It's Our Call.

Earlier this week I met with my regular OB for our every-four-weeks shindig. (All still looks good!) This is a doctor I'm quite fond of, who smiles easily and has confidence in both of our abilities to keep this pregnancy as healthy as can be. And if we can't? "We'll deal with that when we come to it". Always said with a smile.

I came prepared, both physically and mentally, to discuss what the next several weeks might look like. I had brought my home blood pressure monitor to check against hers, as well as a list on my phone of points to discuss so I wouldn't space anything off. Laptop in hand and smile on face, she whooshed into the room. "Kim! How are you feeling?"

Exhausted with a side of heartburn, thanks for asking. "Do you have any questions for me before we get started?"

I recounted for her my most recent experience with the high-risk OB, and expressed my concern over both his advice to ward off what he apparently feels is inevitable preeclampsia (baby aspirin!) and his take on when Baby Girl will be making her debut (37 weeks!). I told her that his seemingly only reason for wanting to deliver at 37 weeks would be because of "long-standing type 1 diabetes", despite no evidence that I have complications or any other health issue indicating early delivery would be beneficial.

Her reaction to his opinion was A-1.

"I guess I need to know how this works - who makes the calls here? I know you're the one who will be delivering, but who has the trump card on the how and when?"

She didn't pause. "It's our call - mine and yours." 

Cue giant sigh of relief!

She explained, just as I hoped she would, that while it all depends on how my body behaves over the next several weeks, there is no reason to assume we'd need to deliver so early just because I have diabetes. As we approach the homestretch of pregnancy I'll be in her office at least once a week, maybe twice, to check all of the things that could force us to an early delivery. She assured me that the only reason she's sending me to the high-risk guy is for "his opinion, and his fancy equipment". She also asked me if I'd like to see a different high-risk OB, and I'm considering it.

We talked through a couple of other things (like that baby aspirin advice, which it turns out she doesn't agree with as studies have mainly shown it effective in women who have already experienced preeclampsia in previous pregnancies, so I'm glad I held out on taking them) before she concluded: "So, my hope is that we can stretch this to 39 weeks. Is 39 weeks something you're more comfortable with?"

I wanted to hug her so hard for phrasing it the way she did. "Yes. I am totally okay with that. And who knows - I might be really ready for her to come out by the time August rolls around." "Yeah, air conditioning is going to be your best friend this summer."

Indeed. Bring it.

#DBlogWeek: Memories.

My participation in this year's Diabetes Blog Week can best be described as scattered, iffy, occasional, not as originally intended... I seem to have once again over-booked myself in terms of both projects and future energy stores. I love this event, though! Everything you need to know about Diabetes Blog Week can be found here if you're curious, and Karen is a saint in my book for organizing us all.

Today's prompt: Today we’re going to share our most memorable diabetes day. You can take this anywhere.... your or your loved one's diagnosis, a bad low, a bad high, a big success, any day that you’d like to share.

Oh, man.

It's hard to pick just one day - plenty of memories, both good and bad, have been a result of my life with diabetes.

My diagnosis story? I don't remember much about it, though I do appreciate the compassionate care I've received from medical professionals along the way. There was that time my insulin pump died and I didn't even care because MARRIED! There were times as a tween where my diabetes scared the crap out of my parents - twice they found me unresponsive in bed and had to use glucagon (though, to be fair, I actually don't remember much of that, except for the part where I woke up to see two paramedics standing in my room). Bad highs? I've had those, too.

But for all of the muck that diabetes has thrown my way, there are some pretty great memories, too: when I ran-ish a half-marathon, when I've traveled to Australia or the Dominican Republic, and during that week in Florida where I met, finally in person, so many of my good friends who also happen to have pancreas problems. Diabetes was the reason I got to attend an awesome summer camp for two years. Diabetes has helped me tell a story that did good beyond just myself, and motivated me to create something that can continue to help other people living with diabetes. It gave me a reason to dance to One Direction.

What I guess I'm saying is that diabetes has made for many memorable days in my life, but my current favorite? The day we found out I was pregnant. It was the day I first really let myself believe that maybe, just maybe, diabetes will let me live the life I want after all.

It gave me hope that this body perhaps isn't as broken as I sometimes fear.

As Soon As It's Safe.

For the entirety of my pregnancy, I've been working under a shared understanding with my regular medical team that as long as everything goes well, there is no reason I can't have a normal pregnancy.

I know; "normal" is a loaded word. What I mean by that, here, is: if my blood pressure stays where it needs to; if my type 1 diabetes behaves itself in a way that doesn't create a Snuffleupagus-sized baby (though I would totally be okay with her having his long, gorgeous eyelashes); if there are no indications that carrying Baby Girl to full-term would be detrimental to either of us, then a full-term pregnancy we shall have. There would be no reason to think otherwise.

And so far? My blood pressure is staying in range (the daily monitoring at home might even be helping it - less to stress about between appointments). While I tend to not share A1C results anymore online, I know that is something that many ladies who have pre-existing diabetes and want to become pregnant ask, so I might as well share for those curious: my first result after knowing I was pregnant was 7.1, and I've seen 6.8, 6.3, and now 6.1 this week. I'm not swelling up like a pufferfish (yet?). I've been gaining weight at a pace we're all happy with, and Baby Girl is moving around frequently. Thyroid levels? In check. Protein spilling into my urine? Nope. In fact, the only things I can complain about, post-prandials aside, is exhaustion and some mild heartburn (a fun new experience for me).

Fast forward, then, to the appointment I had last week with Charlie Brown's teacher the high-risk OB. Baby Girl was active, as usual, but also a bit shy this time, giving us a great view of her spine while shielding her heart. We couldn't get all of the heart measurements they wanted, so I'll be back again in 4 weeks with the hope that she'll be more cooperative. And her estimated weight? 31st percentile. BOOYAH!

Just as I was basking in the "yay, everything is okay!" feeling, the doctor concluded with, "Okay, so we're on point to deliver at 37 weeks!"

....

...excuse me, what?

"I was under the impression that if everything was going well, there was no reason to deliver early."

"With long-standing type 1, I want to get her out of there as soon as it's safe."

As soon as it's safe?

The words bounced around in my head for a moment before proceeding to prick at my heart. Because what he's implying is that, right now, she's not safe. That simply by having had type 1 diabetes as long as I have, despite it being reasonably well-controlled and free of major complications, her tiny apartment inside me is a danger zone. That no matter how hard I may work at it, no best effort is good enough to keep her cooking as long as she is intending to be. That, in my eyes, I can do nothing but fail to have the "normal" pregnancy I was hoping for.

I wanted to poke that doctor with something covered in bees.

He also offered his (unasked for) take on a couple of other items - that I start taking a baby aspirin daily to ward off high BP and eventual pre-eclampsia, and that the last bit of pregnancy "isn't actually insulin resistance", which he followed with some malarkey that I honestly just tuned out. I don't know what to think of this guy now - while I trust in his training and enjoy his sense of humor, what I do not trust is his confidence in calling the shots for a patient he only met a month ago, with limited knowledge of her medical history. (I also question his motive for wanting an early delivery, considering that the recent advice I've seen from the ACOG as well as from the professional organization's president himself, would directly contradict with that. Couple that with my control being "good" but "not too tight", and I fail to see where his concern can reasonably stem from.) I also question his advice on the baby aspirin, and am following up with the other members of my medical team before following through on that request. (I will say that when I relayed this all to my endo this morning, she raised the same eyebrow I did. At least I'm not alone.)

Everything seems a little more unsure now, and I don't like it.

Close Calls.

Especially today, I am thankful for technology that helps me not send myself into a hypoglycemia-induced spiral of doom.

In the past 24 hours I've managed to come dangerously close to double-bolusing for meals on two separate occasions. Luckily I had the sense to check my bolus history the first time, and notice the IOB the second time. (And yet I managed to forget nothing when I packed for the Indy trip earlier this week, which happens to me exactly never, but this really important stuff? Yeah, way too difficult to get right.)

Dealing with pregnancy brain while trying to juggle type 1 diabetes - it seems like it could be an Olympic sport.

Twinsies.

That's an impressive little algorithm you've got there, Dexcom.

Week Twenty-Four.

Remember four weeks ago when I said I was "in the tail-end of that 'is she or isn't she?' phase of roundess? 

My bump, my bump, my bump, my bump. My lovely baby bump. Check it out!

Duuuuude, she is. I've reached a point where people have asked those around me to confirm, and co-workers are offering to lift heavy things for me. Strangers are smiling, holding more doors open and I may soon break out with an "I'm up here, buddy" as I catch people eyeing my belly.

I'm fairly certain that insulin resistance is starting to take hold now. (Cue sad face.) There are times I have a handle on things (top left image, right before the chaos, anyway), but then a few carbs/the wind/looking at a cracker will just send me to the moon. Onward, basal rates and other adjustments!

I mentioned on Monday that my Dexcom receiver busted ("busted" meaning that the button ring fell out), and it took me until yesterday to actually get around to calling Dexcom. Normally that would be okay, but I sort of forgot that I'm leaving town on Sunday (more on that in a minute) and forgot that I'd need the new receiver before then. The gal I spoke to at Dexcom was helpful, and offered that since the black receivers were currently backordered by a day - and thus, one wouldn't arrive until Monday - she could send me a different color. I don't know why I got pink; I think I must have blacked out for a second. But in the end, the hue of my receiver is far less important than having a receiver at all, so I'm delighted that I won't have to travel with a busted medical device.

I'm fairly enamored with the baby legs tutorials I've found on Pinterest, and had a go at making a pair a few days ago. My sewing machine also decided to bust right after that, though I can't confirm whether the two events are related. Right now I have a bunch of cut-up socks laying around and it's driving me crazy that I can't finish them.

Okay, and then to circle-back to the travel comment: from Sunday through Tuesday, my footlong sub* and I will be traveling to Indianapolis for Lilly Diabetes' third second annual Blogger Summit. (Disclosure: Lilly Diabetes is covering the expenses of my travel, lodging, and meals during the summit.)  I hope that our DOC group will be able to walk away from this event thinking, "yeah, we actually got a list of actionable items to work on together in the coming year, and I feel my time here was productive for the diabetes community as a whole". We've been told there will be more info given on the Lilly/Disney partnership, as well as a tour of an insulin manufacturing facility and a meeting with some of Lilly Diabetes' leadership team.

If you have something you feel we should bring up to Lilly while we're there - please leave it in the comments below, and I'll do my best!

*One of this week's pregnancy tracking email updates likened the current estimated size of Baby Girl to a footlong sub, which I found particularly cruel as cold cut subs are on the "hell to the no" food list and now all I want is a darn turkey and cheese sandwich.

Twenty Seven.

Today marks 27 years since I was diagnosed with type 1 diabetes. I don't have much in the way of profound reflections or revelations this year, but what I do have is a life and health I will continue to be thankful for.

I'll be in search of celebratory cupcakes after work today - bring on the Super Bolus!