Wait and see.

I apologize for the hiatus in posts over the past two weeks. Between my shear bewilderment over the Boston Marathon bombings and a horrific stomach pain that has had me sleeping since Monday I've been quite without comment.  But after having spent the majority of yesterday and this morning at the doctor's office running tests, it's about time I get back to it.

So Monday afternoon while driving with HB to get landscape rock for our yard my stomach and lower back began searing with pain.  Leaving him to load the 4 tons of river rock in to the truck, complete the landscaping and generally do everything that involves moving, I've been on the couch and barely eating ever since.  Finally opting to go see someone about it yesterday, the doc found my bilirubin levels to be high and ordered a complete blood panel and abdominal ultrasound that was completed this morning.

Thus far we haven't learned anything from the lab results and the ultrasound found nothing conclusive, but we have learned one thing: with an underlying, chronic condition general practitioners seem to automatically assume that diabetes is the cause of all of my problems.  Now, if my HgA1C was high and I truly had "poor diabetes management" as they accuse me of, then I'd nod my head in silent resignation that I've made myself worse with apathy. However, since my A1C is stellar and I test my sugar so often I have perpetual bruising from my lancets I refuse to sit passively by and take undo criticism of my self-care.  I mean at one point this morning the sonographer went so far as to ask if my stomach pain is because of "improper use of my infusion site" - perhaps a logical question if it wasn't in a completely different abdominal quadrant from where the pain is!

The thing is, while diabetes could be a problem and is regularly a bitter annoyance of mine, right now my diabetes is a reassurance that something beyond the norm is wrong and here's why: Before I began feeling ill on Monday, my blood sugar was completely stable, but especially over the last two days my bgs have been falling lower and lower without a relevant diabetes explanation...  Yesterday afternoon my glucose levels were low (63 mg/dL) so I corrected with a handful of saltine crackers.  But when I checked my blood sugar a few hours later at dinner and it was even lower (61 mg/dL), so I adjusted my basal to 70% of it's usual amount to account for being sick and I skipped a meal bolus for the minimal food that I ate.  Assuming this would set me up for stability via hyperglycemia over night since I had to fast for the ultrasound, I checked my post-dinner two hour postprandial, my bg was still low at 68 mg/dL... I grabbed a quick correction snack, adjusted my basal rate even lower to 50% and went to bed.

You'd think with half of my normal basal rate and a correction I'd have woken up this morning with my blood sugar well into the 100's - if not higher - but nope.  For the second day in a row, my blood sugar was down even farther to 41 mg/dL!  Since I couldn't even have water before this ultrasound I couldn't correct with either solid or liquid carbs, so at 7 AM I suspended my pump and removed it with the assumption that my sugars would naturally go up without my persistent basal dose.  Makes sense, right?
Well, yes, but it didn't work. Three hours later at 10 AM my blood sugar had merely gone up to 48 mg/dL... not awesome.

I've since had breakfast and found a temporary fix to my hypoglycemia, but that's beside the point.  The silver lining of my exhaustion, pain and zero appetite is that my diabetes is providing another quantifiable symptom to go from.  Typically when diabetics get sick the body releases extra hormones that cause a decrease in insulin efficiency and therefore causes unavoidable hyperglycemia,  but for whatever reason, something else is going on right now.  How obnoxious.

I guess we'll just have to wait and see what comes to pass.

Week 37, part two

Thankful for a labor free and turkey full Thanksgiving holiday, I was positively giddy to go into my last perinatal appointment at the Antenatal Testing Center on Friday.  Knowing that Baby's lungs aren't mature and that there wouldn't be a change in plans for what we'd do after this particular appointment ended, I felt like the day was going to be predictable pregnancy-wise for the first time in weeks.   Considering how worried I've been about the stability of my blood sugar, the occurrence of another abruption or whatever else could go wrong, it was a relief to walk in expecting a "simple" a non-stress test, my last sonogram (#20) and a quick conversation with the doc.

Being the day after a holiday, the testing center was ridiculously busy with two days worth of appointments -- there were 16 pregnant women and their spouses in the waiting room when we arrived -- we had a bit of a wait, but it was actually quite a pleasant wait because a 28 week pregnant woman came up and introduced herself to me because she saw my pump clip in my jeans pocket.  As it turned out, she has been a T1 diabetic for almost twenty years, she uses the same pump that I do and, as this is her first baby, she was glad to meet another insulin dependent mom juggling a kid and a baby.  Course I didn't have the heart to tell her that GW wasn't a diabetic baby, but it was nice none the less to swap battle stories and commiserate over the difficulty of our current circumstances... while it sounded like her diabetes gets along much better with her pregnancy than mine has, I really appreciate how this charming woman made me feel far less alone and stranded by my beta cells than I've felt in the last nine months.  So Erin, wherever you are, thank you for that!

Having seen me twice a week for what feels like months, the nurses called my family back to the NSTing area by asking GW to bring his mommy back.   While they're perfectly professional and good at their jobs, I must admit it is the personal touch these nurses give to patients like me that make me absolutely love them...  they put up with my family's quirks and a few of them have even let GW help with the testing process by allowing him to squirt the goo, place the fetal doppler and even help steer the sonogram wand.  Since things were going smoothly today and nothing was abnormal with the sono or NST, they had nothing but nice things to say and well wishes to our family upon my "graduation" from routine testing. It'll be kinda sad not to see them all the time, especially Tam and Sandy, but Lord knows there's always the next pregnancy, right?

Reviewing all the little details, checking my cervix for progress (2 CM) and confirming the plan for my induction on Tuesday, Dr. Bronsky verbally walked HB and I through the last few days of pregnancy.   Knowing my interest in moving about for the sake of labor progression, he said to fly be free and have a nice weekend but to plan on being bed bound from 8 PM Monday until post delivery (boo, walking helped so much last time) on account of how "brittle" my diabetes is and how closely they'll need to monitor the baby because of it.  While I am not thrilled to hear that, I understand the priority and I value that he's concerned with/aware of how sensitive my body is because of my stinking pancreas.   All we can hope for is stable, low (but not hypo) numbers over the next several days and through delivery...

All that being said, I've got a couple days of pregnancy left and by Tuesday (at the latest) we'll go from a family of three to a family of four.  We're going to spend the next several days enjoying our time with just GW and, hopefully, we'll go into next week with minimal complications and confidence in the arrival of a happy, healthy baby girl.

Week 33

It's hard to believe it was a month ago today that I went to the hospital for the placenta abruption.  That day seems like it was just a couple days past and yet it also seems like eons ago... on one hand the stress of the experience and the nerves of it happening again make me feel just as scared as I did in the truck driving to the Stafford Hospital ER, but the boredom and anxiousness brought on by modified bed rest and limited activity make the action of it all seem like a completely different lifetime.  Overall I'd venture to say I'm far more agitated about the progression of things than I'd like to admit, but I'm sure if you were in my shoes you'd be just as concerned and anxious to have a healthy baby to hold and this pregnancy behind you.

Apparently NST go a lot faster after downing
Starburst to fight off blood sugar lows...
Go figure, sugar makes Baby active.

We had our first weekly appointment with the Perinatologist on Tuesday and that officially kicks off the routine non-stress tests and fetal weight screenings.  They did the 13th sonogram of this pregnancy and, much to my relief, it showed that Baby is looking pretty good.  The amniotic fluid levels are normal, the placenta seems to be as stable as it can be given its injury (and does not show signs of advanced calcification), her weight is a bit high at 4 lbs 12 oz but more or less on track for her gestational age and she fortunately remains vertex.  The sonographer was a bit concerned about Baby's leg growth and repetitively measured her femur to ensure her readings were accurate... but her worried expression vanished when she looked at HB and announced "oh, you're the source of stumpy legs" (no, I did not stifle my laugh).   Unfortunately for our daughter, she wont have my long legs, but I think it's actually safe to say that HB is quite relieved and happy about that.

Looking over things, Dr. Bronsky was generally happy with the progression (or lack there of with particular regards to my cervix) of things and recommended that I "continue doing what you're doing" (ug).  He agreed that my recent blood sugar logs are of concern and asked me to keep them posted if hypoglycemic episodes persist because while it looks like the cause may be Baby's appetite (trend estimates for her birth weight were I to make to to 40 weeks are currently in the mid 9 lb range), my placenta has been a persistent concern of theirs and they don't want to take chances.

So I'll head back in again next week for another round of flaming hoops to waddle through and we'll go from there.  If things continue as is, we'll be scheduling an induction (or c-section, depending on how things look at that point) for the week of Thanksgiving or the week after.  While I am glad things are stabilized enough for the doctors to make such statements, I'd be lying if I didn't admit that I hope Baby arrives a bit sooner than that... the persistent concern for her safety, the continuation of increasingly painful contractions and the heart wrenchingly painful look of disappointment on my son's face when I tell him that no, I still cannot pick him up is just a lot to emotionally handle for another four or five weeks.  Obviously I want her to be at a gestational age that is healthy for her to come out and I want to avoid the use of the NICU if we can, but as soon as those boxes are checked lets get this baby girl out and move on from pregnancy complications to new baby bliss.

In additional news, I also had an appointment yesterday with the Endocrinologist since the whole plan to fax in my logs completely fell flat.  The nurse practitioner thoroughly reprogrammed my pump and decreased my insulin rates almost across the board.  Two weeks ago my total daily basal rate amounted to 17.5 units and now it's back to 15.3 -- while that might not seem like a lot to those of you who are diabetic or understand insulin usage, it's a huge amount for someone like me who is so extremely insulin sensitive.  She also adjusted my target blood glucose ranges to be slightly higher to ensure that I'm not dropping lower than I really need to -- so even if the 70s are "safe" to be in, why not shoot for the 80s or 90s and hope for better bg averages?   Fair enough.  I'll go back and see her in three weeks if my blood sugar stabilizes and maintains safe ranges, otherwise I'll see her sooner as necessary.

So... where does that leave me?

Well, at 33.5 weeks, it leaves me waiting for what's next and prepping the nursery, house and family for the arrival of Baby.  I've been doing a bunch of research on diabetes and infant mothering (remember, I'm brand new to this combination) and it's amazing how intertwined the pancreas is to each of the choices I make and, since that little baby is entirely dependent on external care for quite some time,  her overall well being.  As this post is long enough as is, I'll save it for another day, but let it suffice to say that I'm generally overwhelmed by information overflow, physically uncomfortable, anxious for safe delivery and ready to get this show on the road... Granted ready for Baby and ready for Hurricane Sandy are two very different things, but let's just hope that Baby understands that things have been complicated enough as is without being born during the - to quote the Washington Post - most "unprecedented and bizarre" storm that "may be unlike anything the region has ever experienced."  We'll see how that goes.

Week 29 Hospitalization

So after six days of hospitalization, three extra sonograms, countless finger sticks and at least one too many hospital meals I am back at home. Given my last blog post I am sure that comes as a bit of a shock to some of you, but apparently things weren't going as smoothly as my appointment last Tuesday would have made me believe.  Let me explain:

Last Tuesday evening at 7 PM while helping HB sort things at our storage unit, I suddenly got a gush of bright red blood that scared the boohockey out of me. While starting the drive to our doctor in Fairfax I called my perinatologists and was promptly told to scrap the idea of driving an hour north and to get to the nearest hospital ASAP.  Pulling a tight right turn, HB got me to the Stafford Hospital within a few minutes and I was rushed to labor and delivery (L&D).


Upon getting to L&D, the nurses and doctor frantically hooked me up to the non-stress test monitors to check on the Baby and watch for contractions. Fortunately, the baby looked stable and unbothered by the excitement; unfortunately, I began preterm labor with regular, intense, every two minute contractions. They administered an antibiotic, the first dose of steroids to mature Baby's lungs if she would require delivery and an IV drip of 3 units magnesium sulfate to slow contractions. They did a sonogram to find where the bleed was coming from (the placenta), to see if the cervix was open or closed (partially open externally, long and closed internally) and to measure the amount of amniotic fluid (28 cm of fluid on the amniotic fluid index scale, shouldn't be more than 20 cm).

It was at this point that the OB on call explained that she and the Stafford Hospital were not equipped to handle a high risk case like this (yes, I found that scary) and that they would need to transfer me to either my hospital - Fairfax INOVA - or the local University of Mary Washington Hospital depending on how stable they could get me for ground transport. They needed my bleeding to lessen, my contractions to weaken and be less frequent - which eventually happened enough around 12 AM to allow for the shorter (aka less risky) transport to UMW Hospital.  So with every seven minute contractions and minor bleeding I was loaded into an ambulance and sent on to the next hospital.

For my first ambulance ride, I've got to say it was overwhelming and uncomfortable being the one strapped in to the speeding, bouncing (ouch!) vehicle that I usually watch go zipping by. But in 9 minutes and 42 seconds I was from one ER door to another and by 1 AM I was admitted to the L&D department at the local high risk hospital.

At UMW they gave me a second ultrasound, continued the magnesium for another three days, did continuous non-stress tests and administered the second round of steroids to mature Baby's lungs for delivery. I continued to have bleeding and slower, but regular contractions into Thursday morning and by Friday the bleeding subsided substantially and the contractions were sporadic enough for me to be transferred by ambulance again to Fairfax INOVA for longer term observation and care decisions.   GW helped the paramedics get me loaded up:

At the L&D triage at INOVA my doctors requested additional labs and a third ultrasound to actually diagnose the cause of the bleed and preterm labor. While I don't understand the medical nuances of the situation as well as I would like, essentially what happened is I somehow sustained an injury to the edge of the placenta that caused hemorrhaging and it was the bleeding that caused the preterm labor. In the sonogram the rupture seemed to be clotting (and Baby was "plugging" the area with her fingers - smart girl!) and the doctors expressed hope that by the following week I'd be able to go home.  They also said that throughout this whole ordeal Baby has looked stable and is extremely resilient, so despite my "irritable, sensitive uterus" (the doctor's words, not mine - fitting, eh?) she's been fine and that gives them comfort and confidence.

So on Friday night I was transferred from L&D to the High Risk Perinatal unit on the 6th floor of Fairfax INOVA. I was given daily non-stress tests and asked to begin kick counting for a general idea of fetal movement.  Baby continued to look beautiful on the monitors and responded promptly in her kick tests - which I thought was very agreeable of her.

And so begins the week 32 non-stress tests at week 29

Then, finally, yesterday morning the doctors announced that I could go home.  It's kind of bitter sweet to be back in my own space - I'm thrilled to be back with GW and to be causing less difficulty for my family, but I'd be lying if I said that being so far away from INOVA didn't scare me.  For the past many months I've been fearful of the day I might look down and see blood where it ought not be during pregnancy and last Tuesday the reality of what happened was far more terrifying than I could have even imagined (impressive, considering I'm a pessimistic worrier).   I'm definitely nervous that it will happen again and, considering I am still having sporadic contractions, I don't have much confidence that I'll make it to term (another seven weeks) let alone be clear of the NICU... I know God only gives us what we can handle and I managed to stay composed for the majority of the hospitalization (the paramedics actually asked what drugs I was on because they didn't believe I could be that calm on my own), but this has been a lot to take and I'm feeling far more delicate than I know how to deal with.

The doctors were quite murky in what they wanted me to do for the next several weeks, but I have a follow up appointment next Tuesday where I should have more comprehensive answers and new updates. I'm not exactly on bed rest, but I'm also not supposed to do much - and lifting is completely out.   For the time being I'm taking things easy and trying to prevent further muscle atrophy (lost 5 lbs in the past six days) by moving about the house.  I've got GW's halloween costume to make and a bunch more scrapbook pages for Baby because of this episode, so I think I'll be bonding with our couch.

Thanks to everyone who sent emails, text messages and flowers while I was in the hospital - your support means more than you know.

My source of hospital smiles.
What a good boy.

Week 29 Prenatal Appointment

Had my week 29 prenatal appointment this afternoon and I am happy to report that things are looking (mostly) good. The Sonogram shows that Baby is right where she needs to be size wise (a healthy 3 lbs flat) which means my AFP abnormalities are not presenting growth restriction issues and my blood sugar control is tight enough that fetal growth isn't excessive. The sonogram also showed my placenta is securely out of the way of the cervix and it's high enough now that the phrase "what previa?" is completely appropriate to apply to the remainder of the pregnancy. While this is obviously great news, that doesn't necessarily mean I'll get the vaginal delivery I've been hoping for after all – it appears that Baby is extremely content to hang out in a fully breech position and unless she flips over, I'll still require a c-section. For the time being I'm not going to worry about it since there are several many weeks left and I'll just be content to be annoyed with her use of my cervix as a trampoline.

We did receive one new bit of bad news that will require additional monitoring (yes, on top of what they're already doing) - the doctor said that the placenta is beginning to look "old." While I have yet to do my typical extensive research on what this means, it is my basic understanding that toward the end of pregnancy the placenta begins to calcify as it prepares to detach during labor. So when a doctor refers to an "old" placenta that typically means that it looks to be closer to 39 or 40 weeks old, which is not an issue at that point in a pregnancy, but obviously at 29 weeks that's not exactly awesome.

Having read of other diabetic mothers experiencing this complication I was not terribly surprised to have the doc introduce the issue, but I will admit it's frustrating to hear of yet another thing that could/is going wrong with this pregnancy. I asked her if there was anything we could do like an injection of botox or apply a prescription strength anti-wrinkle cream but apparently, much to the dismay of my sense of humor, there really isn't much that is doable about it. She said we need to keep an eye on it more closely by watching amniotic fluid levels for decreases, my blood glucose for unexplainable hypoglycemic episodes or drop offs in fetal growth from possible malnutrition.

So with that "I'm old" announcement, my placenta signed me up for every two week appointments a month earlier than typically necessary. While my life seems to be a revolving door of doctors appointments at least I can say that this little girl will have one very full pregnancy scrapbook with all the hoops they have me (gingerly - come on I'm 29 wks pregnant thank you) jumping through.

Week 26: Good bye second trimester

Week 26, the final week of the second trimester, began this past Tuesday with my second perinatal appointment since I've been back in Virginia.  As the past two weeks have been spent consciously (and unconsciously) brainstorming questions and concerns about the pregnancy, I arrived at the doctors office with a long list of topics to cover and completely full of jitters about what new complication or difficulty they'd uncover this week...

I dropped off what feels like the billionth urine sample (seriously, this is ridiculous, I'm doing one a day and one per doctors appointment) and we were immediately ushered into the ultrasound room.  Which reminds me -

I completely think a shout out is due here to the Perinatal Associates of Northern Virginia for their amazingly prompt and punctual service! At the OBGYN's office I used during my first pregnancy, Care for You OBGYN, all of us pregnant Mamas would be left sitting in the waiting room for hours after the "appointment time" started.  I always tried to schedule my appointments so that HB could come and wouldn't miss too much work, but every time my appointment would be scheduled for 3 PM I wouldn't even get seen by a nurse for my vitals until sometime between 4:30 and 5:30 - and they insist you show up on time!  It was horrible.  Even if I hadn't been diagnosed with diabetes and didn't required a perinatologist instead of a regular OB, I wouldn't have gone back to that office even if I'd been paid to go.  But that is beside the point, the Perinatal Associates of NOVA are on the ball and they deserve much praise for their amazing patient care!

Where was I? Oh, right!

- So the ultrasound specialist has me lie down, squirts the warmed (yes, ladies, they bother to warm the goo!) gel onto my protruding belly and begins to check things out.  This particular specialist isn't as chatty as the other one is, but she's got the kind of "shh-I'm working" demeanor that you don't really mind that she's engrossed with her work rather than asking what color you've painted the nursery (yellow by the way).  Any way, she clicks and clicks and asks me to roll over this direction and then lay back again and - oops! Baby moved - roll back this way again and ba-da-bing!  She announces the placenta has moved up by 3.5 cm and that the baby's weight is - exactly - on track for this week at 2 lbs flat.  After helping me wipe off the gel, she presents GW with yet another series of ultrasounds shots for Baby's already thick scrapbook and happily shows us down the hall to the nurse's station for my vitals check.

After learning that my blood pressure and pulse are still remarkably low (a good thing), my weight is increasing at an appropriately slow rate and that my son is adorable (well I knew that, but it was nice to hear the nurse say so), we were seated across the big mahogany desk from one of my favorite people on the planet - Dr. Barbara Nies. She took a look at my new HgA1C numbers, my sonogram results and my daily pre-preeclampsia logs and without a note of uncertainty in her voice pronounced that my sugars look fantastic, my placenta previa is no longer a concern at 3.5 cm and that I'm as fit as a type 1 diabetic Mama can hope to be at this point in pregnancy. Which means:

* I am not doomed to a c-section unless another problem arrises, but given my history with successful vaginal delivery the doctors are hopeful things will progress as they did last time.  (Ladies and gentlemen, get your stop watches ready, I'm gonna try to beat the 35 minutes active labor record from last time!)

* Pre-term labor is not as major of a concern at this point and they're hopeful that I'll make it at least to 36 weeks, but that'll probably be plus or minus two weeks given my pregnancy history.  Between now and then, they'll continue watching my blood pressure for signs of preeclampsia and Baby's growth rates for irregularities as a precaution.

* With the partial placenta previa out of the picture and just a normal low lying placenta to work with, the doctors have lifted my no exercise restriction and they're even allowing me to pick up GW if it doesn't hurt my back.

So all of that is fantastic news and I couldn't be more thrilled with the out come of the appointment!  I am relatively hopeful that my week 29 appointment in three weeks will go just as smoothly as this one did.  As we'll be signing on the dotted line for the property we are purchasing in VT (have I mentioned that yet?) at the end of the month, I am kind of banking on the doctors saying I continue to look fantastic (and what pregnant woman doesn't like to hear that?) and will let me travel back up to Middlebury for closing...

What did you expect?  You know me by now:  we keep things complicated!

Level II Ultrasound in Burlington today...

My 20 week ultrasound had to be moved to 18 weeks because of a need to watch complications more carefully.  Unfortunately I was all excited to learn the sex of the baby at the 20 wk appointment, but today I am just an anxious wreck (didn't sleep at all last night) with far too many worries about what the doctors have to say and what the next five months will entail.  I will let you know what we come up with, but please keep fingers crossed for us (and send some prayers upstairs if you believe in that sort of thing) that complications remain minor and minimal!

Here goes...

So I've made the announcement...

As of this past week, everyone who knows me personally should know that I am expecting baby number two.  My husband and I are very excited about this and can't wait to meet "Baby" (our name for him/her) later this year!  My due date is December 11, 2012.

The thing about this pregnancy, unlike the first one, is that this go around I am diabetic.  I can't tell you why or how my body's islet cells continued to function properly under the stress of pregnancy back in 2009, but the reality is I will never have a "normal pregnancy" again.  From here on out, all pregnancies I may have are considered to be "high risk" due to the elevated probability for birth defects and other complications caused by insulin dependence.

To be completely honest I've spent much of the past year and half since my diagnosis worrying about the implications of pre-existing diabetes to my subsequent pregnancies.  I've done quite a bit of extensive reading on the topic to arm myself with the knowledge necessary to make the most informed decisions about building our family and I feel like I've formed the best possible medical team I can for my location to help me get through it.  It still scares me to think that my body can harm the precious thing growing in me, but all I can do is be aware of my own actions and what they mean for the baby.

Comprehensively explaining the complex biological issue of diabetes in pregnancy is best left to the professionals, but for those who are curious the most basic implications are:

• Poor blood sugar control (an HgA1C above 6.0) at the time of conception is likely to cause birth defects in the first trimester as this is the time when the baby's major organ systems (particularly the nervous and cardiovascular systems) are developing.
• As the pregnancy goes on, the placenta acts as a sponge for insulin and makes the mother's body not only insulin dependent, but insulin resistant as well.  This means daily insulin requirements can double or even triple just to be able to control the body's glucose response to hormones and ingested carbohydrates. 
• Poor blood sugar control in the second and third trimester causes the baby's body to increase insulin production and therefore the storage of glucose.  This means that the baby will be putting on extra weight to protect itself from hypoglycemia and can result in an overly large (10lb+) baby.  

While there are definitely factors of this short list that can be greatly expanded upon (what defects are probable, which tests are done, what all this means for delivery, etc), I will only be writing about what I experience in this pregnancy here rather than the laundry list of possibilities.  The take away from this list, however, should be that tight blood sugar control is CRUCIAL for the mother to have well before conception and during the pregnancy to ensure the best probable odds for her baby's safety.

That being said, my husband (HB) and I worked extensively with my medical team for five months prior to conception to get my blood sugars under tight control and to get all aspects of my medical profile up to best possible condition before adding the complication of pregnancy.  I got my HgA1C down to 5.2 (the best number I have had yet) and, God willing, that number reduces the risk of diabetes caused birth defects to normal pregnancy standards.  In order to maintain this reduction in risk, the doctors have given me a ceiling of 120 mg/dl or less for my 2 hour postprandial blood glucose readings... which FYI is wicked tight control.  So far, I'm doing pretty well by testing 10+ times a day and my numbers have been relatively consistent in the 65-120 mg/dl range with the occasional unexpected high reading.  I will say though, my insulin usage so far has gone from roughly 18 units a day to about 45 units a day... we'll see what my ratios and numbers are as the second trimester wears on and the placenta begins to work its oh-so-unappreciated-magic of insulin resistance.

One thing I am really enjoying about being diabetic at this point is that I get a sonogram almost every appt.  With GW (my son) I had four ultrasounds throughout the entire pregnancy, but at only 16 weeks along in this pregnancy I've already had four and expect two more in the next month or so.  By the third trimester I can expect bi-weekly sonograms and stress test to check in on the baby, so I know he/she is in good hands and I am thrilled that I get to see the development a bit more closely this go around.

The final thing that I think ought to be shared at this point (more to follow over the next several months of course) is that because of the third point listed above, the doctors will not be allowing me to deliver the baby after 39 weeks of gestation (first week of December).  This means that based on what they find with the ultrasounds in that final trimester, they will either schedule me to be induced or (if necessary) to have a c-section before the baby is full term.  Ideally the baby will stay put as long as possible, but we'll just have to wait and see what happens come November. (I am secretly hoping for a Thanksgiving baby, just don't tell the Doc on call for that day... ha).

 All for now.  I head to the doctor tomorrow again tomorrow, so I'll report back soon on how Baby is doing.