Saturday, September 11, 2010

Follow up to Bloody Pee

I went to the doctor yesterday for my first visit since the second hospital episode with blood in my urine (hematuria). They checked all of the labs that had been run and everything appeared normal, so they weren't particularly concerned. While relieved that it's not something alarming to the doctors, I did feel a bit frustrated by the inconclusive nature of it all. They don't seem to think I need to do any follow-up at this juncture, but if it happens again, they do want me to go in for evaluation.

Port Ache

So far during the pregnancy, I've had no unusual port-related symptoms...until today. According to the doc's measurements, my "fundal height" (top of the uterus) is now three to four inches above my belly button. My port is located about six inches up from this from my belly button and two inches to the right.

I imagine that what's going on is my uterus is starting to push directly on my port or push on my guts (yes, that's a fancy medical term) that are then pushing on my port.

It doesn't really hurt - it's more of a dull ache, but it's enough to make me aware of my port's presence and location.

When I touch my port, it's a bit more tender than usual, but not super-sore.

It seems logical that this port ache is only going to intensify as the pregnancy proceeds.

I'm now officially in my third trimester...so not super long left to go!

Wednesday, September 1, 2010

Hip Pop

I've developed this weird thing where when I move in the night, my hips pop loudly. I feel the vibration in my pelvis, but it doesn't hurt at all...it's just kind of disconcerting.

Doc says it's perfectly normal and is a product of the relaxin hormone that is working to loosen up my muscles and joints in prep for baby's exit. Weird!

Blood Part Deux - With Food Poisoning to Boot! (British Pun Intended.)

So, the blood in my urine thing happened again. I had been feeling kind of achy in my lower abdomen all day, but charted it up to the fact that I'm pregnant and didn't think much about it. However, in the evening when I got home, I again noticed blood in my urine. Around that time, I also noticed that I didn't seem to be passing anywhere near as much urine as I should have been considering the amount of liquid I had been drinking.

I called the doc who encouraged me to go in to the hospital, although they had done nothing useful for me on the previous visit. I told her I'd have dinner and then bring myself in. She seemed satisfied enough with that. She also suggested that I have them catheterize me so that we could find out once and for all if the blood was coming from my bladder(which I insisted it was) or if it was vaginal bleeding (which they were pretty convinced it was).

I went into the "pregnancy ER" and they remembered me from last time. I got all checked in and eventually they got around to doing the catheterization. I don't think I've ever been catheterized before. It wasn't super fun, but it wasn't too horribly awful, either. The verdict? Blood in my urine. I resisted the urge to say, "I told you so!"

They took blood samples and made me hang out hooked up to the fetal monitor for an eternity. I guess they wanted to get 20 minutes straight of baby's heartbeat and movements on record, but baby kept moving out of range. Hours later, after I asked what was going on, the nurse explained this 20 minute thing to me - so I took it into my own hands (literally) as I wanted to get out of there and go home (it was now well past midnight). Every time baby moved out of range, I'd chase him with the monitor until I got a good solid heartbeat. This involved some pretty weird contortions to keep the monitor reading - but it was totally worth it because I did finally get released from the hospital around 2:30am.

Exhausted, dehydrated (they would only give me ice chips) and famished, I headed home. Once home, I fried two eggs, ate them, climbed in bed, kissed GeekBoy, and fell fast asleep.

At 6am, I woke up feeling horribly nauseous and proceeded to go to the bathroom and have a dry heaving fit. That was followed by a nice round of diarrhea. I won't continue with the lovely details, but in a nutshell, my entire day was spent yacking and pooping. I called the doc and he didn't think that my bloody urine episode and the gastroenteritis were related. At first he wanted me to come into the hospital, but when I protested (as they'd done nothing useful on the past two torturous visits) he agreed that I could stay home as long as I was able to hold liquids down by afternoon/evening.

Thank heavens things settled down by then and I was able to drink some tea without losing it. After that point, I worked hard to rehydrate and I woke up the next morning feeling achy and battered, but much better off.

During the food poisoning day, I was a bit confused what to do about insulin and blood sugars since I was unable to keep anything down and I'd heard that blood sugars can skyrocket when one is sick. I decided to skip the insulin (and avoid the possibility of a low that I couldn't address) and keep a close eye on my sugars. Surprisingly, all day, they stayed just over 100 which seemed perfectly reasonable to me.

As a side note, I bought the eggs the day before from underneath a sign stating that the store's eggs had NOT been part of the big salmonella egg recall. So who knows?!?

Saturday, August 21, 2010

It's called diabetes. Duh.

Went to the doc again last week for another checkup and follow-up ultrasound. Apparently, last time they didn't feel like they got an adequate look at the baby's heart due to his position so they wanted to scan again. Fine by me - I've got pretty good insurance coverage (thank heavens). Baby was still there doing his thing! His profile shot looked kind of weird to me (he had a bulbous looking nose) so I went online to look at what other 22 week ultrasounds look like. Can you say...exactly the same? It's weird how similar the scans are. In fact, I'm not sure I could tell the difference between some of them.

During the doctor part of the visit, the doc reviewed my blood sugar numbers from the past couple of weeks. My morning fasting numbers are still significantly higher than they should be despite a couple of increases in my nighttime insulin dosage and plenty of experimentation with my bedtime snack. Nothing (so far) seems to consistently work. I asked the doc if there are some people whose morning numbers are just always out of whack no matter what they do, thinking that I might fall into that category. He looked at me and said, "Yes." Feeling pleased that I wasn't the only one, he continued, "They're called diabetics."

Gee, doc. Thanks for the enlightenment.

Hellooo Lap Band!

Since my partial unfill a while back, I've pretty much been acting like I don't have a lap band. I've been able to eat whatever I want, drink with meals, not chew my food particularly well, sip soda, and all of those other things one is not supposed to be doing with a lap band. In fact, I had kind of forgotten what it was like to have a filled band.

Tonight at dinner, my band decided to remind me that it's still there. Geekboy and I were eating chicken, barley, and salad. A few bites into the chicken, I got that familiar tightness that conveyed "you'd better stop now, or else...". I paused, commented to Geekboy that the band was back, and proceeded to go into a hiccup fit (a common lap band experience). I got up from the table, walked around a bit, and after a couple of minutes, I felt the chicken pass. Wow - it was quite a surprise to suddenly again be lap-band-y. I returned to my meal, taking small bites and chewing well and finished without incident. I wonder if this is the beginning of the band getting tighter from the pregnancy progressing? As long as I can still eat and drink well, that might not be such a bad thing as I've been putting on the poundage a little faster than desired (though I'm really only up 11 pounds from my low point now that I'm 24 weeks along). Originally, my goal had been to gain no more than 15 pounds during the entire pregnancy, but I'm not longer convinced that the pregnancy weight gain is entirely under my control.

Wednesday, August 11, 2010

Sunday, Bloody Sunday...

Warning: this one may be gross.

This past Sunday, I got up, took care of my morning routine, had breakfast, and then headed out to run a ton of errands. I noticed that my lower abdomen was kind of achy in a not-too-bad-but-annoying-nonetheless menstrual crampy way, but I decided to ignore it and go on about my business. At my first stop, I went to the bathroom and noted that my pee looked oddly orange, but aside from the mental note, I didn't think much of it. I figured I was dehydrated or had eaten something strange that had colored my urine. (Kind of like what happens when you eat a lot of beets.)

All day, the crampiness continued and every time I peed, I noticed that it was still oddly colored. By the end of the day, I was starting to think it might be something to be concerned about.

Around 5pm, I finally headed home. At home, I peed in the "pee hat" I had leftover from my 24 hour pee test. (I think I blogged about the pee test, but I can't really remember.) If I didn't blog about it, here's the synopsis: the doctors ordered me to catch all of my pee for a 24 hour period so they could check it for protein and other schtuff. They gave me a "pee hat" which fits on the toilet and catches everything. Then I poured it into a big jug.

Looking in the pee hat, I was completely alarmed. The pee was reddish orange and clearly full of blood. (This hadn't been as apparent earlier in the day due to the dilution of the bloody pee in the toilet water.) I went and got Geekboy and told him that something bad was happening and I needed to get in touch with the doctor.

I called the doctor line and the doctor called me back. I explained what was going on and he suggested that I might have a urinary tract infection, but he wanted me to go to the hospital to be checked out so they would know for sure.

I told Geekboy to grab his computer because we were going for a ride. (He's much better off when he's got geeky entertainment.) I grabbed a big mug of water and we were out the door. I figured I should hydrate so I could pee when we got to the hospital.

At the medical complex where I'm being seen, they have a 24 hour pregnancy triage and assessment center. The nurses checked me in to an examining room and had me pee in a cup. It was pink - there was still obviously a decent amount of blood present, but it was nothing compared to what I'd discovered in the pee hat at home.

Then, while waiting to be seen in the patient room, I found that I had to pee every 5-10 minutes. I think it was a combination of being nervous and having consumed the giant mug of water on the way to the hospital. After a few more pees, the nurse arrived with a different cup for me to pee in. I produced the sample and it was as clear as tap water. For some reason, they decided to check for the presence of bacteria under a microscope on the clear pee sample (rather than the bloody one).

After about an hour, the doctor came in and told me that the sample was clean. She then conducted a quick pelvic exam (the first Geekboy had ever attended) and told me that my cervix looked a little tender and the q-tip swab she did produced a little bit of blood. She theorized that the blood in the urine was actually coming from my vaginal opening, rather than through my urethra. I questioned this theory a bit, but in the end, didn't want to get into a pointless argument with her. However, I'm 95% sure the blood was in my urine and not coming from somewhere else and mixing with the urine.

They sent us home. That evening, I had another slightly off-color pee (in the hat), but by morning, my pee was back to normal and the lower abdominal cramping was gone. I've been watching very carefully and I'm now on my third day of normal pee. I'm baffled by what happened, but I guess that if it's cleared up and the baby is fine, there's not much to worry about.

This is the type of thing where you begin to believe it's all in your head, but Geekboy has confirmed for me that it did, in fact, happen.

Blog Followers - Yay!

I haven't really made many efforts to publicize this blog yet as I've been distracted by my job, pregnancy, a basement renovation, figuring out whether to get married or not, the gestational diabetes, housekeeping, purchasing a new house, tenant turnover, and a whole host of other crazy stuff. However, it is on my list of things to do as it would be nice to know that there are folks out there in cyberspace reading (and hopefully learning from) my experiences. After a blogging hiatus of a few weeks, I was thrilled to sign on to see that I've got two blog followers. Yay! So now I've got impetus to keep up with the posts. Thanks blog followers! I'm glad you found your way here and I hope it's interesting to you. May many more followers soon follow your lead!

Morphing Lap Band Scars

I have five scars on my belly from the lap band surgery. Three are dots and two are more incision-type scars. One is about 3/4 of an inch long and the other is about 1 1/4 inches. They never really had a chance to fade after the surgery (I've been told this can take up to two years), but they used to be relatively flat and light pinkish.

As the pregnancy has progressed, I've noticed changes in the character of the scars. Especially in the last few weeks, they've grown much deeper in color and have also become much more raised/pronounced. In fact, one of the dot scars almost looks like a blister (but it's not infected or inflamed or anything).

I hadn't really noticed the morphing of the scars until one day when I looked in the mirror and I could see them THROUGH my shirt. It wasn't even a particularly tight shirt, but the scars caused the material to sit at a slightly different angle which caught the light. Weird. Since then, I've noticed that I can often see them through my shirts, but I doubt most people would notice. (Note: I'm not going to work in see-through shirts - it's the raised bumps I'm seeing under the fabric!)

I asked the doc about it and he said that weird things happen during pregnancy and a lot of them can be attributed to hormones.

The newly pronounced scars don't really bother me too much and geekboy doesn't seem the least bit bothered by them either - so, for the most part, I don't really care. But it seems like something that could be alarming or bothersome to scar-conscious individuals.

(I just tried taking a photo so you could see what I'm talking about, but it didn't work so well - sorry.)

Med Appointment

2 weeks ago, I had another medical appointment. I've been so bad about blogging that I can't even remember what happened. I'll try to remember and update this post. Consider this a placeholder.

Sunday, July 25, 2010

Insulin in the Vein

The other night, I went to give myself my before-dinner insulin shot and noted that the prick was significantly more painful than usual. Nonetheless, I carried on and finished the injection. When I removed the needle, I noticed that a lot of blood came with it and the injection spot was very painful. There was also a hard bump where the insulin had gone in - it didn't seem to dissipate at all.

Somehow, I seem to have managed to hit a vein. I panicked a bit and got online to see what I could find out about injecting insulin into a vein. Fortunately, it's not that big of a deal and apparently it happens to everyone from time to time. The biggest concern is that one can have a sugar low from the insulin being absorbed too fast, but thankfully that didn't happen to me.

Now that it's been a few days, I've got a nasty looking purple bruise at the injection spot. Geekboy commented that it complements the purple shirt I've got on today!

The Novelty of Insulin is Gone

It's funny to read my last post about my first day on insulin. The novelty has worn off and although shooting myself three+ times a day is still not a big deal, it's become an annoyance remembering to do it. So far, I've only completely forgotten to give myself a shot once, but I've come close a few times. I'm also amassing an alarming number used syringes which I've been storing in a sealed container (as instructed).

I don't know if I've gotten cavalier with my eating or my sensitivity to the insulin is already diminishing, but the quantities I was instructed to use no longer seem to be quite doing the trick. My after dinner numbers are coming back high (pretty much consistently) and my morning numbers aren't great either (in fact, they've never been in the target range...ever). I have a follow-up appointment with the doc in a few days, so hopefully they'll be able to adjust my quantities to get me where I need to be.

With the lap band loosened, I no longer have any restriction so my food control all has to come from me. I've been eating a fair bit more than I need to be and the scale is starting to reflect it. I've also gotten lax about exercise. My goodness - I'm falling apart!

This coming week, I plan to rededicate myself to the "plan" to see if I can get things under control. I'm fairly confident that Bebe and I can get things straightened out.

Thursday, July 15, 2010

First Day on Insulin

So - I'm almost through my first day on insulin and really it's not all that bad! I was fairly scared about getting the whole hang of injecting myself and about figuring out doses and whatnot - but it really hasn't been near the big deal I had made it out to be in my mind. With the exception of my waking blood glucose number which is still too high, all of my numbers over the day have been perfectly within range - which is great considering that I've been fairly "loose" with my eating and I haven't pursued any after-meal exercise all day.

I'm on a combination of two different types of insulin: long lasting and quick acting. In a nutshell, I get a shot of long-lasting before bed and in the morning. I take a shot of quick acting 30 minutes before meals. Because dinner is the only meal where my numbers have been giving me trouble, at this point, I only use quick acting then.

Tonight was my first pre-dinner shot. I filled the syringe and took it with me in the car on the way to the restaurant. Just before getting out of the car, I administered the dose as I figured it would take about 30 minutes to order and get our food. Before leaving for dinner, I did a pre-meal blood sugar test and my number was 84 (the goal is to be under 100). I was a bit concerned that if the food got delayed at the restaurant, the insulin could begin acting and give me a sugar low so I brought along a little Tupperware with dried apricots and almonds. (Remember the pre-unfill apricot of death episode?) I ate one apricot before the meal came and it got a wee bit stuck - but nothing like last time. Note to self: don't eat dried apricots. Ever. For any reason.

The sugar low never occurred and my reading one hour after dinner was 128 (the goal is to be under 140). Woo hoo! Insulin works!

Wednesday, July 14, 2010

Quickening

Somewhere between 18 and 20 weeks, one is supposed to begin to feel the baby's movement inside the womb. I think I've been feeling these movements for a few days now, but only yesterday did I really figure out that was what I was experiencing. I've heard the movements described as "bubbles" or "butterfly flutters", but mine are more like little twinges, short-lasting cramps, or passing moments of extra pressure on areas like my bladder. They'd be easy to miss if I wasn't looking for them, but they're certainly there and seem to have grown stronger even over the past few days.

And the scale creeps down?

I'm fairly sure I've gained three pounds since my lap band unfill a week and a half ago. However, when I weighed in at the doctor's office this morning, it showed that I had dropped a pound since my last visit. I think that this could be attributed to the fact that I peed six times (no exaggeration) between the time I arrived at the medical center and the time I was weighed before my appointment with the high risk OB doctors. Some of it could probably have been chalked up to pre-ultrasound nerves, and the rest to the fact that Bebe is squishing my bladder - which makes me go all of the time anyhow.

I asked two different doctors for their thoughts on my weight. The first said that she'd like to start seeing some weight gain and suggested that a good target would be for me to gain between 10 and 15 pounds during the pregnancy. A second doctor suggested that I might be expected to gain 20-25 pounds during the pregnancy, but then backpedaled and said that less might be ideal given the diabetes situation and that he wasn't really too concerned with my weight gain (or lack thereof) provided that the baby was growing on track and I was feeling good energy and health-wise. He suggested that we shouldn't focus too much on the numbers. From the ultrasound, Bebe's growth seems to be on track and I'm feeling good these days - so perhaps I'm in a pretty good place, but I'm not going to be alarmed if the scale inches up a bit either.

I really don't want to gain too much during this pregnancy, but I don't want to jeopardize the baby's growth or my health in any way either. A target of 10-15 max seems reasonable. But only time will tell what actually ends up happening!

Regardless, tonight I ended up going out for a big steak dinner and ate.the.whole.darn.thing. I don't think that was what anyone had in mind when they suggested that it might be time for a little bit of gain. Goodness! The unfill seems to have worked a little too well.

Uncharted Territory

This whole lap band pregnancy thing is feeling more and more like uncharted territory. I knew that it would be rare, but I had no idea that most of the medical professionals I came in contact would have little to no experience or knowledge about someone in my situation. In fact, just today, I found myself educating three different medical professionals about my situation.

The medical center where I'm receiving my prenatal care is part of a large, well-known, top-ranked research hospital. It's also the same medical facility where my lap band surgeon practices. I guess I assumed that folks would at least be vaguely familiar with the lap band concept.

The first person I had to explain things to was the main high risk OB doctor. He commented that he had been involved in the cases of two women who had undergone gastric bypass and one woman who had some sort of "lap band" as he called it, but mine was the first he had heard of that was connected to a port where adjustments could be made relatively easily. He was fascinated by the concept that by adjusting the amount of the saline in the band through the port, my stomach opening could be opened up or closed down. He told me that the one woman with the non-adjustable "lap band" had actually requested a c-section so that the doctors could adjust her band tightness while they already had her "open on the table". Somehow, his conclusion from the whole conversation was, "If you feel pain, don't just deal with it - tell us and we'll make sure it's not indicative of a problem."

The second person who didn't have any concept of the lap band was the diabetes educator. I mentioned to her that I had a band and asked how that might affect the speed of food absorption or the timing of insulin related to meals. At first, she seemed confused by the question and then theorized that it might speed up food absorption. That made no sense to me so I explained the mechanics of the band to her after which she agreed that it might slow the food absorption. In the end, I figured that the answer probably doesn't matter all that much as I've been unfilled to the point that I can pretty much eat as I did before I had the band.

It's mildly disconcerting that people don't know what to make of the fact that I'm pregnant with a band, but I feel relatively well informed myself about the risks, challenges, benefits, etc., so hopefully I'll be able to adequately advocate for myself if need be.

And it's a ???


The ultrasound tech asked me what I thought the baby's sex was before "the big reveal". She also asked Geekboy who, true to form, was unwilling to wager a guess based on the fact that he had no information to go on. I told her I had a hunch it was a boy though I was kind of secretly hoping for a girl. She said that mamas seem to have accurate hunches a surprising amount of the time. Then she went searching for Bebe's "parts". There between Bebe's two legs, she found...a third little leg! It's a boy!

It's very exciting to finally know how to think of Bebe. It's surprising to me that some people deliberately choose not to find out their baby's sex until birth. I want all of the information I can get!!!

I think I'm going to make Geekboy make the decision about whether or not to get Bebe circumcised, but that's a topic for a whole different blog post.

Marathon Medical Day

Phew - what a day! I spent exactly nine hours at the medical center today. I had taken the day off figuring I'd spend the morning having my ultrasound and doctor's appointment and the afternoon running some errands and enjoying a little free time. NO SUCH LUCK. Geekboy, on his way home from work, walked in the back door right as I walked in the front, having just returned from the doctor's office.

How does one spend nine hours at the medical center, you ask? Let me tell you! First, we showed up for the "big" ultrasound, but were called in about 40 minutes late as all of the earlier morning appointments had run over. Geekboy was able to stay for about 20 minutes, but then he had to run off to a work appointment. Had things gotten started earlier, he would have been able to stay for most of the ultrasound, but fortunately he got to see the baby, most of the important stuff, and the big boy/girl reveal before he had to go.

My ultrasound ended up running long - partially due to the fact that the baby's positioning made it hard for them to get heart images and partially due to the fact that they had to wait on a high risk OB doctor to review the scans. They tried to get the baby to move by making me empty my bladder and later making me roll onto my side, but neither tactic really did much, so I'm scheduled for a follow-up ultrasound in a month.

After the ultrasound, I was sent in (late) to meet with the high risk OB doctors. They were super nice and helpful and answered all of my questions very thoroughly. We discussed my blood sugar numbers, my history of hypertension, my possible diabetic history, my lap band, risks to the baby from the diabetes, and a whole host of other topics. A researcher also came in to discuss a study that they're running on pregnant diabetic women to test a new method of blood sugar level monitoring similar to the HbA1C, but only based on one month's blood sugar levels rather than three. After looking at the pros (minimal) and cons (minimal), I decided to join the study. Heck - why not if it can help advance medical science and it's no great inconvenience to me. And there is one small perk - they give you a free 3D ultrasound at around 35 weeks to try to accurately predict the baby's weight at birth.

After finishing up with the high-risk OBs, I was carted off to the lab by the researcher who wanted to make sure to get her blood sample. I was already having blood samples drawn for some other things, so providing an extra vial for her test was no big deal. Once the needle is in your arm, the worst is over. It really makes no difference if they take another little squirt of the red stuff. They also ran an HbA1c and a CBC (as I've been experiencing some fatigue and was wondering if I might be running anemic).

At the OB appointment, they decided that I should go on insulin - low levels to start out as my morning fasting numbers are consistently high and my after-dinner numbers run a bit high as well if I don't get out and do my walk right after dinner. While I'm not thrilled about this, I kind of figured it would happen sooner or later so I'm also not devastated. If anything, I feel mildly inconvenienced - that's about it.

Based on the decision to put me on insulin, after my blood draw, I had to go meet with the diabetes educator nurse so she could teach me to understand how the insulin works and to teach me how to administer it to myself. It was actually pretty fascinating stuff and I enjoyed the lesson more than I expected to. Based on what she taught me, I examined the doctor's recommendations for insulin amounts and timing and caught a recommendation that didn't make a whole lot of sense based on my history of after-breakfast blood sugar numbers. I showed the diabetes educator and she agreed that I was on to something. She suggested that I tweak my dosage accordingly. I was pleased to have understood the information enough to figure out what made sense for me. It's nice to be in control and to understand the reasons behind things rather than blindly following doctor's orders.

I was amused by the fact that the diabetes educator actually injects herself with saline during the lesson to demonstrate correct technique as well as to prove that the injections really don't hurt if done properly. She must have to shoot herself 5-10x a day! I wonder if that was in her job description when she applied for the position?

Once finished with the diabetes educator, it was 3pm and I was about to pass out from dehydration and low blood sugar. (Oh the irony!) All I had eaten up until that point was a protein shake for breakfast and a yogurt I had brought along in my bag for a mid-morning snack. I made a detour to the food cart in the basement of the building, but all they were offering was baked goods and pre-packaged sandwiches - both bad choices for controlling my blood sugar. I ended up going to a restaurant around the corner to get a bite to eat.

After "lunch" it was on to get an EKG as I had mentioned to the doctors that my heart sometimes seems to beat extra hard after meals. Waiting for the EKG: 40 minutes. Actual EKG: 2 minutes. It's actually probably a good thing that I went to eat before getting the EKG as my heart was sort of doing the beating hard thing when they took the reading so hopefully if there's anything weird going on, the test will show it.

Post-EKG: on to the pharmacy to get my scripts for insulin, needles, and blood sugar testing strips filled. More waiting.

And then finally I got to head home! What an exhausting day - but I fear it's only a taste of more medical fun to come...

Before the "Big" Ultrasound

Today is the day for the "big ultrasound". I'm 18 weeks along according to the calendar and it's hard to believe that I'm almost half way there! From what I understand, they're going to spend about an hour examining every little part of bebe to make sure that things are OK and located where they're supposed to be. It's fairly exciting to know that in an hour or so we're going to be checking out the wee one in great detail. It's also kind of scary though as anything could happen. What if they discover some sort of problem? I try to focus on the positive, but pregnancy has made a bit of a worry-wart out of me.

I'm also excited for Geekboy as this will be the first time for him to see bebe on screen. I didn't really see any point in dragging him along to previous appointments, but I told him to put this one on his calendar.

And today is the day that we should be able to find out whether bebe is a boy or a girl! Last night at dinner, a friend asked us what we thought the bebe's sex would be. Geekboy had no guesses. (I think he's still trying to decide in his mind about whether it's a baby or an alien.) My thought is that a little girl would be fun to have, but I suspect it's a boy - which is great too! (I'd just prefer not to have an alien.) I told Geekboy that if for some reason they weren't able to determine the bebe's sex, I'd go crazy. So according to Murphy's Law, I'm sure the bebe won't cooperate or things will be blurry or something...so I'll have to continue to wait and wonder!

After the big ultrasound, I have my first appointment with the high risk OB - so I should have plenty of news to report later on. I suspect I'm going on Glyburide or insulin or something based on my blood sugar numbers which haven't been stellar (but on the other hand, haven't been terrible). We'll see.

Belly Pooch: Showing


I've just started to show in the last week, although I'm sure someone who didn't know I was pregnant could easily miss it or read the protruding gut as the product of too many hamburgers. (Or maybe that's just what I think and it's wildly obvious?) Geekboy has refrained from responding to my inquiries about whether I'm showing or not (smart boy) and my real estate agent forgot that I was pregnant when we went out for dinner - so I figure it can't be too in-your-face.

Strangely enough, the belly pooch is mostly higher up (above the belly button) although the bebe is still below the belly button. Maybe everything has been shoved up? Here's a pic so you all can be the judge. (Apologies for the quality - I'll take a better one next time.) I've definitely expanded as my belt has gone up almost two notches. That said, I still weigh a good 30 pounds less than I did before the lap band surgery. Almost all of my clothes still fit, but that's probably because most are the same clothes I was wearing before dropping the weight. I used to buy clothes that would hide my fat so I think they do a pretty good job of hiding bebe as well.

The jury is still out, but I wonder if it's going to be unnecessary to buy maternity clothes. I could just buy fat clothes instead - they're much cheaper!

Tuesday, July 6, 2010

And the Scale Creeps Up

I must admit I've grown a bit obsessive about my weight since the decision to pursue lap band surgery. Even since discovering the pregnancy, I've been holding remarkably steady (which has been fine with the OB). However, since getting my unfill several days ago, the scale has crept up a couple of pounds. (Probably because I can finally eat again!) I know in my logical mind that it's good and healthy and probably even necessary to be adding a few pounds for the pregnancy, but my scale-obsessed mind is a bit alarmed. Provided I don't keep gaining at the same rate as I have since the unfill, all should be well, but I need to focus on addressing this issue with my scale-obsessed mind - stat!

Saturday, July 3, 2010

Post Unfill Eating

Tonight, Geekboy and I went out for dinner. I ordered a tomato based seafood stew that came with two big hunks of garlic bread. Before my unfill, I probably would have made it through about 1/3 if the stew (1/2 on a good night) and I would have passed on the bread altogether. I would have taken a to-go container home and had one or two more meals out of the leftover stew.

Well, since my unfill yesterday, things are a bit different.

Tonight, I ate the entire dish, bread included, and was still interested in dessert after dinner! Geekboy and I ended up sharing a berry compote with ice cream. ACK!

On the way home, I decided I'd better get out and do my 30 minute brisk walk to bring down my blood sugar before my after-dinner glucose test or my numbers were going to be out of the ballpark. Despite the fact that it was 9:30pm and already dark out, I went for my trek around the neighborhood. Thank heavens I did my walk as my reading was 132...perfectly good for a one hour after eating number.

I've really got to focus on reigning the eating in or else the scale is going to start climbing in disturbing ways, but dinner sure was fun while it lasted!

Friday, July 2, 2010

Middle of the Night Eating

In an attempt to better understand the whole blood sugar thing, I've been doing a lot of reading online. I came across a site that explained that eating in the middle of the night helps some people to have better blood glucose readings in the morning. It seems counterintuitive, but basically the explanation is that the body goes into starvation mode after not eating for several hours during the night and causes the liver to convert its stores into glucose, thereby causing a rise in sugar levels. This bizarre phenomenon is called the Somogyi effect.

By eating in the night in order to avoid the sugar low that triggers this cascade of events, in theory, one can avoid getting high morning glucose readings. Since I've been using myself as a human laboratory since being diagnosed with gestational diabetes, I figured it was worth a try. I set an alarm for 2am and got up to drink a little individual serving-size box of soy milk. Why soy milk? 1) It's a liquid (there was no possible way I could get any solid food down in the night with my pre-unfill lap band constriction issue), 2) It's got a good balance of protein and carbs, 3) It doesn't need to be refrigerated (trekking downstairs in the night was sure to disrupt my sleep even more). Pretty brilliant solution if I do say so myself (other than the fact that it probably gets absorbed into the bloodstream too fast because it's a liquid and could very well cause a sugar spike).

Anyhow, I managed to get up when the alarm went off, took my blood sugar reading, and drank the soy milk. It took 20 minutes to gurgle down. All the while, I was repeating the mantra, "be calm, don't puke it up, be calm, don't puke it up, this is totally insane, be calm, don't puke it up." I didn't puke and I made it back to bed without disrupting GeekBoy who was still fast asleep. However, I was not. I tossed and turned for a good 90 minutes before falling back asleep. Lying in bed and wanting to sleep while failing to do so is pure misery!

My morning sugar reading was lower than it's been since I started testing - so I think it worked! It was still a little higher than it should be, but it was a significant drop in the right direction. I wonder if it's worth trying to do this every night, or if the disrupted sleep schedule makes it simply not worthwhile?

Bariatric Babies

While at the doctor's office today for my unfill, I mentioned concern about having gotten pregnant so soon after having had my lap band surgery (less than five months out). The general recommendation is to wait one to two years after surgery before trying to conceive because nutritional deficiencies can result from the rapid weight loss.

The doctor's response was surprising to me. He shared that studies have shown better outcomes for babies born to mothers who have undergone bariatric surgery than for those who have not. Babies born after the mother's weight loss surgery have reduced risk of obesity and related metabolic disorders.

This statement made sense to me as people who have undergone weight loss surgery are probably a lot more aware and careful about their eating and exercise and pass these habits along to their kids. He agreed that this might be part of it, but he also pointed out that outcomes of kids born after surgery were much better than those of their siblings born before surgery - which eliminates the behavioral explanation, at least in part.

According to Dr. Picard Marceau of Laval University in Quebec, "When comparing children the women had before surgery with those they had after surgery, doctors noted significant differences. For example, children born after the mother had bariatric surgery accumulated belly fat at a much slower rate.

And while just 17 percent of the children born after their moms had weight loss surgery were obese, a whopping 49% of the children born before their moms had weight loss surgery were obese."

Wild stuff. Who knew?

The Thrill of an Unfill

This morning, I managed to get in to see the doctor for my partial unfill.

For those of you who are unfamiliar with the experience of fills and unfills, basically what happens is you lay on a table and the doctor (or nurse or med tech) feels for your port and then pokes a disturbingly large needle through your skin and through the membrane on the top of the port so that fluid can be added or subtracted from your band. The actual poking doesn't physically hurt all that much - it just feels like a bit of a pinch. However, at least in my experience, the mental pain of knowing you're being jabbed in the gut with a huge needle is excruciating. I've never actually been able to watch the process.

After the fluid has been added, you're raised up into a semi-sitting position (with the needle still poking out of your stomach) and you're given a dixie cup of water to drink. If it goes down well, things are considered to be OK. However, if the water gets "stuck", the general response is to take out a little bit of fluid from the band and to try again. Some doctors pull out the needle before giving patients the water, but as disturbing as it is to sit up with a needle poking out of my stomach, I'd rather do it that way than have to be jabbed a second time if it turns out that the doc added a bit too much fluid.

Today, the doctor had a little more trouble getting the needle into the port than he has in the past. He had to do a little digging around (again, more mentally painful than physically painful), but finally he got it in and pulled out 6.75ccs of fluid - exactly what should have been in the band. I asked him to put back 5ccs, resulting in a reduction of 1.75ccs. It seemed pointless to do the water test as I'd had fluid removed rather than added, but we did it anyhow and the water went down just fine.

He suggested I return if I needed another unfill as the pregnancy progressed or after delivering the baby for a fill whenever I felt ready to do so. I asked what the general recommendation was for how long to wait if one is breastfeeding. He shrugged and said he didn't really have a recommendation as his sample size of pregnant bandsters had been so small.

On my way in to work, I finished my morning protein shake and noticed that it went down a lot smoother than it had been going down on the way to the hospital.

At lunch, I was able to eat without any discomfort.

As I write this, I'm working on my dinner and it, too, is going down fine. In fact, I feel like I could eat a lot more than what I've dished out for myself, but I won't.

It's such a relief to be able to eat again!

I'm a bit worried about how being unrestricted will affect my eating and weight gain, but I hope that if I focus on making good choices and maintaining portion control, things won't get out of hand. My target is to limit my gain to 15 lb gain over the next 23 weeks.

On that note, I'm off for my brisk after-dinner walk!

Tuesday, June 29, 2010

In Desperate Need of a Partial Unfill!

When I found out I was pregnant, I did a bunch of research online and discovered that a good percentage of women are able to maintain their fill level throughout their pregnancy. This was surprising to me as all of the literature I had previously read suggested that if one became pregnant, they'd immediately do a complete band unfill. Once I found out that it was possible to hold on to a fill, I became committed to trying - namely because I was certain I'd be one of those women who gained an ungodly amount of weight during pregnancy, which could be disastrous for the baby's health, for my health, and for the weight loss progress I had already made.

Because I still fall into the "obese" category (even after my significant weight loss since being banded), the medical recommendation is to gain only 15 or so pounds during the entire pregnancy. I was quite certain I couldn't keep the gain that low without the aid of my band.

I called my lap band doctor's office to let them know I was pregnant and to see what they would have to say about my remaining filled. They basically told me that it was my choice and that as long as I was able to get the necessary nutrition to support the pregnancy, it was fine to keep my fill. I was thrilled. They also told me that if I found I needed an unfill, just to let them know and they'd slip me in for a quick appointment.

This week, I decided it was unfill time. I was getting progressively tighter and it had reached a point of absurdity. Solids were becoming increasingly challenging to get down and I was spending more and more time at each meal staring at my full plate and wishing it would just disappear. Dreading meals - now that's another new experience I can chalk up to the lap band! During the night, if I drank water it would get "held up" and then uncomfortably gurgle through the band after a minute or two. And I was experiencing an increasing frequency of sudden, uncontrollable spewing episodes - which are a big no-no with the band as it can cause slippage. Incidentally, they're also a big no-no if you plan to eat anywhere near the vicinity of other people.

Last night, just as I was about to go to bed, I saw a container of dried apricots on the table and decided to eat one. Very bad idea. Despite the fact that I had chewed it well, it got mercilessly stuck and was terribly uncomfortable for a long time. It didn't seem to be moving anywhere - just sitting right there on my band causing me pain. Although I know better, I took a couple of sips of water in the hopes of lubricating it or helping it on its way. Another bad idea. A minute later, the water came shooting back up in geyser form, but the apricot still did not budge. (Someday I'll do a post on the graphic nature of these liquid geysers - I'd never experienced one before getting banded.)

GeekBoy suggested I get in bed, but sit up to help the apricot pass into my stomach. I must've sat there for 20 minutes feeling awful. I think he felt bad for me as he was trying to comfort me by snuggling and stroking my leg, but one thing led to another and he started getting a little frisky, but I was really not feeling it. My response: "You might want to reconsider as there's a good chance that I'm about to spew." I guess that's one surefire way to ruin the moment! He just looked at me dumbfounded - with a mixture of fear, amusement, and complete bewilderment on his face. Bless his heart. Surprisingly, he didn't seem grossed out at all. Poor chap - but I suppose he'd better get used to painfully unsexy moments if he's going to be attending the birth!

I'm Officially "High Risk". Oh Joy.

This past Friday, I called the OB's office at the suggestion of my nutritionist to read them my blood sugar #s. I'd been tracking the numbers for four days which provided a pretty decent picture of the range of my readings. I left a message with a nurse who said she'd talk to a doctor and get back to me, but I never heard anything back. I called again on Monday to make sure the message had gotten through to someone and was told that the doctors had decided that I should be transferred to the "high risk" OB group. Can't they come up with a more delicate term that would be less alarming to us pregnant emotional women??? I'm happy that I'll be getting the extra attention and monitoring that I need to ensure the best outcomes for my baby, but I'm a bit freaked out as well as I don't know how concerned I should be about everything (or not).

The high risk OB scheduler gave me a call in the afternoon to let me know that my previously scheduled appointments with the "regular" OB group had been canceled and that they wanted to see me in the "high risk" clinic. Fair enough. I figured they'd bring me in later that week or early the next for an assessment and probably to put me on meds to bring my sugars down. Instead, she proposed a date at the end of July! July hasn't even started yet. We're still in June. The date she proposed was two weeks BEYOND my next scheduled OB appointment with the regular OB. Trying to disguise my panic and confusion, I managed to ask, "Uh, don't they want me to come in soon so they can monitor my situation? I've got to believe that they're at least a little alarmed if I've been switched over to the high risk group." Her response, "They're not too concerned about your case." OK... I guess I was still giving off somewhat tense vibes as she agreed to search her schedule again. She came up with another date which was just slightly sooner, but I told her I'd take it. Apparently, they're going to do an ultrasound followed by a regular appointment. So I guess I'll just keep monitoring my sugars and hoping for the best in the interim. It really is fairly disconcerting not knowing how worried I should or shouldn't be about everything.

Weight Gain (or Not)

Because I still fall into the "obese" category, the medical recommendation is for me to gain 15 pounds or fewer in total during the pregnancy. The recommendation for an average-sized woman would be expected to gain from around 25 to 35 pounds.

By my best estimate, I actually got pregnant weighing around 211 pounds, but I didn't actually figure out that I was pregnant until I was down to about 204. It's not unusual for women to lose a few pounds during the first trimester due to morning sickness (which I didn't experience), but I don't think a seven pound drop during the first month is considered anywhere near normal.

I'm now into my 16th week and weigh in at 202. I've been holding steady close to this weight for the past 2 1/2 months or so. I'm not making any special efforts to maintain this weight, it's just what's happening. It's somewhat unclear to me whether it's problematic if I'm not gaining now that I'm into the second trimester, but my nutritionist and former OB haven't expressed any concerns yet. The nutritionist just said (in no uncertain terms) that I should not be losing any weight right now (which I'm not).

I'm anxious to find out about the baby's growth at the ultrasound that is coming up in a couple of weeks. Until then, I'm concentrating on getting in the recommended daily carbs and calories and working on maintaining as healthy a diet as I can. I'm reassured by the idea that the baby will take what it needs nutritionally from the mother if its needs aren't being met - so hopefully it's not being adversely affected by my weight holding steady. Gosh - there's so much for one to worry about during a pregnancy! And then they tell you to keep your stress levels down...

Blood Sugar Monitoring

My mother is diabetic and always made a big deal out of how horrible it was to have to be constantly poking her fingers to monitor her glucose levels. For that reason, I was pretty fearful about the whole monitoring thing when I got started. However, I've found that the finger poking really isn't a big deal at all for me. It doesn't really hurt and the pokes seem to heal up more or less immediately.

Learning how my blood sugar responds to different foods and different times of day has been an interesting experiment. For example, my numbers always seem to be higher than desired first thing in the morning and after dinner (if I don't take my walk). However, they are generally completely within range from breakfast to dinner time, provided I don't go overboard with the simple carbohydrates. Also, I've found that when I feel physical hunger, it corresponds directly to fairly low blood sugar readings. The hunger is real - rather than in my head.

According to the nutritionist, my target #s are as follows:

Waking: <90 (I've never been under 100 since I started monitoring)
One hour after breakfast, lunch, or dinner: <140
Two hours after breakfast, lunch, or dinner: <120


One band-related question that came up in my discussion with the diabetes nurse educator and the nutritionist was when, exactly, one is to begin measuring the "hour after a meal". Does the clock start ticking with the first bite or the last? As a bandster, the time span between that first and last bite of a meal, in my experience, is often between 30 and 60 minutes.

Amusingly, neither could definitively answer the question, but they suggested I go ahead an measure my time from the last bite. The other funny thing they pointed out was that if I took an hour to eat a meal and then waited an hour after to measure my blood sugar, I'd almost be ready to start in on my next meal or snack as I'm supposed to be eating six times a day.

Meeting with Nutritionist



I went in to meet with the diabetes educator and nutritionist as instructed. First, the educator went over the basics of gestational diabetes with me and handed me a fancy little booklet packed with info and tips. One of the first things I told her was that I hoped to control my sugars with diet and exercise. She stopped short of snickering, but were we in a less professional setting, I'm sure I would have heard uproarious laughter. At the time of the appointment, I was around 15 weeks into the pregnancy. She pulled out the chart you see above and put her finger on the line around the 15 week mark. "Here's you." She traced the line with her finger. "And here's where you're headed." Oh my goodness. At 15 weeks, according to the chart I was actually at a point of needing *less* insulin than normal...and from there, my insulin needs would increase sharply and steadily. Needles and shots and sugar lows, here I come!

After bursting my bubble, she then presented me with my new leash. It's the FreeStyle Lite - which is actually really tiny and easy to use and comes in a handy dandy little carrying case. (Actually, come to think of it, all blood sugar monitoring machines these days probably do.) The educator walked me through the steps of self-testing and then made me do a trial finger prick on myself. She was shocked to see that my one hour post-breakfast blood glucose reading was 107 - which is great! (The target is for one to be under 140.) Based on my one hour glucose tolerance test results (250), she had figured my sugars would be WAY out of whack.

Then on to the nutritionist. I figured she was going to read me the riot act on what I couldn't eat and what I needed to be eating that I wasn't. Instead, I was pleasantly surprised to find that she was fairly content with my daily diet. Since getting the lap band, I've been keeping food records, so I was able to give her a rather good sense what my daily eating looks like. She was pleased that I was already compulsive about tracking - so adding the blood sugar numbers into my record wouldn't be too much of a stretch.

Based on my diet, what she did tell me to do was to add a couple hundred more calories to my diet, to increase my carbohydrate intake and NOT to add any extra exercise to my regimen. Holy cow! NOBODY has ever in my entire lifetime suggested I eat more. Ever. I hardly knew what to make of it.

Below is the plan she gave me:
Breakfast: 30g carb
Snack: 15-30g carb
Lunch: 45g carb
Snack: 15-30g carb
Dinner: 45g carb
Evening Snack: 15-30g carb

Total: 180g carbs, 1800 calories.

Before, I'd say I was eating around 90g carbs and 1200 calories. Wow. Pretty serious change.

For the first couple of days, I wasn't even sure how I could possibly squeeze in that many carbs without resorting to highly refined carbs such as white sugar and flour, but since then I've more or less figured out how to incorporate more whole grains and starchy vegetables into my diet.

Interestingly, changing to this way of eating didn't cause me to gain any weight. The weirdest part was having to eat a bedtime snack (a big no-no according to lap band education). Generally, I simply don't feel like eating one and it takes a lot of effort and discipline to just go do it. Who would've thought I'd ever find myself complaining about having to eat?!?

Diagnosed

The day after my one hour glucose tolerance test, I received a call from the doctor's office. I was already expecting a call, so it wasn't a surprise. She told me that I'd failed the test and that while the typical course of action was to send a woman for a second three-hour glucose tolerance test after failing the first one, my levels had been so high that they could just skip the second test and diagnose me with gestational diabetes. Apparently, if the reading is over 200, they know there's a problem. My number was 250. Fun! At least that explained why I ended up with the sugar low a few hours after the test.

They had gone ahead and set me up with an appointment a few days later with a diabetes nurse educator and a dietician who would discuss blood sugar monitoring and diet with me and help to get things on track.

I was a bit concerned about how my sugar levels could be impacting the baby and was also wondering if they'd been out of whack since the beginning or if this was a recent development. Online research suggests that uncontrolled blood sugars can lead to a higher incidence of birth defects, large birthweight babies, and blood sugar crashes for the baby after birth. The latter two seemed manageable enough since the situation was caught early, but I still wonder and worry about the birth defect piece.

One Hour Glucose Tolerance Test

I went in early in the morning before work to get my glucose test taken care of. They sat me down and did a blood draw, but I'm pretty sure it was for my blood typing re-test and not part of the glucose screening (something curious and unexplainable had shown up on my first blood typing screen, so they wanted to make sure it wasn't an error).

After taking my blood the tech gave me a cup of something that tasted like flat orange soda and told me that I needed to drink it down in less than five minutes. I was a little concerned that it might come right back up due to my band tightness and the fact that it was early in the morning, but it went down fine. Apparently, there is 50g of glucose/carb in the drink - which, if I understand it right, is the a little over the equivalent of what one might get drinking a can of coke. I was then instructed to return in an hour for a blood draw.

I was fairly certain I was going to fail the test, so I had already resigned myself to that fact and wasn't really too worried about things. After an hour, I went back, got poked, and headed off to work.

A few hours later, I experienced a pretty noticeable sugar low. My hands got shaky, I broke out in a sweat for no reason, and I kind of experienced that dizzy adrenaline high sensation. (This has happened to me a few times before in my life, so I know what my sugar lows feel like.) I didn't think too much about it, ate something to bring my blood sugar back up, and went on about my day.

Third Doctor's Appointment

Another fairly uneventful appointment. Peed in a cup, asked questions, answered questions, and then laid down so they could listen to the fetal heartbeat. This time, the doc managed to find it. Whoosh, whoosh, whoosh... She then moved the little transmitter around a bit and showed me what my heart beat sounded like compared to the baby's. Mine sounded to be about half as fast.

I brought up the topic of blood sugar again (I'd mentioned it in previous appointments) in particular because I'd been noticing that my heart had been beating hard/fast after meals. This seemed weird and had me a bit concerned, though when I mentioned it to the doctor, she said she'd never heard of such a thing. Nonetheless, she said that she'd be happy to send me for an early glucose test so we could know for sure one way or another.

Because of my history of blood sugar weirdness, I figured it would be good to play it safe rather than waiting until the 28th week when they typically send pregnant women for their glucose screening. Also, they'd noticed that I had low levels of ketones in my urine (which can signal blood sugar issues), though the doctor thought it was probably nothing and I was probably just a little dehydrated from the summer heat.

They wrote me a script for the test and sent me on my way.

Second Doctor's Appointment

I went in for my second doctor's appointment one month after my first. Not much had really transpired pregnancy-wise since the previous visit. First, the intern came in to ask me the standard set of questions:

Nausea? No. Vomiting? No. Bleeding? No. Fatigue? No.

I smiled at him and said, "I'm not really pregnant."

He gave me a strange awkward look, let out an uncomfortable giggle-ish sound, stood up and walked out of the room telling me the doctor would be in to see me in a minute.

The doctor came in and answered a few of my questions. She then took out the heart doppler machine to listen to the fetal heartbeat. She placed it on my lower belly (actually, I'm fairly sure that initially she was trying to listen to my pubic bone), but she wasn't able to pick up any sounds. She moved it around a bit, but still nothing. For some reason, I wasn't the least bit alarmed, but I did notice that she looked a little concerned.

Let me interject here that I've got a fairly substantial lower belly flap which I'm sure serves as a pretty good layer of insulation against the transmission of sound. Despite my surgery-related weight loss, this flap doesn't seem to have shrunk much - though I'm holding out hope that as I lose weight after the baby, it will significantly diminish.

Unable to hear the fetal heartbeat, the sent the intern to bring in the ultrasound machine. They gooped me up and fired up the machine. Wow - there on the screen was a clearly formed little baby kicking and thrashing all about. I was completely shocked that this early on in the pregnancy, it was so clearly formed and active to boot! For those of you who are reading this and have never experienced what I'm talking about, go to Youtube and Google "ultrasound, ___ weeks" and you can see all sorts of videos of ultrasounds each week along in the pregnancy. It's truly remarkable how fast babies develop into recognizable forms. For some reason, I'd always thought that babies remained jelly blobs until somewhere mid-way through gestation - not true!

It's very comforting reassuring to see your baby there on the screen in plain view - especially when you're a mad worry-wart like I've become during this pregnancy!

What Does Pregnancy Feel Like?

What does pregnancy feel like? If you're me, not much. I always imagined that pregnancy would somehow feel different - that there would be some sort of different physical experience where I'd just know I was pregnant. Not so much. In fact, even after the pregnancy had been confirmed by medical professionals, I still had a really difficult time wrapping my head around the idea that there was a baby growing inside of me.

The majority of women experience morning sickness during their first trimester. I was one of the lucky ones who, with the exception of one or two incidents, didn't feel queasy or nauseous at all. I also didn't feel exhausted as all of the literature suggested I would. I wasn't super hungry or emotional, my hair didn't change luster, and my fingernails didn't start growing like mad. How did I feel? Perfectly normal - perhaps with a bit more gas than usual.

First Doctor's Appointment

In a state of mild panic, I decided that the first thing I needed to do (after telling Geekboy) was to get myself in to see a doctor. I was concerned that my nutritional state was probably a big issue (not to mention all of the other things I'd been doing since I didn't know I was pregnant). Also - I really had little idea how to approach the whole concept of lap band pregnancy.

I was in a bit of denial and kept fluctuating between not really believing I could possibly be pregnant and freaking out about what could be happening to the baby if I really was, in fact, pregnant. In my state, I really wasn't ready to share the pregnancy news - which meant I couldn't call anyone to ask where to find a good OB doc. After a bit of thought and research online, I opted to call a top-ranked local hospital to see if they had an OB to recommend. They gave me the contact info for a group of five female OBs with a shared practice. It sounded great so I called.

Me: "Hi, I'm a new patient and I'd like to make an appointment."
Scheduler: Takes my name, address, phone, insurance, etc.
Scheduler: "How about October 19th?" (We were in late April.)
Me (a bit shocked and alarmed): "Ummm...I'm afraid that's not going to work."
Scheduler: "Are you pregnant?"
Me: "Yes, and my situation is a little unusual so I'd like to get in sooner rather than later."
Scheduler (chuckling): "Yes, I suppose October would be a bit late. How about next week?"

I went in for my appointment, still in a fair bit of denial. I had convinced myself that the doc was going to look at me, laugh at the absurd notion that I thought I was pregnant, tell me I had gas, and send me home. That's not what happened.

I joked with the nurse about the fact that I didn't think I could actually be pregnant, but after I had to excuse myself twice to use the restroom before even seeing the doctor, she said, "Honey, better believe it..."

The doc saw me and asked a bunch of questions. Then I got my turn to ask a bunch of questions. Afterward, she fired up the ultrasound machine. There on the screen in plain view was a little bean-shaped blob inside a larger circle and in the middle of the bean, there was a light area that was flicking on and off really fast. The doc pointed at the screen and said, "There's your baby." Tears came to my eyes. That was the moment it became real to me. She said it was a good sign that the heartbeat was so visible and strong at six weeks. I was relieved.

The doctor didn't really seem to have any concerns about the fact that I had a lap band (although she admitted she'd never had a patient with a lap band in the past). And she didn't seem too concerned about all of the other things I had been worrying about. She told me that a baby's nutritional needs are minimal this early in the game and that I should probably see a nutritionist to make sure I was getting enough of everything. She also told me not to worry too much about the other things I'd done when I didn't know I was pregnant - just to do the right things from here on out. She also pointed out that most folks don't figure out that they're pregnant for a month or more so it's pretty common for people to drink, eat the wrong things, be exposed to bad stuff, etc. - and in the great majority of cases, things turn out just fine.

I left the doctor's office feeling relieved and also feeling like I needed to get over my denial lickety split!

Figuring it Out

Before and during the trip to visit my extended family, I had noticed that my boobs seemed oddly sore and I kept having to remind GeekBoy to be gentle with them. It seemed a little strange, but I’d been going through all sorts of weird physical experiences since getting the lap band (shoulder pain, gas, spit-ups, port pain, etc.) so it didn’t seem that far outside of the usual. I was also vaguely aware that my period was due during the trip so I thought it might be a more pronounced PMS symptom.

Near the end of the trip, I knew my period was about to start because I started having some twinges and mild crampy feelings in my lower abdomen (as happens when my period is starting) so I took some Advil and went on about my day. The next day, I was surprised it hadn’t started, but I was having the weird crampy twingey feelings again so I took some more Advil and waited.

The trip came to a close and we traveled home, but my period still hadn’t come. It crossed my mind that I might be pregnant for a split second, but the likelihood of that was so slim (next to impossible in my mind) that I quickly tossed the thought aside. When I got home, I checked my calendar and noted that my period was actually almost a week late. That never happens. Could I attribute it to travel stress? Not so much. I travel all the time. Ummm….

The next day, I went to the store and picked up a 2-pack of early detection pregnancy tests. The logic went something like this: if it’s made to be sensitive enough to detect pregnancy hormones before you’ve missed your period, it’ll certainly give me a correct reading if my period is late. I didn’t have any interest in false negatives. I also didn’t want to alarm GeekBoy unnecessarily, so I didn’t mention any of this to him. After all, I was pretty sure I was being crazy and there was a perfectly rational explanation for what was going on. I’d test, verify that I wasn’t pregnant, and go on in my quest to figure out what had happened to my period.

The pregnancy test instructions say that the first morning urine is best for testing. After peeing on the stick, you’re supposed to set it on a flat surface and let it do its thing for two minutes. OK. I can handle this.

First thing the next morning, I go in the bathroom and pee on the stick. A positive sign immediately appears and it’s clear and dark and there’s no mistaking it. No need for the two minute wait time here. My heart starts racing. It’s for real. False negatives are common, but false positives don’t really happen with these tests. Holy crap!

Saturday, June 26, 2010

Pregnant!

I was thrilled to have finally reached restriction after my series of fills and the pounds again started dropping off. A few weeks after the big fill, GeekBoy and I made a week-long trip to visit some extended family members of mine. I was concerned that they'd notice my weird eating habits and ask what was going on, but no such thing occurred. I even had to excuse myself from the table a couple of times and run to the bathroom for a spitting up episode, as I was still getting used to the "eat slowly and chew like your life depends on it" thing. I remember thinking, "They're totally going to think I'm pregnant or something". Funny thing is, I was - I just didn't know it at the time.

As luck would have it, on the day of my March fill (or within a day or two on either side of that date), I had gotten pregnant.

Fills

At the time of my lap band surgery, the doctor put 5ccs in my 10cc band. I've since learned that this is A LOT of fluid to have in one's band from the get-go, but at the time I hardly noticed. I remember thinking I'd have a difficult time consuming anything after the surgery based on all that I had read (and at the time, I thought my band was completely empty). A few hours after the surgery I had no trouble whatsoever consuming the stuff they brought me on my "tray of liquids" consisting of (among other things) jello, a lemon sorbet, juice, and cream soup (which I'd also read was a no-no after surgery). I would never have believed that a half full band would allow me to consume all of those things.

Over a period of a couple of weeks, I was gradually permitted to add in mushy food and then solids. I was shocked to find that I could eat most of the same stuff I had eaten prior to the surgery without any real trouble. I was scared to death to "overdo it" as I'd read all sorts of horror stories about stretched pouches and slipped bands, but on rare occasion, I did end up overeating and pretty much had no ill effects. After some time, I began to even wonder if I'd actually had a band installed at all.

It was 2 1/2 months after the surgery that I went in for my first fill. The doctor added 1 cc to the band. This was also when I learned that I already had 5 ccs in my band. I was shocked.

For a day or two after the fill, things seemed a bit tight, but then they loosened up and I could eat normally again. I started wondering if the whole band thing was a sham or if I was a freak case for whom it wasn't going to have any effect. However, I was determined to keep losing weight so I followed all of the band rules carefully despite being hungry and also physically able to eat greater volumes than I was eating.

The scale kept moving so I opted to pass on a fill the following month.

However, loss slowed and I chose to go for another fill the month after that. At first, the doctor added 1 cc to the band. When he gave me my Dixie cup of water to drink, it got hung up. I tried to wait a bit to see if it would go down, but it just sat there on top of the band - making me uncomfortable. As I sat, the doctor pulled 1/2 a cc of fluid out of the band and I felt the water immediately run down into my stomach. What a bizarre sensation! Instant relief.

While I enjoyed the idea of water actually being able to pass through the band (to say nothing of food), I was desperate to reach the elusive level of "restriction" I'd heard so much about so before the doctor pulled out the needle, I asked if he'd consider putting a wee bit back. He was happy to oblige. Doc added back .25 ccs and gave me another cup of water to drink. This time, it went through - but slowly. I decided to give that level a try, crossing my fingers that I wouldn't regret it. Doc said I'd know if there was an issue before the next day. Thankfully, there wasn't.

6.75ccs in my 10cc band was perfect for me. I could eat fine if I took my time and chewed well, but generally about 15-20 minutes into a meal, I'd just lose interest and put any remaining food away. It was a completely new experience for me as I'd previously been a "plate cleaner". On occasion, I did eat too fast or fail to chew adequately (resulting in hiccups or a spewing episode or both), but these were fairly rare occurrences. I was amazed that I could be satisfied on so much less food and I had to be careful to choose what I was going to eat to make sure I was getting adequate protein.

In the mornings, I was quite tight and could only reliably get liquids down, but it didn't really bother me and I developed a routine of having a protein shake for breakfast every day, which gave me a good jump-start to reaching my protein goal each day of 60-80 grams.

I was content and planned to stay at that fill level for a while.

Secrecy

When I decided to get lap band surgery, I made the decision not to tell very many people about it. I wanted to avoid questions and comments and judgments and all of the other things that one can often expect when making a less-than-mainstream choice. With weight loss surgery, I felt like this "nosy neighbor" phenomenon would be magnified as we live in a society that is so weird about weight issues. My thinking was that I could always decide at a later date to share that I had undergone surgery, but once the word was public, there was no reeling it back in.

To date, the only people who know about the surgery are GeekBoy (who was baffled by my decision, but supportive nonetheless), my parents (one took the news well, the other did not), my brother (who had no reaction at all to the news), and a couple of my friends who've proven in the past that they can keep their traps shut (both were very encouraging and supportive).

Looking back, now that I'm eight months out from my surgery, I'm glad I made this decision. Each person is different and I don't mean to suggest that surgery secrecy is the right decision for everyone, but it's worked out well for me. Surprisingly, keeping the info quiet has actually been much less of a challenge than I expected.

Surgery Day Story

In October of 2009, I received my lap band. This is my surgery day story.

We went in at 6:30am for an 8:30am surgery appointment. Got checked in, garbed in gown and slip-free socks and then the doctor came in for a visit to say “hi” and answer any questions I might have. After that, the anesthesiologists came by and explained what they were going to do. They gave me a numbing shot in my hand, inserted the IV and started a saline drip. My eyes glazed over and I immediately started to feel groggy. I asked the nurse anesthetist what he had given me and he remarked, “nothing yet”. Guess I’m highly susceptible to the placebo effect! They gave me a heparin shot in my stomach which really didn’t hurt much at all and then told me that they were going to give me stuff to make me sleepy and it would take about 30 seconds to kick in. It hurt a fair bit at first going into my hand and then all I remember is asking my BF for a kiss.

The next thing I remember was chattering a lot and fading in and out in a recovery room. I slowly woke up and became aware of a nice warm sensation all over my body. They had hooked me up to some sort of hot air warming system that inflated a pouch inside my gown with soothing warm air. It was wonderful! I was thirsty so I asked for some ice chips which they promptly brought to me. I spent about an hour and a half in recovery and then they wheeled me to my room. I got ice water to sip on and my BF came to sit with me.

I was surprised by how good I felt. I didn’t really feel any pain except for when I tried to move around and experienced the soreness of my stomach muscles. Drinking water was fine and I didn’t feel any “tightness” in my stomach.

After a few hours, they wanted me to eat something to see if I got nauseous. They brought me a popsicle, lemon icee, jello and apple juice. I got the popsicle and jello down without any trouble, which seemed to please them. Soon a foodservice person appeared with a big platter of more stuff – tea, broth, milk, pudding, and cream of chicken soup. Having been told that I could only have clear liquids, I figured they’d made a mistake and didn’t eat the stuff. The nurse came in and asked why I hadn’t touched it. Apparently, they had moved me on to the phase 2 diet without informing me. She said I needed to eat some “full” liquids to check for nausea as they were planning on discharging me early (I had originally been scheduled to stay overnight). I was more than happy to try them if that’s what it would take to get to go home (I was getting bored in the hospital room). The full liquids went down just fine too.

Later on, the dietitian came by to explain the post-op diet to me in detail and a few hours after that, the surgeon came by to check on me and to answer my questions. He was very friendly and told me that everything had gone smoothly with the surgery. He asked me if I wanted to go home or stay and I requested to go home so he wrote up a prescription for painkillers and told me that he was going to discharge me. I got to pack up and go home!

We went to Walgreen's to fill my prescriptions and spent about 20 minutes walking around waiting. That's when the gas pains started. At first, I wasn't sure what they were, but I felt sharp pains in my back, shoulders and abdomen. It was pretty unpleasant. When I got home, I took some gas-x strips and a painkiller and went to bed. I tried laying flat in the bed, but felt a great deal of stretching in my stomach area when I was horizontal so I opted to sleep sitting mostly upright in a recliner which was much more comfortable. The next morning, the gas pains were gone and all I felt was abdominal soreness.

Over all, the surgery was less painful and went smoother than I had anticipated. It's still kind of hard to believe that it's over. I’m now looking forward to a new life with the band!

About Me

Here's a little bit of information about me. (Gee, how self-centered can I be?)

I'm 33 years old and reside in a fairly large city in the United States. I have a loving boyfriend (hereafter referred to as GeekBoy) and we've been together for 3+ years, living together for the past year. I work full-time in a fun and interesting job that could stand to pay better and I spend my spare time on strange creative projects and entrepreneurial pursuits. Generally, I'm a fairly happy and easy-going individual.

I've been overweight my entire life, but I don't feel like it's really held me back all that much. The biggest issue surrounding my weight has been my relationship with my parents who, despite both being mildly overweight themselves, are extremely fat-phobic. A combination of parental pressure paired with concerns about how my weight would affect my health led me to start down a road of dieting attempts and failures from a pretty young age. I'm another statistic: one of those all too prevalent (and still fat) "you name the diet/gimmick/desperate measure, I've tried it" people.

As I grew older and heavier, some of the health-related concerns I'd always been worried about started to emerge. First I was diagnosed as being pre-diabetic. Then I was diagnosed with hypertension. I kept fighting my weight as I knew that was the only thing that was going to get my health in check, but attempt after attempt failed.

Finally, I started researching the idea of weight loss surgery. It scared the bejeesus out of me, but I was intrigued by the idea that it really seemed to be working for a lot of other people who had tried everything else and failed - just like me. It was hard to accept that I might need to take such drastic measures to get things under control, but I did a lot of research and decided that if I was going to do it, the lap band was the type of weight loss surgery for me. Somewhere during that phase of coming to terms with the need for surgery, my employer announced that our health insurance would now cover lap band surgery. That was the push I needed to move forward with the process.

Why We're Here

Why We're Here: No, I'm not going to philosophize or proselytize or exercise (oh, wait a minute - we'll get back to the last one)...we're here because I've decided to start this blog due to the apparent shortage of information available out there for folks in my situation. I hope that by sharing the details of my story, I'll be able to serve as a resource to others out there going through the same experience and also serve as a source of information for those who are merely curious about what it's like to go through pregnancy with a lap band. I have no idea how many of us are out there, but I do know that pregnant bandsters and bandster mommies exist - it's just that we're such a small percentage of the population it can be difficult to find one another.

The number of people getting lap bands is steadily growing and I'm pretty sure a fair number of people getting bands are having sex. (Apologies to those of you who are now thinking "Yeah right, I wish!") With sex comes pregnancy (sometimes intentionally, sometimes not). Ladies and gentlemen, that's how we arrived at the adventure of Lap Band Pregnancy.