Pregnancy Update- 30 weeks

I’m getting a few good nights of sleep a week, which I think is due to a) my total exhaustion and b) I’m no longer in a horrible state of anxiety where preterm birth would be catastrophic for my baby – for which I feel so so so thankful.  When I was first diagnosed with a short cervix, my regular OB said we need to take the pregnancy in stages, and at every stage we can breathe a little easier.

A) get to 20 weeks

B) get to 24 weeks (baby could probably survive with lots of help and a very good hospital staff)

C) get to 28 weeks  (major milestone, baby would be able to survive!)

d) 32 weeks and beyond is “just gravy” (her words)

So here we are at almost 31 weeks and baby is doing wonderfully!

I am overcome with joy and excitement but also fear and anxiety when I think about delivering our baby soon.  I know my blood sugars have to be perfect for delivery but I haven’t yet figured out how I’m going to accomplish that in a state of labor (managing blood sugars is a juggling act on it’s own!).  I haven’t decided if I want to wear my pump or have the insulin drip.  I have had the insulin drip on other visits to the hospital and it has worked out well.  I will definitely be wearing my CGM but other than that I have no idea how to prepare.  Besides the diabetes stuff I am also just nervous/excited/scared to be a first-time parent!  I know life as we know it is going to be totally different.

I have spoken with my High Risk OB/GYN team and the idea is for me to get as close to 39 weeks as possible.   Then they will induce.  If my sugars aren’t stellar after week 37 they will also induce.  At my hospital system C-Sections are a last resort and they let women have vaginal births as long as they are able.  I am hoping I don’t have to have a c-section, but who knows.  Last ultrasound at 28 weeks put my baby in the 37th percentile for size and weight, but our next ultrasound is at 32 weeks (next week) and I’m sure the baby has grown a lot.  I feel so large now.  All in all, I’ve now gained 19 pounds in almost 31 weeks so that’s not too bad.  19 pounds doesn’t sound like a lot to most people but I’m barely 5’2″ so it’s a lot on my frame.

In my hospital system, the regular diabetes/endocrinology team is completely hands off in pregnancy and you end up seeing a team of High Risk OB/Gyn’s the whole time (every 2 weeks starting at 12 weeks).  I had my quarterly endocrinology appointment last week and was happy to see my doctor.  He said I’m doing amazing and not to read too much into what the High Risk team has to say about my blood sugars.  I explained that it’s frustrating to me that I have all these CGM reports and they only look at the blood sugar checks.  It’s like only looking at one piece of data when you have thousands of data points!  He said I’m doing great and not to let them get into my head too much.  I could write more on the High Risk team but I’m just going to stop there.

At my endocrinology appointment, I found out my A1C went up from 5.5 to 5.8 from April to July and I’m not even mad about it.  The second trimester was ROUGH.  It was extremely difficult to combat high blood sugars timely while being on bed rest. (I’ve talked before on the importance of taking a walk to increase insulin absorption.)  I also was able to get rid of most of my lows – so I consider the 5.8 a win. 🙂

I’m able to do most exercise now but majority of the time it just means walking on the treadmill or playing with my dog in the backyard.  I am grateful for that because it has helped me bring my blood sugars into a normal range – especially if it’s right before a meal.

I have stopped emailing my High Risk team my blood sugars unless I get really frustrated, because I think I have a very good handle on them now and I make the adjustments myself.  The famous third trimester insulin resistance has hit me hard the past few weeks so I’m taking a lot more to make up for it – more than I’ve ever taken in my life!  The other day I took 11 units for a sandwich that would have been around 3.5 units pre-pregnancy.  It can be terrifying to have that much active insulin on board at first but I have gotten over those fears when the lowest I drop is 80-90 mg/dl.  I always am in awe – like wow it’s working!  And insulin resistance, while annoying to me, is good for the baby.  It means the baby is producing all the necessary hormones that make insulin resistance happen for mom.  I like to think of the baby’s growth hormones as teflon for insulin – just doesn’t stick!

My basals have gone up across the board as well.  I’m taking almost 1 unit an hour except for 3am to 8am when I take 1.5 units/hr (that crazy dawn phenomena!).  I’ve also (finally) taken the time to set up a separate basal profile for the weekends.  It helps me not to have to wake up at 6 am and eat something on a weekend when all I crave is sleep.  I don’t know why I was so hesitant, because I have now gotten 10 hours of sleep 2 nights in a row. 🙂

I had family visiting in early July which was wonderful!  My dad and my youngest brother were here and earlier that same week my mother-in-law came to help me set up the nursery.  She also gave the house a thorough cleaning –  something I hadn’t been able to do in a long time because of bed rest (and my husband and I have both been busy, busy, busy at work).  While they were here I took a brief 3-day sensor break.  I get nervous not having my sensor on but amazingly my blood sugars were essentially perfect.  I did eat pretty low-carb the whole time and was very careful about insulin dosing so that probably helped.  (And the fact that lows are almost non-existent at this point in the pregnancy).  So I probably don’t need to freak out as much when I have to take a a day off my sensor every now and then.

The nursery is pretty much all ready to go so we’re just playing the waiting game.  Shouldn’t be long now. Eight and a half weeks to go!

-Grace

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