Happy Birthday, part 2

Today is the anniversary of the day that Jake became a big brother. In some circles, this is also known as Ryan's birthday.

My second pregnancy was unplanned. We had been talking about a second baby, and I was taking steps to rein in my diabetes management, but I wasn't there yet. I tell people this, particularly women with diabetes, because it is so important to have your diabetes in great shape before you conceive. Women with diabetes should know that a normal or near-normal A1c reduces your baby's risks of birth defects to that of the non-diabetic population. And when you conceive a baby with an out-of-range A1c, the risks loom disproportionately large, exaggerated and stressful.

The first word out of my mouth when that second line appeared on the pregnancy test was, "shit."

The response from my endo (passed on to me by a nurse) was, "will you consider terminating?"

A planned pregnancy helps mitigate the worry that comes with conceiving with a high A1c. However, let me also say this: if you do get pregnant without being under 7, and you wish to continue the pregnancy, understand that a high A1c doesn't guarantee problems, it just raises the risk. Your response to any health care professional who berates you should be, "Let's talk about how to do the best we can from here on out." Once my endo knew I was proceeding with the pregnancy, he and the CDE in his office were 100% on board with getting down to some serious diabetes work.

This time around, we caught the pre-eclampsia early enough to stall it. Modified bedrest and a reduced work schedule (have I mentioned how terrific my employer is?) allowed me to go from 29 weeks to 34 with minimal progression of pre-e. At about 34, my OB decided that delivery might be warranted. But I wasn't ill enough to force the issue, so I went in for an amniocentisis to check the baby's lungs.

Week 34: amnio = "no go".

Week 35: amnio = "no go".

Week 36, my 34th birthday, I had an amnio at 8:00 am, then up to L&D to await the results. My Dad had made the trip to either meet his new grandson or take me out for dinner (depending upon amnio results). Dad's a photographer and had his digital camera and laptop there, ready to go. While we waited, and I snoozed, he took a picture of my bare feet. Later, when I saw that picture, I apologized to everyone I knew for telling them that I wasn't that swollen.

At about 12:30, my OB came in with the amnio results, and the fun began. Forms to sign, pre-op things to be done, rush rush after so much waiting. At about 1:30 I walked down to the OR. John, armed with Dad's digital camera, took his seat by the anesthesiologist, and asked him if he was a Sox fan. Ah, tradition.

My OB came around to take his place by the table. I was giddy at this point, so when he accidentally knocked up against an IV pole, I said, "I hope your fine motor skills are better than your gross motor skills." It was only when the nurse dissolved into laughter that I realized I'd said it out loud. Way to piss off the guy with the scalpel.

1:54 PM, Ryan arrived, and the doctor held him up for us. This time, I got to see my baby a second after he was born, not after he'd been examined, cleaned up, and swaddled. All I could do was sob and cry with relief and joy.

10lbs 10oz, four weeks early (before you ask, my A1c's were all under 6.2, after that first one).

John went to daycare to pick up Jake, armed with "It's a boy" buttons and a bright red "I'm the Big Brother" tee shirt. I'll never forget the first time Jake stood next to Ryan's bassinet and spoke to him. Ryan immediately turned to the voice he already knew so well.

He had a hard time regulating his own breathing at first, not uncommon in c-section babies. Because he couldn't be brought to me, I was up and about 8 hours after surgery (if you can call standing up and taking 3 steps to a wheelchair "up and about") and down there to sit with him. By the next day, he was released from special care, and in my room with me. After a little bout with jaundice, he came home with us on May 17th. It was snowing when we left the hospital. That's New England for you.

Today, we are having the "Baseball Birthday Party" that he's been talking about since last September. I can't believe he's four years old, today. Happy Birthday, Baby Boy.