Consult with the R.D.

Since I got the ‘ol GD diagnosis last Wednesday, I went crazy Googling and reaching out to women who had GD during pregnancy. And then I went a little crazy overhauling my diet….majorly cutting back on carbs and eating a lot more salads instead of sandwiches. The result: I have been hungry all week. Which I KNOW is not good for the babies, who need to grow big and strong!!!

Fortunately, what I was missing was some advice from an actual expert. I met with my clinic’s R.D. yesterday morning. I learned that I am seriously borderline…she was almost surprised my clinic sent me to her. But the rules about GD are becoming more stringent, and my clinic is dutifully applying their latest rules to people like me. (Women typically have to fail two of the blood draws to be diagnosed with GD, I failed one by less than 10 points…and I passed the fasting blood draw no problem…my OB and R.D. said that means I wouldn’t have been flagged had I done a traditional screening test that most clinics use.)

All of that said, I remain really grateful that my clinic is taking my results seriously. As bothersome as it might be to have to count carbs and stuff, I’d rather be safe than sorry. And who knows, once I begin my weekly blood draws (fasting level then breakfast at the doctor’s office, then another draw one hour later to see how my bod is dealing with glucose), maybe I’ll be failing left and right and we’ll all say SEEEEEE, the new rules are there for a reason!! But I’m hoping I can pass a few tests because then my clinic will just let me follow my new diet and go on my merry little non-blood draw way. 🙂

So here’s the gist….

• Carbs are NOT out, in fact, I should eat them at every meal and snack. But I need to count them and not exceed 175–200g in a day.
• I need to always eat protein with my carbs. So, instead of a plain apple, an apple with peanut butter smeared on it. Instead of a half a cupcake (yes! they are allowed!), a half a cupcake with a handful of nuts. Instead of my usual Cheerios for breakfast, a whole grain English muffin with an over-easy egg.
• I need to eat every 2–3.5 hours even if I’m not hungry.
• Exercise helps insulin do its job better (breaking down glucose so the body can use it efficiently). I’m adding back my morning calisthenics and weight lifting sessions in front of the Today Show, which I’d become soooo lazy on. It feels good! 🙂 And I’ll continue my weekend swims and EZ ellips sessions + upper body weight lifting.

That’s about it. We also talked about my uber-low iron levels, which haven’t improved since they came in so low at week 9—depsite the fact that I went on a daily iron supp and eat plenty of animal protein and leafy greens. My Mom and little sister have always had low-iron but I’m not sure about what my levels were like pre-pregnancy. Obviously, it’s nothing so bad that I was anemic or fatigued—I mean, I used to do marathons and half-ironman triathlons so I had the energy to train at a pretty intense level! The R.D. said iron levels are genetic and that even though my levels are “low,” they are clearly fine for my body. And the only I thing I care about—the health of the babies—is not in question: They get what they need from me. But, we’re splitting up when I take my supps to see if that makes a diff in how my bod absorbs it (iron and colace in the a.m., calcium + vitamin D, prenatie Rx and colace in the p.m.

I realize that I’m not having to do daily blood tests and insulin injections (and I really really really hope I don’t have to down the road!), but I want to put it out there that this is not the worst thing in the world. It was pretty cool to meet with a dietician who specializes in pregnancy. I got all sorts of cool info on calorie requirements for twinsie Moms and basic pregnancy nutrition advice. It’s stuff I wouldn’t have learned were it not for GD. Thanks, GD!

So, first blood draw on Monday. And that’s also the big monthly growth scan day. And I get to see Dr. Zen! (I’ve only met with her at 9 weeks and after the anatomy scan and I miss her.) For those who are counting, I am 27w5d. Inching toward the big 3T…please let everything continue to go smoothly and let our babies be perfect and healthy. Grow, sweet little babies, grow! I love you so much, I would do anything for you!

Anatomy scan, take 2

We had our level II ultrasound this morning. Whew, it was a loooooooooooooong morning! My OB’s office basically does a level II ultrasound when they do anatomy scans, the difference here was that an MFM was overseeing all of the pictures and measurements. Oh, and they did extra measurements to rule out any more soft markers. On both babies. And at the end of it all, the MFM came in to chat about the results and ask for Qs. He was calm and smart and nice. All very soothing to my frayed nerves. I was throwing out some crazy lingo in my questions to the point that the MFM asked if I was a doctor. Hahahaha. Hubs told him I just spend way too much time on Google. Which is so true. (I am totally ready for my med school exam on isolated soft markers!)

But back to the scan. We had a young, smart u/s tech and she happily obliged my request to talk us through everything she was measuring and doing. (I get so nervous when they go silent!) This week Baby A was crazy active. I think my theory that he has a much calmer disposition than his sister is officially out the window. 🙂 They are good little babies and we love them so very much.

The end result…..Baby A checked out perfectly again. Baby B checked out perfectly, too. She still has that echogenic focus (EIF), but it is tiny and very likely harmless. How very likely harmless, you might wonder? Well, Baby B had a 1 in 46,380 risk of a chromosomal abnormality based on the quad screen test results. When FORCED to crunch a new risk number (yes, I made him do it last week, with tears), the director at our genetic counseling clinic re-calculated her risk to 1 in 35,370.

I know it’s COMPLETELY silly to focus on numbers like these, which are just numbers at some point (really, hubs, I know!), but for some reason it helps me. I can’t explain it, but, um, here’s some more food for thought/numbers crunching: Risk of miscarriage from amnio is anywhere from 1 in 350 to 500, based on our genetic counseling office’s rates. Twin pregnancies—even if you only test one baby—have not been tracked as well, but the m/c risk is more in the neighborhood of 1 in 100 to 150.

I want to be very clear about this: I totally support and respect any woman who would make the decision to amnio in our situation (or any situation, for that matter). Believe me, when you hear something like this at an anatomy scan, you cannot help but freak out and want to make SURE everything is okay. It’s just how it is. But given our odds, and all of the reassurance we have gotten from every doctor we’ve talked to, and all of the studies we’ve looked at on our own (like the most recent one, which found only one case of downs in a group of 17,000 pregnant women with an isolated EIF, and she was 38-years-old), we’re not going down that road. It is not a risk to the babies that I can sleep with at night. A 1 in 35,370 risk is one I can live with. It’s essentially the same risk sweet Baby B would have with NO ISOLATED SOFT MARKER evident.

As both Dr. Zen and the MFM told us, this particular isolated marker is really something they “shouldn’t even mention these days,” now that we have other, better tests to calculate risk. It’s an archaic marker that is trumped by NT Scan and Quad Screening results. It’s a variance on normal. They see it every day. Etc. (Have I convinced you everything is okay yet? Haha.)

I’m sorry if this post was too inside-baseball. I have Googled a lot of blogs/sites that have written about EIFs in the past week, and I figured other women may stumble across my blog someday and want to read about how we dealt with this. But this is between you and me, bloggies. I have only told my Mom and we will not tell ANYONE else.

So, the big, huge, giant takeaway: NO NEW SOFT MARKERS!!!! Everything looks good! And they gained a whopping (estimated, of course) 4 ounces each since last Tuesday, which is practically a third of their weights….they are now measuring just over a pound each. Sweet, sweet things! I guess they liked all of the cheeseburgers and steak I ate over the weekend in NYC! 🙂 And hey, while we were there I got my cervix checked again (still measuring 4.3, hold strong, cervie!). The tech said she’d never met a woman who actually REQUESTED a vaginal ultrasound. What can I say?

I am feeling so much better.

Tomorroooooooow!

Well, it’s that time again. The final countdown to a major appointment and my stomach is in crazy knots and my heart is racing and I’m asking hubs a dozen times a day Are the babies okay? Are you sure? But how do you knooooow? But why can’t I feel them? Are the babies okay? etc.

We have our anatomy scan tomorrow. My anxiety is ever-present, but it really builds before each OB appointment. Especially big ones like this one.

My Mom, little sister and sister-in-law are throwing a shower for me in KC early in January….I haven’t bought our plane tickets yet because, well, you know. Everything has kind of been at a standstill for the past week or two. It makes me nervous to look at baby stuff online. I totally clam up when strangers or coworkers or friends or whoever asks how I’m doing (it doesn’t help that everyone is suddenly asking if I can feel them wrestling around in there….um, no, but I really really really want to). I just want to be whisked away to an island (a very very distracting island) for the next 24 hours. I want hubs to rub my feet and tell me everything is okay and I want this wonderful, amazing dream to continue.

I will take a warm bath tonight and I have my meditations cued up on my iPhone to help me through the day. Zen zen zen zen.

So yeah. That’s where I am. AHHHH! If everything is okay with the babies then we will get to find out the gender(s) tomorrow. The honest to goodness truth, my dear commenters who have asked over the past couple of months, is that we do not care one single teenie tiny bit if they are boys or girls or one of each. We just want healthy babies (as cliche as that may sound)!!!!!! We love you so much, sweet little babies, and we can’t wait to see you on the special 4-D ultrasound tomorrow!

I am praying with all of my heart that our babies are healthy and big and happy! Please Lord. Please, please, please.

Zen zen zen zen.

Maybe?

Happy Thanksgiving everyone!!!!

We visited my family over the holiday weekend. My older brother and his wife couldn’t be there because of work, but it was great to see my parents and little brother and sister. Hubs and I split the holidays between our fams, alternating who we visit at Christmas and Thanksgiving every year. I know my Mom is reallllllllllllllllllllllllllllllly sad we won’t be flying home for Christmas….and that manifests itself as intense guilt in me. But beyond little comments here and there bemoaning missing us already at Christmas, we had a wonderful weekend.

Early on Thanksgiving morning, I braved a 16-degree, windy morning for a 5K Turkey Trot with my Dad, sister, brother and hubs. I shuffled the entire thing! Usually I’m out in front of my family, but this year I was the caboose. 🙂 Totally fine by me, I was happy in my snail slow pace. It has been getting uncomfortable to jog/shuffle….I think I am just getting too large. So that was probably my last “run.” From now on, it’s going to be swims, yoga and maybe the ellip and light weights. All of it super EZ, of course. A tiny dose of exercise a few times a week keeps me sane!

After the Trot we began cooking the Thanksgiving meal. Fun fun fun!!! (Even though I totally ruined my dish—what should’ve been a delish sweet potato hash—by over-salting it. I would’ve been cut in a second if it was an ep of Top Chef. So JV!) Later that afternoon I relaxed for a loooong time on the couch to watch football with my sibs and hubs. A couple of times, I thought I felt a very very gentle “bump” in my lower left stomach region. Not bubbles or flutters or tickling or kicking, but a so-subtle-I-could’ve-imagined-it bump. It made me so happy! I willed it to happen again and again. Since then, I THINK I’ve felt it a couple of times….usually on my lower left but also right by my belly button.

I have no idea where the babies are located in my tum, but I sooooooo hope this is them, beginning to make themselves known. It’s not kicking or crazy movement or anything close….it’s MAYBE MAYBE MAYBE something.

I also realized that I’m never sitting for an extended amount of time or laying around unless it’s bedtime. At work, I’m “officially” at a desk-job, but the reality is that I’m on my feet walking somewhere and doing something away from my desk every few minutes. And then I come home and cook or clean or whatev….I finally relax after dinner in front of the TV…and my then I’m so tired that I usually scoot into bed and promptly fall asleep within a few minutes.

SO. The point is….it’s hard to find long spells of quiet where I can replicate my lazy Thanksgiving afternoon during which the babies MAYBE moved. Or maybe I didn’t really feel them move. It could very well be that I want this so badly that I’m imagining things. But I would really really really love to feel more of it. 🙂 It would so help soothe my anxiety!

ANYWAY! Tomorrow will be 20 weeks. And it’s T-minus seven days until our big anatomy scan. I am thankful for so so so so much this year, but mostly these babies, who hubs and I cannot wait to share our lives with. We love them so very very very much. And I pray and hope with everything in me that these babies are growing and healthy and strong and that everything is okay.

I will leave you with our first purchase for them. We saw these Dr. Seuss jammies discounted on the baby-deals site Zulily.com earlier this month and couldn’t resist. 🙂