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Update on BSparl: Third Trimester Goodies.

We've made it this far:  the seventh month of BSparl's little cookie-baking gestational period.  Seven months and one week, actually.  Third trimester. 

(Holy.  Crap.  She's almost here!!)

Last Friday, Chris and I were at Joslin for the first of many, many third trimester appointments.  Turns out that from here on in, the visits to the doctor become as regular as Siah waking me up by putting her nose in my ear. (Read:  all the time)  Here's the long run-down on what's what with the BSparl (and for those bored by the pregnancy posts - bear with me.  Only about nine more weeks to go!):

Baby Girl Sparling, clocking in at 29 weeks

OB/GYN:  She did a quick scan of the baby to take some measurements, and I was very, very happy to hear that BSparl is right on track with her weight.  One of my concerns, and rightfully so, is having a very big baby, but BSparl clocked in at 2 lbs, 11 oz and falls into the 51st percentile for weight, so she's not exhibiting signs of "big diabetic baby" yet.  

"She's long, measuring in a week ahead.  That's a nice surprise!" Dr. T said, laughing as I scooted my 5'3 3/4" self further up the examining table.  

"She'll be tall.  And lanky.  And slender," I said, hoping BSparl will have her father's metabolism instead of my sluggish fight-for-fit.

We discussed, briefly, the day of BSparl's birth.  Apparently, I'll be disconnected from my insulin pump at the last moment and put on an insulin drip, because that's the route that Joslin takes with its mothers-to-be.  "If you have a scheduled c-section, we'll pull the pump right before we do the epidural.  And if you have natural birth, we'll do the drip before you're in active labor."

"So you guys will be monitoring my diabetes throughout the whole mess?  Will I be able to test and treat myself, as needed?"  I asked.  This was a concern of mine, and Chris's, because we are so used to being able to test my blood sugar whenever I feel "off," and the idea of having to rely on others to keep tabs just didn't sit right in my mind.

"Oh, no worries about that.  You can test, with your meter, as often as you want.  We just want you using the same meter throughout, you know?  That way, things are consistent.  We can use your meter through the whole process, if you'd like.  Totally up to you."

"And there will be a glucose drip, too?  In case of lows?"

"Yes.  That's a good question.  Lots of times, keeping moms higher is part of the trouble.  Active labor is like being at the gym!"

"And a c-section isn't a guaranteed go yet, right?"

"Not yet.  I want to see the results of your eye dilation this month, and if that spot near your left macula has been reduced, we can discuss natural birth.  But if it's still there, I'd like to really keep the c-section options open.  I want your baby out, and I want your eyes safe, all together.  But you don't have any protein in your urine, and your baby's size is completely normal, so the only thing that may dictate a c-section are those eyes."

News to me.  So there's still a chance I can deliver BSparl naturally.  (Don't get me wrong - "naturally" means "with drugs," as far as I'm concerned.  I'm tough, but not nearly that tough!)  I have an eye exam scheduled for the end of February, so that will determine how the baby makes her entrance. 

Endocrinologist:  Dr. B and I ran through my basals (her response to my increased rates throughout the day, "Whoa!  I knew this was going to happen, but I'm glad you made the adjustments.  But whoa - some of these spiked a lot!") and made some adjustments to my insulin-to-carb ratios.  Overall, my numbers are creeping up a little higher all over the place, but this is on-par with how a diabetic pregnancy progresses.  Damn insulin resistance!  I'm up to about 60 units of Humalog a day, which blows my old insulin prescription out of the water.  I actually had to have Dr. B write me a new script so that I would have enough insulin to get me through the end of April. 

(And for those who asked about the 185u insulin cartridge in the Animas Ping, it's the same size, essentially, as the one in my Minimed 522.  Before pregnancy, using about 25u total of insulin per day, that size worked awesome for me.  Now?  I'm refilling the cartridge mid-way through the second day and just switching out the set on the third day.  I'm anticipating that my insulin needs will drop dramatically once baby girl is out and that anti-insulin hormone producing placenta is out, too.)

Basically, this was the nerdiest endo appointment I've had yet.  After giving her the quick rundown on our trip to Sundance (the crew at Joslin is very excited for Chris, which makes me grin), we crunched numbers like two little accountants, minus the cool visors and the green lamp.  But by the end of the appointment, we'd done a little more tweaking, and when I see her again in two weeks, I'll hopefully have steadied out a bit.  They drew an A1C and a CBC, and I'm holding my breath to see if the A1C holds steady or goes up a bit.  (I am expecting an increase because of the overall increase of my numbers, but we'll see.)

Phew!  Long day (long post), but only two appointments.  And starting in March, I'll be there once a week to monitor BSparl and her little world in there.  And then, I'll be there twice a week to keep tabs.  I will eventually rent a room at the Joslin Clinic and live there, until my daughter is born.  Good thing I have a flexible work schedule at the moment.  Otherwise, I have no idea how I'd manage this routine.  

The best part of the day, of course, was just after Dr. T put the ultrasound wand on my belly, and the baby swirled into view.  BSparl head-down, feet up, and very active.  And even though she was shy, once again, in showing us her face, I did see her eyes and her cheek and the crest of her little mouth. 

And I love her.  Every teeny inch of her.

Comments

How exciting! Don't be so quick to assume you'll need drugs for labor. See how far you can go without. I did that and it was time to push when I decided I might need something if it was going to get worse. I love reading your pregnancy posts and seeing the differences between a gestational diabetic pregnancy (became Type 2 eventually) and a Type 1 pregnancy.

Glad to hear that things went well at your appointments! The last few weeks of a type 1 pregnancy are chock full of doctors visits! (I was scheduled for 3 a week from 32 weeks gestation on!).

Keep up the good work!

Ahh - again - amazing post to make me feel like I'm the one with the bun in the oven. Makes me very proud to know you (((smile))). You sound right on track. Be glad that you aren't as small as my Mum was when she had me (she's 5'1") - ok - she was nonD - but had thyroid condition (hyper) - and I was born at home - plus I was a 10 lb bundle of joy (sorry Mum). I don't think your little BSparl will come close to what I weighed in at - but the main thing is that she and Mum be as healthy as two peas in a pod! :D

I have NO pain tolerance - I cry when they take blood - but I did labor without drugs twice. You'd be surprised what you can do. I tell all moms-to-be to prepare for natural childbirth just in case they're like me and they go so fast that there's no time for interventions.

I wonder what the post-pregnancy hormonal roller coaster is going to do to your blood sugar. That may be a conversation you want to have with your doc before the birth, because there's a steep learning curve with having any newborn, and you don't want to have any surprises with your diabetes on top of the adjustment to motherhood.

That is exciting!! Hopefully you get to go naturally (with drugs if that is your choice). I was abe to go naturally (kind of). I was induced and I was great until they dialed the pitocin way up. I did it for as many hours as I could and then asked for drugs. It made the experience so much better for me.
I was lucky in that I was able to wear my pump and tested with my own supplies the whole time. They did let me know like with you that if I had a c-section that pump would have to be pulled right before. It never happened so I didn't have to worry about it.

The only thing this time around that I will be very careful of is I plan to pull my pump after I give birth. I had so many horrendous lows after birth. The lows contnued for SEVERAL days. It was such a flurry of exciting things that adding lows to the mix was an awful experience (like 20's and 30's) and they came on fast and furious. I will be much more careful about my pump this time around.

Continue the good work with Bsparl - we are all rooting for you and Chris too!

You are such an inspiration, Kerri! Go BSparl!!

Oh wow Kerri, this is great to hear. Not being pregnant yet I know there are a lot of unknowns about the process but you are helping put my mind at ease with your play-by-play! Thanks :)

Woot! 9 more weeks!!!!!! Awesome! I don't blame you on getting the drugs. The crazy thing is, I wasn't on insulin at all when I gave birth to Niya, strange?!?

Sounds like you're right on track!! That's great news and all of this is mentally stored for me for when I need to go back and reference everything you've said!

I've heard the lows post-baby can be really bad and read somewhere that someone had stashed glucose tabs, juice boxes, crackers, etc. in just about every corner of her house (esp. areas where you feed baby) so you can grab & go easily without disrupting BSparl! :)

Not long now, these last few weeks will fly by! You'll have to start packing the hospital bag soon. Can't wait to meet her!

You're amazing, Kerri :)

You make me just burst with happiness and hope that someday I'll be a mother even though I'm diabetic.

such a cute baby belly Kerri :) ...carry it proudly!

I'm a guy, so in some ways I really can't relate, but as a Dad of 2 I think I can say with clarity that ANY delivery is natural...as long as what you deliver is a homosapien, that is. LOL My wife delivered first child via c-section and second, as I like to say, "The Old Fashioned Way" Both kids, beautiful no mater how they got there. So ease your mind and realize that no matter how she gets here, she's yours and your hers....Good luck the rest of the way.
(kids were best thing I ever did--after marrying the wife that is) Peace.

I love these pregnancy posts, they are very informative on what to expect!

Nothing but well wishes!

I'm definitely NOT sick of the pregnancy posts! I know everyone is different but these posts have been easing my mind a bit about eventually getting pregnant with type 1 diabetes. The process has always been a fear of mine so thank you for posting the details of your pregnancy. Very much appreciated. She's almost here! Happy to hear it was a good appointment.

That's really a different approach to your pregnancy than my dr's took. They were pretty hands off as far as keeping a c-section even in the considerations. It was there in the back of their minds especially if I went to my due-date, but they were willing to let me go up to 2 days past my due date. If that happened they would have opted for a c-section.

It's always interesting to me how different doctors handle diabetic pregnancies.

Awesome that's she's reight on schedule and you are also doing SO well! :)

to second the pp's comment, i am definitely not sick of the pregnancy posts, either - as a type 1 who is currently pregnant with my first, i love being able to get an idea of what to expect...and i wanted to thank the posters who commented about changing the bolus delivery on the animas in your previous post - as mentioned, the first thing i did on the day i started the pump was to change the bolus speed to 'slow' but it's still too fast..i just do every bolus as a combo, works well enough.

I love the pregnancy posts! Keep 'um coming. You are making me think that I can actually do this, too.

Just remember that it doesn't matter how she gets here, just that she get here safely.

Mine were both c-section and I don't feel like I missed out on a thing.

With my first they didn't think I would dilate so they scheduled a section a week after my due date. I never went into labor and had the most laid back delivery with my scheduled section. I never dilated past 1 cm!

So with my second, he was scheduled a week before his due date.

Your belly pictures are beautiful, K. Thank you for sharing our preggo journey with all of us!

I just stumbled on to your blog and I think it's great! I am type 1 and am 19 weeks preggo with our first. I love to read how other "sugar mama's" are coping with their pregnancy highs and lows!

I'm so glad to hear BSparl is cooking along just perfectly in there. One question though, because I'm gullible. Are you really going to live at Joslin toward the very very end, or are you joking? It actually sounds like a really good idea to me - but maybe I'm showing how silly I am by not picking up on the sarcasm. :)

Kerri, I can't believe how fast this is speeding by. I know it probably doesn't feel like it from your perspective, but I'm sort of in shock.

I get busy with work for a month or three, and all of a sudden I'm 9 WEEKS away from being an uncle? Seriously?

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