Monday, January 24, 2011

General update - feeling good!

Well, last week was an eventful week with doctors, and this week will be too, but first I wanted to give an overall update on how I’m feeling at week 33! In short, I feel great. I’m not overly tired or sore or miserable in many of the ways I’ve heard other women can be at this point in their pregnancies. I am a bit uncomfortable at times as my belly gets bigger, and Baby B is starting to give me some good hard kicks that make me jump, but overall, I’m thankful that I’m feeling really good.

My appointments last week went like this—first the fetal cardiologist, then the CDE, then my OB. Here’s a quick summary of them all:

Fetal cardiologist:
Baby B’s heart looked about the same as it did last time. She said the bigger the baby gets, the harder it is actually to see on the echo cardiogram, so she didn’t get a great look, but felt confident that the valve in question isn’t any worse than it was two weeks ago. She said she’d be surprised if the baby needed to have the balloon procedure done in the hospital in the days after delivery and that it is more likely to be done in the months after delivery, if at all. I took this all as good news!

CDE:
My CDE took my A1C and also went over my eating and pump rates. My A1C was 6.0, which she was happy about because they’ve wanted me a little higher than I was before since I was going low a lot. I wasn’t thrilled with this (I was getting used to seeing those 5’s), but if they are happy, I guess I am too. I’m taking A LOT more insulin now than I was in the beginning of my pregnancy and while this is to be expected, my CDE suggested trying to eat less carb-heavy foods so I won’t require such mammoth doses of insulin—so, goodbye bagels and potatoes, don’t worry, I’ll be back soon!

OB:
Everything went great at the OB. I had an US and they checked all the usual suspects—the baby’s movement, position (head down still!), fluids, etc. Everything looked good and I was happy to have an uneventful appointment. Next time we’ll discuss the details of my delivery plans, but my OB did say that she has no problem with me leaving my pump on during delivery, which I was very happy about.

So, all in all, everything is going well, despite the baby’s little heart issue. In terms of the bigger heart issue (my dad’s heart), we found out last week that he will need bypass surgery, which sounded very scary at first, but is actually pretty routine. I’m just hoping they can do it soon so I can be there. If they do it too late, I won’t be able to travel to Philly to be there, so we’ll just have to see.

Tomorrow we’re off to the children’s hospital where I’ll deliver to meet with the folks in the cath lab who would perform the balloon procedure if it becomes necessary and we’ll also meet with a genetic counselor. I’m still not really sure what the genetic counselor has to offer at this point, but I go where I’m told these days. They’ll also take us by the NICU just so we can see it in case Baby B ends up there for whatever reason. Finally, I’ll have my weekly US so they can peek in on the baby to make sure all is OK in there.

While this all seems like a lot and maybe overkill, I’m so thankful that I’m part of a medical team and system that is so prepared and willing to spend a lot of time with us in preparation of all the what ifs.

So, hopefully I’ll keep feeling well, and we’ll sail on through this week without any major issues popping up!

Tuesday, January 18, 2011

What a week

Well, I’ve had some time to digest the news about Baby B’s heart issue, and I’m feeling much better about it this week. I know that we have great doctors, and that even if we do need a procedure to fix the problem, it’s very routine and simple. I still worry that something else could pop up now, either related or unrelated, but I don’t feel the uncontrollable need to cry or inability to shake the worry anymore. It’s amazing what a little time can do to make you step back and get some clarity.

As far as my diabetes has been, it’s been a roller coaster. I literally sometimes will just give myself what seem like totally random and unwarranted amounts of insulin just to keep myself in a good range. While this has been working the past week or so, I need to get better about logging again so I can reset my basal rates and insulin to carb ratios so that I’m not just taking shots in the dark about how much insulin to give myself.

This coming week is a big week for me and my growing family. We go back this week for another fetal echocardiogram where we hope to get a little more information from our cardiologist and will have a chance to get some of the questions we’ve come up with over the past two weeks answered. I also go to see my CDE, who will do an A1C, and I’m very nervous about that because I feel like I’ve been high a lot more than I like to be over the past couple of weeks until I started randomly doling out insulin. I also go back to my OB for a regular check up and ultrasound, so there is a lot on my plate this week—not to mention the fact that I’m still attempting to at least pretend that I’m being somewhat productive at my full time job.

On top of all that, a new stress has been added to the mix. My dad, who has Type 2 diabetes, has recently started to suffer from various complications mainly due to the fact that he has ignored his diabetes for the last 15 years or so. I wrote about this recently on the ACT1 blog. Most recently and very ironically, we’ve learned that my dad now also has an issue with his heart. He will be going in tomorrow hopefully for a simple procedure that is similar to the one that Baby B may need if necessary, but if they get in there and the damage is too bad, they will need to do bypass surgery at a later date.

So, I’m trying to stay as composed as I can through all of this, both for my own sake, and the baby’s. I know stress isn’t good for the baby, and certainly not good for my blood sugar either, so I’ve been working hard to just be rational and as calm as possible about all of this. I also know there isn’t a blessed thing I can do to control any of this, so at this point, I feel like I’m just a player in one big waiting game.

I hope my next post will be full of updates of good news and bright outlooks for Baby B and for my dad. In the meantime, I’ll just keep working to control the only thing I can even try to control, and that is my diabetes.

Sunday, January 9, 2011

Broken Hearted


I’ve learned in the past few days what a helpless feeling it is to know that no matter how much you want to, you can’t always protect your children from bad things that may happen.  I’ve worked so hard on my blood sugar leading up to and during my pregnancy, but in the daily flow of testing, taking insulin and counting carbs, I got lulled into thinking that diabetes was the only thing that could negatively affect my child.  But, when I went for my second echo cardiogram late last week, seemingly out of no where and apparently unrelated to my diabetes, they found an abnormality with the baby’s heart—something called Pulmonary Valve Stenosis.  Basically, one of the valves in the baby’s heart is not working properly, keeping the blood from flowing the way it should.

When the cardiologist first explained what was going on, I felt waves of panic, which I tried to fight with reason.  The words that the doctor was using—valve, stenosis, valvuloplasty—confused and crippled me.  I tried to get my thoughts straight, knowing that I needed to ask questions that would help me make sense of the situation. 

It sounded so serious when the doctor was first telling me what was going on, but as I kept asking her to stop using medical terms and to explain what this meant in layman’s terms, I came to understand that luckily, this particular abnormality is fairly easy to fix should a fix be needed. They may need to do a relatively minor procedure called a percutaneous balloon pulmonary dilation, or valvuloplasty, on the baby sometime after delivery to fix the valve and that should be it.  It is also possible that nothing will need to be done, and the baby may just need to be monitored by a cardiologist throughout the early years of its life.  In terms of heart problems, this is one of the more mild things that can go wrong, and I know I should be thankful for that.  But, ever since I found out, I’ve felt an overwhelming sense of helplessness and fear.

My shower was this weekend (more to come on that), and while it was so nice to spend time with friends and family and it was a great day, as people kept asking how I was feeling and how the pregnancy was going, it felt like I was getting punched over and over.  I smiled and said that everything was great, not wanting to get into it, but my head was spinning with thoughts of everything that could go wrong from here and I fought several times to hold back tears.  I’m not sure why, but even after talking with all of my doctors and hearing how easy this situation is to handle, I am so upset over this whole thing.  Every time I feel the baby move, I worry that it is straining it’s heart, or every time I get stressed, I worry that I’m putting stress on the baby too.  I’m not sure if it’s the pregnancy hormones or what, but I hope in the coming days I can snap out of this fog. 

So here we sit, both my baby and I, with broken hearts.  I just hope that as I work on healing mine, the baby’s will begin to heal as well.

Monday, January 3, 2011

Living Large

I had my 30 week (ahh!) check up and a growth scan today. We were so excited to see Baby B. because it’s been a while! The ultrasound itself was sort of disappointing. Since it was a growth scan, they zoom in on specific body parts (head, abdomen, leg bones, etc.), so you can’t really see the whole baby which was what we were hoping to see. The tech seemed to be in a big rush and also got the gel stuff all over me, so we weren’t a fan of hers. Then, to top it off, the sonogram she printed out was almost totally black because the printer settings weren’t right. I should have asked for another one, but I was busy trying to clean myself up.

During the scan, she said that the baby was measuring a little big. This was my biggest fear. Apparently the baby is measuring in the 73rd percentile, which my doctor said was nothing to be concerned about now (they start to worry if we get into the 90th percentile range), but it is trending on the high/average side as opposed to just the average/average side and since I've been battling some highs (more on that later), I wasn't happy to hear it. Since I haven’t gained much weight, and my A1C’s have been low, I was disappointed by this, but my doc said that often in Type 1’s they worry about the baby being too small because of damage to the mother’s blood vessels from long term diabetes. Apparently, however, this is not a problem for me—my blood vessels seem to be doing what they’re supposed to be doing. I actually hadn’t heard that before and was left wondering how that tidbit of information had escaped me until now.

During the scan, the baby's head was down—when my husband heard this he got nervous because he thought that meant the baby was in a "ready, set, go!" position, but that is not the case. Hopefully, however, Baby B. will stay head down until delivery. No wonder I’ve been feeling kicks up by my ribs!

Also, my blood pressure was great today, which I was really excited about since I’ve been worried since my last appointment about developing preeclampsia. Phew!

My doc also said we need to start thinking about pediatricians. Luckily, there is an office right in her same building, which we love, so we’re going to start there.

I have my second fetal echo cardiogram scheduled for later this week, and then back to the OB two weeks from today. After that, they want me in once a week at least for an ultrasound to make sure the baby is doing OK. While I know it will be a lot, it will also be reassuring to be able to peek in on the baby that often :)

I hope everyone had a great New Years – I know we can’t wait to see what 2011 brings!