Overview of the Pregnancy, Delivery, and After

Don’t buy into all the hype…

I will start out saying, I have a perfect, beautiful baby boy, and my recovery time after the c-section and tubal wasn’t bad at all. HOWEVER, I have a bone to pick with those big promises I read about…

1.       Women who get pregnant after having gastric bypass surgery aren’t likely to have gestational diabetes. WRONG. At least for me. I had type 2 diabetes for 12 years, it hit the worst during and after my first pregnancy. My blood sugar has been under control ever since I got my weight down (yay). So merrily we are trotting along with this pregnancy, nice normal blood sugar, until I hit 160 pounds (9 weeks til delivery) then it steadily, exponentially crept up, despite the fact that my DAILY sugar intake was under 30gms (my calories were around 1600 despite being told they should be around 2200). So on Glyburide I went, luckily no insulin. So it could have been worse, but still, I was under the impression that I would be in the clear. Not that a doctor told me so, I read an article about it, infact this whole rant is about articles I read, supposedly written by doctors, though none of them mine.

2.       Babies born to a born after she has had WLS tend to be smaller than babies born to obese mothers. Hmm, WRONG AGAIN. My first son, born 3 weeks early was 7 lbs, 9 oz, I was around 240 lbs when I delivered him (180 when I got pregnant). My newest son, born 3 days early was 9 lbs, 1 oz and with him I was about 170 when I delivered (142 when I got pregnant). Remember, there was NO INSULIN involved with this pregnancy so we can’t blame that lovely growth hormone. He’s a big guy (at his two month check-up he weighed in at 14 lbs, 11 oz), and I wouldn’t change a thing about him, but I was told he’d be smaller. Now, he may have the reduced risk of diabetes later in life, and he might be thinner than his brother when they grow up, but I don’t know if either of these promises will deliver either.

So here are the pro’s so far:

·         Delivery was easier (okay so it was a scheduled c-section but still easier). They took their time and didn’t push me to have him earlier

·         Recovery was easier too, both boys were delivered via c-section (the first one being emergency)

·         We had lung maturity! No NICU time for this little man

·         He nursed while I was in recovery (not really a plus, but he was born with low blood sugar and needed to feed ASAP, but he latched on immediately and nursed, albeit lazily)

·         He is still nursing and prefers me over the bottle!!

·         Exercise doesn’t dry up my milk like it did with the first time around, I’m guessing this has something to do with diabetes

·         The diabetes went away when the baby came out, I was able to eat what I wanted in the hospital, put on a regular diet but made good choices

 

 

The only real downside was, no NSAIDs after, so the swelling took forever to come down. The upside was extra morphine and Percocet, but that made for a very lazy baby… He’s still very chill, and extra precious. I worked really hard on this guy, and I’m so glad he’s finally here. His brother adores him and tries so hard to help out, but he’s four…

 

So the summary? While the surgery saved my life and helped me reach my goals, it did NOT make my pregnancy any easier, in fact I got more of the bad side effects with it than I did when I was fat and unhealthy. But it was worth it. I’m healthier for it, I’m sure he will also be healthier for it in the long run. I do feel like I short changed my first born due to my weight and health while pregnant with him, but I’ve added so many more years to my life that I’m sure I will be able to make it up to him.

 

Feelings and Family

Everything about this pregnancy has been different, though with the exception of not being fat or diabetic, its all worse or harder. Sometimes I wonder what this surgery has truly done to my body. Sure I'm healthier and more active and not diabetic and I've added years to my life but are those years going to be harder? Its like I took years off my externals only to have added it to my insides. I feel weak and exhausted.
Added to that the crushing emotional strain I'm dealing with I almost don't know why I'm doing this. The baby kicks sense into me before I fall too deep in this well of self-pity, but some days all I want to do is cry.
Everyone wanted or expected this child to be as girl, he's not. Now everyone is bent on destroying me with their pity, lack of interest, or crushing disappointment. My own mother is supposed to be coming to town with my grandma next week, but now I'm told she's leaving after the 4th of July, Caedeon isn't due until the end of August. When I asked her why she told me she'd send dad since he's the "one you really want there".... Seriously' mom??!?!? Way to show your support for your grandchild.
Gods, the number of times she's hurt me or let me down over the years one would think I'd be immune by now. I'm not. She'd rather hold on to her own hurt that I didn't exact the same promises from here that I did from my dad (1- I expected she'd be here with her mom and Tina and therefore me 2- dad missed my first child's birth and 3- dad actually has to put in for the time off whereas she doesn't freaking work) than be here for me and at least pretend to care about this baby. Some days I feel like I am the only one who does. It hurts. At least my baby wants to be here, he reminds me daily with his attempted escape escapades....
Sigh.

NORMAL??!!!????

Yesterday I pretty much got kicked out of the perinatologists office. I went in for a consult since I have such a nasty history of diabetes and because I wanted to get the first trimester screening done (ultrasound and finger stick to check for trisomy 13 & 18 and downs syndrome and neural tube defects). All went well, I'll have results in 2 weeks, I think they said. I'm not really concerned about any of those issues, we have no family history of any chromosomal disorders, mostly I wanted to see the baby and make sure everything was on track with my diet.
Do you want to see my baby? Of course you do....

After they reviewed my info, the diabetes counselor pretty much refused to see me since I'm not on any medication and my A1C is 6.0. She said she'd see me after the doc did if he felt a need. So I waited patiently for my ultrasound. It's rather disconcerting to have people know just how bad you have to pee from scanning a probe over your belly...
So the tech and I had fun watching my little acrobat jump around and flail and attack. She got lots of shots and the baby showed us its hands and feet a lot. Two hands, Two feet, Two legs, Two arms. so far looking normal and good :)
Then the doctor came in and checked it out and then talked to me while updating all my info in his computer, every word in effect saying "Get out of here" and "good job" he remembered me from Trevor's high risk overly complicated gestation. I know this because he fixed some errors in the old report, like it said I had "Severe Gestational Diabetes" whereas I actually had Type II diabetes that got worse during pregnancy. He asked for my last A1C, told me I didn't have to take the glucola test and asked how my sugars were running. He LISTENED to me! It was shocking, I went in there all up in arms ready to defend everything, I had food logs printed, blood sugar logs at the ready, old labs in my folder, he asked for no hard evidence and took me at my word (good thing I was telling the truth!) That NEVER would have happened if I were still overweight. It's amazing how differently you get treated when you're healthy.
So my next appointment is with the regular OB in 4 weeks, and my next ultrasound will be the anatomy scan in 8 weeks. And I'm pretty much left to my own devices. I will keep up with my finger sticks to make sure my sugar doesn't start creeping up, because while ecstatic with yesterday's appointment, I'm not an idiot, I know things can change overnight, I remember how my first trimester with Trevor was pretty great sugarwise and then it just went downhill midway through the 2nd trimester.
For now I am normal, I have no higher risk of complication than that of any other healthy weight non-diabetic pregnancy. How freaking cool is that? I'll be needing to give Dr McKenna  a huge hug!

The Right To Keep Your Mouth Shut

I was perusing babycenter.com and their august birth month forum and I came across this rant yelling at people for not telling others they are pregnant. I was taken aback! Seriously? Who are you to decide when the right time to tell people is? Like with any medical condition, I’d say pregnancy (though harder to hide than some other medical conditions) is up to you to disclose. Some people want to keep it just between the family members for a while, it’s their secret, their lives that are going to change, why on earth should it be shouted from the rooftops? It doesn’t make you any less happy about your expected arrival, everyone has reasons for waiting to tell other people.

The big one is the first trimester being the “danger zone”, not a lot of people who have either lost a child in the first trimester or had someone close to them lose their baby want to announce their pregnancy until the danger period has passed. The way I understand it MOST people don’t announce until after, but there are people due the same time as me that are screaming from the rooftops and urging others to do the same. It won’t change anything, telling people about your baby is a choice you need to make, you and your significant other.

Another reason people withhold their news is because they know someone who has either recently lost a baby or are having trouble conceiving. I think it’s admirable to be cautious of other people’s feelings. Whether you tell them or not will not affect your pregnancy, so why not be considerate and wait until you are further along to tell certain people, they might have gotten pregnant by then too. It’s not like you are putting your life on hold, yours is going on and your baby is still growing inside of you. If you have mutual friends let them know your reasons for keeping mum from certain people.

 

As for me, I’m not lying when people are asking, I evaded early on, changed the subject or gave them outdated information (so I stretched it a little), but now that I’m at 11 weeks I’m more open about it. Same as when I had my gastric bypass, I evaded a lot of questions about why I was out for 2 weeks, but as time went on and my body changed so dramatically I’d give honest answers on how it happened, but its not like I ran around telling everyone who would listen. It was my body and my right to disclose the information about it as I saw fit. No one has any right to take those decisions from me, and I would hope that every woman realizes that for herself as well and doesn’t let herself get bullied into disclosing more information than she is comfortable with.

My Vitamins

 Weird bit of info!

 

So you know how you always hear about pre-natal vitamins upsetting your stomach and ways around it? I’ve actually found a vitamin that settles my stomach! Can you believe it? It’s not a pre-natal, but I’ve been using it in addition to my PN vitamin. The Celebrate ENS in citrus splash is amazing, kinda taste like tang, but most important I can drink it to alleviate my queasiness, and I’m getting in a multi with calcium all in one drink. I’m a fan J and I wanted to share. It’s a bariatric vitamin that I’ve taken off and on for the past 2 years. I highly recommend it whether you have had WLS or not (it just lasts longer if you only need 1 a day).

Since we’re on the subject of vitamins, let me share with you all my intake:

For a multi I use 2 tablets of the Wegman’s Natural Pre Natal Multi (dosage is 4 tablets). It uses both calcium citrate AND ferrous fumarate (this iron is found in the celebrate line multi-complete, so I know it absorbed in my surgically altered body.

For my other Multi-vitamin I use the ENS as mentioned, it’s a multi with 500mg of calcium plus 4gm of fiber and comes in 3 flavors:

 Great stuff. All flavors are tasty, I keep a variety on hand because too much of one thing will make me sick. I need variety in my life.

For calcium I use a combination of Celebrate, BariatricAdvantage, and Costco. The first two have chewies that are awesome, kinda like flavored tootsie rolls (Celebrate) or starburst (BariatricAdvantage). The Costco ones are tablets.

    

 For vitamin D I use either NOW Chewable or Twinlab D-Dots (I use 5000 IU doses to keep my level normal)

 

For B-12 I found a combo with folic acid, we know how important that is. 1000mcg B-12 with 100mc folic acid

 

For Iron I have a couple options, the top two are mega cheap (ferrous fumarate again) but they don’t contain vitamin C. The second two are more expensive and are combined with other goodness, but they get the job done and have higher amounts of iron.

 

     

 

 

 

The Nursery

This is what I've gotten done so far...

Clothes aren't coming down from the attic until we know what it is, and I'm trying to not buy too much stuff until after the first trimester is behind us. You don't get a shower for a second child, do you? I'm registered, but I'm treating it more like a check list. Luckily for us, most of Trevors things were gender neutral in color and design (by design!)

Diabetes: A Girls Need To Rant

It truly is the stupidest disease in existence. It’s idiotic, it follows no logic! I felt this way when I had it for 12 years, I’ve been in remission for 2 ½ years, and now I’m having to monitor it just in case it creeps up to hurt the baby. Here’s an example of it’s idocy:

Last night, I ate healthy whole grain pasta (1/2 cups cooked), my dinner has a total of 7gms of sugar, and yet 2 hours after my blood sugar is 167 (needs to be under 130) for breakfast today i have a mint cookie balance bar with 16gms of sugar, two hours later my sugar is 77! Is my pancreas really so lazy that it doesn’t bother unless I give it a certain amount of sugar?! My daily sugar intake is between 15gm-40gms, and I cannot bring myself to increase it, especially with the reactive hypoglycemia. Evidently 16gms is within my threshold, I think my reactive level is at 30gms which is how I came to declare that my daily allotment, though some days creep up to 40, especially if I have a Balance Bar (but they used to be so good before everything started tasting like cardboard!).

So, low blood sugar makes you energetic, not hungry, and have a positive outlook. It’s a good place to be.

Sudden drops in blood sugar make you tired, dizzy, nauseous. And yet you are supposed to eat something?!

High blood sugar makes you tired and hungry, and yet you need to not eat and/or exercise to bring it down. Shooting up insulin just makes you hungrier and if you do too much then you HAVE TO eat again.

 

With Trevor (pregnancy #1) my sugar was very low for the first trimester, started creeping up around the 2^nd and spiraled out of control for the 3^rd. I was hungry all the time, seriously, my hunger knew no bounds after the first 2 months. I made a lot of bad decisions and I couldn’t stop myself. I know it wasn’t Trevor wanting/needing certain foods, all he needed was for me to take care of us, and I didn’t. I fed the disease instead of fighting it.

 

My surgery 2 ½ years ago gave me the strength I needed to take control of my health, but let me tell you its driving me crazy with this pregnancy.

 

So far I’ve got ridiculously low blood sugar, if I don’t eat every 3 hours, I drop. I’m not hungry at all to the point I forget to eat, my sugar drops, I vomit. Not exactly morning sickness, I call it an annoyance sickness, it’s driving me batty. I don’t want to overeat because once I get in the habit it will be hard to cut back. If I follow form, my sugar will probably stabilize soon, even start creeping up, which we do not want.

I’m tired all the time, so I’m not exercising as much as I would like, but I’m logging my foods and checking my sugars. I’ve got an appointment with the perinatologist on the 11^th for nuchal translucency screening, diabetes counseling (I’m worried about how their advice will conflict with my bariatric dietitian’s), and a visit with the doctor. I’ll see the regular OB first thing that morning, find out what my A1C was and see where to go from there.

 

I’m trying really hard to not let myself stress over anything right now, there’s so much out of my control. My weight is up and down, but within 3 lbs so I’m not terribly worried. My waist is expanding but I think my hips have decided to spread, I seem to be getting wider. Some days I feel like I’m showing, today being one of them. My stomach hurts when touched, the doc said it’s just my uterus working on stretching, but it still sucks.

 

I finally had 1 fasting under 100!! It was 99 yesterday morning, I had hoped the WW pasta was the secret, but I was back up to 104 this morning. My fasting is never really within the requested range, my liver is defective and likes to dump too much sugar in the wee hours. I can’t do anything for it. I’ve tried Extend snacks before bed, I’ve tried protein shakes before bed, I’ve tried whole grains with dinner but that is hit or miss for AM and ALWAYS high for the 2 hour post dinner check. My sugars are low/normal after breakfast and lunch, and mostly after dinner, so I don’t think they’ll attack me over it, I’m not even on any medications and I have these pretty numbers. I don’t want to have to go on anything if I can avoid it. Wish I knew what my A1C was… soon, I guess.

 

In short, diabetes is stupid and I’m trying to not be J Have a great day, thanks for letting me vent.