afternoon highs.  Merely suggesting that I add Symlin to my late-morning coffee or adjust my bolus settings for my mid-day meals, she snaps my chart shut and announces that as far as she's concerned I'm doing beautifully.

"The next time I need to see you is two weeks after delivery.  Otherwise, make sure that you set your pump to your lowest basal setting for delivery and that your husband knows to turn off or disconnect your pump at the infusion site if you need to have an emergency c-section.  If he doesn't do that, anesthesia will just rip it out and you'll need it after the procedure is complete." 

Finding it terribly ironic that she didn't really feel like she needed to see me today and that the more serious conversation she planned to cover was intended for HB instead of myself, I appreciated the vote of confidence from my go-to diabetes expert that I'm doing everything motherly-possible for Baby #3 and that on her scale of patients - both pregnant and not - I'm one of the few she's not slightly concerned about.  Wishing she could send those exact words over to the perinatologist for their diabetes-rant days where I come away feeling like I'm the biggest diabetic screw up on the planet, it was nice to know that at just shy of 34 weeks of gestation that I'm off the hook for additional "you need to be monitored" appointments until the end of February.  

Again: go me. 

And to top it all off, there wasn't a bit of traffic on the way home and door-to-door my typical 2.5 hour Friday afternoon commute took me 52 minutes.  Now that's a good way to end the week on a medical high note! 

Wednesday, January 7, 2015

Week 33: All Alone.

It felt absolutely bizarre to walk into the Antenatal Testing Clinic by myself today.  Finding the waiting room set up completely different than it was the last time I was here in 2012 (back then all of the chairs sat in rigid rows facing away from the door toward the television; now the chairs sit in four sections with two rows facing the door, one row directly opposite those two that faces the center of the room and one row adjacent to the door that still faces the television), I was startled by the collective curiosity that hit me as I walked into the crowded room and became immediately aware of all the couples… Every single chair, but one, was composed of a matched set of mothers- and fathers-to-be and all of them looked up in some sport-like synchronized motion when the door opened and I stepped into view.  In an ideal world, I am sure that would have elicited a walking on water kind of feeling from me or anyone else who was noticed by everyone when walking into the room, but the odd man out, something’s not quite right feeling that stuck with me as I took that last chair in the corner under the surveillance of the paired off parents was enough to make me wonder if I had spinach in my teeth or forgot my appointment was supposed to be black-tie attire required rather than pregnant mommy comfy.   

I realize that this might seem overly self-conscious of me to write about or perhaps entirely too trivial to even mention, but the strange thing about that moment wasn’t so much the receipt of these people’s innocuous attention as it was the fact that I’d never before noticed that pregnant mom’s rarely arrive at the ATC alone and when they - I guess I should say “we” - do it’s enough to distractedly drop People magazine to wonder what’s her story.  I mean, as a high risk clinic it makes sense to have someone there with you to endure whatever bad news awaits or to confirm that whatever medical phrase the doctor just said is actually a positive thing, heck that’s how I’ve been operating up until today, but to realize in such black-and-white, seriously look at your surroundings that, yep, it’s completely strange to be here without HB today was a whole new level of surreal.  Maybe I’m applying too much weight to the shift, but I’ve heard tell that going from two to three kids is the hardest transition for parents to learn and this might just be the first taste of that difference I’ve noticed. 

Anyway, so there I am (no shit) all by my lonesome at my first unaccompanied perinatal appointment dreading whatever gloom and doom report of fetal complications, maternal weight gain or what-have-you when I’m called back for the NST which, much to my shock, Baby passed within the first five minutes of being monitored.  Required to remain on the machine for a minimum of twenty minutes, the nurses let me be and read the final chapters of Lisa See’s Red Princess Mystery series (thanks for sending that AS! Loved it.) in relative peace and quiet with only the constant background noise of little one’s wub-wub-wub heart rate to distract me.  Feeling skeptically hopeful that the appointment might not be such a disaster, I went back to the waiting room (alone) and began my next book (okay, Mom, I’ll read the Eragon series… you happy?).  

Shortly there after, Lin, the Chinese sonographer who works part time at the ATC and part time at the main doctor’s office called my name.  Seeming a bit shocked to see me (alone) at the hospital rather than in the normal office environment (with husband and kids in tow), she was quite a bit more eager to chit-chat while checking on Baby.  Covering the weather, the older kids and what we can only assume is the adorable face of this Baby (he’s shy and keeps his hands in front of his face for the 3D sonograms), she could feel me tense when she began measuring the four amniotic fluid pockets around his body.  

“What were you last week?”  she asked. 

“30.0,” I responded. 

“Oh… well you’re down to 26.8!” she announced with a note of triumph.  

Taking that emotional leap of faith from tentative hope to actual happiness as a result of the appointment’s exams, I couldn’t help but smile with relief at the positive turn of numbers this measurement indicates.  See, the thing about AFI levels is that they are supposed to peak between week 32 and 36 before gradually beginning to decrease as full term approaches - so the concern for the past several weeks has been whether or not this decrease would occur or if, Heaven forbid, the AFI levels would continue to rise making for higher risk complications at the onset of birth (namely premature rupture of membranes or placental cord prolapse).  Given that this 3.2 cm reduction would indicate that Baby and I are actually headed in the right direction… holy smokes! What a weight off the world!

Practically floating into my appointment with the doctor, it was such a pleasant surprise to find the soft spoken, kiddie-gloved Dr. Nies waiting behind the desk with her welcoming smile and perpetual encouragement.  Looking over the NST and AFI results, she announced that they wouldn’t need to see me twice a week at this stage of the game as they had initially anticipated and that, if I had no questions, I was free to schedule a once weekly NST for the upcoming three weeks.  Explaining that we’d be repeating fetal measurements week 36 when we’d also be looking to go-ahead and schedule induction (did you see that?!  She said “INDUCTION!” NOT C-SECTION!) for the second week of February…  what A-W-E-S-O-M-E news. 

You can imagine the unrestrained pregnancy glow that emanated from my being as I reentered that couples-only waiting room a full five inches taller than I had when first arriving earlier in the morning.   Soaking-up the five seconds of “single-mom” fame that repeated itself in the group stare as I began to check out, there was no second-round of doubt going through my head about my vegetable-free teeth or my chic mommy-comfy outfit because, yeah, I am the third-time mom that came alone to the hospital’s high risk clinic and you know what I just did? I had a kick-butt appointment.  All by myself!

Dexcom Down!

I am feeling like the biggest idiot on the planet.  About four days ago, my Dexcom monitor began to doo-da-loo at me with an error message I'd never seen before: "Transmitter Battery Low.  Order Replacement."  Thoroughly confused by this message as I'd just replaced the monitor this past September, I plugged in my CGM to it's USB port and rolled on with life.

Then, at about one o'clock in the morning this past Sunday, it hit me.  The error message was so darn clear, the transmitter battery is low, not my monitor battery -- in other words, the gray piece I attach to my new sensor on a weekly basis needs to be replaced.  So no matter how well charged my blue CGM monitor is or how fresh my sensor is, with a dead battery in my transmitter my CGM is about as useful as when trash day falls on a national holiday (yes, we were hit three times recently thanks to Thanksgiving, Christmas and New Years Day all falling on Thursdays... no, I am not annoyed...).

Having contacted my Dexcom customer service rep first thing on Monday morning, I learned that it will take 3 to 5 business days to arrive here at the house.  So with a possible arrival time of this Thursday at the earliest or next Monday at the latest, I have been crossing my fingers that the low battery holds out until the earliest possible time that my replacement transmitter can arrive.  Unfortunately, however, as I was going about the morning routine today my monitor stopped reporting my glucose trends and indicated my transmitter is out of range.  As I'd seen this error message before it didn't initially register that my CGM needs more than my sticking the monitor in my pocket for a while... so you can imagine how dumb I felt after carrying this thing around for an hour to no avail when it hit me that, yet again, I'm being completely dense.

My transmitter battery is d-e-a-d, DEAD.  I have yet to receive shipment notification from my supplier that my new transmitter is on it's way.   I've officially thrown myself back to the Stone Age of diabetes management as, for the second time this pregnancy, I'm back to finger sticks to track my blood glucose.  As my insulin requirements continue to change over the course of the third trimester with the placenta making my body increasingly insulin resistant and with baby and me being incredibly sensitive to glucose swings - him and my AFI levels, apparently, responding to my in-range 70-140 mg/dL blood sugar variations; me responding emotionally to the mere suggestion of my diabetes incompetence or a potential c-section - this is NOT the ideal time to have my high tech gismo go out on me.

Keep your fingers crossed that my new transmitter arrives soon and that the mean time doesn't somehow manage to make my head explode.  I head to the perinatologist later today (solo... boo hiss) and it's my first appointment at the hospital's Antenatal Testing Center, so I'll report back sooner rather than later on how things are going... so, seriously, all the fingers you can spare to crossed are appreciated!

Tuesday, January 6, 2015


I feel like my whole world, including the baby, are upside-down.  Generally speaking, things are lining up where they need to be and they are heading in the right direction (literally, he's vertex), but that doesn't seem to be translating into anything except what I hope to be a short term stint of full on topsy-turvy.   When we moved into our new house two summers ago, I had every intention of leaving the place as is; the previous owner was an interior designer who'd clearly spent quite a bit of time, money and effort on designing a very formal, Virginian colonial theme to the place so it we've been treating the house as move in ready... but the longer we've been here, the more we've found that's needed replaced and the more I've started to feel like we are living in the previous owner's space and not in our own.  

Wishing to remedy that with at least one of the rooms we've yet failed to unpack (at least 1/3 of the house is still in boxes), nesting fever accosted the house as HB and I began to look at simple paint combinations for Baby #3's nursery and maybe a pinterest-sourced wall accent.  I don't know if you have looked at pinterest before, but what a life-sucking, bottomless-pit of amazing ideas... we could do this! Or we could do that!  Or... or... or... bottom line:  what initially started out as the bright idea to "spruce up the nursery" has morphed from a simple application of a few paint coats and maybe new carpet to what feels like a whole house make over. 

Thanks to Home Depot's gentle reminder that it'd be a better investment to take advantage of their free whole house carpet instillation and lifetime carpet/carpet pad warranty than to only superficially replace the carpet in one room, project creep seeped through our entire top floor: we've ripped the carpet and old carpet pad out of all four bedrooms in prep for new flooring to be installed on Thursday; we've repainted both the nursery and the kid's bedrooms top to bottom; we're soon to be wall papering a room for the first time (HB and I have only ever removed wall paper, so this shall be a learning experience); and, much to my literary glee, we've begun work with a contractor to build a series of built-in-bookshelves that will transform our main floor whatever-room into the dream library we've been fantasizing for years.   So you can imagine the mess the house is... both kids are camping in the master bedroom (so much for my bedtime reading routine), Grandmama is back to sleeping on the couch, there are four dressers crowding the landing upstairs and the dog is bunking with all of the extra furniture that needed to be piled elsewhere for safe keeping.  It's the epitome of absolute, piled to the ceiling, someone make more coffee, where's my left shoe, cereal for dinner, insanity. 

To make things more complicated and (to a spoiled wife like me) less pleasant, HB's work schedule has really ramped up due to an end of the month project review he must complete for his customer.  With a smaller than ideal team working on his particular program, this task - while not insurmountable - is demanding to say the least and causing his hours to lengthen both in the mornings and evenings.  While you might be sitting there thinking "so what?" I have to take this time to remind you that at 33 weeks pregnant, I'm going to NOVA for non-stress tests and sonograms once a week, soon to be twice a week, and that as of yet HB hasn't failed to attend a single prenatal appointment with any of our pregnancies.  Unfortunately, my appointment this week marks a first... we can't have him home to help with carpet installation (a must since I can't move furniture) and at doctors appointments and still enable him to make his deadline while simultaneously fighting shorter weeks due to the holidays being "forced" days off -- it's just not going to happen (#FirstWorldProblems).    So cutting slack where it's curable, he's not coming with me to my appointment(s?) and that makes me sad.  Perhaps I'm just whining at this point, but it's a big shift for us to have me head into the unknown with Baby #3 at the hospital on my own...  granted I'm carrying him on my own and I'm responsible for all things baby-making post x or y chromosome contribution, but it's been a team effort thus far and it feels like for the first time I'm fielding an incomplete roster for the MFM reindeer games. I'm sure that I'll get over it, but the anticipation of going solo tomorrow is nauseating for the time being.  

I guess at the end of the day, the boxes are all still getting checked: we're moving forward with nesting by creating total havoc in the house and the baby is being checked on even if only 50% of his parental team present.  I know it's all working toward a positive end state that is family-time oriented, but in the upside down world of progress I feel like my current steps forward are backward and the finish line is perpetually out of reach, yet somehow it's still rapidly approaching.  Hopefully this dizzy, confused feeling subsides and come Thursday evening we'll be so far past the remodeling, nesting, emotional mess we're currently working through that this blog post will seem utterly ridiculous in retrospect.

If I weren't pregnant right now I'd go back up to my bedroom, shut the door, put my arms out and spin around in circles like I have GW do to "change his attitude" in hopes that my vertigo would reorient life into some ultimately sharper form of clarity... but, since spinning while 8 months pregnant isn't exactly recommended, I'll just continue as is down what I can only understand to be an Escher interpretation of my life circa January 2015.