Friday, January 24, 2014

16w Lows and Wardrobe Freakouts

Let's start with the more frivolous of today's two topics?

My pants don't fit. I have mostly skinny jeans and tight/tailored black work pants. And they all pretty much fail to do up satisfactorily now that I have the tiniest bump in the world. Lol

It is way too soon to start the great maternity-clothes hunt, but I have been getting more and more concerned about my upcoming work week (yes, I'm still on Christmas hols for another week yet! Who'd be a teacher?) especially since I have been living in about two t-shirts and tights for the past fortnight.

That just won't cut it as work attire. So I announced to my Hubby this morning that I was going to purchase a belly band. Off to the shops. I didn't get one, but instead got a couple of long tank shaped dresses that will work with a belt and cardi, and a long singlet to hide the great unbuttonedness.

There are relatively few options in my city for purchasing maternity wear and most of the good stuff I see online just doesn't make it this far. So I tried a shop that looks local and asked them for a belly band.

This was a mother and daughter run operation, and they were really wonderful to deal with. All their clothing is locally produced and it turned out that one of their seamstresses is a student of mine! So we got chatting and they took my measurements and promised to make a custom belly band and txt me when it was ready, all for half the price of what they were going for online. I felt like they really looked after me. Such a rare occurrence in any sort of shopping these days.

Second topic: lows. I'm in the second trimester already why won't these low blood sugars leave me alone? I have heard the alarms ring on the Dexcom so.many.times today :( And juice doesn't seem to make any difference. If I don't get the low up quick enough I will feel faint and nauseous so badly I can't stand up. And then the headache will start.

I've been fighting this low since before lunch and it's now after 8pm. I get up to maybe 5 or 6mmol only to have it crash down again within the hour. I've had over a lute of juice today. And that's the other thing: I can't physically eat too much or I get horrible gut cramps, and too much juice is bad for the day after if you know what I mean. But for me going low kicks my digestive system into immediate overdrive so I'm liable to end up with gut cramps either was.

It hurts to breathe deeply at the moment. I can only imagine what it will be like once the Tiny Fish is a little larger!

I have a checkup with my midwife on Monday so I'll ask her about it.

I made it through yesterday awake, but perhaps I did too much going out on a bush walk / photoshoot? Sigh. I have just taken a couple of paracetamol and now I'm off for a nap.

Tuesday, January 21, 2014

15w4d Exhaustion

The second trimester is supposed to herald in a renewed sense of energy and feel-good-ness. Instead, I seem to be getting sheer exhaustion. It has become rare for me to manage to stay awake the entire day.

Today I woke at 9am, had breakfast in bed, got up and showered at 10am, went for a 30min walk around the local park and the block, had lunch of fried noodles with tomatoes and spring onions, then promptly tried to fall asleep in said bowl of noodles. The dull headache warned me that I needed to get my head down soon or suffer the consequences of a restless night with no sleep and a bad head.

So I slept from 2pm to 4pm. This all sounds lovely and relaxing, but it is very frustrating and feels like I am wasting my days. In the morning I am mostly too groggy and foggy to get anything done, and I always feel like I have to spend my energy wisely. One outing a day is about my maximum. If I do too much one day I might feel ok, but will then crash out the next day.

I am not worried at the moment, everyone keeps telling me that I will perk up soon enough and that it's just the baby sapping my energy. However I start work teaching again the week after next and I am not sure how that is going to work. I have already got a note from my GP so I can request a disability carpark right up close to my building at work, as I know the walk (5min) up the steep hill at work will leave me knackered - plus the round ligament pain can hurt after too much walking!

My next midwife appointment is next Monday (6 days time) so I will ask her about it. I am taking my pre-natal vitamins but it could be anemia maybe? Hope not as the pre-natal vitamins are upsetting my digestive system somewhat. With the in mind I have decided one thing I can do is ensure I am eating enough. It occurred to me that I now need to eat like I am growing, like I did when I was a growing teenager! So I am working out healthy foods and snacks to eat at regular intervals throughout the day. If I don't, for instance, eat a yoghurt for morning tea then I will feel faint and go low just before lunchtime. I always need to eat before exercise. More fruits are on the menu and we are getting a reasonable harvest of fresh veges and herbs from the garden. Plus eggs from the chooks!

At the moment my one real mild concern is when/how we will get the Tiny Fish's nursery started. I am itching to get in there are start planning the room. It has no storage so I will have to find some second-had pieces and repaint them.

Saturday, January 11, 2014

14w1d Bleeding at 13w6d weeks pregnant

Last post I wrote Monday morning, expecting to go and have my nuchal translucency scan later that afternoon. We were planning to take a short holiday trip across the island and in the course of packing became a bit late and had to rush to the scan. Turns out the day started as it meant to go on, as I had gotten the times mixed up and our appointment was not 1pm but 4pm! So that would delay our trip (5hr travel time). We went home, double checked the pack-list and grabbed all the things we had forgotten, then hopped around to my parents' place for a cup of tea and a debrief.

In the car on the way there (4pm) the ultrasound clinic called and apologised: the OB/tech (who is the best in our province, but is private = expensive = only using her for some scans) had to rush to the hospital to deal with a woman in labour. So. No way to have the scan. I started to get agitated as I knew that the scan would only be possible up to 13w6d, and although the ultrasound clinic wanted to re-schedule me for the next day we would be out of town by then. Plus Hubby sort of still didn't really want to do the scan at all. I could try and get my midwife to organise to have the scan at our holiday destination (fun). Or the clinic said they would try and swap another patient so I could get a slot on Thursday, which would be the last day I could have the scan by my count - going from the date of conception. Or we could just not do the scan and only do more blood tests later in trimester 2. Then the receptionist was telling me I had my dates all wrong and I was actually not that far along and I could possibly wait even further. She wasn't really listening to me, just telling me I had it all wrong. Not helpful! I know the date of conception down to the hour for crying out loud!

So, with that, we started out trip and I tried to put if out of my mind. We were only really away for a day, but managed to get in some mountain biking and sailing. Both of which freaked me out. The mountain biking was supposed to be a gentle, flat ride along the banks of a beautiful river. Well, it turned out to be a thin gravel track that went UP and DOWN. I have never ridden that sort of track before and couldn't really control my bike well on the multiple down-hill segments with the gravel skidding my bike out from under me. Long story short I had a panic attack as I thought I was about to crash / roll over / tumble into the river. Oh, and I was having a low (hypo) at the same time! What fun! I was unable to stop from panting these really deep fast breaths and wheezing and trying not to cry and feeling sick and my arms and legs just locked up like stone on the bike. Hubby looked after me and got juice and a muesli bar into me. I recovered ok and we were able to bike back slowly. I did feel much better on the way back as I knew what to expect of the terrain, and Hubby showed me a technique with the brakes which helped me control my bike better.

The sailing was fun although at the first turn I thought we were about to tip over and squealed like a mad thing! hehe The lake was a bit choppy and it was just the pair of us on this tiny little yacht. But very cool experience. Boy did I sleep well that afternoon. We cooked a lovely BBQ at the motel that evening and had cheesecake for dessert.

The drive back the next day took a little longer as we headed up to another city to collect youngest-step-son from his friend's place, then drive us all back home. On the way back I got a bad headache that was awful by the time we got home. I managed to eat some dinner then went straight to bed with 2 paracetamol.

At 2.30am that morning (Thursday 9 Jan) the Dexcom woke me up with a noisy beepy alarm: low. I trundled out to the kitchen to get some juice, as has become my custom in the wee hours of the mornings, and took a detour to the loo first. And there it was. Bright red. Bleeding. No pain, just a feeling I can only describe as numbness, like my heart just sank. I knew that if this was going to go badly, there would be nothing anyone could do about it, and that it would hurt a lot. With no baby at the end.

Aware enough to realise that the low could be part of the problem, I drank down some juice and went back to the bedroom to wake Hubby and tell him. After about ten minutes he asked if I was still bleeding so I went back to check, and it seemed to have mostly stopped. We live 5 mins from the hospital so it would have been foolish not to pop up there and get checked out. Yay: A&E in the middle of the night; my favourite :-/

Thankfully the ER waiting room was blissfully empty and quiet. I rang the bell and the triage nurse came out. I gave her my name, how many weeks pregnant I was (13w5/6d) and the fact that I was bleeding. She took us straight through to the triage room behind the automated security doors, and asked me questions while Hubby filled out the paperwork. From my answers the triage nurse was able to determine that I had a "light bleed" but it would be worth checking anyway, and that there was not much they could do except wait in circumstances like these. She slipped a cute little pulse/ox meter on my finger and announced that at 99% oxygen saturation that was a good sign.

The triage nurse took me around the corridor to a private room and a cheerful ER nurse arrived. She was really sweet and gave me "points" for knowing what my blood type was! She took my blood pressure, temperature and pulse and they all came back normal. Next in came the doctor who asked similar questions: when did it start? (2.30am) how many pads? (none!) do you have any pain? (just some mild pressure and ache as I normally have had that I associate as being normal for me being pregnant. Is this your first pregnancy? yes. Any allergies? (no) etc.

Both the doctor and the nurse agreed that the low blood sugar (hypoglycemia) could have maybe had something to do with the bleed, but it could also have to do with the mountain biking or exhaustion. They listed it as a threatened miscarriage and explained gently that the only thing they could do is check for the heartbeat with ultrasound (a strong and healthy heartbeat was present immediately! The most wonderful news in the world!) and do an internal exam to gauge the blood loss and possible cause. They took a urine sample and tested for signs of infection but everything came back negative. Swabs were taken although the results of those won't be available until next week at my GP's office. So in all, it seemed mild, although they noted that it could progress further. They told me to take it very easy for the next four days, and were happy that I had the NT ultrasound that afternoon. We were sent home and I didn't sleep very much for the rest of the night worrying about every little twinge and ache I felt. I was rolling over very carefully!

In the morning I felt fine. Hubby went to work and I tried to do as little as possible. Mainly this consisted of calling all my healthcare providers to get their advice:

First up, the midwife: she listened carefully and asked me more questions. She promised to contact the on-call specialist at the hospital for more advice, but she advised me to get in touch with my diabetes nurse to adjust the pump settings as she suspected the low blood sugar of being a potential cause.

Diabetes nurse: I got her on the phone the second try (a miracle! It sometimes takes days to get through to her as she is soooo busy with patients). She spoke to me for a good 20 mins and we made adjustments to the basal rates of my midnight to 6am rates. In the two days since, I have lowered these rates even further and I am very close to having a night sans-hypos! Yipee!

Midwife again: she called back and advised that the Charge Midwife at the hospital had advised more frequent monitoring (I think that means Doppler?) and I should come in on Sunday (tomorrow) to the Labour and Delivery ward where my midwife was having a clinic. So that will be an experience. I certainly didn't expect to be going there this soon. Oh, and I also have an appointment booked with the hospital OB. Finally.

Later in the day, we went to the ultrasound clinic for the NT ultrasound scan. I told the OB what had happened the night previously and she immediately got to work looking for the baby and any potential problems. She found the baby straight away (it's hard to miss now. I even have a mini-bump!) and found the probable cause of the bleed too: I have a low-lying placenta. It's completely covering the "exit" and she told us that it could easily be disturbed or aggravated by sudden jostling movements. Such as bike riding. Boo. I love bike riding! She went on to say that at 13 weeks it was too early to diagnose placenta previa as it will most likely migrate up higher, however I should have it checked at 20 weeks to make sure.

Knowing what had caused the bleed was such a huge relief, although the OB did say that I can expect more bleeds which freaks me out a bit. I have been being very careful with my movements since then, but I am still active.

Then the checks for the baby began: she did the NT measurement three times throughout the 20 min scan just to triple check, and each time the result came back just slightly over 2mm. If the result is 2.5mm+ then that strongly indicates Down's Syndrome as the likelihood of potential heart defects causing excess fluid is much higher in that case. So, passed that one.

And then she started looking at everything else. I had only really thought to worry about the NT check, but she was looking for the correct number of arms! I hadn't thought about that! It was all fine. We saw two arms, two legs, five fingers on each hand. The spine. The CRL was 7.71cm and this put the fetus at about 13w3d (3 days slower that what I thought from the conception date). She measured the head size and looked at the brain, stomach, bladder, legs, knees, and the mouth which was swallowing. We could see the stomach filling with liquid as the scan went on! She took at few photos for us and seemed much happier and more interested this time, probably because there was so much more to see.

She checked the rest of my uterus and found a fibroid (towards the top, I think?) in the uterine muscle itself. Apparently this is of no cause for concern at the moment.

So overall it has been an absolutely exhausting week. Good news in the end, out little one is still going strong, kicking up a storm in there.

Thanks for reading this far. Here are some pics as your reward:

Our little one dancing and waving and kicking!

Here you can see the brain and the mouth, nose, and the right arm and hand.

My mini-bump. I can just get my pants done up. And those are stretch jeans too! Gone with a blue inset 30 for my Animas pump at the moment.

Monday, January 6, 2014

13w3d HbA1c

I called to get my latest HbA1c results from my doctor today. They were drawn before Christmas along with all the ante-natal screening bloods.

I present to you my lowest ever reading:

40mmol / 5.8%!!!!!!

This is due to two things: general constant state of low-ish blood sugars caused by being Type 1 Diabetic in my first trimester. And also watching my blood sugar levels like a hawk on the CGM which I've worn constantly since receiving it. Did I mention I loooooove my Dexcom? I honestly don't know how I could have done this without it.

Still having lows pretty predictably in the middle of the night: 4am and 6am. I've recently been gently lowering my basal rates to try and stop these lows so I can get a good sleep. Waking between one and five times a night to pee and/or treat a low is not making me happy. Plus when I do ignore a low (under 4mmol) for more than 5 minutes then my uterus starts to ache! I know! It's obviously The Tiny One telling me to get up and drink juice pronto!

Will try to post again later in the day as I have my 13w NT ultrasound just after lunch today. Cross your fingers and toes that all is ok in there please! Please please please be ok in there Tiny Fish!