It's ramadaan time again, going hypo :(

Ramadaan is a very special and important time for Muslims, where those who have reached puberty are required to fast from sunrise to sunset. This means abstaining from food, drink, sexual activity (if you're married), smoking etc.

It is a mechanism to heal the body and give it the opportunity to recover from all the 'junk' we put in it. Also it is a time to bring us closer to our Creator through increased prayers and the recitation of the Qur'an. We give charity to those less fortunate and traditionally send plates of goodies to our neighbours to ensure that they also have something to break their fast with.

However, having diabetes and going hypo often means that I'm allowed to give fidiya (an amount specified by the Muslim judicial council) that will feed someone their staple food for a day. This year the amount is set at R10 per day. So I don't have to fast but that still doesn't mean that I wouldn't like to.

Also eating in ramadaan is a bit of a challenge especially if you'd like to be considerate of the other Muslims around you that are fasting. Sitting in an open plan office with limited meeting rooms often means I just need to eat at my desk.

I know I have to but even going to buy food leaves me feeling self conscious. I know that my Creator allows me to eat but still people can be very judgemental. I know they don't mean to though.

So wearing my scarf and going to mc D's drive though may have been an interesting sight for the tellers, or I could have just been imaging it! I have been going very hypo even before ramadaan started so I tell myself to just do what I need to. They can either see my eating or have to pick me up, having a diabetic coma on the floor. I figured that seeing me eat would be less trouble for them and me :-)

I've had diabetes for 26 years now and I still have these challenges. I can grow from it and those around me can learn to be less judgemental too. Otherwise I can just wear a big sticker, 'Diabetic on insulin, I'm allowed to eat!' :-)

Be warned of inflated fnb device prices!

I know that it's been a while since I've blogged anything but work and motherhood are keeping me busy :-) since I've gotten my Google nexus tablet it may just make me a better blogger :-) I seriously love this device but don't purchase it via #fnb! I love my bank but this deal was not cost effective.

Given that I could've purchased it for R2900 cash and still received my banking free (on an unlimited option) but instead I've been switched to a mobile pricing option (always be careful of the small print) where it's going to cost R120 every month for bank fees. So I've asked for the early settlement value so that i can return to free banking and it's a whopping +-R4400!!!

So my options are to either settle and pay the inflated price or pay the monthly R120 banking fees plus R150 monthly for the device. Even if I get R50 back monthly if I spend R1500 on my gold credit card it still equates to R5280 over the 24 months!!!

Next time I'm rather purchasing devices cash! This deal was not a saving for me in any way. It would've been if I kept my free banking but this option is rather expensive, actually R2380 more than the cheapest cash price! Come to think of it, it's almost the price of 2 tablets cash price! Bad purchase decision with significant cost implications. Oh well, too late to cry over spilled milk now. So be warned FNB device options are not as attractive as you think plus don't forget to add in the R150 courier fee :(

Yes, this blog has absolutely nothing to do with type 1 diabetes but maybe I can save someone else some money that can be better used for sensors or a pump upgrade :-)

Breast feeding and type 1 diabetes

I discussed breast feeding with Prof Bonnici before I was even pregnant. He advised that I breast feed exclusively for 6 months because even though it's not proven to be more effective, it wouldn't hurt doing it anyway. So I took 6 months off work to do just that and had light (or something) put on my nipples to harden them so that they wouldn't hurt. I also used some nipple cream to assist, if you have it available then why not :)

My blood sugar went low after I started breast feeding and I went hypo quite often. So to prevent this I had to snack or drink juice before and during feeding. Granted I should have done this all the time but when your child wants to drink, it's tough prioritising yourself!

My daughter has just turned 1 and I still breast feed. I figure that if the recommended age of breast feeding is until 2, I should do it for as long as possible. Granted, it's not always the easiest. My daughter doesn't drink milk from a bottle because she wants it directly from the source! Sometimes I feel like a cow....but it's great for bonding so I get over the cow feeling very quickly. I do however make sure that I sing that Old McDonald had a cow first lol

When I returned to work, I expressed for months but since my daughter didn't want to drink it from the bottle I used it for her cereal instead. She would drink rooibos tea and water while waiting for me to come from work and then it was 'nenni' time. Actually 'nenni' was her first word, so you can see her priorities lol

Now I had to learn to prioritise myself and my eating/drinking. This is easier said than done as your body releasing adrenaline when your baby cries so that you can get up and do something about it. However, having diabetes means that I have to fight against the urge to do that and eat first. I can't lie and say that this always happens or that it happens sometimes. Actually my instinct takes over most of the time. My husband is very concerned about this as he keeps reminding me that I can't take care of her if I'm hypo or in a coma! Yes, I know this logically but instinct wins over LOGIC! I have to learn to compromise and find middle ground though.....Also I have to learn that it's ok for her to cry for a few minutes while I go get some juice.

Breast feeding has multiple benefits, not only if your baby is at higher risk for diabetes. I find it easier and fed her wherever I went, with the help of a feeding bib. It was made by my mom in law but you can buy them at baby city. It's a cover so that you aren't exposed but you don't have to go find somewhere private. Plus it burns calories and I was back to my pre-pregnancy weight within a month :)

I'd advise all mothers, with diabetes and without, to breast feed. It's natural, contains all your baby needs and is excellent for bonding. My daughter is still a mommy's girl because of it and I'm enjoying it while it lasts :)

Labor and type 1 diabetes

I started 'spotting' (bleeding) on Wednesday morning. I called my gynae who wanted me to be admitted to hospital so that they could check. She found nothing wrong EXCEPT that I was showing mild contractions already so I was discharged on Thursday. Sr Anke, my nurse educator also came to check as my gynae wanted my endo there when I went into labor as she was not used to dealing with diabetics on an insulin pump.

So the day would finally be arriving! Hello nervousness, anxiety and EXCITEMENT :)

So after supper on  Friday evening, my husband and I went out for supper, I felt slight cramps. I actually didn't really know that I was in labor because my water never broke and it sure as heck didn't look like what it did on TV! So I thought, Braxton Higgs - WRONG!

Friday night the pains got more intense but my husband slept through a lot of my contractions. I actually ended up pinching him awake. He did call the hospital though to find out if they could prescribe me anything for pain but they said that I could be in labor and that I should come in. At that point I didn't want to be a big baby and go in for nothing but shucks it was getting more and more painful as time progressed.



On Saturday morning I was almost crying with the pain. A builder was coming to complete the wall but I literally stood across the road and told my husband to take me to hospital 'NOW!'. Forget the darn builder!! When I got to hospital I was still bleeding and they were going to check to see if I was dilated. Hello PAIN! I'm sure that not all woman experience pain then but shucks I could have passed up that experience. I heard the nurse tell they gynae on duty that I was in pain but this was probably just due to me being very anxious and afraid - oh hell YES!

When she could eventually finish the examination I was 3cm dilated. Then the question 'would I like an epidural?'. Did they even have to ask me that - Of course! BUT all the anaesthetist were busy so they gave me an epidural injection while I waited. Thank goodness for Dr. Lee who came to administer the epidural and did such a great job that it was less painful than my drip.

My gynae came in at noon and after another exam told that it would be another 6 hours. Yes, 6 hours! My epidural worked so well that I felt absolutely nothing but I could still feel my feet (my friend couldn't feel hers). However, it seemed to work too well so it got turned off and I got oxytocine to make my contractions stronger because I needed to push harder. I really didn't know that pushing on demand like I was constipated would be so tough lol I reduced my basal insulin so that I wouldn't complicate the process by going hypo.

I had to stop pushing because the umbilical cord was around our daughters neck. I heard that she had lots of hair (not unexpected :) but her heart beat and my temperature were rising. My gynae thought that I could push her out but gave me some help via suction when this happed. At 19:09 our beautiful daughter was born :D

I got to hold her while my husband did the iqaama and athaan (religious - call to prayer) in her ears. Then I got to nurse her as well. She latched on nicely and the family was outside waiting to see her but I was busy puking my guts out (downside of epidural). Hence the first pic they saw were of her tiny feet :)

They eventually got to see her when my husband took her out to get tested for diabetes and all the other checks. I was told that she was fine and had an APGAR score of 9, also normal blood glucose levels  :)

HELLO MOTHERHOOD :)

3rd trimester with type 1 diabetes

I've learnt that even though I could have expected my insulin resistance to improve, it did not really happen for me. So I injected well into my 3rd trimester because I was still somewhat insulin resistant.



Source: http://www.pfizer4life.com/en/MomsToBe/YouAndYourBaby/ThirdTrimester.aspx

I had all the foetal assessments done and was happy to learn that our baby didn't have anything I needed to worry about. Oh, I didn't have the test done to check whether the baby would be at risk of down syndrome. My view is that I would not have ended my pregnancy in that case anyway so why bother taking the test.

My gynae was a tiny bit concerned about the weight of my our baby though. She was growing at a tremendous speed and there was a risk that I would not have been able to give natural birth. I was told at the foetal assessment that I was most likely to be induced at 38 weeks to prevent the baby from growing too large at full term.

However, the risk with induction is that there is also an increased risk of a c-section. So I had to brace myself for the fact that I could in all likelihood have a c-section even though I would have preferred a natural birth (with epidural of course. I'm not that into pain lol).

At my 37 week scan our baby was 3.8kg (+-300 grams). I was scheduled to come in for an induction the next week. However, my gynae warned that kids have their own schedules and that I could go into labour before that date. She also said that if our baby was more than 4kg that I would be schedule for a c-section and not induced. There was a risk that the shoulders would get stuck and we were not willing to take that risk.

The assessment also showed that there was a 90% chance that we were having a girl :) YIPPEEE pink! Almost time for labor - scary!!