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RE: [IP] pregnancy experiences - long

I think it was Ruth who was looking for pregnancy experiences a while
back.  I finally have a few minutes to write about how it went for me.
I had twins who are now about to turn 5 (I can't believe it:-) ).  Since
it has been a while, some of the details may not be exactly correct, but
the gist of it is.  When I was planning to get pregnant, I started to
get my sugars under really good control and started to investigate the
pump.  I was going to get the pump before getting pregnant, but things
didn't work out that way.  I ended up switching to the pump when I was
about 2 months pregnant.  I also switched to a new endo that had
experience with the pump.

The Kaiser I go to has a really great program for pregnant diabetics,
modeled after Sweet Success programs, such as the one at UC San
Francisco.  I am not sure if they are still called Sweet Success, but
the concept is that you have a team working together, including an ob,
an endo, a dietitian, a CDE nurse and a social worker.  When you go in
for your appt, the ob and endo come into the room together and do any
exam or discussion you need.  It is great having them both in the room
because you can get them both to agree to something and not get
conflicting advice.  Then directly following that appt, if you want, you
can go see the dietitian, the CDE, and/or the social worker.  I was in
to the endo and ob every week, but I have a feeling that was because I
was having twins; if it was just a singleton it probably would not have
been as frequent.  If you can find a program where the whole team works
together, I strongly recommend it.  The team also gave out their direct
lines so I could call them at any time and they would answer or get
their direct voicemail without having to be screened by a nurse.  The
endo also gave his home number out in case I was having problems with my
blood sugar levels.

My blood sugars tended to be on the low side the entire pregnancy.  I
had one of my worst lows that I ever had during my second trimester.  It
was one of the only times that my husband had to help me get the sugar
that I needed.  I was very careful with what I ate, measured things,
didn't go out to restaurants as much, etc.  It is easier to do that when
you know it is only for 9 months and it is for the good of the baby
(babies in my case).  It also helped going to the dietitian frequently
because she would keep me on track and help me get enough food for my
growing body.  I had a few highs, but just tried to get them back down
without getting too stressed about it.  I exercised before I got
pregnant, but didn't do too much during the pregnancy, mostly because
the thing I liked doing was biking, and the doctors were definitely
against that because my center of gravity was constantly changing as my
belly grew and they were worried that I would fall.

I had a pretty easy pregnancy.  Very little morning sickness; the only
real problem was fainting several times near the end of the second
trimester, when my body couldn't keep up with the increased blood
demands that my growing body and babies needed.  For the first few
months, my insulin needs were the same or went down.  However, in the
last months, we were increasing the basals and boluses on a weekly or
daily basis.  At the beginning I was taking about 30 or so units a day;
at the end I was over 100 a day.  I was supposed to gain 40 pounds, and
when I delivered 1 week early I had gained 39.  The babies were both of
normal size.  I had a vaginal delivery that went pretty good.  I was
induced because one of the babies had a less than perfect non-stress
test and the doctors saw no reason to wait.  They did an amnio on each
baby the day before I delivered just to confirm that the lungs were
ready.  They also said they don't like diabetics to go past term because
the placenta, etc. degrade faster in diabetics than non-diabetics.  My
husband checked my blood sugar each hour.  It went on the low side once,
so I had some juice.  I also had an IV in, but I am not sure what was in
it.  Until Sara's recent comments, I never realized I needed to think
about how much sugar would be in it.  We took my pump off at sometime
during the delivery and I think I had an insulin drip in the IV.  The
babies were just fine when they were born.  One of them had a blood
sugar that would seem very low for an adult (in the 20's or 30's I
think), but that was ok for newborns.

I had a number of tests through the pregnancy.  I had ultrasounds about
every month, again I think because of the twins.  The one they did at
about 20 or 24 weeks was especially thorough.  That is when they want to
make sure there aren't any problems that high blood sugars can cause.

After they were born, I only stayed in the hospital over night.  Both
the ob and the endo had said to expect to stay longer, but the babies
were fine, and the endo thought I would be able to control the food
better at home.  The first few days my basal was at about .1 or .2,
gradually working their way up over many weeks.  Quite a difference from
the 100+ units just a few days before.

I nursed them both, one for 14 months, the other for 15 months.
However, there were times when they were both screaming and I had to
test and eat before I could take care of them.  I tended to run my
sugars a bit high during that time because I didn't want to be low when
I was taking care of them.  Having twins, you get used to a baby
screaming, because there is only one of me and two of them who want to
be fed (or changed or carried or rocked or...) so I just learned to deal
with it.  I made sure that I ate when I needed to, although it was tough
and I ate things that took very little preparation.  You don't need a
lot of insulin for the first months of nursing, but after a while your
body gets more used to it and your needs go back up.

The funniest thing is that when I look back on the 9 months of pregnancy
and the first few months after, I get a smile on my face and don't think
it was too bad.  It took several years before I could even think of
doing it again, but now I think about it and think it wasn't a big deal
to do.  My husband, on the other hand, thinks it was the hardest time he
has ever had and doesn't want to go through it ever again.  I wonder why
women see it through such rosy glasses?

I can't believe that I had so much to say.  I guess it was a pretty
special time.  Of course, as I read back over what I have written, these
were my experiences and yours may differ.  Other than the diabetes I had
a pretty smooth pregnancy, so I was pretty lucky.  Good luck to all who

-	Jodi
Diabetic for 8 years, on the pump for 5.5 years, with Humalog for about
5 months
Mom to Ariel and Benjamin (5 in March)