Last Friday, Chris and I were back up at the hospital for another round of doctor's appointments to spy on Ms. BSparl. (This might be another long post, because I'm trying to include everything we're doing for this pregnancy, just in case someone else is looking for this info. So thanks for bearing with me!)
Fetal Echocardiogram No. 2: We started with a follow-up echocardiogram appointment at Children's Hospital in Boston, because last time we tried to see the structures of our little girl's heart, she was hiding out too low in her little uterine apartment to be properly found. This time, a full month later, she's over a pound and a half, and the size of an eggplant. So hiding is a little harder.
The babies of type 1 diabetics aren't prone to every kind of complication, but are instead screened for everything under the sun, just to make sure. The ultrasound technicians were looking for problems with BSparl's heart - ranging from a floppy valve to flow problems between the atria and ventricles, checking out the umbilical cord blood flow, too.
"She not much of a cooperator, is she?" the technician asked, pressing the ultrasound wand firmly against the left side of my uterus.
"I guess not. Bit of a shy one."
(I love this kid already!! /sidenote)
"Well she can run, but she can't hide. We're going to get these pictures today, whether she likes it or not."
The technician visually isolated BSparl's beating heart, looking at every chamber and pulse to make sure she was in one piece. But as the technician worked to get the ultrasound images she needed, she was pressing pretty damn hard against me ... and against BSparl.
"Almost done. Just one more image to capture. You doing okay, Kerri?"
"No problem. But I think our friend here is ... ooof! Um, she's not very happy with you."
And when I looked down, I could see the baby kicking and fussing on my right side as the technician pressed the wand against my left. Big kicks, clearly visible to Chris, who was sitting in a chair on my left. BSparl was pissed - she didn't enjoy being bothered while she was trying to sleep during the day, apparently.
'Fiesty one, eh?"
I felt a little proud.
"Yes, she is."
(I guess if you poke at my kid, she fights back. I like that.)
The fetal echocardiogram came back without any red flags, so thankfully her little heart seems to be okay in there.
After that appointment, we had a quick visit with my OB/GYN who took some measurements of BSparl to see how big she's getting in there.
"Looks like she's about one pound, 12 oz. She's right on track, so nothing to worry about with her size at this point."
I was relieved. "I'm glad you're saying that, because I've had some really tough blood sugars these past 2 1/2 weeks. I was afraid she was beefing up in there."
"No, she's in the 61st percentile, and we aren't going to worry about anything until she's in the 75th. We're going to watch you to make sure she doesn't get too, too big in there, but at this point, she's doing just fine. And so are you."
She printed some ultrasound photos for us (which will go into the baby scrapbook I've started but definitely need to catch up on) and then I met with my endocrinologist about my blood sugars.
Endocrinologist: I am very, very thankful that I have a comfortable relationship with my endocrinologist, because the emotional toll of diabetes has really affected my ability enjoy being pregnant. I've had some highs that wouldn't go away, and plenty of unexplained blood sugars that have made me feel so frustrated over the last few weeks. I'm pretty sure my A1C will be up again this month (hopefully still under 6.5%) but I needed help fixing some of it. And I also needed to be told that what's happening to me is normal.
"I'm high. Like, crazy high, sometimes first thing in the morning. And other times, I can't make my post-prandials come down under 160 mg/dl for at least two hours, no matter what I do. Is this normal? Is it normal for me to be experiencing such wild insulin increases at this point? And is it normal for me to be sort of losing my mind at this part in the pregnancy, too?"
She assured me that this is the point in pregnancy when the placenta does, in fact, produce anti-insulin hormones, causing my numbers to elevates and my need for more insulin.
"Anti-insulin hormones? That's cruel. Cruel irony."
She smiled as she worked to adjust my basal rates (now up to almost 20 full units of Humalog per day, in addition to bumping my insulin to carb ratio down to 1:8).
"You're doing fine. And you've been adjusting your own basals and going after these highs, so that's the right thing to do. We just don't want you chasing. I want to help prevent them in the first place."
I could have hugged her.
"Me, too. I want to make sure she's safe in there. I don't want to hurt her in any way, and the recent highs have me freaking out a lot."
"Don't freak out. Just keep doing what you're doing. Follow those numbers, stay as controlled as you can, and fax me any blood sugars that have you concerned. I can review the changes you're making, or I can make changes for you from here. Either way, we'll get her out just fine."
Building this baby is tough work, and these days, I feel like a full-time diabetic. This baby, and by default, diabetes management, is my top priority and I am focused on keeping her as safe as I can. But as my body changes and my insulin needs become less and less predictable, it's getting tougher to stay in good control. And in solid spirits.
We're almost at the end of the second trimester. Third trimester starts on February 8th, and after that, it's a fast track towards her arrival. This is happening really fast. We actually started registering for baby stuff this past weekend - holy crap. Emotionally, I'm overwhelmed and excited and scared and trying to figure out how to just slow things down for even a day.
(More on that tomorrow, once I wrap my head around the whole concept. For now, I need to go make some pancakes.)