Wednesday, November 13, 2019

Show Up


Yesterday I had my first post pregnancy diabetes appointment with my endo. During pregnancy I was seeing them every 3-4 weeks to follow up on my diabetes since my insulin requirements were constantly changing as my body accommodated carrying a baby! I remember booking my November appointment long ago and thinking that it seemed so far away, but in what feels like a blink of an eye - it came and went.

I knew going into this appointment I was not as prepared as my previous ones. Of course because during pregnancy diabetes was high on my list. I had a huge motivation and the time to put as much effort in as possible. I actually looked forward to getting my blood work done because it gave me feedback and reassurance that I was doing the best I could do.   This time around, I didn’t print my reports ahead of time, nor finger poke nearly enough (only sensor data) to give them any kind of direction or pattern of my blood sugars.  My goal was just to make it to my appointment on time, make sure my blood work was alright and get out of there.   

Turns out taking a baby to an appointment that drags on isn’t fun. I mean, it’s never fun to wait for doctors to come into the small, sterile holding cell (ha!) but adding a baby into the mix who wants no part of being there adds so much more stress.  Needless to say my heart rate was high, I was sweating like I had just finished a marathon and I began to worry as I saw snow swirling around outside. I just wanted to move on. 

However, my thyroid levels came back a bit off which apparently can happen to type 1s after pregnancy.  According to blood work it appeared I had hyperthyroidism - meaning my body is producing too much of the hormone. The good news was that my endo explained it usually cures itself over time.   I wasn’t diagnosed, because she needed more blood work to confirm which meant after waiting, I had to go wait some more to get my blood work done.  

My doctor let me know she would follow up with me after the results came back from the blood work. I was also instructed to keep an eye on my resting heart rate since it was high while I was there.  She gave me a prescription for beta blockers in case it was regularly over 100 while resting.  That frightened me the most because of the history of heart conditions in my family. However, I think I can chalk up the heart rate to stress because since being home my resting heart rate hasn’t gone over 84.  

The appointment overall was fine. My a1c was 6.1 which surprised me. While I didn’t give her much to look at data wise, she gave me some suggestions for preventing morning lows. My next appointment isn’t until August (I’ll be 30 and Nixon will be 1 by that time - oh my!) and in the meantime I will wait to see what my thyroid is up to.  

It was eye opening to realize that health is ever changing and how important it is to show up to appointments even if they’re long, exhausting and sometimes difficult.   While it wasn’t easy trucking around a 3 month old in the snow, through the busy parking garage and all around the hospital - it was important that I showed up. Being a healthy mama is important. 

Kayla 

Tuesday, October 29, 2019

Nursing & Diabetes

Photo by Erin Girard Photography 
I remember when we were registering for our baby shower, the sales associate asked us, "What's your feeding plan?"  I felt like a complete fish out of water because the only plan I had was to feed my baby the best way that I could whether that was breastfeeding or by bottle.  What she meant, was if I needed to look into bottles, breast pumps, nursing pillows etc.   While I did get all those things, that was really nothing in comparison to really figuring out my feeding plan once baby was here.

When we prepared the nursery, I thought about what my future self would need.  Low supplies - everywhere.  I put low supplies in the nearest drawer to the nursing chair, as I imagined I'd be spending lots of time stuck on that chair without the energy or ability to get downstairs for a juice box. I burned through those low supplies in no time.

Things I didn't think about before hand was the mental and physical exhaustion that breastfeeding takes. Like, I would say it caused the most doubt in myself, literally every day I questioned if I could continue breastfeeding.   Not only did it cause my blood sugars to do whatever they wanted to do, I also physically felt sick each time. (I looked into this and it seems that a small amount of moms experience this sort of nausea in the early weeks of breastfeeding.) To add to my self doubt, baby was not gaining. However, every day I told myself tomorrow is a new day and now we are at 3 months! We are still nursing without the nausea or doubt - yay!

I still seem to be figuring out how nursing and diabetes can co-exist in a way that I am not going into deeper lows or having random highs (probably because nursing makes me SO hungry in the night sometimes!) Taking care of myself both physically and mentally is important and has been a learning curve in this new phase of life.  Diabetes adapts to these life changes, but not always in a helpful way.

Kayla



Thursday, October 3, 2019

Priorities

It can be hard to make diabetes a “priority” when you have a family to take care of.  Between caring for Nixon, Cola and the household, even with help from Mike it can be difficult to find the time to manage my diabetes.  Of course this leads to highs I didn’t expect, that have been creeping up for hours, that I never noticed because I didn’t have the second to check.  

The biggest issue is making sure I change my site and fill my pump. While there are warning for low reservoirs, the time between the warning and empty seems to fly by. I then find myself having to fill my pump in the early hours of the night while combating high blood sugars and a very, very tired body and mind. 


Technology makes this 100x easier, because I imagine if I had to pull out a syringe or pen every time I needed insulin, I’d forget.  I also imagine if I had to prick my finger to know my blood sugar that also would take a backseat. So I am thankful for technology that makes it easier to manage diabetes when diabetes becomes a challenge to manage. 

Of course I want great numbers and an awesome a1c. I want to be healthy for my family and for myself, but it’s a balance between sanity and perfection and finding the right space can be challenging.

Kayla 

Friday, September 27, 2019

I Know That Worry

I know that worry.  I know that worry of carrying a baby while managing type 1 diabetes. I know that worry that you’re going to do something wrong and that the whole weight of the pregnancy (not just literal weight) but emotional weight is on your shoulders and only yours because you’re the one with type 1 diabetes, and you’re the one carrying that special baby. 

I know that feeling that you’re not checking enough, you’re not eating healthy enough, you haven’t cut back on carbs, you aren’t working out enough (or at all). I know that feeling. 

I worried while I was pregnant - I’m sure many do. But I worried that because I have type 1 diabetes, I had less of a chance of having a “perfect” baby, less of a chance of being a healthy pregnant woman and a glowing mother.  I know that worry.
Photo by Erin Girard


If you google type 1 diabetes and pregnancy a bunch of worry clouds the screen.  Articles about risks, complications and stories that will make you worry more than what drove you to google in the first place.  If you join a type 1 diabetes community page about pregnancy, you’ll encounter even more worry - other type 1s typing out their worries - I don’t blame them because we all feel that way. (Tip: leave the groups, and find a few key type 1s to confide in!) 

But, even though I know that worry (I won’t tell you not to worry) I will say that it’s all worth the hard work you’re putting in whether it levels up to other expectant mothers / mothers or not.  Because you worry, you care and that’s the best comment I ever received and I now pass it on to you. 

Almost 9 months of worry and my beautiful baby is here and now I worry about other things (of course!) but I worry because I care. 

Kayla 

Tuesday, September 24, 2019

The Call



We got the call at 1 a.m on Wednesday morning. I must have known something was going to happen because I had delicious pizza, a warm bath and got to bed early, Mike on the other hand... 

Shortly after 2 a.m on the way to the hospital 

We showered and I checked my pump
to make sure it was also ready to go - I didn’t want to be changing reservoirs or batteries mid delivery because that’s what totally would happen!  I put in a new battery and checked my insulin.  

Through labour and delivery, I had decided - along with my Endo that I would manage my diabetes myself unless I decided I couldn’t no longer.  Really, it meant both Mike and I would manage my diabetes because there were definitely times that I wasn’t able to.  So thank you to Mike who learned my pump and diabetes over the years! 

The “fun” begins 

The nurses also seemed happy I’d be managing my own diabetes, as one nurse said “type 1s know how to do their diabetes more than anyone else!” It’s true. We deal with our T1D 24/7 and know the trials and errors of managing a disease that literally changes minute by minute. 

To sum up 24+ hours, I laboured until I spiked a fever, which then led to having an emergency c-section so that both myself and baby were safe!  

Diabetes wise, I stayed fairly low. Having been on just fluids for over 24 hours, I managed to keep blood sugars between 3.5 and 5 mmol/L the entire time. A little lower than I wished, but better than high.  I balanced my blood sugars with Gatorade, Jello and Ginger ale.  The nurses still were in charge of checking my blood sugar every hour (I persuaded them to use my lancet - to save my fingers!) but I also wore a sensor. 

After delivery, as promised by my endo, my insulin needs would dramatically decrease. Since I was in recovery and was on quite a bit of medication, Mike changed the settings on my pump to adjust my basals.  I was visited by an endo a few times during our stay to make sure all was good. To be honest Diabetes wasn’t what I was trying to adjust to, so diabetes seemed easy in comparison. 

It was all really a blur during our stay, I don’t remember how much I was bolusing for or how well my blood sugars behaved, but I don’t recall it being too bad. 

Kayla 

Friday, September 13, 2019

Third Trimester

Alright, let’s take it back to third trimester. The hardest trimester of pregnancy for type 1s and probably for any woman really. You’re officially visibly pregnant whether you carried it all in front or all over (hello, giant butt!) and you’re uncomfortable, so very uncomfortable.  But, for type 1s it also means your blood sugars are creeping up and harder to control.  You throw so much insulin into your body only to have to wait it out and hope it comes down.  My basal rate was literally 3X the rate it was pre pregnancy! 

The doctors appointments become incredibly frequent, in fact the nurses and doctors knew me by name before I spoke and remembered past conversations we had - and they see A LOT of people.  You also are getting impatient because you just want to meet the little one whose keeping you up in the night kicking and forcing you to stop at EVERY SINGLE STORE to pee. 

For me, third trimester was a bit rough, only because my blood pressure began to creep up around 34 weeks ish. It was stressful because while I didn’t have any other symptoms of high blood pressure (besides actually having high BP) I wasn’t sure what this meant for me and my baby. Would this mean I’d be induced early? Was my baby okay? Would I need a c-section? Should I rest more? 

Well, what it meant for me was going to the hospital triage literally every single day (including weekends) to get my blood pressure taken and do a few other tests like a non-stress test, and urine / blood sample.  This is when the staff began to recognize me as I’d stroll in there and literally know exactly what to expect.  Lay on the bed, get hooked up to the NST machine which I called my “seat belt” and then get hooked up to the cuff to check my BP.  Oh and pee in a cup, the number of times I peed in a cup, I couldn’t even count. 

Each time I saw my OB, which was a couple times a week, I never knew what she’d say. If she’d tell me to it was time to have the baby early or if I’d be okay to keep going on. I know she was aiming for 38 weeks, but began to talk about 37 weeks or maybe even sooner. This scared me, but at the same time I didn’t want to wait too long and face the risks. 

On the Monday (36.4 weeks) I went in for my appointment with my OB. We took my BP and urine sample and within a few minutes of my appointment she looked at me and said, “I think it’s time to have baby!” I agreed because I didn’t want to play the game anymore of being scared of high BP. 

Then I was told to head to triage and of course this time my husband didn’t come to my appointment, so I had to get a hold of him to come down because I didn’t really understand what was about to happen.  They decided to induce me then, but then told me to come back when they called me. So we then waited for that call!

Kayla 

Thursday, September 12, 2019

I did it. We did it.

It’s been a few months - and I’m not sure where the time has gone, but healthy baby boy has arrived since my last post in May!

Hoping to have time (Ha!) to blog more about the experience of type 1 diabetes and pregnancy / now as a new mom because I know how valuable lived experience is in the diabetes  community. I googled many diabetes bloggers during my pregnancy for reassurance and guidance and I plan to pay it forward by being “that” blog for someone else.

But, first the most reassuring part that a soon-to-be Mom can come across. I managed my diabetes with all my mental and physical strength to my best ability and delivered the most beautiful baby boy August 1st at 8:33 am via C-Section (More on that in another post!)

The hard work that it took to get where we are today, paid off more than I can imagine and for those other moms out there living with type 1 diabetes, and those that are currently pregnant, we know how much work and energy it takes both before, during and after pregnancy.  I did it. We did it. We are amazing humans!

More posts soon (Or so I plan!)

Kayla

Saturday, May 4, 2019

Type 1 Diabetes & Pregnancy: The A1C

When I started this blog I often imagined I'd be documenting all the monumental moments of my life.  I imagined I'd write about going to college / university, and I imagined I'd write about living on my own. I also imagined writing about my wedding day and eventually about starting a family.  And while ten years has quickly passed since starting this blog, I can smile here knowing that I did manage to check quite a bit off my list of things to of course blog about, but also to experience.

It's a Boy!  Photo by: Girard Photography
In December 2018, Mike and I got the most exciting gift to date, a positive on our pregnancy test. This was probably one of the most emotional and overwhelming feeling to date.  We are going to be parents!  The first person I called was my endocrinologist, followed by my family doctor.  Having never had a child before, I had no clue who I was supposed to tell first.  I knew that my endocrinologist had said that as soon as we were pregnant to give her a call, so that's what I did.

A year prior I wanted to prove to myself and my diabetes team that I was capable of maintaining an A1C that was safe for conceiving and carrying a baby.  I aimed for the low 6's every couple months that I got my A1C done. My endocrinologist told me that I could get one done every month, which really allowed me to stay motivated and on track.  I bounced between 6.5% and 6.2% which was deemed great. This was done with minimal highs and minimal lows, as I know that sometimes an A1C test is not a great predictor of blood sugar control.

I knew that I was capable of maintaining a good A1C all while still enjoying the food I enjoyed. It really amounted to pre bolusing (taking insulin x amount of time before my meal versus just as I was putting food in my mouth or after)  and paying attention to my blood sugars, rather than guessing and bolusing.

After conceiving, the new step of diabetes management was now in place.  The first trimester meant a lot of lows. This meant that I needed to be checking often and be prepared to drink juice or eat rockets at any moment.  This was an interesting balance of making sure that I wasn't overeating my lows out of fear, and hunger frankly and keeping that balance between the lines of 4.9 and 8 mmol/L where I wanted to be. (Everyone is different, that was just my goal target for myself!) 

With the lows in mind, but also knowing that I felt my lows, I was watching for them and I was prepared, I managed to have A1C's in the high 4 and low 5's since.  I am now in my second trimester and I am having less lows, but still attempting to keep within my personal goal target.    This is not to say that I do not ever go above 8 mmol/L, in fact more recently it has proven to be more difficult, and require a tremendous amount of brain power to try and prevent spikes. There are for sure moments that I go above and to be honest, panic a little.  My doctor reassured me that a random high was not going to be detrimental, which eased my worry.

A1C has always been a daunting phrase within the diabetes community because it holds so much power over how we personally view our diabetes management and also how health care providers gather an idea of our management, while I look forward to having some brain space for other things and not diabetes, for now, I will do anything for that little guy in my belly!

Kayla

Note: The A1C test is a blood test that provides information about your average levels of blood glucose, also called blood sugar, over the past 3 months. (
https://www.niddk.nih.gov/health-information/diabetes/overview/tests-diagnosis/a1c-test)

Wednesday, March 13, 2019

Cheers to Ten Years

June 2009
March 13th 2009, I was told that I have type 1 diabetes.  Now, March 13th 2019, ten years later, I sit here and marvel at the journey that my diabetes has taken me on.   Little did I know what living with type 1 diabetes meant at the time of diagnosis.

While ten years is quite the span in time, I can still picture my eighteen (almost nineteen year old self) in the waiting room. Waiting without any idea what was going on, crying as the doctor told me I had diabetes and then walked away and closed the door.  I remember trying to get a cell phone signal in the room so that I could text someone, anyone.   I recall the quick drive home after they told me get a bag together because I'd be staying at the hospital for a couple nights, something I'd never done before.  I remember the look of panic on my mom's face as she gathered my things together and then drove me to the Brantford General Hospital.

I remember a question I asked the first doctor I saw at the hospital.  I asked, "Will I still be able to have a family?"   it wasn't something that I was actively planning at the time, having to still complete College and University, but it was an important question for me to ask.  I remember him smiling and telling me, "of course." Probably wondering why out of all the things to ask during time of diagnosis, I decided to ask that.

Ten years later, and I am smiling thinking, 'of course' as my husband and I get ready to add a beautiful baby to our family in August.


Baby O'Connell Arrives in August! 
I remember sitting in the hospital bed, as the patient beside me went on about all that Popeye's Chicken had on their menu, laughing at how excited they sounded, "they've got spicy chicken, spicy wings, even spicy fries..."   I remember that wonderful nurse who let me use the computers to look up a group called Connected in Motion, which I believe full heartedly immediately paved a beautiful, growing, supportive path for my journey.

After that, I remember the doctor, the same one who answered my question about having a family, asking me why I kept smiling, as if I should be in sorrow, or mourning my forever broken pancreas. I remember shrugging my shoulders and not really knowing, but now looking back realize that when in doubt, smiling can take some of the pain away.

The fear I recall was when I was taken up to a room, them not letting me get out of the bed as they pushed me through the hallways and up the elevator.  Myself thinking, I can still walk, you know? 

I was nervous to be left alone as they asked the visitors give me time to rest, even though I felt that I would be much more restless without them.  I was most nervous to not know who laid behind the curtain of my shared room, as I saw some individuals in the waiting room that I imagined were beside me.  I wasn't scared about my diabetes, or what life with diabetes meant, which seems to be the way I have combatted my diabetes, without fear, just courage.

Mount Kilimanjaro 2013 
That day, although ten years ago now, still stays crisp in my mind, like it happened yesterday. But, remembering all that came in between reminds me just how long ago it was.  I have been incredibly privileged and lucky in my journey thus far. I have met so many incredible friends from around the world, and have been granted opportunities that I would have never imagined myself doing.  While diabetes has come with tears, anger and frustration along the way, knowing all that this journey has given me, it's hard to imagine without it.

I want to thank all of the amazing supportive people in my life, some that may have come and gone, but most definitely played an important part along the way.  My diabetes journey has been made successful because of all of your understanding and support.   Thank you for the people that have read this blog for nearly ten years and have continued to follow along with my journey.

I love you all.

Cheers to Ten Years,

Kayla