Let the whacked-out labor dreams begin.

For those of you who have never been pregnant or have never spent a significant amount of time around a woman who is pregnant, news flash: pregnant women have crazy vivid dreams.

From the reading I've done out of sheer curiosity on the topic, the increased amount of hormones in a woman's body are partially to blame for these dreams when combined with the increased amount of sleep a pregnant woman requires and the increased number of times a Mama-to-be wakes up mid-dream because of (i.e.) fetal kick or needing to pee.  By waking up mid-dream, our brains are able to remember what we were dreaming about due to the recency of the experience.  And since we only sleep in 20-25% of a dream state, these factors create a prime environment for the wildest, weirdest, scariest things to happen every time we lie down to rest and the details of which rush back upon roused from sleep.

I've had several dreams lately that I woke up from wondering where the heck that line of thinking came from, for example in one I lived at high school, but my high school was actually the preschool I went to and in another I was roaming around New York City looking for a parade to lead.  Last night, however, was a first for this pregnancy:  I dreamed I was in labor.   It's my understanding that the baby-related themes pregnant women dream about are generally about what is currently going on in real life or about anticipated events - like what gender the baby is, what he/she will look like or what a wonderful/horrible parent the Mother will turn out to be.  But as the transition into the third trimester begins, which I do in just over one week, the big day becomes an ever present possibility with waking each morning and anxiety about uncontrollable factors seems to drive dreams about what could happen.

In my dream, mid-week 26 (this next week) I started to exhibit serious signs of pre-term labor.  I had regular contractions (which by the way, Braxton Hicks this go around stink since I know and remember what actual contractions feel like) and I began to bleed (a serious sign of complication with placenta previa).  So I went to the hospital and my doctors (who weren't actually my real doctors, but some shmucky dream doctor) didn't believe I had the symptoms I reported, refused to do an exam and promptly sent me to the labor and delivery waiting room where crazy women, like they thought me to be, were put to wait it out until actual labor began.   Rounds and rounds of horrifically young looking medical students were sent in to "check on my progress" but after the first three sets of them, I quickly realized they were there not to care for me but to practice their bed side manor... I was not amused.  Eventually, the doctor did come in and asked me to lie on the middle of the floor in the hallway because of the "proven expediency" this tactic had - had with what is a question I never got an answer to.  It was only after significantly hemorrhaging on the floor did they begin to take me seriously, but it was at that moment of unadulterated panic that I woke up... 

Charming, yeah?  I agree... not so much.

Of course HB was all sorts of reassuring that what happened in my dream would never happen in real life and that he and my doctors have me covered for the worst case scenarios, but I tell you what, that is not the introduction to labor related dreams I had hoped for.  I so enjoyed labor (admittedly after the epidural) last time and I so want this time to go like the first because of the sense of accomplishment and connection I had with the physical act of delivering my own baby.  But with the complications this go around, I don't know when or how delivery will go and frankly that increased degree of the unknown with Baby just makes relaxing into peaceful sleep all that much more difficult.

I remember a dream I had when I was pregnant with GW about how I heard a baby crying some place in our house but I had no idea where it was coming from.  I know I felt lost before becoming a mom last time - I had no idea what I was doing and I had all sorts of concerns about my ability as a woman to emotionally connect with this tiny being.  Retrospectively that was the most ridiculous concern to have given the wonder of mommy-genes, but for me at that point such anxiety was perfectly real and unfortunately relevant in my sleep. With this pregnancy, however, I know I'll connect with her and that we'll adore each other, but the search for quality medical care and the ever present reality of diabetes et. al. as complicating factors makes my pre-birth protectiveness of Baby all the more intense.  In my waking life I'm doing everything I physically and emotionally can and I am working with the best people possible, but in sleep the "what if's" I don't let myself ask creep in and scare the boohockey out of me...

I know it is perfectly normal to have nightmares and for dreams to color outside the lines of reality, but I've got a request for you, Mr. Sandman:  try bringing a dream about Baby that is all pop tarts and rainbows next time.  Go ahead, man,  turn on your magic beam and Mr. Sandman bring me a non-crazy, non-scary, non-complicated dream!

If you are interested in the topic of pregnant-dreams and want to read more, click here and check out this fascinating article.

And that, my friends, is the Webster's definition of amazing.

So my endocrinology appointment on Monday came and went with next to no fanfare.  I anticipated the doctor to tell me that my numbers this past week were atrocious and that my body is obviously becoming insulin resistant, but instead she looked at my numbers over the past three months and decided that I actually need to turn my sensitivity levels down from 80 ml/dl per unit of insulin to 85 and that if I continue to see regular lows I should decrease it even further to 90.  Fair enough...  beyond that she had nothing else to say about my self care and asked to see me every three weeks until the baby  is delivered.

Unfortunately their office was out of the in-office HgA1C test kits and they were unable to tell me right away the most important information of the appointment.  HB, GW and I trotted down stairs to the hospital lab to have them run the test and I must say that I had the best phlebotomist I think I've ever encountered draw my blood with absolutely zero pain.  Maybe I'm getting too used to needles, but seriously this girl managed to get four vials of blood without even the smallest pinch!

Any way, I had to wait and wait and wait and wait and... wait before finding out what the number was.  But instead of eventually receiving a random phone call from the nurse's assistant, the doctor herself called to deliver the news. My HgA1C is down and that it is the wholly impressive number of 5.3!  Yes, people, that is in non-diabetic range and, yes, I have been doing that well with my blood sugar control.  Little party for me!

For the time being, I'm continuing as is until my next appointment with her on September 14. The reason she wants to see me every three weeks until delivery is to make sure that my sugars are in the range they need to be in for the third trimester of pregnancy.  It's particularly important that my blood glucose be under control now because if they are too high too often then the baby will grow larger than she ought to and that could lead to issues with delivery.  Furthermore, it is very important that my sugars are in control with regards to my other pregnancy complications because if Baby could arrive whenever it is extremely important that my sugars are normal so that the baby is born with normal blood sugars as well.  If my sugars are high, that glucose is transmitted via the placenta to the baby and causes her pancreas to increase insulin production to combat her resulting high bgs.  But if she is born while I am hyperglycemic and she is subsequently disconnected from the placenta (aka the source of extra glucose) she will be born hypoglycemic and will need to be put in the NICU until her sugars stabilize.  Which I, obviously, want to avoid to the best of my ability.

I'm planning to keep my sugars on lock down until she's out, but even during delivery I am planning to run my own diabetes management.  Typically most hospitals want to take over checking a diabetic's sugars and administering insulin via an IV drip for the patient, but I am not comfortable with anyone's standards but my own - so I'm going to do it.  Either HB or I will check my bg every 30 minutes and we'll keep my pump on so that we can fine tune as necessary to keep me at 120 mg/dl or under throughout labor.  If I have to have an emergency c-section, obviously that goes out the window, but in all other scenarios I'll fight anyone tooth and nail to maintain as much control over my body and my pancreas as I possibly can.  It's my responsibility, after all, to grow this baby and raise her once she's out, so while I am willing to accept outside help I reject anyone's suggestion that I hand over the responsibility for my baby daughter while she is encountering the world for the first time.

Yes, I am stubborn, but you probably noticed that already.  Ah well, this stubbornness is why my HgA1C rocks the socks off of my endocrinologist... pardon me while I keep it up!

Holy OW.

So I had a feeling that this might happen sometime soon since I'm not putting on too much weight and the baby bump is getting bigger and harder, but alas inserting my infusion site has become a ridiculously painful experience.  I went to reinsert the site at a new place on the left side of my abdomen and instead of only going into the subcutaneous fat like it usually does, the needle bounced off my abs or uterus or something and seriously hurt like all get out.

Don't get me wrong, I have a really high pain tolerance and I am used to the pinch of a two inch needle jabbing my stomach every few days, but having a needle hit muscle or something more tender than fat is SO uncomfortable.  I've had to switch my infusion sites from the parallel lines next to my belly button to my sides since Baby has oh so lovingly deposited extra cushion for Mama there... So far the swap seems to be working out, but it makes lying on my side uncomfortable and carrying a purse is a bit painful when it bounces on the site.  Oh the joys of being a diabetic!

In other news, I've been completely on the ball with checking my blood pressure twice a day, weighing in daily and checking my urine for protein to make sure preeclampsia isn't setting in.  So far things are all within normal levels and that is great.  I'm going to be talking with my perinatologist at my next appointment about whether his concerns are for "IF" preeclampsia sets in or "WHEN" it sets in.  I'm not sure what to make of this high risk pre-preeclampsia routine since preeclampsia is frankly much more intimidating to me than any of the other complications we're having with this pregnancy.

The Preexisting Diabetes and Pregnancy book I've been reading has several many stories of women who had similar combinations of complications that had their babies as early as week 30 (which, by the way, is only six weeks from now)... scary. But face it, week 30 is better than week 24 -- and week 36 is even better than week 30!!  I registered for delivery this morning with the Fairfax INOVA Women's Center and I am glad that is ready to go just in case.  I've pretty much resigned myself to the expectation that we'll likely deliver earlier than optimal and that the use of a NICU may actually be required, but that is all in God's hands and I can only hope for the best.