WEEK 36 - NO BABY YET

Well, no baby today. Her lungs aren’t quite ready. The amniocentesis went really well, but we weren’t able to get the results until around 4pm so we waited around the hospital ALL day. I was on a fetal monitor most of the time and it showed that the baby is doing GREAT! Very very healthy and strong! (And getting chubby, per the fetal assessment.) We do have some good fetal assessment pictures, but I have to try to be quick on the computer now because my feet/legs are really swollen and need to be up, so I won’t be able to post them.

All of my bloodtest results re: bloodpressure came back fine, so that was good. My bp is coming down a bit, but not enough to make my doctor happy, so he’s upped my meds again. Interestingly, I was also having Braxton-Hicks contractions ALL day. Wouldn’t that be interesting if I just ended up going into labour over the weekend now….

So the plan now is that I’m on virtual bedrest for the weekend (instructed to only do boring things), taking more bp meds, and then going in for a c-section at 9:15am on Monday morning. No amnio this time – we just take her out. Her lungs were almost ready, so by Monday they should be close enough.

So, by Monday at 10:30am, we should have a daughter!

I'll post again when I can!

WEEK 35 - TOMORROW???

Quick update!

The baby is probably (HOPEFULLY) coming out TOMORROW!

Long story short, my blood pressure is not going down, even with meds. So my obstetrician wants the baby out as soon as it's safe for her to come out. He's worried about the potential impact on my retinopathy. The amniocentesis tomorrow morning will determine if her lungs are developed enough for her to come out.

So I get the amnio at 9:30am, and then I'm supposed to stay at the hospital to wait for the results (3-4 hours). I'm also not supposed to eat anything after breakfast, in case we're good to go for the c-section. While I'm waiting for those results, I'm also supposed to get some bloodwork done regarding the high blood pressure (my understanding is that they're checking for pre-eclampsia, even though I don't have all the symptoms). The good news is, my blood pressure should go down within a few days of the baby coming out. So by 12:30 or 1:30 we should know the results of the amnio. My obstetrician is at the hospital all day tomorrow, so when he gets the results, he's going to meet with us. If the results are good, I go to get prepped for surgery and hopefully by 2:30 or 3:30 I'm having a c-section, and hopefully by 3:30 or 4:30 we have a brand new baby! (Of course, nothing goes as quickly as anticipated, so it could be longer.) If the baby's lungs are not sufficiently developed, then, according to my obstetrician, we "wait a few days"....which I'm guessing puts us at Monday or Tuesday. I REALLY hope it's tomorrow, though. I just want to get this over and done with and meet our baby!!!

So, it might be a while until my next post, but I'll update you all as soon as possible - with pictures!

Wish us luck! I know we're in good hands!

WEEK 35 - TO AMNIO OR NOT TO AMNIO

I figured a mid-week update was in order this week, given the current up-in-the-air state of affairs. :)

First of all, my husband and I got lots done this weekend in preparation for the baby - her room is almost completely ready now and all her clothes are washed (some of which may actually be too small when she comes out, the way it's going). So we're starting to feel quite ready.

Today was another fetal assessment. My obstetrician assumed they would do an amniocentesis at this one, but they didn't. They said that there was virtually no way the baby's lungs would be ready already - particuarly because often babies of diabetic mothers do take a little longer to mature - so there was no point in doing an amnio yet. Instead, we have one scheduled for Friday morning, at which point the baby will be 36 weeks. So no baby this week (barring the unforeseen), but perhaps next week.

The doctor at fetal assessment was actually quite happy with the results of the fetal assessment. They baby's still big (almost 8 lbs now), but she's steady at the 90th percentile - not still rising, so that's good. Everything else about her looks great - heart, lungs, liver, kidneys, brain, etc. She's not showing any signs of problems. In fact, her responsiveness to touch (she kicked the ultrasound machine numerous times), and the practice-breathing she's doing are very good signs of both physical and mental developement, so that's good to hear. We even saw her make sucking motions with her mouth! So there's definitely no cause for immediate concern, but we/they definitely want to keep an eye on her.

The resident doctor doing the fetal assessment said that the baby had moved since last week. She's still breech and her head is still in the same place, but instead of having her back along my right side, her back is now along my ribs and left side. How she has room to move around in there, I have no idea! That said, she also mentioned that I have a LOT of amniotic fluid in there, which is part of why I have gotten so big and uncomfortable, and also part of why I'm having so much swelling in my legs/feet - I guess my heavy belly puts a lot of pressure on the veins in my hips and doesn't let things flow around between my legs and my body the way they're supposed to, so it all gets stopped up in my legs. Fun fun.

It's interesting with all these doctors' appointments how often I'm hearing phrases that start with "babies of diabetic mothers often..." or "babies of diabetic mothers usually...." It's starting to get a bit old, honestly. I keep feeling like I need to say, "But I'm a WELL-CONTROLLED diabetic mother!" I keep feeling lumped in with all the poorly controlled diabetic moms they see - and if good control really does make a difference during pregnancy, I shouldn't have to feel like that! It was especially frustrating today because I actually had high bloodsugar when I went in there. It was just "one of those things". I guess I underestimated my carbs at lunch, or haven't been active enough today, or the stress of the appointment got to me....but before I went in, I was 14.0. I took a correction bolus, so at a break in the appointment I quickly checked it to make sure it was coming down, but not too fast. It was still 14.0 for some unknown reason. Of course the resident doctor wanted to know what my bloodsugar was and why it was that high, and of course "I don't know - it's just one of those things. I'm almost never this high! (I'm really not!)" just doesn't cut it. Instead, I get a note in my file. Super. :P Then, of course, when I say "but I'm well-controlled, so these 'diabetic mother' comments shouldn't all apply to me" I feel like I have no way to back that up. I'll tell them what my A1C is, and they ask, "Ok, but what's your bloodsugar like right now?" or "Ok, but what is your bloodsugar usually?" Huh? Really? Define "usually". Do we mean an hour after I ate, or when I first wake up in the morning?? I truly don't feel like they get it. So when I get the "most diabetic mothers" spiel, I just smile and nod, and make a mental note to discuss this with the people who actually understand me and my diabetes control - i.e. my endocrinologist, my CDE (Michelle), my doula (who has been Type 1 for as long as me), etc. Anyway - it's just another hurdle, I suppose. Ok, rant over :)

So, for now we're still in this "wait-and-see" mode. I'll post an update after Friday's amnio.

Here are two pictures from today's F.A. They're both a nose & lips shot. Look at those lips!

WEEK 34 - A WHOLE LOT OF APPOINTMENTS....AND SOME CHANGING PLANS

Ok blog-readers, this could be a long one. I had lots of appointments this week, and some fairly significant potential changes have resulted....

Monday:

Monday was another fetal assessment. Unfortunately my husband was unable to come to this one due to some stuff at work, but my parents happened to be in Winnipeg that day and they were able to join me instead, which was very special for me and for them! We got to see the baby open and close her eyes again, and this time we even got to see a little bit of hair on her head! So cute! She rated very well on everything except her size. As you may recall, 6 weeks ago she was at the 40th percentile, 4 weeks ago she was 60th, 2 weeks ago she was still 60th, but this week she had jumped to 90th! She's 7 lbs already and suddenly growing very fast! This is quite common in babies of diabetic mothers with poor control of their bloodsugars, but since my control is really very good, this was a bit surprising. So we left it as a bit of a wait-and-see...see what my OB says, and see how much more she's grown by next week. (More on that later.) It's good to know, though, that she is otherwise VERY healthy and looking great!

Monday night our doula came over for a meeting and also brought her back-up doula. (Since our doula has 3 small children, she may not be able to be at the hospital for the whole time I need her, in which case she will call on her back-up.) We talked about the change in plans (i.e. to a c-section), and how she will be involved under the new circumstances.

Tuesday:

Tuesday's first appointment was my counsellor from the Youville Diabetes Centre. She gave me a recording of her reading a relaxation exercise (hypnotherapy) to help me relax for my c-section. (As some of you know, I'm a bit nervous about the idea of surgery.) I've listened to it a number of times already and it's really great! I just need to get it embedded in my brain before the c-section so that I can get into that relaxed state without the recording by then.

Tuesday's second appointment was the pre-op appointment at the hospital. It involved some physical checks and a lot of questions, but also gave us a LOT of information about the day of the c-section and the recovery days to follow. It actually made both of us feel a LOT better about the whole thing. I am now much more at ease about the thought of being cut open :)

Wednesday:

Wednesday was my appointment with my endocrinologist. She noted that my blood pressure is still too high. We talked about the frustrations of having my retinopathy resurface and the too-quickly-growing baby, and she encouraged me that I really am doing the best that I can, and that sometimes these things just happen anyway. It was good to hear her say that, because it's easy to feel that these complications are a result of something I'm doing wrong...and that's not the case. It's just the way the cookie's crumbling, unfortunately. (The downside is that it means there's not really anything I can do to change it....) We also talked about bloodsugar management during the pre-op fast and during the surgery itself, and about how my bloodsugar is going change significantly once the baby and the placenta are out. She doesn't want me to stay on my pump during the c-section because of the chance of something happening with it (e.g. occlusion, or it gets pulled out, or something) when nobody will really be in a position to fix it. I can understand that and accept it, even though I cringe at the thought of somebody other than me managing my diabetes. So I'll be on an insulin drip (the hospital's version of a pump) and a glucose drip, and my bloodsugar will be monitored very carefully! I'm hoping to keep the pump attached and just on "suspend" so that as soon as possible afterwards I can get it going again. We'll see how that goes....

Thursday:

Thursday's appointment was a massage. I can't complain about that one. ;) My lower back has been bothering me and the swelling in my feet/legs has been bothering me as well, so this was great! She was able to ease my sore muscles as well as get some of that fluid in my lower extremities moving around. I highly recommend pre-natal massage!! (Especially by Tracie at Ankyo Therapeutic Massage.....there's my plug for her!)

We had intended to go to the hospital's labour & delivery information session Thursday night as well (they hold these once a month), but opted out of that one. We had so many of our questions answered at the pre-op appointment, that we just felt it wasn't necessary and that we'd rather spend the evening at home relaxing.

Friday:

Yesterday was my obstetrician appointment. A couple of things came out of this.

First, my blood pressure is still too high and going up. (After this busy busy week, I'm not surprised!) So he gave me a prescription for baby-safe blood pressure meds. I had hoped to avoid those, but clearly it has become necessary. As an added incentive, I actually had another spot in my eye yesterday, likely indicating another small bleed in my retina. (This is not terribly surprising as the leaky blood vessels take a while after pan-retinal laser treatments to shrivel up.) I'm not overly surprised or concerned at this point, because I'm confident that the laser treatments I had in the last couple of weeks will deal with this in time, but it does make me quite anxious to get my blood pressure down. (As a side note, I think the spot is gone today, which hopefully indicates that the blood cleared up.) I started the pills today, so hopefully they make a difference.

Second, and more significantly, my doctor is tentatively planning on taking the baby out earlier than anticipated. He is concerned about the fast growth at this stage, as this type of growth in babies of diabetic mothers can sometimes lead to sudden unexplained intrauterine death. Not something we want to risk. He didn't seem worried that she was in imminent danger, but we definitely want to weigh the various risks and take her out as soon as doing so is less risky than leaving her in. What this means is that I will likely have an amniocentesis (i.e. a big long needle stuck into my belly to extract a sample of amniotic fluid) at my fetal assessment next Tuesday (the 19th) to determine if Bud's lungs are sufficiently developed. If they are, she comes out. If they aren't, we wait a few days and then she comes out. (I'm not sure if I'd need another amniocentesis first or not.) I will see my obstetrician either on Tuesday after the F.A./amnio or on Thursday and he will make the decision then. So, in theory I could be having my c-section as early as next Wednesday, but it sounds more likely that it would be Friday or later. By next Friday she'll be 36 weeks, at which point taking her out is very safe (as long as her lungs are okay), but she will likely need to stay in the NICU (Neo-Natal Intensive Care Unit) until she's full-term (i.e. 37 weeks), so we may end up coming home without her for a few days (well, nights - our days will be spent in the NICU with her). Obviously that's not what we had wanted, but obviously we want to do what is best (and safest) for her, so we will roll with the punches! It will probably make for some new challenges with bonding and breastfeeding, but at the end of the day we will be able to bring home a healthy baby girl - and THAT's what's important. :) If her lungs are fully developed, she will not be considered "premature", just "pre-term", and we are told that pre-term babies at this stage are just fine in terms of health and development, so it shouldn't have any lasting effects on her. She'll just need a bit more help and observation at the outset.So...that's that. Now we wait and see what happens on Tuesday at the Fetal Assessment and the amniocentesis.

My husband and I have become very aware this week how lucky we are to have all of the fantastic medical support that we do. The appointments are definitely frequent and tiring, but we are so happy with the wonderful team of health professionals we have behind us. This includes our soon-to-be pediatrician, with whom I've already been in contact with, and with whom I'm already VERY impressed! We've often heard "Oh he/she is the best in the city!" about various of our doctors too, which makes us feel EVEN better! The three of us are in very good hands! In spite of these factors that are making a diabetic pregnancy a little complicated, we do feel very very lucky.

Also, after the initial "ohmygoodnesswemighthaveababynextweek" shock from yesterday, my husband and I are VERY excited about the possibility of meeting our little baby sooner than we thought. We can hardly wait!! (And since I'm at the get-her-out-of-me stage, I'm starting to daydream about having my body to myself again...well, mostly.) We whittled down our to-do list to only the must-do-before-she-comes items, and it's really very doable. We're hoping to have most things finished by the end of this weekend, in fact. So it looks like we'll be ready! (And I do use the term "ready" loosely, as I'm not sure if anyone is ever truly ready for this.)

In other news, I have been exhausted this week, but I guess that's not surprising given all those appointments! Also, I haven't been sleeping as well as my belly is just getting so heavy and I've been having a lot of Braxton-Hicks contractions at night which aren't painful but aren't really comfortable either. Plus, now that the baby is so big, anytime she moves around in there I REALLY feel it! (And she still moves around a lot!) On a kind of cute note, she seems to really like her daddy's voice. When he talks to her close-up, she moves around in response to his voice!

Now, a couple of pictures from the fetal assessment, and a few more pictures from the photo shoot with my very talented friend!

33 WEEKS - MORE APPOINTMENTS

So last week Tuesday was my last day of work. I t was pretty weird to leave there, realizing that it would be over a year before I'm back. I was glad that I already had a pretty good idea that my doctor was going to recommend stopping work, because I spent a lot of time the previous week cleaning stuff up and passing my work off to others. I'm still trying to get the hang of this whole "relaxing" thing. Between my numerous appointments (8 this week) and various "baby projects" at home, I have to consciously make an effort to keep things at a reasonable pace and not overdo it. It looks like I may also have to be okay with leaving some of the baby projects until after the baby gets here. Oh well. Keeping relaxed and healthy is the most important thing.

I only had two appointments last week and both were on Thursday. Thursday morning I saw the obstetrician. My blood pressure wasn't as good as last time, but still nothing too scary. (I think my blood pressure now goes up when they check it just because I get nervous about what it will be...) He's still okay with leaving me off meds for now. I see him again this Friday. He gave us a tentative date for the c-section - June 1st (around noon)! He did say it may get pushed to the 2nd, though. He said I should expect to be in the hospital for about 3 days, so that would have me getting home on Thursday the 4th or Friday the 5th, I assume. He also quelled some of my fears about nausea during/after the c-section, saying they have some new drugs that apparently work VERY well to help manage nausea. This was one of my biggest concerns, because I'm a bit phobic about nausea/vomiting. There are a lot of aspects of the c-section that I'm still really not looking forward to, but I've been hearing so many encouraging stories from friends who have had them, so I'm starting to feel a lot better about it. A nd when it comes down to it, even if it's miserable, it's FAST! (The OB said about 35 min!)

The baby is still breech, but obviously this is a moot point - except for the fact that her growing head is really starting to push into my ribs and make it difficult for me to bend over even to put on my socks and shoes! Also, my belly is soooo tight - even the obstetric nurse at the OB's office was commenting on it. I've gained almost 40 lbs now, and very little of that is anywhere other than in my belly (maybe 10 lbs elsewhere, but not more). Given that the baby was 6 lbs at the last fetal assessment, that leaves almost 25 lbs - pretty much all of which is in my belly! Ugh! No wonder my back is sore and my feet are so swollen! I feel like a pin prick to my belly would pop me like a water balloon!

Anyway, the second appointment on Thursday was my second laser treatment for my left eye (i.e. the retinopathy). We didn't get any more of an assessment from the doctor, just the treatment. I got 1400 zaps this time and the ones near the end were VERY painful and left me with a terrible headache for a few hours afterwards. But it was the last set of treatments, so at least it's over now. I see the ophthalmologist again during the last week of May just to assess if there has been any further pregnancy-related damage to my retinas. This will help us in the future if/when we need to assess the risks to my eyes of having another baby. He did say, though, that there is still a lot of "room" to treat my eyes if things did go badly again in the future...but obviously that's not terribly desirable either. We'll just have to take things one step at a time.

My bloodsugars have been a bit of a challenge lately with the stress of my eye treatments, plus making the adjustment to not working anymore. My meal times are different, so I'm finding I get some insulin-stacking between breakfast and supper, plus I'm slightly more active as I putter around the house or take the dog for a walk than I was sitting at my desk at work. Also, my eat-oatmeal-for-breakfast-every-day pact with myself is over. I'm soooooo tired of oatmeal! Ugh! I'm also still having a weird nighttime drop in bloodsugar. I've got my basal rate down to almost nothing at this point, so I'm not even sure where to go with this anymore. It seems like the only thing to really do is to have a bedtime snack every night. That works for me because it seems that I'm always hungry, but it's still a bit of a puzzler. Maybe my endo will have some new ideas for me at this Wednesday's appointment.

On Saturday we hit the big Whyte Ridge Mothers Day Garage Sale. We didn't have anything specific in mind that we wanted, but we came away with some toys and some clothes (all in VERY good condition) for the baby. It was quite a success after walking around for an hour in barely-above-freezing temperatures (there was actually snow on the ground when we woke up)!

I'm attaching a few pictures today that were taken last weekend by a very talented friend of mine! We did a whole "pregnant photo shoot" and I get to see the rest of the pictures tomorrow, so I may add more to next week's blog, but for this week I'm just putting in a few of my favourites. Here they are!

WEEK 32 - BETTER NEWS

My last post was the bad news from this week, so this will be the good news (and I guess some neutral news too).

On Monday we had another Fetal Assessment (right before the ophthalmologist appointment). The baby is still doing great! She's approximately 6 lbs now, which keeps her right around the 60th percentile like last time. She grew about 1.5 lbs in 2 weeks! It seems like a lot (and it is!), but it's normal for this stage of the pregnancy. She's still tracking perfectly on her growth chart and the Fetal Assessment nurse was very happy with everything she saw. She estimated that she'd be approximately 7.5 lbs by 38 weeks (i.e. when she'll be born). The baby is still breech, but that's kind of a moot point now that we know I'm having a c-section anyway. The nurse actually said that, since she's been in this position for weeks now, there's not a great chance that she'll turn. But that's okay. If she's comfortable like that she might as well stay there :) Her head is up under my ribs on my right side (I can very often feel it there), and her bum is on my bladder (which explains my frequent bathroom trips). She's facing my left side and kind of has her legs folded up. The most exciting thing was that we got to see her open and close her eyes! She was sleeping at first and when the nurse started to prod her she woke up and blinked a few times. :) It was really something else to be able to see that! She has the cutest, chubby cheeks...I've attached pictures below.

I'm starting to get a lot more comfortable with the idea of a c-section. It's not what I had hoped for, but there are definitely some advantages and since it's what's best for me and for the baby, I might as well focus on the positives (e.g. it's quick!!) And really, with the previous scenario (i.e. induction) there was always the possibility that we'd go through an uncomfortable induction that wouldn't work and still have to go for a c-section after a lot of stress, whereas now we can plan for one and know exactly what to expect...and we can definitely have MY obstetrician (who I love!) So I'm starting to get a lot less nervous and a lot more excited!! So soon we'll be able to meet our baby! And I know I'll have a lot of help during the longer recovery period. My husband is able to take a couple of weeks off, and his mom will be staying with us for a while, and my mom will be staying with us for a while...so we'll be well taken-care of. :) It'll just be frustrating that I won't be able to lift the baby carrier and/or take the stroller in/out of the car by myself for quite some time. But I'll just have to exercise patience :)

Yesterday we had an appointment with the OB. I explained the retinopathy situation to him and we talked about the c-section a bit. He actually pulled out his schedule, but it's pretty full so he said he'd have to move some things around and get back to me. He wants to do it between 37 and 38 weeks, barring further complications, which puts us in the week of June 1st - 5th. As soon as we have a solid date, I'll let you all know! We all want to keep her in there as long as possible, as long as it's not threatening her health or significantly threatening mine. We also talked about my bloodpressure (which, incidentally, was EXCELLENT when his nurse checked it...I guess my efforts to slow down and reduce stress this week have been working). He initially wanted to put me on meds (baby-safe), but then suggested that it would be better to first try quitting work...and then go on meds if that doesn't work. So...as of this coming Wednesday, I am on mat leave! I had been anticipating that he might tell me to quit work, so I had spent most of this week cleaning up. After Monday/Tuesday next week, everything should be in order, so I'm feeling alright about it. My boss had a slightly panicked look in his eyes when I told him, but he did also know it was a possibility, and really everyone at work (including him) has been very supportive. My doctor says I don't have to sit around with my feet up all day (i.e. I"m not on "bedrest"), and I can still putter about doing the things I want to do before the baby comes, but I am to take it slowly and easily and relax a lot and keep from doing anything stressful or strenuous. I think I can handle that. :)

So that's the update! My husband and I both feel like we're in a much more positive place now than we were on Monday. We've had a chance to process everything and have some good solutions on the go now, so we're optimistic. And if the rest of this pregnancy plays out well (i.e. with my eyes and my bp), maybe the risks of having another child in the future won't seem so significant. Either way, our focus now is definitely on the exciting event that is only a month away!

In other non-medical news, we have been cleaning up around the house to get the baby's room all ready. Also, my mom and I went to the Welcome Wagon Baby Shower on Sunday. The baby's still moving around a lot, but it's more pushing now than kicking. I think she's going to one day just poke a fist out through my belly. The nurse at the OB's office said my belly is really tight (a comment I would have welcomed when WASN'T pregnant), but it sounds like that's normal based on her position so high up - she's really sticking out. I guess that's why I can feel her pushing so much too. It's neat, though, to be able to rub her little head or pat her little bum. :)

Anyway, here some pictures of our chubby-cheeked cherub. :)