Friday, June 26, 2009

Lost Icons, and Unfading Icons

The AP ran an article this morning on the events that added up to a "bad day" for Generation Xers, the generation to which I apparently belong by virtue of my birth year. It was a bad day because we Xers lost two cultural icons (or three, if you want to count Ed McMahon, whose passing quickly became passe in the wake of the news about Farrah and Michael).

I guess I have my parents to thank for my failure to feel like the world of my youth has begun to crumble before my very eyes, because while they are cultural icons for many of my peers, they amounted to curiosities to me, since my growing up didn't include much exposure to them. Sure, I saw Captain Eo at least a dozen times at Disneyland, and I remember the commercials for Charlie's Angels and the avian-inspired hair made popular by the show's blonde vixen, but the people behind these images remained rather mysterious to me as I never became immersed in their culture.

My appreciation for Michael Jackson's artistry has come only recently, and even then it was a sidebar to the weird news that broke about him, his changing face, and his Neverland scandals. He, love him or hate him, really was the "King of Pop", and he altered the face of pop culture as surely as he rearranged his own features.

I was shocked to read that he died, and saddened in some way that is hard to explain. Farrah's death is similarly sobering. I think it is because I recognize that underneath the hairspray, lights and image, here were two real people who had struggled -- with life publicly in Jackson's case and with death publicly in Fawcett's -- and lost the ultimate battle.

Daniel and I sat on the couch last night watching my belly bounce up and down as a little person stretched his limbs in his rather tight confines. I rubbed the surface of my tummy and remarked to him, "You, baby Ian, will be born into a world without Michael Jackson... a world in which he is only a memory." Daniel added, "and a well-preserved plasticine corpse."

In the end, well-preserved or not, a corpse is all we leave here... outside of our legacies, our offspring and the seeds of the eternal we have planted in other lives, and I derive strength from that thought.

You see, my icons did not die yesterday. They still hang on the walls of our home and church, illumined by candles, linking this fallen world to the imperishable. Culture will pass, and its icons will fade. The light of Christ and the beauty of a life well-lived will not. I hope to be defined by that fact. I may be a part of Gen. X by birth, but I hope to number in the generations of the faithful by adoption. I hope, as well, that these recently departed souls find in death some of the peace that may have evaded them in life.

Your kingdom is an everlasting kingdom, And Your dominion endures throughout all generations.

Thursday, June 25, 2009

Hustle, bustle...

During my time in Junior High, I was in several musical productions at school. There are two song snippets that come to mind at times like these from those rather silly musicals:
"Hustle, bustle, hustle, bustle, got so much to do... Hustle, bustle, hustle, bustle, will I ever get through...?"
"Hurry, scurry, bother and worry..."
They are different songs from different years, but they both have the same emotional intensity and message -- sometimes we just plain get too busy and find little time to slow down!

We've been really busy lately between events, including a baby shower thrown by people from church, a job interview for me, a wisdom teeth extraction for Dan that slowed him down a bit for a few days, volunteering, and a visit from Dan's mom all in the last 7 days. We have new house guests arriving tomorrow and spending the weekend, so it may be a while before I properly update, but I did think that it was appropriate to say that we're hanging in here.

On the health front, my gestational diabetes seems to be fairly well controlled, with the one exception that I am having some trouble consistently with my fasting levels in the mornings. The values I am getting are just borderline high - still low enough that they won't warrant treatment with medication, but high enough that I miss my target, which makes me want to solve the problem if it has a solution.

I check my blood pressure in the morning and again at night and have been a bit surprised to watch it actually get lower as pregnancy progresses. I have gone from marginally high to perfectly normal (anytime I am not at the doctor's office) over the last several weeks. I also do kick counts before bed, but that's getting harder to do since I so easily mistake kicks for sheep and start to doze. I suppose it doesn't help that my instructions are to lie comfortably in a dark, quiet room... Anyway, nights like last night baby has pity on me and it only takes 2-5 minutes for him to give me 10 kicks. Some nights the process can take about 20 minutes, in which case I have usually caught myself dozing off at least 5 times before we are done, which makes me wonder just how accurate the timing is, since kicks don't wake me - no way, no how!

The nice thing about this phase of pregnancy is that I seem to have no trouble falling asleep at bedtime... and I have started waking up pretty consistently early in the morning when I need to get started on my testing and eating. For a while I was avoiding naps, but I don't think I can anymore. I just make sure I am also walking once or more daily when I am awake to compensate for my naps! The trick is to just make sure I never walk more than about 50 feet from a restroom, since Mr. Wiggles in my tummy has decided to occupy the space that used to house my bladder. So, I exaggerate, but not by much!

It's amazing to think that in less than a month this little guy will be considered full-term, and that it's only 45 days until he's due. We still have plenty to do to prepare for him, but I'm looking forward to finishing up the last-minute details.

I have a few shower pictures that I eventually plan to post, and I have more to say on several subjects, but at the moment I want to go walk while the temps are still in the 70's! So, pardon my hustle as I waddle off...

Monday, June 15, 2009

Yippeeeee!

No diabetic meds for me!

My gestational diabetes seems to have responded well enough to diet and exercise, so as long as I can keep the numbers under control, it looks like I am an "uncomplicated" case for the present. I am sooooo relieved. I suppose that if this changes in the next few weeks, I will figure out how to deal with it, but it is great to have my work trying to control it pay off this way!

My uterus is measuring about 1 cm large still, and my weight is a little less than it was last visit (2 pounds, I believe), but not so much that they remarked on it. Baby's heartrate was good, and in the 130s, so I actually don't have to go to another doctor's appointment for 2 whole weeks, provided nothing interesting happens in the meantime.

Phew!

Tuesday, June 9, 2009

Quick update - Gestational Diabetes

I had another doctor's appointment today, and the upshot is that the doctor says he can't yet decide if I am "complicated or uncomplicated." [The answer seems pretty clear to me... ;)] But
seriously, what that means is that he doesn't think that my blood glucose values over the last week warrant treatment with medication yet, but we are going to revisit the numbers next week to see if I have been able to consistently keep the mostly normal numbers coming. Uncomplicated would mean no medication and "normal" care; complicated would mean medication plus non-stress tests for baby twice per week.

I've had a couple of really good days this week and a couple of days when I didn't meet the targets, but none of my numbers have been ridiculously high. This week has been better than last week, so the trend is towards good control through strict diet and exercise (I'm walking about 1.5 miles or 25-30 minutes per day, sometimes twice per day). I've had "normal" values about 75% of the time this week, and no huge spikes, which should be okay if I can manage to keep the trend going or even improve upon it.

I have also gained about 3 pounds since last Monday, which is good, since, at the very least, I needed to quit losing weight. Baby's heart rate is good at 140 and my uterus is measuring about 1 week larger than expected, as opposed to 1.5 weeks larger last week, which indicates that he's probably growing at a more appropriate rate.

I had a couple of additional blood tests while I was there (HbA1c and fructosamine) that should give us a better idea of what my glucose levels have been over time. It won't change anything about my treatment now, but it may help point to whether I actually developed the condition earlier than it was detected, for what that knowledge is worth. This was spurred by my recollection that I had complained of some GD symptoms about 2 months ago. They were brushed off by one of the other doctors because I didn't have sugar spillage at that visit. Even if I did have it back then, the lack of diagnosis probably hasn't caused any real harm, but it would let me know if my concern back then was justified, which would give me more faith in my own judgment. So... we shall see how this week goes!

Thursday, June 4, 2009

By the Numbers

I have found for most of my life that if I work hard enough at something I want to accomplish, I can usually eventually achieve it. Of course, it helps that I generally set my sights on attainable feats. I find few things as annoying as circumstances that are theoretically under my control and at the same time not at all under my control.

Nikki, meet your endocrine system.
Nikki, meet your match.

So, I was diagnosed with gestational diabetes about two weeks ago now. I had one week to stew in my juices before I received dietary instructions, and then the day after I received them, we were off to spend time with Daniel's family for the memorial service for his dad. (About that... I have pictures that I intend to post and things to say about the trip, but I am not well organized on that front yet, so it will have to be saved for another time.)

The trip was great and I am very glad I went, but it made it nearly impossible to accomplish the blood glucose goals I had been given, in spite of what Daniel would probably call heroic measures on my part to try to follow the instructions to the letter, even though I had little control over my schedule, my location and everything else I had to try to work around. Just to give you an idea of how exacting the instructions are, I have to eat 6 evenly-spaced times (3 meals/3 snacks, snacks are marginally smaller meals, really) with specific carbohydrate counts (adjusted for fiber, of course) approximately every 3 hours. I also have to test my glucose one hour after meals and when I get up in the morning, for a total of 4 required tests per day. As you might imagine, some of my snack or meal times came when I couldn't possibly eat -- I was in a service or on the road in the middle of nowhere, Arkansas, or delayed deplaning because they forgot how to park it properly (no joke) -- in spite of my best planning. Daniel's family was extremely understanding and supportive, but there were limits to what I could manage, even with lots of help.

When I got home and reviewed my chart, it was clear: by the numbers, I had failed.

Okay, so when my numbers looked bad enough that the doctor started talking medicine when I got back on Monday, I was bummed, but I felt I had done my best. We discussed the fact that I was losing weight (not a great thing in the third trimester, as you might imagine) and that I just felt undernourished and was spilling ketones, meaning my body has been cannibalizing itself to get energy. Rather than sending me to get my pills, he gave me a week's reprieve. I was to add some calories somehow and do whatever other tweaking I needed to do, and then come back in a week to show him my numbers, with the proviso that medication seems imminent either way.

On Tuesday I talked to my nurse/dietitian and got her suggestions for where to add the calories. The plan was to add protein all day long and to add carbs to lunch and dinner. Yesterday I got to try the new plan out (plus exercise), and I finally got good numbers ALL day long. I was so happy!

This morning, I woke up and had good fasting glucose levels. I was really happy! Then I had breakfast - the SAME breakfast that has produced good breakfast numbers 3 times in the past, and when I tested after breakfast, my glucose was too high - and not just by a few points!

Gaaaaaahhhhhhhhh!

What's at stake here is medication or diet alone, and, as you might imagine, I think diet alone is a much better way to go when there is a developing baby to consider. The sobering part is that my body may simply be uncooperative such that I have to have medication to make the diet work.

I felt my eyes tearing up a bit when I saw that number on the meter screen, but then I decided to look around online for anything that might give me some clue about why my numbers were so bad under what should have been conditions controlled for success, so that if there is anything I can do to keep it from happening again, I will know what it is. What I find is this:

"The truth about Diabetes is that some days 1+1=2. Other days, 1+1=43. It's best to just be prepared for the unexpected."

You mean I am not in control? No. Not really. The hormones secreted by the placenta, my stress levels, my activity... they are to some degree, but I can only plead with them to behave. I can't control them.

So, I did what I could. I packed up my carefully measured snack (the food scale is my friend these days...), a book, my meter and some water, and I headed over to the Arboretum for a walk, followed by some scheduled reading, eating and relaxation.

Why? I may have met my match, but I intend to keep on fighting the only ways I know how! Perhaps, just perhaps, I can at least make 1+1=3, and squeak by under the limits.