Week 24 Close: The Single Life, Cankles and New Insurance

Look at that--three posts in a week. I'm getting prolific!

Big news here is that Mister Lyrehca went out of town for a week for a work conference. My mother and father in law and others have been like, "How could he leave his pregnant wife?" and my mother has suggested I move in with her and my father this week so that I'm not alone AND because I'll have late work nights all this week and my parents live closer to my office than I do.

To be honest, I'm fine with the Mister going out of town. He left yesterday, and all day yesterday and today, I've done only things that I want to do. It's like being single again: I got up early enough and didn't have anyone in bed to keep me from going to a prenatal yoga class this morning. I went shopping in stores that the Mister has no interest in. I drove my own car. (The Mister is a control freak about driving and insists on driving when we go anywhere together, even if we decide to drive my [nicer, newer, cleaner] car. We disagree about radio station music: I like it loud and head-banging, he likes softer stuff and always thinks I'm going deaf. [I'm so not.] As I drove home yesterday from a nice shopping day out, complete with store visits and long stretches in two different bookstores [another Mister no-no; he finds bookstores boring, while I could live in one and never leave], the Killers' song, Jenny Was A Friend of Mine came on. I turned up the tunes, told the baby to rock out, and had a great time. Felt movement and everything. Perhaps Baby L. will be a future rock star. Without the drinking and drugs and groupie sex.)

But I digress.

More weird pregnancy symptoms are popping up this week. Saturday night I woke up to test my blood sugar and pee around 6ish, and felt this major knot of pain in my right calf. WTF? I stumbled off to the bathroom, where I keep a copy of "What to Expect When You're Expecting" for easy reading. Leg cramps apparently are common as pregnancy progresses, and if stretching didn't alleviate the pain, I shouldn't massage or heat the area, as it could be a blood clot and need immediate attention.

Uh, great.

I stretched a bit, then went back to bed. A few hours later, after I'd driven Mr. L. to the airport shuttle, I walked around a bunch and noticed, mid-morning, that the pain was gone. So that was good.

More persistent has been the appearance of super swollen ankles. Like, total cankles (calf-ankles). I first noticed them last week after I came home from work, devoured two half-sour pickles as an appetizer, then had a frankly unhealthy dinner of veggie chips (which are essentially potato chips) and egg salad. Honestly, I found it delicious, and figure I eat nutritiously most of the time. Right after dinner, however, I looked down and noticed total fat pads where I'd normally see two rare slim body parts. The tops of my feet looked pillowy, too.

Oy.

It was around 9:30 at night, so I thought paging a doc on call would be a good idea to do sooner rather than later. This was after I looked up swollen ankles in the aforementioned pregnancy book, saw that it's another common side effect of pregnancy, but that it could lead to pre-eclampsia, a pregnancy horror show, if it continued.

I paged my OB's office and a doctor on call returned the call within 15 minutes. Yes, despite my eating salt-filled foods in the past and not suffering any detrimental blood pressure or other ill effects, nowadays the pregnancy can cause bloat around the lower regions. I slept with my feet elevated on pillows and the next day, they looked better. I wore boots to work and they were a bit tight, but felt fine as the day progressed.

Again, last night (after a pesto chicken meal out with the parents, high-fat and yes, salty, but Oy! so delicious), I came home to find more ankle bloat. I even measured my ankle circumference, then went to bed with feet raised.

Today, things looked better, and I lost an inch of bloat when I measured my ankle again. (As I type this, I figure, "Jeez, who measures their ankles?" But if you've been reading this blog for any length of time, you already know this sort of thing doesn't faze me in the least. I mean, who out there has measured her bloated ankles before? Anyone?)

But after lunch, the ankles looked big again, so I paged the OB's office and talked to another doc on call, who assured me that ankle bloat is common, and that lacking any other symptoms like a splitting headache, rib pain, or some other thing I definitely didn't have, it's likely I don't have pre-eclampsia and that I should be fine until Friday, when I next have an OB/Endo visit. He did suggest I lay off the pickles and pesto chicken, if I wanted my ankles to stay small.

Diabetes-wise, I actually got it together to send my Endo some daily readings. For some reason, I read about how people download their meters and their pumps and all that into their Palm Pilots and Blackberries and just email the results to their docs. I have all the technology (or at least I think I do), but still, it seems the only way to get every detail down is to write down my blood sugars, my basal and bolus rates, the exact carb amounts of what I eat, and whatever other stuff worth noting, like a set change, on a good ol' slip of paper. I download daily logs from Minimed's website, but writing all that stuff down is so darn tedious, it kills me. It's worse when I try to do several days at once, because while my meter will go back for 90 days of readings, my pump only goes back a day and a half. And do YOU remember specifically what you had for dinner four days ago? Plus, since I eat mostly the breakfast and lunch day to day, and my A1c has been great (the last one was 5.4, a new personal low), the doc hasn't been on my case about sending them regularly.

But the insulin resistance has kicked in hard, and I'd noticed my weekly average going up to about 140, which is higher than it's been this whole pregnancy, so I called the doc and she wanted to see the data. Of course, the few days I wrote stuff down, there were only a few unexplained highs mostly in the morning, and they were unresponsive to correction boluses for a few hours. The rest of the numbers looked pretty good.

The Endo called me on Friday and upped a few basal rates, and increased my morning carb ratios. Now I eat something like 1 unit of insulin for every 3.5 grams of carbs in the morning, and 1:6 at night. For you diabetics reading, it translates to taking about 30 units of insulin a day when I was a New Yorker, walking all day, to about 45 units when I moved to Mass. and became more sedentary, to currently 75-80 units a day now that I'm a second-trimester pregnant lady. Correction factors are now 1:25, down from 1:40 or so before. It's all normal for pregnancy, and it'll likely only get worse as things move on, but Oy! I'm zipping through insulin so much quicker these days. I regularly refill my pump and change out my infusion set at work--I do it every other day now, too. (Yes, I have an old pump that only holds about 160 units at a time, but until the damn thing breaks, I'm going to hold off on upgrading til I have to. I mean, I'm dealing with enough daily changes with the cankles and the baby moving. I can handle a few extra set changes a week.)

And in a final bit of medical news, my new husband-provided-for health insurance kicks in this week, a change from having my own insurance through my own job. We got our new cards last week and I was annoyed that MY card has MR. LYREHCA's name on it, since he is the primary carrier. Oy. Plus, it wasn't effective until today, since that's when his new pay period started. This means, technically, that my insurance ran out on 12/31, and I was uninsured for seven days. I called to complain about both the name indignity and the lack of coverage and was told that's just the way this plan worked. While there was a split moment with that leg pain that I thought, "What if I have to see a doctor because I have a blood clot the week I'm between insurances?" thankfully that didn't turn out to be a problem.

Hopefully I'm now covered under the Mister's plan and I hope it won't be a hassle learning how the new system works and there won't be any surprises about what the written plan says it covers and what happens when bills actually get processed. I know some people have issues with things getting covered, due to "pre-existing conditions" when they have a break in insurance coverage, but I read specifically that pregnancy isn't considered a pre-existing condition, and that specifcally, this hasn't been an honest break in coverage. I'm hoping my obsessive thinking about health issues will, in this case, turn out to be unwarranted.