Friday, November 18, 2011

It's the Blood Sugar Roller Coaster!!!

Blood Sugar Roller Coaster!

Monday, November 7, 2011

Xander's Arrival Story Part 4

That first night after Xander was born was tough. Xander spent most of it in the nursery because none of us had had any sleep in what seemed like ages and I needed to recover. As exhausted as I was, I didn’t sleep well at all. A c-section is major abdominal surgery and I was seriously uncomfortable as a result, the nurse had to wake me up frequently to check how things were going, my blood sugar was trending low, and I was still throwing up like nobody’s business.

At one point, determined to get at least a little sleep, I asked the nurse to please put me on a dextrose drip. This nurse (who was not my favorite in general!) actually seemed hesitant, and then said that it would mean taking me off of the pitocin for a while. It was suddenly clear to me why I was still throwing up. I told her to switch it anyway and we could just switch back once my blood sugar was up, because being constantly in the 50s and 60s very simply isn’t healthy. She made the switch, my throwing up slowed down, and my numbers started to rise. (I also wasn’t in a rush to get back on the pit, because it was really just supplemental to what my body would do naturally to return the uterus back to normal.)

After that, everything was manageable again. I had lows, especially since I didn't feel up to eating full meals right away, but I could hold food and drinks down once I was off the pit the next morning. Other than having to ask for a lot of juice and soda, diabetes kind of dropped into the background again for the rest of our hospital stay.

Of which I am glad, because we had other things to focus on.

Xander was healthy, and seemed just so perfect! At 8 pounds 10 ounces, he was on the bigger side of normal (but was actually smaller than I was when I was born). The other common risk when a mother has diabetes is that the baby’s blood sugar can drop right after birth. Xander’s was described as “borderline” on the first test, but they simply fed him and all of the following tests were normal.

Chad, Xander, and I were Tired with a capital T. There were times when it took me 10 minutes to test my blood sugar because I would fall asleep 4 times before I finished. Seriously, I’m not exaggerating! Really! Chad has a little story about one time when I was going to put my glasses on, but I paused with the glasses suspended a few inches away from my face… and just dosed off in that position for a minute. When I came to, I just finished putting them on like nothing had happened.

But like I said, all three of us were tired. Chad was trying to feed Xander a bottle on Xander's second night and was just nodding off repeatedly. The nurse told him that if we’re going to give him bottles, “We can do that. Don’t try to be a hero. Let us keep him in the nursery, and you get some sleep.” I imagine this must have been a relief to him since I really couldn’t do much that day after Xander was born. Having a C-section makes even walking to the bathroom and back hard work, much less changing diapers and bouncing babies. Chad was suddenly thrown into the task of taking care of both of us. We let Xander go for the night and finally got some decent sleep.

To sum up the timeline: We went into the hospital Friday evening, Xander was born Saturday (August 13th) evening, and we left the hospital Tuesday afternoon. The entire experience was exhausting, but the results were so worth it.

Going home... Please focus on how cute Xander is and not on how
aweful I look when swollen and without makeup!

Thursday, November 3, 2011

In The Meantime...

I'll talk more about the initial adjustments when I give you installation four of "Xander's Arrival Story," but let me tell you, delivering a baby is like hitting "reset" on your insulin needs.  I still need far less than before pregnancy, let alone compared to needs during pregnancy!  But it's all in flux.  My one month average blood sugar?  116.  My most recent one week average? 145.
Can you tell by looking at those numbers that I started back to work almost two weeks ago? Yeah, pretty clear what's thrown a wrench in the gears.  I've had a few 200+ numbers sneak in there during work hours.  I finally took 20 minutes this morning to look at time of day averages and adjust my overnight basal rate and up the insulin on my breakfast and lunch I:C ratios. With both a baby and work to keep up with Time to get this under control.

I only have one set of organs, after all.  It's kind of important to take care of them!

Xander's Arrival Story Part 3

I'm finally posting the next installment.  I think I'll make a goal of posting the last installment by the end of this upcoming weekend!

They mentioned starting me on pitocin very early in the game because I wasn’t feeling any contractions, but I really wasn’t interested in that stuff. Contractions started not long after they got me all hooked up to the monitors, and I told the nurse that I didn’t want pit as long as my body was laboring on its own. I settled down to try to get some sleep, but I really didn’t get much at all. I’m guessing I had maybe an hour total, considering the disruption of contractions and nurses. Overall though, early contractions were not bad.

In the morning, the nurse pointed out that my contractions had gotten further apart and I was on a time-crunch since my labor had started with my water breaking. This hospital, like most, had a policy of doing a c-section 24 hours after that happens.

I was terrified of the stuff because of what some mothers had told me about their experiences with it, but agreed to the pit... but only after tears and a phone call from my own doctor. Long story short, I believed that pit was Xander’s best chance of being born vaginally.

Once I agreed to pit, I also planned on getting an epidural before contractions got intense. The pit didn’t “hit me” like I’ve heard so many women say. I could tell the contractions were picking up, but they still weren’t bad. After a while, at a point when the contractions were getting slightly harder to manage but not so bad that a contraction would prevent me from staying still, the anesthesiologist came to see how I was doing. He’d talked to me about the epidural the last evening and I really liked him and the way he talked to me. He obviously believed epidurals were a very good thing, but I didn’t feel pressured or talked down to when I expressed concerns. I decided this was a good stage, so he went to get what he needed for the epidural.

This was more scary and disconcerting than painful. Had I felt the same pain in my arm, it would have been an “ouch” moment. But when it’s going into your spine, it’s an, “OMG, needling in my freaking spine!!!!” moment when your lizard brain starts screaming. Your spinal cord is, after all, essential to your body working correctly! I had to struggle not to squirm, but once it was over it was worth it. My legs grew comfortably warm and I was actually more comfortable than I’d been in at least two months!

But they continued to up the pit, and that was about the last time I was 100% independent in managing my blood sugar.

There was a drawback to these interventions, and I’m convinced it was most likely caused by the pitocin. I started puking, which meant I couldn’t keep any sugar down when my glucose levels went low. At first I struggled to keep up, with marginal luck. At some point though, they hooked me up to an IV drip for a bit, and things smoothed out.

Worse than that, Xander’s heart rate dropped whenever I threw up. It lasted long enough at one point that a group of nurses came in and started manipulating me, turning me from one side to the other, and then finally putting a sensor on Xander’s head (so they wouldn’t lose track of his beat). That was truly scary. It also would have been truly painful, if it weren’t for the epidural. Vaginal exams before the epidural were, by far, the most painful experience of my entire labor. Putting the sensor in surely would have been even worse, especially considering it took multiple tries to get it in place.

I believe I labored for a total of 22 hours. Nearing the end of that, the doctor on call double checked and found that Xander still had not dropped, and my dilation hadn’t progressed well. I had a brief amount of time during which I could wait, but the chances of things not ending in a C-section were now extremely slim.

The doctor and a nurse stood there waiting for my decision, and practically all I could think of was how completely wrong it was to have to make such important decisions at a time when I was so utterly exhausted that I probably couldn’t have decided which flavor of popsicle to eat anymore. Chad asked them to leave for a minute, and both he and my Mom said they thought it was the best decision. I think I probably asked them a couple questions, and then I agreed.

And things were set in motion.

Everything was something of a blur from this point on and, once I was in the operating room with the anesthesiologist starting to deliver that cocktail of meds, my memory is very spotty. I know I couldn’t move myself to the table on my own even though my epidural was a “walking epidural,” because I was just so exhausted and had barely been able to shift my pregnant body around even before labor. I’d carried in my Dexcom, which I clutched in one hand, but had given my meter to my husband. He was sent to a room to get into scrubs and was soon over my shoulder. The anesthesiologist was over the other shoulder, and he described everything that was happening to me. He told me what to expect, which was mostly changes in pressure. I do recall that when he told me they were about to pull the baby out, I expected one sweeping motion but instead felt a lot of digging and manipulating before he was pulled free. I remember hearing his complaining voice and I remember him being shown to me, but I was so exhausted and drugged that I could barely see him. Chad went with Xander for the weighing and examination, as we’d discussed he would do if Xander couldn’t be immediately handed to us. Being sewed back up was slightly painful and the anesthesiologist asked if he could give me more anesthesia, warning that I wouldn’t remember the remainder of the procedure.

I’m pretty sure I wasn’t actually knocked out from the last dose, but my next memory is of being in a patient room, and being asked if I wanted to hold my baby.

To follow, recovery and first days with Xander…