For the first time in this entire pregnancy, I feel ready. Sure, the only baby item we have purchased thus far is a Halloween-themed baby bib (it has a black cat on it and says “I’m so cute, it’s spooky!”) but that’s not important. I finally feel like everyone is on the same page and we’re all working towards the same goal, everyone has a job to do and it’s all going to be great.

It’s a good thing they give women 40 weeks or so to get used to all of this because it’s a lot to cover. Bear with me.

When I first got pregnant I knew very little about labor and delivery. Hell, I knew only a moderate amount about pregnancy, based almost exclusively on my friends’ experiences. You know that cliche where they say “your mileage may vary”? Yeah, that’s pretty much how it is. Pregnancy, childbirth and parenthood are all just basic lessons on taking things with a grain of salt.

When I first told friends that I was pregnant, one friend in particular (actually a woman I haven’t talked to in probably 10 years) sent me an email saying how I could have a homebirth as a diabetic and quoting me a myriad of statistics. I admit my first reaction was “uh, what the hell.” I wrote back with some generic “we’ll see how it all goes” thank you email and got back another four page reply about how breast is best and don’t let doctors scare you with “dead baby” tactics. (I shit you not. She wrote “dead baby” several times in an email to a pregnant woman.) I swiftly archived that email and moved right along.

My own mother’s labor stories were from the perspective that things were hectic and a bit confusing but it didn’t matter because the goal was to have healthy babies. My most vivid recollections are of her telling me the Chinese doctor that delivered me spoke little English and sewed up her episiotomy crooked. (You see where I get my oversharing from. I come by it naturally.) Perry and I were huge babies and Mom did it all without any pain meds. It was no cake walk and from her experience she talked like a cesarean would have been just as easy to recover from if not more so. Like so many things my mother has endured, I got the feeling that childbirth was not joyful by any means, but was what we endured to get the baby we wanted.

I scoffed at women who talked about what music they wanted playing during labor. I may have even said, “do you tell your doctor what music you want playing for your appendectomy? It just doesn’t seem important to me.” Yeah, I can be a butthead like that.

One of the first visits I had with my OB, I told her that I was not “one of those Earth mother goddess types” and my goals were 1) a healthy baby 2) to not have my lady parts shredded and 3) as little drama as possible. She said that vaginal delivery is still possible for diabetics but that in some cases the head would make it out but a shoulder would get stuck if they were too big. I balked that that didn’t sound like low drama to me and mentally started scheduling my induction date and possibly my cesarean.

All of these thoughts went through my head in a time period when I knew I was pregnant but hadn’t really interacted with this baby at all. He was a blueberry in my belly, according to BabyCenter.com and I just couldn’t focus on how that blueberry was going to be our son or daughter eventually. It’s a big thing to wrap ones head around.

For the first half of this pregnancy, I went along my merry way. I figured we would take one of those day long birthing classes and get a tour of the hospital. Then around week 21, I started feeling this person inside me.

At first they were just tentative movements. But as he started to grow, our son developed a personality as well. On the plane to BlogHer, I sat in the window seat looking out and humming an old bluegrass gospel tune stuck in my head. From the moment I started humming, the little guy started swimming lazily back and forth in my belly. It was very comforting. I landed in Chicago, dumped my stuff in the hotel room and headed down to the pre-conference party where people were stacked like sardines and yelling over the un-chu un-chu un-chu of pop music at volume 11. And as I sat down in one of the only available seats and felt the crush of humanity around me, my unborn son started freaking out in my stomach as if to say “WHERE HAVE YOU TAKEN ME, WOMAN?!” I cut that evening short and headed back to the peace and quiet of the hotel room.

As all these experiences were happening, my attitude about bringing a person into the world started to change. I wasn’t thinking about how labor was going to be like all my other hospital experiences where I just wanted to get the hell out of there and more on how I wanted to know everything I could about how my body was going to successfully introduce this person to the world in the best way possible.

Unfortunately, every book I read talked about all these options for “most women” and “low risk pregnancies” and I wasn’t really feeling like they were speaking to my demographic. But as I sat in the waiting room at EVMS amongst some morbidly obese pregnant women or ladies who didn’t look like they could withstand the stress of a brazilian wax, I didn’t really feel at home there either. As Rich has said before, “not everyone is like me.”

Faced with these challenges, I turned to the Internet for help. I read up on natural childbirth. Rich and I interviewed several doulas. I made Google documents called “Questions for OB” and “things to worry about” and updated them regularly. And in the beginning I felt very much between the rock of medicinal “high risk” birth as a type 1 diabetic and the hard place of adversarial “keep your dirty paws off my womb” philosophies.

In the last week or so, though, things have started to fall into place. We hired a wonderful doula who will come to our house and help me labor at home for as long as I’d like. She will be a wonderful middle ground between my housecat instinct to try and birth this child in a pile of laundry at home and Rich’s protective instinct to rush me to the hospital if I so much as fart with gusto after week 38.

Our doula gave us a list of birth instructors to contact and one of them was starting a class this week. We managed to switch to an 8 week course on unmedicated childbirth. The first class was last night and everyone was great. Best of all it has given Rich and I a common experience and list of topics to discuss before we are in a hospital room with a bunch of strangers. Even after the first session, I already feel like he and I are very much on the same page.

The final piece of the puzzle was to get my OB on board with our game plan. Our previous visit three weeks ago was alright except that there were quite a few mentions of epidurals and inductions. But today I had a very candid conversation with her. I can’t stress enough how much having this particular doctor and her campaign to let me manage my own blood sugars throughout labor (which is a major control issue for me that has caused epic fights in previous hospitals) is a huge deal and something no other hospital would let me do. She said that my decision on if I’m induced is completely up to me and that she believes strongly in a mother’s instinct to know what’s best for herself and the baby. She also said no one would pressure me to do something I didn’t want to do but just give me all the data and let me decide.

I could have hugged her right then. That’s all I wanted. I just wanted to know that going into the hospital was not going to be going into a war zone and that I would end up throwing down with every medical professional around me while in a very vulnerable state. I just wanted to feel like we’re all on the same team.

I am not like most pregnant women. I have a very particular disease that adds additional risk factors to my pregnancy but is relatively easily managed. I also have a birth instructor, a doula, an OB, my kick ass husband, ridiculously excited grandparents and a cast of thousands out in Internet-land to all cheer me on. With all that support, I feel downright invincible these days.

I have changed my diabetic basal rates, bolus ratios and correction numbers as of yesterday. As a reminder, the basal rates I take are the insulin I need for just walking around. The extra insulin I take to counteract food is a bolus. And if my blood sugar is too high, I need to know how much my blood sugar will lower for each unit of insulin I take.

All these settings are stored in my insulin pump but I have to set them up in the first place. I also have to tell them all to my doctors with each visit (which most of the time involves my stammering and looking them up in the pump, particularly now as they change over time).

Since this little guy in my belly has been making my blood sugars crazy for about a week, I had enough data to try to fix them. I’ve changed my basal from 1 unit of insulin per hour to 1.3 units of insulin per hour. I changed my bolus ratio from one unit for every 13 grams to one unit for every 10 grams of carbohydrates. And I changed my correction settings to give one unit for each 40mg/dL I want my sugar to drop down from 50. It’s a lot of changes and I’m a bit tentative I may have overdone it. But those numbers were conservative considering how many corrections I was having to take all day.

So far my sugars have been much better today. It’s barely crested 150 all day and only a smidge low after a huge dinner. It was a little creepy, though, to dial up what seemed like a huge amount of insulin compared to yesterday. Sometimes I have a hard time trusting the technology.

This afternoon, my sensor alarmed in a meeting, telling me I was at 204 and climbing. I checked my blood and it said I was only 130. Hmm. I calibrated the sensor and went about my business. An hour later, I felt a little fuzzy headed and the sensor said my sugar was 120 and dropping. Figuring it was off earlier, I wondered if I was low. I checked my blood at it was 183. Hunh?! I checked immediately again (using blood from the same finger and needle prick) and it said 153. Oh for Pete’s sake!

I just put the meter away and told the sensor to shut up and trusted how I felt. And today, I feel pretty okay.

Food and I have had a tough relationship lately. There are some things I eat that taste so good, I feel like I’m experiencing them for the very first time every time. And other things I eat just to put nutrients in my system. I waffle between starving and completely uninterested in anything.

One of those things that wasn’t necessarily in the pregnancy brochure is the need for extra fiber to keep ones system from shutting down. However, my dietitian harps on protein and ignores anything I say about fiber. If I eat nothing but steak and cheese for the protein, though, I may not survive. (Side note: I’ve always figured that those people who eat nothing but cheese must have bowel movements that are more like a menstrual cycle where they get all bloated and cranky beforehand but only poop once a month or so.)

So since I had to go to the grocery store anyways, I decided to share some of my favorite high fiber and protein foods of late. As always, I’m open to suggestions.

Quaker High Fiber oatmeal

I eat this every morning for breakfast with a hard-boiled egg. It has 10g of fiber in it! It’s also got 4g of protein, so add that to the 6g for my egg and it’s not too shabby.

Kashi Go Lean bars

I stumbled upon these in the Power Bar aisle and they’re way tastier. They hold up well to living in ones purse or laptop bag for weeks at a time and they have enough protein and fiber to make the pretty versatile (8g of protein and 5g of fiber). They make a good breakfast on the go or snack. The blue box of cinnamon coffee cake is THE BOMB but they’re really hard to find.

Fiber Plus and Active Lifestyle chewy bars

I first found the Fiber Plus bars and they’re pretty tasty. Then I stumbled upon the Active Lifestyle bars in Kroger and they’re a bit more tasty and less heavy. Both brands have a whopping 9g of fiber in them but only 2g of protein.

Frosted Mini Wheats and Fiber One raisin bran clusters

These are my two favorite cereals of late. The mini wheats have 5g of fiber per serving and a respectable 5g of protein, while the Fiber One earns its name with 11g of fiber (!) and 4g of protein. I had low blood sugar last night (31mg/dL) and ate three servings of Fiber One cereal to fix it. It was delicious.

Other random snacks to mix and match

Pretty much every day I have something from this photo. The apple and fiber selects have a decent amount of fiber in them (5g per serving) and the peanut butter, cheese and yogurt all have good levels of protein (7g, 5g and 6g respectively). After some of those high fiber things I’ve listed before, I can manage a bit of cheddar cheese and live to tell the tale. Oh, and fuji apples are the best, hands down. Our child’s middle name may be Fuji.

I’ve spent about $200 for test strips since Friday. Since the beginning of the month, I’ve been trying to get my test strips from Liberty Medical (yeah, Wilford Brimley’s place) with no luck. I bought 50 strips on Friday hoping they would last me until my refills came. Yesterday I had to buy another hundred.

I called Liberty today to find out what the hold up is only to find out that they claim to be waiting on doctor’s orders. I’ve been diabetic for 24 years yet I have to have an annual doctor’s notes saying it’s okay for me to have supplies that I’m going to pay for. It’s like needing a hall pass for a disease.

I’m running out of CGM sensors and I’ve been out of test strips for weeks. If I run out of sensors, I’ll be going through test strips even more than I already have. Even with the sensor, I tested my sugar 15 times today (at $1.20 each from our local Rite Aid).

As luck would have it, I’ve reached my 23rd week of pregnancy and as the ultrasound technician was kind enough to explain to me, this is when the placenta starts really growing with speed and it trashes my blood sugars.

Every day it’s like wrestling a bear to get my blood sugars down with only sporadic success. Without sensors or test strips, it’s like paying hundreds of dollars to wrestle a bear blindfolded.

This is a sample of what my last two days have been like.

First, some explanation of the picture. Remember my blood sugars are supposed to stay under 150 at all times. I highlight my morning fasting blood sugars in blue so the dietitian can scan through them over three weeks (she complained about that a month ago that my chart was too confusing for her to read). I also label my breakfast, lunch and dinner meals to help break up each day and I made a pink header for each day to help separate those in each week. I do a new worksheet for each week, starting on Monday. I log my blood sugar, a description of the food, estimated carb content, how much insulin I took and any notes. I also added that protein column this week as a bit of a “screw you” after my last appointment. Oh and while I’m not a military time kind of person at all, it’s much easier for logging data quickly.

What is so infuriating is that the dietitians want to have some reason (generally something I did wrong) that causes any blood sugar out of range. It’s how they feel helpful. But if you press them too much with “alright, I give up. You tell me why my blood sugars were so high all day!” what usually happens then is they give some lame excuse of “well, sometimes there just isn’t an explanation.” Well, that’s just fucking great.

I can’t wear my infusion sites on my stomach anymore because the skin is tight and sensitive but everywhere else I’ve tried so far hurts and happens to be some place I run into all the time so I’m afraid I’m going to rip them out. I got a huge bruise on my arm from my last CGM sensor so much so that it hurt to sleep on that side. My blood sugar is 211 right now, despite taking twice the insulin I should have at lunch (I bolused for it and then punted on half the meal because it was gross).

The other day I was casually trying to explain something about one of the many devices I wear attached to me or some complicated routine I go through to manage all this and someone remarked, “I just couldn’t do all that. If that were me, I’d just die.” Really? You’d let something like diabetes sucker-punch you like that? You’d just give up? You’d just find someone else to make you a baby or tell you what to eat or do your math for you? God I hope not.

Matt used to talk about the hassles of his colostomy then laugh and say, “it sure beats being dead, though!” It’s hard and it’s unfair and it’s a giant pain in the ass, but it’s just another one of those things that isn’t going to get better by ignoring it. I was hoping writing all this down would make me feel better, but I’m still pissed off.

I’ll change my infusion site and tubing in case it’s gone bad (wish me luck finding a new spot that doesn’t hurt). I’ll close my office door and have a good cry about it. I’ll drink more water and check my blood again in an hour. And I’ll just keep going. They don’t make vacations from stuff like this.