The differences between Kid 1 and Kid 2 will be stark, I’m sure, and it’s starting with their respective pregnancies. This attempt is very different from my first in some ways, but refreshingly similar in others.
There was morning sickness. Not actively throwing up, but a moderate-to-high level of nausea that kicked in first thing in the morning and stayed active throughout the entire day. (“Morning sickness” = all day long sickness) With my daughter, I never had a moment of queasiness, but this time, I ended up with an Amazon subscription to Yogi Ginger Tea, which was consumed for three months straight in order to keep my stomach contents settled.
The bump was visible much earlier this time around. Around eight weeks, there was bloating that looked suspect, and by ten weeks, there was an indisputable bump. Now, at 15.5 weeks, yoga pants fit fine but buttoning my jeans that fit loosely at Thanksgiving is a thing of the past. I have one pair of maternity pants but I’m scared to look at them but they have been staring at me, all sultry and potentially roomy enough. Hey, you.
Preparing my diabetes management for Birdy was more of an issue than conceiving here, which was the opposite problem with t his pregnancy. My A1C has been in nice, happy baby range for a long time now; it was adding the baby itself which became the problem. I’m happy knowing my numbers were in-range well-before I conceived.
To that same end, I spent two years “pretending” to be pregnant half the time, so I already have a significant level of “tired of diabetes bullshit” baked into this pregnancy. I’ve already been testing a pile of times a day and tweaking food, exercise, and basal rates as if I were pregnant, so when I actually became pregnant, I was more inspired to continue on with vigor, but a little tired at the same time. It’s a lot of work, preparing for pregnancy. It’s even more work to actually be pregnant. I’m preemptively a little nervous about post-partum diabetes burnout, and trying to line up a support approach that will make that transition gentler.
The infertility issues building up to this pregnancy have made it harder to fully invest in these moments, too. I am scared to enjoy the feelings too much. The rounded belly is something I feel the need to hide more than I did the first time around because I’m afraid to say, “Yep, I’m pregnant,” in case something happens. I did not feel this way at all the first time, as I had no concept of it not working out. Of course you get pregnant. Of course you give birth. Direct line from start to finish. But now, I’m acutely aware of the different paths that this journey can take, and every doctor’s appointment comes with a holding of breath and then a relieved release.
My medical team is slightly different. My endocrinologist is the same as before (the pregnancy team happens to include my regular endo at Joslin, so that was easy), but my OB/GYN is different. The new OB seems very smart, and capable, and hopefully she views me in the same light.
The drive to my medical team is also the same: too long. I live in Rhode Island and see the team at the Joslin Clinic for my pregnancy care, so for now, it’s an appointment every two weeks. So far, I’ve been able to line up my OB/GYN appointments and my endo care on the same day, making for a long commute and a long day every other week, but at least it doesn’t require two separate trips. Once I’m in the third trimester, I’m sure I’ll want to rip Joslin off its foundation and move it to Rhode Island, but for now, the commute is doable.
Because of pre-eclampsia in my first pregnancy, it’s an issue that’s already being addressed now. My high-risk OB had me do a 24 hour urine collection a few weeks ago to establish a baseline, and she recommended that I take a baby aspirin daily, starting at 13 weeks. My at-home blood pressure monitor should arrive today, and that should help me keep track of things at home. Hopefully it will not be an issue.
So far, with my eyes, everything looks good and there’s been a discussion about potentially delivering vaginally, depending on how things progress with any retinopathy issues, etc. That won’t be determined until closer to my delivery date, but it was nice to hear that my eyes looked fine enough to discuss delivery as an “option.”
The Factor V Leiden is being proactively managed as well, with doses of blood thinner in my medicine cabinet for use before long flights, and a hematologist on call as part of my medical team.
My issues with skin irritation and adhesive allergies have been a big problem with this pregnancy because I do not want to take any breaks from my pump or my CGM, but compromised skin integrity makes real estate an issue. It’s challenging to rotate sites appropriately when my skin is still unhappy from devices put there weeks ago. (Itch, please.)
And blood sugars have been predictably unpredictable. The lows during the first trimester were epic, as expected, and sometimes took an hour and a half to two hours to fully escape. My current daily dose is only slightly higher than my pre-pregnancy dose, but I’m sure it will climb once I’m deeper into the second trimester. (But, as a bonus, the Tandem pump holds 300 units, which will serve me well when insulin resistance does start. With Birdy, I was up to 100 u of insulin per day, over triple what my pre-pregnancy TDD was. If that’s the case this round, at least I don’t have to swap the cartridge every day and a half. Also, here’s my Tandem disclosure.)
But the biggest different this time? Is that my daughter is excited, too. “Can I talk to the baby?” she asks, pressing her face close to my abdomen and whispering a secret of some kind to her sibling.