Thursday, June 30, 2011

Why I love using Etsy

Knowing a gift was made (or found or restored or whatever) with care and craftsmanship is important to me. Seeing that I'm supporting someone's passion is even more important. And having a personal connection - no matter how fleeting - is irreplaceable.

Wednesday, June 29, 2011

Babies are not just about delivery

Other than finding out an actual date for BabyH's arrival (eek!) and sobbing to the tunes of MJ, B and I have been super busy. Our doc stepped our scans up to two a week now to check amniotic fluid, baby heart rate and movement, and the placenta - all the parts that make up my OB's "thriving" test. Three of these scans in, and oh my goodness am I tired of them already.

Who does this in a doctor's waiting room?!

I've also 

•  Visited the best ophthalmologist in the universe, who said my eyeballs are holding steady and have no bleedy changes. At this point, I will take any good news or compliments people want to give me. You think my hair looks shiny? Say so. Does my maternity top look extra flowy today? Tell me. I look like I deserve a cupcake? Shout it from the rooftops.
•  Filled out incredibly daunting FMLA paperwork. I'm taking vacation prior to delivery to make sure we make it to the 22nd. (Bleeding might be cause to move our c-section up to the 36-week date of July 15th. I'm doing everything in my power to sit on my tush and avoid causing any sort of said bleeding.) As such, my last day in the office is July 13th! Ack! That is in no time at all....
•  Suffered from horribly gnarly edema-related cankles:

•  Had a prenatal appointment with our pediatrician, who I already adore. How can you not love a doc who mentions another T1 family in her practice that wants to breastfeed exclusively to see if that helps with the fears and hopes behind The Thought? Or doesn't think it's crazy to discuss Vitamin D's possible connection to incidents of Type 1? I left feeling happy and reassured...and way too young to be meeting with pediatricians.
•  Enjoyed a baby shower! Nothing like good friends, adorable baby clothes, and delicious chocolate cake to celebrate impending parenthood. I felt loved, and incredibly lucky.

I'm still dreaming about this cake!

It's been an incredibly busy few weeks, and I have a sneaking suspicion life is not going to slow down in the near future. Rest assured, my DOC darlings, I miss you all but am doing my darndest to lurk on Twitter and keep up with all your posts on my Google reader.


Tuesday, June 28, 2011

Purse Guy knows - so you should, too!

Every morning on my way in to work, Purse Guy is at my Brooklyn Q stop hawking his "designer bags." (For the record, the likelihood of buying a true designer bag at a Q train stop in Brooklyn is just as good as you're imagining right now.) And every morning since my belly became readily apparent, Purse Guy has something to say - nothing rude or anything, but always something for "Mama." Today it was "So when is this baby comin' anyway?!" And that's when I realized I've not yet posted about this very thing.

So, friends, the (mostly) official announcement: BabyH is due to join the Hoffmanderson household on Friday, July 22nd.

For those of you keeping score at home, that is three weeks earlier than my original August 12 due date. And no, I haven't contacted a psychic or had any crazy premonitions about delivering the baby girl. Sadly (but not too sadly), we've got a c-section scheduled for the day. My freakin' placenta previa has not budged one iota.

So why sadly but not too sadly? Sadly because clearly I got into this whole thing with my brain stuck on my diabetes. Since day one, it's been going on the pump, logging food and insulin, doing everything I could to prepare my body for a healthy pregnancy. It was always about the D. And then I get the bad luck of some random crappy placental placement - which has nothing to do with anything in my life, other than reassuring me I'm smart for avoiding gambling as a hobby. I'm bummed that there's a monkey wrench despite all of my hard work and planning.

But I'm not too bummed. How could I be? I am grateful I live where and when I do - and that I have access to the medical care I've received - so that they caught the complication before it became a threat to anyone's life. Women and babies still die during childbirth. I'm lucky that I know about my condition so my doctors can do everything in their power to avoid that threat.

The other not-so-cheerful thing to hear at that appointment was the reason she's giving us until the 22nd, which is the later 37-week c-section option. Apparently, normals with complete placenta previa are usually delivered at 36 weeks to avoid the possibility of premature labor and delivery, which could have some pretty dramatic consequences. (See paragraph directly above.) But because I'm diabetic, she wants to extend it - babies of diabetic moms have lungs that develop more slowly, and she wants to allow for that extra week of development if possible.

I did not handle the appointment too well. We left the office for the train, and I burst into tears on the street. Logically, I know we didn't get any bad news and weren't told anything we didn't already know. But hearing it all out loud at once was terribly overwhelming so...instant sobbing pity-party on 168th Street. Which continued to the A train. And persisted throughout the "Michael Blackson" dance routine on the train, complete with boombox and moonwalking.

(Side note: NYC is such a strange place. Can you imagine being on the A train, going about your business, while some giantly pregnant woman sobs across the aisle from you while some dude in a costume dances around to Michael Jackson songs and collects tips?!)

I'm more settled about the news now, of course. I know a healthy and safe delivery is worth any amount of monkey wrenches or guilt about a disease you can't help having. And I just keep thinking about how excited we both our to meet this little kicky baby. Eyes on the prize, kids, eyes on the prize.

Monday, June 27, 2011

I love you, baristas

How else could they be sure I get my preggo decaf-with-splash-of-regular order just the way I want it?

Thursday, June 9, 2011

So cute it's making my eyes bleed

My cube is way more adorable now than it was five minutes ago.

Lab bloods are drawn!

Are we taking any bets on whether or not the A1c will match Monday's finger-stick test?

Back to our regularly scheduled programming: Visit with the CDE!

Monday marked the first time I've been in the same room with anyone from my endo team since November. "But you're pregnant" I'm sure someone is spluttering out there, agog that I could be so cavalier about prenatal Type 1 care. Truth is, I'm a lucky lady and 99% of my endocrinology work - all the basal rates and I:C ratios and food logging I've been doing - has been monitored and exchanged with my CDE and endo through Kevin's kick-ass log and Medtronic's Carelink.

That being said, I'm not sure how the Center makes money this way, so I try to go in for an actual billable appointment every once in a while.

Waiting to be a billable patient!

My goals for the visit - since going over numbers wasn't going to happen, as I send those in every two to three days - were bigger picture stuff:

1. OB mentioned the "protocol" for delivery, but was super dodgy about what it actually is. GOAL: find out what the heck is going to happen to me, my pump, my insulin for delivery.

2. OB is really, really weird about her expectations for my BGs: "Your fasting BG is around 90, right? And you're keeping your post-prandial under 120?" do know I'm Type 1, right? GOAL: Find out what the heck her problem is and whether or not my BGs are actually a problem.

3. My basals are nearly double what they were in November, and all my rates are all over the place. What's going to happen after delivery?! GOAL: Learn what to expect post-delivery and during breastfeeding.

I don't know that I got super-concrete answers, but I got enough information that I have a different set of expectations for this whole process:

The protocol that's in place is going to depend largely on whether or not I have a c-section. (Finding out next Thursday!) Actual labor is apparently a real bitch on blood sugars - not surprising, of course - but I won't need to do that if I'm getting surgery. All of my pump rates and insulin IV decisions will come from the Berrie-affiliated endo team that's at the hospital at that time. They will work with my endo/CDE to come up with the basal rates I should have for the procedure and afterward, using the pattern function ahead of time so we're not fiddling around with my pump while my daughter's being born. So, still technically waiting on the actual numbers for the protocol, but I know a lot more about how that's conducted and I'm relieved to know the Berrie Center will be the source of those decisions.

As for my OB's insane expectations? That's just what happens. Whether it's because endocrinology just isn't her specialty or that she's just used to patients with gestational diabetes numbers I don't know, but per the CDE "Oh, I KNOW - OBs drive all our Type 1s crazy." She said I'm doing just great and that I should keep doing what I'm doing - that part of the reason she hasn't had me come in is that I'm sailing along so well that I didn't need an in-person appointment. I'd assumed things were okay (she does see my logs all the time, after all), but it was still nice to hear her say the OB is nuts and I'm doing just fine. [Caveat: My finger-stick A1c, for those of you waiting to see how Dex stacked up, was 6.2. I went up a tenth of a point, which is just hard to see as BabyH kicks around in my belly. I'm getting an actual blood draw A1c today, though - will be interesting to see how consistent the numbers are!]

Lastly, post-delivery and breastfeeding? Sounds like it's much like the protocol. I'll have rates that will be set up before I leave the hospital by the endo team, and they'll be rates that'll most likely leave me a little high at first so that I'm not in danger from serious hypoglycemia. Rates will just be adjusted from there. Again, not a concrete answer...and certainly one that leaves me scratching my head: "Um, I don't think I'll have time to do all the logging I've been doing for the past year and a half!" But still good to know there's some sort of plan in place, even if it's not fleshed out enough for my Type A personality.

All in all, I was happy I went to see her, and feel a bit calmer about all the questions bouncing around my head. Not actually calm, of course, but we're moving forward!

Monday, June 6, 2011

Dear Connie

The following is in reference to a comment I received this morning on an earlier post and which I've chosen not to publish.

You're right. My blog is absolutely not the right forum for this. Your anonymous comment, lacking any and all contact or identifying information, was shocking in its impropriety. But, as you felt comfortable with the venue and the method, I'm just going to follow your example.

I have not had a direct conversation with my father since my sixteenth birthday, and I have not laid eyes on him since family court more than a decade ago. Similarly, I have not been in contact with my grandmother since 1996 - not only do I have no idea how to get in touch with her for whatever important information you think I deserve to know, I have no desire to do so.

I am unclear what you hoped to achieve with this morning's middleman-brokered message. I am sorry your husband is sick - as this is what I assume must be happening - but believe me when I say that has no bearing on my life now. I'm a grown woman with a loving family that is present for me every day of my life. As far as I am concerned, my family circle exists unbroken.

I wish you and Paul the best, and can only hope that you do the same for me - and that in so doing, you cease googling me or whatever brought you to my space on the internet, and respect our distance.

Friday, June 3, 2011

Rrrrrock the Dexcom, ROCK the Dexcom

The Hoffmandersons bought a new laptop not too long ago, and last night I decided I was way overdue for a download of my Dexcom receiver. Sadly, I decided this at 10:00 pm. I thought it would be a matter of just plugging that bad boy in and letting everything work its magic while I brushed my teeth and got ready for bed - no such luck.

Instead, I needed to download the DM3 software. And then I needed to export all my old patient records from the old laptop - 4 of them, of course, since in their infinite wisdom Dexcom doesn't allow patients to just edit their receiver number and keep all their data in one file...and I'm on receiver #4. And then I needed to import them into my new database. Finally, an hour later, I was ready to go! Dex was plugged in, I clicked my Karen box, and...the transfer was canceled.

Well, this is new, I thought. So I restarted the transfer. It died again. Wash, rinse, repeat. The transfer would go for varying lengths of time and then croak. B - my usual computer wunderkind, my go-to nerd-whisperer - had nothing to offer, other than the dreaded "Maybe it's a compatibility issue with Windows 7." Not what I wanted to hear as it was nearing midnight, and by now I was a mix of screamingly frustrated and incredibly overtired. And, as most PWDs know, these data management programs often look like they're done in crayon, they don't always provide the most elegant methods for data analysis, and we all consider ourselves extremely lucky if we can get them to work on a Mac - all resounding arguments for "Shit. I bet it tanks with the newer operating systems."

So I prepared to go to bed. Shut off all the programs, prepared to close the computer, and thought "Aw, hell. One more try." Lo and behold, it worked! I don't know why it would work, since I've never had such a problem before, but I was grateful I got it to work at all. (See above: as most PWDs know....)

As it was midnight, I didn't get to do my usual fine-tooth comb data ogling. I did, however, do a quick look-see to get an idea of how my past two weeks have been going. Folks, I restarted the program because I didn't think it could possibly be right - per my Dexcom, my BG average is 125 (little higher than I'd like, of course, but that could put me in the running for an A1c of 6.0 next week), more than 60% of my BGs are in my 70-140 target range, and my SD is in the low 40s. While I wish I had a more thorough idea of how my numbers have played out, for a pregnant lady battling third trimester insulin resistance, ever-increasing insulin dosages, and just general body spazzing at every single thing that goes in my mouth I'd say those numbers are not too freakin' shabby...