28 week check-up

I went today for my 28-week check-up at the perinatologist (and a follow-up at the OB, too).

Here are the highlights (or the lowlights, as it were):

Curve Ball is showing signs of being in a "diabetic environment."
This is new. At my last check-up at 19 weeks, she was not.

What does that mean, exactly?

Well, for one thing, her little abdomen is measuring in the 97th percentile. That is pretty darn big.
By contrast, at 19 weeks, it was measuring in the 50th.

The big belly indicates that she is storing sugars and fats in her tummy, which is exactly what she is not supposed to be doing.

Also, she is 3. lbs. 6 oz. -- almost a full pound heavier than she should be (no wonder she packs such a wallop!)

This means that -- if she puts on half a pound a week, as babies can do during the third trimester -- I could be in danger of having a nearly-10-lb.-baby. Holy macaroni.

The doctors have stressed that there are many reasons why having a huge baby like that is not good for me.
1. I am 5 ft. tall, and a size 2. OK, a size 4.
2. Shoulder dystosia is a real concern at that size.
3. Therefore, dreams of an uneventful, vaginal birth (which I had with the boys) might be blown to smithereens.
4. Babies who are big because of being grown in a sugar-rich environment are not just cute and chubby normal babies. They are big in different ways: in the bellies, for one thing, and especially in the neck and cheeks and jawline. This can mean Curve Ball might get stuck trying to come down the birth canal and out of my body into the world. Very dangerous.
5. Again, vaginal birth = bye-bye.

In addition, Curve Ball is now at risk of having low-blood-sugar at birth (when they cut her from the placenta) and she is also officially at risk of developing diabetes as an adult.

To say that I am bummed would be severely under-selling all the sadness and anxiety I feel right now.

The good news is, I have been monitored since early on and will continue being monitored (now, even moreso) until she's born. My doctors assure me that all this monitoring means she should be just fine, in the end.

On the way back from my appointments, I put in the prescription for insulin, which I'm to take three times a day. I've already been taking it at bedtime (did I forget to mention that?) so I've got the needle-part down. But now I'll have to mix two kinds together (a fast-acting and a long-acting), so I do have a bit of adjusting to do to this new regimen.

But I'm totally prepared and willing to do it. I really do not care anymore about what I have to do. I will do whatever it takes, for however long I have to do it. Anything to help shrink Curve Ball's little Buddha belly, and get her to not be the size of a small turkey at birth.

I also have to go back to the OB every 2 weeks now instead of four, and at 32 weeks, I go back to the perinatologist for another growth scan and to start twice-weekly fetal monitoring. My boss is going to LOVE this!

On the bright side, everything else about her looked great today -- and the sonographer even broke the rules and gave me 3D photos of Curve Ball. I'm not a huge, huge fan of the strange-looking 3D photos, but we got them -- without asking -- for Cary and Dean. We put the pics in a frame, and those photos crack us up now because of how you can really see Cary in there and Dean in there, all smushed and water-logged, but still very much themselves.

So we begged the sonographer to give us pics of Curve Ball, even though they've changed the rules in that office about doing them, ever since too many crazy parents (not us, this time!) called in panics after getting their 3D pics home, thinking surely something must be wrong with this alien-skeletor-hole-in-head baby I'm carrying.

Truth be told, Curve Ball does look a little Twilight-zone-music-esque in the pics. And they're not as clear as C & D's were, because of the way she was lying.

But ... here she is, her first glamour-shot:


I have no idea who she looks like.

And, the last bit of bright-side news is: Regardless of whatever is going on in my sugar-soaked womb, little Curve Ball seems happy about it.

The sonographer and I both cracked up at this picture of her, which shows my little sweet treat looking just like she is in there just laughing her head off:


Awww. My sweet, happy little baby girl.

Now who wouldn't do anything in the world they had to do to make sure she stays that way? Certainly not me. I'm in hook, line, and sinker! Insulin -- here I come!!!

Skipping meals and popping pills

It appears the sleep regression in our house is something that will wax and wane.

For about the last week or so, the boys have been blissfully sleeping through the night (cue the angels singing). The only person waking up a million times at night is their baby-resting-on-her-bladder Mommy. (cue the heavy sighing).

I knew a week of STTN meant that we had had too much of a good thing, so I wasn't surprised when Dean woke up last night around 1:30, crying, needing a hug, his Lovey and some more hugs. And then I wasn't surprised when Cary then woke up, too, saying "Ma-ma! Up, pees!"

No, I was not surprised. But as this would not be my life if there weren't some drama involved, of course I had to worry about something.

Two things had happened earlier in the night that have never happened before in our house:

1) Dean refused to eat even one bite of his dinner. Instead, he decided it was better to get remanded to time-out -- twice -- for throwing food on the floor or across the dining room table. Nothing I could do would make this child eat. The pediatrician had just told us a few days earlier that we should not allow Dean to continue with dinnertime if he insists on quarterbacking his meals. "Two times," Dr. Bodnar says. "And then dinner's done." He said if he was hungry, he'd eat and not throw. And the fact is that kids his age eat so much during the day (with snacks and all) that by the time they reach dinner, they're often not all that hungry. And that's OK, he assured me.

But is it? IS IT?

Because when Dean woke up last night, all I could think of was: "This child is starving!! He needs to eat! What should I do? What should I DO??"

2) While Lester was getting Dean undressed for his bath, Cary somehow, somewhere unEarthed an old pill that was hidden God-knows-where in our bedroom. I think, from the size and shape of it, that it is one of the old diabetes-related pills I was taking pre-pregnancy, and that it must've fallen at some point and I forgot about it. Whatever it was, Cary found it and of course, ate it.
Thank God the pill-makers purposefully make pills bitter, because Lester spied Cary's (actually quite-hysterical) screwed-up, sour face and immediately removed the pill from his mouth. So he only sucked it a little bit, as opposed to gulping the thing down whole.
Helpful-Poison-Control-Man assured me over the phone that this particular medicine was fairly benign, even in small children, and besides, 'it sounds like he only sucked off the coating anyway." So, he summed up, no need to worry. Cary should be just fine.

Will he? WILL HE??

Because when Cary woke up last night, all I could think of was, "This child has been poisoned!! He needs his stomach pumped! What should I do? What should I DO??"

I really considered filling Dean's stomach, and emptying Cary's (somehow), but then Lester got up, went in the room with the crying babies, said something I couldn't hear because I was too busy thinking of what I would tell CPS when they came asking me why my one child was sucking on diabetes medicine and why my other child was starving to death, and then came back in the room and said, "Go back to sleep. They're fine."

About 10 more minutes of really half-hearted crying later, they were both knocked out again -- this time until 7:15 this morning.

And they've been fine since.

The moral of this story is....I have no idea. But I am certain I will have more such stories to tell in the future. Stay tuned.

Sugar seriousness

So...

The perinatologist did not put me on insulin yet. She wants to try changing up the medication dosages and times that I take the meds a little first.

That's fine, I suppose. I'm not sure how I actually feel about it.

But then she also gave me a real heart-to-heart, with a stern, serious-business tone, about what I eat, and how non-great I have been about eating right for my condition.

And unlike my meetings with the diabetes educator and the nutritionist yesterday, Dr. Rossiter did not give me a rosy picture of my current state or my future.

To begin with, she said I am "diabetic." Not pre-diabetic; not gestational diabetes. I do not have gestational diabetes, she said, because that is classified as having sugar issues after 28 weeks. I am diabetic, because my issues started so early. I'm just 22 weeks today and this has been going on since my first trimester.

Secondly, she said it is entirely possible that I will continue to be diabetic after the pregnancy. Lord, help me.
Everything I've read and all that the nurses and other folks have told me seemed to indicate that there was a high probability I would not be diabetic post-delivery. Dr. Rossiter agreed that we won't know for sure until after I deliver Curve Ball, but she seemed to be trying to prepare me for what research and science and her expertise indicates about me and my condition thus far.

Thirdly, she said I have GOT to change my diet, in a big way. No excuses. No short-cuts. Tastebuds and hunger pangs be damned! (That last part is my own editorial comment. She didn't actually say that.)

This is depressing for many, many reasons.

1. I don't want to be diabetic. I especially don't want to be diabetic this young. Both my grandmothers had diabetes, but they got the disease much, much, much later in life -- after they were already grandmothers. I have been struggling with my sugars since before I got pregnant with the boys. (And probably much, much longer. Now that I know what it feels like to have severe lows, I know I've been having them since I was a teenager, at least).

2. My pancreas' issues with producing insulin, and my body's ability to process the insulin will only degenerate with age, not get better. So this just means I have more time to get worse, more time to have to think about this, more time to worry about all the complications of diabetes that can come with age. More time to eat rabbit food in order to survive.

3. I want to be around for Cary, Dean and Curve Ball. I hate that I feel like I have an expiration date on my head already - at 38 years old.

4. (And here's where the whining begins): I really, really resent having to think so hard about EVERY SINGLE thing I eat, at every meal and every snack, every day and every night for the rest of my life. I really, really hate that there is so little I can eat that is good for me (sugar-wise) and that won't leave me feeling hungry all day. (Especially while pregnant! When I'm already starving!!)

Every-frikkin'-thing is carby! Breads, pastas, smoothies, oatmeal, juice, soda, fruit, rice, yogurt, frozen yogurt, waffles, French toast, sandwiches, hot dogs, burritos, raisins, Craisins, grits, cream of wheat, cold cereals, corn, peas, crackers, syrup, jellies, jams, chutneys, French fries, sweet potatoes, squash, chips, beans, tomato soup, chicken noodle soup, croutons, stuffing -- and of course, any and all desserts. (And we all know I have a raging sweet tooth!)

Here's what I can eat:

• eggs
• meat
• fresh vegetables
• nuts
• cheeses
• small amounts of Greek yogurt
• whole fruits in moderation
• milk
• water
• sugar substitutes in moderation

Here's what you need to know about that list:

Eggs - Since I found out that I was pre-diabetic and that almost everything for breakfast besides eggs was bad for me, I have eaten so many eggs, I really start to gag when I eat them now. I can eat maybe two bites of egg, and then that's it. Stomach churns. Fork down. I am TIRED of eggs.

Meats - I'm not a HUGE meat person. I'm not a vegetarian by any stretch, but unlike my husband, I cannot just eat chicken breasts as a meal. Or even juicy a steak. I need more! I like my old-school meat-starch-veggie mix at meals, and to be honest, I could really do without the veggies, if the meat and starch comes topped with a yummy gravy. I don't eat pork, and until I was pregnant with the boys, I didn't eat red meat. And frankly, I'm a little tired of chicken. P.S. Try going into a quickie-lunch-food-type store with your officemates when they go to buy bagels and muffins for a 3 p.m. snack and asking for a side of chicken. Just try it. I dare you.

Fresh vegetables - How many salads can a person eat? Seriously? How much baby spinach? How many carrots can I nibble on at my desk? Honestly, I LIKE corn and peas. Especially corn. Why is corn a bad food for me? Ugh!
And I prepare meals on the weekends to last all week, because I don't have time to cook on weeknights. It is really, really hard to prepare fresh vegetables on Sunday and have them still good on Thursday. So we eat a lot of frozen veggies, and apparently that's not so great.

Nuts/Cheese - Don't really like nuts, thanks. I'll eat cashews and pistachios most often. Then almonds, if there's nothing else. But I don't love any of them enough to want them every day. They're just OK. Which means I tire easily of having to eat them all the time.

And I really, really dislike most cheeses. I will eat mozzarella cheese and the cheeses that make up pizza, lasagna and only SOME mac-and-cheese dishes. I'll also eat American cheese, melted in eggs and grits. And -- once in a blue moon -- provolone cheese on a hot sandwich. But that is it.
No bleu, no feta, no cottage, no Muenster, no fancy Whole Foods stinky cheeses, no cheddar, no Swiss, no Parmesan.
When I do eat cheese, I like my cheeses melted. This does not bode well for me snacking on cheese all day. I am sitting here now eating a mozzarella stick because I'm starving, and it's kinda gross. Not as bad as if I had to eat a stick of cheddar cheese, but that's a bad comparison because I would never, ever do that.

Greek yogurt - Greek yogurt is OK, and I actually do eat Chobani, or some generic of Chobani. But the total carbs in one serving is more than the 15 grams I'm allowed to have for a snack. So I can only eat half of one if I'm being careful about my sugars. I don't know about you, but when I'm hungry, a half a yogurt just doesn't cut it. Neither does a handful of frikkin' nuts. Or a bowl of baby carrots and cherry tomatoes. I want something substantial. And that means carbs. (Waaaah!)

Fruits - LOVE them. All of them. Could eat them all day long if someone would let me. But again, 15 grams for a snack goes pretty quickly. 17 grapes, for example -and small grapes at that - are 15 grams. If I eat 17 grapes, I can't have any other carbs with that snack. And if I ate fruit all day, my sugars would be through the roof!

Milk - Love milk. But, seriously, I am not a newborn. A glass of milk doesn't fill me up or curb my hunger pangs. And I really, really love milk in oatmeal and Honey Nut Chex or Multi Grain Cheerios -- all which are BAD, BAD, BAD for me. And also, although milk has a good amount of protein, it also has amount an equal amount of carbs. So I have to watch it there, too. Same is true for peanut butter -- good balance of protein and carbs, but still carby.

Water - Water is pretty much all I drink all day, so I have no problems here. But sometimes I'd love a hot and frothy Starbucks drink (too much milk and sugary flavoring, even if I get it with a sugar substitute). Or a fruit smoothie. Or a milkshake or a soda. OR (when I'm not pregnant) a cocktail! Just about every kind of drink in the world besides water is carby. Tea, you say? I was born in Boston. I like my tea New England style: with lots of milk and sugar.

Sugar substitutes -- I have embraced Splenda as my saving grace, and I try desperately to ignore the scary reports that come out every so often saying all sugar substitutes are bad for you. The fact is, real sugar - in all its forms - is killing me as it is. If I want to have a cup of coffee with some Splenda, then please just let me be.

So there's my list of acceptable foods. Oh wait, I can also eat butter. I do love butter, so there's no downside there. Just wish I could put in on a hot roll, or a Belgian waffle, or candied sweet potatoes. Mmmmmm.

Of course, I can have almost all foods every now and then in small, ridiculously-unsatisfying doses. I have to count all carbs meticulously and be sure not to go over a very strict amount. And when I do splurge on say, a waffle, I'm supposed to pair it up with protein. Every carb that comes into my body is supposed to be paired with a protein. The mental gymnastics I have to do when thinking about what to get for any meal I eat (Is a veggie panini too many carbs? Is that artichoke salad enough carbs Or enough protein? How many grits is too many grits?) is really annoying and difficult and a pain in the you-know-what.

So...all that being said, what does this mean for me?

It means I am depressed. I want to be able to eat like everyone else can eat -- and only worry about gaining weight, not about having kidney failure in a few years.

It means I am scared. I feel like I'm fighting a losing battle here. No matter how good I am about eating (if I can ever get past this mental block I have about it) my body is not getting any younger or any more efficient at dealing with insulin. I worry that I will have nerve problems, blindness or worse.

It means I feel sorry for myself. Why me, Lord? Why do I have this cross to bear? When eating is such a big part of our society (Let's meet for lunch! The girls are having a dinner! It's my birthday; we're going out to eat! It's the holidays; we're planning a huge meal! I heard you weren't feeling well; I made you a batch of chocolate chip cookies. We're having this important business meeting over lunch. I'm meeting a friend for coffee and muffins. A co-worker is leaving, so we're going out for drinks, etc. etc.) why do I have to feel so shut out of all of it?? Waah, waah, waaaaaah.

And it means I feel guilty. My baby is growing and developing inside of me and deserves the best start in life possible. And so far, I have bathed her in high sugars and worry and bitterness and non-compliance. I suck. I am whining about not being able to eat spaghetti or rice (God knows I love rice) or French toast or ice cream or chicken minis at Chik-Fil-A. And meanwhile, my baby is possibly developing in danger.
Wow...just typing those words makes me feel like crap, crap, crap.
Not to mention my feelings about what it would mean for Cary and Dean (and Lester and Curve Ball, too) if I were to be too sick to be of any real use to them, or if I were to die because I can't get this diet thing right.
When I think about them having to grow up with a Mom who's not her best self -- or no Mom at all -- I feel worse than crappy. I start crying, like I'm doing now. I feel horrible. What kind of mother am I? Why can't I just get with the program?

Needless to say, this doctor's visit has left me in quite a state. And I'm not really sure what I'm going to do about it just yet. I'm kinda tired of talking about it (I've been talking about what I can and can't eat ever since I was diagnosed with pre-diabetes four years ago). I'm tired of thinking about it.

I just want to go home, eat a bowl of cereal or some Chinese food (sigh) and go to sleep.

But instead, I will pray. And pray. And pray. For guidance and help and strength and miraculously-changed-taste-buds.

And then, if Cary and Dean cooperate (which they have NOT been the last few nights -- ugh! Whole different post there...) after I do all that, then I will sleep.

And maybe I'll feel better tomorrow.

I want my daughter to be sweet, but good grief!

So it's come to this.

Tuesday, I go in to the perinatologist to learn how to inject myself with insulin.

I resisted as long as I could, but my sugars just kept creeping up. And the new meds worked a little too well, making my blood sugar dip horribly low -- particularly in the middle of the night.

The last THREE nights I've had to bound out of bed twice to go down to the kitchen to stuff myself with cereal and sausage or frozen waffles and orange juice -- just to stop the shakes. This usually is around 12 or 1 and then again around 3 or 4. Waking up every three hours to feed?? Ridiculous -- my baby's not even here yet!!

All that up-and-down with my sugars has totally wiped me out. I feel like crap a lot of the time, and it's just no fun at all. I think I could suffer through it (maybe) if it was helping keep the blood sugars in check. But like I said, my sugars just continue getting higher and higher.

So insulin it is.

I'm nervous about it, because I still think in the back of my head that my body will get used to the extra help and then continue needing it even after I've delivered Sweet Miss Curve Ball.
And I also really don't relish the idea of excusing myself from meetings to go stick myself with needles in public bathrooms.

But, I must do what is best for my baby -- and what is best for me. So I will.

So just to make myself feel better, I am having some kind of warm, chocolatey, delicious thing this weekend! Sugars be damned! Heck, I might just splurge all weekend!

(Kelly, if you're reading this: Shut IT!) :-)