Could the Dr's Have Been Wrong?

It's been a little over 2 weeks since the medical professionals in my life told me I have Gestational Diabetes, and it's been a little more than a week since they instructed me to stab myself 4 times per day to check and see that my blood sugar levels remain within a "good" range for a preggo with Gestational Diabetes.

Here's what the peeps at the Diabetes Clinic instructed me regarding diet, post-diagnosis.
Recommendation #1:
INCREASE carb intake to the following schedule:

Breakfast - 30 g's
Mid-morning snack - 30 g's
Lunch - 45 g's
Afternoon snack - 30 g's
Dinner - 45 g's
Evening snack - 30 g's

They all turn into glucose.

* Note: there was NO mention of other recommended foods to include or what sort of nutritional balance to aim for.  I was told that veggies are "free," excluding potatoes, corn, and sweet peas.  They also informed me that our bodies process carbs into sugars no matter if they're jelly beans or whole wheat pasta.  "Count the grams," they told me.  So I have been  << I've experimented with cereal, fruit and fruit juice, whole wheat bread, cookies, ice cream(!), and many other typical staples >>. 

Recommendation #2:
EXERCISE for 30 minutes a day, 5 days a week.

*Note: If you know me, you know I have a love of exercise.  My pre-pregnancy exercise routine consisted of high-impact cardio, lifting heavy weights with the big boys, and long bike rides with the hubs-- typically 5 days a week.  During pregnancy, I've shifted to swimming, yoga, walking, low-key weight lifting, and water aerobics, still averaging 5 days a week.

After the appointment at the Diabetes Clinic, I've come to a few conclusions about what they recommend in order to control my Gestational Diabetes. 

Conclusion Regarding Recommendation #1:
 The food recommendation IS NO DIFFERENT than what I was eating before.  << For clarification purposes, I'm raising my voice here- not quite shouting >>. If anything, my carb intake is higher than it was before. I've always eaten 5 - 6 small meals per day, and they're almost always really well-balanced nutritionally.

Conclusion Regarding Recommendation #2: 
The recommended exercise IS NO DIFFERENT than what I was exercising before.

FINAL CONCLUSIONS:  
With over a week of recording the numbers the little monitor spits out after I stick a needle into my fingertip, NOT ONCE have my blood sugar levels been higher than the number they're looking for.  In fact, the number hasn't once come close.  I feel great! The baby moves, wiggles, and dances ALL the time.  So the way I see it, there are two possibilities. First, maybe, just maybe, the medical professionals were wrong. Or second, it's a miracle!  Maybe there was in fact a time where my body struggled to process the sugars from my food, but as miracles go, that imbalance has been re-balanced.

Either way, I'm grateful.  I know it could be so much worse -- there are plenty of women with a lot of complications and challenges during pregnancy.  I had one week << between diagnosis and treatment plan >> of fairly poor mental health resulting from all this drama.  At this point, I'm feeling great.  I'm sleeping well (for the most part), and my excitement levels continue to grow over the notion that our family is growing.  Let the nesting continue!

Laughter to Cope with Pregnancy

These days, I'm laughing a lot.  Seems like humor is my new favorite coping mechanism.  It's great until my sides hurt- then it's just uncomfortable.  I think I've laughed until I cried more since I've been pregnant than ever in my entire life.  I'm mindful that sometimes what seems absolutely hysterical to me at a particular moment just flat doesn't convey when I try to re-tell it later << so take that as your warning... this post may be dreadfully boring for some of you >>.

Examples:
1) A while back on the phone with my mom, I casually told her, "This week your grandbaby's the size of a small cantaloupe."
"Oh goody," she squealed with delight. "I have a cantaloupe in the fridge at home."
"When you get home, I think you should pull it out of the fridge and cuddle your melon for practice."  As soon as those words were out of my mouth, I fell into an uncontrollable fit of giggles.



2) After she finished reading a previous post on here, my sister comments on the FB link, "_Whoa, cool! Not sure if this makes me want to have babies or not..._" For some reason, this tickled me bright pink!  It's hilarious to my progesterone poisoned mind that sharing this amazing, ridiculous, miraculous experience with the whole world << who am I kidding, the "hits" I get from Russia and Malaysia are probably just spammers >> would possibly cause folks to re-consider whether or not they should take the plunge... bite the big one... go for the gold... okay, I'll stop now.

3) I definitely laughed at myself for all the fruit I was eating.  If we're friends on Face, you know of my obsession with fruit. Specifically citrus fruit, but there have been other strong contenders.  I've been known to polish off: an 8 lb bag of oranges in less than a week; a pint of blueberries in less than 24 hours; and a 10 - 12 lb basket of mixed fruit in 4 days.  My fruit cravings are the only consistent ones I'm having, and not a moment goes by where I don't think to myself... "Mmmm... oranges...  mmmmm... strawberries... mmmmm..."  You get the point.

Here's the humor: at the height of my fruity cravings, the inside of my mouth was almost one big citrus blister.  I literally had to be cautious how much fruit I ate, otherwise my mouth would react.  One day in particular, a colleague at a lunch meeting says to me, "Jess, I can't believe you're not getting fruit!"  Embarrassed, I was forced at that point to confess my excesses. And believe it or not, I giggled my way through it, recounting all the fruit that I'd eaten in the past 5 hours.

4)  If you know me, you might know that I have an unusual, and heretofore un-matched, talent for memorizing all of the song lyrics to all of the best early 90's Rap music that I grew up jam skating to at the roller rink.  Every now and then a song comes on, and I'll happily sing along.  I might even booty dance, which might take place in the bathroom when I'm getting ready in the morning... at home... by myself (except for the dog).  If I happen to see myself dancing along as I'm rappin' my heart out, I just about fall out. Every time.  There's something << wrong? hilarious? absurd? >> about having 2 large melons up top and an extra-large melon on my waist while shimmying around the room shakin' what my momma gave me that throws me into uncontrolled fits of giggles.

Your Last Request

We recently watched a movie that I was utterly unimpressed with. When it finally ended, I looked at the hubs and told him bluntly, "I'd like that hour and a half of my life back."

Then a couple days later I found myself thinking back to a part of the movie that sort of, kind of << okay, I'll reluctantly admit it >> stood out. The chick who plays the main female lead asks the main dude, "If you were on death row, what would you want your last meal to be?"  There's more conversation around last songs, last conversations, etc., and overall it didn't make me like the movie any more or any less.  A few days later, it did, however, give me pause to reflect.

In light of my Gestational Diabetes (GD) diagnosis << I know, I know, it sounds SO dramatic, doesn't it? >>, I reflected back on what my last meals were the Wednesday prior to "failing the test," in the words of the inexperienced nurse at the dr's office. << Reminder: an appropriate alternative to "You failed the test" would have been, "Your number was a little higher than what we were hoping for." >>  Here's how it went down.

Breakfast- We had staff meeting at The Plaid Apron, which involved a delicious breakfast of a Bacon Omelette (good for GD!) and two decadent slices of whole wheat toast with strawberry preserves (not so good for GD!).  Everything was oh, so delish, even down to the coffee.

Lunch- I met one very dear friend for some eats at a new-to-me restaurant, Chez Liberty. This is a place for real life, hard core foodies. I ordered a crab cake sandwich with french fries (not so good for GD!).  Fresh ingredients, perfect quantities- I was a happy kid.  Unbeknown to me, my sweet friend had ordered a dessert for us to share: chocolate torte with a dark chocolate ganache, served with 4 raspberries and a scoop of raspberry sorbet.

Now this baby growing inside of me has provoked just one consistent craving: fruit.  Early on it was citrus fruit, but it has transformed into a more general "colorful fruit" craving for the last couple of months, including all sorts of berries.  So for my eyes to fall upon both raspberry AND chocolate on the same plate, I'm not sure the folks at the restaurant could have found a quicker way to my heart.

We got the first round of news the next day with the possible diagnosis of Gestational Diabetes.  Since then, it's been sugar-free, low-carb for this girl.  Again, after watching this awful movie that I felt wasted my time, it did subsequently cause me to reflect on my "last meals" ... not that I'm on death row or anything.  << Let's be dramatic, but let's not be that dramatic. >>

In hindsight, I'd like to thank my boss for having a daughter and son-in-law who own a nifty little breakfast/lunch/coffee shop in town that serves such fresh and delicious local food. And I'd like to thank the Figgster for suggesting such a froo-froo lunch spot and sharing a most-decadent dessert with me.  Mighty fine way to spend my last day of "free eating" if I do say so myself.

Luck of the Draw: You've got Gestational Diabetes!

Guess who gets to be on a low-carb diet for the next 3 months or so?  :: thumbs in shoulders :: This girl!

Guess who gets to give up dessert for the next 3 months or so?  :: sobs :: ... this girl...

Okay, I'm being dramatic. I know.   I didn't actually sob when I found out.  But I did have an emotional roller coaster of a day.

Turns out around the beginning of the thrid trimester, it's entirely customary to test all preggo's for something known as Gestational Diabetes (GD).  At the time our mommies were giving birth to us, this particular test was not being done.  The hubs and I are confident that his mom had GD, since the guy was born weighing more than 12 pounds.  << Yes, she delivered naturally, with nothing to numb the pain.  Did I mention she powered her way through labor and delivery with the support of her husband and a midwife in a small village in Bolivia?  She wasn't even in a hospital!  There was no trained doctor attending to her... WOW! >>  My mom is not sure whether or not she might have also had GD, but it's possible because we were all 3 fairly big babies requiring an epesiotomy with each delivery.  As she likes to say, she huffed and puffed and blew us out. Ha!

Here's how we found out that I'm one of about 200,000 women in the US every year who develop gestational diabetes during their pregnancy .

Thursday: At 27 1/2 weeks gestation, we show up for the 1-Hour Glucola test which required me to fast since midnight, drink a super sweet and very cold orange drink, then sit and wait an hour while my body did its thing to process all the sugar.  After an hour I followed the nurse to have my finger pricked to read my blood sugar level.

These were the words out of her mouth. "You failed the test."

Pardon me for getting on a soapbox here, but this is another one of those DO NOT EVERY UNDER ANY CIRCUMSTANCE SAY THIS TO A PREGNANT WOMAN statements: "You failed."  It's bad enough for any non-knocked-up person to be told that they've failed, but when you say this to a pregnant woman you might as well go ahead and assume she can NOT be held accountable for her actions. << I had a brief fantasy where I turned into a monster, ripped her head off, chewed it up, spit it out, and then went right back to being sweet and gentle preggo Jess.  I blame the violent fantasy entirely on the raging progesterone that has hijacked my body. >> The initial fury at the news delivered from this inexperienced nurse passed, and I became simultaneously hopeful that there had been some mistake, saddened by the thought that something was wrong with me, and scared that something could be wrong with our son.

We then go to see the nurse practitioner, and she assures us the test results from today only tell us that we have to do the 3-hour test to get an accurate look.  At this point it's not definite that I have GD. So we schedule the 3-hour test for the next day.

Friday: We arrive and I have a pre-sweet-drink finger prick to measure my fasting sugar levels. They're GREAT. The doc wants that initial number to be 110 or below, and mine was 87.  Drink the drink and wait an hour for finger prick #2. Ideal number would be 190 or below, and mine was 212. :-(  The nurse, a different one from the day before, gently and sweetly tells us, "Your number is a little higher than what we're looking for." << In contrast to the reaction I'd had the day before, I took this news in stride... I think.  The hubs might tell you differently, but do me the favor of not asking him. >> We go back to the holding area to wait for finger prick #3. Here's the deal- I could have failed 1 out of 4 of the finger pricks and still "passed" the test.  So if my numbers for finger sticks #3 and #4 were below the desired levels, then we would have avoided the GD diagnosis.  Turns out the #3 test read 175, when they were hoping for 165.  So we wait to see the doc.  It's official according to the doc: I've got Gestational Diabetes.  The Dr's office will make a referral to a local Diabetes clinic, and they'll call us to make an appointment to come in and learn what's next. We'll do this in the next few days.

So what is Gestational Diabetes, exactly?
The National Institute of Health has the following information.

Normally, your stomach and intestines digest the carbohydrate in your food into a sugar called glucose. Glucose is your body’s main source of energy. After digestion, the glucose moves into your blood to give your body energy.  To get the glucose out of your blood and into the cells of your body, your pancreas makes a hormone called insulin.  If you have diabetes, either your body doesn’t make enough insulin, or your cells can’t use it the way they should.  Instead, the glucose builds up in your blood, causing diabetes, or high blood sugar. Gestational diabetes happens in about 5 percent of all pregnancies, or about 200,000 cases a year in the United States.

How is gestational diabetes treated?

Many women with gestational diabetes have healthy pregnancies and healthy babies because they follow a treatment plan from their health care provider.  Each woman should have a specific plan designed just for her needs, but there are some general ways to stay healthy with gestational diabetes:

• Know your blood sugar and keep it under control – By testing how much sugar is in your blood, it is easier to keep it in a healthy range.  Women usually need to test a drop of their blood several times a day to find out their blood sugar level.
• Eat a healthy diet – Your health care provider can make a plan with the best diet for you.  Usually controlling carbohydrates is an important part of a healthy diet for women with gestational diabetes because carbohydrates affect blood sugar. 
• Get regular, moderate physical activity – Exercise can help control blood sugar levels.  Your health care provider can tell you the best activities and right amount for you.
• Keep a healthy weight – The amount of weight gain that is healthy for you will depend on how much you weighed before pregnancy. It is important to track both your overall weight gain and weekly rate of gain.
• Keep daily records of your diet, physical activity, and glucose level – Women with gestational diabetes should write down their blood sugar numbers, physical activity, and everything they eat and drink in a daily record book.  This can help track how well the treatment is working and what, if anything, needs to be changed. 

What happens after the baby is born?

For most women, blood sugar levels go back to normal quickly after the baby is born.

Additionally, I digitally sauntered on over to the U.S. Food and Drug Administration's website and found some very good, NOT ALARMIST, material about Gestational Diabetes.  Here's a snip of what the US FDA website said about GD, in case you're confused, concerned, worried, freaking out on my behalf, etc.

Why is gestational diabetes a problem?
For you:
• Your risk of developing type 2 diabetes is increased.
• You are more likely to have a large baby (a condition known
as macrosomia). This may cause discomfort during the last
few months of pregnancy.
• Having a large baby may lead to a cesarean section
(C-section). If you had a C-section, it may take longer for you
to recover after the birth.
For your baby:
• Large babies are more likely to suffer from birth trauma.
• Soon after delivery, your baby may have low blood sugar.
This can be treated with early feedings and should not result
in any long-term consequences after birth.

What can I do during pregnancy if I have gestational
diabetes?
Go to all of your • prenatal visits.
• Follow your health care providers’ recommendations for
controlling your blood sugar. This can help reduce your risk
of having a large baby.
• Stay physically active.
• Make healthy food choices.
• Ask your health care provider to see a dietician or a diabetes
educator.

In order to avoid a total melt down while attempting to be proactive and become informed over the Memorial Day weekend, I decided to research carb content in some of my favorite foods.  As far as my preferred fruits and veggies, I learned that lemons, limes, avocados, and strawberries will be A.O.K., and there is a huge long list of veggies that will be just fine for low-carb requirements.  

In closing, you should know that if you're planning to come for a baby-viewing visit at any point postpartum, I may just have to charge you an entry fee of fresh bread, pizza, pastries, macaroni and cheese, cookies, or something else of the carb and/or sweet variety.  And in the meantime, if you have any sugar-free, low-carb recipes you love, send them my way!