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Re: [IP] pregnancy experiences - long



Jody,

Thank you for your wonderful, thoughtful description!

Congratulations on Bejamin and Ariel!

Ruth

Muirhead, Jodi wrote:

> 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
> follow...
>
> -       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)