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Saturday
Aug292015

Update on the gestational diabetes: it's harder than I thought

Everyone keeps saying, "At least it's only a short amount of time!" and everything I read says managing gestational diabetes is really not that hard. But so far I've found it frustrating and overwhelming, and while 10 weeks is short in the big picture, right now it feels like a lifetime.

I admit, I've had a hard few weeks outside of the GD, and that has made it difficult to process everything involved with this diagnosis. My job has a busy season, and it has a few weeks in particular that are painfully busy, and one of those weeks is what I call "hell week." Hell week happened to be this past week. It's a tough week no matter the circumstances, but add in that I'm 30 weeks pregnant, and that I'm still figuring out how to live with GD, it was mentally, emotionally and physically draining. I had several break downs. My brain stopped working. Someone would ask me a simple question and I'd just stare at them like they were speaking a foreign language. 

It was bad.

And in the middle of all that, I ended up having three separate pregnancy-related appointments, I had to start testing my blood sugar four times a day, and I had to try to navigate the ridiculousness that is our health care system.

This is long and boring, but I'm going to write it anyway because I think it'll be therapeutic for me. Keep in mind, all of this was happening during hell week, and I was completely devoid of the ability to mentally and emotionally process anything.

Saturday night Mike and I spent several hours planning out food for the week. Meal planning is a whole new ball game with diabetes. There's no "we had a rough day, let's just order pizza." Plus my work schedule was so crazy that I wasn't sure if/when I'd even have time to eat, even though regular food intake is important in managing diabetes. We had to literally write out what I'd eat each day: breakfast, snack, lunch, snack, dinner, snack, while taking into consideration that sometimes I'd be on the road with no fridge or microwave, or that I'd be leading a training all day, etc.

Monday and Tuesday were long and difficult, but I made it. Wednesday I had an appointment with a nurse educator at the diabetes center. She gave me my glucose meter, showed me how to use it, and told me all about the risks and possibilities with GD (many more frightening things than I realized!). So now on top of the stress of work and the stress of eating, I had to find time to test my blood sugar. 

I had heard that finger pricks are not a big deal, but I'm here to tell you, they suck. I've figured out a few tricks, but those first few days, I had anxiety all day long, knowing that every few hours I'd have to poke myself. Every time I ate, I'd get a pit in my stomach knowing in an hour I'd have to test. Here's what I learned though, for those that might need ideas:

  • I warm up my hands before testing. Sit on them, rub them together, run them under warm water. That brings the blood to the surface.
  • If possible, put the lancet on the lowest depth setting. The first time I tried this, I didn't get enough blood, got an error message on the meter, and had to start over, pricking myself again, which is something I never want to do! But later I learned how to draw blood up from the bottom of the finger to get a big enough drop to test. It's a less painful poke, and even though I still hate it, it makes a difference in my anxiety.
  • Use the sides of the pads of the fingers. I think that's pretty standard practice, but in you didn't know, the sides have fewer nerve endings. 
  • I don't use my pinkie or my thumb. My thumb has thicker skin I guess, it's hard to get blood without using a deeper setting. And the one time I used my pinkie, it bled like crazy. Turns out I had accidentally used the deepest lancet setting, but now my pinkie just seems too fragile and innocent to poke.

 Anyway, at my appointment with the nurse, she said I'd have to call my OB office for a prescription for testing supplies. Thursday morning I did that, and the nurse there told me that was wrong, someone at the diabetes center had to write the prescription. This nurse also told me I'd be able to fill the prescription at the hospital pharmacy. When I called the diabetes nurse, she said a) that's not true, my insurance will only allow me to fill the prescription through a certain mail order company, and b) I'd have to come back in to see a physician before I could get a prescription.

Am I the first person in my health care system to have GD? How can there be that much confusion about who writes the prescription, and who I need to see to get one, and how I get it filled?

My options were either, find a way to make an appointment that afternoon, or wait a week. I was going to be out of test strips by Friday afternoon, so I went that afternoon. During hell week, in case you forgot. The physician gave me 10 more test strips (that lasts two and a half days, by the way), and faxed my presciription to the mail order company, instructing me to call the next day to set up an account with them.

Friday morning, I called the mail order company and set up an account. I was told an account representative would call me that afternoon to gather more info and confirm my prescription. I didn't get a call, so on my way to my 30 week OB appointment that afternoon, I called them. I had to leave a message, and of course they called back while I was in my appointment. When I finally got ahold of someone, I was told, "They were mistaken in saying someone would call you today. We can't tell you when you might get a call. It depends on what priority you are."

Excuse me?

I'm going into the weekend with only enough test strips to get me through Sunday, and you can't tell me when I might get a call? Because it's not like the call is the last step. No. Then you have to fill my prescription and mail it to me. Best case, I'll have the supplies I need by mid-week. I asked her if she could give me any sense of timeline. Not a specific day, but does this typically take days? Weeks? Months? I have gestational diabetes, I'm on a time crunch here!

All I got was, "Ma'am, I can't tell you anything. There are a lot of people waiting, and it depends what priority you are." This is the company my insurance provide has decided to work with exclusively.

So I called the diabetes center to ask for guidance. I was told that if I could get there in 10 minutes (they were closing), I could get more sample test strips. I was at least 20 minutes away. My only other option was to have them call a prescription into Walgreens, which I could pay for out of pocket. My research tells me test strips are 50 cents to a dollar each, and because the mail order company couldn't tell me when I might get a call, I had no idea how many I'd need. This could get costly.

In the end, I'll probably just test until I run out of supplies, then wait. Fortunately my blood sugar levels have been good so far, and hopefully they stay that way even if I'm not able to test and know for sure. It has been a pain to eat this way so consistently, especially with so much else going on, but it seems to be working.

I was 30 weeks this past Wednesday. Ten more weeks to go. Approximately. 

(See, I feel a little better even though that was the most boring thing ever written!)

 

Tuesday
Aug182015

I've got gestational diabetes and I'm so hungry!

The bad news is I have gestational diabetes.

The good news is it's not something much worse.

When I failed my first glucose test, I wasn't surprised. I failed with Mo, too, but passed the longer test. I decided if I failed this time and was diagnosed with GD, it was fine. With my struggles to conceive and my past losses, and with knowing people close to me who have been through hell when it comes to pregnancy complications, diabetes seems like nothing. I'm thankful for that perspective.

However, let's be honest. It kinda sucks. When I first got the diagnosis, five days ago, my concerns were as follows:

  1. Great, now I'm at greater risk for diabetes later in life.
  2. Crap, I have to prick my finger four times a day (blood draws and shots in the arm I can handle, but finger pricks make me queasy).
  3. What the heck am I going to eat?

I wasn't terribly concerned about my health or the baby's during the pregnancy, I figured I can manage it with diet, and if not, insulin. But then I started researching what a diabetic diet looks like, and I realized this might be tougher than I thought.

I don't meet with the dietitian for another week and a half, and I'm sure I'll learn a lot more then, but my initial research has taught me that carbs hide EVERYWHERE! All I can picture now is a life eating nothing but carrot sticks and chicken breasts for the next few months. I know it's not as restrictive as that, and I know I'm allowed some carbs, especially when eaten with proteins. But so far, in my mostly uneducated attempts to eat in this new way, there's one resounding thing I know:

I'M STARVING!

LIKE, ALL THE TIME!

The problem is we don't have enough options in the house yet. I eat an acceptable lunch, and 30 minutes later I'm hungry. Yet I can't find a thing that seems appropriate and will fill me up. I munch a few carrots just to eat something, and 20 minutes later I'm hungry again. My appetite with this pregnancy has been greater than with Mo, and now I find myself looking around our kitchen as if it's a desert. There's nothing to eat.

I got really stressed about this over the weekend. I felt so unknowledgable and so annoyed and mostly SO hungry. Then I realized...

...some women don't even take their first glucose test until close to 29 weeks (I'll be 29 tomorrow)

...if I had been one of those women, I wouldn't even know yet that I had GD

...they obviously were in no hurry to schedule me for a consultation with the dietitian as it's set for over two weeks after the diagnosis (per their request, not mine)

...the nurse who gave me the diagnosis didn't give me any guidelines for eating, knowing I'd get those from the dietitian

So really, it's possible I wouldn't even know about this yet if I hadn't tested when I did, and nobody else seems terribly concerned about making huge changes immediately. So why am I driving myself crazy?

I decided to make as many good choices as possible, but not let myself be miserable with hunger. I'm counting on learning a lot from the dietitian and getting some concrete ideas about what to eat. If there's a problem once I start actually testing my blood sugar, then I'll fret.

For now, I'm having ice cream for dinner! 

Kidding.

But I'm not going to feel guilty about that bowl of cereal I had when I woke up hungry at 2:00 last night.

Tuesday
Aug112015

Mo update, two and a half

Mo is now 31 months old. No, I no longer measure her age in months, but I just did the math and that number seemed very high. The last week everyone has been commenting on how old she looks. Maybe it's a growth spurt or maybe her looks are changing ever-so-slightly to make her appear more mature than she did weeks ago. I love watching her grow, but it's sad at the same time. 

IMG_6821

 I said it before, but if I could freeze time right now, I would. Mo is in such a great stage. Now that she is fully potty trained (by the way, she's even more solid than last time I wrote about it. She hasn't had an accident in a long time, including poop, and she can even use the potty by herself. She has a little trouble pulling up her pants alone, but everything else she does without assistance. Sometimes she even takes herself to the bathroom without our even realizing it. Where's Mo? Oh, she's peeing on the potty.), I feel like this is the perfect age.

I'm sure there are huge benefits in the ages to come, and I do miss many things about the baby stage, but right now she's old enough to be independent - she can communicate like an adult, she can do most things for herself, she can entertain herself - yet young enough to still be unjaded. She is full of love and life. I'm not just saying that because she's a kid and kids are supposed to be full of love and life. She really is bursting with excitement for life. I'd say she's happy 95% of the time, and when she cries it's almost comical because it's so out of character. She's a toddler, so she's still learning about sharing and other manners, but most of the time she is very polite. And with a little prompting, she always does the right thing. "Mo, can you share that toy with your friend?" Of course she can. She's really great about saying thank you without prompting, and much of the time she asks for things politely (though I do have to remind her sometimes to "ask a question" instead of commanding things).

IMG_7281

Mo pool

I know I sound braggy, but I fully recognize that her behavior and personality are only partially due to my parenting. Mostly, we just hit the kid jackpot. Which means Baby Boy is probably going to be a hellion!

Speaking of Baby Boy, Mo has decided his name is Tennis. Every time someone asks what we should name him, that's her answer. She still likes to say hi to him and will pull up my shirt to give him a kiss. But I'm starting to think that to her "baby brother" is actually my belly button. She directs her affections there, and she's even tried to feed baby brother a doll's bottle by sticking it in my belly button. 

The other day, completely out of the blue while we were in the car, Mo said, "I will hold my baby brother in my arms. I will give my baby brother a hug. I will bring baby brother a paci when he cries. I will put baby brother in his crib then lay by him." My heart, it can't handle that much cute!

Tuesday
Aug042015

An update, 27 weeks

Tomorrow I will be 27 weeks pregnant. Some people say this pregnancy is flying by, but for me it has been quite slow. Not because I'm uncomfortable, but because I spent most of the first trimester unable to really connect with this pregnancy for fear of losing it. But I guess the days have been long and the weeks have been short because suddenly I'm entering the third trimester. I've been sad about how much it feels like this pregnancy is slipping away without the fanfare it deserves, but I just can't get myself to nonchalantly celebrate.

I think after my struggles to conceive the first time, and then my first loss, a part of me naively thoughts, "OK, well the shitty part is over with now." I knew bad things could happen at any moment, but I compartmentalized those feelings and let myself enjoy being pregnant with a healthy baby. But then I had another miscarriage after Mo, and I can no longer compartmentalize the heartbreak and the dread of possibly more heartbreak. 

Every day I try to stop and focus on this pregnancy, cherish is, acknowledge it. But in the big picture, it's just not the same as it was with Mo despite how I try. 

Anyway, I read some blog posts from around this time in my first full-term pregnancy for inspiration about what I could share and celebrate. So here's a little update at Week 27.

ENERGY

I thought it was supposed to come back in the second trimester, but it never really did. I've been physically, mentally, and emotionally drained the whole time. I did sleep pretty good during my second trimester, but now I seem to be heading back into poor sleep mode, which doesn't help. I did take a four day weekend this past weekend and went to the lake to try to relax a bit. It was a fun weekend, but I wouldn't call it relaxing. I don't think much is with a toddler.

BELLY

I think my belly is bigger at this stage than last time, but oddly, I still have this idea that most people can't really tell I'm pregnant. I did get a couple comments from strangers recently, which I know are not popular with some people, but I love them. I'm pregnant and proud, and if you can tell, all the better.

This was me at 27 weeks last time:

This is me at 25 weeks this time (the most recent pic I have available):

IMG_6816

GLUCOSE TEST

I failed my first glucose test. This happened last time, too, but I only failed by 3 points. This time is was 19 points (I scored 149). I'll have to do the second, longer, test again, which is fine because I know it's just long, not difficult. I do hope it comes back fine. While gestational diabetes is minor on the scale of bad things that can happen during pregnancy, I'd still prefer to not worry about it!

NURSERY

Yes, I am putting together a nursery for the baby. It's a very therapeutic process for me, and it helps me connect more with this baby. We could easily put up some basic furniture and throw some diapers in there and call it good, but I enjoy the process of putting together a space specifically for this new little person. He will probably sleep with me for the first month or two, like Mo did, but I'd still prefer to finish his room before he's born. I'll do a separate post soon about the nursery, but looking back at my posts from last pregnancy, I think I'm further along in the process than I was then!

DOULA

We will not be hiring a doula this time. I was so thankful to have one last time, but the real benefit came from the work we did with her pre-labor. She helped us feel informed and empowered, and we'll take all of that with us into this delivery, as well. But in truth, I hardly noticed her during labor and delivery. I was so out of my mind with pain that I barely registered she was there. While I hope this labor isn't quite as painful (I had 19 hours of back labor and contractions right on top of each other from the start, so it is entirely possibly this labor will be more manageable) and that I'm more aware of my surroundings, I decided I am well-equipped to make informed decisions and do everything I can to have the type of birth I wish for, without the aid of a doula.

DAYCARE

As usual, daycare decisions are stressful. It's a long, complicated story that I'll spare you, but after many ups and downs and changes and facts and figures and who knows what else, it looks like Mo will start attending her current daycare full-time (she currently goes 3 days a week and stays with family 2 days a week) next month, and the baby will start there full-time after my maternity leave. It's not exactly what we had hoped for at first, but given lots of complex circumstances, it really is the best solution for them and us.

NAMES

This, of course, is everyone's favorite question. Unless you're one of few select people though, I just lie and say we have no ideas because I'm confident we won't decide for sure until he is born, and I don't want anyone to falsely lock into a name. But the truth is we do have a few ideas. We haven't talked about it as much as you'd expect, but we have a list about about 12-15 name contenders, and we eliminate a couple every time it comes up. However, I keep adding name ideas, so we're not actually making much progress. Hopefully we can get it down to 2-3 names before going to the hospital.

MATERNITY LEAVE

With Mo, I only had 6 weeks off. It was paid in full, which was great, but it was not nearly long enough. Plus, I interviewed for a job the day after my due date, accepted the job a week after Mo was born, and started the new job two weeks after returning to my old job. So it was a lot to take in while still full of post-pregnancy hormones. This time I will have 12 weeks off, at least half of which will be unpaid. I'm grateful for the additional time, but don't understand how the US is so backwards when it comes to maternity leave.

Mike only took a week last time, and that was not enough. Unfortunately, this time he has no PTO and no paternity leave, so any time he takes will be unpaid. We're trying to save enough for him to take 2 weeks off, but I'm not sure it'll happen.

ACHES AND PAINS

I remember toward the end of my pregnancy, I had to start seeing a chiropractor because Mo's butt or feet kept dislocating my rib, but I don't remember having that discomfort this early on. Turns out my memory is bad. My Week 28 update from last time reveals that I had a "foot in my rib" by then already, and that is the case again this time. Plus my entire pelvic region hurts so bad that it's hard to move sometimes. I think I might need to see a chiropractor soon. Other than my pelvis and ribs, I feel pretty good though!

Sunday
Jul262015

Our potty training story

This topic will appeal to maybe one of my ten readers, but I'm putting it out there because potty training can be frustrating, and when we were in the trenches, I wished there were more personal accounts and fewer bits of scientific bull shit. Here is what worked for us.

Background

Mo is a girl. She is now about 98.7% potty trained at 2.5 years old. We were not in a hurry to potty train before now because we are not bothered by diapers and neither was she. But with a baby due in early November, we wanted bathroom habits to be solidified in advance, not only so we would only have to change one person's diapers, but also so there was less liklihood of regression in this area when a baby shows up to stay.

Pre-training: Totally Casual

Before she was two, we introduced Mo to the toilet. We had no expectations, we just wanted to familiarize her with the environment and the vocabulary. We let her sit on te toilet sporadically, paying no attention to patterns and possible signs that she had to go, we just sat her there when the mood struck us. Sometimes she'd want to hop off after 20 seconds, sometimes she was content to sit and read for long periods of time. We put no pressure on how long she stayed or what happened while she was there.

However, after many months of this, she still had not produced anything on the toilet. I thought for sure with so many cumulative hours there, something would accidentally come out and we could cheer and celebrate and start to instill the idea that this is what is supposed to happen here.

But nothing ever happened, and so there was nothing to point to and celebrate. I began to think we'd never make any progress because there's no way to instill a habit when you can't get it to happen in the first place. 

Plus, none of the "tricks" we heard about were working. We tried keeping her naked for periods of time, but she had no shame about peeing on the floor. We tried just undies, just pants, undies and pants. Wet bottoms did not bother her a bit. She'd walk around, feet wide, and go about her day. She just wasn't ready yet.

Phase One: Let's Do This...Sort Of

We decided we wanted to try the weekend approach, wherein you do nothing but potty train for 2-3 days. (It's a thing, google it for details on how to make it work. Our approach is detailed in Phase Two.) We picked a weekend where we had nothing going on, and we kept it that way. We wrote Potty Training! on the calendar and stuck to it. But for a few weeks leading up to that weekend, we got a little more serious about familiarizing Mo with toilet-related stuff.

We found a potty training sticker chart in a book we happened to have, so we made a big deal about how peeing in the potty earns you a sticker. And a candy! We bought plain M&M's and used those as rewards, as well. A sticker and a candy when you pee in the potty. 

We started to put her on the toilet more regularly, hoping to actually catch her when she had to pee. We both work full-time though, and we weren't ready to involve daycare just yet, so we only did this in the evenings and on weekends for the first couple weeks.

It didn't go well at first, it just wasn't clicking for her. She didn't accidentally pee on the toilet and didn't grasp what we meant by "pee on the potty." We put her in pull-ups in between and so she still felt totally safe to pee in her pants.

Finally, one evening, she peed in the toilet! We made a huge deal about it, making the sticker and candy into a big ceremony, talking about it for hours. She was really into the stickers and candy, so they were great motivation, and the sticker chart was a good visual about the progress we were making. And a few weeks later, she was earning far more stickers than the early days. We even told daycare (and Grandma, who watches her twice a week right now) what was going on, and she had some success with them too.

Toilet Seat v. Potty Chair

Let me pause here to say that I tried, early on, to avoid a potty chair. She was not afraid of the toilet, and she even liked to sit on her potty seat (the ring that goes on the toilet seat), so a potty chair felt like an unnecessary regression. We pee and poop in the bathroom on a toilet, so we may as well train to that from the start. 

But then one day I was digging through some stuff in our basement and found a potty chair my sister had given to us, and I thought, what the heck. Mo loved it of course, and it turned out to be really helpful in potty training. When she was just learning, it was great that we didn't have to travel far to the toilet (we primarily kept it in our living room), that she could sit on it with very little effort, and that we could take it anywhere we wanted, including outside.

I didn't find itto be as gross as I anticipated, and I'm a potty chair convert

Phase Two: The Weekend Approach

When the pre-determined weekend arrived, we did nothing else all weekend. We woke up Saturday morning, stripped Mo naked, and told her we were going to use the toilet from now on. We left her in the nude the whole first day, except for diapers for naps and bedtimes. We gave her lots of juice so she'd drink more than normal, and therefore pee more than normal. And then we put her on the toilet all the time. About every 30-60 minutes. And holy crap, she peed! In the toilet! 

The first day was incredibly successful. She earned 13 stickers that day, including one for a poop, which was a total fluke. Mo had pooped on the toilet only twice before, both times when she was home with Grandma, so this was a first for us. After such a great day, we thought we had this in the bag, but it proved to drag out longer than we anticipated, as you'll see later.

Mo potty chart

This is the only picture I have of the potty chart. Day One of the Weekend Approach is the bottom line (S for Saturday) of Week 4. We used the free potty chart the first two weeks, then I made this.

The second day, Sunday, was equally successful as the first. We put her in pants without underwear to start, because the pee would run down her legs more that way, hopefully making her uncomfortable enough to realize her mistake. We didn't give her as much juice, so she didn't pee as often, but she mostly did it in the toilet or potty chair. There were accidents, too, but very few that weekend. By the end of the day she was in underwear and pants, and still doing great.

I had taken Monday off to give us a third day to instill the habit, but she was doing so well, I decided to see how she did at daycare. She did excellent her first day at daycare, even pooped in the toilet. But turns out that was a fluke. Poop ended up being the most difficult part of the whole process.

Phase Three: Almost There

The big weekend happened in mid-June. It's now the end of July. Until a week or two ago, Mo still needed frequent reminders to pee. We'd ask "Do you have to go potty?" and she'd almost always say no, but then we'd make her try and sure enough, she'd pee. Now she mostly initiates using the bathroom on her own. We remind her at key times - before leaving the house, before naps and bedtimes, if we notice it's been awhile or she's doing the potty dance - but more often, she says "I have to pee!" and off she goes.

We still use the potty chair, and she can get on and off that by herself. If she chooses to use the big toilet, which she can now do without the aid of the potty seat, we help her. With a stool she can get on and off herself, but it takes longer and could more easily lead to accidents. 

She still has the occasional accident, but it's at odd times. The other day we were out at our pool, and she was standing nearby, outside the pool, and suddenly said, "I'm peeing." Sure enough, it was streaming down her leg. At daycare last week, she had an accident because she was busy playing in the sandbox and didn't tell anyone she had to pee until it was too late. But I'd say she's 99% potty trained for pee. Poop? Well...

The Poop Problem

Poop training Mo has been the most frustrating thing I've done as a parent. That's not saying much since Mo is a pretty easy kid, but the poop business really tested me for awhile.

She was just not getting it. At all. And nothing I read anywhere was helpful. Here's what I kept reading:

Your kid doesn't poop in the toilet because s/he is scared to. I don't think that was true for Mo. She never expressed any fear or discomfort with the idea. In fact, she seemed totally down with it. Yet, she kept pooping her pants.

Look for signs that your child has to poop before it happens. We called Mo a Stealth Pooper. You didn't even know it was happening until it was over. She didn't hide in corners, she didn't grunt or make faces. In fact, one time she got off the toilet after peeing, immediately ran around the house for less than two minutes, then told me she had pooped. She had pooped mid-run!

Your kid may be holding it in on purpose. Nope, not at all. It was coming out, just not in the right place.

I concluded that Mo truly didn't know it was happening until it was happening. She didn't recognize the sensation until she was mid-process. One weekend, I hit my limit. She had had poop accidents all week, then didn't poop at all Friday. So that evening and all day Saturday, I watched her like a hawk. I put all my energy into encouraging her, reminding her, asking her, taking her to the toilet just in case. It was exhausting. She didn't poop Saturday either, so I knew it was going to happen sometime Sunday. 

We were in the garage after watering the plants when she said, "I have to poop!" I swooped her up and had her inside faster than I knew was possible. She was wearing a skirt and no underwear (on purpose because I knew we'd need easy access), so I plopped her on the toilet and waited. Nothing happened.

Finally I got her off the toilet and noticed there was a need to wipe her clean. But there was no poop in the toilet. What the heck? I retraced our steps and found the culprit five feet from the toilet, on the kitchen floor. She had pooped mid-air as I carried her in. 

I lost my shit (pun intended). I had hit my limit and I started crying. Bawling. Poor Mo, she had no idea what was happening. Through tears, I told her how gross it is to poop on the floor, and how big girls poop on the toilet. Mike came inside at that moment, and I told him I needed him to take over, and I went to my bed and cried for 20 minutes. It was not my finest parenting moment. Mo still mentions the time she pooped on the floor and mama cried. What if that's the first memory that imprinted on her brain? It's embarrassing for me that I got so upset with her when it clearly was not her fault, but like I said: most challenging thing I've done as a parent so far.

It continued like this for awhile. I almost called her doctor to ask if maybe she wasn't anatomically ready to control her bowels, and should we stop trying for awhile? I didn't want to revert back to diapers to catch the occassional, and unpredictable, poop because she was a pro at peeing, but I could not clean up anymore poop! I didn't end up calling, but here are a few things we tried:

Making poop something funny. We joked about how poop didn't go in the fridge or the car or on her head or in her toy box or in her undies. It goes in the toilet! She thought this was hilarious and loved to play along, but she still pooped her pants.

Sing the poop song and read poop books and watch poop videos. There are a lot of resources our there for potty training kids and parents, and it was great to keep it at the forefront of her mind. But she still pooped her pants.

Rewarding her for successes. The sticker/candy system was great for peeing, but it did not work for pooping, so we upped our game. I bought a bunch of dollar store crap and showed her the prizes, telling her she'd get a present every time she pooped in the potty. She loved those gifts the few times she earned one - she still tells people that she got these things because she pooped in the potty - but she still pooped in her pants more than not.

Making her clean herself up. This kind of worked. When she'd have an accident, instead of cleaning it up quickly and moving on, I'd get her involved. It ultimately made for a bigger mess, but it showed her just how gross it is to poop anywhere but the toilet. The first time I did this, she was so pleasant about helping, but every time she tried to talk, she gagged. It was hilarious, I'll admit. I still laugh out loud to myself every time I remember her innocently gagging as she tried to ask me to wipe off her hand. The next time she tried to refuse to help, but I told her she made the mess, she had to help clean it. We sat at a stalemate for 15 minutes before she gave in and did it. I think this actually helped her realize that this was no joke, poop is gross, but less gross if it goes in the toilet. She still pooped her pants pretty often though.

In the end, I don't know what finally clicked. I guess it was just enough time and practice, but now she poops in the toilet far more often than not. Sometimes she has several false alarms before the real thing, but I'd rather her sit on the toilet to toot than poop in her pants. I wish I had could say what magic trick finally helped her figure this out because I never did read anything that helped us, but there isn't just one thing that worked. It was just time, practice, some tears, and a lot of accidents.

And Now

Like I said, she's about 98.7% potty trained. The accidents are truly accidents, mostly when she is too busy to listen to the signals. We still put her in diapers at naptime - though she often wakes up dry - and bedtime, where she still wakes up wet. We aren't making any effort at this point to drop the diapers while sleeping. She's still in a crib, and I figure until she can get out of bed and to the bathroom if she needs to go, we'll keep her in diapers to sleep.

We've taken a few longer car rides since she's been trained, and we've put her in a pull up for these. We still treat it like underwear, stopping frequently for potty breaks and encouraging her to tell us if she has to pee rather than just let it go. For the most part, she gets to the destination dry, but it is a good backup in case we're not able to stop. 

Not everybody is as confident as us. We consider her potty trained and make a point to make frequent bathroom stops if we're out and about, but others who watch her are more hesitant. When her grandparents watch her, for instance, they will put her in a pull up if they leave the house for more than 30 minutes. I don't blame them, it's intimidating to think about dealing with an accident out in the world, and it's tiring to have to visit the bathroom before you leave the house, when you get to your destination, before you leave your destination, etc. 

All in all, it took about two months to get from never-ever-peed-or-pooped-in-the-toilet to almost completely potty trained. Some kids do it faster, some take a lot longer.

My biggest tip is wait until you think they're really ready. If you start too early, it will take longer to click and to eliminate accidents. We decided we'd rather change diapers for a few more months than start too early and deal with wet clothes on a regular basis. 

My second biggest tip is chill the eff out. Stick with it and be consistent, but don't expect results over night just because someone else says they potty trained their 18 month old in one day. Ignore them and go at the pace right for your child. It can be really frustrating because it takes a lot of your time and energy, only for them to pee their pants in the cart at the grocery store (happened to us!). But if you set realistic standards and chill out a bit, it will happen. I can't believe how different things are from less than two months ago, and in the big picture, it was no time at all.