Friday, June 27, 2008

Surrender

I had a breakdown in the midwife's office last week. It all suddenly became too much for me - I had gained 8 lbs in a month (bringing my total to 12 lbs gained for this pregnancy so far), my blood sugar was slightly elevated, and I generally felt scared that I wouldn't be able to escape what happened last time.

She listened and assured me that, even if we ended up in the hospital, she wouldn't abandon us. She also told me that I'm doing everything possible to ensure a good outcome and that I needed to let go of controlling the process.

She was right. I thought long and hard that day and made the decision to completely surrender this birth to G-d. The results were almost immediate. The sun seemed brighter, my step was lighter, it was easier to pick up the Hippo, and I slept peacefully at night. My blood sugar numbers went down.

I have been living like this for a week now and I'm a much calmer and happier person. I have made the word "surrender" into my mantra. I can now visualize the birth taking place here in my house.

Wednesday, June 18, 2008

Just when I think I've dealt with all the c-section fallout...

I really don't spend my life being afraid. I do worry too much and I do have an overactive imagination (mostly when it comes to worrying about the Hippo).

I've been trying to uncover and process any remaining "stuff" left over from the Hippo's birth. I've reached the conclusion that I can dwell on how much it sucked, or I can accept it and move on. I'm rapidly reaching the point where the sequence of events makes no difference in my life (almost to the point of "just be happy your baby is healthy - but not quite ;).

Except.

I want to make sure I've sufficiently dealt with anything from the Hippo's birth that might relate to this birth - hence the blood sugar drama, the visits to the chiro and acupuncturist, the walking, obsessive vegetable eating, etc.

I've pretty much gotten past the blood sugar. Yes, it is a little elevated from where it was 4 weeks ago, but everything I've read points to the fact that this is absolutely normal in the 3rd trimester. I'm not planning to binge on donuts every week (though I did indulge on our vacation simply because we can't get kosher donuts here), but I've also decided that cutting out any whole wheat bread or other sensible grains is not productive.

I've also started to wonder about the contents of the IV I was given while being pumped full of pitocin. It's not on any medical records I have, but I'm beginning to wonder if there was a glucose drip. After all, the local hospital doesn't "allow" you to eat during labour (or during an induction attempt) - a glucose drip would make sense from that point of view, wouldn't it?

The Hippo spent 48 hours in the NICU for persistent hypoglycemia after he was born. Yes, he was a big boy (9 lbs 8 oz at 38 weeks), but a random blood sugar taken (without my consent or knowledge) 5 days prior to his birth revealed my levels to be 4.0 mmol/l - you can't get more perfect than that. I don't pretend to understand the mechanics of blood sugar, but that number doesn't really point to gestational diabetes.

I'm left wondering if the glucose drip kept our joint blood sugar elevated during the induction and that in combination with his size (like more due to my poor nutrition and perhaps a little genetics than anything else) made his body unprepared for life off the glucose drip.

Ah well, this is all speculation and just another question I need to ask the midwife when I see her today.

My other issue I'm trying to deal with is the fact that the Hippo never dropped into my pelvis. The op report says that, at the time of extraction, he was in the LOT position - his head was turned so that he couldn't drop into the pelvis. This makes sense to me and since I was planning on carrying him to nearly 42 weeks based on family gestation periods, he still had plenty of time left to drop.

BUT - here's the glitch - the midwife I had for that pregnancy said, "If the baby hasn't dropped by now, he probably won't". In my head I know this is crap. I even know it in my heart. Yet, as I approach 28 weeks with this pregnancy I'm starting to wonder when this baby will drop. I know it can happen moments before birth and I shouldn't expect it until then, but I'm also worried that I have a mental block now and that I will somehow mentally keep this baby from dropping...

Time to get out the visualization tools.

I actually had a really healing dream about a year ago where I was pregnant and the baby had dropped into my pelvis - I could feel it in my dream. Maybe I should focus on that.

I'm almost past the "what if the baby doesn't drop" nagging thought (I hesitate to use the word fear) and I feel like I'm almost mentally ready for this birth. It helps to write everything out - committing it to the computer makes it take up less space in my brain. I feel somehow as if I've crossed an imaginary line in the past few weeks in my healing from the Hippo's birth. I can't quite describe it, but the pain is less gut-squeezing when I revisit that week in my mind. I still cry when recounting the story, but it hurts less.

So, here's my list of things to discuss with my midwife at the appt today:
* blood sugar - what's ok, what's not both in terms of nutrition and numbers - I just can't live out this pregnancy on cottage cheese and cantaloupe
* some, ah, bumps I've developed that I think are just skin tags, but which I worry might be HPV (I suppose I could've picked it up in college and it was dormant all these years...). Gut says skin tags which isn't really any better because I've heard they don't go away by themselves after pregnancy... ew.
* the baby-dropping-into-the-pelvis scenario from the Hippo's birth
* position - just for my own info - she's still pretty mobile now and I sometimes feel like I'm carrying siamese twins.
* ???

Thursday, June 5, 2008

Oy...

So I took a week off from checking my blood sugar (somehow knowing I would have to be diligent about it soon enough...) since it had been fine. Imagine my surprise when I tested 1 hr after breakfast (measured from the beginning of the meal) on Monday and found that my blood sugar was hovering close to the "uh-oh" line.

I panicked. Things evened out the rest of the day (all numbers were completely normal), so my worry abated...a little.

Tuesday, ALL my post-meal numbers were high-ish (official cut-off is 7.8 and I was near 7.6 on the metric scale - I think the units are mmol/l but I'm no scientist) no matter what I ate (unless, obviously, it was pure protein).

Wednesday, my fasting number continued to be completely normal and I ate 1/2 cup of cottage cheese and 1/5 of a cantaloupe for breakfast. Numbers were fine (5.9 1 hr post-meal), but I forgot to pack a snack for myself and was seriously hungry by the time we got home for lunch. I ate 1 c. lentils, brown rice, and yogourt. Numbers went back up.

Crap. Lentils?!?!? I freaking ate lentils! Where is the "legumes+rice are supposed to equal the perfect protein"???? Was I doomed to cottage cheese, steak, and chicken for the rest of this pregnancy? Ugh. I had made peace with no sweets, but I would like the occasional piece of whole wheat bread, for crying out loud!

I called my midwife just to check on the accepted standards for gestational diabetes control in our community (I had been going off info published by the province, but anyone who has looked into GD will know that standards of care and acceptable numbers vary widely). I had retested at 1 hr 15 min after the lentils and, surprise, my numbers were way down to within normal range. My chief question for the midwife was whether I should be counting the hour from the beginning or the end of the meal (my logic being that my numbers would be fine if I could only have those extra 15 minutes without endangering the baby or my health!).

My midwife was awesome. She said I should definitely time from the *end* of my meals and that I should wait 2 hours before testing after a meal and that as long as the number was under 7.5, I was golden. She said it's totally normal for my blood sugar to go up since I'm about to enter the 3rd trimester - nearly every pregnant woman experiences some rise in blood sugar. I *knew* this, but it was reassuring to hear it from her. It's not necessarily indicative of GD, but it does bear watching since the Hippo was in the NICU unable to maintain his blood sugar for 48 hours after he was born - an experience I definitely don't want to repeat with this baby.

You can't imagine how relieved I was. My two hour numbers are always below 7.0, even after gorging on ice cream and cake (I've only done it once, I promise...).

So, now I'm down to testing 2x a day - fasting and we agreed on two hours after lunch. I hope all stays well. I'm still going to avoid sweets, but the odd bit of therapeutic dark chocolate may not come amiss...