Reasons I Love My Healthcare Team.

1. My OB and my endocrinologist are not only located in the same building, but on the same floor and two doors away from each other, as if they anticipated hugely pregnant T1 ladies such as myself needing to jog between the two
2. They use careful and thoughtful wording when something isn't up to snuff; careful to not place blame where it isn't due or to make me feel any more badly than I already do when goals aren't quite acheived
3. My endo's exam rooms each have a "Carb Drawer" full of juice boxes, peanut butter crackers, and glucose tabs for in-office lows, which I had to dig into at my visit yesterday
4. When my endo's nurse whisks away my Dexcom receiver in order to download my data from it, she circles back within seconds after seeing the current graph: "You know you're low, right? And you're going to eat something?"
5. Pedicures and pool time are doctor's orders (actual wording from OB: "You're going to be pretty uncomfortable for the next several weeks, so make sure to do things that can distract you and make you feel good: go get pedicures! Go find a pool to lounge in!")
6. When I describe my unconventional method for dosing as of late (I'm doing injections for the larger amounts instead of bolusing from my pump*, which helps my pump sites last longer - and saves me money by not needing to order pump supplies again so soon - but does eliminate that handy IOB feature on the Ping. It works for me, right now. YDMV.), my endo pauses, then replies "Oh, that totally makes sense! I'm absolutely fine with that. Do you need (Humalog) pens or needles?"
7. I get to tell her that no, I actually don't right now because my internist gave me a small village of sample pens last week ("I want that baby to be healthy! She needs insulin!"), and I nearly wept with joy
8. Sidebar: who else but a pregnant diabetic would shed tears of joy over free digestive hormones
9. My last two A1Cs have been some of the lowest I've had, and while a lot of that is due to what I'm doing when I'm on my own, it doesn't hurt that we've been meeting bi-weekly to adjust all of my rates  (and now, it will be every week)
10. While visits to an endocrinologist have, in the past, resulted in me being in tears, I feel nothing but uplifted every time I meet with my current doctors, and that is exactly what I need right now

New basal rates = new fasting BG swagger

*Another reason that bolusing doesn't work well right now: the Animas pumps have a bottom threshold I:C ratio of 1:2, so for those of us who need something more aggressive than that, the bolus calculator is useless. I can do the calculations myself and then dial up the proper amount, but I really miss the pump figuring it all out for me.

Week Thirty One.

Last week began the phase of pregnant-while-awesome diabetic where I'm at my regular OB's office every week, for the main purpose of doing an ultrasound that checks out Baby Girl's development in several areas - a biophysical profile (or "BPP", for short). This test involves the ultrasound tech measuring things like the amount of water in the swimming pool (amniotic fluid), looks for "practice breathing" (and she's been doing that with gusto both times), and measures all parts of the baby's rapidly growing body, including heart rate and muscle tone. I think that non-diabetic people get these too, but later on in pregnancy, and not nearly as often.

A BPP is also where they estimate her current weight, and though her weight has been creeping up a bit, I'm happy that she's remaining in a normal range. So what if she ends up being a little chubbles? (And, really, with Aaron and I as her tall, non-skinny parents, the likelihood of her being a small baby was preeeeetty tiny.)

I'm also happy to say that Baby Girl has received perfect scores on both BPPs so far. Yahtzee!

As for me, everything still looks pretty good. We continue to keep an eye on my blood pressure, and I continue to wish that the nurses would give me more than 30 seconds after we've entered the exam room to check it, as the readings are always consistently higher than the ones I see at home. Heartburn has been less frequent, and while the belly has gotten more uncomfortable to lug around, I haven't let it be too much of an excuse to sit out of possible fun. (I even made it through seven innings of a College World Series game this past weekend!) While my weight gain is following a good pace, I found out at my most recent appointment that the actual belly is measuring five weeks ahead. FIVE. What?

The toughest part for me now, mentally, is that for at least another month I have no idea what The Plan To Get Her Out is. There are too many variables; too many things that can change for better or worse between now and go-time. Decisions like when, the manner of delivery; all of it rides on what happens in the coming weeks, and there's no way to really know how it will all shake out, yet. Her estimated weight, how many (and how large) the fluctuations in my blood sugar are, and many other factors will determine how we proceed. No pressure though, right?

At least I can say that the temp basal I started running last night has made some significant impact:

And sometimes, too much.

Just keep moving forward - that's what I'm telling myself. 

(Even though the mere thought of moving in any way makes me out of breath - no room for the ol' lungs anymore!)

My #DayOfDiabetes.

Yesterday found me participating in #dayofdiabetes, where I tweeted the majority of my day as someone who is both pregnant and lives with type 1 diabetes. Sorry about cloggin' up your feedz, but I wanted to be honest in what was happening, how I make decisions, and how I felt about the results of those decisions, and that takes a lot of words.

And in the spirit of honesty, I also shared what could possibly be the most facepalm-y moment in my diabetes life so far.

Well of course it's on the day I decide to tweet everything diabetes-related that I drop my pump in the (clean) toilet. #dayofdiabetes

— Kim / Diabetes (@txtngmypancreas) June 17, 2013

I saved all of my tweets through Storify, so if you'd like to go back and relive my exhilarating (not really) day, here's the link. (Tweets are organized with the newest on top, so you'll have to scroll to the bottom of the story to go chronologically. I know.)

If you'd like to explore the #dayofdiabetes events that others have contributed too, head to the Tumblr site.

I don't know that this could be called a typical day with diabetes, but seeing as how no two days are ever the same, perhaps it was.

What Helps.

Being pregnant while trying to wrangle blood sugars, blood pressure levels, morning ketones, food, boluses that seem too huge to be right, and everything else that comes with diabetes-while-gestating can feel really overwhelming sometimes.

But you know what helps me a whole lot?

(click image to enlarge, if you can't read the text)

My online friends who have either been down this road before, are going through it right now, or have supportive and wonderfully encouraging things to say (derived from compassion, not necessarily personal experience) when I post pictures like this.

They help the scary seem not quite so very.

(By the way, that bolus was for 64 carbs. Third trimester insulin requirements are no joke.)

Find Mari Ruddy.

UPDATE: Mari has been found! Check with findmariruddy.com for updates on her condition.

Have you ever heard of the ADA's Red Rider program? How about Team WILD Athletics (who so kindly sponsored one of my giveaways last December)?

The woman behind these wonderful programs (and so many other good things done for the diabetes community) is named Mari Ruddy. She has type 1 diabetes, wears an insulin pump, and she has been missing for nearly two days now.

From findmariruddy.com (which is where you'll find updates on the search):

Mari was last seen at her apartment in the St. Anthony Park neighborhood of Saint Paul, MN around 1 p.m. on 6/11/13. Mari has type-1 diabetes and wears an insulin pump. Her phone and other belongings were found in her home. She left in her car, a dark green 2002 Honda Civic, Minnesota license plate #102-LNC,  with a bike rack on top and a red Namaste bumper sticker.

Mari’s family fear that she may try to harm herself and appreciate any help locals can provide in search efforts. She may have gone to a place with spiritual significance, beauty or seclusion. Please contact Mollee at 952-406-0081 to volunteer. You can also join the search effort by connecting with this Facebook group: https://www.facebook.com/groups/172257126284014/?notif_t=group_r2j

If you have any information please call the St. Paul police at 651-266-5612 until 2 p.m. PST or 651-266-5700 after 2 p.m. and on weekends. Reference case number: 13118370.

Please keep Mari and her family in your thoughts and RTs as the more time goes by, the more dire circumstances become.

Week Thirty.

Let's start with a bumpdate, shall we?

I'm simultaneously starting to feel quite uncomfortable in my own body, yet pretty good about how that body looks. While my rib cage misses all of that luxurious room it used to have, things like random ankle swelling seem to have been a one-trick pony who has now wandered off to Montana or somewhere. The pregnancy hormones that graced me with the skin of a fifteen year-old are letting up a bit, and my inclination to care about those leg blotches seems to be inversely proportional to the temperature outside. Want to stare? Don't care.

Last night marked the first time that a stranger asked with full confidence when I was due. Yay?

Our recent visit back at the high-risk OB this week yielded several notable outcomes:

• Baby Girl finally stopped moving long enough for the doctor to look more thoroughly at her heart, which appears to have developed normally - the screening he did ruled out "about 85% of possible heart defects"
• She apparently experienced a growth spurt, as her weight is now in the 69th percentile
• Everything still looks GREAT development-wise
• She's decided that laying across my belly is obviously the most comfortable position, with her head on my right side (just under my rib cage) and her feet so thoughtfully using my bladder as an kickable ottoman
• The doctor took more time to explain his stance on the 37 weeks comment from last month, and it would require certain results from testing we'll do next time before he'd push for a 37 week delivery (which means he's respecting my preference to go 39 weeks, even if he doesn't understand it: "most women just want to not be pregnant anymore at that point")
• He and his staff give really good restaurant recommendations

So, overall, it was a good appointment. Probably the best one we've had with him so far.

I managed to spill some small ketones this morning - a during-pregnancy first - that can be attributed mostly to the fact that, what was I thinking, I actually slept through the night. Breakfast and a large amount of water intake cleared them up within a couple of hours.

And as for the non-diabetes stuff, everything's coming along there, too. I'm totally amped about the upcoming baby showers our friends and family have been so kind to plan for us, and I'm swiftly becoming addicted to the smell of Dreft as I wash the baby outfits, toys, and accessories we're storing up. Packing a hospital bag (okay, two) is a thing I've started, mostly because at least having it started makes me feel calmer.

And while I had originally planned to never post an ultrasound photo online (because somehow that just felt too private), I'm breaking my own rule. Her cheeks made me do it.

Two months to go!

Really? Okay.

Have you ever had to crank up a basal rate so high that you wondered, "How am I not dying right now"?

And have you ever, then, seen a line so steady on your CGM graph that you could swear this was a dream/nightmare/did breakfast make me hallucinate?

That.

(Not complaining - just a bit in awe that something that colossal is producing results like this right now.)