Sunday, July 31, 2011

31 Week Photo

Here I am at 31 weeks pregnant. My belly measures like a 37 week pregnancy with one baby, and Leo and Zoe together already weigh more than Sam did at birth. No matter how difficult this pregnancy becomes, I still love that huge belly!

Friday, July 29, 2011

Crunch Time

Things are happening fast. The gestational diabetes is a non-issue (my ob even agrees with me about not following the meal plan), but now it looks like I might be on the road to pre-eclampsia. My blood pressure has been rising and fluctuating. At my ob appointment today, they took two readings. The first was something like 143 over 69 and the second was 125 over 70. I tend to have low blood pressure, so these are definitely high for me.

The doc did a blood test for pre-eclampsia again today (the last one was negative) and he wants me to come back on Tuesday - just four days from now - for another check. I told him that I had purchased a home blood pressure monitoring kit and he agreed that it would be a good idea to test at home here and there. If I get a reading of over 130 systolic or 80 diastolic (did I get those right? I always get the names mixed up), I need to call him immediately, and if it's on the weekend, I'll be sent to the hospital.

I'm not worried about pre-eclampsia, so much as I'm pretty sure I'm going to end up with it - it's just a matter of when. To me, all the signs are there: the incredible swelling, the rising blood pressure, and the clear signals I'm getting from my body, telling me, "you must lie down immediately!" And, just in the past week or so, I've been getting nauseated in the middle of the night, which I took as a need for more food, but which can also be a sign of pre-eclampsia.

If I am diagnosed with mild pre-eclampsia, I'll be put on bed rest. If it is severe, I'll be on bed rest in the hospital.

The good news is that the problem can always be solved by delivering the babies (and the placentas). So when the condition gets to a certain point, they just do a C-section. I am 31 weeks along now. If I can just get a couple more weeks in, we're past the really bad premature delivery issues. But I still have a goal of making it until September, and hopefully until September 16. (Did I tell you that my "just in case" C-section date was changed from the 15th to the 16th?) So, I now have the excuse that I need to slow down. I mean, I really, really have to slow down. It's going to be very difficult. I don't really know how to do it. What do I do with all the things that need to get done? Sam's last day of camp is today. What will I do with her all day after this? It might be time to start calling on that list of friends who have offered to help. And I have to sit down with Adam and figure out a plan to deal with this. Asking for help is hard, but I'm going to do it.

Thursday, July 28, 2011

G.D. Update

Well, the gestational diabetes class wasn't as stupid as I thought it would be. The dietary advice was much better than things I had read on the internet for diabetics, and they did a personalized meal plan for me (based on my weight gain, the fact that I have twins, etc.) which is very close to how I actually eat. The only real difference is that I pay much more attention to timing and balance (and my body's own signals), whereas the meal plan I was given was basically just a way of controlling overall carb intake. They do spread it out over the day (in three meals and three snacks) but there is no recommendation to also take in any certain amount of protein or fat, so there are suggestions like having a snack of fruit and a slice of bread. That would be a problem for me. Another suggestion would be to eat for breakfast, one egg, two slices of toast with butter, and a glass of milk. That much carb with that little protein would be a problem for me. Give me three eggs and I could handle two slices of toast if I really must eat them. But why must I eat them?

I was pleased to see that they didn't make any distinction between complex and simple carbs. I suppose they would do so before putting someone on insulin, but by default, we were all allowed to eat white bread and rice and even have fruit juice, if that's how we want to spend our carb allotments. They also didn't ban candy or ice cream, just told us we had to count the carbs. Again, that works for me, as long as I have protein and fat in my system, too.

I did get a free blood glucose monitoring kit. (Well, I guess my insurance is paying for it - nice how I have absolutely no idea about medical costs, huh?) I'm supposed to test each morning and two hours after each of my three main meals. I'm also supposed to test my urine each morning for ketones, which will supposedly tell me if I'm drawing on my body's stored fat. (I need to do more research on that. I don't understand the relationship between ketones and low blood sugar, and I don't understand exactly what the problem is, and whether it's only a problem in pregnancy.) And I'm supposed to follow the meal plan and write down everything I eat and at what time.

But here is what I'm going to do. I'm going to do all the testing. And I might test more often as well. (I'm suspicious that my blood sugar is dropping in the middle of the night.) I'm going to record everything I eat. But I'm not going to follow the meal plan. I'm going to eat like I always do and see what happens. If I never have an elevated blood glucose level on my own diet, then why change it? During the class, we did a finger prick just to make sure we all knew how to do it. It happened to be exactly two hours after I had eaten lunch, which is the time I will be testing going forward. My blood glucose level should be less than 120. It was...ready? 67. And my level two hours after dinner? 76.

I go back in a week for the nutritionist to analyze my data. Maybe I'll get more insight into hypoglycemia and how I can even better manage my condition after pregnancy. That would be wonderful. I also look forward to showing her how worthless and stupid that glucose tolerance test was in my case.

Well, that's assuming I'm right and my levels stay low. But I'm pretty sure I'm right.

Wednesday, July 27, 2011

31 Weeks

Okay, I'm really hurting now. But the heat wave is over, and we got a window a/c unit for our bedroom, so I'm not nearly as swollen as I was last week. Sam and I did go to a hotel for two days and it was a fabulous getaway, even though the hotel a/c couldn't quite get the room cool enough for me. Yes, the heat was that intense here!

I don't think I've mentioned it here, but my biggest problem symptom of this pregnancy is the carpal tunnel syndrome in both my hands. It stared about two months ago and it's bad enough that I can't hold a pen or a razor or a hair dryer without my fingers going completely numb. I'm also awakened in the middle of the night with excruciating pain occasionally, although the wrist braces that I wear at night help a lot. Luckily, it doesn't seem to be progressive. It started out bad and it's still bad, but no worse, and it should disappear after I deliver. The cause is all the extra fluid in my body compressing that nerve.

What is causing me to hurt more now is the fatigue. It is so hard to carry around these babies. They're heavy! They wear me out! Getting in and out of the car is a challenge, and as I've mentioned, I try to avoid stairs at all costs. But I have good days and bad days. Two days ago I had a great day. Yesterday I struggled all day. Today seems somewhere in between. But as long as I can keep cool and get a lot of horizontal time each day, I think I'll be okay.

I'm going to the gestational diabetes class tomorrow. What a waste of time. But I think they're going to give me a prick kit as part of the program. I look forward to testing my glucose levels and proving the stupid test wrong.

The bathroom remodel continues. We can't do anything about preparing the nursery or even buying supplies for the babies until it's done. But I made a list, and I think we should be able to get everything done by the end of August. I'm figuring that there is no way, even if I deliver before the end of August, that the babies will come home any sooner than September 1.  So that is my drop-dead date to get everything prepared.

We still haven't decided on the exact names for our babies. We know we'll call them Leo and Zoe, but we haven't yet decided if they'll have middle names, and if so, what they would be. Adam and I don't have middle names, but we gave one to Sam. (Miriam, after Adam's mom who died a long time ago.) And we have to decide if Leo's name will actually be Leonidas, or just Leo. Leonidas is the inspiration for the name, but we don't intend to ever call him that. Still, it's a pretty damn cool name. Of course Zoe is just Zoe, unless we want to give her the middle name Alleyne, which might be cool since that is the inspiration for her name. I just thought of that. I'll have to talk to Adam about it. Our two warriors.

We have decided that we're not circumcising Leo. Maybe I'll write more about why we made this decision in a future post, but the short explanation is that we think that circumcision is a relic of religion and nothing more. Any arguments you hear about the medical benefits of circumcision appear to us to be complete rationalizations for a barbaric practice. It actually seems to be such an obvious decision that it's hard for me to get motivated to write any further about it. But someday I'll probably get angry about it and go on a rant, so you have that to look forward to.

Tuesday, July 26, 2011

Gestational Diabetes

Well, I finally have an official "problem" with this pregnancy. The test says that I have gestational diabetes. But unless someone can convince me that the standard interpretation of the test trumps my history, experience, and other aspects of the test, I don't accept the diagnosis.

I've had a problem with hypoglycemia all my life - that's low blood sugar, due to my body's overreaction and overproduction of insulin after I consume sugars. At least, that's how I've diagnosed myself, since no doctor seems interested in testing me. I know I have a problem with sugar because if I eat too much sugar (or simple carbohydrate) without protein and fat, I crash about two hours later. And when I crash, it's very, very bad. All my symptoms are in-line with those of low blood-sugar. It's still a serious problem that has to be managed, but it's not due to pregnancy, and it's not diabetes. The glucose tolerance test just seemed to confirm my self-diagnosis.

So here's how it works. You fast for eight hours. Then you have a blood draw. Then you drink a huge, super-sugary drink. Then you have your blood drawn at one, two, and three hours after consuming the glucose. If two or more of your blood-sugar levels are above a certain threshold, then you are diagnosed with gestational diabetes.

My levels were:

  • fasting: 68 (normal is less than 100)

  • one hour: 193 (normal is less than 180)

  • two hour: 175 (normal is less than 155)

  • three hours: 50 (normal is less than 140)

Did you catch that last level? 50! That is why I would never, ever, eat pancakes for breakfast, or even fruit and toast, or even cereal with whole milk, or even a bagel with cream cheese. Even those smaller amounts of sugar without enough protein and fat will cause me to crash. I'm better off not eating. A blood glucose of 60 or less is considered hypoglycemic, and at 50, I was technically in insulin shock, which can be very dangerous. Not one person I've spoken with yet seems to care about that last level, which makes me crazy. This is the first time I've been unhappy with my ob-gyn for just following the rules. But apparently, the way it works is that he just orders the test and, based on the black and white results, refers me to a diabetes center.

Now, I didn't expect my earlier readings to be so high as to fail the test, and that might be a part of what I call my existing hypoglycemia, or it might be due to pregnancy. I did have one bad experience about a month ago - I ate a McFlurry, which is more sugar than I'd normally consume at once. But I had just eaten a huge hamburger and felt like I could handle it. I never did crash, but I had a different reaction: I got the sweats and a rapid heartbeat. Adam told me that it sounded like too much sugar. I don't know - I've never had that feeling before. So indeed, I might be having more trouble getting the insulin process started during pregnancy, and maybe I do have gestational diabetes on top of my existing condition. I'd like to find out more once my body is back to normal. There is also something called "occult diabetes," where the body is extremely slow to react to blood sugar, and then overreacts. That sounds like me, but the crash is not supposed to happen until about five hours after consumption of the sugar to be a candidate for that condition. I've noticed that, during this pregnancy, my crash is taking longer than usual. I would have expected the low level at two hours, not three, but three is still early for occult diabetes. Still, I might have some variation of that. And the fluctuation in my levels is not a good thing, one way or another.

But the point of all this is that I already know how to manage my condition. My dad has the exact same problem and he taught me how to avoid sugars without protein, especially in the morning. I've experimented with this for years. I've found that I do need some carbs in the morning - just a small amount, and always with protein. I've found that nuts don't balance out the carbs as well as meat, so a peanut butter and jelly sandwich can be a risky meal unless I've eaten a lot of good protein earlier in the day. I've found that there is almost no difference in effects on me between simple and complex carbohydrates so I rarely distinguish between them. I also need to eat more often than most people, and when I feel a certain kind of urgent hunger, I know I have to eat immediately, and I know that I have to eat a certain kind of thing, to avoid the crash. But I also know that I can eat desserts at night, as long as I've eaten well during the day. I know a lot of things. I know what works for me. And I'm not going to go on some standard diabetic diet (which probably contains more carbs than I eat anyway because complex carbs are supposed to be good!) unless someone can give me a compelling reason to do so. I'm not giving up my occasional ice cream after dinner in exchange for disgusting whole grain bread for breakfast which I know will make me sick.

So now I have to go to some kind of educational class, which I dread. If it is some standard thing about gestational diabetes, it will probably be a complete waste of my time, but maybe there will be someone with a brain who will actually talk to me about my particular case. And I'm going to have to monitor my glucose levels. That I won't mind doing. After I failed the one-hour test earlier this month, my father-in-law lent me a finger-prick kit to use for a week and I tested every m0rning, and after a few meals. It was fun to actually know my levels. (I was always in the 70's or 80's in the morning, and under 110 after meals. No signs of elevated levels at all, because, dammit, I was eating properly, not drinking sugar-water!)

And I'm not clear on what the risks of gestational diabetes are for me or my babies, except that it might cause them to be bigger. If that's the only downside, then maybe I should just start eating more chocolate anyway.

Friday, July 22, 2011

A Little Thing

It's not a coincidence that, after being permanently pale for most of my 20's and 30's, I've had a nice tan every summer since Sam became old enough to enjoy the water.

Thursday, July 21, 2011

30 Weeks

I'm 30 weeks along. A singleton pregnancy is usually 40 weeks. For twins, the average is 37 weeks. Sammy came 2 weeks early. I have no idea when to expect these two little babies, but I'm starting to look forward to the end.

Just a few weeks ago, I was stressed out that it was all going too fast, and that I had so much more I needed to get done, and I wanted to just take some time to enjoy the pregnancy. Well, now I can finally relate to all those women who talk about how, by the end, they were just desperate to get it over with. I used to think they were wimps, or just couldn't appreciate the awesomeness of the experience. I knew they might have been more uncomfortable than I had been with Sam, but I still harbored that feeling that they must have some kind of bad attitude, or they would be able to ignore all of that and just enjoy the good parts.

Well, I'm one of them now. Well, not completely. I'm still enjoying aspects of the pregnancy, but I am in such pain and discomfort that it's hard to just get through a day. I am seriously grumpy. This insane heat wave is not helping. My air conditioner can't keep up and the bedroom is usually about 75 degrees by the time I go to sleep, despite the thermostat being set at 69. 75 degrees is simply too hot. In fact, it's unbearable. I slept a good part of the night on the sofa in the living room last night, because it was cooler there. If I get five hours of sleep in a night, I'm doing well.

And then there is the chaos of the bathroom remodeling. We're having the master bath done now, and the work is going well, but the chaos in the house is unbelievable. A lot of my energy is going into things like keeping the cat from slipping into the space between the joists and the ceiling below. I also have to coordinate all laundry and dishes and showering with the workers' schedules, which change hourly.  We've had power to one circuit off for two days now which means, in the one bathroom that is not being worked on, we have no light. I'd just use it with the door open, except that there are strange men all over my house and I really need a bathroom where I can lock the door. I have to pee at least once an hour, and each time, I have to give serious consideration to where I might be able to go this time, and a lot of times it means going up and down stairs, which, in my condition, is another major challenge. (One time, I walked up two flights and had to lie down for five minutes before I recovered my breath.)

I can't take a nap. My bed is covered with a tarp all day. I certainly can't cook or even pick up all the crap that is all over the house. I just don't have any energy left for those things. Adam has been doing most of that stuff for me when he gets home in the evenings. But today and tomorrow he is working late. I'm seriously considering moving to a hotel with Sam for the next two nights.

So that's all the bad news. And I'm refraining from telling you all the gory details about my pregnancy symptoms. It's not fun.

But still, I'm fundamentally healthy, and so are Zoe and Leo. I did the dreaded glucose tolerance test yesterday. I had to go to the lab at 8am with no food or coffee, drink the horrible sweet drink, and sit there for three hours while they drew blood every hour, my blood sugar dropping so low that I had the shakes and felt like I was going to pass out by the end. It ended up being the best part of my week. It was freezing cold in the lab waiting room, and it was mostly quiet. I propped up my feet on a chair and slept the entire three hours, waking up only for the blood draws. It was heaven.

Yes, I think I'll do the hotel. But first I have to figure out how I can find Sam some clean underwear.

Friday, July 15, 2011

A Little Thing

Sammy peed in her bathroom trash can tonight, and I'm proud to be the kind of parent who doesn't get mad about such a thing. I'm sure she just wanted to find out what it was like. And since I don't punish her for things like this, she always tells me about them, saving me from consequences like pouring urine all over my feet. It's a win-win!

Thursday, July 14, 2011

29 Week Photo

I happened to be wearing the same shirt for my photo tonight that I wore for the last photo. Check out the difference 5 weeks makes:










29 Weeks

If I'm too busy to blog while I'm pregnant, how am I ever going to blog once Leo and Zoe arrive?

That question is one of the many that is seriously stressing me out here at the 29 week mark. I feel like I have to get some kind of update written here, but I fear it will be mostly random thoughts. Oh well, here it goes.

We had a successful trip to OCON and to visit Adam's parents. I felt great when we arrived, but by the end I was really dragging. Adam's dad is doing as well as can be expected - he's tough. OCON was not nearly as great for me this year as it was last year. That was partially due to the content of the courses, but the fact that we had Sam with us had something to do with it as well. She spent enough time with babysitters that I was able to take a few courses, but I found that I actually enjoyed the time I spent with her and Adam, just hanging out at the beach or the pool, even more than the conference. And the babysitting situation was so fluid that it was like putting together a puzzle every day. That stressed me out. So, the trip was not one of my favorite vacations, but I'm still glad I had the chance to go, mostly for the social aspect. Finally meeting Lynne and Stephen in person was something I would not have wanted to miss! And there were other new and interesting people to talk to, and so many of my friends that I see so rarely. There were a few that I promised to catch up with at the closing banquet, but alas, Sam lost it that final night and had a meltdown of epic proportions. I ended up spending the evening with her in our hotel room, getting shoes and trash cans thrown at me and protecting myself by putting her in the closet and holding the door closed. After she calmed down I consoled myself with two desserts from room service.

Speaking of sugar, I failed my glucose tolerance screening test, which just means that I have to do another, longer test. I'm almost positive that I don't have gestational diabetes, but I'm pissed that I have to do the longer test. It means fasting for 8 hours then sitting around at a lab for 3 or 4 hours after drinking some super-sweet liquid. Oh, this is going to be torture. Not being able to eat for that long is seriously scary.

Otherwise, everything is still normal with the pregnancy. Leo and Zoe happen to both be head-down right now. I'm hoping they remain that way so I have a chance at a vaginal delivery. Today, I scheduled my "just in case" C-section for September 15. It struck me quite suddenly that that could be their birthday. And it's highly unlikely that they'll be born any later than that. That's two months and one day from now. Wow.

I'm finally starting to experience many of the difficult symptoms of pregnancy with twins. I could list off a bunch of annoying problems here, but really, nothing is so terrible. I'm tired and have some pains and it's hard to sleep. But I'm healthy and so are my babies. I'll get through it.

The home improvement projects continue. We got two bathrooms mostly finished. This week we installed recessed lighting and new lights in both of the kids' rooms. Next week work begins on the master bath, which is going to take about eight days to complete. Then we have to paint a few rooms, put everything back its place, and set up the nursery. I still have a lot of supplies to buy for the babies, but I don't want to do it too early because there is nowhere to put anything right now. We have a stroller and car seats in the living room, boxes of tile in every hallway, a toilet in the dining room, and cans of paint everywhere. It's been like this for a long time and it's really starting to get to me. I hate environmental chaos, and I really need to peace out and rest right now. Sam is going to full-day summer camp for the next two weeks starting on Monday, so I'm going to try to spend as much time as possible out of the house and away from the chaos. I need to find a place with free Wi-Fi and actually put my iPad to use for something other than Barbie movies. My new Kindle will be put to good use as well.

Well, that's all I can think of. Maybe I'll remain in my daytime clothing long enough today so that Adam can snap a photo of me when he gets home from work. But the pajamas always seem to call to me immediately after dinner. That's the one time that I do seem to do a good job at relaxing. After Sam goes to bed, I typically get right into bed and stay there until I go to sleep. Lying down is heavenly. It's almost 6pm now. Only two hours to go...