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!
Sunday, July 25, 2010
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.
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!
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.
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.
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...
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.
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!
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?
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 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!
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!
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