Sunday, April 5, 2009

WEEKS 27 & 28 - SOME IMPROVEMENTS!

Overall, the past two weeks have been pretty good.

My energy is starting to wane a little and I'm definitely starting to feel bigger and more awkward. Sleeping is starting to get less comfortable too. I wake up everytime I have to turn over, and I also wake up to pee a lot. My right hip has been bothering me still, but it's managable. I'm still craving fruit like CRAZY - mmmmm....pineapple! mmmmm....apples! - and the newest craving is now bread & butter pickles (which have a lot more sugar in them than I thought!), and now coffee (decaf) too! The baby is kicking LOTS - unfortunately many of her kicks are directed at my bladder - my poor tiny bladder! Last week I'm SURE she had the hiccups. It's the first time I had noticed a feeling like that, but it was sure funny! Apparently that's very common at this stage.

My mother-in-law was in town staying with us for a while, so she and I did a bunch of baby shopping. We are now ALMOST done with the shopping! The crib and the changetable/dresser are set up in the nursery now too, but the computer desk is still in there. (We'll be losing our "office" when the baby comes.) It's a bit crowded right now, but that will change soon enough.

The baby is still VERY active, and is putting a lot of pressure on my bladder. On Thursday I had an appointment with my massage therapist and the baby got so active during my massage that my massage therapist could actually SEE my belly moving! Crazy! Also, this week without thinking, I gave my belly a little smack with my hand - not hard, but I guess hard enough because she JUMPED inside me! I must have really startled her!

Last night, my husband and I went on a date! We're not sure how many more chances we'll have for that, so we thought we'd better make the most of a free weekend! Thankfully he's not opposed to dating a pregnant woman :) We had a very nice dinner at Joey's and both ate waaay too much. It was just impossible to pass up the banana bread pudding! Mmmmm...... Thankfully I've gotten pretty good at managing my insulin around little indulgences like that and had a pretty stable bloodsugar evening - even after a decadent dessert! (Have I mentioned how much I love my pump and CGMS??)

I've had two baby-related appointments in the last two weeks. Last week was the endocrinologist appointment. It went very well! My A1C was even better than last time, and is now the lowest it's ever been! (Yes, I rock!) Also, my endo signed my Disability Tax Credit forms (yay!) so now all that's left is for the CRA to sign off on it too. I really REALLY hope they do, because the refund could buy me a lot of sensors!

I had been having some problems with high bloodsugars in the afternoons and evenings and then low bloodsugars at night, but my endo and I devised a few strategies to deal with them, which I have put into practice since the appointment and which really seem to be working! Another yay! :) I also realized that I have a surefire way to keep almost completely stable morning bloodsugars. One word: oatmeal. Yes, from now until the baby comes, breakfast is oatmeal and only ever oatmeal. It's boring, yes, but it's worth it. Thankfully I like oatmeal, and thankfully even instant oatmeal seems to work (even though it has a higher GI value than the non-instant stuff), and thankfully instant oatmeal comes in a wide variety of flavours. I'm also subbing in Red River Cereal from time to time because it seems to work too. With this sort of breakfast, I can get my 2-hour post-prandials under 7.0 and still not go low before lunch! I really never would have thought that I could do that! Thank you Mr. Quaker! :)

The small bit of bad news at my appointment was that my bloodpressure was a little elevated. We're going to keep an eye on that. Hopefully it was an anomoly. It wasn't way too high, or anything, but definitely something to watch, especially because I am seeing some occassional swelling in my ankles. (None in my hands/face, though, so I have no reason to suspect pre-eclampsia or anything.)

My baby-related appointment THIS week was the OB. Everything was A-OK! I'm still healthy and the baby's still healthy! He checked my bloodpressure too and said it was fine. It was still a tiny bit high, but he wasn't worried about it. All of my latest bloodtest results came back just fine too, which is always a relief!

I'm at the point now where I'll be having OB appointments every other week, endocrinologist appointments every other week (not the same week as the OB), and fetal assessments every other week! Ack! Busy! And at some point at least some of these will be moving to EVERY week! Thank goodness my boss is very understanding and accommodating! I'm very lucky in that respect!

Another piece of good news is that my infusion sites are working again! Yay! I'm still using thigh sites with the Silhouette sets. If I put them in too shallow they can be uncomfortable and bruise, but as long as I get them in at a deep enough angle, they've been good! I haven't pulled any out yet either! I still am putting the CGMS sensors in my abdomen, but it's really been a good break to not have the infusion sites in there too!

And now for something I have learned this week: Accurate Carb Counting Makes A Difference!

I was having a lot of trouble understanding why I kept going high in the evenings. I weigh a lot of my food on a food scale (the kind with the database of foods in it that'll tell you how many carbs a certain weight of food has), but I"ve taken to eyeballing a lot too. It turns out that, even when you're a good eyeballer (or think you are), it's worth checking from time to time. It also turns out that some of those standard carb-values we're taught in Carb Counting 101 aren't always accurate. Just to test it out, I measured absolutely everything carb-y on my scale for one meal. It was 20g of carbs more than I would have counted it!! Ridiculous! These days I'm on a 1:5 ratio at supper, so that would have meant I would have underbolused by 4 units!!! That's a big difference! Some of the biggest mis-counting culprits were fruit! A small apple (emphasis on small) was 20g of carbs! I figured a medium apple would be 15, so a small might be 10! I was also miscounting pineapple, and TOTALLY underestimating the carbs in bread & butter pickles! When I actually counted the carbs right and took the correct bolus for them, my bloodsugar was fantastic in the evening! Who would have guessed?!

So, from my lesson, here are some suggestions I would like to offer to you other carb-counters out there who are looking to refine your carb-counting (and, in turn, your diabetes control). Take 'em or leave 'em, but they're making a big difference for me!:

1. Invest in a good food scale - the kind with the database. Mine was about $40 at Canadian Tire, so they're not TOO terribly expensive. They are FAR more accurate than the measuring-cup method. For example - how do you measure a cup of spaghetti? How do you squeeze those wiggly noodles into a measuring cup, and how tight do you pack them in? How do you measure a cup of Corn Flakes when they're at the bottom of the box and broken up vs. the top of the box and whole? A good food scale makes this SO much easier and SO much more accurate! It's also good for measuring anything that has nutritional information on the package, if it's not in the database (or even if it is). For example, a big container of yogurt tells you how many carbs are in 125g of yogurt. Instead of looking it up in the database, you can just weigh 125g and figure it out that way. The one caveat to all this is that you have to make sure you're only weighing the part of the item that you're eating. This is particularly important to keep in mind for fruit. For example, if you put a whole apple on the scale it will count the weight of the core and include those carbs, even though you're not going to eat the core. To weigh it properly, you really have to cut out the parts you aren't going to eat and just weight the parts that you are. But then, if you have a whole bag of apples all the same size, you really only have to weigh one like that, and then you can assume that the rest will be the same. Anyway, I'm a big supporter of the food scale! Rah rah food scales! :)

2. Don't assume that the "standard" carb values we're given in Carb Counting 101, or even on packages of food, are accurate. Don't get me wrong, these standard values are a GREAT place to start, and are MUCH better than nothing, but if you're looking to fine-tune, they may not cut it. My apple example is a good one, but also a piece of bread. There are so many types of bread out there now, and so many sizes of slices, that you can't really assume they're all going to be a standard 15g of carbs (and most of them aren't!) Even when you're reading the bag for nutritional information, you need to consider if all the slices are the same size. With rye bread, for example, they usually aren't. This is another place where a food scale comes in handy.

3. When you think a food is likely low enough in carbs not to matter, read the label anyway! I thought bread & butter pickles would have negligible amounts of carbs - I mean how much sugar could they REALLY pick up from the brine? Well, it turns out that one slice has 2g of carbs! So if I eat 6 little pickle slices, I've just eaten 12g of carbs! That's significant! The same applies to sauces - e.g. BBQ sauce. There are carbs hidden everywhere!

Anyway, if what you're doing is working for you, feel free to ignore all that, but if any of you are trying to fine-tune and could benefit from the lessons I've learned, then great!

(It's funny how I'm still learning so much even after 27 years with this disease.)

Alright, that's enough rambling for this time. Finally, here's a picture of me at 29 weeks, ready for my date last night :)



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