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Posts from the ‘Infertility and Pregnancy’ Category

Guest Post: Giving Birth to Violet as a Woman with Type 1 Diabetes (Part 2)

Today is part two of Ginger’s guest blog about the birth of her second little bird (part 1 is here). While this post takes a bit of a dangerous turn, things did work out okay!  (And if you’re a woman with type 1 diabetes who has had babies, is curious about having babies, or wants to read about other people and their babies, check out Ginger’s latest book, Pregnancy with Type 1 Diabetes!)

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[Note from Kerri:  This story picks up where yesterday left off, with Ginger just home from the hospital with her newborn.]

… but then…when Violet was 6 days old, I woke up from an afternoon nap to a huge gush of blood rushing from my body and onto my brand new iKea striped duvet cover. (It was only $30 but I adore this duvet!)

“Roger!” I hollered to my husband, “I’m bleeding, we gotta get this duvet in the wash ASAP so it doesn’t stain!”

While he took the precious duvet to the laundry room, I went to the bathroom to clean up the blood only to find that I was still bleeding. Seriously bleeding.

I couldn’t move off the toilet without blood pour out of me and onto the floor. Meanwhile my husband was on the other side of the house with the assumption that the gush of blood was a one-time thing and very busy trying to save my precious iKea bedding.

I jumped into the shower thinking maybe I just needed to wash off thoroughly and let the blood finish…but the blood didn’t stop. It continued to pour from me.

“ROGER!!!”

It didn’t take long to realize this wasn’t going to resolve itself at home. Fortunately, our teenage babysitter Mikayla was home and came over within minutes of calling to stay with Lucy.

After filling my sweatpants with wads of paper-towel to contain the bleeding, Roger, Violet and I rushed to the Emergency room that was just 10 miles away at a smaller nearby hospital than where Violet was born.

Between home and this hospital just minutes away, the blood had fill my pants.

I was able to get a good meal of breastmilk into Violet’s belly before I was given anesthesia and taken to the operating room to see what was causing the bleeding. I didn’t know whether I was going to wake up from this operation having had an emergency hysterectomy or something less severe.

When I did wake up from surgery, already back in my room, I suddenly burst into tears.

“Why are you crying?” the doctor asked me.

“I’m just so glad I didn’t have to be cut open again!” I blubbered.

Instead they performed a simple D&C (dilation and curettage).

Apparently, my uterus had stopped properly contracting postpartum to manage healing and bleeding, and the area where the placenta had once been attached looked like a giant open wound. It wasn’t healing properly either so every blood vessel was just gushing with blood.

My uterus was also apparently filled with grape-sized clots of blood. (Why it started nearly 6 days postpartum instead of during my initial hospital stay, nobody knows.)

I’d lost about 3.5 grams of blood in that short span of time between naptime and the hospital. Another gram and I would’ve likely needed a blood transfusion. (I credit this to our awesome babysitter who came over so quickly when we called!)

Of course, I can’t prove that this was related to my feeling during the last few weeks of pregnancy that something was wrong, but for me, it was enough evidence that my uterus has probably had enough of this baby-making adventure.

Today, as I type this, Violet is about 2 months old. She still sleeps 18 to 20 hours a day (which is actually a very recent reduction from her 20 to 22 hours a day). She’s a very good eater and I’ve managed to avoid many breastfeeding-induced lows by keeping my background insulin dose about 1-unit lower than it probably would be otherwise, and taking my normal doses for meals.

Lucy doesn’t mind Violet’s high-pitched screams during the first few miles of any car-ride, and continues to tell us the baby is cute. The juggling act of two little girls’ needs would make for a good reality show: this morning Lucy pooped on the floor (because she’s potty training)…while Violet was desperately pleading for another meal on the boob…while I was making myself breakfast with the hope of getting us all out the door by 9 a.m. to make a mess at the children’s art studio in town. Don’t worry, I’d already had my cup of coffee!

(It goes without saying that my A1C has definitely popped up from 5.8 to 6.5 percent in these first 8 weeks of Violet’s life!)

Amidst the chaos, we are mostly just grateful, because type 1 diabetes has lost again at its attempt to interfere with real life. This body that can’t even produce a few drips of insulin has now produced two gorgeous little baby girls who are as healthy as any mama could wish for.

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Thank you so much, Ginger, for sharing your daughter’s story here.  Congratulations, from one T1D mama to the other!  <3

Returning to diaTribe.

After a long hiatus, I’m back at diaTribe and explaining where the hell I disappeared to:

“Diabetes is the dog I don’t like but I still have to be kind to. It barks and occasionally pees on the floor (or worse), it has chewed up at least ten of my shoes, and it jumps up and freaks out whenever the doorbell rings. And somehow it has me on a short leash. But even if I’m not into having this dog, I still have to walk it and feed it. It still needs to be cared for and protected. I am its reluctant owner, but at least it behaves when it has my attention. When it’s well-groomed and attended to, it doesn’t bite me. And becoming a parent meant I needed to protect my children from the beasts in my house (with diabetes falling into that beastly category).”

More of this column over at diaTribe, and keep up with all the news by subscribing to the diaTribe newsletter.

Diabetes Pregnancy: Now and Then, Part Two.

Welcome to the continuation of Laddie’s pregnancy story, showing what pregnancy with type 1 diabetes was like back in 1979 and 1982.  Today is a continuation of her story, with details about her sons’ births, the cost of care, and how diabetes did, and didn’t, play a role in bringing her sons into the world.

For more about Laddie’s life with type 1 now, you can visit her blog.  She’s awesome.  🙂

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1979: Baby Boy #1

I was diagnosed with diabetes late in 1976 and became pregnant with Mike less than 2 years later. I was referred to the obstetrician down the hall from my internist’s office. I didn’t know to ask for more intensive care and my personality probably would have insisted that I was not “different” from other pregnant women in their mid- 20’s. There were no home BG meters in those days and I was in good health. So I am not exactly sure what would have been done differently.

What are some of my memories? I had “morning” sickness that got worse as the day went on. No puking—just sickening nausea. I was hugely sensitive to smells and barely survived the weeklong visit of my mother who smoked. Although women who suffer from morning sickness are advised to avoid greasy foods, I totally craved Kentucky Fried Chicken and without fail it made me feel better. I remember the clothes: two jumpers, one hunter green and one navy blue, that I alternated daily with different turtlenecks and the horribly-patterned tunic blouse that I wore with beige corduroy pants. Because we didn’t know the sex of our children before birth, I sewed gender-neutral Winnie the Pooh cafe curtains and yellow-checked bumper pads for the old wooden crib that had been my husband’s. Crib safety standards weren’t a big thing in the 1970’s.

If you want a clue about my birth experience with Mike, just look at his statistics: 11 pounds 11 ounces and 24 inches long. Labor and delivery were hugely painful and towards the end, I received a drug that was magical. Most of the delivery is a blur in my mind but my husband vividly remembers the forceps. We always joke with our grandchildren about the “yankers” used in the Berenstain Bears dentist book to pull out teeth. Well, Mike had the big yankers that pulled him from his warm comfy floating life inside Mom. It took weeks (or months?) for the dent on the side of his head to resolve.

Although I mentioned previously that I only had two glucose tests during my entire hospitalization, Mike had five on the day he was born. I assume that this was to monitor hypoglycemia that is common in babies of moms with “poorly-controlled” diabetes. There were other health concerns that required specialized monitoring, but ultimately Mike was fine. He developed jaundice and required a couple of days under the lights. In today’s world I would have gone home on my third day with daily nursery visiting privileges. Not in 1979. I was asked whether I wanted to stay in the hospital with him and I did for a total of six days. I might argue that for psychological reasons and breast-feeding, it was medically justified …

1979 Statistics:

  • Birth Month/Year:  April, 1979
  • Birth Weight:  11 lbs 11 oz
  • Birth Length:  24 inches
  • Mom Days in Hospital:  6 days
  • Baby Days in Hospital:  6 days
  • Total Fee to Obstetrician:  $450
  • Mom Hospital Bill:  $1,079
  • Baby Hospital Bill:  $1,044

1982: Baby Boy #2

When I became pregnant in 1981, nobody had learned their lessons from my first pregnancy. Once again I visited the obstetrician down the hall from my internist. Once again I visited my doctor every 6 weeks for a blood test and probably drank a lot of water to dilute the sugar in my pee for Diastix tests. It is only because I know the story of Chris’ delivery that I am appalled that I did not see a high-risk obstetrician during this pregnancy. I am appalled that a C-section wasn’t performed. I am appalled about a lot of things. But I didn’t know any better and I guess my doctors didn’t either. Once again I had no home blood glucose monitoring. My insulin regimen was better than in 1978-79 with the addition of Regular insulin. However, as far as I know the doses were fixed and not an equivalent of today’s MDI (multiple daily injections) regimens.

I remember less about this pregnancy than my first. Probably I was too busy taking care of a 2-year old to pay much attention to routine doctor appointments. I do recall that Mike knew where every bathroom was in the southern suburbs of Minneapolis. “Mom, why do you need to go the bathroom again?”

If you look at the birth weights of my children, you might think that I had better diabetes control during my second pregnancy than my first. Fooled you! Chris was born three weeks early and missed the final weeks of sugar-saturated nutrition that is baby-poison.

Three weeks before my due date, I made a new casserole that had spaghetti sauce, hamburger,  and crescent rolls from the tube. This recipe is not on the list of the Top Ten Meals to have before delivering a baby and I have never made it again. Later in the evening my water broke and off to the hospital we went. My baby book notes indicate that I spent the night at the hospital with light contractions and Dad slept at home.

I did not go into labor and the next morning was given Pitocin to induce contractions. Pitocin labors tend to be “rougher” and ‘harder” than natural labors but I don’t remember whether this labor was worse than my first one. 5-6 hours later Chris was born. Once again, I want to ask: why wasn’t a C-section performed???

I don’t have many memories of Chris’ birth. I remembered the incredible pain of my first delivery but had the confidence that it would be over soon and I just needed to breathe and relax. My husband has the nightmarish memories of the birth of a baby who was delivered and stopped breathing. Chris had broken his collarbone during delivery which is not an uncommon occurrence. Unfortunately the broken clavicle bone pierced his trachea and lung. I don’t remember anything else before hearing from my husband later that Chris was in intensive care at Minneapolis Children’s Hospital and was doing OK. Actually I do not think that I even knew that there had been a problem with the delivery and must have been in some drug-induced stupor.

I recovered quickly from the delivery and 3 days later began the daily commute to Children’s Hospital. I was provided with a tabletop breast pump that I recall weighed a ton and was about a foot square. Chris was amply provided with breast milk through a feeding tube. I’m not sure that there had ever been a baby like Chris in the NICU which is usually filled with tiny 1-4 pound premies. At 10 pounds 3 ounces Chris probably weighed more than the combined weight of the other babies in the unit! He spent 15 days in the hospital on a ventilator as his trachea and lung healed and his lungs matured. In those 2 weeks there were two record-setting snowfalls of 18-24 inches and my memories are of cold and endless 11-mile commutes on slippery snowy back roads.

Chris ended up being fine and 35 years later I continue to give thanks for that. His close call didn’t need to happen. Of course I blame my diabetes for putting him at risk, but I also blame my obstetrician who didn’t perform a C-section based on the history of my first delivery.

1982 Statistics:

  • Birth Month/Year:  January, 1982
  • Birth Weight:  10 lbs 3 oz
  • Birth Length:  21.75 inches
  • Mom Days in Hospital:  3 days
  • Baby Days in Hospital:  15 days
  • Total Fee to Obstetrician:  $575
  • Mom Hospital Bill:  $1020
  • Baby Hospital Bills:  $898 + $14,795

Babies at Home:

I don’t have memories of how diabetes impacted my life once I was home with babies. However, just because I don’t recall anything doesn’t mean it wasn’t hard. If there were lows while nursing, they are lost in the brain frizz of watching soap operas and snippets of TV shows in the middle of the night and never knowing how they turned out. My scary memories of lows with young children are all a few years later when I was driving and I can’t stand to think about that. I didn’t know anyone else with diabetes when I was a young mom and I was very private about it anyway. I think I just ate lifesavers and took my shots.

I don’t recall worrying that my children would have diabetes and I don’t think that I ever pressed a Diastix strip into a wet diaper. Diabetes books indicated that the risk was low and without the DOC, I didn’t know any Type 1’s parents with Type 1 children. Also in my family, only my sister and I had diabetes and not my brother. Therefore only girls got T1 and I had boys…. That ignorance used to be bliss, but I now have 4 granddaughters.

I hate diabetes and it tried to rob me of a lot of good things when it came to having children. But it didn’t win. My babies were warriors and I was pretty darn tough also. I rejoice for the great medical care that women with Type 1 diabetes get these days and I admire how incredibly hard these women work throughout their pregnancies. Healthy babies are a prize worth fighting for.

Diabetes Pregnancy: Now and Then.

Managing diabetes and pregnancy in 2010 and then again in 2016 was a lot of hard work, and my story is similar to so many moms in the diabetes community:  a heavy focus on blood sugars, piles of doctor appointments, and dozens of tests for mom and baby.  Today’s management of diabetes and pregnancy is very different than what was available 30-something years ago.  Which is why I’m thrilled that my friend and fellow mom with diabetes, Laddie from Test, Guess, and Go, offered to share her story about what diabetes and pregnancy was like 30 years ago.  

Laddie held on to an incredible amount of information regarding her pregnancies, which is why I’m breaking her guest post into two sections; I didn’t want to leave anything out but I didn’t want anyone’s finger to fall off from scrolling.  🙂  Here’s part one of her incredible journey.

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Like everyone in the DOC, I’ve followed Kerri’s pregnancy diaries with smiles, tears, and warm fuzzies in my heart. I’ve watched her hard work optimizing blood sugars and the intense and state-of-the-art medical care. I’ve delighted in the joy of her posts and the depth of her love for her children. At the same time I’ve always felt a little sad at how much fear and self-judgement was mixed in with the good stuff. I can’t pretend that I don’t have 40 years of diabetes inner demons, but sometimes my rose-colored glasses allow me to forget them. Unfortunately diabetes loves guilt and blame and few of us are exempt from its demands.

I’ve never been able to read the pregnancy narratives of Kerri and other T1 bloggers without a few chuckles at how different my childbearing experiences were. I am a woman with diabetes who had really big babies and no c-sections. That is not necessarily a good thing or anything to brag about, but it is my story. I had two children before the availability of home blood glucose meters and before the landmark Diabetes Control and Complications Trial that proved that good blood glucose control makes a difference in diabetes outcomes. As a mom-to-be in my late 20’s, I received no more intensive medical care than my gluco-normal friends. That was probably fine for my health but the risk to my babies was off the chart.

I must stop here and confess that I can only tell my tale because it has a good ending. Two adult children and 6 grandchildren are testament to my good luck, the grace of God, and good medical care interspersed with less than optimal care. My story could have had a nightmare conclusion and it scares me how close we came to losing our second son.

Recently I approached Kerri with the idea of collaborating on a “Then and Now” discussion of having babies while living with type 1 diabetes. We shared a few statistics back and forth and Kerri quickly discovered in a diabetes circle-of-life way that she and my first son were born the same year. Maybe I should be talking with Kerri’s mom! For sure this explains my once-in-a-while tendency to overstep DOC etiquette and write bossy-Mom comments to her.  [Note from Kerri: my mom would love you, and also I value your mom-ments so much.]

With a seven-year old daughter and a son not yet one, Kerri’s memories of pregnancy are current and accurate. Suitcases of BG logs, Dexcom tracings, medical records, and insurance EOB’s allow her to neurotically detail how many doctors appointments she had during each pregnancy, how many miles she drove to and from Boston, and what her blood glucose numbers were every minute of every day. I have muddled memories and little way of knowing how accurate some of them are. I don’t have medical records from those years but do have itemized medical bills, handwritten spreadsheets, and faded photos. For the most part anything I write here will be a combination of fuzzy recall along with a “Follow the Money” analysis of my paperwork.

I’ll start by paraphrasing and answering a few questions from Kerri’s email.  [Another note from Kerri:  the details of both pregnancies will be included in the second post.]

What kind of preparing did you do diabetes-wise? The answer is a straightforward “Not a darn thing!” I was diagnosed with diabetes when I was 24 years old and have a vague recollection of my GYN telling me not to delay pregnancy because it would be easier sooner rather than later. I wasn’t afraid of pregnancy because I was naive about diabetes and had few books, no community, and no Internet to remedy that. Unlike women like Kerri who were diagnosed as children, I didn’t have years of doctors warning me about the dangers of pregnancy. I had no Shelby-dies-nightmares because Steel Magnolias hadn’t been released yet.

As far as I know, I didn’t do anything special related to diabetes to get ready for pregnancy. I suspect that because of my apparent good health and the short duration of my diabetes, my doctor underestimated the care that I should have received and did not refer me to an endocrinologist or a high-risk obstetrical practice. With no home BG monitoring, I’m not sure what options there would have been to “intensify” my diabetes management. During my first pregnancy I took 1 or 2 injections of Lente insulin a day. Pharmacy records show that Regular insulin was added to my regimen before my second pregnancy, but I’m sure it was a fixed mealtime dose. I was probably advised to follow my Exchange Diet as best I could.

How did your OB/GYN handle your diabetes alongside the pregnancy?
I hate to say that I don’t know a lot about this except that I think urine tests were performed at each visit. Why do I remember this? Because one of my most vivid memories is drinking a ton of water on OB days and then going to the library near the OB’s office for a final pee before showing up at my appointment. This was all so that when I peed on a strip at the OB office, the pad might remain light blue instead of changing to the dreaded dark brown. Although I keep saying that diabetes education was minimal in those days, I obviously knew enough to try to hide what my blood sugars were doing. Too bad the developing babies in my womb weren’t fooled by the drink-a-lot trick.

Did you check your BG more? Cue the laughter track. I did not get my first home BG meter until my youngest son was 3 years old.

Were you using a urinalysis kit? Yes. When I was diagnosed with diabetes in 1976, I used Diastix several times a day to check the sugar spill into my urine. I dutifully logged the result as anything from Neg. to 4+. People diagnosed before me and many diagnosed at the same time used Clinitest with drops of urine, tablets, and test tubes. I never used that. My hand-written spreadsheets indicate that urine strips were not reimbursed by insurance and I remember cutting them in half to save money.

Did you see the doctor more often than your non-D counterparts? My copies of doctor bills indicate that I saw my internist about every 6 weeks for a Glycosolated HGB lab test (early version of A1c). I have no medical records to indicate the test results or my doctor’s advice. I do not think that I saw my obstetrician more frequently than other patients. I have few bills other than the comprehensive fee “OB Care – Total” and a couple of itemized lab tests. Fetal ultrasounds were extremely rare in those days and I did not have them. The tech-iest excitement I had was hearing the baby’s heartbeat with a magnified stethoscope device.

As someone who had two C-sections, I’d love to hear about labor with diabetes. These days few women with Type 1 diabetes carry their babies until 40 weeks. Doctors prefer to deliver early to minimize risks to mother and child. I went into labor with my Mike almost exactly on his due date and was sent home from the hospital I because I was not far enough along in labor. I have absolutely no memories of my blood sugar being a concern and my hospital bills collaborate that.

For the entire 6-day hospitalization including labor & delivery, I was billed for 2 Lab Glucose tests. For my second son three years later I had more intensive care with a total of 3 Lab Glucose tests! I was new enough to diabetes for both deliveries to know that I would have been symptomatic for any low blood sugars and I don’t remember any. My children were born in the heyday of “natural childbirth” and I didn’t have pain drugs until close to delivery. My memories of labor are of pain. My memories of delivery are excruciating pain. To you moms who had C-sections and think that you missed the beauty of labor, don’t stress over it. Enjoy your healthy babies and believe me, it wasn’t all that beautiful.

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Join Laddie tomorrow for her story about the birth of her two sons, the story about “the yankers,” and what pregnancy was like then versus what she’s seen the DOC moms do now.  Thanks for going back in time to revisit your beautiful babies, Laddie!!

The One About the Gym.

UUUUUUUGGGGGGHHHHH the one about the gym.

Dude, I wanted to start this post with a story about how hard it’s been to regain traction with losing the baby weight and then end with a BAM I NO LONGER WANT TO BURN MY SHAPEWEAR IN A BONFIRE.  But no.  That is sadly not the case.

The road to my last pregnancy was paved with fertility drugs, miscarriage, depression, and other terrible crap.  Ends eventually justified the means and I was beyond grateful to find out I was pregnant after such a journey.  (The little Guy is my favorite guy.)  My son was born eight months ago and he is exactly who we had been waiting for.

Table all the parental happies for a minute, though, because this post is not about infertility.  Or the little Guy.  It’s about the tarnish that’s settled onto the word “just” in the sentence, “I’ve just had a baby.”

No.  I did not just have a baby.  I had a baby eight months ago.  And I still feel like I’m trapped in the postpartum schlubby chub club.

So I joined a gym.

I used to go to the gym a lot.  It was kind of a family thing and while I never sculpted a physique that would stop traffic (unless a vehicle actually hit me), I was stronger and healthier and slimmer than I am now.  I didn’t feel ashamed of my shape and I wasn’t avoiding my closet in favor of athleisure wear.

Oh yeah.  “Doing absolutely nothing in my active wear” has been a theme these last eight months.

Postpartum anxiety didn’t help (better now, though) and neither did the c-section recovery.  I didn’t feel great after my first c-section and, despite rumors I’d heard that the second one is easier, I did not find that to be true.  Add in some wrist and hand issues (I ended up with breastfeeding injuries, which feels silly as eff to type but is actually a thing) and my body felt like something I was renting out instead of taking ownership of.

That did not feel good.  I want change.  Can’t wait around for change, though.  Have to chase change.  Change is exhausting.  So is this paragraph.

So about a month ago, I joined a gym.  It wasn’t a cheap decision, but the gym feels low pressure, has great hours, and also provides childcare for small baby people, so I have no excuse NOT to go.  Also, something about paying for it makes me less likely to NOT go because I hate throwing money away.  So I’ve been going.  Despite feeling shy (is exercise timidity a thing?) and despite feeling flumpy, I’ve been going.  I use the treadmill and the free weights and I’m debating a class or two if I can find some glasses and a fake mustache to wear while participating.  I’m trying not to weigh myself but instead using a particular pair of pants as my barometer for progress.

I hope to see some progress soon but I’m trying to find small victories in the steadier blood sugars and increase of energy.  And also in the “hey, I left my house and didn’t spend the entire day juggling kid requirements only.”

Hopefully, in time, I’ll schedule my shapewear bonfire, but in the meantime, I’ll try and find some pride in taking small steps now.  Especially wearing these mad cool glasses and this fake mustache.

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