Sunday, July 17, 2016

Week 20: Humming Right Along

I had another ultrasound this week. The 20-week is such a big moment for most women in their pregnancies, but given how many I've already had, it was almost a non-event! The placenta previa still present but could still move. Baby looks great. At least we didn't find any missing kidneys this time around.

I am still tweaking my insulin rates. In fact, I've done so much tweaking from three weeks ago that I think I may almost be back to my original "units used per day," but they are delivered at different times than before. My bolus ratio for breakfast is significantly increased. My overnight basal rates have been adjusted to accommodate both lows I was having early in the night and highs I was having in the middle of the night. My daytime basal rate is a little higher, but my late morning and late evening rates are so low as to be almost non-existent. I sure do appreciate the Dexcom CGM for helping me to pinpoint the need for rate changes more precisely.

I also found an endocrinologist this week! He was very pleasant, unlike my last endocrinologist. He let his suggestions be just that - suggestions - rather than "commands" or "instructions." They were helpful. But he was also very respectful of all the observations I've made throughout five pregnancies and 23 years of diabetes, and it was such a relief. I will not be seeing him again until the last month of pregnancy, but of course, he told me I could call if I had any questions. A real gem! A1C 6.2. A little higher than my previous pregnancy records (5.4, I think, some time during the second trimester of my third pregnancy when I had a number of very serious lows), but much fewer lows. Quality of life is improved; hopefully baby will continue to grow at a normal pace even with a slightly higher A1C.

My regular OB (not the perinatologist) told me she thought that twice a week biophysical profile testing during the last few weeks of pregnancy was not necessary. "We know," she said, "that additional BPP testing at the end of pregnancy does not reduce stillbirth." Babies can still die in utero with twice a week testing for a mom and baby at term. I will wait to broach the subject of postponing induction from 39 to 40 weeks until we both see how the baby's growth and health progress throughout the third trimester. His size is just right for the time being, and hopefully we can keep it that way.

So it was a rather boring week full of doctor's appointments, but no news is good news!

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