See, I haven't gained any weight. Since I was rather seriously overweight due to losing almost none of the weight from A's pregnancy (thank you, thyroiditis, thank you PCOS), I would be happy to be happy with this. If I knew this is ok. I have failed a few glucose readings in the past couple of weeks. Only a few, here and there. But the times I am not failing, I am on the low side. Too low, I think.
It's not helping that the last couple of weeks at work I have been writing problems for the midterm and answer keys for same. Yes, I have been staring at the various aspects of glucose metabolism for work. And somehow, while I was
[Brief diversion for hand-wavy explanation. All the food we can absorb can be described as fat, protein, or carbohydrates. We like to send the protein we consume straight to be chopped into amino acids and incorporated into our own proteins, and we build different proteins in our cells all the time. If we have enough carbs, we can send fat straight to storage. If not, we'll burn it for energy. We break complex carbs down into simple sugars. And the preferred, easy to use fuel for the cells in our bodies is glucose. Fuel for dummies, so to speak. So we break our carbs down, and we dump glucose into the blood, for easy distribution to all cell types in need. Now, all cells have glucose transporters on their surface, and they take glucose from blood as needed. Neurons have greedy transporters, for example, so they get first dibs even if we haven't eaten in a while.
But after a meal, our blood glucose spikes. Our pancreas is watching this, and the beta cells therein have this special type of glucose transporter on them that only trips when there is a lot of glucose to deal with. So beta cells make and dump insulin, and insulin goes in the blood stream to all these needy cell types, namely muscle and fat, and trips the insulin receptor on the cells, and that trips a somewhat long cascade reaction inside the cells that results in the cells putting more glucose transporters on the surface. Now the party can start-- the cells can take in more glucose than they need to use for basic metabolic functions, i.e. just for survival. High times.
So you know how there could be too much of the good thing? Yeah. So if these cells take up more glucose from the blood, and they pay a certain energy premium to convert it into storage form for later use-- muscle as glycogen, and fat cells as well, fat. The storage form is so that when we haven't eaten in a while, but decide to say take a walk, our muscle cells don't have to go begging to blood for that glucose they need to work, but can instead again pay a premium to get it back out of glycogen. Our liver also stores glycogen, a lot of it. This is so that when other cell types need glucose, and suck it out of the blood, liver can replenish that supply by breaking down glycogen. Again, for a fee.
If your insulin regulation is screwed up, like mine is, it may take too long to shut off production of insulin, resulting in too much glucose being cleared out of the blood stream after a meal, resulting in those reactive lows that I blabbered about a little while ago. Eventually the cells demand glucose, and if you don't react to that by feeding the beast, your liver has to give up the goods.
Um... not so brief with the explanation, I guess.]
So this hypothetical energy waste on paying storing and un-storing/usage fees would all be fine and good, of course, if not for the concern I have developed about whether these reactive lows mean that I am stiffing the creature behind the placenta of the glucose it needs to, you know, grow. If my cells are doing this last call run on the bar thing every time I eat, what gets to the other side? Adding in that at our early risk assessment ultrasound, the measurement was four days behind the due date, and that is the due date they have, which is two days behind the date I know to be correct, well... paranoia is my middle name these days.
Dr.Best is not convinced. Looking at my glucose measurement numbers he said that they look great, except he thinks I may need to up my intake. Ha! How is he to know that I am certainly not skimping? If anything, I stuff myself. Well, I told him, so now he knows. And of course, in my pregnancy with A, I started gaining weight and fast after I stopped taking the insulin-sensitizing meds. This time, I stopped those almost two weeks ago now. And still reactive lows galore, with a few failed readings in spots. Those usually have some inauspicious balance of carbs/fats/protein, although I can't always predict what is likely to bump me over. A cupcake might not, for example. By its lonesome, it is actually more likely to send me to a reactive low.
So Dr.Best is not convinced, but since he knows that I calm the hell down on any particular issue in the face of actual observable data, he is willing to employ modern medical technology to resolve this one. Thus, we have a previously unplanned ultrasound scheduled for Friday morning. Not the big anatomy scan-- that will be another three weeks later, provided things keep going well. This is a quick peak to assess growth. But I am also planning to ask for a check on the placenta, position of said placenta (low-lying I am willing to bet, as I had a little brown spotting episode about ten days ago), and cervix length (because of the selfsame spotting thing).
I will also ask to see whether sex of the occupant can be determined. That last one is not for vanity, I assure you. So tomorrow: the post that explains it, one I have been putting off writing since almost the start of this blog.