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Re: [IP] Labor with Pump on
On Tue, 18 Jul 2000 16:20:58 -0700, Kristen wrote:
<<To anyone who gave birth while on pump, did you wear the pump during
actual labor? I am 6 1\2 mos pregnant and asked my OB today if I can keep
pump on and he basically said YES, he just wants to talk to my endo about
the difference/conversion of humalog in pump to regular intravenously,
since that is what he is used to dealing with. I'm not sure but he sort of
made reference to letting me control my own numbers?? I'm not sure if he's
willing to give up control though, since he kept saying he would have to
speak to endo to determine conversion????? Any suggestions? >>
I was on intraveinous insulin during my first labor and on the pump during
my second. For me it was pretty much 6 of one, half a dozen of the
other. Here's the rundown of my experience.
As far as the conversion rate, I don't know if there is one. I don't see
why they couldn't use Humalog in the IV, but there would still be changes
because you're going from subcutaneous to IV infusion.
Nurses are in control of both basal and bolus rate. They operate according
to a standard protocol. This--for me--included not administering bolus
until an hour or so after a meal, so sugars tend to go high for a brief
period. Because I was uncomfortable with this protocol I was eventually
able to convince my OB to allow me to administer the boluses via
injection. This made me feel me feel much more comfortable, especially
since I was on a clear liquid diet that included not much more than fruit
juice and regular jello, and I have a relatively high carb/insulin ratio
(between 6:1 and 9:1).
Until I had negotiated with my OB to obtain this control I was
uncomfortable about my blood sugars. I had just spent 12 months keeping my
blood sugars as close to normal as possible and now the nurses wanted me to
drink apple juice and eat jello without bolusing for an hour!
Because I use a very low basal rate, the standard protocol didn't work well
for me and I was low until they worked out the kinks. This isn't fun when
you're on a Pitocin drip. Can you say "Technicolor Yawn?" (Vomiting)
Nurses are comfortable with the standard protocol and are more
accommodating for that reason. When you're in labor an accommodating nurse
is a wonderful thing.
You don't have to worry about the basal rate, since someone else is doing
it for you, though it may take a while to get it right. We all understand
that, of course. (VBG)
I was on Pitocin anyway so adding insulin to the IV tree wasn't a big burden.
I was on the fetal monitoring device so I didn't have a lot of mobility;
hence the IV tree wasn't an added inconvenience.
You are in control. This made life much more comfortable for me.
I did not want to turn my pump off completely--which my OB had advised me
to do--so I kept a 0.1 bolus rate going during labor. Because of this (I
suppose) I was a bit low during most of the labor, but not as low as I was
on IV insulin. (No Technicolor Yawns, and, yes, I was once again on the Pit
I still had the IV tree to carry around with me since I was on the Pit
Drip. No gain there.
Still had the fetal monitoring device so not much mobility regardless.
As I look over my post it seems I have a lot more negative things to say
about the IV insulin, but I don't really feel that way.
Both of my experiences were positive and both of my daughters came out
healthy and crying at the top of their lungs.
I guess it depends on whether you want to take the cruise ship or sail off
into the sunset yourself. I enjoyed both journeys.
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