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.

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!

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.