The longest day ever...

OK, so it could have been worse I suppose, I could have been stuck with my 6th period class

...but the power went out at school a little before 11:00, the kids who were in the cafeteria for first lunch (I take second lunch) immediately went crazy and started a food fight. Everyone was evacuated from the cafeteria and noone else was allowed to go to the cafeteria. Kids were starving, teachers were starving, and finally at 12:30 they let us go for second lunch (usually it is at 11:10). Then back to the SAME class...other classes went to third lunch and returned to the SAME class around 1:40...we stayed in the SAME class from 10:40-2:00....

It was a terrible, no good, very bad day. LOL

And, no, still no power...

Insulin averted

I was once again able to escape the insulin, but not forever.

Saw the perinatologist today and she decided that because my numbers were more often good than bad, we would wait until they were more often bad than good to add insulin. She did, however, tell me what I had already assumed, and that is that I would definitely have to use insulin at some point during my pregnancy.

At one point she asked something about my OB and I told her that I had switched OBs and was quite reassured when she told me that new OB was very good.

Apparently, I had a blood test for my thyroid a couple weeks ago, and it was low, so she ordered up a repeat as well as I got my quad screen done. Unfortunately, I won't have results until I go back in to for my big ultrasound which is in 3 weeks...I almost asked if I could do it at my HMO so I could get results online, but it sounded like if there were anything really concerning that the genetic counselor calls and offers an amnio...not a phone call I hope to receive.

She didn't check my blood pressure (much to my surprise) but the nurse weighed me since it was apparently needed for one of my blood tests. I mentioned that I was a bit concerned that I seem to continue to lose weight each visit instead of gain weight. She mentioned that could be due to a thyroid problem, but she wasn't too worried. Don't get me wrong, I am always thrilled to lose weight, I just thought at this point I was supposed to be gaining 1/2 pound a week...

In all, I like the perinatologist (breath of fresh air compared to my OB problems) and it was overall a good visit.

On an absolutely unrelated note, the latest baffling search that brought someone to my site? "swimsuit deck plop" WTF??

And the OB saga continues...

So, Friday was a non-student day and we had meetings based on grade level. It so happened that my room was being used for one group, though it was not the group I was in.

When I came back to get my snack, a teacher handed me a note telling me that someone had called for me. It was the OB clinic. I called back and was told that the other female OB who I switched to had now reviewed my charts and didn't think she could give me the kind of care I needed because she only worked part time. (I didn't realize she was part time). Also, she told me that this female OB wanted to refer me to the university hospital for all of my care (much like my former OB did). I just don't get it since the things that make me high risk (high blood pressure and diabetes) are both well under control.

Of course, that was my only other female option, but I told the nurse I guess I could live with a man. She said she would ask around and find one of the male doctors who could take me.

Throughout the day, we continued to play phone tag and I finally got a hold of her when I got home. She had found a male OB who had reviewed my files, wasn't planning on shuffling me out to the university (in Seattle which is why I am quite opposed to it...if I was OK with going to Seattle, I would just go see my regular OB/GYN), and even had appointment spots for my next appointments in the afternoon. So, I am switched to him. I hope that this works out as I think my only other option at this point is Seattle...

I have also set up my appointment for the blood pressure clinic (which only happens at the university hospital in Seattle on Thursdays from 8-12) in two weeks. I hope that I pass whatever test they give me as it will determine how frequently I have to go back.

Live-in help?

So, I always assumed my parents would come up (or down..depending on where they are..in AZ or Canada) for a couple weeks, maybe even a month around the birth.

Tonight, I was chatting with a friend of mine who lives in my hometown. Since my mom retired this year after many, many years of teaching, she has been distributing some of her teaching supplies to my cousin and my friend who are also both teachers. Apparently, my mom called her over this week to pick up some more things, and my mom (who is always quite a chatterbox), told her that she was thinking she would stay with me until school got out and babysit...

Now, that isn't that much of a problem, and in fact, it would be a great blessing to not have to wake up a very very young baby to get him/her ready at 5:30am...but she hasn't said a thing to me...

Just today I was talking to someone at school and she was asking what I was planning to do about child care (she actually uses the woman I would love to get in with). I told her that I really hadn't decided yet, but it occured to me that I really do need to start looking and likely reserving a spot.

So, do I ask my mom about this? Do I just not make child care arrangements for May-June and assume she will be here?

The telling

So, I decided last week that I would tell administration about my pregnancy during my preconference meeting which was this morning. I was a bit nervous as I didn't know what to expect, but it was so uneventful!

Asst. principal: And I like to do an observation before Thanksgiving and another in the spring.

Me: Hmm. I won't be here from March-May because I am pregnant.

Asst. principal: Congratulations! No problem then, I will schedule yours in first.

And that was that! (aside from a brief comment from her at one point about whether I had considered coming back part time for that last month...not worth it for me. I would still have to pay day care, so either full time or on leave) LOL. But, it is a big relief that I have said *something* to administration now so that I don't have to worry about who knows at school.

I actually almost said something at lunch (after the conference) because I am very interested in using the same day care provider as a couple women who eat lunch with me and want to know if she has any openings, but I couldn't get up the courage. One telling a day is about all I can do, I think. LOL

YEAH!

I am a happy camper. I was able to get in with the other female OB at my current clinic. While I really hate conflict and usually try to avoid it, it just seemed that having appointments here where I live (as well as delivering here where I live) would make my life so much easier.

I don't know why I am so bent on a female OB, but I have only seen female doctors since I started choosing my own doctors, with the exception of an OB/GYN who took me in when mine was away and I had an emergency. I just feel more comfortable with a woman, although, I never really feel that comfortable with any doctor. (except maybe my current perinatologist...she was pretty cool).

In any case, I had to take an appointment during the day (meaning I have to miss half a day of school) with this new doctor since I was late booking, hopefully I will be able to book a bunch in advance after this and won't have to always miss work. The nurse was very nice, and over the course of our conversation I mentioned a few of the reasons why I was leaving the other doctor (they came up in our conversation...I wasn't just ranting), and she seemed very understanding.

This has made my day...I feel so relieved. In the meantime, I still haven't heard from the place I was referred to for the blood pressure clinic. The new nurse gave me the contact info so if they don't call tomorrow, I will call them (because I was supposed to go this week or next).

I gave a test to my second year students today, so I guess I should work on marking those so I am not really behind tomorrow when the first year's get their test.

Really quick OB update..

I am back from retreat and very tired, with much marking to get caught up on, and laundry to do, etc, so will keep this brief.

I called my current OB office and asked if I could change to the other female OB that accepts Group Health. She apparently is full for pregnancies in March, but the receptionist said she would ask her if she would be willing to take on one more patient. Of course, she also asked me why I wanted to change, and I just said "I am not happy with Dr. *****". Now, I suppose that means that even if the other female OB won't accept me, I have to change...and then I will have a whole new dilemma...stay where it is easy to get to appointments and the hospital but see a man, or go all the way into Seattle just to see a woman...

My appointments this week

On Monday, I met with the diabetes nurse. She taught me how to inject insulin, if it should come to that. She asked me, "do you want to try it now with saline?", and I just looked at her and said, "no. Does ANYONE want to stick themselves with a needle?". Of course, I did try and it took me three attempts before I could actually get myself to let the needle pierce my skin. It barely hurts...a gazillion times less than when I test my blood sugar. The weird thing is they like you to do it in your belly, and I know once the baby gets bigger, that is really going to freak me out. Other things we talked about were what to do if you are sick (my HMO actually supplies "sick kits" for diabetics with things like gatorade and other things...), getting a medical alert bracelet, and ketones (protein I think? found in urine...not a good thing apparently, means the body isn't getting enough nutrition) which I now have to test every morning. The nurse commented that she didn't think I needed insulin at night...so hopefully that will be the case. I also got results from my labs that I took on Saturday...and it was all great news, my A1C was fantastic (5.3!) and my cholesterol was down/up in the right places, all within normal range.

On Wednesday, I met with the nutritionist. It was a different lady than I met in January. We went over meal by meal what I have been eating, looking at my blood sugar results one hour after eating them and discussed changes. The nurse had told me that my snacks were supposed to be bread and protein, and no fruit, however, the dietician decided since I had been eating fruit and my numbers were good, that I could continue having fruit for my snacks, which was reassuring (the thought of a half sandwich at 8:30 am makes me nauseous..LOL). In all she was pretty happy with what I was eating and my numbers, except for breakfast. She really wants me to add more protein into breakfast. This is never a problem on the weekends when I always have eggs, but during the school week I just never feel like getting up any earlier to take the time to cook anything...cereal is so fast, filling (for me), and delicious. I am trying though, and had toast with peanut butter on Thursday and noticed that my numbers after breakfast were much MUCH better...I forgot (yes, I really did...I am so tired in the mornings and cereal is just so automatic...) on Friday. She wants to follow-up with me, by phone, next Friday.

And, on Thursday I saw my OB. I have really come to realize that I don't think she is the right OB for me. The very first time I saw her, I remember asking her something (I wish I could remember what it was...) and I remember her response clear as day, "And what do you want ME to do about it?". When it just happened that one time, I figured she was having a bad day and let it go...but she continues to be curt and I just am very unhappy.

This week, I asked her about the letter I had received from my HMO on Monday that stated that my referral to see a specialist had been approved. It was unclear what specialist this was, whether it was the diabetes people that I cancelled last week or the perinatologist or someone else. When I asked her, she told me, "I don't know. I don't do paperwork." I told her, "but it came from you" and showed her her name at the top as the doctor referring me. Again, she told me, "I don't know. I don't do paperwork." Then I tried to explain why I was concerned, that it said it was only for three visits, and if this is the perinatologist, this just wouldn't do since they wanted to see me monthly. Again she told me, "I don't know. You will have to ask my staff." But her "staff" was not her real staff...her nurse has left this practice and in the meantime they have a temp (she actually told me so when she came in to take my blood pressure..which was wonderful, by the way!). She also told me that the perinatologist will have to deal with it (if indeed it was even for her!), which seems a little odd as usually the person you are referred to is not the one who assures you are covered...

The other thing that really bothered me about this appointment was my referral from the perinatologist. Last time I had seen her, I had told her everything that was said, but she didn't want to do anything until she had it in writing (as if I would lie!). So, she goes down the list of concerns, stating exactly what I had told her as detailed in the letter she had apparently just received. I suppose that is not the end of the world...but what really got to me was the diabetes stuff. So, she asks me about my blood sugar numbers, I show her my book, and she tells me, "well, let's wait and see what the perinatologist says." H-E-L-L-O!!! The perinatologist said TWO WEEKS AGO to start insulin at night. While I may not agree that it is necessary, the perinatologist HAS already spoken. So now I am waiting another week and a half until I see her (the peri). I really hope that these FOUR WEEKS from the time she told me to start insulin have not caused damage to my baby...

One thing I learned that I don't think I was told at my appointment with the perinatologist last time, is that I need to have some special consultation (in Seattle) at the university hospital between weeks 14-16. I am in week 14, and the temp nurse was supposed to set up that appointment, today. I have not heard from her...

Finally, there was one very wonderful and positive thing about my appointment. I got to hear the heartbeat for the first time!! :) At first I was getting worried as she didn't find it right away, but then just as I was saying something she said, "I think we were just kicked!" how cool! And then soon after she found the heartbeat. A beautiful 165 bpm. :)

I am taking this weekend (well, tomorrow really since I leave for leadership retreat with the kids Sunday morning until Monday afternoon) to figure out what to do about my OB. I feel strange changing, but on the other hand, I am just not happy. My choices are: stay with her and grin and bear it..it is only another 6 months, change to another OB at that same clinic, go to an OB in Seattle (30-40 minutes away on a GOOD traffic day, an hour back in the afternoon). If you made it this far (I know it is a long post), do you have any thoughts?

Resolved

Yes, all of the problems with the HMO and the referral have thankfully been resolved.

On Friday, the OB nurse got a hold of my PCP (primary care physician's nurse) and together they got me urgent referrals for the same services there at my HMO. So, on Monday, I have the appointment with the nurse will show me how to do insulin, and on Wednedays, I have the appointment with the dietician.

Since I really needed to see the dietician earlier rather than later (because I was supposed to try and see if we could fix things with diet before THursday), the nurse I spoke with on Friday (for almost an hour on the phone...she was so nice) gave me the basics. Basically, I have been put on a gestational diabetes diet. It sucks. It has me eating double what I would eat for breakfast on a normal day: 2 breads, 2 fats, 2 meats, 1 milk. Then when we get to lunch, it gives me less than what I would usually eat, or at least in a totally different variety so that I haven't quite figured out what to eat exactly. I ALWAYS have a sandwich, but I only get one bread at lunch...Supper is more and less of what I would usually eat. More variety, a gazillion times less carbs (1 bread exchange!!!!!!! that means one piece of bread, or 1/2 cup of rice or 1/2 cup of noodles). I also have to have three snacks a day. Not an issue so much as trying to figure out what exactly to eat for those snacks. Morning snack, for example, is to be one bread and one meat, usually, I would have just had a piece of fruit...so this is very different. I suppose this is why I will see the dietician...but I foresee a lot of cooking, and preparing, in my future.

The first week of school is over. As usual, my class sizes are changing daily, but I think they range now from 25-31. Hard to say what my kids are like right now...they are always good these first few weeks. I did, however, give out two detentions on Friday, but that was just for constant chatter. I have two second year classes this year which is nice because I know most of the kids already from last year. Unfortunately, that also means I have to courses to plan for and while I have taught second year before, this is the first time I have taught second year since we revamped our program and actually use the second year book for the second year kids (what a novel idea, huh?).

I still have not told administration that I am pregnant, but think I might do that at my pre-observation conference which is next week. It's not that they need to know right now, or that I am anywhere near showing (still wearing my same clothes, and actually lost a pound last week, I think!), but slowly there are teachers who know (a couple more may know since I was so upset about the whole health care thing at lunch and was telling one colleague and blurted out "not acceptable, you're pregnant"...not sure who all heard that LOL) and I really don't want them to hear it from someone else first. Besides, then I won't have to worry about what I say or where. :)

This next week is a busy one: Diabetic nurse Monday immediately after school, Wednesday dietician (had to reschedule my toe surgery as this was the only appointment with the dietician), and Thursday appointment with the OB also immediately after school. Then, I may really be off my rocker, as I said that yes I would go to leadership retreat on Sunday-Monday seeing as I am the class advisor. This could prove to be very interesting if indeed I begin insulin on Thursday....LOL, and regardless, it will mean I have no control over what (or when) I eat for two whole days.

Whew..that was a long update. I really need to pay better attention to the blog these days...I will try. :)

Breakdown

I had a mini-breakdown this evening. I received a phone call from the Hospital where I was supposed to have my appointment with the diabetes education people on Monday. They wanted me to call and be sure that my appointment would be covered by my insurance because they didn't think it would be. So, I called my HMO and the lady on the phone (with an absolutely annoyingly upbeat lilt-y voice) basically told me that it was unlikely that it would be covered (because they offer the same thing in Seattle) but that I could ask my Primary Care Physician (PCP) to put in a request for it to be covered which would take 3-5 days if marked "urgent/emergency" or 5-7 days if not.

Of course, this would just not do. The plan was for me to go to this appointment on Monday, incorporate what they tell me and then on Thursday I have the appointment with the OB where she will then decide whether or not to start me on insulin.

I called the lady back at the hospital, asked how much it would cost if I paid out of pocket ($650) and then I said I had to cancel the appointment.

I called my OB's office and left a message for them to call me back.

I got online and I emailed my PCP but really didn't even know what I wanted her to do.

It was at this point, that I decided to check that my diabetic test strips had been approved to send me more for my one month copay since I now am testing 6 times a day and the perinatologist was going to call. As I am looking at the pharmacy online, I see that it has not been changed, and worse yet, I start panicking because where it should say refills remaining, it says "OTC" and I have to pay full price for things that are over the counter....at about $85 a box and needing 3 boxes just for ONE month

By this point, I am getting rather hysterical. I frantically sent an email off to customer service (it is after 5 so there was no point calling again) asking if I now had to pay full price for my strips even though it says in my explanation of benefits book or whatever it is called that diabetic supplies are covered at the cost of a copay...I also emailed my PCP again this time to ask her about calling the pharmacy to a) increase my test strips each month and b) find out why I now had to pay full price.

Finally, the OB's office called back. As I am explaining the situation to the nurse, I can just feel and hear how I am panicking more every minute. She was very reassuring and told me that "this will just not do. You are pregnant" and that she would call my HMO tomorrow. Everything she said made sense. The whole reason it had never occured to me that it may not be covered is because when I asked about seeing this OB who is affiliated with my HMO but not at my HMO, they said it would be fine and everything OB/pregnancy related would be covered. Hopefully, the nurse is right and this should be covered and who knows, maybe she can reinstate my appointment on Monday.

I am calmer now. I am surprised that my doctor didn't respond to my email as she is usually very good at responding, and this time I felt like it was really important, much more than other emails that she has always responded to by the end of the day.

In other news, you haven't been hearing much from me because I am so exhausted with the beginning of school. I always find it so hard to readjust to getting up so darn early!

More appointments

I had my follow-up with the OB today. She said that the peri had faxed a note saying to continue my Metformin and to add insulin at night. My OB, however, decided to hold off on the insulin until after I see the diabetes educator person to see if a diet change will help...I hope that it is OK to wait and that it won't be hurting the baby. I don't think it will since what she is concerned about are my fasting blood sugars which seem OK to me (usually 100-102) but that they want them under 95 (used to be 90 so I am glad they changed that LOL).

Then, she tried to hear the heartbeat, but just kept getting my heartbeat. So, I had another internal ultrasound. I was so sad that the screen wasn't working so I never got to see ANYTHING, but she immediately said, "There is lots of movement, the head looks good and the heart looks good". She said she would print me a picture since I couldn't see the screen.........but the printer wasn't working either! I was so sad. But, she saved it and promised to mail it to me, hope she remembers!:) At one point she goes, "Looks like E.T. He's waving saying "hi mom!". Wish I could have seen it...

I go back in two weeks for the follow-up after my diabetes appointment (my diabetes appt is on the Monday, OB on the Thursday...is that really enough time to evaluate if there is a change?)

Then, this afternoon, I went to a regular doctor because I have been having pain in my toe for like a month. I thought it was an ingrown toenail, but couldn't get at it with my clippers or anything. Turns out it IS an ingrown toenail but so deep I have to have it surgically removed. So, that will happen between the diabetes appointment and the OB appointment...that will be one busy week of doctors! (Monday, Wed and Thursday!)

Everything else is good with me. I am happy to be back at work, even though it exhausts me. I haven't quite got my classroom ready and will be back in this weekend to finish getting ready. I am so near the second trimester already, doesn't that sound wonderful?? :)