Thursday, September 22, 2011

Our Vacation, The BIG Ultrasound, & My Latest A1C

It's been a couple of weeks since I last posted, and let me just say...they've been a busy (and eventful!) couple of weeks.  First, an update: I never received a call about our prenatal screening tests, so that's a big "yay!"...No news was good news, so that's definitely what we were hoping for.

We also had our big appointment with a maternal-fetal medical specialist last week that included a level 2 ultrasound to check for developmental/anatomical abnormalities.  Level 2 ultrasounds are fairly commonplace these days, even in women who aren't designated as high risk; however, my OB sent us for one specifically because I'm automatically labeled high risk thanks to my type 1 diabetes.  From my first appointment, my OB has been very supportive and encouraging, and was impressed with my A1C and tight level of control.  I appreciate the fact that he's treated me as normally as possible, because a lot of doctors have a standard procedure for treating "diabetic" women (as most of you already know, I hate that label!) that they don't deviate from, regardless of the patient's level of control.  The way I see it, if I'm able to keep my numbers relatively normal and generally within a normal person's range, there is no reason I should be automatically sentenced to C-section or induction at a certain cutoff point, provided everything continues to go as well as it has for the first half of my pregnancy.

I appreciate my OB's approach to my care thus far because he has been thorough and cautious, but optimistically so.  He has said from the beginning that if I'm able to keep my blood sugar levels as close to normal as possible, I should have an easy and uncomplicated pregnancy.  Of course, bad things can happen in pregnancy even for the healthiest of women, so he's also made recommendations (like the prenatal screening tests and level 2 ultrasound) to ensure that everything is developing as it should.  He did (predictably) go over the risks commonly found in pregnancies with preexisting diabetes, but thankfully didn't dwell on them.  Like anything else diabetes-related, pregnancy with diabetes is very YMMV (Your Mileage May Vary), and luckily my OB realizes that.  Some women have excellent control, but their prexisting complications from diabetes (like retinopathy) make it impossible for them to delivery naturally.  Other women have horrible control, but are able to (somewhat miraculously) have a normal pregnancy and delivery.  Therefore, I believe it's important to focus on the individual patient's unique situation in lieu of a textbook procedural code.  In that way, I feel very lucky to have found a doctor whose philosophy is closely in line with my own.

Due to some differences/problems between my OB's practice and the maternal-fetal medical specialists in the city where my doctor's office is located (about two hours from where we live!), we were sent to a different city three hours away to have our level 2.  Since we had a wedding in a nearby town the weekend before, we just decided to make a mini-vacay out of it and spent a few days in Carlsbad, NM, the week before our appointment.  We toured the Caverns and did A LOT of walking, but had a blast.  We stayed at the Trinity Hotel, an old bank that was renovated into a nine room hotel and restaurant.  The room we stayed in had a super comfy bed and the biggest bath tub I've ever seen:

The restaurant, which we ate at twice during our stay, was WONDERFUL.  The first night, we both had the lobster and cheese ravioli with vodka sauce, which was to die for, along with a piece of berry white cheesecake.  A couple of nights later, my husband had a ribeye and baked potato, and I had the Mastachana, penne pasta with massive grilled shrimp and a tomato-bacon sauce.  Per my husband's request, we also shared another piece of the same cheesecake we had before.  It was definitely some of the best food I've had in a long time!

The first day in the Caverns, we did the self-guided Natural Entrance tour, which begins at the Natural Entrance (duh) and ends in the Big Room.  I had never been to this or any cave, so it was a pretty cool experience.  It's like a completely different world down there...a world that remains a constant 56°F yearround.  Surprisingly, I wasn't cold, despite the fact that I was wearing a tank top and capri pants...I guess all the walking (mostly downhill, much to the irritation of my toes) kept me warmer than usual, because normally I'm freezing at 72°! 

Unfortunately, my blood sugar decided to not cooperate that day, leaving me stressed out at 308 post-lunch before we hit the trail.  I hadn't seen a number over 300 since I started insulin, and any number higher than 140 makes me nervous...Not to mention, I still struggle sometimes with the diabetes numbers game even though I have a generally healthy attitude about it most days (see #4 of this post).  It's hard enough for me to deal with an out-of-range number normally, but now that I'm pregnant that anxiety is sometimes through the roof.  After all, it's not just my life that depends on my numbers anymore.  Anyway, I corrected and hoped (and prayed) that the 1.25 miles of walking would bring me back to normal range.  About halfway down I tested again, and was at 209.  My hubby reminded me to not overdo it, but I'd rather be low than high any day, so I did another small correction.  By the time we finished our tour and made it back to the vehicle, I was at 46.  A Nature Valley Oats 'n Honey bar brought me back to normal range once again, and we were back in business.

The second day, we took a ranger-guided tour with 13 other people through the Left Hand Tunnel, which takes you through an unpaved and unlighted part of the cave not open to the general public (except on the guided tour) with only an old-fashioned lantern to light your way.  My husband wanted to take the more adventurous Lower Cave tour, but it was off-limits after I told them I was expecting...I'm pretty sure I would have been able to do it, but they didn't want to take any chances!  Anyway, the tour we took was pretty awesome since we were with such a small group and there was so much neat stuff to see (i.e., a mummified bat).  Towards the end of the trail back, we gathered in a circle and after telling what our favorite part of the tour was, blew out the candle in our lanterns.  The resulting blackout was an all-encompassing darkness that I'd never experienced before.  With absolutely no natural or artificial light in the cave, you literally couldn't even see your hand in front of your face.  Our ranger then re-lit our lanterns for the rest of the tour, and we ended up back by the restaurant area (750ft underground).  Since we'd seen the rest of the cave the day before, we decided in lieu of taking the elevator back up, we'd hike back out the natural entrance.

Mummified Bat (Lying Diagnally Across Above Rock)

Lanterns From Left Hand Tunnel Tour

The reason you "walk" down and "hike" up, we found out, is because the steep grade that leaves your toes aching on the way down is particularly murderous on the way up.  In the cold cavern air, my pregnancy lungs had to be given rest fairly frequently, and my buns/thighs/calves were all aching by the time we made it out.  The funniest part of the whole thing was when we encountered an older couple on their way down.  The woman asked her husband if they'd be hiking back up as well, and when I told her how difficult it was, she told me, "Well if you need any help, just holler and I'll come get you!"  Fortunately, we made it back to the surface (mostly) unscathed, and got back in the truck to return back to town--only to stop at the Living Desert Zoo and Gardens State Park, which gave us another 1.3 miles of trails to walk through that afternoon!  Although there weren't a ton of animals to see, it was a pretty neat place.  I was sad the cougar wasn't in residence (or possibly stalking us unseen) that day, but we did get to witness some prairie dogs freaking out when they noticed the wild hawks circling above them (hilarious!) and a mad rattlesnake (safely behind glass, of course) that looked like it was ready to strike at us.

We left the next day to head back to the city where we'd have our ultrasound and stopped to visit my husband's parents and some of his sisters on the way.  We rarely get to see them since they live so far away, so it was nice to be able to visit with them.  The next morning, I was so nervous that I didn't want to eat breakfast, but I knew I needed to eat something, so I forced down some eggs and cereal as quickly as I could so we could find the doctor's office in time for our appointment.  We made it with just a few minutes to spare, but I still couldn't calm down until they called us back for the ultrasound.  I don't think I've been that nervous in a long time, mainly because everything I'd done to keep myself and therefore our baby healthy up to that point was at stake...I can't begin to explain the tension and helplessness I felt.  I had been praying every night for the baby's and my health, but I still couldn't help but be a little nervous thanks to all the "what ifs" that creep into your mind if you let them.

It turns out all of my worries were for nothing, because our little one was perfectly normal and developing as expected!  After that was out of the way, I was on pins and needles wondering if our baby was a he or a she...I had been convinced throughout my whole pregnancy that I had to be carrying a boy, not due to any evidence but a feeling.  As it turns out, my intuition in this case was totally and completely wrong, because the ultrasound technician told us she was thinking we were having a girl, even though the cord was wrapped between the legs and she couldn't be completely sure.  She scanned a few more important areas then came back to double-check, and sure enough, it was definitely a girl!  I almost couldn't believe it at first, but I was definitely pleasantly surprised.  I always secretly wanted a girl, but wouldn't let myself dwell on it for fear that we wouldn't have one.  It's not that I would have been disappointed had we been having a boy; it's just that I'm so girly that I wanted a little girl to dress up and play Barbies (and John Deere tractors!) with.

I wrote a couple of months ago about how much the gender issue bothered me, not because we necessarily cared much one way or the other, but because of people's comments about our baby in relation to my sister's.  Since she is 10 weeks ahead of me and having a girl, we had to deal with everyone telling us that "maybe we'd have a boy" so that (a) my parents would have one of each for grandchildren or (b) because there'd be less competition between us.  It's hard to know what to say when people make those remarks, and even harder when they ask what you're hoping for.  For that reason, I never told anyone aside from my mom that I really wanted a girl...I didn't want to have to eat my words later.  My husband never said which he'd rather have, but I think he's thrilled at the thought of having a daughter.  He always tells me to be sure and take care of his little girl, and wanted to go buy her a little single-shot pink rifle as soon as we found out what we were having...Ours will be the third girl in our group, which currently contains five little boys to run from!  In the first stages of pregnancy, my hubby thought that baby monitors were ridculously expensive, but just the other day when we were at Target, he was scoping them out and commenting on how "cool" the video monitors were!  It's so nice to see him taking an interest in everything, and I know he'll be an amazing (and protective!) dad.

Last but certainly not least, I got my latest A1C results back yesterday.  Before conception, I was able to bring my number down from 6.5% to 5.7%, which fell safely within the person without diabetes's normal range of 4.0-6.0% that they like you to shoot for pre-pregnancy.  With all the higher numbers I'd been dealing with lately, I was afraid my number may have gone up slightly, but I was just hoping that it would still be lower than 6.0%.  When I got home yesterday and nearly ran to the mailbox, I ripped open the envelope with my test results and was shocked to see that my A1C was 4.9%!  I almost couldn't believe it, and had to read it a couple of times for it to sink in.  With all the challenges I've had to deal with and hard work I've put into managing this disease, it's so nice to see positive results.  In a way, it validates everything I've been doing and re-affirms my confidence in my ability to manage this difficult disease.  Most of all, it reassures me that I am doing everything I can to ensure my child's health and well being, which is the most important end result for me.


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