Friday, April 22, 2011
At 21 weeks baby is now weighing in at 12 to 13 oz and is around 10.5 inches long crown to heel. All of his facial features have formed, and hair is growing on his head. Fetal bone marrow is now making blood cells, a task done previously by the spleen and liver. Baby has been swallowing amniotic fluid for a while now, but his intestines are now able to absorb some sugars.
We've had a rough week so far. On Tuesday morning I woke up to a blood sugar of 200 (had gone to bed normal). I did a correction bolus and went back to sleep. When I woke up again, I was over 300. My pod looked like it was partially pulled out so I changed the pod but within minutes the pump was beeping that there was an occlusion. I changed out again and did another correction bolus. I continued bolusing throughout the day, but could not get my blood sugar below 300. I tested my urine for ketones and the strip immediately turned purple-large ketones. After numerous calls back and forth between my endocrinologist and my perinatologist, it was decided I should go to the hospital in Savannah and would be directly admitted to the High Risk Perinatal unit.
I got checked in and after some unpleasantries (I was not dilated and we got a nice sterile urine specimen) i.v. was inserted after 3 tries, and they hooked me up to the contraction monitor. The nurses told me to deactivate my pump as I would be hooked up to an insulin drip. I did so begrudgingly as I had no extra pods with me and once it was deactivated, I could not reactivate it. After a while my endo comes in and says "I want to keep you on the pump". Nice. Too late. So they hook up the insulin drip and put me on this insane regimen of adjustments every hour according to my blood sugar (yes they stuck me every hour). If I were to drop to 80 (80 is low?) I was to receive an amp of D50 (an insane amount of dextrose).
Then comes dinner time. Dietary calls to take my dinner order but since there is no menu in my room I must get the regular dinner which consists of Salisbury steak, russet potatoes, corn bread and pound cake! I protested that I am a diabetic but the lady stated that these foods were allowed for diabetics and didn't give me an option to change. The nurse came in later and asked about my dinner. She brought me a menu and told me to call and change my order. I am told that it is too late and I cannot change my order. I again bring up the fact that my blood sugar is over 300 and I don't need to be eating all those carbs. The lady starts getting nasty and yells "they are allowed foods, there are no sugars in them!". No sugar in cornbread or pound cake? Ok. At this point the nurse takes the phone and states that I will not be eating that food and to please change my order. So I finally got a nice dinner of beef stir fry with broccoli and my blood sugars slowly came down. I continued to be poked every hour and the insulin drip had this lovely habit of beeping every 15 minutes or so (always right after the nurse left the room) so I got absolutely no sleep whatsoever. This was also the nurses' first experience with an insulin drip and her first type 1 as well!
Now it's time for breakfast. At this point after going all night with no ketones, I now have small ketones which I am positive were just normal fasting ketones because my blood sugars were normal, but my dr wanted me to eat some carbs and correct to get rid of the ketones. I deliberate over the menu. Fruit will spike me cereal will spike me. Ok I'll get the biscuit with sausage gravy, not horrendously high in carbs and some fat to balance it out. "I would like to order the biscuit with sausage gravy" "You aren't allowed to have that. You are on a 2200 ADA diet". So what was I allowed to eat? Bacon (pretty sure it was imitation) scrambled eggs, a biscuit, grits, milk, orange juice, orange slices and coffee. I added up the carbs and the meal by itself was around 90g of carbs. But I wasn't allowed the gravy biscuit. Why, you might ask? Drum roll please.....Because of the fat! OMG what is wrong with these people?
At around 9am Matt brought me some new pods and I was allowed to put the pump back on, but get this: they kept the insulin drip running at the same time! Yes, double basal rates going. Does this make sense to you? The rationale I take it was that if my pump were to fail there was a backup going, but what the heck? Double insulin? This is not a problem? As I watched my blood sugar start to plummet, I insisted that the drip be turned off. After this it was just a waiting game. I did get to hang out with my old friend Angela, I mean Dr. Faulkner (we used to be phlebotomists together and she is now an OBGYN) so that was pretty cool catching up and chatting. Finally after 32 hours of no sleep (the baby was also awake most of that time as well!) they discharged me. I was a zombie at this point, but somehow was able to drive home. I went straight to bed and slept until late the next morning. Matt was kind enough to arrange daycare for Aidan and got Diana ready for school so I could rest.
Since then, my blood sugars have been much better. They think the site just got pulled out and I went so long with no (or diminished) insulin that I built up ketones and that made it almost impossible to bring down. I'm feeling much better and hope not to see that hospital for 4 more months!