29w4d Scan and stuff

I am on a two week mid-term break from work at the moment, so no teaching. But there are so many appointments and baby-things to do that it's not exactly a restful time either. I will try and put this down in the right order but things are starting to just become a big ol' blur!

Since my last post the weekend before Easter (when I got sent to labour and delivery for a minor bleed on a Sunday night 13 Apr) I took the Monday off work to rest up and recover, then on Tuesday morning I phoned my diabetes nurse educator (DNE) and told her what had happened and do a pump download. She promptly got me an urgent appointment with both her and my OB for Wed 23 April. She saw that my blood sugar levels were too high (averaging about 10 - 13 mmol/L semi-constantly) and was worried that this may have contributed to the bleed. She also saw that the tests the midwife had taken on Sunday night hadn't been entered in the hospital database and asked me to pop into hospital on my lunch break to re-do tests including a complete blood count and urine test for infections.

The Wednesday appointment was good, if for no other reason that getting two of my 3 medical care team in the same room! The OB took my blood pressure (118/73?? slightly elevated for me) and blood/ox (95% slightly low) the measurements were so out of character for me that the OB tested the machine on himself! That was like the highest BP I've ever had. But I know why... it was raining, I was stressing about my blood sugars and getting to the appointment, and having to reschedule the class I was teaching. Oh, yeah, and I was having another bleed just before leaving campus for the hospital! The OB basically said that since the bleeds were so minor, and apart from slightly elevated white blood cells, and slightly weird BP and blood/ox readings, and slightly raised blood glucose, everything was fine and there was no sign of any definitive problems. He wasn't fussed and put my mind at ease :) saying that some women just have bleeds, and that it could be the placenta previa??

My DNE took me up to her office afterwards, which is just two floors above antenatal clinic, and we went through my blood sugar CGM graphs with a fine tooth comb. I made another bunch of changes, and they seem to have worked out ok. Well, better for now, but things are requiring constant adjustments.

That was the last week of term, and the OB had speculated that it may just all have been caused by stress. An excellent time to have two weeks off!

First week of the hols was supposed to see me have a midwife apt, growth scan, and OB apt.

The appointment with my midwife was supposed to be on Easter Monday 21st April. And I promptly forgot all about it and we went out to have morning tea with friends then have lunch at a cafe instead. I felt VERY guilty when I looked at my phone and saw all these missed messages! Whoops! Brain fade. Got it rescheduled for later in the week.

In the meantime, on Wednesday 23rd April, I had my first growth scan ultrasound which was done at the hospital, and that was followed by another appointment with the OB.

At the growth scan we got to see Tiny Fish looking happy and healthy, with a good heartbeat of 142bpm. Growth sitting at 1417g which places in the 61% percentile. That lines up with what the midwife had measured with the tape measure at previous appointment. Baby was facing towards my spine with head down. Thankfully, we were able to see that the placenta had well and truly moved up and back, right out of the way. No more placenta previa hooray! This means I now have the opportunity to give natural delivery and/or induction a go.

The scan itself was quite quick, and Tiny Fish seemed too big to fit in the picture nicely like had done in the past. And was hiding and squirming about making it nearly impossible to get a nice shot of the head. Here are the pics:

This is, believe it or not, a front-on shot of the head. It is upside down, with the nearly horizontal curved line in bottom-centre of image the top of skull. See the two white horizontal lines on the left of image? They are pointing to Tiny Fish's chin. You can kind of see the right eye socket, and some smudges where nose and mouth are. Tiny Fish was head down way down low, and did NOT want to be photographed thank you!

This one is easier to understand. It is a whopping great foot. See the two little cross-hair markers, those are the heel (top) and toes (bottom) and it is nearly 6cm long! Wow that is big!

The OB appointment was good, and after the Dr talked for a little bit and made happy noises about no more bleeds, that I was looking better, and my blood sugars were now averaging much lower, I made sure to ask a bunch of questions:

• Can I keep my pump and CGM on during labour? Yes, that sounds like a good idea for you to do that.
• Is it possible for me to avoid an induction, as I have read that artificially induced contractions can be much more painful. Plus I don't really want the additional risk of more interventions - specifically a c-section. Yes, if you spontaneously go into labour before 40w, and you are both still healthy then that should be possible. Ideally you would start or be induced between 38 - 40w. But you can't go longer than 40w. That's the max.
• I want to restrict who will have management rights of my diabetes, will that request be respected? Yep we are happy to work with you.
• Can the IV line be placed nice and early in case I need dextrose / glucose? Yes.
• What is causing the nerve pain in my thigh? That's your femoral lateral subcutaneous nerve.
• I had more questions to ask, but silly me didn't actually pull out my phone to look at my list. D'oh. Oh well, next time.

Yes, this post is continuing... feel free to reach for some snacks and refreshments. You deserve some form of chocolatey treat for reading thus far!

Thursday 24th April rolled around and I decided to bake a cake to have ready to come out of the over at just the time when my midwife was due to pop round. What a coincidence! I was thinking that would be a nice touch since I had stood her up on Monday :P

Well, cake was delicious*, but midwife didn't get any of it cos SHE forgot! hahaha We figured that she had been called to a birth as she told me when I rebooked the appointment that that could happen. No drama. More cake for meeeeee! *it had ganache om nom nom.

The step kids came for the weekend and we had some family in from out of town. We went to the 10am ANZAC Day service at the Cenotaph, then took poppies up to Hubby's Grandfather's grave. I Facebooked my midwife and she phoned up terribly apologetic to have missed our apt and we got another one scheduled for tomorrow. Third time's the charm!

Oh, and yesterday I lost my sh*t for the first time in this pregnancy journey. It wasn't a bleed, or blood sugars, or even concerns about whether I will make a good Mum. It wasn't worries about breast-feeding, or how my diabetes will be managed in labour, or what it will be like to leave my job and go on maternity leave. No, all of these things are scary to a certain degree, but have not yet freaked me out.

So what did it?

I feel silly admitting this, but I lost the plot over our earlier purchase of stroller and capsule. See, I was thinking how the capsule didn't have much/any real padding in it and from there it was a short trip to looking at online safety ratings websites and finding that our capsule wasn't listed at all. This did not give me a good feeling and my instinct was that I needed to get a better capsule. The stroller is ok, not great, but I could live with it.

Then things got awfully complex quickly, since that particular model of stroller and capsule are designed to go together, and capsules with higher safety ratings wouldn't fit in the stroller at all. Not even with adaptors. The old capsule we thought had the option of getting a base as the lady at the store we got it from advised us, but when I called the shop they said no, no base to go in the car. Boo. And then I started thinking about how hard the stroller was to fold up. And I wanted to get rid of them and start again. It was a difficult thing to admit because a) I felt stupid b) I felt like I was making a fuss c) the items in question were not broken and would probably be perfectly fine d) Hubby didn't understand, initially, what I was trying to communicate, which upset us both e) I was incredibly confused about what I actually wanted to do to remedy the problem - or even how I defined the problem in the first place.

But once I got my ducks in a row and explained my worries more clearly to Hubby, he was lovely and understood my sometimes awkward feelings-logic.

The end result is that we will look at either selling the current stroller and capsule (about $300 worth) or if we can't then may keep them as spares. I have selected a top-ranking capsule which was an absolute bast4rd to get a stroller to fit it, however I had a ray of sunshine from a local store owner who actually knew what she was talking about. I visited her today and she presented a plan of attack to get the capsule I want with a base that fits in my car (we can hire this for 6 months), with a fantastic new stroller that is easy to fold up. Just waiting on her to order the adaptor and check that the two items will indeed marry-up. Other than that, it looks like a go. So you will get pictures of said stroller etc once it's all done and dusted :)

I know I have been stingy with the belly pics, but it is nearly midnight and I was awake until about 6.30 AM!!! last night (3 x lows, 2 x pee trips + lots of general aches and uncomfortableness) I saw dawn. So I am too tired to take photos right now. I promise to take some more but I will probably just post them to my twitter feed - you can get that over here in my sidebar - - - - - - - - >

Got my HbA1c results in, and even with that spell of higher glucose results, I have dropped ANOTHER mmol/mol:

Don't you dare call me normal.

And now my brain is feeling really scattered, but I will just tack this on the end. I promise, it's the last thing:

I had a bit of a scare on Saturday night when my blood sugar came down from a high to normal reasonably fast, over about 2hrs, and I noticed an anomaly in the vision of my right eye. I was trying to read the fine text on a Beatles album cover that my step-daughter was playing, and I noticed this blurry fizzing shape that was tracking with my vision, just to the right of the centre of focus.

Because I have a Dad who had detatched retinas, and because I am a pregnant Type 1 Diabetic, all these warning signs lit up in neon and screamed OH-MY-GOD-YOUR-VISION-IS-CRAPPING-OUT!!! Followed by a whispered ***don't panic, it's Saturday and no eye place is open now. Just be calm, be calm, and call them on Monday morning***

I called my optometrist first, noting that ironically I have just had my diabetic retinopathy screening within the past 3 weeks and got the all clear. They explained that I needed to see an opthalmologist, and to go via my GP to get a referral. I called the GP's nurse/receptionist and we both agreed that I may be able to phone the opthalmologist directly and get a private appointment quickly. Nope. They were booked up and short staffed and the only was in was for me to go to the GP and get an "acute referral". The nurse phoned me back and said, sorry, you'll have to come in for an appointment. So I did that yesterday (Monday), and the GP had me lay on the bed while he shone the light in my right eye, checking the blood vessels and looking for signs of any pressure or damage. He found none, and declared my eye ball perfect, like that of a 10 year old, and said I didn't need to the urgent appointment since there had been no change in 48hrs. Although he did say to monitor it like a hawk and any change at all I could get the referral letter in a flash. It's still there, but no change so far. I am wondering if I should go back to my optometrist anyway?

So yeah, it's been a busy 3 weeks.

21w3d Midwife appointment and HbA1c

This HbA1c result really blew me away!

Two lots of good news: my HbA1c is the lowest it has ever been. In fact, it's so low that I don't believe it, but when I think of all the hard work I have done working with my Diabetes Nurse Educator and learning about using the advanced pump features, I realise that it is justified. I am so very happy with this number because, unlike the last HbA1c test I had, this one is not caused by masses of low blood sugars. Rather this 5.4% has been achieved by massively reducing the range and fluctuations of my blood glucose results. When I used to get high-symptoms at around 15 - 20 mmol, I now get those symptoms at around 9 - 11 mmol. I have acclimatised to this nice, luscious lower blood glucose range and it genuinely makes me feel better (healthier, clear-headed) when I am sitting in the 5 - 7 mmol range. So that is awesome. I never expected I would be able to achieve this. Trimester two must have something to do with it as well I think, plus I have recently taken up swimming. And of course eating a really healthy diet for the Tiny Fish.

And speaking of Tiny Fish, my midwife visited this morning and in her words I'm "doing awesome." It can't get much better than that. My blood pressure is a lovely 100/60, and Tiny Fish's BPM is around the high 140s still. I am getting a load of movement (read: kicks and thumps. None of this "feels like butterflies" stuff haha) and when I told the midwife that I've woken up a couple of times with a rock-hard belly she said those were classic braxton hicks contractions. Already. With the movement starting at 16w she thinks it might be an indicator for an early arrival.... we shall see. I still haven't gotten the info I want about insulin pump protocols during labour for my hospital, but she promised to follow that up for me.

Other medical things on the to-do list in the near future include:

• another midwife appointment
• a second OB appointment
• am waiting on a retinopathy screening appointment (retina photos)
• I will get monthly scans from 28w onwards or so... Should get to see Tiny Fish a lot!

Oh gosh, I haven't done any belly pics for a while (scrabbles about and takes a quick snap of the ever-expanding belly-o-saurus) and..... here you go :)

A bright teal 21w3d Tiny Fish house.

18w4d - When space starts to become sparse

The bump has most definitely gone "pop" in the last 10 days. When I wear a dress to work everyone comments on how big it is.

Tiny Fish is kicking with regularity when I wake up and when I go to bed. TF also quite likes the sound of Hubby's voice and often starts kicking up a storm when he/she hears Daddy.

Over the weekend I experienced TF's first really big growth spurt: my belly got really tight and the skin at the sides became itchy.

I got pretty tired out on Friday night and that tired-headache came on and I couldn't shake it for the whole weekend. Boo. Even with panadol each night. I was sleeping huge amounts and barely doing anything, but scared it would turn back into a migraine with more vomiting. Thankfully, it didn't, but those growth spurt hormones really treat me badly.

My blood sugars went quite high and I was using multiple temp basal increases each day to try and keep it down. I actually thought that I might finally be getting to the second trimester insulin resistance. But no, on Monday it was back to almost "normal" including the lows.

We met the obstetrician last week. He seems nice and my aunt and cousin who have connections to healthcare both say he is very nice and very good. I've got to do a PCR urine test for protein. I asked him about this numbness and pain I'm having in my leg (like a pinched nerve when I stand too long) but he didn't seem too concerned. I'll keep an eye on it and talk to my midwife about it when I see her next.

Back to work this week and things are going well. I am managing a reasonably busy day but I have to be in bed quite early or else that headache comes back.

Had a wonderful evening tonight celebrating my Dad's birthday. I ate too much and I'm paying for it now with high blood sugars and the most incredible uncomfortableness in my tum :(

Oh, and I appear to have become lactose intolerant. All that extra yogurt and milk I was advised to eat for calcium was turning from uncomfortable guts to painful.

Belly button is starting to change shape getting wider and shallower, with a knobby bump at the top. I have also noticed some tiny veins appearing on the skin at the base of ribs on both sides. No stretch marks yet but I'm using some nice smelling body butter to prevent them (not holding my breath) but it does help with the itchy skin a bit.

Here is a belly pic for you:




That's the Dexcom sensor, and I am really reacting to the adhesive now that all the skin is stretching. Also, no, those pants are not done up. Not even close lol

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.

12w3d Second midwife appointment

We got to hear the heartbeat tonight! Our midwife R said it could take a while to find the heartbeat using the Doppler, or even be impossible, but our little TF was loud and strong straight away.

It is nestled low down, and R thinks that my uterus has come up above my public bone already. She noted that the pubic bone itself was quite low down.

The appointment was about 1.5hrs and we were able to ask a lot of questions and learn about all manner of things.

We spoke about pre-eclampsia and how it could be detected in me since, as a woman with Type 1 Diabetes, I unfortunately already spill protein in my urine. Thankfully there are other markers of the disease such as high blood pressure. Hubby suggested borrowing my Dad's home blood pressure monitor to test me every couple of days and R agreed that from 28w that would be a good idea. She also told us about some other women she'd worked with who had experienced pre-eclampsia and told us what happened for them.

I still has to do a urine dip stick test for both protein and glucose (!) and surprisingly the protein test came back near-enough to negative. I have no idea how that happened. As expected the glucose test came back 3+, and I offered to do a blood test for her, and showed her the Dex readings but she didn't want them. Sigh. Will keep working on that one!

I have had this nasty head cold for a couple of weeks now. Last night I gave in and took 2x paracetamol which of course threw the Dex readings out for 8hrs :( Boo. R suggested that a trip along to the GP would be a good idea to check I don't have a sinus infection. R said that it is now a bit safer for me to take antibiotics should I need them.

I asked about the pains I've been getting low down just above my hips. These happen especially when I wake up at night and turn over too quickly. Or reach for a tissue because I'm up all night sneezing. Seriously, I was up 6 times last night variously peeing, sneezing, or treating lows. R said they are probably just round ligament pain and completely normal, however if they are low and central then that would be bad. She also advised to roll over with my knees together, and advised not to stand on one foot as it can aggravate a central ligament.

I'm sure we talk about more, but that's all I remember for now. Next appointment will be in about a month.

6w4d First Antenatal Appointment with our Midwife

We had a long and thorough initial appointment with our Midwife this evening. She seems like a good match for us and we are both comfortable with her.

As well as fill out loads of forms, she also gave me a lots of brochures to read.

We discussed my medical history and she is going to organize the NT scan with the OB.

But this is where I am not so happy. I had always thought we would test for Down's Syndrome since I am at a higher risk due to T1D. But Hubby is against the idea, arguing does it matter since we have already decided what we would do with the information should the baby have Down's: nothing. We have both known people with Down's Syndrome as we grew up and we agree they can be wonderful happy people who lead rich fulfilling lives.

But I still want to know. I hate surprises, especially the sort where a simple blood test could put my mind at rest either way. Of course, the blood test is not definitive, the only way to do a diagnostic test and know for sure is with an amino, and I know I'm not keen on that due to the increased risk it carries.

Plus, we also disagree on antenatal classes. Having done this 3 times before Hubby is bored of them, thinks they are patronizing and that you learn more off the midwife. Which may all be true. But it is trampling all over my nice vision for this time. He would prefer the weekend short course. The midwife plainly advised against this as it can be information overload. I prefer the six week evening course, where you get to journey through it with others and potentially find others to share the experience with.

I am feeling very alone right now. I have no friends my age pregnant, my sister desperately wants a child bit circumstances make it hard, my Mum unfortunately has not yet had any meaningful/useful conversations with me, she mainly claims that too much has changed. And now Hubby is pulling a sad face when I say what I want. And I admit I am pulling a sad face too.

I want the best of both worlds: Hubby and the benefit of all his knowledge and experience, just minus any bad or prejudicial experiences from last time. He says he wishes this were his first time, well, now I really wish that too.

I want to test for Downs as I want to know. I want to do the NT scan to know my baby I'd healthy. I do not want to wait with my head in the sand and get a big nasty surprise with an ill baby on its birthday. I want to be proactive and prepared, even if all I can do is prepare mentally for a potential outcome.

Do I understand Hubby's reasoning: yes, and I was settled with it until I considered getting that nasty surprise. It's NOT the same as waiting to find out the gender - which I currently am happy either way - it is serious and could affect both my maternity care and the early care of our baby.

I dunno, I'm just so tired all the time now. Can barely stay awake through my class. Leaving work as soon as I can. Just, feeling overwhelmed, lost, and a bit alone right now. I know Hubby loves me very much, but I don't know what to do and I can't seem to hold my own in a conversation / debate / argument with him when I just can't concentrate. :(

Other than that disagreement which I'm sure we will resolve, everything is fine, no news.

Symptoms over the past several days: cramping, tender breasts/nipples, mild constipation, extreme fatigue, hunger for protein, some very mild nausea/ vertigo feelings yesterday, nosebleeds a couple of days ago, copious sneezing, fuzzy brain, hypo unawareness.

Baby should have a heartbeat now.

5w3d Panadol vs. Dex

I woke yesterday morning to the mother of all headaches. I knew instantly that it was going to be a long grueling day: my super-human sense of smell sniffed something like paint as I was waking up, and the headache decided to stay with me from 7am to 11pm.

Of course, I can't take neurofen at the moment, bit I didn't want to take panadol either as that messes up the Dexcom readings.

We had the step kids and they wanted to go to a gala day which was a beautiful, noisy, rowdy, fun outing except my head was killing me and I kept going really low. Hubby bought me a lolly kebab on a stick!

I slept fitfully most of Sunday afternoon, waking a couple of times for high alarms. At one point I woke up enough to check the tubing and found a massive bubble going right into the infusion site, so I unplugged things and primed. It dripped a few drops and then seemed to stop. With the bedroom curtains drawn, and bleary eyes, I couldn't see that I was actually shooting a thin spout of insulin across the bead spread! Oops!

By 11pm, and after every natural remedy I could think of, my head was pounding so I gave up and took 4 panadol - why that many? Because paracetamol normally doesn't work for me.

True to form, the Dex duly started to rise higher and higher. That's because it measures glucose molecules, but acetaminophen molecules look very similar to the Dex sensor. This causes false high readings. Very high. My meter said I was about 10mmol, while the Dex thought I was about 19.3! Let's just say I learnt how to disable the high-alarm feature pretty quickly. With the Dex and the Vibe pump both going mad at me every couple of minutes there was no way I would get sleep with them on.

Felt much better this morning, taught Monday class - always a drain that class - and tried to get away early but failed.

I did however get home in time to start calling midwives and OBs. Turns out the OB I want is private only, and costs nearly $4000!!! Although we could just afford that, it would be stupid as there are funded OB options available. I'll just have to make sure I don't get the one we had at the start of this IVF journey as he was strange and gave bad advice.

I did manage to book in my 8w scan with the private OB, as she has ultrasound equipment. I then had to email the fertility clinic so they can send a referral letter through to her offices, and that way it will be covered under maternity funding so free to us - yay! I just hope I don't like her too much :/ I'm checking with my health insurance to see if it covers obstetrics, but don't hold out much hope. I'm just going to have to accept the fact that I won't get the OB of my choice. Which sux big time since I've heard great things about her. Sigh.

The midwife was a more positive call. We left a message and she rang back after dinner. She is the first one I looked at, mainly because she stated in her online profile that she works closely with specialists. She took time with us on the phone and we will meet her early next week.

3rd HCG test is tomorrow. I don't really have any nerves about this one, as I've had so many symptoms. And no bleeding with cramping, or bleeding at all, which I take as a good sign.

Oh, did I mention that the gala day was held at the primary school where me, Hubby, his Dad, my Sister, my 3 step-kids all went? Yeah, it has zoning and we're not in the zone, but Hubby knows the principal and asked him if it's possible to put our name on the list anyway and we can! Talk about forward thinking! So exciting! I really hope this pregnancy sticks and goes smoothly, I am getting a bit fond of our little embryo!

5w2d a useless appointment with the GP

Yesterday we duly trotted along to see our GP to tell him I'm pregnant and ask for advice on getting a midwife and an OB.

Turns out, our GP was pretty much useless and couldn't really tell me anything I didn't already know.

So now it's once again up to us to research and figure out exactly what services are funded and how to access them.

Because I'm Type 1 Diabetic I should be allocated an OB since I'm classed as a "high risk" pregnancy. I seriously hope I never really need the help of the OB, but I definitely want those skills available to me!

My husband, having had 3 kids previously is very keen on a midwife and I like that idea too. I can have both I believe, and I've looked up local midwives online and found a couple who may be good matches. One in particular states that she works closely with specialists - and I will have a lot of specialists.

There is one OB/GYN that I really want, but she is private and I'm not sure if she is available through hospital funding. The GP confused me on this - I couldn't tell if he meant the local district health board or the patient would be charged several thousand dollars.

Anyway, I will be calling quite a few places on Monday to get some answers and to hopefully book in to meet them.

One important thing I have to do is sort out where my 8w scan will be, either the radiology place or perhaps at this OB's clinic as she has some fancy ultrasound equipment which is one of her big drawcards.

My symptoms these past couple of days are pretty mild. I feel really good in myself, and positive overall. I have noticed I am getting minor nosebleeds and also severe head rushes when I stand or sit up, to the point where my vision goes black for a second.

Since cutting back the progesterone to 300 and today just 200mg p/day, my blood sugars have been a lot more stable. Heavenly almost. I am no longer having to use a temp basal. I think the "serious hypo unaware lows" of the first trimester have hit, and my juice consumption has risen back up again. It's not too bad and I'm able to treat myself and watch for them on the Dex, but even do I've still adjusted my breakfast I:C ratio to be a weaker 1:7.

Still peeing like a champion, and getting thirsty as a result all the time. Fatigue is with me especially in the afternoons, and I am currently going to bed early while the teens stay up watching movies!

Although I have no morning sickness or nausea (hooray) I am finding that watching what I eat closely (do deli, no caffeine, no uncounted-unbolused carbs etc) mean that I am generally hungry quite soon again after meals. Hard to tell if this is real hunger, or thirst, or just my body going "holy heck did you finally figure out how to stop the post-prandial blood sugar spike??!"

Note to self: once again, you have proof in the form of blood sugar reading that show work and stress is bad for your health.

Went for a moderate 1hr bike ride today and it felt really good to be out moving. I often feel really sleepy in the evenings, but also in dire need of a walk at least.

My lower tummy is actually slimmer this week than last week, I think that is the effect of all the injectables wearing off. Hubby has been taking pictures of my "belly" aww he's so cute!

In terms of texture, it used to feel squishy like inner-thigh flab, and now when I press my tummy there is a definite firmness. Inside, the cramping has eased, although I feel a pretty constant pressure. There are still the occasional twinge or cramp, and when I woke up this morning I sat up way too fast causing not only a bad sharp cramp but also a spinny head rush.

15dp3dt Second Beta (aka 4 weeks 5 days)

Second beta test today came back at 453! Woohoo!

This gives us a doubling time of roughly 42hrs, which is right smack bang in the middle of average.

Got a different nurse on the phone this time, but she sounded very positive and said "it's a good number". The relief I felt when I finally got the call was amazing. As you can tell from my previous post, I was getting a wee bit stressy about it. I was just so unbelievably happy that it came back positive that it was like walking on a cloud for about half an hour. After which time the adrenaline rush wore off and the fatigue set in.

They tested my progesterone too and it is 338 so the nurse said I should start weaning myself off the dreaded progresterone pessaries by dropping the dosage from 2 x 3 times daily, down to 1 x 3 times daily until they run out, or roughly 4 more days. Apparently I am making plenty of my own.

I need to go back in a week (next Tuesday) for another HCG test. The only way I found this out was by refusing to let the nurse hang up on me a la "just one more question!" haha I was determined to get the info out of her! Actually, I think the nurses' office must have been fairly busy, as I could hear other nurses talking to patients on their phones in the background.

I enquired about when is appropriate to enlist an ob/gyn and midwife. Nurse said that the fertility clinic has care of us until the 8 week mark which will be 29th November for me. At that time I should travel back up to Hamilton for my first ultrasound scan. Now, don't get me wrong, I cannot wait for this ultrasound. At about weeks today, I'm about halfway there. These milestones are incredibly important and hold great significance to me and my husband, and all those supporting us. But do I really want to travel over mountains for 3 hrs, have an over night stay, pay for a night in a motel, and book a day off work for two people?? Um, no. I asked the nurse if there was anything special about the ultrasound scan, and she thought about it for a moment, they said "well, there is a radiology place that you could ring and enquire if they would do it, but you would have to pay privately for it, just call and see if you can get an appointment for around the 29th Nov and then let us know so we can send a referral note through to you. They will then need to fax the results back to us." If it's less that the cost of all that travel and missed work, then we'll do it.

I keep thinking it would be great for the fertility clinic to provide a flowchart of procedures and appointments, just a general "what could happen" document. Rather than having to wrangle the info out whenever they choose to phone.

Once I got home Hubby suggested we book an appointment to see our GP this week to get his advice, as we may be able to get the scan for free??? I don't really care too much about paying for it, I just want to know that I won't have to travel. We have an appointment with the GP this Friday so I'm hoping I will learn heaps there!

Some more good news: I got my HbA1c result back. 16 Oct = 45 or 6.3% A slight rise, but this was taken after the transition to the pump (still learning) and before the application of copious amounts of crazy IVF hormones.

Not too shabby.

Went to the two elder step-kids senior high school prize-giving ceremony tonight and they both received awards! Very proud. It was cool with Hubby and I, their Mum and her parents, youngest step-son, and MIL. Some big cheers!

The school hall was packed for the ceremony and it got very hot. I was fanning myself with the paper programme, and started to get some really bad cramps, especially on the right side again but moving all over the place. I felt a bit faint, and figured I just needed to cool down and have some water. Which worked very well.

Thank you everyone for your lovely comments and support. It's wonderful to know you are all out there cheering us on! :D

CD 15: Embryo Transfer day! 0dp3dt

Our Day 3 embryo transfer went perfectly. I am now - dare I even type it? - PUPO!

Since our appointment was at 11.10am, we didn't rush getting up. I woke at about 7.30am and made us both tea and toast (I am on caffeine free tea, but not being terribly strict about it).

We packed up the motel room and drove down to the lake for a walk. Since it's spring here in NZ, there are just loads of cute baby animals all around. Awww! I saw 3 baby pukekoes and a bunch of ducklings. In case you have never heard of a pukeko, here is a pic:

Source. These rather prehistoric looking creatures have enormous feet and live in fields and wetlands.

And that is not counting all the baby lambs and calves, and kid-goats and piglets I saw out the window on the car on the drive up!

Focus. Ok, so it went really well. When we got to the clinic I was busting, since they needed me to drink lots of water for the external ultrasound. We were shown to a room where I could get changed into the beautiful hospital gown moo-moo. Once again I clipped my insulin pump to the neckline, and we then found I'd cleverly left the Dexcom receiver down in the car! Poor Hubby had to race back down to get it. The embryologist and Dr G both came to see us, and nurse M gave us a gently-toned lecture about keeping my core body temperature after the procedure, and using the progesterone pessaries until told to stop.

We were led through to the OR with the spaceship door, and I had to walk right around the bed and climb on. The lovely nurse D was helping setup the bed with stirrups and towels and stuff, and Hubby took a seat to the left of my head. The ultrasound screen was, as before, to the right of my legs and then - I looked more to the right, past the hatch to the lab - I saw our one little embryo on screen!!!! The photo had been take yesterday when it was just a 6-cell, although the embryologist, M, had said it was now a great looking 8-cell. We only get to transfer 1 embryo since this is a publicly funded cycle, and even then I don't think anyone would be in a hurry to risk multiples in a Type 1 Diabetic woman.

Hubby and I were both shocked at this tiny little thing. Granted, it was magnified to be about 10cm wide on screen (only 125 microns in real life, we later learned) but it was amazing. I am hoping to receive a copy of the pic soon, will share when I get it!

Nurse D squeezed gel on my tummy and used the ultrasound thing to show us my (full) badder and uterus-squashed-flattish-under-said-bladder. She showed us where to look. Then Dr G came in and both of them laughed about how no one had told the lab that we were in here, and how there was some mild role-reversal going on with doc making the call to the lab and nurse working the ultrasound!

The doctor inserted the speculum and did something else, advising me I would feel some "mild tugging" on my cervix. Now, how am I supposed to know what that should feel like, eh? Anyway, to me it felt like a catheter being inserted - I could feel it go the length of the, um, journey into my cervix and there was some mild stingy/cold (very mild), mainly tickley sensations. Not unpleasant at all. Just weird as it was novel. This was not the real deal yet, so I'm now entirely sure what Dr G was doing, a test run maybe?

Next thing they were checking my name and date of birth again, Dr G checked the name matched the petri dish on the shelf at the lab-hatch. The lab tech then loaded up the catheter from the petri dish. I could see her peering under the microscope and taking her time/having a devil of a job scooping up the embryo into the catheter. She passed it carefully through the hatch to the doctor, I made sure to watch the screen and take a deep breath.

Of course, I was looking in the wrong place. I caught the "bright spot" out the corner of my eye right in the centre of the screen, but Hubby saw it no worries. It stayed bright for the time the ultrasound was trained on it, and Dr G told us that it was the bubble of liquid around the embryo that we could see.

And then it was over. I wasn't asked to lie down for an hour. I could get up right away and make my way back to the first room. Cue a stream of nurses all telling me to avoid raising my core body temperature, again. Nurse H, Nurse D, and Dr G all wished us best of luck and that they hoped it would work for us.

So that is that. We drove home this afternoon. I had a horrendous high blood sugar caused by a not so brilliant lunch choice, and that damn progesterone. Seriously, that stuff is an absolute nightmare for a diabetic, let alone one who is now supposed to be watching her blood sugars like a hawk! I am having to set a 20% basal increase for 2hrs every time I have the progesterone, although unlike an injection I never know when it's going to "kick in"! Arrgh!

Apart from that it's all good. Surreal, but good. I don't feel any different and it will be nice just to be calm for a while with no trips back to Hamilton planned for the near future.

p.s. So, you are wondering about the other embryos eh? Well, yesterday the second-best one was a 5-cell and had grown to a 6-cell today. They will culture it on and if it gets to blastocyst stage, then it will go into the freezer. The other one stopped growing at 3-cells. I kinda wished we had at least one more to freeze, knowing that we have had a pretty consistent 40% attrition rate all along this journey. Maybe my stim meds were not strong enough? Oh well. For now, I will wait and see what happens at the end of the 2ww.

p.p.s. Dr G said I have a small polyp on my cervix. Looks benign, but that sux.

CD 14: How many embryos made it?

And are we going to be doing a day 3 or day 5 embryo transfer?

Today was the first day I lost my shi*t in this whole thing. I had been getting dreams last night about the embryo transfer and so when I woke up it was the first thing on my mind. I woke at 7.30am, and then had to wait until "lunchtime" for the embryologist to call us with the news of how many embryos had made it overnight.

I didn't realise how attached I would get to them. Those three little potential-people.

MIL was preparing for her first open home so we went around there to help her prepare a bit, and we were just walking in from the garden when I heard a phone ring. I nearly jumped out of my skin and literally yelled at Hubby "PHONE!!!!" He looked at me like I had lost my mind - which I had - and politely told me it was my phone.

I answered, but in my nervousness I couldn't remember how to put it on speakerphone so we were head to hear trying to listen-in. T the embryologist was lovely, and said that of the 3, one of them didn't look so good today. But of the other 2, on looked great and the other was ok. She said "well since we already have our shining star, we will do a day 3 transfer, I have an appointment for you at 11.20am tomorrow morning."

I asked about whether it would be possible to get a photo of the embryos and she said yes she would note that down for us but we would also need to tell the embryologist on tomorrow as it will be her day off. Then I wanted to know if the clinic provided valium or anything for the ET, and she said no. I explained that I had read some things suggesting it would be good to relax the muscles, and she said "stop reading!! I have seen hundreds of ETs over 7 years and there has never been a problem like that" I felt very reassured. We thanked her once again for explaining things so well the other day, and then hung up. We were off to Hamilton again!

Every now and then the enormity of what we are doing just hits me. It is so amazing and scary and exciting. There is such hope. We have been through so many obstacles and although I am trying to think of this as "a chance at a chance" it is becoming more difficult not to get attached to those little embryos. I must try and think of this just as another medical procedure. Stay calm, as going nuts doesn't help and it just puts additional pressure on Hubby.

So we are now up in Hamilton. We have been out for a big meal and I have been writing lesson plans to send to the relief teacher who is looking after my class tomorrow.

Wish us luck. This is a surreal time.

p.s. my sister just clicked that she might become an aunt tomorrow! How cute :)

CD 12: Egg retrieval procedure

Please forgive me if this post makes less sense than usual, or rambles, as I am still awash with codeine!

Good news! We got 5 excellent looking eggs! I'm really happy with this and the embryologist said they all look the have good membranes.

By now, we may have a 7-hour-old! How crazy is that?

Started off this morning very early with a light breakfast at 5.40am (4hrs prior to OPU) and then napped until 7am. I got up, had a shower, got dressed and we packed up the car and drove over to the fertility clinic at 9am.

As normal we checked in and were given little slips of paper to take across to the other side of the building. Mine said OPU 9.40am (oocyte pick-up) and Hubby's said sperm sample! I told the receptionist that wouldn't be necessary or possible since Hubby had to have TESA sperm retrieval, but on closer inspection the form said "from andrology" so it must just have been a "defrost this please" note lol.

We were in the waiting room long enough for me to look through a couple pages of the morning paper, and then our old nurse came out to take us through to the Pre-op/post-op room with the armchair.

We got talking about diabetes and she told us how she has struggled with T2 and so has her family. It was nice to share with her, and Hubby showed her the Dexcom while I went to the bathroom.
Then started an onslaught of nurses, doctors, embryologists all checking my name and date of birth. I had yet more forms to fill out, and they must have told me all about everything at least thrice.
I was very impressed with the embryologist, T, who told us how she feels a great responsibility to take get time to search for the best quality sperm from a sample, since she is choosing the DNA of our potential future children. We asked her when exactly would the ICSI fertilization take place, and she said she would start the process at 2pm, carefully washing the eggs, then putting then in an acid solution to remove the outer membrane. She would then take her time looking for good quality sperm to fertilize all the eggs with. She reckoned that 2.30pm should be about fertilization time! :D

---- I had a break from writing, got a bit tired! ----

Anyway, after the doctor tried to come in several times only to find the nurse and I were busy chatting (she took my blood pressure too - slightly raised for me), she was finally able to put in the cannula for the IV. I only told her afterwards what a drama it was last time!

It made a lot of difference having a plan to manage diabetes, and having the medical folks take it seriously. I made sure that I remained calm (and I truly never got stressed even when I got locked OUT of the OR! Lol) as it can affect my blood sugars and make them drop rapidly.

Getting the cannula in meant that I could have IV dextrose should I need it, and having the early breakfast ensured I had a "buffer" in the tank. But the Dexcom was the absolute winner on the day. Hubby could hold on to the receiver and manage it, we even practiced with him testing my blood sugar via fingerprick test the night before. We made sure to tell all nurses and the doctor that the alarms might go off and not to panic. We were able to discuss with Dr G how she would give small boluses of 20% dextrose should I go hypo.

I was now in my stylish white hospital-moo-moo gown and I clipped the insulin pump to the neckline. I was told to go to the bathroom one last time, and then it was show time!

When I came out of the bathroom the pre-op room was empty, but I could hear Hubby's voice behind the big wooden spaceship theatre door. They were saying "push the green button!" and once I figured out they were talking to me, I let myself into the OR!

Setup similarly to when Hubby had his sperm retrieval, the bed was on the left and I had to walk around him at the head of the bed, around the ultra-sound machine at the foot, past the hatch to the embryo-makin' lab, and climb on from the other side.
The stirrups were padded, but they still freaked me out a bit. I knew that there would be lots of scary equipment in there so I guess I was prepared for it. I hopped up (carefully this time!) and the two nurses, H and P, kept wanting me to shuffle down the bed. I got my calves in the stirrups and they laid a large white towel across me and asked me to shuffle the bottom of my gown/moo-moo up.

--- got tired again and had some dinner! ---

While one nurse attached a blood pressure cuff to my right arm, and a blood-oxygen monitor to my left index finger (which kept slipping, causing me to adjust it, causing the nurse to scold me for moving my IV arm hehe!), the other nurse was placing black drapes over my legs to keep them warm. They unhooked the "bum" of the bed and suddenly the towel didn't feel like enough coverage lol!

The doctor appeared at the foot of the bed and asked me my weight, she then used this to calculate the dosage of midazolam and fentanyl. The nurse gave me these (and some augmentin antibiotic since I'm T1) and warned I would start to feel loopy. I got a rush of cold choking feeling all up around my neck and got a bit worried, but everyone quickly reassured me that would just be because the medication was cold.
Hubby was right by my side and kept his hand on my right shoulder. :D

The drugs took effect very quickly and I got loopy really fast! I was intent on watching the ultrasound screen - I really wanted to see my eggs! - but it was all mostly hazy. I don't remember seeing the hatch or hearing the embryologist to my right at all, although she was well within earshot.

I felt the ultrasound probe and then the doctor told me to take a deep breath and she went in for the right ovary. There was pain which made me wince, but it was over relatively fast. Two eggs retrieved on the right. I knew I'd seen 3 there the other day so my brain was still working, sort of. I was awake enough to make jokes and be surprised at how awake I was. The sedation was pretty light, but I was really loopy.

Another breath, now the left side. This one was a lot more painful, and it got worse in the seconds following the needle going in, a kind of wrenching movement. I described the nature of the pain later to Hubby as being similar to when you get an intra-muscular injection in your arm, well think of a wider needle, and then imagine you get a really bad cramp in the muscle the moment of the injection. Yes it hurt, but it was very short lived feeling and I got instant relief once the needle was out. I later learned we got 3 on the left side.

It was over! We had eggs! I was really happy to be through it, and to know that it was a calm, happy, exciting experience. Yes there was some pain but it wasn't too bad and it felt like it was only a total of 30 seconds.

It seemed like after all the activity, there was a lull for a minute. The doctor and nurses seemed to vanish out of the room (probably just out of my line of sight) and I recall a kiss with my Hubby and him telling me he loved me and how brave I was. It was pure relief.

Nurse H took my blood pressure one last time and then re-installed the end of the bed and helped me take my legs out of the stirrups. I was unhooked from all the monitors and the nurse put a pad in my knickers and then got me to slide into them while half sitting up.

Then came the slow ascent to sitting up, swinging my legs down to the left. They made me wait until I was steady enough to stand and then Nurse H helped me up and held me steady from behind by each upper arm as she walked me back to the pre-op/post-op room. I sat in the big armchair and she wrapped me up in one of those flannel blanket sheet things. Nurse P brought in a tray of tea, coffee for Hubby, and plain biscuits. The embryologist popped in to say there were a total of 5 high quality eggs retrieved. Dr G came in on a couple of occasions to check on me. Two nurses and the doc all explained on separate occasions how to use the progesterone suppositories which I have take for 5 days at least! Eew!

Oh, the embryologist wrote her direct dial number down as I have to call her at 10am tomorrow (Sat) morning to learn how many have fertilized.

She will also call us on Sunday to advise whether a day 3 or day 5 embryo transfer will be best. Looks like we will be back in Hamilton on Monday or Wednesday!

We waited about an hour then I was awake enough to leave and we went to get lunch at our favorite kitchen. I picked up the prescription for codeine and then we set off home. I took another 2 codeine tablets after the one at the clinic, but the ride home was fairly loopy and dozy, although we were both pretty happy about how well things went.

After the clinic meds and the initial Codeine wore off I got some sharp stabby cramps so took another tab. I have had mild to moderate cramps for the rest of the day, although not too bad. I can walk carefully but no long distances - by which I mean walking from the house to the car is plenty!

It was great to get home and see the pets. My friends and family were all texting me supportive texts, and after a yummy dinner cooked by Hubby, he dropped me around to my parents and my Mum cut my hair for me! Win!

Please cross your fingers, wish me luck, say a little something, or think a happy thought for good news from the embryologist tomorrow! Thank you! :D

CD 10: Blood test and trigger shot

I was full of beans for most of today even after the huge road trip (9.5hrs) yesterday, trying to get home from the clinic through a storm, floods, slips, bridges out, trees fallen over!

The fertility clinic had called yesterday and advised that I would need a blood test this morning (progesterone and something else...?) so I was up early, had my last Orgalutran injection, then it was off to the med lab to visit the vampires. I passed over my "regular fertility patient" card for the first time, and decided to get an HbA1c while I was there. The technician was really great and told me an awesome story about the last time she got stuck on the road after a crash involving, of all things, a molasses truck. Good times.

Work was alright and I taught my class fine. In the after-lunch session the nurse called to advise me of the exact time for the trigger shot (Ovidrel): 9.40pm tonight. Since the egg collection will be precisely 36hrs after trigger, that means our appointment will be 9.40am on Friday morning (CD 12).

Mid-afternoon I felt absolutely exhausted. Yesterday is really catching up with me! I went around to have a chat with my Mum, and the Dr G (who did the scan yesterday) called twice to give me advice about the egg retrieval procedure. I can't eat for 4, preferably 6 hrs before the procedure, and can't drink for 2hrs prior. If I go low I can manage things with small amounts of clear apple juice, but the doc would really prefer if I woke up early and ate a small breakfast (this would be at 5.40am). At one point she wanted me to disconnect the insulin pump altogether as she thought that would prevent hypos, but I quickly informed her that it delivers my basal and I can't take it off. She was cool with it once I explained the difference between basal and bolus doses, but man, I really hate when other medical professionals (especially well meaning ones I have only just met) make sweeping proclamations about Type 1 Diabetes management! She wanted to know what model of pump I had, cos, she said, if I had one of the newer ones with the cgm capability that would be better. Why yes, yes I do have one of those, and Animas Vibe with Dexcom CGM and it is fantastic. I should have done it ages ago. But hey.

Paracetemol (acetiminophen) is contra-indicated with the Dexcom, and the nurse yesterday had asked me to take 3 x panadol tabs before the procedure. Dr G confirmed that I could just skip that altogether as it would be far better to have Hubby able to monitor my blood sugars, and they could manage my pain with fentanyl and codeine... good stuff. Codeine normally doesn't cut pain for me, it only makes me loopy. And I have had fentanyl before with no pain so I figure I should be fine. I confirmed that they will have a dextrose drip handy should I go low during the egg collection, and to get the cannula line in as soon as possible. That's all I really wanted them to do. I did not want suggestions on the pump or anything, I can do that thanks, been doing diabetes management for 25 years, and now Hubby and I have the Dexcom it's taken it, in his words "from a dark art to a manageable science." Indeed.

Oh, and I also had to do an infusion site change, and a dexcom site change! I was working my way through those site changes methodically while Hubby cooked dinner, and it took me over half an hour. By the end of it I thought I was going to slide off my chair with tiredness, but a tasty dinner of fish cakes, bacon, eggs on toast worked well to perk me up.

I took a shower after dinner, and didn't hear any of the reminder alarms going off telling me to take the Ovidrel. Whoops! step out of the shower and the insulin pumps says 9.39pm OMG rush out dripping and rip the Ovidrel out of the fridge. I quickly prepped my skin with an alcohol wipe and stabbed it in no probs. But man, I could have thrown the whole schedule out of whack!

No drugs or anything tomorrow. We have been madly checking the road closure websites, and it looks like we should be able to take our preferred route up tomorrow afternoon. Although Hubby has also been checking the airlines to make sure we can take a flight should it all go pear shaped! I figure we are setting off the afternoon prior to our appointment for a 3 hr journey, that should give us enough time to drive even the longest way should we need it. But I have to teach one more class tomorrow before we leave. Thankfully I will only miss one class this week (I don't teach Friday's on this semester) and then maybe another couple of days next week if we get to embryo transfer. Fingers crossed. I believe I am calm now, but I suspect I might get more tense and nervous once the transfer takes place cos then it's just up to me.

CD 8 + 9: A Scan and a Mega Road Trip

Wow. What a way to spend a Tuesday. We have just returned from the clinic where we did the first ultrasound scan to check this IVF cycle is on track.

Results: Yes, all good.

Lining = 7.9 mm

Left side: 12, 16, 14, and 13 mm follicles

Right side: 16, 16, and 14 mm follicles

Total of 7, although the nurse said at this stage only 6 of them will probably be useful.

My scribbly notes from the meeting post-scan with the nurse.

The scan itself was the only part of the day that went well.

We started off getting up nice and early, and realising we had forgotten to pack any breakfast and wouldn't have time to get to our favourite cafe. I was due to have a FSH and Oestradiol blood test early enough to get the results in to the clinic. Got over to the path lab at 8.05am and I walked in while Hubby waited in the car. The waiting room was about a third full, and I started the-first-of-the-things-to-go-wrong! It took over 35 mins for the technician to call my name, which was plenty of time for Hubby to get worried and come looking for me.

We hurried out of there, and had 20 mins so we skipped around the corner to a cafe and got a quick bite of quiche lorraine and a cuppa tea.

In the clinic doors and up to the reception. The clinic is arranged with two wings, I like to call them the "office" and "doctor" wings. I was expecting us to be led through to the office wing to have the scan, like last time, but instead we were given a slip of paper and told to go across to the doctor wing. The doctor wing has no reception, and you have to just wait, in limbo, in the waiting room for the locked doctor-doors to open. Sometimes someone in the office will take pity and come and check on you, but most of the time we get left there for ages staring at the horrid crart (craft-art).

The nurse associated with our old Dr R came out to see us, and informed us that we were terribly early. To which I said, no, you are 6 mins late! She then pointed to the slip of paper and it did indeed say 10.22am. We had been told 9.10am!!! "Oh! But so-and-so called you yesterday and left a message!" I said no, I got no messages and no phone calls. I have asked them who-knows how many times to EMAIL ME. How hard is that? This nurse gets super-defensive very quickly, and sure enough she was intimating that I didn't know how to work my phone, or Hubby his phone, or either of us our home phone!! Grrr. Long story short we had another hours wait, so we took off and drove to a mall. I was wanting a bit of walk and it was raining, so a mall seemed like a semi-tolerable option. Of course, as soon as we got there it was time to turn around and come back. Red lights all the way back to the clinic.

When we strode into the doctor side for the second time, there were two other couples (?) in the waiting room. One of them had a toddler (! Why would you do this??? To the other patients? I mean really? You brought your CHILD to a fertility clinic. Words fail me.) and when a passing nurse asked who we were and what time our appointment was for, I said "9.10" this patient-with-toddler snidely commented "9.10!!" because we were now a tad late. Grr. Anyway we were hurried through the locked doors and I was asked to go for a wee then join Hubby and the doc in the scan room.

A new nurse, a new doc. Just whoever was on-call. I don't know their names. "Just take your bottom-things off" I nearly cracked up. Damn, should not have worn skin-tight skinny jeans! Doh! I was just hopping up on the exam table when the doc whipped back the curtain and at the very same moment my knee went through a hole in the table! Turns out it is a fancy pants table/bed and most people do not get on it knee first. lol.

Ice broken.

The scan went well, no pain at all. See the good scan results above. 7 follies. Definitely no over stimulation. Whew.

Pants on, go next door to get more drugs and talk to the nurse.

Turns out the egg retrieval will be this Friday (3 days away CD 12). I have one more stim injection of Puregon which I have given myself tonight (Tues CD 9). Tomorrow morning (Weds CD 10) I have the last Orgalutran injection, and in the afternoon the clinic will call to tell me what time to give the trigger Ovidrel injection. It has to be given exactly 36hrs prior to the egg collection procedure.

We asked what that procedure would be like, and the nurse said it was done under sedation (hyponovel and fentanyl) and should take about 10 - 15 mins in theatre. I asked to have a dextrose IV ready, and Hubby asked to have the IV cannula inserted as early as possible because we have learnt from prior surgery that a diabetic hypo + collapsed veins = no fun. The nurse agreed that this was all a good idea, and then said "so are you what, type 1 diabetic?" This was after telling her directly that I was type 1 diabetic, and showing her my dexcom and insulin pump prior to the scan to check it wouldn't interfere with the ultrasound. So she finally understood (at one point she thought it was Hubby who was the diabetic one! Read the medical notes PLEASE) and went to check with another doc if the egg retrieval procedure could be scheduled as late as possible so that I could still eat breakfast on Friday morning. This was after telling her not to worry, and that I would prefer the first appointment actually, and that I could miss a meal now that I am on the pump. People hear what they want to hear, not what you tell them sometimes.

She gave us these drugs:

Puregon Pen and needles.

My dosage for tonight is 150 more units of stimulation using the drug Puregon this time.

Puregon (Tuesday night, 150 units) (for the record, I had an unexpected low blood sugar 30 mins after injection. Don't know if it's related or not.)

Orgalutran (for tomorrow morning, this one is to prevent premature ovulation)

Ovidrel (this one is the trigger injection and is to be given 36 hrs before egg collection)

It was a bit hilarious being taught how to use the puregon pen, considering I had been doing multiple daily injections for diabetes since I was 5. Still good to watch and just make sure there was nothing new to see.

We got out of there are started the drive home knowing that a major storm had just thrashed the north island and the road south was currently closed.

The trip should consist of 3 hrs in the car going across one mountain.

It ended up taking us 9.5 hrs, and we went to 3 cities, tried to get over 1 mountain, went around 2 other mountains, across a gazillion rivers, through a million puddles, past a trillion slips and goats, and got turned back back sorry-for-themselves looking road workers in orange jackets telling us "the bridge has been washed away" "there is severe flooding" "you will have to go back" "the road is closed".

We were trying to go from a northern region to the south-western region. We ended up having to go south-east, then more south, then more east, then very south, to come right around and enter the western region from the south instead of the north! It was the longest road trip of my life and it is the only occasion that I have physically been unable to get to my homeland. At one point, I considered how it would have been easier to fly to Australia and back in, rather than drive!

But we are finally home. Everything went wrong except for the scan!

Oh, and I have to go in for a blood test tomorrow morning, do an infusion site change, and teach a class. Oh and re-book the motel for Friday. I need a nap.

p.s. If you're wondering what happened to CD 8: I went to work and taught class in the morning, then we drove up to Hamilton and checked into the motel. I had my Orgalutran injection in the morning and did a +20% temp basal increase for 4 hours which worked great guns.

Our Pre-IVF Appointment

Yesterday we had our pre-IVF appointment in Hamilton. It went very well and Hubby and I are both much more relaxed about the process. :)

We travelled up (3hrs) on Thursday, had an interesting meal at a restaurant named after a lizard, and stayed in a nearly-brand new motel which was superb. Our appointment was for 11.40am on Friday 6th September so after a breakfast at a kitchen over in East-Hamilton, we had some time to kill.

A walk around the lake sounded like a fine idea, but the wind got up and then it got nasty-bitter, so much so that my ears were aching bad :( So we experimented with the navigation app on Hubby's new phone and drove to the botanic gardens which wasn't so windy-pants.

The appointment itself was very good. We learnt a lot and left feeling like the process is truly underway now.

In the waiting room, our old doctor walked in and although she smiled and said hi, she couldn't really look Hubby in the eye. Awkward! :/ For a moment there I thought there had been some mistake and we would still have to see her.

But our new doc, the head of the clinic Dr S came out and greeted us shortly afterwards. He was very friendly and seemed genuinely happy to meet with us. First up, he mentioned how he was familiar with our file and he confirmed that we had now transferred to his care. The relief I felt at hearing this was quite surprisingly strong and I immediately felt confident about our treatment - for I think the first time ever.

Dr S explained that we would be good candidates for a newer IVF regimen. As he put it, at least there was some silver-lining to having to wait so long! So we will be using a drug called Elonva which is a one-shot injection that replaces 7 daily FSH injections. Personally, I don't mind having to do injections (hey, I do about 8 a day already!) but I like the other benefit of Elonva: the action profile seems to make sense to me. He explained how it has been created by taking the FSH molecule, which has a half life of about a day, and combining it with a segment of the hCG molecule which imparts it's 7 day half. He said the results are equivalent or better to what they are seeing as with patients using the traditional daily injections. Oh yeah, and no down-regulation will be necessary with this protocol which means no menopause which is the most terrific news you can give to a woman, let alone a T1D woman! Yay! :D

We discussed my AMH test (which was 9.35 about a year ago) and Dr S advised that I should do another one that day since it would be funded as part of the cycle. We talked about how it is kind of useful to have such long term (3 years worth) data on my FSH (latest: 5.5), oestradiol and AMH levels.

Since we have good quality sperm frozen already, it all came down to what my body is doing. I must say I was immediately nervous when Dr S said he wanted to re-check the AMH since it was just at the cusp of the "green" level last time, but he didn't expect it to have altered too much, and he explained how it is variable. He wouldn't be worried unless it was 3 or below, and treatment wouldn't change unless it was below 5 or above 20.

We talked about my diabetes and how that is controlled, and this time it it felt like I was really being listened to when I spoke about my diabetes treatment. Because it DOES matter. I told him how I will be going on a pump on September 18th (in fact, my prescription was written last week and I should pick it up from the pharmacy this coming week! Exciting!), and Hubby talked about how I need any IV lines placed as early as possible to avoid my veins collapsing with a hypo in pre-op.

I had prepared a short list of questions with Hubby the night before, and they had pretty much all been answered before I even got to ask them :) The only thing he raised that I wasn't expecting was that both of us would need to do a short course of antibiotics, and that because of my diabetes I would need some antibiotics prior to egg retrieval / transfer (I can't remember which oops).

One thing that we spent a lot of time on was getting an idea of possible scenarios and outcomes. Although we have been given a 40 - 50% chance of IVF working, there are many ways this could play out:

• IVF stimulation works perfectly first time (best guess for drugs, dosages, and timing)
• Could result in a positive pregnancy test, which could result in a baby... or not.
• I could get OHSS (Ovarian Hyper Stimulation Syndrome) which would probably mean the cancellation of the cycle while I recover.
• Dr S expects us to retrieve about 10 eggs, although this is of course just a guess. Out of that he estimates we may get 1 - 3 usable blastocysts, so maybe one or two to freeze. But maybe none. I really hope we get some to freeze!
• If I make it through the stims alright, but get OHSS which makes embryo transfer not a good plan, then we could do a "freeze all" cycle, which apparently has very good outcomes and Dr S said that there is some research to suggest that all IVD cycles should be freeze all so that the woman can rest and recover her body for best possible chances.
• So depending on what the embryologist thinks, we may end up transferring day 3 or day 5. Only day 5 embryos are frozen, and of course there is the chance that they may all need to be frozen if I am in no fit state for a transfer.
• If this first transfer is unsuccessful, then we can continue and do FETs with the remaining frosties. These are all considered part of our first cycle. If none of these work, then we can apply for a second funded cycle, but there would be a waiting time of between 6 and 12 months for this. Any pregnancy from the first cycle negates the second funded round of treatment. I am not sure if by "pregnancy" they mean "live birth" or just a positive pregnancy test??? Will have to find out, not that it will change much...

We discussed the fact that I would need a high-risk obstetrician, and although I knew this, I asked if we should secure one now or wait until I'm actually pregnant? His opinion was that we didn't need any more pre-conception counselling (although he offered us IVF counselling - which would have been useful, like, 3 years ago maybe!!) and he recommended one out of the two high-risk OBs in our home town. Now I need to find out a) how expensive they are to attend privately, and b) since I am diabetic I will be needed one anyway, so could I choose which one? I wonder...

Dr S wanted to do an internal ultrasound to check my follicles (antral follicle count), so we got to meet our new nurse and even before I'd seen her, I was behind a curtain stripping of my pants lol. I was pleased with myself for wearing cute socks and entirely by accident! We got on well immediately and it was all so much easier and relaxed than with the previous doc and her nurse. So, anyway. No pants, ultrasound, Hubby, nurse and doc in the room with me. Should have been unnerving but I always find any chance to look at my insides just fascinating. I was asking lots of questions and the doc explained it very well, showing that my uterus is looking good with lining and no polyps (which I had been worried about), and then looking at the right ovary which proved hard to find as normal, then the left. All up I had 11 follicles with one showing the corpus luteum - a burst follicle indicating I had probably ovulated the day before on the 5th Sept. Interesting, as this means I will finally be able to work out precisely how long my lutenising phase is. :P

Although I was worried about what the AMH re-test might show (we won't get the answers for another two weeks) Dr S said that the antral follicle count number usually is very closely related to the AMH number, and he expected my AMH re-test to come in anywhere between 8 - 11. So, good, predictable news. In fact, the whole appointment was just all about good news!

After the scan, we went through to the nurse's office to discuss our plan and have our drug training, which although was not scheduled for the day, they decided would be fine to do so we wouldn't have to make another trip up just to be taught how to do a handful of injections. I mean, really. I have done tens of thousands of injections. I am NOT freaked out by needles, only by the actual drugs themselves. Who knows what holy-hell they are going to play on my diabetes?

She gave us our plan, and discussed how it would all occur. We got our drugs in a little green cooler bag, just about the right size for a six-pack, along with a sharps container and enough alcohol wipes to do 36 injections - just a bit overkill. I only have 1 Elonva injection to stimulate egg growth, then about 5 Orgalutran injections to prevent premature ovulation, and other meds will be added later as they work out how my cycle is progressing. The FSH may need to be topped up, and of course there will be a trigger shot at some stage.

I got three scripts for antibiotics, plus blood-draw forms and a serial blood draw card to make things easier but it turns out that I won't have to do any in hometown, and it looks like there will be approx 3 more trips up to Hamilton (1 for scan and blood draw, 1 for egg retrieval, 1 for transfer) I think. Just as well we've found a really good motel. It will be hard getting time off work, because Hubby is just starting in his new position and I have a rigid weekly schedule, but I have given my employer over 1 years heads-up so there can't be any complaints there, I will just have to do a lot of prep work so my job can be covered appropriately. 

Oh yeah, and did I mention that I am turning bionic on September the 18th? More to come on that adventure... :)