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Posts tagged ‘diabetes and pregnancy’

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!!

Five Months.

To my Guy,

Five months old!  (And I’m pretty sure I forgot to write you a letter at the four month mark, so here’s a quick high five for turning four months old a bit back, too.)  Five months ago, I was excitedly awaiting your arrival and folding piles of baby clothes.  Now, I am greeted by your big, toothless smile every morning while you excitedly slap your legs against the crib like a mermaid.

Sorry.  MerMAN.

You are a tiny sweet potato with an appetite for both pears and destruction.  Despite being on the more petite side at the moment (single digit percentile for weight and barely double digits for height), you eat like you are a teenage boy.  In the last few weeks, I’ve had trouble keeping up with your food demand, so we’ve started working in the occasional formula bottle here and there.  I’m still breastfeeding and pumping as often as possible, but you need to eat, so formula is at the ready for the moments when I’m not.

You’re more tolerant about tummy time these days and you spent a lot of time on your play mat.  (Although when you’re feeling done being on your stomach, you fling yourself to the side to roll over, like you’re trying to roll down a hill.)  Just like your sister, you are content to holler happily at the plush animals dangling overhead.  This morning, though, you slammed a rattle against your head and engaged in your first “crying because of little injury” jag.  Real tears. It sucked.  And now you are giving that rattle some major side-eye.  Welcome to the world, little Guy.

Real food is also a recently introduced thing, and you’ve joined us at the table in your very own (belonged to your sister and is more than six years old but whatever – we like to save stuff) high chair.  The food you’ve tried so far are pears, and that first go wasn’t very successful.  Lots of confusion about what on earth a “spoon” is and also WTF “pears?”  But now, a few days and many attempts later, you wait with your hands on the high chair tray all excited, ready for the SPOON! and PEARS! and the mess that follows.

At the table. #milestone

A photo posted by Kerri Sparling (@sixuntilme) on

In the last few weeks, you’ve gone on your first trip to New York City to meet some friends, slept over at your Grammie’s a few times, and you’ve decided that Loopy is your favorite cat because she has a fluffy tail and she walks circles around you and makes you laugh, while Siah is the one who watches you sleep from afar, not daring to go closer but keeping tabs on you all the same.  The world is starting to crack open and let you peek inside, and it seems like you’re a fan.

It still amazes me, even though I’ve done this once before, how quickly the weeks change you.  You used to be a little thing with half-closed eyes and unable to hold up your own head, snuggled carefully and warmly against me at all hours.  Now you’re this much sturdier little man, smiling all the time and entertained by books, patty cake, and the series of foolish songs we make up and sing to you.  I’m afraid to blink because you’ll be crawling, then running, then refusing to eat your eggs before school every morning.

Time goes by very quickly, and I’m trying to appreciate these moments when you are little.  

Thank you for being part of our family. And for sleeping. And for the smiles that make me feel like I must be doing something right. You’re my littlest friend and I love you bunches.

Love,
Mom

Muted.

Ahh bullet points.  Ye be the only(e) way I can process things at the moment.

  • I don’t have a lot to say over here lately, and there are a dozen different reasons for that.  One is that the new baby kiddo keeps me extremely busy, what with his cluster feeding and chatty ways, and also the fact that he is still not much of a nighttime sleeper, with his sleepless nights becoming my sleepless nights.  Which translates into not a lot of creative brain power during the daylight hours.
  • (But holy fuck am I creative at night.  I make up songs on the fly, can produce ounces of breastmilk without a second thought, and have taken to texting writing ideas to myself with one hand while hugging Guy Smiley with the other.  The problem is executing on these ideas once the sun rises, because it’s then that I fall apart.)
  • The baby is getting much bigger, though, and even though we’ve had some issues getting him to gain weight (not a problem now – more on that tomorrow or Friday), he’s thriving perfectly now.  He has also entered that super smiley/finally giving feedback stage, which I love.  The baby grins and gurgles are my favorite.  He sounds so much like his sister at this stage, and yet he’s so distinctly himself.  His smile lights up the room, even when he’s spitting up into my freshly washed hair.
  • My kids are my focus these days, which keeps my heart full but my blog kind of empty-ish.
  • I’m also reluctant to get political in public, mostly because the diabetes community is united by busted pancreases and political discussions have the potential to cut our crucial community in half, but the election did not go the way I had hoped and I have grave concerns about health insurance, safety, and social issues these days.  This is contributing to the maelstrom of thoughts in my head, and the CGM frowns on my desire for Tylenol.
  • The election circus also sort of sucked the wind out of my sails in terms of diabetes awareness month activities, as well.  I’m having a difficult time focusing on the diabetes community when the country as a whole seems to be imploding to a certain extent.  I wear my blue circle pin when I’m out and I gave a presentation at a local hospital system last night, but for the most part, I’ve felt quieter than normal these days.
  • And another reason for my silence is that diabetes isn’t fun to talk about lately.  Back when I first started blogging, I would share a lot of the minutiae because I’d never had the chance to get that sort of stuff off my chest before.  Talking about a rogue low blood sugar that hit while I was in the shower?  That story came out easily.  But all of those diabetes moments feel redundant lately.  Yes, I was low.  I was high.  I was frustrated.  I was burnt out.  I was empowered.  I made steps forward in some areas, backwards in others.  It isn’t interesting to me at the moment.  When I think about diabetes, it’s this hamster wheel of the same tasks and the same emotions earning similar outcomes.  I’m still living with this disease, still trying to manage it, still having good and bad days.  Documenting those moments isn’t coming as easily to me anymore.
  • Maybe it’s because of my increased desire to keep more things private, even in the health space.  I looked back at some of my past blogs and saw that I’d chronicled a lot more of my pregnancy with Birdy than I did with my son.  I definitely blame infertility and fear of losing another pregnancy for that silence, but even now that my son is out and safe, I’m still reluctant to share a whole bunch about him.  I have a monthly letter than I’ve been writing to him (there’s two done already and a third one is in my mental queue … maybe I’ll feel up to sharing that third one here sometime) but I like keeping those in his email account (password to be given to him when he’s older).
  • Maybe this privacy surge is a result of being older.  Or tired.  (Or maybe being tired is a result of being older.  See also: non-sleepy cute infant person)
  • I love the diabetes community – truly love it – and I remain a big fan of blogging,  but maybe long form blogging is starting to shift a little bit.  Lots of activity on Instagram and Twitter (never got into Snapchat – my luck, the cat would walk by and puke while I was recording a video or something), but the long and winding blog posts are harder to find these days.  Do they require more effort to read?  I keep seeing things on Medium marked as “long reads” that are also marked as “8 minutes” and that sends me into “get off my lawn” mode because is eight minutes really a long read?  Does that means all books are becoming pamphlets and Jodi Picoult will suddenly start writing her tomes in tiny tattoo form?
  • I think I’m a little tired, overall.  Tired of diabetes (post-pregnancy burnout in full swing, thank you very much) and tired from adjusting to the arrival, chaos, and joy of a newborn baby. (I think there’s some guilt half-baked into that, because I wanted my son so much that I feel a little guilty about some of the exhausted frustration I’ve felt.  I could not possibly love him more, and I simultaneously could not need a nap more.)

Things will settle down.  I’ll post here as time allows and as inspiration strikes.  Diabetes will always be here, right?  It’s okay to take a breather from talking incessantly about it.

90% of my day is this snuggly.

A photo posted by Kerri Sparling (@sixuntilme) on

Day in the Life of a New (Old) Mom … with Diabetes.

Six years ago, I was adjusting to motherhood for the first time during Diabetes Blog Week, and one of the post prompts was to write about a day in the life with diabetes.  My day in the life was flanked on all sides by figuring out what to do with a newborn, so I chronicled that.

And just before my son was born, I thought maybe – maybe? – I’d be less of a mess this time around?  Maybe I’d have things a bit more figured out, and a day in the life post wouldn’t read like a desperate plea for help?

Once again, ha.

A Day in the Life of a New (Old) Mom … with Diabetes.

6.30 am – Hi, little baby!  Let’s do this feeding/changing diaper thing … again, because it’s not like 6.30 is the first time our tiny tomato goes off.  On the overnight, the baby wakes up around 2.30 and then again around 6, so we’re hardly breaking a fast when breakfast time rolls around.  The main diabetes thing I do at this point is check my CGM graph, because the baby is usually fussing for food, so even the 45 seconds it takes to check my BG is not happening.  (What – did you want me to lie and say I am totally on top of my diabetes stuff?  Nope.)

7.30 am – It takes me about 30 minutes to change and feed the baby, and then I go into the bathroom to clean teeth, find face, etc.  It’s at this point that I should be pricking my finger to check my fasting BG, but my alarm usually goes off (set for 7.30 am, just in case, even though it is redundant when pitted against the baby) and then I have to run back into the bedroom and turn the alarm off so that it doesn’t disturb the sleeping babe.  At this point, I forget what I was doing and am only positive I brushed my teeth based on the delightfully minty taste in my mouth.

7.33 am – Check my CGM graph again.  Showing 60 mg/dL.  I’ll check my BG officially when I go downstairs to make breakfast, but for now I need to get ahead of that low and have something to eat before the breastfeeding aftermath hypo moment kicks in.  Hi, banana.  I’ll eat you.

7.35 am – Time to wake up the Birdzone and get her sorted for school.

7.40 am – “What do I need to do again?”  “Brush your teeth, go to the bathroom, and put your clothes on for school.”  We have the same conversation every.  single.  morning.  Hasn’t changed in two years.  Yet she still wonders what the morning routine involves.  (Note:  now the morning routine involves my head popping off and the subsequent reassembly of aforementioned head.)

7.41 am – Dexcom alarm is still going off, but I drank the half-kicked juicebox that has been on my bedside table for the last three days.  Relieved it hadn’t turned to wine after sitting out that long.  Or maybe I wish it had turned to wine.  #jesusjuicebox

7.45 am – 8.20 am – This is a messy pocket of time during which Chris and I orbit around one another in the kitchen, making breakfast, making school lunch, assembling work bags, finding shoes, checking on baby (who is usually asleep in the bouncy chair in the kitchen, blissfully unaware of the circus), etc.  Usually, I check my blood sugar during this time, and most often calibrate my CGM.  At 8.20-ish, Chris and Birdy head to the bus stop and I think about combing my hair.  (I do not actually comb it, though.)

NOTE:  I forced myself to ditch the extra-strength Tylenol prescribed to manage post c-section pain because it rendered my Dexcom useless.  The data from my CGM is beyond instrumental in helping me keep my wits intact in this postpartum period.  Blood sugars are very unpredictable as I adjust from pregnancy insulin rates to postpartum rates, in addition to the chaotic ebb and flow caused by breastfeeding.  I could manage without the CGM, but it’s much, much easier to feel safe and like I have some semblance of a clue when the graph data is streaming.  Dexcom gives me the 30 lives I need on some days, Contra-style.

[And I do have a relationship with Dexcom – disclosures here.]

8.30 am – noon – My intentions are good in this block of time.  I usually boot up my computer and open my email, letting the messages come flooding in.  I read every single email, and in my head, I compose useful responses … that never end up being typed and sent, because this block of time also includes a baby who needs to be fed twice.  I use the breast pump once (to build a supply stash for when I start traveling for work again).  I try and check my blood sugar once or twice more.  I spend at least half an hour coordinating the next round of pediatrician appointments, surgery follow-ups, and attempts at assembling a medical team here in Rhode Island (moving my care away from Boston now that I’m done pursuing pregnancies … more on that another day).  Oh, and there are baby snuggles.  MANY.  Because I did not work this hard for a baby to not snuggle the hell out of him.

So basically, I get a lot of important things done in this timeframe as it relates to keeping my son happy and cared for, but I’m spinning my wheels in a lot of other departments.  That’s okay – it’s Baby Time for the next few weeks/months, and I’m happy about that.

Noon-thirty – Tomato Man and I go for a walk around the neighborhood (using the stroller on days when I’m trending lower blood sugars, and on days when my BG is more stable, I wear him and walk that way).  This walk is necessary because it gets me out of the house and ups my mental health and happiness.

1.30 pm – Hey, lunch would be awesome, right?  I’m still trying to cook more at home/make some vegetable-based options, so my culinary creativity is at a high (despite cooking talent remaining woefully low).  I am not ravenously hungry most of the time, but I do want to snack/eat a small meal every two and a half hours or so (modeling my behavior after that of my son’s).  I’m kind of into protein balls (uncomfortable phrase) these days, and one version I like a lot is a peanut butter/pumpkin seed iteration that’s easy enough on my blood sugars but packs a caloric punch that keeps me from falling asleep.  (Will post the recipe tomorrow!)

2.00 pm – Baby snuggles.  And let’s feed him.  Oh, and snuggle him again. And restock the ever-waning supply of diapers and wipes.

3.15 pm – Use the breast pump.  (Our boy lost a fair amount of weight after delivery, so our pediatrician has been following his weight gain with interest.  We’re back up to birth weight, but our doctor has encouraged us to supplement breastfeedings with bottles of pumped breastmilk in order to ensure the little guy is getting enough.  So when he’s not attached to me, physically, the breast pump is.  Thankfully, he bounces easily from breast to bottle, so we’re thankful he’ll eat in a variety of ways.  Also, if you have dissenting opinions on how babies should be fed, can we just agree that babies should be fed, and leave it at that?)

4-something ish – Birdy’s school bus comes roaring through the neighborhood, and she comes scrambling off it, regaling me with stories about first grade and how much she missed her brother.  “I missed you, Birdy!”  “Yeah, but I missed HIM!”

4.30 – 6.30 pm – Another mangled window of time during which the baby is fed, changed, and snuggled.  Chris usually arrives home in this pocket.  Birdy (and a cast of characters from our neighborhood) rotate from house to house on their bikes, the embodiment of every gang of kids on bikes from 80’s movies.  I remember that I haven’t checked my blood sugar in a few hours, so I do that.  Dinner is assembled.  Dishes are ignored.  Loopy builds a biplane.

7.30 pm – Birdy gets a bath or a shower, and while she’s in there, I charge my CGM receiver or my pump (depending on which one is more depleted).  I’ve been trying to stick with changing my pump site every three days (the reminder for the site change on the t:slim is very useful these days, as I forget my name, nevermind when I last put an infusion set in).  Changing the site is hard sometimes because I hate wasting insulin, and sometimes my reservoir (even half filled) will last four days without any trouble.  I like using every last drop.

8.15 pm – Birdy is tucked into bed.  (When she actually falls asleep remains the mystery.)  Chris and I start to get punchy, realizing we haven’t properly slept through the night in weeks, and we know another long night is on tap.  And then the baby wakes up because hey, it’s getting dark out, and that means it’s time to wake up!

9.30 pm – I look at my email, cry, and shut my computer.  I eat a yogurt and wonder if it’s okay to eat these chickpea things straight from the bag with a spoon.

9.31 pm – I grab a spoon.

10 pm – Medical onslaught time.  As I’m getting ready to close up for the night, I need to take my blood thinner injection (thank you, Factor V Leiden and c-section combination – three more weeks of shooting up and then I’m DONE), my blood pressure medication (back on that as of last week), check my blood sugar, make sure my pump has enough insulin to last through the night, make sure my CGM receiver is charged, and that my bedside table is stocked with a glass of water (breastfeeding makes me dehydrated as eff) and something to treat low blood sugars with.  Baby is fed and changed, and tucked into his proper bed (in our bedroom).

And as I’m about to fall asleep, I realize we made it through another day, and we’re adjusting the best way we know how.  The exhaustion will give way to more sleep, and eventually we’ll be a few months out from life with a newborn and more in the swing of things.  (I know I will miss the warm, snuggly newborn cuddles a ton.)

We don’t have everything figured out, because our son is completely different from our daughter, so what we knew to expect is braided with a hefty dose of “what the hell do we do with that?!” sort of sentiment.  I have realized that all the preparing we did for our second child doesn’t actually prepare us … we’re still hot messes of exhaustion and confusion and hope.

And I also realize that it looks like I’m into some kinky stuff, considering the bag of marshmallows on the bedside table.  Whatever.  When you’re hypo, anything goes.

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