WEEKS 25 AND 26 - INFUSION SITE FRUSTRATIONS, ANOTHER FETAL ASSESSMENT, AND THE DISABILITY TAX CREDIT

First with the non-diabetes stuff.... I'm still doing well. I'm starting to get a bit more tired, but I've been waking up more at night lately, so that could be why - perhaps because the baby's kicks are getting stronger now. My ankles started swelling a bit too, but I'm finding ways to reduce that (including elevating my feet a bit at work and sleeping with a pillow between my knees).

I'll start with the bad news and move on to the good news.

Bad news is that I have been having SO MUCH TROUBLE with infusion sites! ARGH! I decided that my abdomen needed a break because it is so holey (between infusion sets and CGMS sensors) that I'm afraid soon I'll take a drink and leak like a sieve! Plus, it's kind of a pain to have to move (or remove) sites when I go for fetal assessments, and even if I don't move them they're totally in the way. I don't want to start moving my sensors around because I don't want to pay $50 just to find out that a new site doesn't give as accurate readings and/or is uncomfortable, so alternate infusion sites it is!

I started with upper buttocks. Problem #1 - VERY easy to pull out when taking down my pants to go to the washroom. Problem #2 - Painful! Problem #3 - Slow slooooowwww absorption. Bah. To be fair, I only tried one type of infusion set in this site, so maybe I should have given some others a try before giving up on my butt, but I'm pregnant and impatient for my bloodsugars to normalize again! I have been using the Sure-T sites, which are a 90 degree steel set. That's right folks - an actual NEEDLE stuck in me all the time. I suppose I shouldn't be surprised that having a "thumb tack" stuck in my butt is uncomfortable - especially considering that my butt moves a lot when I walk, sit, etc. (Don't laugh - yours does it too!) So even taping the site down with loads of adhesive dressing, while taking care of Problem #1, didn't make the butt a successful or desireable alternate site. I'll spare you all the details, but suffice it to say I wasted about 6 sets trying to make it work and experienced pain, yanked-out sites, and unusually high bloodsugar levels. I gave up.

The next alternate site I tried was my thigh. I don't have a ton of excess fat on my thigh, so the thought of those little thumb-tack-like Sure-T's didn't appeal to me. Instead I switched back to Silhouettes. I had been using these prior to my pregnancy and had switched to the Sure-T's because I suspected that the teflon sets were causing "tunnelling" (i.e. absorption problems) when I had to start changing them every 2-3 days. But even 2-3 days is better than the 1 day at a time I've been getting out of Sure-T's lately. So, I've now had a Silhouette (i.e. angled teflon set) in my thigh for about 2 days. I've taped it down very well, otherwise I'm sure I would have pulled it out by now. It's been a little uncomfortable from time to time, but definitely better. The absorption does seem a little slower than in my abdomen, but definitely not as bad as the butt sites. And who knows...it may be that my insulin needs are just starting to increase again now that I'm heading into the 3rd trimester. So, I'm cautiously optimistic. It's definitely nice to give my abdomen a break. It will also be very good for me to be able to use alternate sites for the actual delivery of the baby - particularly if a c-section becomes necessary.

So now the good news! Yesterday was our 2nd Fetal Assessment. It went VERY well. The nurse said everything looked great - heart-rate, size, placenta,etc - and she said that I must be taking very good care of my diabetes, judging by the health of the baby. This was SO GOOD to hear, especially after a frustrating diabetes-week. It's so nice to know that my hard work is really paying off and that my baby is healthy because of it! The nurse estimated her weight at about 2 lbs which is apparently exactly where she should be. According to her growth chart, the baby is tracking perfectly just below the 50th percentile. Again, it's good to see that we don't have a big-baby situation because of the diabetes - at least not so far.

The baby was very responsive to being "prodded" by the nurse and kicked the ultrasound machine a number of times. It was really neat to be able to actually watch her move around instead of just feel her! The nurse said she had a "very sweet face", but I'm not sure how she could tell in all that wavy black and white :) All of this just makes us SO excited to be able to meet her in a few months!

Another new (but far less interesting) aspect of the past couple of weeks is that I have been working on proving my eligibility for the Disability Tax Credit. To do so, I need to be able to show that I spend a minumum of 14 hours per week on "life-sustaining therapy" - which basically means "diabetes management"....except that you can't count carb-counting, which seems a bit unfair to me. Anyway, it's the first time I've tried to claim it because, in the past, I could never have honestly said I spend 14 hours per week on "life-sustaining therapy" (just being hooked up to an insulin pump doesn't count), but now that I'm pregnant and controlling my diabetes as tightly as I know how, it turns out that I DO spend that much time! So I've got the form in to my endo to sign. Hopefully she likes the support I gave her and fills out the form for me, and then hopefully the CRA accepts my application! Fingers, toes, and everything else crossed! If any of you have any experience with claiming the Disability Tax Credit for diabetes, I'd love to hear from you! Write me a comment or drop me an email (email address is in my profile).

Lastly, here's a picture of me (taken today) and some pictures of the baby from yesterday.

Week 24 - Take Two

Yep, you read the title correctly....we have a new due date! It's now June 19th. This puts the 38-week mark (i.e. induction time) around June 5th...which just happens to be my husband's birthday! Perhaps I will only have to make ONE birthday cake every year for the two of them. :) (Who am I kidding, I've never made my husband a birthday cake!)

Long story short, between the first ultrasound, the first fetal assessment, and clearing up an earlier miscommunication about cycle-length, my OB did a recalculation at my appointment on Tuesday, and we came up with our new date. Under this new date, the baby is tracking perfectly size-wise. :)

Also during the appointment, the nurse was using the doppler machine to listen to the baby's heartbeat, and the baby kicked the doppler machine! She's feisty! The good news is that her heart rate accelerated exactly as it was supposed to when she exerted this little effort, so it was a very healthy response.

Speaking of kicks, this week I SAW a kick for the first time! She is very very active still, and has started a slightly annoying habit of kicking my bladder. I get to feel her movements lots, but every time my husband tries to feel her, she stops moving. I think her Daddy has a calming effect on her, but I think it's starting to make him question whether I'm making all this up about her being so active! ;) The other day I could actually pinpoint where her head was, and when I gave it a little push, she responded by kicking me! I'm really looking forward to being able to "interact" with her more now if that happens more often!

I've still been having a lot of energy lately which is very good. I'm hoping that lasts for a while, but with the 3rd trimester looming, I'm not so sure it's going to. I've still been trying to keep at least mildly active with walks over my lunch break, a few walks after work, and some yoga on the weekend. It actually really seems to help with my energy levels, my bloodsugar, and with the comfort of my joints.

Speaking of bloodsugar, I have had some major frustrations this week! Augh! My infusion sites just don't seem to be lasting as long as they used to. I don't know if it's pregnancy hormones, my stretching belly (I'm still using my abdomen), or developing scar tissue, but I'm starting to only get about 2 days out of them. (I usually lasted about 4 pre-pregnancy, and then I just changed it because the site was getting irritated.) After the 2 days my bloodsugar starts creeping up. I think it's time to start trying alternate sites...

Just this week I had remarkably high bloodsugars this week for seemingly no good reason, and every effort I made to bring it down just wasn't working as well as it should. It wasn't a complete lack of insulin, but there was definitely something wrong. Even after changing the site it was still bad, so I ended up changing the whole reservoir/tubing/infusion site - everything. So finally it worked, but by that point I was up around 17, and then when the "good" insulin hit, I dropped to an uncomfortable 2.5 in the middle of the night. Ugh! (Thank goodness my CGMS woke me!) I know it was just one day, but it's hard not to think about the effects a bad day like this could be having on my baby. Plus it just felt miserable to have high bloodsugar all day. (Not up at 17 all the time...but above 12 pretty much all day.) Yuck yuck yuck.

On a somewhat unrelated note, I have a hint for those of you who are somewhat new to the whole CGMS thing. I have found that the CGMS isn't especially good at keeping up with quickly dropping (or rising) bloodsugars, so to keep me safe at night, I've actually set my low bloodsugar alarm a bit high. I have it at a 4.0 right now. It does mean that sometimes it alarms when I really don't need it to (i.e. I don't need it to tell me if I'm a nice stable 4.0), but it has really come in handy a few times. For example, this last week when I dropped so fast at night, the CGMS alarmed at 4.0 when I was actually 2.5 - I was just dropping too fast for it to keep up. If I had left it set for 3.5 or 3.0 I might have been a lot lower by the time I woke up (unless I would have woken up on my own, which does eventually happen too). It might not work for everyone, but I do find it's a good workaround for one of the CGMS's quirks....it works well for me.

All for this week! I have another fetal assessment coming up later in March, so I'll be posting again in a couple of weeks!