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!):
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.