I promise it has not been intentional to not be consistent or to be absent in blogging. Things were becoming increasingly busy near the end of my pregnancy trying to prepare for the baby, which proved to be a needed thing because I actually went into labor on Father’s Day weekend.

Yep. Totally unexpected. I even had an OB check-up the Thursday before and there was absolutely NO sign of her coming early. I knew my pelvic bone felt as if she had shifted down, but my OB said he didn’t think she had dropped, and that labor did not seem to be any time soon. Yeah, right. My body thought otherwise. Late Friday night / early Saturday morning, I started having contractions. Not bad, but stronger than normal, and only a few of them. I went off to bed with no problem other than the usual hip/pelvic pain that I had all throughout my pregnancy. Saturday morning, we went shopping for the weekend and for things for the next week (food, etc). Halfway through the shopping trip, the contractions were very strong, but not consistent. I thought maybe it was the pelvic pain from walking as long as I had been. Activity was not something I could do without major pain anyway, and this was just over the top. All I wanted to do was to go home and rest in my recliner and wait for the contractions to ease too – because, ya know.. they just had to be Braxton-Hicks since I was no where NEAR ready for labor right?? Ha. They stayed steady all.day.long. And into the night. By that evening, I told my husband we had better go just to get checked since the contractions were then becoming about 4-5 minutes apart.

After a 2 hour stay at the hospital (SUPER strong contractions, but no dilation… only a half centimeter!!), I was sent home with a cocktail shot in my hip to make me sleepy and to ease the pain (which made me super drunk and sleepy, but did NOTHING to ease my pain)… and some juice, crackers and peanut butter because my BG was dropping… which wasn’t usual.

All day Sunday (Father’s Day), I had contractions. I stayed in bed or in my recliner and simply kept a watch on my contractions, and took warm baths to help ease some of the pain. We went to bed that night and by 1am, I was crying and moaning through the contractions. Something HAD to be happening. We went in and I had dilated to maybe 1 cm.

O. M. G… Seriously?!? Yes… Seriously. And they were going to send me home again. I fought against it. By the end of that two hour wait, I was so uncomfortable. I couldn’t sit any longer. Walking helped, but not much. The contractions made the pelvic pain so much worse than I felt I could stand. Finally, the nurse came in once again an hour later to tell me my options and insisted that she check me. I also believe she tried to ‘help’ the dilation along because I had gone from that measly 1cm to 4cm. She called my OB and came back  and said “Congratulations, you just booked yourself a c-section at 7:30am!”

I cried. I was so ready to not be in pain, but was so unsure if she was ready since I had JUST made it to 37 weeks that morning.

My section was bumped to 9:30 due to an emergency one. By then, I had no idea how much further I had dilated, but there was no going back. I knew it. The pain was VERY intense, and I shook, cried, and moaned uncontrollably through contractions. I wish now that I had an idea of how far I had dilated just for curiosity’s sake.

Funny thing about c-sections, once they begin – it’s super fast and over before you know it. I was wheeled in and being prepped at 9 and by 9:35, I heard the cries of my little girl. And this time, I got to see her because they took the blue sheet down far enough for me to see as the doctor suctioned her and cut the cord.

And just like that, I had 2 kids. One, so happy to be a big brother, and the other just as happy, content and healthy as could be to be out of her cramped living space and out in the world. She was perfectly healthy with only a dip in BG after birth that was brought back up with some formula while I recovered with no NICU time.

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As far as my BG the whole time? I owe a HUGE thank you to the Nightscout team – both for the push to get Dexcom to release Share and for them to have the Pebble app be able to get the info from my Share account so that I could be monitored VERY closely with just a glance by my husband at his watch, and my Dexcom and phone be tucked away in his pocket. Oh, and the medical staff was super impressed ( nurse: “hey, what’s her BG?” husband: “136” OB while cutting me open: “awesome!”… yeah… that’s pretty darn awesome!!)

It’s been a while since I posted, I know. It’s not purposeful at all – I’m just either super busy or super exhausted most of the time now.

We are in the last month of this pregnancy (pretty much, anyway) finally and things are beginning to get “real”, if ya know what I mean. I’m so ready for her to be here, but not so much because I know this is the last time I’ll be pregnant, so it’s sort of bitter-sweet. I’m 34 1/2 weeks pregnant now, and yesterday, we attempted to schedule the c-section for delivery at 39 weeks if all continues to go smoothly as it has so far. This pregnancy has been a lot better toward the end than my last one, and I’m very thankful for that.

As far as the diabetes front, we’re doing well with it. I’ve had some very frustrating times as well as some moments of utter relief… and a few WHAT.THE.FREAK moments too. My OB was very happy with my logs yesterday (first time in 2 weeks!!) and my endo has been super supportive and encouraging the whole time. The major insulin resistance gets to me at times because it’s hard to believe a pregnancy can make you need so.much.more insulin than when you’re not pregnant and it’s a mental thing I’m having to overcome. I’m learning how to balance pre-bolusing, lower carbs, and also exploring multiple-site (sometimes three different locations – what I now call, the “triple shot” method) injections for larger boluses that would be over 8u so to keep the tissue where my insulin is being infused as non-irritated as possible (and it also seems to help with absorption as well).

Right now, the goal is to keep as healthy as possible to try to make it to the 39 week mark. After talking with my OB, I understand the reasoning for waiting until that week, and it’s sort of the sweet-spot for healthy mom and healthy baby. I’m sort of excited now to have a date (or at least narrowed to two dates!) so that if I don’t go into labor on my own, I know she’ll be here by then, and she’ll be healthy enough to be born. It’s put my mind at ease.

34 weeks today! Baby girl is getting big!!

A photo posted by Sarah (@sugabeticme) on

Jun 1, 2015 at 1:56pm PDT

For most of the pregnancy calendars I’ve looked at, this week ( number 27) marks the beginning of my third trimester… or either the last week of the second. I’m going with the first of the third because of simple math reasons (40/3=13.3, so TECHNICALLY 26w6d would be the shifting point). Either way, I’m now in what they call “the home stretch” and I’m very happy to be.

Don’t get me wrong, the ability to be pregnant and feel a little one moving around inside of you is pretty darn awesome. From her kicks and jabs to just simply rolling around, it all amazes me and makes me so excited to imagine what she looks like. But there have been a lot of differences with this one – mostly I’ve had a lot more pain throughout this pregnancy, and I’m ready for it to be over.

One thing that is not very different and knew would be coming on full force sometime soon was the lovely insulin resistance. It’s like I was telling a lady friend the other day who was talking about how she hates the monthly resistance that comes before the week of her period. Pregnancy is the same way, except it’s a cycle that lasts 9 months. The third trimester is like the third week of that month where insulin resistance hits and makes no sense but you have to roll with it – except it lasts for about 10 or so weeks and increases with vengeance. I think I made adjustments two or three times last week. And I’m already very close to being at twice the insulin intake that I was pre-pregnancy. I have to remind myself that I’m not doing anything wrong and that I’m not a bad or irresponsible diabetic – I just need more insulin. When I have to bolus and what would normally have been only 3 units, tops, is now close to 7, I have to mentally keep myself from feeling bad and just realize that it is what it is because of my current state of pregnancy.

Looking at the overall picture though, I’m doing very well with this pregnancy just as I did with my first, and that’s what I’m most thankful for. I’ve been bumped up to 2-week visits now and will start that lovely Fetal NST (non-stress testing) visits twice-weekly when I’m 30 weeks along. Yay. :-)

 

It’s no secret that I am someone who can’t seem to make up their mind when it comes to diabetes devices. Granted, I have (according to my Countdown app) 19 more months until my current t:slim pump warranty expires, so I do have some time to mull over this – which is a good thing. I don’t think that choosing a pump should be a quick decision for anyone, nor should it be one that a doctor should make for you – one should have the time to research all available options and to do as much research as possible. You are sorta “stuck” with the decision you make for a while – at least 4 years, 5 years for some, if insurance paid for it, so it needs to be a good one. And it should be one that you listen to your gut about as well.

I do have a Medtronic pump and while I have no issues with the pump itself in how it fits into my life – I do have issues with their CGM system and prefer Dexcom whole-heartedly over it. I’m not saying it’s a bad system, just that it doesn’t work for everyone and I’m one of those people. Which brings me to my next point.

Seeing as how they (Medtronic) will probably never answer the clicking of my ruby slippers and wishful thinking and offer a pump that also integrates with Dexcom, I’ll always have two separate data systems to look at when viewing my data. My endocrinologist works very closely with me and allows me to make tweaks as I see that they need to be done. He knows that I fully understand how my pumps work and also knows that I have taken time to study how my body works. And until this pregnancy, I never really cared about the data being separate. Now? It’s a huge deal to me. Maybe I’m losing my touch or I just don’t have the time to upload and analyze like I did before, but the separated systems irritated me to the point that I stopped making my own tweaks. And while I absolutely LOVE my endo to pieces, his office is busier and he doesn’t always have the time to get back with me.

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So, I’ve made a big part of my decision. Any system that I use HAS to upload to Diasend for Dexcom integrated reports. I don’t care whether the Dexcom is integrated into a pump at this point because I have the Dexcom Share receiver and it fits me and my needs better than having it integrated into a pump would.

I also know how my particular insurance works, so I also know that pumps that are partly disposable (ie, the Snap by Asante and the Omnipod by Insulet) will not be choices in my line-up due to on-going costs. I totally get that up-front, it’s cheaper, but I’d rather pay more upfront and have lower monthly costs than commit to a pump that I may not be able to afford supplies for. These pumps are good pumps as well, but for me, it’s a financial factor that’s swaying me.

And, to go back to Medtronic’s system for just a minute, cost is a factor there too. While I could just go back and order a Revel pump still and use the Dexcom separate – why would I want to get a pump that I know I’m not going to use it for it’s full functionality? It’s sort of a waste of money if you ask me, and not an option I can bring myself to choose.

So, that leaves me with either:

  • Tandem again (which hopefully their new t:slim G4 will be available and the upgrades they make to other things in the pump – like reverse correction – will make it better, though I’m sort of leery about going back with them after all of the problems I’ve had with that particular pump),
  • Accu-check – though I’m not a fan of having to use their dedicated remote for bolus calculations since it’s not built into the pump, and you have to use the integrated meter to even use the bolus calculator (you can’t input a manual reading to base it off of like you can with other systems), or
  • Animas – which seems to be a strong contender as I do like their Ping and I’ve honestly not had any issues with the pump or customer service from them, and it also works with Diasend. Plus, the Ping has a remote to bolus with, with FULL calculations, not just an “easy-bolus” of a pre-determined amount.

In short, I’ve made a decision really to stick to Dexcom, Diasend, and one of those three pumps. It’s just deciding which one of those now that I’m left to make the choice between, which I’m sure I’ll continue to think and weigh options between them over the next few..okay, several… months.

Today marks one year since possibly the scariest day I’ve ever faced in my life of living with diabetes. It has been an emotional week leading up to it and I’m sure I may catch myself having moments today as well. As I look back, I remember and feel the fear and the feeling of failure that I faced that day just as raw as ever.

It was the day I woke up and couldn’t see anything but light and darkness out of my left eye.

Since then, I have gone through dealing with three different diagnosis’, with the final one being a macro aneurysm that dissipated before the vessel could burst. The fluid from the swelling was what caused the temporary vision loss, and without it, I would have never known it even happened. The final diagnosis was both a blessing and a wake-up call. I was blessed in that it didn’t burst, it was a wake-up call that I needed to (1) find a new doctor and (2) stop getting so stressed about everything and to be thankful for everything.

image (3)I’ve been one to try to be positive about things in life, especially my diabetes. The Serenity Prayer says it best – “God, grant me the serenity to accept the things I cannot change…”. I cannot change the fact that I have diabetes. I cannot change the fact that after 26 years, there is a much higher risk of developing complications. I cannot go back in time and change how horribly I took care of myself for so many years – especially those teen rebellion years. BUT, the next part? “…Courage to change the things I can…” – Yes, there are things I can change. I can continually do my best to take the best care I can of myself. And lastly, “…and Wisdom to know the difference”… We have to know that there are things we can and things we can’t change. There are sometimes things that no matter how much we try, will never make the situation better. We have to recognize them and learn to let it go.

Not too long ago, a post I had written was syndicated to DiabetesDaily about if I were to be cured, what would I miss? A few commenters on their Facebook page called me crazy for even thinking I’d miss anything about diabetes. I don’t blame them – if I hated diabetes as much as some do, I’d think the article was pure craziness. But you know, after all of this time, it’s one of those things I’ve had to come to accept – I cannot change that I do have diabetes, so while I do, I have to embrace it and try to find the positives from it. Is it hard? Yes. Do I have moments of utter anger and resentment for having this disease that I know will progressively cause damage to my body? Yes.  I still get angry. I still get upset. I still cry when no one is watching because I’ve taken all I can take for the time being and I need a break. But you know what? I also realize that I cannot stay in that mindset. I have to have it and move on because I cannot change the fact that I have diabetes.

What I can change, though, is my attitude toward it. And I can continually work on knowing when to just let go and move on.

It’s been a rough year, to say the least, but it’s been one filled with blessings. I can see, my eyes are healthy again, and most of all – the thing I thought would no longer be possible for me – I’m carrying the most precious gift God could have ever blessed me with, and we’ve continued to be healthy throughout the pregnancy.

Hope, Courage, Prayer, and Faith. It’s what it takes.

 

(I turn to music for a lot of things. This song helped me through some pretty dark times. )

One little thing I like to do is design graphics. I piddle with it, mostly, so it’s not a big thing, but it gets my creative juices flowing and takes my mind off of other things that may be stressing me out.

So, I wanted to make a design to get a custom PumpPeelz made so that my Dexcom and Medtronic pump matched and looked cute. Crazy, I know, but that little bit of color and art makes having the devices not so mundane. So, I set out to make a design using a blank canvas in Photoshop and some “brushes” (some of them are more like stamps, like the ones I used). I also used color inspiration from my niece’s favorite show, Strawberry Shortcake. My favorite character is Cherry Jam because, well, she sings and her colors are pink (like, fuchsia pink), a purpley-tinged pink, white and purple. This is where I LOVE Adobe Color because I can pull the exact colors from the photo and use them in my design work in Photoshop. (okay, okay, enough about my geekiness…)

Scott was able to take my image that I sent him:

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And with it, he was able to make my matching skins:

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I love them.  And the purple almost matches the color of the pump too. And, since I really don’t like the pink that the Medtronic pumps come in (someone likened it to a naked mole rat once, so now that’s all I see with it!! hahaha!), this gives me a perfect mix of purple AND pink… a pink that I like.

Is this post about diabetes? Not necessarily. But I do believe that things that make us happy and creative around diabetes helps us to do better and be more encouraged to take better control of ourselves. And if a silly pump skin or Dexcom skin helps do that and also gives me a means to display my artwork, then hey, it’s all good. :-)

So go and get creative. If we have to use these things to help us be healthy, why not get creative with them? No use in being drab all of the time, I say. (Unless that’s your thing… if so, go for it.)

 

If you like this design too and would like to have one like it, feel free to email me and I can let Scott know that you would like to purchase one. I don’t charge for the designs, so it would be the cost of a custom designed skin from PumpPeelz.

I am one of MANY people who choose to use the Medtronic pump system with the the Dexcom CGM system. Since my endo took me off of my t:slim, the biggest thing I have been irritated by is how I cannot get all of my information into one report. I was finally SO happy to have that ability with Diasend for the t:slim and the Dexcom, and now I don’t. I know Medtronic has their own CGM system and I do have the 530G that will work with the Enlite sensors, but I had a bad run of luck (about 3 months worth) with it when I used it last year and I am hesitant to go down that path again, especially right now.

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Plus, now that Dexcom has Share built into the receiver, it has been SUCH a valuable tool for me and my family. I even contemplated using my old, out of warranty Animas Ping system so I could have all of my data in one place, but after one day of all of the irritating quick-scrolling and constantly missing my intended mark, I got irritated and used my Medtronic pump again. Not to mention, logging everything into the Medtronic through the Capture option so I could keep complete records was just irritating in itself (not that anyone else should have to do that, but I was just for my own sanity’s sake).

It really baffles me how Medtronic, being the big business that it is, and knowing that not everyone can wear their sensor, wouldn’t work with Dexcom to have a Dexcom version of their pump. Of course, I don’t know if maybe the feeling is mutual between companies and they just don’t want to be friends or what, but it would seem that if a company wanted to reach a HUGE customer base for their combination product, it would offer options that would fit almost everyone’s needs.

Anyway, that’s where I am right now. I have had a good experience over the past month and a half with my Medtronic pump and it’s made handling diabetes with pregnancy since switching a lot easier. I just wish I could have my reports all in one place, instead of two. It helps me make better decisions about my care. Sort of like what having access to Medtronic Pro reports would probably do too, but that’s another beef I have with them ( I mean, seriously?? Why can’t we have access to the more comprehensive stuff if our endo’s trust our judgement? And why have TWO systems anyway – other companies don’t [I don’t think, anyway].)

Bottom line is I know Dexcom works very well for me. I know that I like the Medtronic pump. I just want my world to be perfect and have the option of having those two combined.

*clicking my ruby slippers*

In a way, it’s sort of funny how the medication used to bring up a low if you ever have to go there is labeled D50W… sort of makes me think of the metal lubricant WD40 in a way – though it has no connection whatsoever other than the letters are the same and in different spots and one number is off.

BUT, that’s not what this post is about. It’s about actually having to go to the ER to get it.

Most of the time, a stomach virus is simply an inconvenience to most people. It sucks, no doubt about it. But when you’re a diabetic, it can be dangerous. Some people react with high glucose levels due to the sickness and can easily go into DKA (diabetic ketoacidosis) because you’re dehydrated from the sickness. That’s usually how I am in that I stay high for the most part because of dehydration, but I’ve never gone into DKA. I’ve also not had a situation where it had the opposite affect on me and made me low for an extended period of time… until this past weekend.

Saturday morning, I woke up feeling very queasy and knew I had caught my son’s stomach bug that he had the day before. Knowing that I usually run high, I didn’t turn my pump down at all, but also being pregnant, I didn’t want to assume that I would run high and turn up the basal unless my BG showed the need for it. And it was a good thing that I didn’t.

I was able to eat breakfast as long as I ate slowly enough. But, two hours later, I started trending down. I started eating glucose tablets and drinking juice as I could tolerate. Before long though, my stomach was full and not digesting anything, and my sugar was plummeting even more. I kept trying to eat glucose tabs. Eventually, upon smelling yet another drink, I lost everything. I could see that I had thrown up every bit of anything with sugar – glucose tabs, juice, my breakfast… all of it. So, as much as I didn’t want to, we had to get to the ER. I knew I wasn’t going to be able to hold down anything and I needed help.

It took 30 minutes to even get treatment, even though they took me back immediately. I had heard the doctor give the orders for half of the syringe of D50, but the head nurse was busy trying to find the billing code for it and apparently got side tracked. I guess because I was awake and not passed out they didn’t see it as quite the emergency that I felt it was. I knew before getting there, my BG was 52. By the time another nurse came in to start an IV of fluids, my BG as down to 45. I asked her about it, and finally the head nurse came in with the D50.

It wasn’t long and I began to come up again. However, it didn’t hold very long and they had to come back an hour later and give the rest. All this time I had been trying to find a good temp basal to set my pump at but that wouldn’t have me skyrocket and get sick from having no insulin at all. The last thing I wanted was to go into DKA straight from a low because I was dehydrated and now I was going to be cutting off all insulin… and from what I could tell, the staff in the ER had no idea of what to do with an insulin pump.

The ER visit

I was finally stabilized and set home around 3-ish, and I did okay the rest of the day. I will say it was one of the scariest things I’ve had happen in a long time. I hate when I am no longer in control of what happens with my diabetes for whatever reason and it makes me anxious, plus I was scared because it wasn’t just me that I was worried about but also this little person growing inside of me.

While I’m angry over how long it took to receive treatment and how some things happened while I was there (they were more worried about paperwork than treating me at all to begin with), I’m thankful that it wasn’t worse than what it was. My ultimate fear is losing consciousness and no one knowing what to do and how to treat me because they’re unfamiliar with how I manage my diabetes. That, along with being labeled as an uncontrolled or careless diabetic for letting it happen in the first place. I work my tail off to achieve the control that I do, but all it takes is one person giving into the stigma that only uncontrolled diabetics end up in bad situations (the ER, with complications, etc), which projects through their attitude toward me, to make me not want to trust them or feel like I have failed.

I know that I didn’t fail and that it wasn’t in my control, but it’s the emotional aspect that gets me every single time. I don’t know that I’ll ever be able to ask for help without that overwhelming sense of having failed and crying my eyes out every time.

Yesterday, I had my monthly appointment with my endocrinologist. I always look forward to my meetings with him – he’s always on top of everything to do with my diabetes, knows what a data nerd I am, and he fully trusts my decisions about my diabetes as much as I trust him to help me make decisions when I can’t.

He also knows that before my pregnancy, I switched pumps within my arsenal pretty regularly. He never had a problem with it. We even laughed about the amount of “backups” I have, even though all but one are out of warranty. When I received the second t:slim replacement in April of 2013 and started using it in January/February of 2014 after the cartridge recall and continued with it for a year until it was replaced earlier this month, he was impressed that I stayed with one that long. Last week, when I finally had enough of the craziness from my third replacement, he was willing to try to help because up until then, he (and I) was under the impression that I had found “the pump”.

So, when I went in yesterday, I told them about going to my Minimed once again (for documentation purposes), but this time I showed him the Dexcom reports between the two. He was floored just as much as I had been. Just as I had thought all along, he would expect to see that if I had switched insulin brands, not simply insulin pumps – because essentially they all should work relatively the same at delivering the set amounts of insulin. But the difference I had shown worried him. He told me not to use t:slim for the remainder of my pregnancy, and to stick to Medtronic. I had told him my husband and I discussed it and we had already planned to do that anyway, but hearing that from him validated it. And, in all honesty, it shocked me. He’s always been one to trust what decisions I make and go along with what I want to try, with the exception of ONCE telling me “no” to a medication I wanted to try, and this time I had the same reaction. He had stepped in and told me not to use a pump. Part of me is in shock, but partly not. It once again reassures me that he’s allows me to do what I want with my diabetes management, as long as it is within reason, and staying on a pump that would potentially cause harm would not be within reason, and he stepped in.

I will have add to all of this, though, that I did receive a call from Tandem at 10pm about replacing my t:slim once again. Since it is in warranty, that’s what I expect them to do. I went through all of the common questions they ask for record purposes, and the representative documented my answers. The replacement t:slim will be here next week, however both following doctors orders and for my own sanity, I will not be using it until the end of my pregnancy – or a bit later once insulin needs become somewhat predictable again. I’ll already lose some of my brain cells and energy to taking care of a newborn, and I won’t want to add switching pumps into the mix. He documented also that I wouldn’t be using the replacement until after August/September, so I wouldn’t be able to give feedback until then – and to my surprise, he didn’t try to pressure me into trying it any earlier. That made me feel very comfortable. I am glad that they reached out and were willing to replace the t:slim without hassle this time. I’ve only had a couple of sub-par experiences with their tech support, and the rest of the time it’s been good, so it does help to know that they are listening.

So, out of everything that’s happened this month, I am thankful to have an awesome Endo that I fully trust and that I know truly cares, and to know that Tandem does care – even at 10pm at night.