Cute Overload

I’m not in the least bit superstitious. I’m generally of the belief that if something is meant to be it will be. And I absolutely don’t subscribe to the idea that buying baby items automatically means that something will go wrong with the pregnancy. It’s just not going to make a difference.

On a practical level, though, I don’t see the point in kitting out an entire nursery too far ahead of time. I hope that we will be parents before the end of this year. But if not, I at least feel reasonably confident now that we will be parents one day. So any items we buy will get a use at some point in time. But, if something were to happen, I think having lots of baby items hanging around the house would just be an added insult to deal with. And since the chances of miscarriage are at their highest in the first twelve weeks, we made a decision that there were to be no baby items bought until after that first 12 week scan.

On the Saturday that we saw our baby for the first time, we went straight from the scan centre in to the town centre, and in to Mothercare.

Walking in to that shop was like cute overload. Already hormonal, and on a high from the scan, it was all I could do not to burst in to tears over all the little outfits, tiny socks, hats and scratch mitts, and little stuffed animals. Honestly, this stuff is so cute. There is just something about how small everything is. And knowing that we’re going to (hopefully) have our very own little thing to fit in to this stuff makes it even more exciting. Even Ian had to admit it!

I could quite easily have left with half the shop, but I’d imposed a strict limit on myself before we started and Ian was there to hold me to it. We were able to exclude all the gender specific stuff, which helped narrow our options down. We left with baby’s first cuddle toy. And these:

Cute sleepsuits

I keep holding them up and grinning at them. I just hope the little person inside me really does have those sentiments.

Mini Meltdown

Last night, I had a bit of a meltdown. I’m guessing it may have been good practice for Ian on what we have in store as this baby gets older because it was a bit like a toddler tantrum, with shouting and tears – lots and lots of tears. And snot. Plenty of snot too. I’m a classy bird, me.

I wish could say it was the first time in this pregnancy that I’ve lost the plot a little bit. But in truth, I first lost the plot within a few days of that second pink line appearing. While I’m sure all mothers-to-be, and especially first time mothers-to-be, experience plenty of early pregnancy anxiety, the source of my distress was very definitely diabetes. On that first occasion, my blood sugar had risen seemingly inexplicably to something like 13mmol/l. I panicked, in a very full on hyperventilate-y way. Even though I was aware of how ridiculous I was being even as it happened, I could not stop the strong sense of fear overtaking my rational, sensible side. All I could imagine was the harm that high number could be doing to the delicate little beginnings of new life inside me. The result was a crying fit that it took Ian a good thirty minutes to talk me down from.

What that first high number really underlined for me was what a mammoth task I’ve taken on. I was, and still am, totally and completely scared by the awesome responsibility of building a new life. I’m so, so afraid that I can’t do it. That I can’t keep up the necessary blood glucose control and fit in the weekly or bi-weekly hospital visits required of me, all whilst continuing to do my job well. I’m afraid that my broken body will let me down. I’m afraid of letting Ian down, by not providing the very best environment to nuture his child. Most of all, I’m afraid that I will let our baby down.

The rational and sensible usually prevails, but I can’t suppress those fears all the time.

I cried at each and every one of my first few hospital visits. I cried to my diabetologist, expressing my concern that if anything goes wrong in this pregnancy, it will be my fault for not managing my medical conditions, and most specifically my blood sugars, well enough. I do understand that even if I were perfectly healthy, and a model mum-to-be, that things could go wrong. But if something does happen, I’ll never know the exact cause and I will always tend to assume that it’s down to me. My consultant tried to reassure me that any problems would be the fault of diabetes, not me. But diabetes is under my control. If I fail to control it well, any problems *will* be down to me.

I’ve cried at hospital appointments just because of their intensity. I don’t want to feel like a medical experiment. I don’t want to feel continually petrified of what I am doing to our little baby in there. I want to be a mum more than anything, but I also want to at least enjoy pregnancy a little. The amount of time spent at the hospital reinforces that pregnancy just seems too hard for me. That would see me dissolve in to tears again.

Last night I had a melt down because my DexCom was throwing screwy numbers, and a fingerstick revealed a much higher number than I thought I’d been sitting at. It sent me in to a spin, wondering just how long the DexCom had been giving inaccurate readings. Had I been high for the 3 hours since I last took a fingerstick reading? And that of course made me curse my laxness, for going too long without a “proper” blood glucose test. I’d been slacking and I was paying the price.

I know that I need to lighten up. I know that there is every chance the stress I’m putting myself under will do as much harm as the occasional elevated numbers I’m getting. But I also think that much like I have to accept that high blood sugars will happen occasionally during pregnancy, I also have to accept that these kind of panics and melt downs are par for the course with a diabetic pregnancy.

Luckily for me, Ian certainly seems to be accepting it.

Morning, Noon and Night Sickness

Morning sickness is a misnomer, in more ways than one.

For starters, it doesn’t just happen in the morning. It happens in the afternoon. It happens in the evening. It happens all through the night as well. And secondly it’s not as simple as “sickness” which sort of implies that you throw up a few times, feel better and then move on. The worst part of morning sickness isn’t the actual throwing up part, it’s the constant, unrelenting feeling of nausea and the complete inability to face eating food even when your stomach is empty and protesting by attempting to digest itself.

For the first twelve weeks of my pregnancy, this was how I felt. From the moment I awoke to the moment I went to bed, I felt a bit like I was at sea in a small boat in a rough storm. I had peaks of nausea as soon as I got up (which led to some very icky moments, like throwing up in the shower) and also at around 5pm, but the feeling of sickness never really went away. I got used to figuring out where the nearest toilet was and never going anywhere without a stash of plastic bags and tissues in my handbag. (Have I mentioned yet about what a classy girl I am?) I got pretty adept at planning my work day so I could seize appropriate opportunities to relieve my stomach and I was either very good at being quiet, or blessed with spectacularly unobservant work colleagues as I got away with it without arousing suspicion long before I’d announced my pregnancy at work!

I tried every remedy under the sun. I tried ginger biscuits. Eating before I got out of bed (it ended up back down the toilet). I tried sucking ice. I attempted to eat often, keeping food in my stomach as much as possible and I tried drinking lots of water. I tried sucking on mints. I tried getting plenty of fresh air. Nothing really made that much difference. I hated to do it, but eventually had to resort to medication, which did work. I felt like I had little choice in the end, because the nausea was affecting my food intake to such a degree that it was beginning to interfere with my blood glucose control.

During this time, my appetite basically packed up and moved out of the building for several weeks. For a while the only things I could stomach were yogurt, jelly, mini Mars bars, Hula Hoops and Special K or Cheerios. Oh, and macaroni cheese, which would be fine other than it’s a diabetic’s nightmare food at the best of times, nevermind when you’re aiming for super tight control and post prandial readings of less than 7.5 at one hour. I had to send up another prayer of thanks for my unobservant colleagues, as I managed to explain away my sudden diet of nothing but yogurt for lunch without any of them asking if I was pregnant. Which was pretty surprising.

Once the medication kicked in and the nausea settled, my appetite improved. It was still a bit limited, but finding healthy options to eat was much easier. I figured that much as I wanted to avoid medication, I was being kinder to my developing baby by being able to provide proper nutrition and better blood glucose control. The risks are very tiny anyway, and seemed outweighed by the risks of carrying on as I was.

The only thing that medication could not help with was the unrelenting tiredness that seems to come as part and parcel of the first trimester too. This isn’t like the kind of tired you get when you haven’t had enough sleep. Or even the kind of tired you get after running a half marathon. It’s a all consuming, bone crushing kind of tiredness, that’s leaves you feeling like a soggy blanket, as of your brain is filled with glue and your feet are firmly embedded in a muddy bog. It’s almost impossible to relieve. Even sleeping doesn’t really help, but I often tipped the dental chair back at lunch time for a quick 30 minute nap, just to try and take the edge off.

Actually, I’m starting to think my colleagues can’t have been that unobservant. I was practically wearing a six foot neon sign screaming “I’M PREGNANT”. I think I’m actually blessed with the world’s most sensitive and discreet work colleagues instead!

First Trimester: The Diabetes Edition

In addition to all the symptoms you read about in the ‘Yay, I’m Pregnant, Now What?” books (like the tiredness, and the morning sickness), diabetes brings a whole host of its own challenges to the first trimester party.

It starts just about the moment you see that second line on the pregnancy test , where three seconds of sheer elation is followed by lingering sense of panic. I’m guessing that all women experience some degree of worry during early pregnancy – about the risks of miscarriage and about keeping themselves and their baby healthy. But with diabetes in the mix, the stakes seem higher. Because one of the major factors that may influence the outcome of the pregnancy is directly in your control, but sort of uncontrollable at the same time. The sudden realisation that you need to keep your blood sugars on the absolute straight and very, very narrow day-in, day-out for the next nine months is overwhelming. More-so because you’ve almost certainly been trying to do that for a long time anyway, and know just how difficult, if not impossible, it is to do.

The worry about whether my best is good enough is something that gradually settled down in the background. It’s never gone away, stalking me wherever I go, but it has become a bit less front and central. To a point I need it there, to keep me motivated to put in the huge amount of effort that so far seems to be paying off.

Worry aside, if I had to pick just one word to define my diabetes during the first trimester it would be: hypoglycaemia. Oh yes. The lows moved in to the building and took up very firm residence.

I sort of expected it. Other women with diabetes, and my health care team, had already primed me that lows were a possibility due in part to all the efforts for very tight control, but also just because. I didn’t expect the lows to be so… persistent, though. My basal insulin requirements dropped like a rock, and I was often drinking my body weight in carbs, without bolusing, just to stay ahead of the curve. Which was pretty challenging when I also felt like throwing up the whole time. And there is little worse feeling than knowing you are low as you are vomiting up the juice you just drank to try and reverse the low. In the end, when I did eat I had to sacrifice good post-prandial numbers to avoid crashing lows if I was sick. I learned it was safer to wait at least a little while before bolusing in case the carbs never made it in to my system.

Despite all the sickness and lack of appetite, I still gained a couple of pounds in the first trimester. I can’t help but think this had more to do with all the empty calories from treating lows than it did with the baby growing inside me. My basal needs eventually levelled out at around 13 units per day, down from around 18 units per day before I was pregnant. That drop still makes my eyes pop.

But my A1c, 5.9% at conception, remained in the mid to upper 5s throughout those first twelve weeks. Each time I got a result back, the worry knot inside me loosened just a tiny bit. All the testing, all the insulin dose adjusting and even… even all the lows, seemed worth it if it was keeping our baby safe in there.

Diabetes Care Decisions

I’ve been going to the same diabetes centre for almost 12 years. I transferred there as a twenty year old student when I hit a brick wall with my previous doctors about transitioning to a pump.

They not only got me up and running on my first pump, but they saw me through my entire twenties. They took care of me through my battles with non-diabetes related health issues and helped me come out the other side. They saw me qualify as a dentist and turn from student to professional. They’ve seen literally hundreds of highs and lows, and everything in between, with me.

As a twenty-something woman, pregnancy was a bit of a recurrent theme at regular review appointments. In particular, the importance of not letting it happen without proper planning and of course the advice that if I should fall pregnant, I should tell them straight away, almost even before I told my partner!

In the event, I didn’t tell them quite that soon. Ian was with me when we did the pregnancy test, and both of our sets of parents heard the news straight away. But I did have an appointment the morning after my positive pregnancy test, and so my doctors were the next people, and the first non-family, to know. I was happy, sitting in that waiting room, waiting to share good news, wondering which familiar member of staff I’d encounter first. And when I went in to the consulting room I almost bubbled over. Everyone was happy for us too. They did another pregnancy test and concurred that yes, I was very definitely pregnant. And with a diabetic pregnancy, that’s when everything kicks in to high gear.

Or at least, it seems to. Suddenly there are more appointments than you know how to deal with. Your A1c has never been tested so often and your blood glucose records come under closer scrutiny that your average tax return. Everyone is working towards a healthy mum and a healthy baby at the end of the nine months, and is there to support you to help that happen.

Only, it didn’t quite feel that way. My frustration set in at the very next visit, the following week. I saw a new registrar who I’d never met before and didn’t know my history. A whole bunch of stuff relating to my complex endocrine story was dragged up again. Stuff that had been previously laid to rest long before we’d been given the go ahead to try to conceive. No one had mentioned this stuff again in a long time, but suddenly I was left with a horrible feeling that maybe I’d been foolish to get pregnant at all. None of my other worries or fears were addressed at that visit. There was quite a lot of “I don’t know” and even more “We’ll deal with that later”.

The issues got resolved, and I did get some fantastic support and reassurances from staff that know me better. But at the same time, I couldn’t help but feel that the stress with getting to these appointments was far greater than any positive outcome from them. It all started to feel a little bit pointless. I had the diabetes regime down pat. I knew everything there was to know about the risks of poor control and what I needed to do to stay healthy, and I was achieving excellent results. Now I just needed some normal pregnancy support. You know, the kind of care that non-diabetic and “regular risk” patients get in early pregnancy.

It wasn’t forthcoming. By the time I was approaching ten weeks of pregnancy and still all we’d done was talk about my numbers, it was getting a bit thin. I didn’t feel pregnant anymore… I felt like a numbers machine… a science exeperiement. Spending £25 and a two and half hour round trip to look at DexCom graphs that Ian and I can look at together at home, or even email to the hospital if we need extra input, was starting to really grate. And the final straw was when I was told that  got a “gold star” for my A1c of 5.8. “It’s brilliant I was told “We don’t normally see numbers like that until much later in pregnancy, when the blood volume really increases and the red blood cells turn over faster. This is the first time I’ve seen a number so low so early in pregnancy.”

That made me think “Whaaaaat…” Because it made me think that maybe they can’t be so hot at this diabetes and pregnancy thing if an A1c in the 5s gets remarked upon. But more than that it really cemented the fact that travelling all this way wasn’t worth it. As far as they were concerned, I was already doing great. I could agree on the diabetes front, but I wasn’t so sure about the rest of my pregnancy.

I’ve always been a bit of a diabetes care rebel. Not in terms of not doing what needs to be done, but more I terms of doing things my way. My parents started the trend by giving me extra insulin for treats as a child. They were frowned on at the time, but a quarter of a century later it’s the accepted norm. The thing is though, I didn’t want t be a rebel anymore. Becase suddenly this isn’t just about me anymore. It’s about our baby too. So I wanted to toe the line and do what was best for both of us. Which is why I felt so frustrated when the care we got didn’t feel like “best”. By default, they drove me to rebel.

First of all, I put my foot down and said I was only coming once a month, instead of once a fortnight.

But that still didn’t address the fact that I felt as though I was getting no routine pregnancy care. I didn’t like the fact that the hospital was so far from home, and couldn’t see how that might work if I went in to a spontaneous labour at the end of my 40 weeks. So I made a pretty big decision to move all my care to my new local hospital. It would mean that I could get my pregnancy and diabetes care closer to home, and deliver the baby just a few miles from home as well. Their reputation may not be as an internationally renowned teaching hospital, but they can provide excellent pregnancy knowledge and care, and as much diabetes support as I need.

It was strange, attending my first appointment at the new hospital this week. The people seem lovely, but of course I don’t know them like I know the people I’ve been working with for over a decade. I don’t know how the system works at the new hospital, or where anything is. But I do feel that I’ve made the right choice for my health, and my baby’s health, during this pregnancy.

I’m planning to return to my old diabetes centre just as soon as pregnancy is over. They haven’t really done anything wrong. It just wasn’t the right place for the pregnant me.

Peek-a-Boo. We See You!

Our official “twelve week scan” was at our new hospital. It turned out to have been a very good thing that we’d already had our NT scan done privately since by the time the scan came around I was already at 14 weeks and past the cut off point for the NT measurement. Which meant that this scan, last Tuesday, just turned in to an opportunity to spy on our little beanie in there.

He or she was rolling around, stretching their little arms and legs out. And it was pure magic to watch.

I still. Cannot. Believe. This.

The Most Comfortable Jeans in the World

I’m one of those girls that struggles to find jeans that fit me really well. I have pretty big hips and thighs, relative to a fairly small waist. Jeans that fit well on the hips are often left gaping around the back of my waist. Jeans that would probably nip in at my waist beautifully, I struggle to get over my thighs. And when I find some that fit well, there is a reasonable chance of them being too long, too short or in a style that I just don’t like!

Comfy jeans that fit well and look good are precious things to me. It’s a good job that denim is hard wearing and my weight doesn’t tend to fluctuate much, since when I find a good pair, I want to hang on to them.

So the thought of needing a whole new wardrobe to accommodate my expanding girth is not exactly one that fills me with joy. Nice elegant wrap tops, and lovely long, drapey tunics I can do. But Jeans have been worrying me.

So I was totally shocked this weekend, on my first foray in to the maternity sections of several stores, to find the most comfortable, well fitting pair of jeans I think I have ever owned. Of course, the wide jersey band at the waist gets rid of any waist fitting issues, so I was free to find a pair that fitted beautifully on the hips and bum. And I’m left wondering why women don’t wear maternity jeans all the time They adapt to every curve. There are no awkward button or inflexible waist bands to cut in when you’re slouching at the end of a long day.

When this pregnancy is over, do I have to pack my maternity jeans away in the loft?