Food restrictions

So just when I thought life was getting a little bit easier and my pregnancy diet of eggs, eggs and more eggs was beginning to fade from memory, the follow-up appointments we've had for FG at the pediatricians have constricted my reality to a new level.   While things post-RSV wise are going well for our little angel boy, the antibiotics that he was given at the ER and over the first several days of his stay in the PICU have proven to be so strong as to thoroughly kill off the good gut-bacteria along with whatever other bad bugs may have been lingering. And although this is a minor complaint compared to the risk of facing bacterial meningitis (and therefore a call I would gladly make again), the knock on effects of this complete zeroing of the "pro" biotic scale is enough to both pity his sensitive little tummy and to rant at my rotten luck. 

Causing him to suffer from a constant case of reflux and a smattering of rashes and diarrhea, the doctors have recommended that I assist his recovery from the antibiotics by beginning a series of food restrictions to help his little stomach get back to normal.  As my diet directly impacts the nourishment he gets through breast milk, I am placed in the position of doing what he needs at the expense of my palate or forfeiting the opportunity to breast feed -- which I can flat out tell you is not going to happen.   So, starting the restrictions with all things containing dairy at last week's  appointment, the pediatrician handed me a sheet of paper with all the dietary vocabulary that, until further notice, I need to be leery of: 

Unfortunately, at the follow-up appointment we had yesterday, the pediatrician agreed with me that his symptoms of rash and copious spitting up warrant the escalation of my dietary restrictions to include soy and nuts as well.   Hoping that the combination of these three usual suspects enables his skin to clear up, his spitting up to diminish and his diapers to be more predictable, I have my fingers crossed that some combination of the three will be the key to making tummy wobbles disappear for our quickly growing little one.  

The thing that is surprising me, however, is that as straight forward as it seems like it should be to avoid all things with dairy, soy and nuts, it's a lot harder to find ready made food or ingredients that don't include these in some form or another.  Who knew that soy is in canned tuna, most breads, mayonnaise and cereals?  What's a diabetic to exercise if my go-to quick carbs of chocolate, yogurt and milk are all off limits? How the heck is a girl supposed to attack the world in the morning without a cup of coffee (the "proper" way to make a cuppa in my opinion: two scoops sugar, one part coffee, three parts milk)?  I am sure that I'll figure this out the further we get into this, but daggnabbit! 

I guess on the up side, all the proteins, vegetables, fruits and grains I can eat should be able to help me shed the rest of my baby weight, but with GW and GV sitting here next to me eating pb&j on store bought bread it's hard to see any of my own benefit from this scenario.  For the little man, of course, it makes total sense and I'm not about to cheat, but were this just for me, I'd be off the bandwagon before hitting the doctor's office parking lot! 

FG, may you never doubt how much I love you... 

Breastfeeding in Virginia

So as one of three remaining states in the Union that does not outright protect the rights of breastfeeding mothers, the legislature of the Virginia Commonwealth took to voting yesterday to change state law to benefit lunch time.  As it currently stands, it is perfectly legal for mothers to breastfeed their infants on state-owned property in Virginia, but if she is breastfeeding - covered or otherwise - on privately owned property it is legal for the proprietor, employees, volunteers or whomever of that establishment to demand the mother stop nourishing her child or face enforceable eviction.   But the vote is in and that archaic law has changed!

Having largely become an issue due to uncomfortable individuals accusing mothers of introducing "biohazardous" materials in public venues,  it has long befuddled me how something so natural and completely innocent could be misconstrued as dangerous, lewd or "disgusting."  A baby needs to eat just as the rest of us do and I don't see non-closed mouth chewers facing the same social commentary about their preferred eating method despite the truly displeasing sight their public mastication presents.  But while it may, to some degree, be justifiable to politely ask such individuals to shut their faces, the difference I see between their choice to share their meal with others and breastfeeding in the public sphere is that a mother doesn't choose when her child must feed or where God made her milk come from.  I cannot tell you how infinitely more convenient I would find it to nurse with a finger or something that would enable a wider wardrobe, free my mobility and save my favorite shirts from the accidental leak or lanolin stain.  But, as it is, the breast was made for the purpose of feeding and the fact that we have attached a sexualized stigma to it or socially distanced ourselves from the source of our food (hello, that nugget you're eating is actually chicken; yes, as in "cluck cluck") doesn't diminish the function or utility that God intended of it.  Breastfeeding is beautiful and not something to be regulated.

As I am heading in to have baby #3 in a few short days, this victory for breastfeeding mothers couldn't come at a more prefect time.  I plan to nurse this child just as I did with the first two and, while I prefer to cover and keep the breast-formed bond between me and baby private, I am so grateful that the state has taken the next step to protect a mother's rights to nourish her infant and in doing so combat the discrimination that was no less ignorant than past issues of class, religion, gender or race.  There is so much pressure to make this decision or that choice with regards to how we act and how we raise our children that this new law makes me, as a Mom, feel greatly more empowered to do what is right by my children without fearing that my actions will result in unnecessary drama or legal trouble simply by feeding outside the home.   I've known in my heart since the first day my oldest was born that breastfeeding was right for me and right for our family, but having someone beyond my husband and my intimate friends accept and understand that was a reach -- until now.

So, thank you, Virginia, for the birth day gift you've given me and my new son.  You can bet we'll celebrate your twenty-first century solution the next time errands and snack time just happen to overlap.  

Food introduction

Although it may not seem like there is very little method to my madness, I believe we've hit a tipping point where counting GV's age in terms of weeks is no longer rational.  Up until this point she has been, for example, "twelve weeks old" rather than "three months old" because, at least in my mind, a week is so much shorter than a month and the sound of just a handful of weeks drags her infancy out perhaps a moment longer in thought than it is in reality.  But now that we need more than ten fingers and ten toes to count the number of weeks she is old, the tides turn and twenty-two weeks sounds audibly cumbersome compared with a "mere five month" reference.

So, at five months old, our beautiful little Dolly is doing wonderfully and it's been a week full of notable milestones: she rolled over from front to back and then from back to front for the first time and, after glowering at GW for eating waffles in front of her, she's had her first introduction to solid foods.  I'd initially planned to only breast feed her until six months given the positive research such a diet has shown for infants of type one diabetics, but seeing as that date is technically two weeks away (24 weeks old on Tuesday May 14) I decided that she is ready given her ernest protestations when she too isn't presented with a full plate of food at the dinner table.  (Honestly, I think that if she truly had her own say in things, she'd be running and eating steaks already...)

But once again, in spite of the fact that she's child number two, I feel completely foiled in my parenting knowledge and experience by the role diabetes is playing in our family (not just my) life.  When GW began eating solid food, I remember the momentous weight of the occasion being thoroughly placed on his act of eating rather than on my choice of cereal products.  With GV, however, I'm spending hours of time surfing online medical journals and diabetes resource pages trying to make sure that the external environmental factors I actually have control over don't unintentionally exacerbate the biological possibility of islet autoimmunity.  So while I am completely thrilled that she has (proudly) eaten three full bowls of rice cereal, I feel the weight of my off the shelf selection as a consumer each time I lift that tiny spoon to her gleeful mouth.

GV's first solid food

Now, to reiterate my disclaimer, I am not a medical professional --  I am only a mother 
making as informed of choices as I can in the hopes of doing what is best for my children.  

I have absolutely zero knowledge as to whether what I am doing is right or if - Heaven forbid - 
it is wrong,  so if you're like me and searching for a "recipe for success" you need to use
your own best judgement and ask your pediatrician or endocrinologist for their medical advice.  

That said, back when I was researching what impact my diabetes would have on breast feeding I learned that there is a possible correlation between the introduction of cow milk proteins and the later life development of type 1 diabetes.  Seeing as this whole line of thought started with my research on formula and since it is typically the first non-mother's milk food to be introduced to infants, I'll start there:

The American Journal of Clinical Nutrition published a 2010 research study that indicates the large size of bovine protein may be too difficult for infants at "high risk" for diabetes (children of type 1 diabetics, with type 1 siblings or those that have tested positive for autoimmune antibodies) to digest and may lead to the onset of islet autoimmunity.   In an effort to reduce the possible impact of this environmental factor, the study suggests that such infants be fed breast milk as long and as much as practical but if formula is warranted to only use highly hydrolyzed, hypoallergenic forms like Alimentum, Nutramigen and Pregestimil due to the smaller, non-cow milk proteins used.

I admit the repetitive use of "may" and "possible" doesn't provide much comfort to the concerned parent in me, especially in light of the price tag assigned to hypoallergenic formula, but seeing as this is the only study I've come across with anything remotely close to a definitive "cause" for diabetes (even these researchers state more studies are necessary) I'm willing to work with their results.  I mean, even non-diabetic parents are cautioned against the introduction of cows milk in the first year of life anyway.  Straight cows milk is significantly more difficult for infants less than 12 months old to digest and, even if the correlation to diabetes is uncorroborated, there is conclusive evidence that indicates early introduction of cows milk leads to iron deficiency anemia, an increased risk of a milk allergy and potentially life threatening dehydration.  In my mind, those risks alone are worth consideration and avoidance of bovine proteins!

Having learned this about the liquid end of things, I obviously looked into solid food introduction as well and, unlike formula, I learned the most important factor about cereal introduction is not necessarily what but when it is started.  So working with the general medical community's consensus that all parents should start all infants on iron fortified rice cereal (again, to avoid iron deficiency) -- I chose an organic brown rice cereal based on the nutrition label you see here -- I used my pediatrician's guidance to start solid foods around 5-6 months, the age infants are physically ready for more than breast milk.  Before this time frame, infants don't have the proper gut bacteria necessary to break down solid food safely and there is no nutritional need for more than breast milk or formula then anyway.  Not to mention, starting cereals any earlier than 5 months is linked to an increased risk of not only developing diabetes but obesity, eczema and celiac disease!!  But, all cautionary fear-mongering aside, assuming a baby is at the very least 20 weeks old and showing physical signs of interest in solid foods - putting hands in mouth, practicing a chewing motion, watching and mimicking eating motions - go ahead and get your camera ready!

I know what you're thinking: all of these baby-feeding guidelines seem completely overkill.  And, you know what, I am with you.  I feel like I have opened the medical journal version of Pandora's Box and am falling insulin pump first into a rabbit hole of hypochondria... but I made the active choice to learn everything I can about my disease, for better or worse, so that I can run it instead of the other way around.  I can't passively wait and see what my pancreas has in store for my kids with clear conscious, so overkill or not, at least this degree of research helps me sleep at night.

Breast Milk, part two

So you know my last post on breast feeding? Thought I was done? Well, guess what? There's more!

Now that I've explained the complexity of breast feeding as a diabetic and how the balancing act is more a matter of self-care than baby-care, it's about time that I move onto the real impetus for getting around to writing these posts: Downton Abbey.  For those of you who watch the show, I've tried to give you all a few weeks to catch up on the fourth episode so as to not inadvertently spoil the plot for you, but seeing as this topic has been eating me up inside I just cannot wait any longer to vent about it.  Several Sundays ago, Lady Sybil died from eclampsia after giving birth to a beautiful, healthy baby girl.  I wept my freaking eyes out.  I simply couldn't believe that Julian Fellowes (the writer) would do something so horrible to the most wonderful character on the show... I mean for God's sake man, kill Bates if you have to, but not Sybil!

Many of you might find this to be completely random and not at all relevant to a diabetes related post about breast milk, but bear with me -- you see, when Mr. Carson, Mrs. Hughes and Mrs. Patmore began talking about the baby's need for a wet nurse I got to thinking.  While breast feeding is an extremely personal choice for mother's now a days and there are definitely social stigmas that go along with not just nursing, but sharing breast milk, the reality still exists that there are babies out there that need to be fed by other means than their own mothers.  Clearly formula is the go-to option now a days for such situations, but I'd heard tell about the practice of breast milk donation and wanted to check it out.

So off to Mr. Google I go to look into what organizations are out there and what it takes to become a breast milk donor (face it, with the image of Sybil Branson's baby fresh in mind who wouldn't want to help out?).  The search engine pops up with several different groups that collect donations for families in need and I delve into the mission statements, success stories and finally into the requirements pages... logically, the organizations insist that a donor have her own baby's feeding covered before considering donating extra milk; they also mandate that a donor's freezer be capable of reaching - 4 degrees Fahrenheit; and, oh yeah, donors under no circumstances can be diabetic.

Putting diabetes under the same category of disqualifying diseases as HIV (SERIOUSLY?!), using artificial insulin on a regular basis classifies me an "unhealthy" mother...  ouch.  Now I am not so irrational as to deny these organizations consideration of liability reduction in making this decision, but likening my milk quality to that of a disease that is actually transmittable from person to person and actually communicable through breast milk is just insulting.   Women with HIV cannot safely breast feed without taking antiretroviral medication to prevent transference of the disease to their babies, but women with diabetes - as I said earlier - are not only capable of breast feeding safely, but they are encouraged to do it!

Having the past several weeks to stew on this topic, I'm not angry with these groups because I cannot donate something I willing would under different circumstances, but I am furious with diabetes that it has taken something important away from me.  It never crossed my mind to donate milk while breast feeding GW, but now that I'm actively feeding GV and am in a physical position to do so now, it really stings to know what opportunity I missed and what difference I'll never be allowed to make for another mother.  Don't get me wrong, I know mothers today who can't or don't breast feed have alternative options with formula, but it's the principle of the thing...

While I understand that I have a disease I work tirelessly to manage it and make it as irrelevant as possible.  But, being of spiteful character, diabetes seems to take pleasure in continuously adding insult to injury -- making me wear a battery operated computer 24/7 was just selfish; forcing me to cut out cream of wheat was just rude; making candy a thing of necessity rather than pleasure was sick and twisted; and, worst of all, having my milk practically labeled as carcinogenic is just unforgivable.

Screw you, diabetes. And the horse you rode in on.

Breast Feeding and Diabetes

For months now I've been saying that I'd write a blog post about breast feeding as a diabetic.  I'd skipped the topic while still pregnant since it wasn't quite relevant at the time and for the past 11 weeks since GV was born I just haven't made a priority of writing about it since doing it seemed more important.  But seeing as she's happily asleep in her swing chair and GW is at least pretending to nap in his room, I'm going to take this opportunity to tell you about it since I know you all must have been anxiously loosing sleep over it since I first mentioned I'd write about the topic back in 2012.

No? Just me? Ah well, c'est la vie.

According to the American Diabetes Association, the best thing that a diabetic mother can do for her new born child is to breast feed.  Citing multiple research studies, the ADA explains that babies that are exposed to diabetes in utero and are breast fed for upwards of six months after delivery have a decreased incidence of respiratory infections, a lower risk of asthma and atopy, tend to have lower blood pressure and are less likely to develop childhood obesity.   All great things, right?  Well, combining these medical benefits with the fact that the disease is not transmittable, that there have been research studies connecting certain types of baby formula containing bovine protein to the development of autoimmune diseases like diabetes and that I thoroughly enjoyed breast feeding GW, the choice was easy for me.  The practice of breast feeding with diabetes, however, is not so easy.

Blood sugar affects everything we do in our daily lives because it provides us with energy, so it seems only logical that there be some relationship between blood glucose and the natural formation of breast milk.  While you've probably heard that breast feeding burns calories, you may not have taken the next mental step to connect that with blood sugar... Essentially, in a similar way to how our bodies burn both calories and glucose when we exercise, a mother's body burns both fuels to create milk for her infant. So while a non-diabetic mother can singularly reap the weight loss benefits of nursing her little one due to her self-regulation of glucagon and insulin, a diabetic mother needs to monitor her blood sugar with extreme caution so as to not put herself (and by extension her baby) in danger of hypoglycemia.

To prevent this and to keep blood sugar stable, it's important that I eat before, during and sometimes after feeding GV.  But that brings me to the next topic of difficulty: weight gain and nursing.  Because of my sugars I need to eat more to keep my blood sugar up to be able to safely nurse -- but then that means that although I am burning calories while nursing I am required to ingest more calories to nurse which means any weight loss I should have with breast feeding is replaced with weight maintenance, if not additional weight gain.  Obviously this creates a source of stress for someone as physically self-conscious as me, but to take it to a less superficial level, weight gain can change a diabetic's chemistry enough to change the body's response to glucose and therefore its artificial insulin requirements.  So... to keep this complicated... that means that I need to eat more to nurse more and that I must exercise more to compensate for not only remaining pregnancy weight (15 lbs to go) but the extra calories necessary to nurse (and exercise) all in order to keep my sugars stable enough to nurse in the first place.

Furthermore (because why, really, would it end there?) not only should my blood sugar be kept from going low while breast feeding, but they should not be permitted to go high either.  While the majority of perinatologists, pediatricians, obstetricians and diabetes organizations insist that there is no connection between a mother's in-the-moment blood sugar and the quality of her breast milk, there is a school of thought out of the Sansum Diabetes Research Institute in Santa Barbara, CA that believes the value of a mother's breast milk decreases when her bg is over 150 mg/dL.  According to these researchers, such deficient breast milk can cause infants to have "reactive hyperglycemia" which causes them to vomit, be excessively irritable and require more milk to satisfy their nutritional needs.  While there aren't additional studies to backup these claims and I've never seen such negative effects in GV's behavior when I have nursed her while high, a lack of evidence doesn't necessarily refute the possibility and I've decided to play it safe rather than sorry.  Admittedly it voluntarily adds another level of complication to breast feeding, but what does it really cost me?  If it is no big deal, then oh well.  If it actually matters, then it's worth the effort.

The bottom line is, I am thrilled to be nursing; it's a very personal choice and I find it completely satisfying. But breast feeding and diabetes take a lot of conscientious thought -- and at 3 o'clock in the morning when GV wants to nurse that is a lot to ask for.  Don't get me wrong, glucose control is definitely less critical and requires far less attention to minutia now than in pregnancy, but it's still exhausting to continuously consider.  I could let it go and give myself an easy DKA-sponsored trip back to my skinny jeans, but I cannot justify cutting myself any self-satisfying slack on my sugar control since a lax take on it would imply irresponsible parenting at best.

Seeing as I take my vocation as wife and mother extremely seriously, I guess this is just another one of those necessary "diabetes says this is how it is going to be" horse pills to swallow and get over it... now if only they made that in a gummy I'd be happier.

Why take a horse pill when you can have a gummy?  

Mommy Genes

You know when you stop doing something for a while how difficult it can be to start up again? Even if it's something you love like exercise, cooking, flossing or ... writing ... it's just hard to get back in the habit after letting things slide to a tranquil, yet non-evolutionary stop.  But as GV and I have been home for two weeks and she is growing ounce by ounce (up to 7 lbs 6 oz!), it's really about time that I get back on the horse and begin regularly writing again... So thanks to some persistent and much needed prodding from HB, here goes:

While I can rationally look at the calendar on my refrigerator and see that I was pregnant only a matter of days ago, it physically and emotionally feels like it has been ages.  While I am still not entirely sure how to parent two kids at the same time instead of just one, it feels natural to have both GW and GV here and I love them both like they've always been the best part of me.  All of the traumatic worrying and flaming mental "what if" hoops of the pregnancy are now seemingly irrelevant and inconsequential - which at the time I thought would never come to pass.  Essentially, the magic "mommy genes" have once again kicked in and wiped the slate clean... 

After my first dose of mommy genes back in 2009, I happily anticipated their wondrous impact this go around: the phenomenal disappearing act it makes of labor pain upon first sight of the new baby, the awe inspiring, tantrum-taming patience it provokes, the sleep-deprived juggling and plate-spinning it balances and don't even get me started on the gigantic seemingly oversized heart it straight up causes.  It's like when the Grinch's heart grows three sizes in that one day - Dr Seuss must have mistakenly infected that green-goof ball with mommy genes!!  But, in all seriousness, the biology behind child birth and motherhood amazes me in it's combination of emotional simplicity and physical complexity...  there's nothing quite like it and, no matter how sympathetic a person you may be, until you've got 'em, you just don't really get 'em.

Big brother week one - October 2009

Little sister week one - November 2012

Actually, I must admit that despite having two children I still don't understand the breadth of impact mommy genes have on a person - especially on a broken pancreas.  Don't get me wrong, I remember very well the differences between the before GW me and the after and I've done more than enough reading on the medical explanations of what to expect when you're diabetic and expecting to catch the gist, but these super-genes have still managed to surprise me in the last few weeks with their significance... namely their apparent panacea for insulin dependence.  Okay, maybe that takes it a bit far... I wish mommy genes were like some hopped up version of stem cells or something that could actually cure diabetes, but the effects breast feeding is having on my body are a pretty darn good consolation prize.  

So, breast feeding while diabetic is like constantly running or doing any other endurance sport because the body is perpetually burning calories and glucose to make milk.  This means that there is an incessant risk for diabetic mothers to become hypoglycemic and, as such, results in a decrease in the artificial insulin required to maintain a healthy HgA1C.  Combine this with the much lower presence of hormones in a new mother's body and you're looking at insulin rates that are at - and in my case, much lower - than pre-pregnancy levels.

On one hand this means that, if not careful or aware of on setting hypoglycemia, that there is an increased risk for new mothers to go into shock post-delivery (remember my third trimester hypoglycemia was abnormal).  On the other hand, this can mean a very welcome return to eating carbs with absent minded fervor... for example (yes, this is seriously a big deal) I can eat upwards of six - repeat: SIX - miniature Heath bars just because I feel like it before my blood sugar will respond like they "ought" to.  Now that I am reading this it sounds kind of wantonly gluttonous to eat that much candy in one sitting, but pardon me while I cackle at my new found ability to smuggle simple carbs past my pancreas! THANK YOU MOMMY GENES!

Now I doubt this new trick the mommy genes have introduced to my body will do anything positive toward me getting back into my other jeans, but hey, we've got to cut them some slack... they have me cooing and gooing over my sweet little girl (she's sleeping in my lap right now and so darn cute with her smiles - see video) and able to pretend I'm somewhat normal for the time being.  Exercise is still four weeks off before I'm "cleared" to hit the pavement again by the perinatologist and there is plenty of time to cover that topic once HB and I've figured out our post-pregnancy work out plan.  In the mean time, I'm going to continue enjoying my maternity pants, turn my insulin pump on ultra-low, and grab a candy bar -- I'd rather be snuggled up with these two kids than out running anyway!

A whole bunch of pregnancy firsts.

As many of you already know, I wasn't a diabetic when I was pregnant with GW back in 2009.  I didn't even have a hint of gestational diabetes let alone a full on type 1 dependence on artificial insulin.  It was a normal pregnancy in many regards with no complications and only a few quirks - namely I didn't realize I was pregnant until week 12 (nuva ring, baby!) and GW arrived "pre-term" by being two days short of 37 weeks.  But all in all, the pregnancy with him was smooth sailing and what I'd typically refer to as "all pop-tarts and rainbows."

Obviously this go round is quite a bit different.  I've got type 1 now, I'm having loads of non-diabetes pregnancy complications and I don't even want to attempt to go there with pop-tarts or rainbows because (lets face it) those probably have more carbs per serving than I have insulin -- especially if the rainbows we're talking about here are made of skittles.   But seeing as this is round two for me, I know what a little bundle of joy I'll get at the end of this and I'm grateful to my pancreas for at least providing me a degree of perspective by sparing my first pregnancy from it's wrath.

The thing is, though, despite my almost three years of hands on parenting experience, there are so many new and different things with this pregnancy that I feel in many ways I'm a brand-new mom all over again:

• My medical care is different and more complicated - leaving many new tests to research and understand.  
• My diet is more restricted and calculated - requiring more attention and proactive tracking.  
• My to go bag is ready to go much earlier (okay, it's been ready for several weeks and is actually re-packed after last week) - making me more anxious and nervous for labor to begin.  
• My expectations for delivery are more grey - causing me to unavoidably "what if" about before, during and after labor. 

So although I'm some how managing to keep calm and accept that the only thing I can really DO to help Baby is put my feet up, I find my experiences with this pregnancy far more resemble that of a first-timer than typical of a pregnancy-vet.  Don't get me wrong, I'm not back to absolute square one of trying to figure out which way the diaper goes on or what the heck a Manhattan Whoozit is, but there is something to be said about the difference between a straight forward, non-diabetic delivery of a baby and the complicated, ultra-sensitive (I mean you're even allowed to eat - yes, more than ice chips) delivery of a diabetic. Wrapping my head around the changes to my experience-based-expectations is turning into quite the task and emotional challenge.

On a completely unexpected note, one of the biggest differences that I've noticed this past week between this pregnancy and the last is contractions.  I know this probably sounds weird, but bear with me... When I went into labor with GW the only sensation I experienced was this sharp, unbelievable point pain that I quickly learned was caused by dilation.  The pain I felt with that was more than I expected and - as a firm believer in modern medicine - very much the reason I opted for the epidural.

Oct 12, 2009 - post epidural and much, much happier.
Hallelujah!

The past two weeks, however, I've had my first taste for what a contraction feels like and I previously had no flippin' clue there was a difference between "contractions" and what I felt in Oct 2009.  Contractions, unlike dilation, feel more like a solid, crescendo-decrescendo of pressure spread across your entire uterus that cause it to go entirely rigid.  I would not describe it as painful, it's just rather unpleasant -- and actually, if labor and delivery were confined to only contractions and not dilation I'd venture to say that natural childbirth would be quite within the non-medicated pain threshold I personally have.   But seeing as dilation is the bleepity-bleep-bleep that it is, I have no shame whatsoever in saying "yes, please" (or something to that effect) to a gigantic needle being rammed in my spine.

Perhaps I've developed too much of an immunity to needles?

Honestly, the biggest change I am scared of (well beyond any possible necessary use of the NICU) is the challenge maintaining healthy-range blood sugar creates with breast feeding.   As with any calorie burning activity, breast feeding requires a mother's body to burn energy - aka glucose - to the point that many diabetic-mommy's report that it is excessively easy to experience their worst episodes of hypoglycemia ever (click here for an example).   Not that these other changes or complications have been a walk in the park, but it's scary to think that the "high risk" of being a diabetic mother doesn't necessarily go away once Baby is born.

When I was expecting GW the only intimidating part about breast feeding was that I'd never done it before.  In trying to sooth my nerves, HB and I experimented with the Medela pump we bought and it made such an audible suction sound that I insisted he try it before I did.  As an extremely supportive husband and incredible good sport, he did and within the first weeks of GW's life I took to that sucker (ha, literally) with far more confidence because of his gallant courage.  But this go around, I can't just ask HB to test drive for me... it's my pancreas and my second baby after all and not some odd electronic that in any non-internet based forum would otherwise make me blush.  Obviously, I need to do some more research on this topic so as to understand the implications of my disease better and hopefully dissuade some of the fears that go along with it.  I'll let you know what I come up with.

Without wanting to jinx myself, I really must admit that I'm looking forward to baby #3 whenever he or she comes around.  Maybe by then I'll have wrapped my head around not only pregnancy, but pregnancy and motherhood with diabetes that I can finally go into the experience with the luxury of fewer questions and concerns than before.  Course, knowing me, there will be some other nuance that will change the situation and give me yet another run at pregnancy with an amateur status... but, by the grace of God, I've got HB and two amazing children that will help me get through whatever that challenge is when it arrises.  All I ask, Lord, is that if I'm allowed my druthers that next time the complication is something as straight forward and "easy" as twins!