26-week update

How far along: 26 weeks

Meds: all taken daily – prenatal vitamins, vitamin D, DHA, probiotic, Levothyroxine 100 mcg

Gestational diabetes: I saw the maternal-fetal-medicine specialist today for a more detailed ultrasound and counseling. Baby girl looked great and is measuring just a few days behind, which is appropriate for being Asian 🙂 He praised me for my good blood pressure and weight, and on-target blood sugars when following the diet. I can now check my sugars just once a day, though my breakfast and dinner numbers today were a tad high, so I’ll likely keep checking those the next couple days to make sure they don’t stay that way. I’m getting close to cutting out all carbs at breakfast soon – numbers are borderline. It’ll get tougher to control as the placenta grows and pumps out more hormones, so I do anticipate starting insulin at some point.

Baby is the size of: an eggplant (and approximately 1 lb 13 oz by ultrasound today)

Belly pictures: Another pre-maternity outfit – though before pregnancy, I would’ve gone without leggings, this is more tunic than dress now 🙂

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Total weight gain: Down 0.2 pounds from last week, thanks to the GD diet, so still almost 17 pounds up from pre-fertility weight.

Stretch marks: None that I can see!

Sleep: Still pretty good, sometimes I wake up around 5am to pee, but I’m able to get back to sleep easily.

Symptoms/Feeling: Still really good, I occasionally get some round ligament pains, but they aren’t bad and don’t last long. Constipation is better (again – GD diet), I get heartburn rarely.

Best moment of this week: The MFM specialist had fun checking out everything on baby girl, including really detailed looks at her heart – he said it was easy to see since I’m thin. Then he took my favorite ultrasound image of baby girl yet – here she is covering her eyes and pouting! Hard to say whose nose she has, but I think she has daddy’s fuller lips.

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Miss anything: As always, time! Everybody keeps saying to sleep as much as I can, but I feel like there’s so much to prepare before she comes along. I do get 7-8 hours a night pretty consistently at least.

Movement: She’s as active as ever, and I felt and saw her hiccup at the same time today on ultrasound – pretty funny! She’s breech right now, so those are definitely kicks I’m feeling in my lower right side a lot of the time.

Food cravings: Thankful for being able to fulfill my ice cream and milk tea cravings at bedtime, since the rest of my day’s consumption gets pretty boring.

Anything making you queasy or sick: Nope, been feeling good in this respect!

Labor signs: A few Braxton-Hicks here and there.

Belly button in or out:  Still solidly in there. I’m guessing it’ll flatten by late 3rd trimester.

Wedding rings on or off: Still on and loose.

Happy or moody most of the time: Happy but occasionally hungry. Having to hold myself back when going out to eat definitely makes me grumpy. We have a wedding Saturday, and will be interesting to see how I’ll figure out portions then.

Purchases for baby: I’d bought a ceiling fan to install in the future nursery last month, since it gets very hot in there during the summer, even with air conditioning. The electricians installed it today, having to run a new power source to it since there was nothing in the ceiling before, and that makes it by far our most expensive purchase!

Looking forward to: Wedding and a birthday this weekend, though I have to really watch what I eat!

Awesome day, and blood sugar success!!

Today was a great day all around! Spent a gorgeous morning stand-up paddling with a friend. I’m not as efficient since I can’t twist as much as before pregnancy, but balance was no issue and I still felt pretty strong. I wasn’t planning on leaving the safety of the harbor, but when I saw how calm it was outside, decided to try heading out. I went to my knees through the wave break, then hopped on up, and felt great! Stable enough to paddle out far enough to visit the sea lions at their buoy. A woman who paddled towards us called out to me about how great it was that I was out there – up until that point, I hadn’t really thought about how much I’m showing right now, especially since baby girl had been lulled to sleep by the wave action. We also spent a good amount of time leisurely sitting and paddling, and catching up. It felt amazing to get out there after 4 months away, and I can’t wait until my next chance! I still had enough energy for a kettlebell workout in the afternoon while hubby and his friends did their regular weightlifting workout.

And another big reason to smile today, my first day of all great blood sugars!

  • Fasting of 72 after my small scoop of ice cream with Brazil nuts last night.
  • 102 an hour after breakfast – chicken, spinach, and bell peppers with 1 Tbsp Greek yogurt (great substitute for sour cream!) wrapped in a multigrain tortilla.
  • Orange and hard-boiled egg for morning snack before paddling. Afterwards I ate lunch of Vietnamese shaking beef, watercress salad, and garlic noodles (leftovers from Valentine’s dinner I cooked). Blood sugar 100 an hour later.
  • Half of this recipe for 2-ingredient pancakes (2 eggs + 1 banana) for afternoon snack after kettlebell workout. Then we went out to dinner with a friend at a place known for their Chinese soup dumplings. I was really nervous about this, but ate only 7 dumplings (as opposed to my usual 15+), 1 slice of green onion pancake, a spare rib (after blotting off lots of glaze), and lots of asparagus and mushrooms. And an hour later, blood sugar of 102 🙂
  • Tonight instead of ice cream, my bedtime treat is a green tea latte (Taiwanese style). Yay!

So now I know my approximate carb tolerance – <20 g for breakfast, <45 g for morning snack and lunch, <45 g for afternoon snack and dinner, and <30 g for bedtime snack. This is pretty low, but on previous days when I’ve gone a little higher, my sugars went out of range. Today showed I definitely have more room to go up on carbs when I exercise vigorously (not just relaxation or prenatal yoga). It feels great to finally be getting the hang of things!

Frustration

I had such high hopes this morning! I know I need to give myself some more time to figure out what works for me. After all, I’ve only been checking my blood sugars for 4 days, but I’m still frustrated after 2 high numbers this PM.

  • After the prescribed small scoop of ice cream with some crushed Brazil nuts before bed last night, I tested this morning and had a great fasting sugar of 82.
  • Whipped up a breakfast wrap using a multigrain tortilla, one fried egg, a slice of turkey bacon, and some wilted spinach, and had my best after-breakfast sugar ever of 114!
  • Morning snack of an apple with peanut butter and 3 Triscuits. Then lunch of 3 oz chicken, 1/2 cup oatmeal cooked in 1 cup almond milk with flaxseed, and a half a large tomato. My blood sugar after was 153 😦
  • Afternoon snack of an orange and a hard-boiled egg. At dinner, I ate 3 oz baked salmon with spinach, a multigrain English muffin with mashed avocado, and a cup of lactose-free milk. Afterwards blood sugar was 142, and this was after a 20-minute brisk walk with the dogs!

Yogurt and cheese have been OK for me the last few days, but I’m beginning to think plain old milk and almond milk just aren’t going to do it for me. So I’ll have to take a calcium supplement to make sure I get enough. Oatmeal is out for me since I can’t stand it just cooked in water. All right, tomorrow is a new day, and at least I get to eat ice cream before I go to bed tonight!

25-week update

How far along: 25 weeks

Meds: all taken daily – prenatal vitamins, vitamin D, DHA, probiotic, Levothyroxine 100 mcg

Gestational diabetes: I had my “class” today, which was short since it was just a private session and I’d already done so much homework. I definitely don’t need insulin right now, but she predicted I may in the last month as the placenta grows and pumps out increasing hormones. She did give me some stricter blood sugar numbers than I’d read online – 60-89 for fasting, and 60-130 for 1 hour after meals. Based on these targets, my issue is the mornings – I’ve had one high fasting number in the last 3 days, and my after-breakfast numbers are consistently high. So as healthy as it is, no more oatmeal for breakfast – but I can eat it for lunch, ha! I need to limit carbs in the morning to just 20 g, and then 30 g at each meal and snack the rest of the day. Funniest thing she instructed me to do was eat ice cream as my bedtime snack – this helps to balance out insulin and glucagon activity overnight while not eating for so long, so that my sugar in the morning is nice and low. Crazy, right?? But so happy the ice cream in our freezer won’t go to waste!

Baby is the size of: a zucchini

Belly pictures: Still my favorite maternity dress!

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Total weight gain: Stayed the same as last week, almost 17 pounds up from pre-fertility weight. Will be interesting to see if my weight gain slows on my GD diet.

Stretch marks: Still nope!

Sleep: Really good, though I keep waking up 15 minutes before my alarm. Probably a good thing.

Symptoms/Feeling: Really good, some aches and pains but they seem to be more from working out than from pregnancy!

Best moment of this week: Squeezed in some much needed girl time at my aerial studio, which is sadly closing in under 2 weeks. I can still do a headstand, and climb to the 14′ ceiling! I’ll be going again for the last class ever next weekend, and my teacher and classmates want to take pictures of me – going to be tough to find something photo-worthy that I can still wear but it would be pretty cool to show my daughter one day 🙂

Miss anything: Holy crap, where is the time flying?? Hoping to get the hang of my new diet soon, since right now it consumes a lot of my time to plan, eat at the right times, and check blood sugars.

Movement: Still kicks and thumps all over the place, I can’t tell the difference so can’t figure out how she’s laying in there yet.

Food cravings: Let’s not talk too much about this, given my new diet. Though thankfully, I discovered I can have a milk tea as my bedtime snack and have a good fasting sugar in the morning! 🙂

Anything making you queasy or sick: Strong odors, but actually nothing crazy this week.

Labor signs: A few Braxton-Hicks.

Belly button in or out:  About a 1/2 fingernail deep, lol.

Wedding rings on or off: Still on and loose.

Happy or moody most of the time: Definitely a moodier week with the gestational diabetes diagnosis, but I feel grateful that I should be able to keep it under control with diet and exercise.

Purchases for baby: Still holding steady, I think we will go pick up the already-purchased glider by the end of the month. First I REALLY need to get our bedroom cleaned out though.

Looking forward to: Yet another peek at baby girl at my MFM specialist appointment next week. I’ll be in for many more ultrasounds now, to monitor her growth closely.

My tools for dealing with gestational diabetes

So after one episode of hysterical crying to my sister after getting my abnormal glucose challenge result, I did what I always do when faced with a tough situation – researched the hell out of it. Armed with a shopping list, I stocked up at the grocery store yesterday, then came home and proceeded to work on a meal plan for the week. This is a snapshot of the Google doc spreadsheet I’ve created:

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So the basic goal is to distribute my carbs evenly throughout the day, and balance them out with protein most of the time. Even light walking after each meal is supposed to help bring blood sugars down, so I’m trying to time meals and snacks before my existing walks and work-out sessions. I based my meal structures off this pamphlet from a medical group, though I tweaked the carb amounts because their framework allowed for quite a lot of carbs, which I don’t think I need.

I’ll learn more when I have my first GD teaching appointment this Thursday, and see what the NP recommends specifically for me. Technically, I should be attending a class with other newly diagnosed diabetics on Wednesday, but there is no way I can get out of clinic that day. Fortunately the NP in charge of the GD program also happens to be the same NP who performed 2 of my IUIs! She was able to squeeze me in Thursday afternoon for a private session. I will also see the maternal-fetal medicine specialist next week for a consult and I assume a level 2 ultrasound.

I picked up my glucose meter at lunch today, and was pretty impressed. I don’t think I’ve handled a glucose meter personally since I was in residency, and they have come a long way! Mine can download to a computer, which makes it easy for providers to quickly check my blood sugars, and it also picks up on patterns without using a computer. I had to charge it and calibrate it using the control solution while I was at work, so I didn’t test for the first time until after dinner tonight. Which came back at only 88! Huh… We’ll see how the next few days look, and I also have fasting labs tomorrow to check a glucose and hemoglobin A1c. The NP said that if my fasting glucose is >92, she wants to start me on long-acting insulin at bedtime. And here I thought I was done with subcutaneous injections! We shall see…

And just like that, I’m another high-risk pregnancy besides just the AMA

I drove to lab bright and early for my glucose challenge test since I’m on call today (and thankfully haven’t been called in, with <2 hours left of clinic being open!). Downed the chilled orange drink in under 2 minutes just to get it over with, then busied myself for the next hour until they drew my blood for glucose, as well as a complete blood count and my monthly thyroid labs. Saw at least 5 other preggos there getting their test done, a few looking like they were doing the 3-hour test – poor things.

Received an email notification in just a half hour that my CBC had come back – for the first time in my life I’m borderline anemic with a hemoglobin of 11.9. Not too surprising given my decreased meat consumption for the last several months, so I’ll be more conscious of that going forward. Then a half hour after that, my glucose result came back…

206!

Holy heck, I mean I thought I was definitely at risk given my mom’s pre-diabetes, my HgbA1c of 5.6 at the start of pregnancy (5.7 is the cut-off for pre-diabetes), and my unfortunate reliance on fruit, bread, and yogurt for sustenance especially when my nausea was at its worst, but 206?! Normal would be less than 130. So yeah, my OB emailed me almost immediately and said, “Dude, at least you don’t have to take the 3-hour test”. Yes, those exact words. 😛

So I’ll be called soon to enroll in the gestational diabetes class, which they hopefully have available on my day off, otherwise he’ll try to arrange a private class for me. Not looking forward to having to do finger-pricks, given the amount of typing I do all day. But I have no choice, especially if I want to avoid meds. As soon as I get my glucose meter, I’ll be logging what I eat and how my blood sugar responds.

In any case, it definitely looks like I won’t be going past my due date, since I’ll likely get induced by then if she hasn’t decided to come out on her own.

24-week update

How far along: 24 weeks. It feels good to reach the milestone of viability, but my past experiences in the NICU during residency along with some of my patients have definitely instilled a healthy fear of preterm labor.

Meds: all taken daily – prenatal vitamins, vitamin D, calcium/magnesium, DHA, probiotic, Levothyroxine 100 mcg

Baby is the size of: a grapefruit

Belly pictures: Well hey, I found a non-maternity shirt (courtesy of Stitchfix) that I can still wear!

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Total weight gain: Down 1.2 pounds from last week, so I’m guessing I was still bloated from air travel then. Back in a healthy range of almost 17 pounds up from pre-fertility weight.

Stretch marks: None that I can see!

Sleep: Good now that I’m back in my own bed with my Snoogle. I usually wake up once to pee, but fall back to sleep pretty quickly.

Symptoms/Feeling: I’ve been feeling great this week, I almost hesitate to say this, but the best I’ve felt all pregnancy. I think the credit goes to the float session I had Sunday evening – it was a 90-minute forced meditation in an isolation tank while floating weightless in a heavily-concentrated Epsom salt bath. I left feeling very relaxed and connected with baby girl, and proceeded to have the best night’s sleep ever! My hip and back soreness were also eased. Even better, no constipation the next day. Wow. I’m definitely planning on going back every 3-4 weeks until I’m full-term – I’m a little nervous about going into labor while in there, though who knows, I may want to take advantage of that quiet time while I can!

Best moment of this week: Every chance I get to see baby girl is wonderful, and she continued to be her feisty self at my appointment this morning, kicking hard in response to the ultrasound probe and not wanting to show her full face.

Miss anything: Still time – work has not slowed down thanks to this miserable flu season mixed in with fear of seeing measles. I have no idea how I’m going to get this house cleaned up and ready for baby. I no longer have any time off until I start maternity leave at 36 weeks 2 days.

Movement: Yup, she continues to be crazy active, I’m curious how things will change when she starts to get more cramped in there.

Food cravings: Still my precious milk tea – I already had it 3 times this week and it’s not even the weekend yet. Yikes!

Anything making you queasy or sick: A little heartburn here and there but no retching at all this past week!

Labor signs: Just the rare Braxton-Hicks here and there.

Belly button in or out:  Still very much in.

Wedding rings on or off: Still on and loose.

Happy or moody most of the time: Happy, I’m enjoying feeling good while I can with a mix of weightlifting and yoga, also walking the dogs as much as possible.

Purchases for baby: Nothing on our part, but received some more sweet gifts from friends in the mail this week.

Looking forward to: The hubby returning home from his short work trip tomorrow!

23-week update

How far along: 23 weeks

Meds: all taken daily – prenatal vitamins, vitamin D, calcium/magnesium, DHA, probiotic, Levothyroxine 100 mcg

Baby is the size of: a pomegranate

Belly pictures: Moving around is definitely getting more awkward.

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Total weight gain: Time to really be careful, I’m up another 2 pounds in the last week, so up 18 pounds total. Granted, that was with a lot of good eating in NYC, but we walked a ton (in the snow even) and I worked out with my hubby and friends a couple times!

Stretch marks: Still no.

Sleep: I’m so glad to be back in my own bed with my Snoogle. I need to make up for lost sleep!

Symptoms/Feeling: Constipation as always, hip soreness/round ligament pain, and foot swelling has definitely shown up 😦

Best moment of this week: Definitely the hubby feeling baby girl kick for the first time while we were with friends! Also getting the normal results of our ultrasound, and enjoying NYC despite the blizzard that never was interfering with some of our plans.

Miss anything: Time – I SO need to de-clutter, and rather than having these next few days off to myself, my parents are staying with us right now on their way back home from their trip abroad.

Movement: Lots of kicks, punches, and twirls happening throughout the day and night now. She definitely responds to sugar, uh oh!

Food cravings: Fruit, milk tea, and ice cream – definitely indulged in these on our trip!

Anything making you queasy or sick: Still mornings and long stretches between eating.

Labor signs: Nothing thankfully!

Belly button in or out:  Starting to really stretch horizontally but still really deep.

Wedding rings on or off: Still on and loose.

Happy or moody most of the time: Mostly happy, we had a blast on our trip, though the plane rides were definitely tough on my tailbone. I am definitely done with air travel for the rest of this pregnancy, hurray for no more manual pat-downs! A bit of stress as the refinance we started over a month ago dragged on until we finally signed the closing documents this morning, and I had to send a wire of a big chunk of money to the new title company. But worth it, since we’ll be saving quite a bit each month now! We’re also in the process of hiring a lawyer to create a living trust and will for us.

Purchases for baby: Found a Shel Silverstein book I’d never even heard of in a cute used bookstore in NYC. We’re starting to receive more gifts from friends too!

Looking forward to: My first float session Sunday after the parents leave – I so want to feel ache-free and get some good rest!

22-week update

How far along: 22 weeks

Meds: all taken daily – prenatal vitamins, vitamin D, DHA, probiotic, Levothyroxine 100 mcg

Baby is the size of: a papaya

Belly pictures: Loose top today, so you get to see my linea nigra, for better or worse!

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Total weight gain: Yikes, I’m up 2 pounds from last week, so now up 16 pounds total, a bit over where I should be, with lots of eating forecasted in the upcoming week in NYC. Hopefully all the walking will offset that!

Maternity clothes: See above – I’m taking this part out from now on!

Stretch marks: Nope, but definitely have the linea nigra!

Sleep: Pretty well, other than the one night I had the dreaded leg cramps. I need to start taking better care of my back and wearing my maternity belt more often.

Symptoms/Feeling: Constipation as always, hip soreness, some lower back pain at the end of a long work day, and my massage therapist noticed a tiny bit of swelling at the top of my feet. Doh!

Best moment of this week: Seeing baby girl again this morning – I skipped breakfast and that kept her calm enough for the tech to get good images of her spine. They haven’t read the results yet, but assuming everything is OK.

Miss anything: Still time! At least my friend the handywoman is helping us out with some long-overdue items around the house, and I’ll probably have more for her as I move into nesting mode.

Movement: Pretty sure she kicked hard enough to move my arm resting on my belly last night!

Food cravings: Fruit and eggs, oh and chocolate, haha.

Anything making you queasy or sick: Mornings and going too long without eating as usual.

Labor signs: Starting to feel a few Braxton-Hicks but that’s it.

Belly button in or out:  Still deep but definitely smaller looking!

Wedding rings on or off: Still on and loose.

Happy or moody most of the time: Moodier this week – flu season is hitting us hard, and on top of that the measles outbreak just makes me angry when I see families where the children aren’t vaccinated. Thankfully I know my measles titers are protective.

Purchases for baby: Still holding off on more for now – more stuff is getting reserved off our registry though!

Looking forward to: Good food and time with friends in NYC this week!

21-week update

How far along: 21 weeks

Meds: all taken daily – prenatal vitamins, vitamin D, DHA, probiotic, Levothyroxine 100 mcg

Baby is the size of: a carrot

Belly pictures: I really prefer the look and feel of maternity dresses, but don’t have enough cool-weather ones to wear them every day.

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Total weight gain: Didn’t weigh myself until the afternoon as opposed to my usual morning weigh-in, so hard to say how accurate, but up 3 pounds from last week, total of 14 pounds up from pre-fertility treatment.

Maternity clothes: Pretty much all I’m wearing nowadays. I’ll probably get rid of this part in my next update.

Stretch marks: None so far.

Sleep: Was rough this past week due to unexpected interruptions such as the house phone ringing at 5am, and my husband’s laptop falling to the ground as he drifted off. Ugh!

Symptoms/Feeling: Heartburn is definitely picking up, and still constipated and having morning nausea. Hips are starting to feel a bit achy – can’t wait for my massage next week, and I’m debating trying a float clinic after our NYC trip – supposed to make you feel weightless!

Best moment of this week: Starting to see people reserve things off our BabyList registry after one of my baby shower invites went out – this is getting real! My sister is throwing me one the last weekend of March when she is out for a friend’s wedding. Since many of the hubby’s teammates will be out of town that weekend for a tournament, they’re throwing me one the weekend before.

Miss anything: Time – work is crazy right now, and I have to make sure I eat and drink throughout the day. By the time I get home, I have lots of charts to finish, and still nothing is getting cleaned/organized around the house! I’ve also been busy getting all the fur-kids into the vet for routine appointments since I won’t have the time/energy to bring them in after baby girl’s arrival.

Movement: Getting stronger, and she definitely acts up after I eat or drink something sweet!

Food cravings: Have been enjoying my fried eggs over easy again since discovering pasteurized eggs – hallelujah!

Anything making you queasy or sick: Getting out of bed 😛

Labor signs: Please stay faaaaar away!

Belly button in or out:  Maybe a tiny bit shallower now.

Wedding rings on or off: Still on and loose.

Happy or moody most of the time: Mostly happy, but definitely moody when my sleep’s been interrupted. I think the hubby’s been moodier because he keeps getting sick.

Purchases for baby: Holding off on buying anything more at this point until we see what’s left on our registry after the showers, other than bigger nursery items. Going to keep it pretty neutral with mostly white and wood tones, but accented with turquoise and orange, and lots of animals. There’s already a queen bed, wood dresser, and white bookshelf that will stay in the room. I went in to Buy Buy Baby a few weeks ago and reserved the Little Castle Savvy glider (only available in-store), thinking we’ll pick this up sometime next month. We also need to plan an Ikea trip by early March to buy the cribshelves for the closet, and a cute utility cart that will work perfectly next to the dresser/changer to hold more diaper supplies.

Looking forward to: Another peek at baby girl next week, hopefully this time she’ll cooperate and we’ll be able to visualize her spine! After reviewing all the measurements from last week’s ultrasound, I’m more convinced than ever that she inherited her daddy’s bigger head and forehead – I’m more in favor of an epidural now, especially if I’m able to specify the anesthesiologist I want.