You've come a long way baby

Ever since my ultrasound on Thursday I've been dreading my doctor's appointments today. Thursday's ultrasound brought the news that they estimate our baby boy at 8lb 10oz and that started the hen clucking of when they were going to induce me. If it hasn't been obvious to this point I really really really don't want to be induced if I can avoid it, so all this idle chatter about bringing on interventions I don't has been stressing me out. I went for my nonstress test this afternoon and baby boy performed marvelously as expected, wiggly around on cue and showing a great heart rate and fluids. As I got up from the nonstress test to head to my ultrasound, Cathy the fetal diagnostic nurse asked how big my baby measured last week.

Me: "8lb. 10oz." Cathy (looking at me seriously): "Uh huh. And when is he scheduled to show up?" Me: "When he's ready." Cathy (looking even more serious): "Uh huh ..."

We walked back to the ultrasound area for her to check my amniotic fluid. The entire time she measured my belly she just kept talking about how these things can be so unpredictable and how she's seen patients that everything looks great and the next day the placenta just gives up and it's a crisis. She said she's even seen one or two patients whose babies didn't make it to the c-section scheduled date. Sigh. I just nodded my head and told her I'd talk to Dr. D and see what she had to say. Cathy seemed convinced I would get an induction date at my visit today. I thanked her for her concern and told her I'd probably just see her again on Thursday.

As I walked from the hospital over to the doctor's office for my visit, Cathy's comments started to get to me. As I sat in the waiting room, I was only partially successful in fighting back tears.

They called me back to take my weight (211), blood pressure (115/74) and check for proteins (negative). They checked the baby's heart rate again to record it and I sat in the room waiting to see the doctor. After a bit, the diabetes educator I don't mind so much, Georgia, showed up to look at my blood sugars for the week. She was very nice and told me she wasn't going to change anything because I had already taken care of it all. But once she finished and was flipping through her notes she mentioned that she thought Dr. D was going to give me a date today. "I've been wrong before, but you're at 39 weeks and I think she's not going to let you go any farther. So we'll see what she says. But I'll be surprised if we see you next week for an appointment. She'll probably give you a date before then."

She then packed up her stuff and walked out while I sat in the exam room by myself and was even less successful in fighting back tears. My face was hot as I listened to Dr. D. out in the hall talking to another doctor about something else. I just kept trying to keep the tears in check so I could have a rational conversation with her, but all I could think about was all these people with very strong opinions that they were going to pick a date for me and not allow me to be pregnant anymore. It was distressing to say the least.

Eventually Dr. D walked in with Georgia in tow and asked how I was feeling. I gave some lame statement of doing okay and she said I looked a little flushed. That's when I told her I was trying to keep my shit together but was having a hard time.

Dr. D: "Why are you having a hard time?" Me (choking up): "Because everyone today keeps telling me they're going to take my baby and I just want him to come on his own." Dr. D: "Nonono! Nobody's going to take your baby! You're the doula woman. You're doing fine! Who told you they were going to take your baby?" Me: "Well, you know Cathy ... she's great, but she's kind of a spaz and she just kept telling me all this stuff about how my baby could get worse any second now and no one will want to risk it and everyone keeps telling me you're going to make me induce this week." Dr. D: "Ugh, you know Cathy didn't mean anything by it, but I'm sorry you had to hear all that. We're not going to make any decisions like that quite yet. You just have a big baby so we need to figure out what we want to do." Me: "I know. Everybody means well, but I'm just very pregnant right now and I just really want the chance to do this my way. I feel like the only woman in this office begging to stay pregnant at 39 weeks."

Dr. D then asked if I wanted her to "check me" or if I wanted to wait a week. It was totally up to me. I paused for a second and told her I wanted to know because I was curious and hopefully it would give us some more information to work with. She said she was curious too and agreed it would give us some more info to digest before we made any decisions. As she walked out to get her stuff ready, Georgia walked over with huge eyes and told me, "I'm so sorry, I never meant to upset you! I just was guessing what Dr. D would say based on your date." I smiled at her and told her that it was okay and I wasn't mad at her, I was just very pregnant and very sensitive to all this. She apologized another half dozen times and then backed out of the room.

Dr. D came back and first sat down with me to talk about the statistics we know. We know I probably have a large baby. We know that the bigger he gets, the harder he will be to delivery vaginally. But we also know I'm not a small person and that both Rich and I were large babies so this little guy is probably genetically large and not large because of the diabetes. There's a 20% chance that a large baby could have a problematic delivery because of his broad shoulders. And that of those 20% there's only a 5% chance that any of those would suffer any ill effects from it, but we would all hate for this baby to be part of that statistic if it's avoidable. We just have to weigh the factors.

Then she checked my cervix. I'm about 80% effaced/softened (hooray!) and about 1cm dilated. She could get her finger past my cervix and feel his head but he wasn't so engaged in my pelvis that she couldn't push him away. She'd like him to be a little lower and engaged in my pelvis but otherwise this is all very promising. My cervix is very soft and ready to dilate, I'm having contractions off and on and he's not too high. We just have to encourage him down and out.

She asked if she could try to work my cervix loose a bit and I agreed. As she wiggled around for a bit she suddenly said, "Wow, you're a real trooper. I can't tell you how many women would have jumped off this table or yelled at me by now." It really wasn't that bad, but it's encouraging to know that I've got a higher tolerance for discomfort than other women (something I kind of suspected anyways).

Dr. D asked if I had been doing my squats. I told her yeah, but not daily. She told me to go home and squat as much as I could. She even got down and leaned over her examination stool to show me how and give me tips.

Then she told me that she thinks I'm going to have this baby on my own this week. She told me that she thinks I can have him vaginally and I'll do just fine. But if not, we'll just see how far he's progressed by next Monday and go from there.

So while everyone else there is exhausting, I am more and more pleased with Dr. D. I truly believe she's going to work with me and help me do this my way.

I still had a good cry in the car on the way home. Then I called my doula and had a great talk with her. Rich and I went for a great big walk, had dinner and sexy time and I'm currently squatting for all I'm worth. Everyone is doing everything in their power to encourage this baby to not be late.

35 weeks

I'm not sure if it's a coincidence or if maybe my heart-to-heart with the OB two weeks ago got through to them, but everyone was at the top of their game today for my appointments. I did have to see a dietitian, but it was Georgia this time and I don't mind her nearly as much as Marilyn. She was super pleasant and asked me about my weekend and if I had any questions or issues. She told me I was doing the right things and that the occasional high blood sugar for things like changing my infusion site was understandable and easily fixable.

I had a physician's assistant come in and tell me I was doing great as well and they just want to monitor me but don't see any reason for alarm. She complimented my Excel sheet and said my A1C of 6 was great. (I was hoping for something in the 5s but that test was from a crappy blood sugar period for me and there's no reason to get all Lisa Simpson about it.) They did my Group B Strep test today and sent me off for my nonstress test. That also went swimmingly and I have "great fluids" (I bet they say that to all the girls). Apparently anything over 10 is good (which I think is 1000mL or 1 liter) and I had 15.5.

It was almost creepy how pleasant they all were. Maybe they're scared of me. Which I would be fine with at this point.

I've got one more two week appointment at 37 weeks and then we're down to weekly visits until the baby makes his debut.

The baby and I are fine, but everyone else is insane

I've tried writing this several times and I don't even know where to start. Thursday was my 32 week ultrasound. Our healthy baby boy is 4lb 12oz (67th percentile) and apparently sleeps as soundly as his mother in that the ultrasound tech could not get him to move his hands out of the way to get a good profile picture. He was just sawing little baby logs and wanted nothing to do with us. As a side note I think it's funny that my father is worried that the vibrations from the riding lawn mower might hurt the baby, but the ultrasound tech was literally poking me with a stick and shaking me all over the place trying to get the baby to move.

The main reason to do the 32 week ultrasound is to get an estimate on his size and how much he will weigh at term. The ultrasound tech started doing math in her head.

Tech: "Well, the baby gains half a pound per week at this point." Me: "So with 8 weeks to go that's another 4 pounds." Tech: "Oh, but you're type 1 diabetic so we'll take him at 39 weeks." Me: "Uh ... we'll see when he's ready to come out." Tech: "Oh, well, that's just what we normally do." Me: "Well, we'll cross that bridge in seven weeks and not now."

I'm still amazed that she said they would take him at 39 weeks. Granted, she's not going to be there in the delivery room with us and she's not really part of our birth team, but it just smacks of how they do things versus how I want to do things. Apparently, I don't have to just worry about crazy women trying to steal my baby from me but the damn hospital itself.

So let's all just ignore that because we know that my last conversation with Dr. D was a good one and she told me they wouldn't force me to do anything I didn't want to do.

This afternoon brought a variety of appointments. First, I had to go in for a nonstress test (they don't hyphenate nonstress and I'm still not sure that's right, but we'll just treat it like a proper noun and let it go). Twice a week, I'm supposed to go to the fetal diagnostic unit of the hospital and sit in a recliner while they hook up an external fetal monitor (those straps on your belly) to measure his heart rate and my uterus activity for any contractions. The goal is to see movement from him over 20 minutes and that for each of those movements his heart responds "normally". So you have to hope your baby is active then and not sleeping as soundly as his mother does. Then you have to hope the chart looks normal or they'll make you wait even longer to get a better reading. It's about 90% boring and 10% stressful as you hope your baby will play nice so you're not there all afternoon. That visit was pretty uneventful. Little baby's heart rate is fine and they checked my blood pressure while I was there to find it 94/68. All is well.

I left there and walked over to my regularly scheduled OB appointment. Some of you may remember that I declared I was going to break up with my dietitian Marilyn last week. I dutifully called the office the following morning and left a message for my OB saying I wanted to talk about my dietitian, specifically never seeing her again, but I never got a call back. I chalked it up to some confusion since I had just called about a scheduled appointment and figured I would sort it out once I got to the office in person.

But as I sat in the waiting room, I started getting more and more anxious that it was going to be hard to bring up my "special needs" with them when they're all used to just going through the regular routines. I went in to have my blood pressure checked again and it was 115/75. It had gone up 20 points in an hour just at the thought of having to deal with Marilyn. When I went to my exam room for them to check heart beats again, I told the nurse about my voicemail from last week and asked if Dr. D could be reminded that I wanted to only see her and not a dietitian. The nurse looked confused but agreed to relay the message.

Once Dr. D came in we talked a bit about why I don't like seeing the dietitians. I told her specifically that Marilyn stresses me out and that I'm tired of hearing nothing but criticisms over silly things that don't matter but no real help or information about how to manage my blood sugars. I don't need to be chided for drinking milk or eating watermelon. And I would like someone to take the time to read all the crap that I bother to record and bring with me.

Dr. D said that I'm not like other patients they see so they're not used to seeing my charts. I reminded her that even if I'm not like everyone else, that shouldn't be an excuse to be treated poorly. It's straight up rude.

We moved on to the topics of my blood sugar specifically. She had good information for me on what my blood sugar should be expected to do over the next 8 weeks or so. I'm going to keep using more insulin as the placenta grows until about 36 weeks. Then I should plateau or even back off of insulin a bit as the placenta doesn't need to grow as much even though the baby is. But I should take note and call if I need significantly less insulin because that can be a sign that the placenta is breaking down. Remember that all this is related because the placenta produces a hormone that makes me insulin resistant. We also talked about trying to cut back on some of the carbs I'm eating to help maintain my blood sugars. All of that seemed reasonable and I was optimistic that I had managed to get Marilyn out of my life and had a really productive chat with Dr. D instead.

As she got up to leave, though, she told me that she would relay my concerns to the two dietitians and that she would make an attempt to see me first on my next visits but that if they did come in to talk to me I shouldn't kick them out because they're just trying to help. I looked at her blankly and told her, "they stress me out."

Dr. D: "I know they stress you out but I'll tell them to be aware of that when they talk to you. They're just not used to dealing with someone like you." Me: "Exactly. Which is why they should be grateful and not fuss at me. I bring freakin' Excel sheets of all my logs." Dr. D: "Yeah, but you're OCD." Me: "I'd rather just say I'm extremely organized." Dr. D (laughing): "No, you're OCD."

I managed to leave, go upstairs for my lab work done, come back to make my next appointment and get all the way to the parking lot before I started crying. I came home to tell Rich about my visit and cried again. I couldn't even type that previous conversation without crying.

As I lamented to Rich, I don't understand how they can have an entire medical practice focused on potentially hormone-influenced women and be so insensitive to their feelings. I have worked really hard over my adult life to not be a control freak and during this pregnancy in particular to not obsess over blood sugars if I'm doing well overall. To have come so far, only to have someone casually call me OCD really stings.

In the morning I will be officially 33 weeks, which means I have only seven more weeks of this madness. With each of these visits, I'm more and more convinced to just birth this baby on a pile of laundry like a house cat. But since I'm so OCD, we'll have to make sure the laundry is all clean and sorted into lights and darks first.