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September 2006 posts

Wait, no, I change my mind, I think.

I've been cleaning up, getting things ready for our little baby party tommorrow.  I talk to Bob at work about some things I need him to bring home from the store.  He asked me if I told the girl at the bakery the baby's name to add to the cake I ordered there last week.  I didn't, because I didn't know what in the heck to write on the cake, since we're having our own get-together, and writing "Congratulations" or something doesn't make any sense.  So, Bob says we should add the baby's name, in the form of "Welcome/See You Soon/Come On And Hurry Up Damnit Baby _________!"  That does make more sense than a blank cake, so I was thinking about the wording.

Then it occurs to me, I've missed a very basic problem with this name.  You can easily poke fun at it with our last name.  I was sitting here mentally illiterating the name, and realized that it's got the potential to be made fun of.  Just giving the name to a group of 7-11 year olds and telling them to repeat it would bring out the tease quality.  I don't know how I missed it.  Of course, you have to intentionally (or unintentionally, because every salesperson that calls here says it wrong) say the last name wrong to cause the problem... but...still.  Ugh.

36 Weeks - Hey, wait, ten months?!

36 weeks tommorrow.  Nine months down.  Wait, nine months?  Oh yeah, forgot about this part, the tenth month.  I went today for a regular weekly OB visit.  Stats:  No protein in the pee (yay), blood pressure 96/70, weight = less than an elephant, (even two pounds lighter than a week ago on the same scale!)  The baby's heartrate was fine, though she was very quiet, so they popped me on the fetal monitor for a little while and I drank some cold water to see if we couldn't prod her awake.  She passed the test with a couple of movements after I lay there for about a half-hour. 
This OB felt around for baby parts, and also decided that we need to see where in the heck she's positioned, since it still seems very sideways, upside-down, backwards and square.  I let her know that we're already scheduled for an ultrasound Tuesday, to check the position, and I'll be at 36 weeks and a few days.  She mentions that we could try for the external cephalic version to move her down, but I am still not keen on that idea, so she suggests like last time that we're probably looking to a scheduled cesarean in a few weeks (unless we have the miraculous flip over, like, now.)
While I was waiting for my appointment, a very hugely ginormous pregnant woman came in, and another lady in the waiting room looked up at her, and the preggo woman just says:  "Don't Ask."  She's having twins, due a week after me, and looked like she might explode right there.

Vitamin Deficiencies After Gastric Bypass Info

Just found this snippet of info - a good explanation of some of the vitamin deficiencies after gastric bypass.  In my experience, all are true, I'm low in Vitamin B-12, Iron & Vitamin D.

"...the restrictive and malabsorptive gastric bypass procedure commonly produce an increased risk of predictable nutrient deficiencies. There are predictable deficiencies of vitamin B12, iron, folate, and calcium absorption. Less common, are deficiencies in zinc and the fat soluble vitamins A, D, and E.

Vitamin B12. Vitamin B-12 typically comes into the body bound in a protein. The stomach secretes acid and Intrinsic factor which release the Vitamin B-12 for absorption in the small intestine. The gastric pouch secretes little if any stomach acid or Intrinsic Factor. Hence, it is very difficult for the small intestine to separate and absorb Vitamin B-12.

Vitamin B12 deficiency has been reported to occur in greater than 30% of gastric bypass patients a year after surgery.(1) Normally, vitamin B12 containing foods (meat, eggs, and milk) undergo acid and peptic hydrolysis in the stomach to liberate vitamin B12. Once released, vitamin B12 is avidly bound to R binders, which are glycoproteins secreted in saliva, gastric juice, bile, and intestinal secretions. Pancreatic pro-teases then degrade R binders in the duodenum and permit vitamin B12 to associate with intrinsic factor (IF). The IF—vitamin B12 complex then is bound to specific receptors in the distal ileum, where absorption occurs.

There is virtually no stomach acid secretion in the constructed gastric pouch. Consequently, cobalamins are not liberated from protein and are not available for intestinal absorption. Normal plasma cobalamin levels can be usually maintained with oral supplemental vitamin B12. The inadequate levels of secretion of IF and/or binding of cobalamins to R binders requires a bypass patients to take daily oral supplementation of crystalline vitamin B12. Vitamin B-12 is most effectively taken sublingually, i.e., a tablet that dissolves under the tongue. Alternatively, monthly vitamin B12 shots may be administered.

Iron. Iron deficiency has been recorded to occur in 33% to 50% of patients after a gastric bypass, with a greater incidence in menstruating women.(1) Iron enters the body in two forms, heme or organic iron, which is derived from animals, and non-heme, which is derived from plants and other non-animal sources. The primary absorption spot for iron is the duodenum and beginning of the jejunum.

The cause of iron deficiency is related to 1) reduced intake of organic (heme) iron (gastric bypass patients tend to reduce their intake of animal products) and 2) the bypassing of the acid environment of the stomach and absorptive surface of the duodenum and upper jejunum. Organic iron is more soluble and readily absorbed than inorganic iron. It must be liberated from its protein structure by exposure to stomach acid and gastric juices. The bioavailability of nonheme iron, or non-animal in origin, also depends on an acid environment where the low pH of gastric secretions solubilizes iron by reducing it from the ferric to the ferrous state for absorption in the duodenum and upper jejunum.

Since the gastric bypass patient has almost no stomach acid and both their duodenum and upper jejunum are surgically bypassed, iron absorption is greatly impeded. Thus, development of iron deficiency anemia is likely to occur in all gastric bypass patients, especially in women who have concomitant menstrual blood loss.

Iron absorption is increased or decreased by different factors. It is more bioavailable when the iron is in an acidic environment. Taking an iron supplement with Vitamin C, ascorbic acid, increases its absorption.

Iron absorption decreases when taken with coffee, tea or red wine. The presence of calcium can also inhibit iron absorption. It is believed that calcium and iron compete for the limited absorptive capability present in the body.(2) If both iron and calcium supplements are to be taken, they should not be taken within on hour of each other(3).

Folate. Folate deficiency is a common occurrence amongst the population at large. One researcher has concluded "that over 44,000 lives could be saved every year if just half the population of the United States were to supplement with 400 micrograms per day of folic acid."(4) The best dietary source for folate is, wouldn’t you know it, animal liver. Green leafy vegetables are another good dietary source. Folate is absorbed primarily from the first third of the small intestine, although it can be absorbed from the entire length of small bowel(1). Since most, if not all of the first third of the small intestine is bypassed because of gastric bypass alterations, gastric bypass patients are more prone to folate deficiency.

Calcium. Calcium deficiency can result from several factors: (1) reduced intake of calcium and vitamin D containing foods; (2) bypass of the duodenum, where most calcium absorption typically occurs; and (3) malabsorption of vitamin D due to mismixing of pancreatic and biliary juices in the jejunum(1).

Unlike deficiencies of vitamin B12, iron, and folate, for which periodic blood testing is a sensitive indicator of status, calcium deficiency is more difficult to detect. Only 1% of the body’s calcium is in the blood stream, the rest being in bones, teeth and marrow. When blood stream calcium is low, the body regularly borrows calcium from bones and marrow. Consequently, blood stream calcium is seldom low even when the body intake is insufficient. The blood stream calcium may be adequate, but the bone calcium level has been depleted. Hence, a blood test for calcium will not register a bone calcium deficiency. A bone density scan is required to do this.

Many gastric bypass patients are unable to tolerate dairy foods because of an underlying lactase deficiency. Since the majority of calcium comes from dairy foods, which are also an important source of vitamin D, avoidance of these foods can have a significantly impact on calcium absorption. Once ingested, calcium normally is absorbed in the duodenum and proximal jejunum by an active saturable process that is assisted by vitamin D. The surgical exclusion of these intestinal segments from digestive system acts to diminish net calcium absorption.

Gastric bypass patients must therefore depend on a second and more passive mechanism of calcium absorption to maintain bone health. This passive component functions by simple absorption throughout the entire remaining small intestine. Hence, within certain limits, an increase in dietary calcium will be followed by a proportional increase in amount of calcium absorbed. When increasing calcium supplementation, one should bear in mind that doses in excess of 400 mg have little additional effect.(5) Calcium is absorbed in an inverse ratio, the more calcium taken, the smaller the percentage that is absorbed. A dose of 100 mg has a 41% absorption rate, but a dose of 2000 mg has an absorption rate of only 14-15%.(6) So more calcium is not necessarily better.

Two other factors can affect the bioavailability of calcium for a gastric bypass patient. The first is the presence of Vitamin D. The presence of Vitamin D increases the bioavailability of calcium. The body can make Vitamin D from sunlight, but this ability decreases with age. A daily supplement of 400 mcg of Vitamin D will enhance its absorption.

A second factor affecting calcium absorption is the form of the calcium. Calcium is most commonly available as calcium carbonate and calcium citrate. Calcium carbonate, table chalk, has a higher concentration of calcium and is less expensive. However, calcium carbonate is not absorbed well in a non-acidic environment. Calcium citrate has a much higher bioavailability rate than calcium carbonate(7), particularly for gastric bypass patients who have little if any stomach acid available to assist in absorption. Magnesium will also assist in the absorption of calcium into the bones.

Gastric bypass patients should receive calcium supplements of 1000 to 1500 mg/d in divided doses. Calcium intake in amounts greater than 500 mg are not absorbed. It is better to take three times a day than once a day. Calcium citrate with vitamin D is the preferred preparation because it is more soluble than calcium carbonate in the absence of gastric acid production.

Zinc. Zinc sometimes presents a problem because it is absorbed in the duodenum with iron. The bypass of the duodenum reduces the opportunity for zinc to be absorbed. This can largely be overcome by using a zinc amino acid chelate supplement. A zinc amino acid chelate is a combination of two amino acid and one zinc molecules. This compound is very small and easily slips through the lumen of the small intestine. One inside the lumen, the body easily strips away the amino acid leaving the zinc by itself.

The deficiencies in Vitamins A, C and E are not directly related to bariatric surgery. The non weight loss surgery population often runs a deficiency in the vitamins. Weight loss surgery patients will need slightly more Vitamin C, ascorbic acid, to provide an acidic environment for iron absorption.

The Diah-beadahs!

This morning at the oncology and hematology clinic they were running late as usual and I couldn't find any magazines to read I closed my eyes and sort of cat-napped while I waited.  This joint is the hopping place for little old ladies and men to get together to catch up on the weeks' events, and everybody knows everybody.  So across the room today sits "Mary & ________."  (I didn't catch her name.)  They're blood buddies - they meet in passing each week when they're receiving blood treatments, injections or meds.  They gossip and chat, and push their husbands out of the way to talk amongst themselves.  I look up and noticed a very pregnant young woman come in for labwork, I find myself wondering if I look as big as she does, and whether maybe she's carrying twins, because she looks a lot bigger than I do, but not "fat."  She notices me, because I'm sitting back with my hands resting on the baby belly while I "nap."  This woman brings attention to me to the little old biddies on my left.  After the very pregnant woman leaves, I hear the biddies say, "You know, they get The Diah-beadahs!"  I peek over at them, to see that they're staring me down, trying to figure out why I'm at the hematology clinic.  Then they went all hush-hush and whispered with hands at their mouths about my Diah-beadahs.  I couldn't really care less, they probably thought in a Diah-beadahs coma because I was resting my eyes, so whatever.  They could have been worried about the ingestion of my Iced Sugar Free Skim Vanilla Latte, that kinda thing "can give ya The Diah-beadahs, with all that Sugar."

Anyways - there's no point to this post, as many posts lately - but, I just realized, I never did have any legit Diah-beadahs testing during the pregnancy since I refused the jelly-bean test.

Target Baby (Sucks.)

So I have the fetus registered at Target, since I thought it was less expensive for products in general than, say, Babies-R-Us, and that it's close-by.  Also, I figured that it would be easier for Bob to go, physically, to the store while I'm in the hospital to pick up whatever we didn't acquire pre-baby from a list, since he's better knowing exactly what to get as opposed to just picking stuff up that he likes or whatever at the last moment.  This way, he can go and get what's left on the list when it becomes absolutely imperative that we get it - like - when a head is emerging from my body.  Now I thought this list was a good idea, but it's turned into a pain. 

First, something silly, but that I don't understand?  Why can't a person register for diapers?  I really wanted to put the cases of dipes on the list, but you're not allowed to add diapers or wipes.  Is there a reason for this?  It makes sense for me to place dipes on a registry since this isn't my first baby (duh!) and people are more likely to gift me with things LIKE diapers because they ARE a necessity, right? 

I've had a couple people ask me what we "need" for the baby this week,  (A. because we're having a baby party on Saturday.  B.  The baby is going to arrive no later than 29 days from this very moment!) and I've told them about the baby list, but it's been met with frustration because half of what I'd added to the list is either unavailable, out of stock, online-only, in-store only, discontinued, or plain old MIA.  My mother in law went today to another Target location, with the list in hand, and couldn't find what she wanted from the list.  She had asked me to even circle the Items Of Most Importance, which I did, and they weren't available.  I mean, I went to a store an hour away and found one stroller/cassat combo in a ripped up box, and grabbed it because it WAS the only one, and a cassat was one of the absolute first necessities on the list.  It's just frustrating that the stuff isn't available, especially when there are customers willing to purchase product from a list, but they're turned off by the lack of supply.  Lesson learned, don't register with Target.  They suck.

How you happened on the blog today.

"make women moan"

Here's how:  Come home from work early.  Better yet, take a mental health day!  First,  slowly clean the bathroom, paying strict attention to the tub and shower walls which need manual scrubbing and lots of bending over to do so.  Then, make your way to the kitchen, where you get on all fours and wash the floor by hand.   Continue to do menial tasks all around the house until your woman feels nesting is complete, clean yourself up, kick back - relax - give your wife a back massage until she moans, "Thank You."

That's my suggestion.  Hey, it works.

Yeah, stomach acid burns 'em up nice.

Glancing at the keyword searches on the blog today:

"do babies grow inside the old stomach after gastric bypass surgery?" 

Please don't reproduce.  I beg of you.  If that baby is gonna grow in your old stomach, where on earth are you getting pregnant, down, the, uh, throat?

I might not wear a sheet.

I spent a very long time last night online looking for a suitable dress to wear to my brother-in-laws' wedding that is happening, uh, very soon.  I was avoiding the dress-purchasing because I had a feeling that I might be post-partum at the date of the wedding, (albeit like, three days post-partum, and depending on how this baby makes her entrance, head or foot-first, I may not be so much fun dancing at a reception, so...) I was waiting to see. 

Well, one trip to the mall let me know there isn't anything that will fit my newly expansive ass that I'd be able to buy the day before the event and just put it on.  Not only that, I'm cheap, and spending money on an outfit I will only wear once kills me.  (Well, technically it kills HIM, but he's wearing a tuxedo that was rented FOR him.)  I'm the hot date of the Best Man, so I will be on camera, and I don't WANT TO BE WEARING A MUU MUU.  It took me a year not to have to order my special occasion outfits from Lane Freaking Bryant, I refuse to do it now.  Even though, technically, I'm in the size range again, I won't do it.  No. You. Can't. Make. Me.  So, I searched Motherhood, and all of those online maternity shops, to find that what I need, would cost hundreds of dollars.  Uh, no.  I'm never going to be large enough to fit into a "XL Maternity Special Occasion Dress" EVER again.  If I can't wear it twice, it's not worth the money.  Sorry.  I ended up finding a "little (big) black dress" on clearance at one of the maternity shops online.  I'll still need me some Spanx Mama (didn't know they had these?!?!) hose, some cute shoes, and a shawl, wrap or fancy cardigan to cover my chicken flap arms, but I won't be wearing a sheet!


Because of course it wouldn't last.

Three cycles and the clothes are still damp.  I'm going to hang them out before it rains ::insert expletive here:: This, as I'm going to get the clothes out to get dressed and go pick up the birthday girls' gift.  Please, stop messing with me.

...Ok, I'm distracted, completely...utterly...by the two brothers playing guitar and harmonica on the Ellen Show.  Must Google Now.  Ok here we are... COLE & LD MILLER... Wow.  I'm looking for video.  The Ellen snippet will probably make it to YouTube... but here's a crappy one for now:

Happy Birthday Miss C!

Nine years ago today, I had a baby girl.  7 lbs.  12 oz., 20.5 inches long, with a little bit of brown hair and very blue eyes.  She was born one week after her due-date, with a scheduled induction, at 3:58pm.  Labor was pretty uneventful, though right after her birth, we realized she was a stubborn girl.  She held her breath and turned a lovely shade of blue.  After doing that, and making several doctors poke and prod her for signs of a problem, she checked in to the NICU for five days of all expenses paid intensive baby care.  I still believe to this day that she just wasn't ready to come out into the world.  We were very lucky that there wasn't anything wrong with her, and she's been a healthy girl.

I have a giant under-bed box filled with photographs from basically then until now, and she was looking for a picture of herself for a school project.  The pictures were at one point all organized into albums, but we had a flood in the last house we owned, and much of what I did have got water damaged, and I had to remove and save what was left.  The pictures ended up in boxes, and have yet to make it into anything more permanent. 

I think my daughters' teacher does something on each childs' birthday to make them special for the day - and it requires a photograph.  She looked in that box for over an hour last night, looking for the perfect one.  She didn't explain if it needed to be a baby picture or a current one, but she found both.  She found several photos of herself as a newborn, and told me without a doubt, that "this is Baby _______, why are her pictures in the box?"  (Baby _______ is her new baby cousin, and we have a little pile of new pictures of the baby out, and she's been looking at them.)  We then realized that this new baby resembles her as a baby - and she really couldn't tell the difference.  She told me at least three times, that those pictures of her as a baby are really just the new baby, and there's just no way it's not.  She knew that the pictures of her own siblings were not her, because they don't look as similar to her as the new baby cousin does.

So, anyways, Happy Birthday To Miss C.  Nine is Divine.  :-)

34 weeks 6 days.

34 weeks and 6 days today.  I went to my OB visit, and I showed the doctor my swollen leg, ankle & foot.  She didn't think much of it, and even measured the right leg to show that it really isn't all that much bigger than the left side, although it is swollen, and measured like a half-inch bigger.  My blood pressure was okay, 118/80, so the bottom number has been going up a bit.  I do have a slight amount of protein in my urine, so I'm watching for any further signs of pre-eclampsia, since these are the early signs of it.

The baby seems to be breech, still.  The OB went to find her heartbeat and got nothing but my smooshy loose skin and fat belly where there is no baby.  I told her to move up, since the baby is all crunched up very high and upside down.  I've now got an ultrasound to determine the position on October 3rd.  If she's not in firing position, we're scheduling a c-section at 39 weeks.  The OB recommended trying all I can to get the baby to move, because cutting me where I do have all that loose fatty skin will be a bad deal, since it's unlikely to dry out and heal, especially once I'm sans fetus and not stretched out.  I never really even thought of that, I just don't want to be out of sorts after the birth and I really hate pain medication, it makes me sick.

Oh, the good news?  No weight gain. 

Because we can't call her The Fetus.

We may or may not have a name for The Fetus.  I came up with a suitable suggestion - and most everybody has dug it.  I say "most" because the husband immediately made fun of it, but then cocked his head to the side and repeated the name, Rainman-style, until it sounded better to him.  When I explained to him further how I "came up with the name" - it was more appreciated for what it is.  ::sigh::  What a pain in the ass this naming stuff is.  Since my name is all over the Big Bad Internet already,  I suppose "announcing" a name here isn't going to change anything.  I've already sounded it out over on my other page - but it's not a done deal yet.  It's still liable to change, because the baby may not look like a ____________, also, what if the Fed-Ex Man's DNA really stands out and the baby really really doesn't look like a ___________. Eck13


This morning I had my weekly IV iron infusion.  My hematocrit level is down again, so perhaps last week was a flukey higher (but still anemic ) reading due to dehydration?  I was at 24 (blood transfusion level),  then last week at 29 (better, fluke?) now today barely pushing 26 (better still than 24, so maybe the IV is helping a wee bit.) 

The doctor asked if I was having any trouble breathing.  I told her that it feels as if the fetus is now large enough that she's cramping my personal space and that it's interfering slightly with the breathing business.  Like, if I'm running laundry up the stairs, I most definitely have to catch my breath once I'm back up.  Sometimes, I have to stop and literally "take a breather."  This doesn't seem to be anything other than the pregnancy, but I could be wrong. 

In every other pregnancy I was in excess of 250-320 lbs., so I don't know if the size THEN also made it hard to breathe - because I was just winded being super-morbidly obese AND pregnant.

Just after baby #2, '99...

I'm "obese" technically now, too, but having little to no oxygen in my blood cells may also contribute to lack of breathing.

Hematocrit levels:  The normal hematocrit range in pregnant women may be as low as 34% (normal for a non-pregnant woman is 37%-47%). This discrepancy has been explained by hydremia (dilution of the blood), or the physiologic anemia of pregnancy.

  • In the first trimester, a pregnant woman at, or near, sea level, is anemic when her hemoglobin level is less than 11 g/dL or her hematocrit level falls below 37%.
  • In the second trimester, she is anemic when the hemoglobin level is less than 10.5 g/dL or the hematocrit level falls below 35%.
  • In the third trimester, she is anemic when the hemoglobin level is less than 10g/dL or the hematocrit level is less than 33%.

My blood pressure was 120/80, which has been the same level at that office for three weeks.  My pulse, 88, also the same as it's been for those three weeks.  Before that, the pressure was slightly lower, and at times gets really low.  I suspect I may spike in the next few days/weeks with just 37 days until my estimated date of delivery. 

Tommorrow I have a regular OB visit, it will be nearly the beginning of the 36th week.  Whee.  I really hope she schedules an ultrasound to check on the true position of this child, as she still feels ass backwards in there.  Everything I've read has said that most breech babies will have turned by now if they're going to be in the optimal position for a vaginal birth.  I will not have a external cephalic version (physical turning of baby via hands-on in hospital bed, while it CAN work, there are risks and you can end up in an emergency situation due to the actual procedure),  so do a little voo-doo for me that she's turned already.  A c-section would just not be good for me, I don't want to have major surgery with my blood situation.  Yeah, a tubal ligation would be a bonus if they're gonna cut me open, but... I don't want to bleed any more than is necessary for a regular childbirthing here, since I'm so low on supply.

Otherwise, I think I get the Strep-B test done tommorrow, and I usually am a carrier, so that means I'm already hooked up to an IV during labor and delivery anyways to take in antibiotics.

I'll post more tommorrow when I see the OB and hopefully will have news regarding what's next.


To Everything Turn, Turn, Turn.

Last night, I awoke to one of "those" phantom pregnancy pains that make you sit up straight in the bed and consider waking somebody up to drive you to the hospital.  It went away quickly, probably a  couple of really good Braxton-Hicks contractions, which in a fourth pregnancy are much more intense.  For a moment, I seriously thought to myself, "Well, I guess this is it.  Let's go."  Then, once I realized it was the middle of the night, and I've still got a few weeks to go, and that I do NOT want to be going into any sort of pre-term labor, I got a drink and went back to sleep.  I think it's just the fact that this is a fourth pregnancy, and my body is all like "We know what to do, let's get it done."  The contractions are so much more frequent and intense than in any other pregnancy, it makes me wonder daily how I'm still holding this fetus in.  It feels as if she's clawing her way out.  I'm hoping that the OB schedules a looksie ultrasound for the next week or two, because I really want to know if she's still in a breech position or if maybe she's turned head down.  I truly don't think she's moved, since I feel like she's got all four limbs in one spot on top.
Transversepresent "Transverse: A baby in the transverse                         position is sideways, usually with his shoulders or back                         over the cervix. Sometimes referred to as a shoulder or                         oblique position, a transverse position occurs in 1 in                         2,500 births. The risk for having a baby in the transverse                         position increases if you go into labor prematurely, have                         given birth four or more times, or have placenta previa.                         Your doctor will deliver the baby by cesarean section,                         either right when you start labor, or a little earlier.                         A vaginal birth would be too risky for you and the baby.                         If there is a long labor period before the cesarean is                         performed, there is an increased risk of uterine rupture                         and umbilical cord damage." 

That sounds fun.  I don't want a cesarean, so I'm off to hang upside down before bed.

Good Eatin'

I had a good belly day today.  For whatever reason, I didn't eat anything that made me want to curl up in the fetal (haha, funny, this fetus doesn't lie in the fetal position, she's all folded up ass backwards) position after eating.  I 'spose I should sit back and rethink today's menu to see why it was a winner?  Okay, what the hell did I eat today?!  Umm, breakfast... oh yes, Breakstones' 2% Cottage Cheese in the snack-pack, of course.  Then, a half-cup of coffee. (Beth has lost her taste for regular hot coffee lately, this is a huge shock, yeah?)  Then, Sesame/Peanut Balls.  I found these at a nutrition/vitamin store in a huge bag for like five bucks.  These are a good pick because I can't overeat the actual nuts, which generally make me throw up.  I can eat a serving of these crunchy balls, and it turns out to be like 10-15 nuts.  Lunch, a picnic.  My mother packed lunch.  I had cucumber pieces and snap peas with Cedars' Horseradish Hommus.  (YUM, this stuff WILL come home with me next time I go grocery shopping.)

Then, a few bites of her version of chicken salad (chicken breast, celery, cranberries, mayo...) which has been one of my mainstays during pregnancy.  We took the kids for ice-cream after playing, and I ate the very bottom of a nearly-empty ice cream cone with soft serve vanilla in it.  I think that's it for lunch.


Dinner was one square of leftover thin crust pizza from last night, meat-toppings.  (Dominos' which we all know has nothing to it, they're so freaking stingy with the toppings!)  Snack tonight was more cottage cheese.  Now, I want hot tea.