Friday, 25 May 2012

Hospital Life

As I said last time I am settling into the hospital life routine, however there are three things that I wanted to share with you about what I don't like about hospital life and what you should prepare for should you be in a similar situation!

1. The food! This is getting quite funny now because they just can't seem to bring me what I ordered. Every day (up until today actually) I have asked for a sandwich on brown bread. I have circled 'BROWN BREAD' in capital letters, underlined it, double circled it and underlined it at the same time and every day they bring a white bread sandwich. Today when I got back to my bed guess what - I had brown bread!! But not Ham & Tomato like I ordered, it was Chicken Mayonnaise! Evening meals are pretty much the same, you ask for one thing and get given the complete opposite. Last night I asked for an omelette and a yoghurt  and I ended up having chicken curry and ice cream! Breakfast seems to be the easiest to accomplish.

2. The stockings! I knew I would have to wear stockings to prevent blood clots if I was to have a c-section but I didn't realise I would have to wear them ALL the time. Even in  this heat! They are very fetching white knee hot socks. They're on it too, you can't fool them, if you take your stockings off they are on you like a shot! However it seems you can take them off for outings, thankfully I don't have to sit here typing this in Starbucks with them on.

3. The heat! This is only an issue at the moment because of the heat wave we are having but it is like a greenhouse on our ward. What a week to be in labour! Add point two to point three and the result is not good.

Now that I have moaned about all that I feel like I should say something positive. So on the plus side everyone has been lovely and the midwives are fantastic, which is the main point over the food, stockings and temperature!

Just a couple more days to go till my induction, I will try and squeeze one more post in before then!

Wednesday, 23 May 2012

34 weeks + 5 update...Plan C?

The plan for his release has changed!

Yesterday I saw the obs in my appointment and the plan was the same – induction to start Friday but he warned me the baby might not be here before Monday, we would have to see how things went and possibly stop for a little break mid-process, don’t worry I don’t think we would be looking at a constant four day labour or I might be asking the c-section question once again. I spoke with my diabetes nurse and we discussed whether I was happy with it being over a weekend, final outcome was to stick to the original plan.

Anyway this morning they had their weekly meeting (which I mentioned before) where they discuss all their in-patients and they have decided to wait till Sunday before they get the ball rolling. That way when things start to progress my diabetes team will on hand and also my usual obs on call, that's anticipating that he won't pop out on Sunday! As long as all the heart traces stay normal (as they have been) this is the new plan, what are we on now Plan C I think? I’m still allowed out for a few hours at a time so if this good weather lasts I will hopefully be able to enjoy some of it this weekend.

So it looks like he will still be a May baby, but which date?! For those who don’t know already I have a thing that I would like him to be born on a nice round, even date. But the month of May has messed that up already! Will it be Monday 28th, Tuesday 29th, Wednesday 30th? Monday or Wednesday would be my preference, I may have a different view if I am in labour a long time, I doubt I will be worried about hanging on for the 30th!

Tuesday, 22 May 2012

Sliding Scales

All is good here. I am settling into hospital life and routine and Friday when my induction is scheduled is fast approaching! I'm getting used to the daily routine of monitoring - see above!

I mentioned in my last post that I went onto a sliding scale whilst I was being given steroid injections to help develop the baby's lungs, apparently this is because the steroid injections can send your blood sugars all over the place. I came off my pump on Tuesday afternoon before my first steroid injection and stayed on the sliding scale until Thursday afternoon after my final injection. At first I was just on insulin then they added a drip that was a mix of saline, potassium and glucose.

Basically how it works is they/you measure your BG hourly and then the slide is adjusted depending on the result. I was on rates between 1-5. One when my blood sugar was at it's lowest (i.e. normal levels) and five when it was at its highest.  

Each time I ate my BGs rocketed and I was on a scale of 5, with it taking a few hours for my BG to come down. After breakfast one day it hit 17mmol/l and I kept questioning them about the sliding scale and how it was obvious that every time I ate I needed more insulin and wasn't being given it quick enough. (For example I could eat at 1.10pm but the sliding scale wouldn't be adjusted till 2pm). Some of the doctors/midwives were saying it was fine it was the steroids etc. but I knew there just wasn't enough insulin being given to me to cope with eating. I spoke with my diabetes nurse and she said that sometimes people gave an additional bolus when they ate but seeing as though I wouldn't be on the scale for long it was probably okay, we would also have to work out how much bolus to give and that could be difficult.

I was getting quite stressed and annoyed about it, after all I had been putting all my effort into not getting BGS of 17 mmol/l and here I was in hospital running higher than I had in weeks. Also apparently it is protocol to give the glucose/potassium/saline mix - although I have since found out that this really should only be given if you are not eating and I was eating! Clearly some confusion along the way...

It was Thursday morning when I spoke my diabetes nurse again and she told me that one of my diabetes doctor (I have two - one more focused on the baby side, one more focused on the diabetes side) had said she never wanted me to go on the sliding scale, she had wanted me to stay on my pump. It was the other doctor who said I should be on the sliding scale. I came off the sliding scale that afternoon based on this and guess what by evening time my BGs were down to normal and an hour after my evening meal I was 7.6 mmol/l. 

So now I am anti the sliding scale! I have said that when I get induced on Friday there is no way I am automatically going onto the sliding scale. I would like to be given the opportunity to self manage for as long as possible. If I get to the point where I can't eat, start vomiting or am completely our of it and can't manage then I will give in and go on the sliding scale but until then it is me and my pump! I have been told my diabetes doctor will fully support me on this. 

Tomorrow I have an appointment with the obs so will be bring this up with him and I will be flagging up the fact the sliding scale was useless. We may have a fight on our hands! 

Friday, 18 May 2012

34 week + 0 update

Can you guess where I am then?

Lots has happened since my last post as you can probably tell from the picture. I had a couple of half written posts and each time I went back to them they were now out of date as things had moved on so much. This could become quite an essay but I will try and summarise and come back to the details another time.

I’ll tell you the outcome first and then work backwards so as not to leave you all in suspense! At the moment the baby plan is to induce me next Friday 25th May  (I never expected a May baby!) when I will be 35 weeks pregnant. The reason being is that as well as the concerns over the baby’s growth they are also worried that a drop in my insulin requirements recently could indicate that my placenta might be starting to fail. So best to get him out but it’s all about timings, not too early and not too late – a bit like a nice joint of roast beef.

I came to the hospital on Tuesday for my regular appointment with the obstetrics team and also for another growth scan. The scan results weren’t too alarming, when I looked at the graph relating to his tummy size of course it had increased but it hadn’t gone steeply vertical it had progressed along on an upward curve. Estimated fetal weight was 6lb 9oz, I had in my head between 6-7lbs, so just under 2lbs weight gain since the last scan nearly four weeks ago.

In my obstetrics appointment I explained that over the last five days I had reduced my basal doses by 40% across the board as my BGs just seemed to be dropping and I was having to eat quite a few extra sweets and snacks without insulin to maintain normal levels. I hadn’t thought in depth about this to be honest, I had thought it was a little early for my requirements to be leveling off and had a fleeting thought as to whether I could actually be further along in my pregnancy than I thought. They said I wouldn't be that far ahead, a few days maybe but not a few weeks. There were a few discussions about my blood sugars etc and then the words I knew may come before I even reached 36 weeks ‘we’re going to admit you’. I savoured my last hour and went and got a coffee and made some calls before heading up to the maternity ward. Even though I know my hospital quite well I had never ventured up to here before and it felt very much like when you arrive at a hotel and need to work out where everything is. What was ironic was that we were booked to do our maternity ward tour later that day, I didn't need one now I was going to experience it for real! Within a few hours I had been passed from pillar to post and finally settled in the third bed they put me in and it was there I stayed until this morning.

On Tuesday afternoon I was given my first dose of steroids via injection in order to speed up the baby’s lung development. I was also put onto a sliding scale of insulin (I think I will probably do a whole post or should I say vent on sliding scales later!) and taken off my pump, my BGs were then monitored every hour and the sliding scale adjusted accordingly. Nothing else really happened on Tuesday in terms of finalising the plan for birth etc. but on Wednesday morning I was the hot topic (well that’s what I like to think) in the morning meeting between the doctors, paediatricians and who knows who else. The report came back to me that they wanted to hold off another week if possible and induce when I reached 35 weeks. In the meantime I was to stay in hospital to be observed and for the baby to be monitored three times a day to check he was okay. When I pushed them to ask if it really was necessary for me to stay in between now and the birth they said that it was a recommendation and that they wouldn’t keep me here unwillingly but if anything happened whilst I was away from the hospital they wouldn’t take responsibility. It was just like the Australia saga all over again…
Being type 1 there is a chance of still birth and they threw it at me that if anything happened when I was here I could be in theatre within minutes, at home the outcome could be much worse so what was one week in hospital putting it all in perspective? That doesn’t make it easy though for some reason I long to go home even though I am only a couple of miles down the road!

There’s loads more to tell and lots of updates for those interested in all the diabetes details but I’ll leave it there for now and let you digest. Blogging from hospital isn’t impossible but with no wi-fi I will now venture off to find myself a little wi-fi spot so I can post this online. One week from today it should all be happening and unless anything changes I will keep you well posted in the meantime.

P.S. This photo is already out of date they have moved me again since I took this, now on bed no. 5!