Fort Casey Retreat (pt. 2)

Alright, I think that worked so here is my attempt at Part 2, Black & White photos of the actual fortress part of the Fort and a story below about the little complication we ran into towards the end of the weekend!

Playing with overgrown sea kelp.

Puget Sound from the top of the Fort. 

Gun tower. 

Walking through the inner halls.

Hanging out!

Boys being boys!
(Notice Asher's belly shadow standing watch over his dad!)

Ammunition elevator. 

It was a wonderful fall weekend away but not without its difficulties (you would think that by this point I would have just learned to expect complications!) When we left on Friday I was getting over a bad cold/respiratory infection but I was hoping that a few days away relaxing outdoors would help me get over it. It did... in a way. I feel like the cold was slowly getting better but I was still coughing a lot Friday night! By Saturday my ribs on the left side were so sore from coughing (and from Asher and his hard little bum being wedged up underneath the ribs on that side) that it was difficult to cough and take deep breaths but I spent a long time walking through the Fort and it was refreshing to get out and be a little active. But by Sunday I was having a much harder time breathing (because of rib pain not the infection) and was having to curl up and brace myself each time I coughed. As we were packing to leave Sunday morning Asher kicked a few times right underneath those ribs that were so painful that it sent me into a coughing fit, after that I had a hard time even standing up right. Charlie had to help me do just about everything that day, even walking would send my rib muscles into spasms that were excruciating. Luckily I had an appointment scheduled with my OB Monday so I just had to make it through the night. 

By Monday things were not any better, it took me almost 2 1/2 hours just to get out of bed, shower and get dressed for my appointment. By the time I got there my blood pressure was pretty elevated and I was in tears. It didn't take my doctor long to determine that I had most likely fractured the lower false rib on my left side. She said there was a chance that I could have torn the intercostal muscle attached to that rib also but she said either way there was not much they could do about it. They gave me some meds to try and help with the pain that are safe for the baby but I'm trying to take as few of them as possible. Other than that it is back to more 'bedrest' for me (a least a week or two) to try and let the rib heal. 

The good news is that the little man is doing well, he had his first official Non-Stress Test at the doctors office (since I wouldn't be going into work this week to do one myself) and he looked good, not quite as lively as usual but he passed. We've got another one Friday so maybe I can post another update after that one! I hope you guys are enjoying the fall weather, I for one love it!! It makes me feel like we are getting closer to actually getting to meet this little man, making it more real for me I guess. I personally think tomorrow would be a pretty cool birthday 10/11/12, huh? But if you asked me everyday I could probably think of a reason any of those days would be cool! (We still actually have 6 more weeks so I am trying to learn to improve my patience!)

-Cait

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Week 21 and beyond...

Alright all, I'm sorry that I fail miserably at this repeatedly but I'm trying to do a little catching up. So this is my attempt at filling you in... on the last trimester!

It has been a busy summer for sure; lots of travel, new experiences and unexpected complications! Charlie and I are doing well but I have definitely put him through a lot these last few months. Below is an ultrasound photo and update of Asher at his 21 week check up:

21 Weeks and 6 Days

 This week Asher had a detailed fetal growth ultrasound and a fetal echocardiogram to check the growth and development of his heart. He passed (for the most part) with flying colors! His heart looked great, it wasn't enlarged like they were worried it might be and it was pumping just how it was supposed to be for his age. They noticed a slightly enlarged spacing between one of the valves that they said he might be slow to close (meaning he would likely have a heart murmur at birth) but that shouldn't cause him any significant problems and would likely resolve by the time he was a toddler. As far as his growth was concerned he was big for his age (surprise, surprise). He was supposed to weight about 1 pound but was measuring at 1#5oz putting him in the 95th percentile for his age. Overall things were going well!

At the 22 week mark I changed my work schedule to part time which was really helpful. It gave me time to finally feel like I could get things at home organized and cleaned. I spent a long time fixing up our apartment but by the end of the week I had started contracting a lot! It wasn't too bad, I would just go home and lay down and they would go away. But once I hit the 23 week mark I had to go back to work, I was scheduled to work 52 hours in 4 days which made me a little nervous! I wasn't feeling great Friday night when I went in and things continued to go downhill from there!

It was a crazy shift by 10pm I was already contracting every 3-5 minutes and things were getting worse. I had to take an active labor patient who was going natural at midnight and by the time I got her admitted and her IV started I was unable to stand up straight or talk through the contractions that were now coming every 3 minutes. Thankfully my co-workers noticed and took over (aka they talked to the MD on call and had me admitted to our last room), my poor co-workers, not only did they loose a nurse but they gained another patient, and not an easy one at that!

They tried all different meds and IV drips but nothing worked to stop the contractions, by 6am the doc had done all she could for me at my hospital and they decided to transfer me by ambulance to a high risk hospital just incase I was actually going into labor. By this time Charlie was there with me and we packed up our stuff and headed downtown. Long story short we were admitted to a few different units at the high risk hospital until they finally determined that although I continued to contract I wasn't actually in labor (no cervical change). So they gave up trying to stop the contractions and just ensured that they weren't going to get worse without the medicine and finally let me go home on bed rest!

I spent the end of July and the beginning of August at home trying to take it easy but finally got the okay from my doctor to go back to work at 27 weeks but only doing 8 hour shifts with no labor patients! Needless to say the end of the second trimester was long and stressful for both Charlie and I so we were both very glad to get into the third trimester! Below is a photo of our fridge and our daily reminder of how big our little man is getting!

Our little guy!

I've since had another ultrasound but the little man was being a stinker and we didn't get a great photo but I will post that next time. I hope you are all enjoying the end of your summer, we here at the Akes' household are but I think we are both eagerly anticipating the arrival of Fall!

-Cait

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A rough start, Week 16...

Well... it's been a busy 48 hours since I've hit the 16 week mark. It started Wednesday night with projectile vomiting that continued into the early morning hours! Poor Charlie, I couldn't make it to the bathroom in time no matter how hard I tried so finally he just slept on the bathroom floor with me so that he could help me. I had a difficult time keeping much of anything down, which makes controlling my diabetes even more difficult because every time I would get sick my blood sugars drop very quickly so I have to eat and drink to keep them up (well this would usually just make me throw up more... you see the problem.) Anyways be morning I had stopped getting sick but still had a severe headache and was very dehydrated but I managed to make it downtown for my 16 week appointment.

Unfortunately because of the dehydration, and messed up blood sugars, I was spilling ketones in my urine by the time I got to the office (my bodies last resort to try and compensate for elevated blood sugars when not enough insulin is available or able to be used). Due to the dehydration, and ketones, and my inability to stand up straight without having my heart race and getting dizzy and out of breath my doctor decided to start an IV to rehydrate me. Well after 3 failed IV attempts and 3 failed attempts by lab to draw some blood work that IV turned into a full hospital admission... 24 hours later I am still here, hooked up to an IV, continuous EKG monitor, and hourly blood sugar checks (I thought I looked crazy and bionic before, now there are more wires and tubes attached to me than I can count). I was hoping to be able to leave this morning but the nurse I talked to told me 24-48 hours, which means maybe if I'm lucky later tonight but I will definitely be here for a while still.

Charlie has been amazing, he came home early yesterday to bring me the things from home I needed and stayed with me here last night (which involved eating hospital food, sleeping on the floor next to my bed for an hour or two before we got a guest bed pulled out, and hourly wake up calls through the night by my nurses, poor guy). The good news is I'm feeling much better now, just tired but I'm really hoping to get out of here sooner rather than later but I'll keep you updated once I see the diabetes educator and the cardiologist this morning.

-Cait
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P.S. Stay tuned for a new photo and some exciting news about the sex of our little one!!!

Electronic Upgrades

This post could also be called "Turning me into the Bionic Woman" because sometimes lately that is what I feel like!

It's been a busy weekend around here at the Akes' household... well kind of. I have been working most of the weekend which means I sleep all day and am gone all night, but that feels busy to me. The exciting part though is that I had a doctors appointment last Thursday and found out that my insurance approved me for a new pump and continuous glucose monitor!!! This is a big deal!

The first time I talked to the MiniMed rep about getting a new pump he told me that in all his years doing this he has never seen my insurance company approve a new pump when the old one was still in warranty. But, thanks to a well written letter from my diabetes educator and my high risk OB explaining my severe lows resulting in multiple 911 calls they approved me for both (probably because in the end it's going to be cheaper for them than continuing to have to pay ambulance bills). After a long day stuck at home on Friday waiting all of the new supplies got delivered to our apartment.

Multiple boxes, books, computer updates and supplies... a little overwhelming!

It took me about 2 hours to set up my new pump. After reading the updates and checking out the new changes I got started on changing all the 8 million settings to be the same as my old pump. I was really surprised at how long it took me because I know how to use the pump and I've been doing this forever, so you can imagine how long it took me to go through all the sensor information!! 

My new pump, much darker than my old one.  

Charlie likes it though because I didn't pick the pink, purple or neon blue option!

I started reading through the instructional booklets on Friday (240 pages long, I skipped a few sections), then on Saturday I found the Sensor Startup Folder and the two page long to-do list which included an online training class (to be completed prior to attending the training with my diabetes educator). So I spent the next two days reading through that class online and taking the tests. My initial plan was just to read the instructions and put the new sensor in, but after reading huge warning signs on every other page saying: 

Do not attempt to enter your insulin pump or glucose sensor settings without the direction of your health care provider.

Warning: DO NOT start using the system until medical personnel trained on the system teach you how to use it. Your health care provider will provide you with settings to program into the system.

Over and Over and Over again it warned you not to put the sensor in without your provider present! So... much to my dismay I decided to wait until my appointment on Friday to start using the sensor.

Well, that was the original plan. Then I went to work last night and it was kind of overwhelming, I had so many patients and so much to do, I was running around like crazy! I had checked my blood sugar and it was okay but by 9:30 at night things started to get even more overwhelming for me. I kept dropping things when I was in a patients room so I knew I needed to leave, I went out to the nurses station and I don't remember much of what happened after that. One of the midwives I don't know well came up to me, as I sat staring blankly at the clock on the wall, and apparently started talking to me but I was unresponsive so she got one of the other nurses. Within minutes half the nurses on the floor were surrounding me trying to get me to eat or drink something, test my blood, and wipe the sweat out of my eyes. This, while you think would be helpful just overwhelmed me more and I shut down (not like I was really with it in the first place). But they got me to eat and drink finally and one of the nurses had called Charlie to come get me.

By the time I had gotten myself together and changed out of my wet clothes a few doctors had showed up each with their own opinion about what I should be doing (most of which was ignored... sorry). But the general consensus between all the nurses (And the midwife, And the doctor) was that I needed to have my sensor in place before I came back to work. So... that is what I have spent most of today doing!

For those of you who don't know what the Sensor is (also called a Continuous Glucose Monitor) it is another small device with a sensor that I inject underneath my skin and wear on me at all times. It communicates wirelessly with my insulin pump and checks my blood sugar level every 5 minutes. I can set parameters for it on my pump and it will alarm if my blood sugar goes above or below a certain level. In addition to that, it also has more emergent alarms that sound if my blood sugar is dropping too quickly (even if I am still within the 'good' range) notifying me in advance of possible severe lows. The idea is that this will give my doctors a much better idea of what is going on inside my body before and after meals, severe lows, highs, and while I'm sleeping. This will also give me the ability to know when I am going low and to be able to do something about it before I get to the point where I am so disoriented I am unable to take care of myself.

So... here it is:

The sensor injected under my skin, and the transmitter (white part) attached to it. 

It takes two hours to get set up initially before it will have any readings to display on my pump, so I am still waiting to calibrate it for the first time (hopefully in about 15 minutes) then it will start working. I will get a continuous reading and graphs on my new insulin pump (this is why I needed the new pump) showing what my blood sugar is and what direction it is trending in! It's exciting and will hopefully be very helpful for me and it will allow Charlie to breathe a huge sigh of relief while I am home sleeping and he is at work all day!

We'll see how it goes and I hope to have an update later in the week to show some new graphs and charts and such (the really exciting part for me!)

-Cait

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Sterile My A**!!!!

Sorry guys but this is going to be somewhat of a very big rant!

My blood sugars are doing much better these days which is awesome but taking away that major stress is making some of the other more normal difficulties of pregnancy even more irritating! Last week when I went to see the high risk doc he told me he wanted to do a 24-hour urine on me. For those of you who don't know what that is it is just what it sounds; it's a urine analysis checking for protein but instead of just taking just one sample they collect EVERYTHING you pee out in a 24 hour period. So in the office he has the nurse get me a collection kit and a sheet of instructions, she put it in a bag told me not to forget to get blood drawn when I was done and I was on my way.

After I got home I was reading the instructions (not that I haven't instructed patients a million times how to do these but just to be a good patient), as I was reading I was a little concerned that the container they gave me wasn't going to be big enough (roughly 3,000ml) but Charlie assured me that they knew what they were doing, and its in an OB's office so they always have pregnant patients who pee a lot not to worry. Fast forward a week and it was time for me to head back to the Dr's office to see the diabetes educator.

I got home from work Wednesday morning and started the collection at 8am so that I could pee for the last time at 8am today before heading in to the doctors office. What you guys have to understand about me is that pre-pregnancy I peed easily twice as often as the normal person, during this pregnancy its been a giant joke! The only time I can ever go more than 2 hours without making a trip to the bathroom is when I'm sleeping, when I'm awake it's at least once an hour, sometimes as frequently as 3-4 times an hour. I'm going to attempt to spare you guys the details but by 2 in the afternoon when got up for the day I had already filled almost 2/3's of the container. I debated at this point what to do, I knew I peed most in the morning and during the night so I though maybe I would be okay but to be safe I decided to stop drinking as much just incase.

I went through the day stuck in the house, but in the afternoon I had to run to church so I was thinking as I was on my way maybe I could stop by my work and con them into giving me another container just incase. By the time I made it to church and got the things and talked to a few people I NEEDED to go home right then because I though I was going to pee my pants! I don't know about you guys, but I wasn't prepared to tote around 3 liters of my own urine with me in a brown paper bag every time I left the house so I gave up on the idea of stopping by the hospital (most patients didn't even have that option so I figured I'd be fine).

The next thing I'm sure you have all seen coming... around 11pm I ran out of space in my little (giant) orange container. By the time I woke up again at 2am I was running around the house looking for some sealable clean container that I could fill (and never get back). I was planning on using tupperware with the screw-on lids, but much to my dismay they had all disappeared, so I collected a random assortment of bottles and decided on the large 1500ml Gatorade container. I washed it out really well (with no soap so I didn't contaminate the urine) and went on my way. By the morning I had completely filled the gatorade container also.

My appointment with the diabetes educator went really well, we didn't change much and things are getting better so after I saw her I headed down to the lab with my 4,500ml's of urine at my side! I walked in and already the tech was irritated because I wasn't on her schedule, but she said she'd see me anyways. I handed her the urine and she looked down at it then looked up at me with a face of disgust. Our conversation went like this:

Lab tech: "What is this?"
Me: "My 24-hour urine sample."
Lab tech: "Yeah, but what is this? "(lifting out the gatorade container)
Me: "My pee."
Lab tech: "Who gave you this? Why isn't it in the orange container?"
Me: "It didn't fit, the orange container is totally full."
Lab tech: "What am I supposed to do with this?"
Me: Blank stare
Lab tech: "Did I give you this?"
Me: "No, the nurse did, last week."
Lab tech: "Didn't she give you instructions?"
Me: "Yeah, and I read them twice, it says is that if you miss collecting ANY urine you have to start over, it says NOTHING about what to do when the container gets full!"
Lab tech: "Well WHAT am I supposed to do with this?"
Me: "I didn't know what else..."
Lab tech: "You realize this isn't sterile right? The orange container is sterile until it is opened, THIS... (pointing disgustedly at the gatorade container) is NOT sterile! I don't even know what kind of detergent you used to clean this!"
Me: "I didn't use soap cause I didn't want to wreck the test, I just used a lot of hot water."
Lab tech: "They're not going to accept this. I don't even know what I'm supposed to do with this?"
Me: (about to lose it) "It was 2AM, What was I supposed to do!"

At this point there are a million things running though my head! I wanted to scream at her, I mean they make people do this all the time, I can't honestly believe that I am the first person ever to run out of room! And who is she trying to kid, that freaking urine container became unsterile the second I opened it. They are having me pee repeatedly in a hat in the toilet then pour it into the container, with no instruction on how or even if I'm supposed to be cleaning the hat. Do I just leave it and let it collect bacteria and bugs between voids, or do I clean it with tap water and a towel every time (effectively making it less sterile than the gatorade container). I mean common, they weren't even having me do clean catch urine samples, which means that no matter how clean I keep the containers, the urine is FAR from sterile!!!

The conversation above continued for quite a while but after my 2am comment I just stopped talking and stared at her. After she asked for the 5th time what she was supposed to do with the urine it took every bone I had in me not to get out of my chair, grab another clean "Sterile" orange container from the shelf above her head pour my "gatorade" pee into it, hand it back to her and say "Here, problem solved!" But I knew that if I did that I would just stomp out of the room and never go back, and she hadn't drawn my blood yet, and if I left without getting a blood test they would throw the urine away anyways so I kept my mouth shut! Stupid, I was so irritated when I left I didn't even know what to do with myself! She was acting like I was an idiot someone picked up off the street and dropped at her doorstep.

End of story she finally drew my blood (irritated again that no one gave me a lab slip) and let me leave but not before warning me that "the Lab is going to reject this sample and you are going to have to do it again." Well if it does fail I'm pretty sure they better wait a freaking long time before telling me, because if anyone even mentions the words '24-hour' and 'urine' to me together in the same sentence anytime in the next month I might just throw my decaf coffee in their face! Sorry... I'm blaming the pregnancy hormones for some of my irritation but seriously, I'm not joking about the coffee thing!

-Cait

P.S. On a brighter note, I'm seeing my regular OB in the morning tomorrow (if she hasn't gone into labor herself) and will hopefully have a lighter, shorter update to post after that!

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Quick update...

This is going to be brief, I hope! Since my last post (like 3 days ago) it has been a rough and trying week at best; one last minute sick call, a 911 call, 3 different doctors visits, 3 pump adjustments and multiple check-ins and updates with my diabetes educator.... And, its only Wednesday! I'm not going to go it to detail but I just wanted to post a new picture for our families. Despite all of the trauma that myself, the little one, and Charlie have been through this week I got to see him again today, moving around with a strong heart-beat (I could actually hear it this week!) So although the picture looks worse than the last one we got at 10 weeks I thought I would post a Week 11 photo (kinda... 10 & 5/6ths but who's counting). Here you go:

The little bean at almost 11 weeks!

-Cait

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