GW is 5!!

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

Left: age minutes.  Right: age 5 years. 

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

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

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

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

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

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

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

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

Week 20: Fetal Echo

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

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

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

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

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

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

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

Accessorize your Triceps!

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

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

Literally.  

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

Cannula and CGM location options

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

Not quite as trendy as a bracelet or watch,
but, hey! It works! 

Fortunately, in the few days that I've been rocking this new look (note the implied confidence) I've seen more accurate readings popping up on my CGM receiver screen for my calibration tests and it showed in my endocrinology appointment this week.  Meeting with Dr. Rogacz to adjust my pump settings, get a grasp on appropriate symlin usage and run a new HgA1C I'm thrilled to report that all is looking tight and tidy.  My A1C is down to 5.6, my symlin dosages have been increased from 15 units once a day to 30 units up to two times daily and my settings are as accurate as they can be for the next five minutes.  So thank you for that, Dexcom!


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

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

It's a...

 

 

 Baby#3 is a Boy! 

Week 18: Level-II Ultrasound

With most pregnancies, moms-to-be go in for an ultrasound only a couple of times in their 40 weeks of gestation.  If I remember correctly, we only saw GW four or five times in total and that was excessive because of the circumstances (realized we were pregnant after we were already 12 weeks along).  With baby bump #3, today marks sonogram number six in only 18 weeks and I know for darn sure that we have many, many more to come. 

We went into the perinatal office today for our level II ultrasound to check on baby's physical development.  As I talked about with the previous pregnancy, the risk with elevated alpha fetoprotein levels is that either there is a malformation with the baby or there is a maternal issue impacting the reading.  While the second isn't necessarily a walk in the park, the first is obviously the more scary of the possibilities and this in depth analysis of baby's body helps rule out conditions like spina bifida and abdominal wall malformations. 

GV in tow, the sonographer gels-up my belly and projects the images of our little one on the screen inciting excited squeals and flailing toddler enthusiasm at the sight of  "BABY!!"  Starting with the spine, the image gradually works down the vertebrate one by one until the sonographer reports that all looks good there before moving on.  Skipping the heart because I'll require a fetal echo in a week or two anyway, she examines all the internal organs, the baby's growth in girth and length and, again, pronounces all's well.

Lapsing into momentary euphoria, all I can think is "THANK GOODNESS!!"  I can't even begin to tell you how relieved I am to once again have a healthy baby despite my abnormal readings.  Granted I know this means there is something up with either my diabetes impacting the pregnancy (typical) or that there may be issues with the placenta (likely), but as we went through these hoops last time I know that I'm in good hands and that my MFMs wont let anything get out of hand.  If it is, in fact, an old placenta as it was with GV, I can only pray that we don't repeat the abruption of all things.  High AFP, okay.  Placental concerns, gotcha.  Abruption - heck no!

Bringing me back to reality, the sonographer then asks the one question every second trimester mom is tempted by: "are you finding out the gender?"

Answering yes, but no - we're doing a fun gender reveal this go around because, why the heck not?! - she tells HB and me to look away from the screen while she pokes and prods the little guy/gal into a conclusive position. Taking a folded card from the cabinet she then announces "I'll be right back, I don't want you guessing from my scratching!" and exits the room.   Upon returning, she hands me the thoroughly stapled shut card and says "CONGRATULATIONS!"

As tempting as it is to open this card now and know what we're having, we found out the quick way the past two pregnancies and knowing now or this weekend doesn't impact what we'll have the rest of our lives.  Either, this card says it's another little girl (what I want) or it says it's another little boy (what I think it is) - but either which way, I'm putting that card in my purse, handing it straight off to the best mommy-buddy a girl could ask for (yeah, you, SP) and thanking God that baby is healthy and doing exactly what he or she is supposed to be doing: growing!    

Next appointments:  week 20 fetal echo and week 21 MFM check up.  But first: gender reveal! 

What do you think baby will be?  :)

Broken CGM. DANG IT!

I don't know what my problem is. I seem to have this amazing knack of breaking equipment that I've become thoroughly reliant upon.  At just over three and a half years into my life as a type 1 diabetic, I'm not only on insulin pump number three, but I'm now on continuous glucose monitor number two. 

Last night, our local RWB community hosted a September 11th memorial event supporting both Team RWB and another veteran service organization, Operation Enduring Warrior.   Intent on participating in this moving tribute, I anticipated run-walking between three and six miles of this "11 on 11" relay, but my blood sugar had other plans.  Waddling almost the full length of one whole block (see how I made that sound like a loooooong way?), I reluctantly had to turn around when my CGM announced my impending hypoglycemic doom.  As I didn't have sugar on me or on the stroller (bad habit to get out of, eh?), I shuffled my way back to our start/finish line to avoid catastrophe and wait for the triumphant return of our patriotic crew. 

HB leading the event invocation (check out that growing belly! Oh my!) 

Upon flopping down on top of the large green cooler RWB provided for the runners, I set my glucose monitor, keys and cell phone on the ground beside me as there was plenty of time (11 miles, even for the fastest will take a while) before needing to pack up for the evening.  I then spent the next couple hours cheering for our athletes as they completed their laps and knocked out their memorial miles, I conducted a quick interview with a local online newspaper and I chatted with both new and familiar faces about this, that and the other thing -- none of which did I conduct near my piled electronics. 

Finally, the event completed, we packed up our belongings and made the collective family decision to scrap the idea of going out to dinner as it was approaching 10:00 PM and,  therefore, well past the hour of human/toddler decency.  Having tucked the kids into their respective beds, I came downstairs to check my BG and grab a quick piece of toast or whatever else to eat before crash landing on my own pillow… little did I know, my night was just beginning. 

Upon reaching the kitchen, I pressed the main button on my CGM and promptly covered my ears as the receiver made the loudest BEEEEEEEEEEEEEEEEEEEEP I'd ever heard.  Reading the never-seen before message on the screen saying "HWFR CALL TECHNICAL SUPPORT," I attempted to compose my angry, confused and concerned mind into a calm and collected voice-mail to the Dexcom support team.  Unsure of what happened or how to fix it, I waited next to my phone for a return call until I'd fallen asleep.  Much to my annoyance, it was only when I called them back again this morning that I began to get even the slightest hint of what might have happened and what we could do to correct the problem.

Supposing that the receiver was stepped on, dropped in the ice water or some sort of combination of horrible fates one doesn't wish for one's electronics, the Dexcom representative attempted to walk me through the "simple" process of resetting the receiver before we determined that, nope, there was absolutely no shot at saving my barely six month old CGM from warranty replacement.  

So here I sit today, up a creek without my monitor and I'm feeling absolutely lost in the world.  A year ago, I was doing exactly what I am doing right now - occasionally pricking my fingers to test my glucose levels - and it wasn't at all a problem, but now that I've become so conditioned to having CONSTANT access to my trending information I feel uncomfortably naked and horribly ignorant of my own body.  It's like part of me has been amputated and my phantom parts are just too much for me to wrap my head around…  I keep reaching for my CGM and groping the bottom of my purse in hopes that the last 24 hours didn't actually send me back to the stone age only to remember that, yep, I was in fact stupid to be so careless. 

Fortunately, since my system is so young and still under warranty, Dexcom is overnighting me a replacement receiver and I should be back up and bionic tomorrow.  However, even with this quick solution turn around,  I can't help but kick myself for the irresponsibility, the unappreciation, the negligent behavior I exhibited yesterday that cost me, yet again, a piece of technology I am thoroughly reliant upon.  In a lot of ways I find my angst today incredibly ironic given how hard I fought against this system in the first place, but it just goes to show that the mind and the body can adapt to anything and I guess I'm finally okay being part plastic and batteries.  Maybe one day scientists will make a pump and CGM that will actually be able to withstand the trials and tribulations of an active life like mine, but for the time being, let's just hope I've learned my lesson and my new electronics are blessed with a much longer life than their predecessors.  

Week 15: Abnormal AFP Results

And so it starts.  

Had to provide my doctors with the oh-so-charming 24 hour urine test this past Monday along with several many blood samples to get the ball rolling on our alpha fetoprotein testing.  Somewhat anticipating abnormal ranges given the high numbers we found with my second pregnancy, I've spent the last several days stressing and nights tossing and turning.  And, for better or worse, my concerns came to a head today. 

Had my 15 week appointment with the newest partner at the Perinatal Associates practice, Dr. Obi (ironic name if you ask me), and I could tell just by the way she walked into the room that my AFP numbers were high.  Not having experience with our case history or our family's generally stoic response to medical complications, I expect that she anticipated a full on melt-down from HB and me to her news that my levels were 2.2 multiples of the median (MoM).  In the non-diabetic world, this number is perfectly fine given that "normal" ranges from 2.0 to 2.5 MoM, but given the higher risk for complications for both me and the baby due to my diabetes "normal" in my case is nothing higher than 1.8 MoM.   

Responding to her with a disappointed, but accepting "we kind of figured as much" she wasn't entirely sure how to respond.  Explaining that we'd been through this rodeo before, Dr. Obi obliged me by avoiding the implication-explanation and the if-this, then-that details and jumped straight to the next course of action.  

"It's standard to run the test again to double check the results and we can do that today.  If the results are high as this first test would indicate, we'll need to do a level-II ultrasound in about three weeks and get you scheduled for a fetal echo."

Having familiarity with both of these exams, we nodded and left with at least the conciliation that we'd have full answers in a few short weeks (not to mention that we'd likely know the gender of baby two weeks earlier than otherwise). 

That said, I'm still waiting to hear back on the results of the second AFP screening but I'm not expecting the results to be different from the last.   We go in for the level-II ultrasound on Sept 24 so, until then, fingers crossed! 

Freaky Friday, Medical Style

For the past three and a half years I've become accustomed to being "the sick one" in the family.  Hospital visits seem to be typical, a variety of specialists are on speed dial and I can't help but feel that one medical complication usually leads to another.  Throughout this roller coaster of diabetes induced boohockey, the rest of my family has been at my side and, GW in particular, has been my little trooper.  There to snuggle me through my hospital stays, to entertain us through longer than normal waits at doctors offices and to tell all nurses to "be very careful" when drawing blood because he doesn't want me to have another ouch, you could easily say that he's acclimatized to the world of medical issues. 

Left: diagnosis hospitalization at Georgetown University Hospital, January 2011.
Center:  partial-abruption hospitalization, September 2012.   Right:  week 36 ultrasound, November 2012.

Well, yesterday, GW and I swapped places and I have to say, it has me respecting him in a whole new light.  At the beginning of August, GW started speech therapy to help correct his articulation (for example, he often says the "f" sound in place of "th") and his therapist made the suggestion we have his tongue evaluated because of it's heart shape.  Indicating that this shape is caused by an overly tight frenulum (the flap of skin that connects the tongue to the bottom of the mouth), she said it may likely play a contributing factor in his difficulty pronouncing certain sounds.   

Thinking this made sense, I called our pediatrician to get her take on it and she recommended that we take GW directly to see a pediatric ENT by the name of Dr Robert Bahadori in Chantilly, VA who would be able to evaluate the situation much more accurately without being overly quick to surgery as a solution.  Stating that she'd take her children to him specifically if she were in our position, I thanked the pediatrician and promptly called to get GW an appointment with Dr Bahadori no matter how long the wait.  Having several years of experience with specialists as the "new patient" with minimal necessity requiring prompt scheduling, I anticipated it'd be several months before we could get an appointment with this particular doctor or that we'd be given the "our junior practitioner has availability" option, but much to my surprise GW was promptly scheduled for the following week for a frenulum evaluation. 

So back-roading it around the early morning commuting horror that is I-95 North, we arrived at the doctors office (which has an amazing children't play room by the way) where we were promptly seen by a nurse and then Dr Bahadori.  Walking in just as you'd expect a pediatric ENT to - aka Patch Adams style in a yellow shirt and polka-dotted bow tie - he casually asks GW to play with him by sticking out his tongue.  Looking at me for approval before doing something that would under other circumstances get him in trouble, GW darts his tongue out as far as he can (barely to the edge of his bottom lip). 

"Yep, tongue tied," says Dr. Bahadori. 

After a few more playful checks, the doctor looks at me and informs me that there are two points at which he typically sees frenulum issues.  The first is in the first four weeks of life when infants struggle with their tongue movement enough that it negatively impacts their ability to eat and inhibits growth; and the second is roughly in the three to six age range when speech issues begin to appear, as is the case with GW.  Recommending that we do a frenulectomy, Dr Bahadori explained that for those children under four months old, the procedure is a quick in office snip that can be taken care of at any time, but as GW is almost 5 years old it would require that he go to a surgical center and have full anesthesia to make the cut.  

Taking a moment to think about what's best for GW, all of these thoughts about the issues he's had flash through my head:  he can't push food into his cheeks when he takes too big of a bite, he always spits it back out… he uses his finger to swipe away the food that collects between his teeth and his cheeks… he can't whistle and substitutes a "hoot" he learned from Dinosaur Train as his version of whistling… the way he says "teef" instead of "teeth" and "birfday" instead of "birthday"…  the way he's commented that so-in-so is able to stick out his tongue (both because, well, his mom let's him and because he physically can).   Feeling like his little 4 years old life played out in seconds of random memories and snapshot images, I decided it made more sense to go ahead and enable him to use his tongue for the rest of his years by doing the clipping than it did to protect him from the terrifying idea of a scalpel anywhere near his beautiful little body. 

Estimating it'd take less than five minutes to do the procedure and roughly 1 to 2 days for recovery, Dr Bahadori helped me to schedule the procedure for two weeks later and, for better or worse, that came and went yesterday.    While I waited in a consultation room, HB escorted our popsicle-motivated little toughie into the operating room where he helped GW get into place on the table and helped to calm him as the "super-hero" anesthetic mask was placed over his nose and mouth.  While acknowledging that he was glad GW wanted his Dada to accompany him into the OR, HB reported that there was nothing quite so scary as leaving our little man lying unconscious on the table surrounded by scrub-clad strangers… 

HB and GW happily playing in the children's waiting room.

Having been "the sick one" for so long, this reversal of roles introduced a new level of helplessness into my hospital-based repertoire that I must admit I never want to feel again.  Knowing that my own cooperation with doctors orders, control of glucose levels and attempted maintenance of personal health is entirely irrelevant to the ultimate outcome what's happening with my loved ones made the experience far more terrifying than any of the other times I've been lying in any ER waiting for results on this, that or the other thing. 

Fortunately, my patience vs. parent-concern ratio wasn't tried as it otherwise could have been as it was literally two minutes after HB joined me in the consultation room that Dr Bahadori appeared.  Reporting that everything went smoothly, he cleared GW for regular activity within 24 hours and asked for us to call if there were any concerns that arose after discharge.  Impatient to get to the recovery area and see our little guy, we thanked the Doctor and eagerly walked to where GW was curled up under a blanket and eagerly awaiting not us, but the popsicle the nurses had promised to him.  Forty-five minutes, one popsicle and two boxes of apple juice later, he was discharged.  He had a rough afternoon and evening coming off the anesthesia, but in looking at him this morning he is keeping food down and appears to be happy about his new found ability to wiggle his ever-so-slightly medicated and considerably longer tongue.  

Left: Frenulum before procedure.  Right: Frenulum after clipping.

Out of all the procedures he could have had this one was particularly minor (knock on wood), but this reversal of roles provided me a considerable dose of my-own medicine and it definitely was lacking in Mary Poppins' sugar...  I've come to accept my own medical issues as typical and I'm no longer shaken when something new pops up with my body that requires additional attention, but I'd never really stopped to think about how my being sick makes my family feel.  They don't have the symptoms, they don't have to do the tests or get the injections, but they are just as much smacked in the face with my diabetes as I am and it's just as present in their daily lives because of me.  Seeing GW in his scrubs and having these doctors poke and prod at him was more painful than any of the things I've had done and it's opened my eyes to how high of a pain-tolerance this little guy has for everything he endures to be there for me.  For better or worse, he's grown up quicker because of my pancreas and he knows more about hospitals than any almost 5 year old should (Heaven help those children who know even more...), but Lord love a duck is that kid tough and I cannot say how thankful I am to have him at my side or to have the blessing of being there, as his mom, at his. 

"Can I have another popsicle?" 

Okay, fine. I'll talk.

It's probably about time that I actually start writing again… for a long while I've been buried under a voluntary pile of community service work and my hectic schedule transformed itself into a convenient excuse to avoid writing about what I wasn't ready to share, but now that it's pretty darn obvious I haven't just eaten one or two too many burritos I'm pretty sure the shelf-life of my "busy" excuse is up.  

So… long story short… we're pregnant!  HB and I are excitedly expecting Baby #3 this next February and, as of right now, I'm just about 15 weeks along.  It's been difficult this go around to feel comfortable announcing our news given how rough things were with GV's pregnancy, but, let's face it, not writing about this baby-bump doesn't impact the way things go anyway so I might as well get over it.  

Goodbye running condition!

Things started out a bit on the scary-end of the scale for us as we went in for our 7 week viability appointment only to have the sonographer and perinatologist say the baby was measuring much smaller than it should.  Instead of showing a yolk-sac size appropriate to the estimated date of conception - which is initially based off of the first day of the last menstrual cycle and then confirmed by ultrasound - the yolk-sac size was measuring closer to 5 weeks of gestation.  Asking to repeat the test in one week, we went back in with hopes of getting better numbers… unfortunately still measuring small the doctors prepared us for the higher probability of a miscarriage… something, you can imagine, we were terrified to hear.  Repeating the ultrasound again the following week as requested, the numbers were at least showing consistent growth from one week to the next so the doctors felt at least comfortable enough to grant us a due date two weeks later than initially expected:  February 21.  

Obviously this size-discrepancy left us still very concerned about our small baby, but powerless to do much about it we were sent home to wait for further information.   With five weeks until my next prenatal appointment, i tried to find pro-active ways to help care for baby since all else was out of our control:  I decided to limit my physical activity to the stair stepper as I did with GV to keep my heart rate below 140 beats per minute (going on the previously identified concern that hyperthermia could hurt baby) and we cut my carb intake as much as possible to control my glucose levels.  Unfortunately I found myself regularly chasing lows as a result of morning sickness and this second attempt wasn't terribly successful, but with a bit of hands on help from my endocrinologist we smoothed things out. 

One thing Dr. Rogacz taught me that I didn't realize with the previous pregnancy is that the injection of symlin during pregnancy hasn't been formally FDA approved yet.  So while she prescribed that I use it for the later trimesters of my pregnancy with GV, she was adamantly opposed to the idea of starting symlin during the first trimester with Baby #3.  I found this to be somewhat disconcerting, but GV turned out perfectly fine and those injections helped me to regulate my glucose - and therefore her development - so I anticipate that I'll start them again here in a few weeks or months. 

Anyway, so the next few weeks went by ever so slowly with more weight gain and vomit than ideal, but we finally made it to the week 12 neural translucency test.  Knowing that if all goes well this test would be only the start of the flaming hoops I'd be jumping through in the second trimester, we anxiously awaited the doctors assessment on baby's growth… 

… 

And, thank God, heart rate and size were right where he wanted to see them!!  The weight of the world seemed to lift from my shoulders as we discussed the normal ranges they were discovering across the board… talk about music to my ears!  Granted the doctor warned that we'd need to start alpha fetoprotein testing week 16 - the tests were we started to see abnormal results with the second pregnancy - so the music may be short lived, but hey, where we are right now is a definite step in the right direction! 

I must admit that starting to finally talk about the pregnancy, while nerve wracking and definitely to a certain degree unsettling, is cathartic.  I've been so worried about judgement and commentary from the peanut gallery about this, that and the other thing that all my concerns and angst have been bottled for the past several months to the point of pure exhaustion.  I haven't so much minded the exhaustion up until this point thanks to the support from HB and Grandmama, but getting past this phase of stress and morning sickness, and into the second trimester honeymoon phase that was so unfortunately truncated last time will be a huge relief.  

So with that, you now know, and there's no going back from here.  More soon! 

Supply... meet demand.

So HB and I recently had to change our insurance when he switched to a new job and under this new insurance policy I am not able get the my insulin pump supplies from the same manufacturers/suppliers as I was before.  Fortunately this change didn't mandate an entirely new brand of pump, so the hoop jumping I've been doing is relatively minor in the grand scheme, but I can't even begin to comprehend why this whole process is so. darn. complicated. 

First things first, I contact my Dexcom CGM's intermediary supplier to give them my new insurance information.  I've had a horrible time of it trying to work with this company to begin with so it wasn't too much of a shock when they announced that my insurance isn't accepted in their pharmaceutical branch but maybe - only maybe - their durable medical department could assist…  they, of course, didn't return phone calls or process my prescription for two weeks until I'd practically run out of sensors (3 days were left on the one I was wearing) when finally the company's management and I made sense of what should otherwise have been a very straight forward process.   Headache number one conquered (and "case management" officer identified for my file - time will tell on how she does). 

The second phone call I made to update my insurance information was to Medtronic, the makers of my MiniMed insulin pump.  For the most part, their customer service is ON IT and I love to work with them.  This time, however, my heart nearly broke when they flat out said they don't accept my insurance directly and that I'll need to start working with an intermediary supply company to get my infusion change supplies instead of working directly with Medtronic.  Given the terrible support I've had with these types of companies before, this was a bad-news-bears kind of moment.  Having been assigned to a new company, I called them to set up my account and start my next supply order which, much to my relief, seemed to go smoothly. 

Unfortunately my sense of relief came too soon.  When my supply order arrived, I found that the supply company decided to change the reservoirs I use in my pump from the 1.8 mL size to the 3.0 mL size given my recent increase in insulin use.  This is all well and good, minus the fact that the pump I use only fits a 2.0 mL size reservoir at the largest… meaning I'm up a creek with a bunch of supplies I cannot use for the pump design I've been wearing since 2011.   AWESOME. 

I call Medtronic to see what my options are - either I return the un-returnable medical supplies that I cannot use OR I see if a larger pump is covered under my current pump warranty (expires spring 2015 - eep!) and their legal definition of "medical necessity."  Fortunately, since their customer service rocks as I said, they were quick to discover that YES! I am entitled to a new pump… but it's on back order for at least 5 to 6 weeks due to increased demand for the 3.0 mL size snazzy, updated MiniMed pump.  Knowing I can't use the supplies I have on hand and can't  go without insulin for the next month and a half, Medtronic generously covered a box of the 1.8 mL size reservoirs for me so as to get me through the wait time.  Thanks, Medtronic! Grumble, supply company, thanks for screwing with my supplies and demand!

Note the size difference... 

Long story short, my new pump finally arrived and I'm in the process of updating my settings in pump #3.  I don't so much mind the larger size of the pump, it still fits in my pocket after all, but the ordeal of programming is a pain!  I have 10 different basal settings to transfer over (total daily basal currently 24.975 units), 4 different carb-ratios (ranging from 11g  to 15g carbs per every 1 unit of insulin) and don't even get me started on the random alarm/system settings I use to keep on top of my glucose treatment.  I know it will all be for the best once this whole two-month insurance-change deal is over, but for the time being my head is still ringing from the knock-on effects this hypothetically simple process caused.  

Maybe when it comes to my next three-month supply order this fall, it'll be straight forward.  At least one can hope. 

Actively Passively Aggressive.

With HB starting a new job and our switching insurance providers (thank you US Congress for removing pre-existing conditions clauses!), the bureaucratic flaming hoops pushed my three month endocrinology check-up back from June to July and I must admit I am feeling anxious about my next A1C.  I'd been slacking back in December with a general apathy toward the world of diabetes and let my A1C increase into the abnormal range with a reading of 6.5.  Feeling self-depricating and flat out pissy about my inability to be under 6.0 without constant focus on my blood sugar readings, I remember Dr. Rogacz looking at me and plainly saying "get over it, perfection just isn't gong to happen."  You can imagine the dismissive internal monolog my brain launched into at this...

Obviously this particular "get over it" method of diabetes management is beyond my scope of comprehension, so I decided to implement a more passive-aggressive approach toward my pancreas by starting on the Dexcom G4 Continuous Glucose Monitor (CGM).  Instead of making me prick my finger or forearm several many times a day to check my glucose levels, my CGM enables me to weekly insert a (rather bulky) sensor into my abdomen and then passively glance at the number and trend line displayed on my i-pod sized display screen.  Letting the CGM do the active work of testing every four minutes (yes, essentially constant), I can pretend I'm non-diabetic all I want without having to endure bruised and sore fingertips.   Granted, I have to calibrate the sensor daily (+) so I am not test kit free, but at least there is some emotional distance between me and my pancreas that didn't exist when my apathy shot my A1C up to 6.5.  

In a circular logic kind of way, my creative interpretation of "passive diabetes management" with the CGM is actually much more actively aggressive than it was before -- even when I was testing 10+ times per day during the pregnancy with GV.  By rarely testing my blood sugar but regularly monitoring the constant sensor information about my glucose levels and trend patterns, I lowered my A1C from December to March all the way down to 5.9!  It seems that despite my continued annoyance with the reality there's no "getting over" being diabetic, I owe all credit for my sanity and overall health to the technology that I'd previously been avoiding...  ironic.

Perhaps in being curious about what another three months of CGM usage will do to my next A1C I am actually starting to take Dr. Rogacz's advice to some degree and I'm finally curbing my apathy towards my diseases.   I definitely have my hopes up that I'll have an even better reading than 5.9 this go around and, as much as I may try to pretend otherwise, that shoots my "don't give a dang" facade straight in the foot.

My July 3rd appointment can't get here soon enough.

Long over due...

I honestly can't remember the last time I sat down to write something more than an email or news letter... how sad.  The last several nights I've been mentally kicking myself for letting yet another day pass without getting back on the proverbial horse, but then exhaustion takes over and within a matter of moments my alarm clock is going off and somehow all of the good-intentioned-tomorrows became a stream of oh-well-yesterdays.   While I can't anticipate this to be terribly pretty, let this blog post be the end of that and a return to what fuels me.

The last several many months have been chalked full of this, that and the other thing - some of it important and worth mention, much of it common and likely beyond my memory at this point.  Instead of focusing on what's been, however, HB suggested I simply list out what I could have written about and move on with it (with or without further details as necessary).  Makes sense and starts a clean slate, so here goes:


* My Dad had a massive heart attack two days before GW's 4th birthday in October so we cancelled his party and flew to Colorado.  Upon arriving, GW promptly came down with a passing virus and deliriously missed the whole trip while riding out the Motrin-wave.  Fortunately, while serious, the heart attack wasn't fatal and my Dad's made as solid of a recovery as one can and GW recuperated with a few weeks to thoroughly enjoy his birthday gift (the helmet) for Halloween.

* We raced in and finish the 2013 Marine Corps Marathon in 4:50:25 (goal was between 4:30 and 5:30).  Having missed the last 10 miles worth of distance training due to unhappy kids wanting no more than two hours in the stroller at a time, I hit the wall at mile 18 and limped it in the rest of the way with excruciating IT Band pain.  Thank goodness I had amazing support from HB and our awesome friend TS, I couldn't have done it without them.  THANK YOU!

* One thing I am not thrilled with from that day is my disastrous judgement with regards to my pump... I chose to keep it on me instead of leaving it in the car so as to enable me to get food at the finish line.  Unfortunately, the sweat and salt build up that happened during the course of the race broke my pump beyond repair - effectively preventing me from eating at the finish line anyway.  Thank Heaven, at least, that we have insurance that covered the cost of getting a replacement, because otherwise the cost of running 26.2 miles just became much, much, much more expensive!

* The pain I felt in Marathon wound up leading to an IT Band release surgery that took me off my feet and out of running for two months.  My doctor said that he was glad to have done it because my Band is the thickest he's seen and that it's no wonder stretching wasn't enough.  The surgery largely fixed the issue and I haven't had issues with it since starting back into running.  At some point I may need to go in to have the right knee done as well, but as of now I am a-okay!

* I gave in... I got a Continuous Glucose Monitor (CGM).  I can't remember what it was specifically that made me change my mind, but I've forfeited another portion of my abdomen to yet another diabetic device, which, surprisingly, is very handy and not nearly as obnoxious as I anticipated.  I'll definitely have to write more about my Dexcom G4 so I will make a note to save this topic for later.

* GV turned 1 year old in November and is the biggest bundle of joy you can imagine.  She's talkative, curious, friendly, incredibly smart and very engaging - particularly when she ought to be quiet at mass.  She eagerly wants to do everything GW is doing and, in spite of his initial protests and her flagrant acts of retaliation, they appear to be growing on one another with actual (there is nothing censored about these two) affection.

*  Much of the time I would have otherwise spent writing over the last year has been spent volunteering for Team Red, White & Blue. Admittedly, it does not provide me the same sense of accomplishment I get when I've written a piece I'm proud of, but there is definitely a happiness involved in creating a positive community that enables a sense of connection and belonging that didn't exist for me - and for many - before.  At just over one year into building our local Community we have roughly 300 members and I think it's about time to reclaim some of my own life and that starts here...

In the coming weeks I hope to finish some blog drafts I've had sitting around collecting dust and, with a little bit of luck, I will actually start some new ones.  I anticipate that in a similar sense to running, starting to write again may be initially painful and it may be difficult to find my stride.  However, I have faith in muscle memory and I'm sure my fingers can find their way one after the other just as one does when starting exercise again... if not, one has hope that HB is an excellent editor and all that is irrelevant to you!

Fingers crossed.

Post MCM IT Band 3 Mile Hell.

It's been nine days since HB and I finished the Marine Corp Marathon.  The tips of my toes are still numbly tingling, my knees continue to ache with every bend and my weight is still lower than it probably ought to be in spite of my excessive eating.  I feel like the world has been in slow motion ever since that mile 18 marker where each step became labored and each mile - now each day - seems longer than the last.  Obviously the change with daylight savings time can take some of the responsibility for this, but I have a hard time looking much farther than the tip of my nose for a better place to lay responsibility for my under-trained, over-stubborn pain.

I went into the Ortho yesterday - the beloved Dr. Hawken up in NOVA - and had him look at my knees.  Pleased to see I had zero swelling and to hear I've actually been stretching, he wasn't surprised to learn I finished the race or that I plan to continue my version of "short distance" running.  However, when HB outed me as having complained that my knees hurt worse during the marathon than the rest of me did giving birth to GV, Dr. Hawken narrowed his eyes and my options.  Identifying the non-aggressive approach as physical therapy and cortisone shots, he felt the boney structure of my knees once more and admitted the likelihood of continued pain following this treatment unless I were to wise up and pick a different sport.  Knowing me, as he does, he therefore recommended I skip the blood sugar chaos caused by cortisone, cut to the chase (ha) and go directly to the aggressive approach of surgery.

Explaining the details of a "release," Dr. Hawken outlined how he'd make a small incision and then punch a nickel sized hole in the IT Band to reduce friction at the knee.  Granted, surgery is surgery is surgery and shouldn't be taken lightly, but given the facts (my passion for running, the persistence of this pain and the permanence of this solution) and that he successfully fixed the carpal tunnel in both of my wrists in 2011 (not to mention HB's knee in 2012), I'm totally on board.  So sometime mid-December I'm going to have my right knee done and, once that is healed, I'm going to go back in the spring to do the left.

Course, in full knowledge of my current discomfort and what's in store for its remedy, I decided to give into my recent self-deprecating feeling of under-accomplishment (yes, post 26.2 miles I am feeling indolent) and go running with Team RWB tonight.  Having spent the past week hobbling stiffly like an injured grandma - if you can even call it that - and mentally whining my way from room to room, it shouldn't have been a surprise to me when less than ten steps into the 3 mile loop my knees went straight back to their rating of 12 on a 1-10 scale of pain... But since I didn't stop for the last 8 miles of the marathon, there was no way I was walking my head-lamp wearing self back to the car on my own to mope.

Hard not to feel motivated with these guys!! 

So, with HB's encouragement and the company of one very motivated RWB teammate, DN, I made it the full loop without stopping.  The last little bit I was able to kick up the speed a notch (logic: run faster, sit down sooner), but I know for darn sure that I am going to feel it tomorrow.   I am hoping to power through a 10k Turkey Trot and at least one more half marathon between now and the scalpel, so maybe by the will of God and perhaps a mix of my stubbornness and pain killers I'll get it done.  I'm already putting hopes of personal record (PR) times aside - which, if I am being completely honest, is very big of me.  I guess I am becoming nicer to me in my old age, go figure.

All for now.  BG is 107 and I'm going to bed.

Endo Check Up

I am so beyond frustrated with myself for having thoroughly dropped the ball on my blog posts recently... with the best of intentions I keep logging on to start writing and then immediately get distracted by something shinny and wind up hitting save after typing the most basic reference note to come back to in my "free time."  What with unpacking the new house, GW starting pre-school, GV being just moments away from walking and trying to really sink my teeth into my work with Team RWB, I've hardly had time for sleep let alone a coherently written sentence.  Fortunately for tonight, however, I told myself that I am not allowed to unpack another box until I put on background noise and, in order to do that, I decided I need to publish at least one timely blog update first.

So here it is.  

I went in for my every three month check up with the Endocrinologist this past Wednesday, Sept 11.  Beyond the issue that I couldn't provide recent blood glucose logs to her because I've lost my pump download USB in the move, I knew going into the appointment that it wouldn't be a stellar one.  The last couple months have been beyond difficult for me and not because of stress from running, Vermont or any of the other drama that has magically appeared, but because of the gosh darn fact that I'm diabetic.  I'm just done with it and I don't want to play any more.

I am sick of checking my blood sugar so often that my forearms get bruised and my finger tips are painful to touch.  I am sick of needing to count every dang tortilla chip I eat to make sure my carb counting is right.  I am tired of shopping for clothes with an eye to where to put/hide my pump rather than what actually looks good.  I'm frustrated that people glare at me in mass because my "pager" is going off.  I'm annoyed that my training runs resemble more of a staccato sprint than a crescendo of distance because of carb stops.  And, dagnabbit, I am jealous that HB gets a milkshake with his meal and doesn't bat an eye at the massive amount carbs he's inhaling absentmindedly.  It's just not fair.

Yeah, yeah, yeah, I know - life isn't fair.  And, yeah, I got it - God gives us what we can handle.  But that doesn't diminish the acrid reality that chronic is as chronic does and I don't want to "is" or "does" any more.  And, going into my appointment today, I knew that this attitude would come back to bite me  in the butt with my HgA1C reading.

Back at the beginning of June, my A1C was a 5.8  - which as you recall is within the limits of "normal." Today, it's up to 6.1, which in all reality is pretty tight for most diabetics, but is wildly loose for this one.  Between my current (hopefully ephemeral) apathy for the disease and an increasing difficulty with hypo- and hyperglycemic awareness it was no surprise to me that the numbers were up into the abnormal range, however marginal. I rationally understand that I need to do better and that it's just a matter of exerting a bit more effort into self-care, but, seriously, what stay at home Mom has time for self-care? Maybe some have figured it out, but I certainly haven't.

Of course, Dr. Rogacz was generally encouraging as usual and, knowing me far too well, she went out of her way to merely make a gentle nudge on the CGM topic rather than hit me over the head with my own bad attitude.   The latter would probably have been far more effective and appropriate, but I think she knew that I'm ready to give in to her this time anyway and give a CGM a chance since I'm already blowing off active participation in my disease... and since HB wont let me do that (however super model skinny that'd enable me to be) and our NFP requires better of me, I'm planting a white flag of general diabetes resignation and forfeiting the other half of my abdomen to Dexcom.

Sigh...

I don't know what my deal is... perhaps I'm just overextended?  I'm trying my hardest to be the best parent, wife, catholic and veteran advocate I can be, but I know I need to seriously step up my game at writing, home decorating and (oh yeah, supposedly doing a marathon) running -- maybe if I drop out of diabetes 101 the rest of life's course work wouldn't seem so heavy?  Figures, the one thing I don't want, is the absolute one thing I can't get rid of...

Diabetes, I seriously don't like you.

GW Starts School

My (not so) little man officially began pre-kindergarten today.  Ever since he had his interview last spring, he's been asking and asking and asking to go to school and I think it might have shocked him a bit when we actually said "yes, today you can go!"  So dawning new shoes (size 2!!), a plain "Just GW" shirt and his beloved dinosaur backpack, he raced through breakfast and marched to the car with absolutely zero trepidation. 

Course, just because he isn't nervous, that doesn't mean that us parents are in the same boat.  But in attempts to ease nerves for all concerned, the school invited parents to attend the first day with their kids today and, in probably the most adorable move ever, HB asked if he could be the one to take GW.  Obviously I was a bit sad to miss seeing the little guy in action for myself, but from all reports it sounds like he did a marvelous job.  On the playground he played on the bikes and with the trucks in the dirt; inside he made a bird puzzle and, during circle time, he even introduced the little girl sitting next to him because she was too shy to say her own name... awwwwwwwww!

Of course he's commented several times since he's come home about the pretty long haired brunettes in his class and their resemblance to certain princesses he admires (Kate Middleton and AS - you know who you are), but at almost 4 years old I've come to grips with the fact that this kid has excellent taste in women and I'm going to have to keep him incredibly busy with sports.  In fact, I've signed him up for piano lessons and soccer lessons already...

Let the age of school children begin! Congratulations GW, I'm so proud of you!

11 Miler

Since getting back to Virginia, I've really been struggling to find time for training runs.  Between unpacking the new house, wrangling the high-energy GW and fully-mobile GV and dealing with knee pain, things just haven't been falling into place for me to hit the trails.  Unfortunately, with only a handful of weeks left before the Marine Corp Marathon (Oct 27), I can't really afford to be missing as many runs as I am, but it is what it is and I've at least got running on my to-do list... that burns calories, right? 

Each week HB and I should be running four days, with short runs on Tuesdays and Fridays, medium runs on Thursdays and long runs on Sundays.  Lately we've done our short(-) distances on Tuesdays (thank God for RWB because it is at least one run we do consistently) and the occasional distance run when we randomly feel guilty about having missed our Sunday run goals.  Today was one of those days.  Last week we completely missed our 10 mile run when we drove back from Vermont (does 10+ hours in the car count?), so today we made a point to get out for tomorrow's 11 miler BEFORE we had an opportunity to miss it.  

We went over to the Mount Vernon Trail along the GW Parkway next to the Potomac River in NOVA and, aside from being a bit longer of a run than pleasant, it was a great outing.  Holding roughly a 9:30ish pace, we loped along the trail and randomly raced a family with two under-10 kids on bikes between water fountains.  By mile 9, both HB and I were feeling the distance and we were lapped for the last time by our young competitors who patiently waited at their car for a good-natured "na-na-na-na-boo-boo" in triumph.  Having managed to finish our desired distance despite pain and a sincere dislike of energy-goo, we accepted our defeat and happily congratulated the future Tour De France champions on their resounding victory.  While they might not be in our competitive age group, those two were an excellent reminder that finishing far outweighs winning -- after all, I'm running for me not for any competitive necessity.  Even if that means I'm thoroughly walloped by an 8 year old.

Welcome to the DC Metropolitan Area - let's go running!