Sugar, Sugar: Gestational Diabetes (continued)

It's been about 3 weeks since I was diagnosed with gestational diabetes, and it's been, to say the least, a little bittersweet.


I met with a nutritionist and endocrinologist twice already, and have been checking my blood 6 sugar times daily, keeping meticulous logs of blood sugar levels and writing down everything I eat. So far things are more or less under control through changes I've made in my diet. No need for insulin, thank goodness.

But even so, it's a lot like walking a tightrope, and since I changed my diet, my ideas about food have really been challenged.

The obvious change is adding more proteins and veggies to my diet, and to reduce carbs and eliminate simple sugars. That's definitely part of it. But it's not that simple, especially when pregnant.

Portion size is really important, which means I have to eat 5 or 6 times per day, or every 2-3 hours (including late at night) to keep blood sugar levels on an even keel. What's more, if I wait too long between meals, I end up eating too much at the next meal, feeling full and uncomfortable (especially now in my 8th month of pregnancy!) and levels end up getting elevated because I get the carb craving.

The timing of eating certain foods is also critical. The breakfast meal has to be protein based, with just a touch of carbs. The carbs, of course, have to be whole grains. No cereal is allowed in the morning (now that's the antithesis of the American Special K morning!)and very little, if any fruit. Half a grapefruit seems to work ok, but other fruits just have too high a sugar content. Sometimes I even have some veggies for breakfast as a side dish, like steamed spinach or kale.

My nutritionist told me that fruit is a necessary part of my diet, but that fruit should generally be eaten as part of my snack regiment, not part of meals.


Eating late at night also has thrown me off -- I once went on a diet which restricted food after 6 p.m. Not in this case! Strangely enough, it's important to have a late night snack of carbs shortly before sleeping to keep blood ketone levels low or negative.

Ketones are substances that are made when the body breaks down fat for energy. Normally, your body gets the energy it needs from carbohydrate in your diet. But stored fat is broken down and ketones are made if your diet does not contain enough carbohydrates to supply the body with sugar (glucose) for energy or if your body cannot use blood sugar (glucose) properly. Hence, the need for carbs at night. Usually you'll find me at night munching on a bowl of Trader Joe's Os with milk, and I'll wake up with negative or minimal ketone levels.

The other thing I've found is I need a glass of milk for added proteins during meals. I used to drink almond milk, which is also healthy, and has a lower sugar content than milk. However, it's protein level is significantly lower.

If anything, these dietary changes have challenged me to rethink the quality of my nutrition, and ideas I previously had about what is healthy eating. And that is always a good thing.

I Have Gestational Diabetes, Now What?

I was diagnosed with gestational diabetes in week 31 of the pregnancy -- and I'm already at week 33.

I had to do the typical glucose tolerance test, which required fasting all night and a good part of the morning, and drinking a small bottle of sickly sweet soda and having my blood sugar levels tested every hour for 3 hours. Apparently my readings did not make the cut of typically normal sugar level readings.

It was a bit unsettling at first, to receive a voice message from the nurse, and then to speak to one of the doctors in the practice, who immediately told me the levels were "out of normal range" and referred me to a specialist.

When I first heard the words "gestational diabetes," I thought of daily insulin injections, large babies and potential pregnancy complications. Then when I spoke with other moms, I found out that some of them had GD too, and were able to control it with diet and exercise, and never actually got to the insulin stage. They apparently eliminated the diabetes postpartum, which gave me even more hope.

To an extent, understanding the condition makes it more manageable. What's happening is that due to pregnancy hormones and other factors, my body is either not making enough insulin or my cells are not using it properly. This causes the glucose to build up in my blood, hence the high blood sugar readings.

I can't say having GD is the easiest thing in the world to live with, but it's not the worst either. I have to prick my finger 6 times daily to measure the blood glucose. I keep logs of these levels as well as what I eat daily, and see an epidemiologist and nutritionist every two weeks.

Sometimes monitoring the glucose can get confusing, if not somewhat contradictory. You attempt to lower glucose levels by lowering your carb intake, then find out that your carb intake has to be higher to keep the keytone levels in your blood low, and the baby's needs met. You try to eat less, but then find out that a GD patient has to eat more frequently to keep the levels stable -- every two to three hours, ideally, plus a late night snack.

Sounds a bit schizo I know, but since I have changed my diet, pretty much avoiding all simple sugars and starches, my moods have undeniably changed for the better! Although I occasionally get upset and start crying uncontrollably from time to time, provoked by causes sometimes out of left field, the instances are rarer. More and more I feel like I am on level train tracks versus a roller coaster. All things for good, I tell myself, and also, this too shall pass, G-d willing.

The Santa Secret

My kids are getting at the age where they are starting to catch on to the Santa secret. Especially my 6-year-old son Benjamin.

Every year our playgroup has its annual Christmas party at one of our houses and one of the dads dresses up like Santa. The costume is quite good, and this Santa actually convinces his followers that he commutes down the chimney, before thundering down the staircase with a giant sack of toys for the eager, wide-eyed children waiting below.

Last year Benji pulled me aside after the gift giving and said, "Mom, that's not really Santa Claus, it's Tulah's dad!" It was hard to deny the pressing truth. However, while we admitted that people do dress up as Santa Claus, we told him that the real Santa Claus only comes on Christmas Eve. He seemed to buy that, and still does as far as we can tell.

The hard part was having him keep hush about the Santa secret to the other children, who are his age and younger. My friend tried to bargain with Benjamin this year, admonishing him that Santa would not give him a gift if he spilled the beans. It worked to a point, but he did admit that he "tried to tell Tulah that Santa is her dad, but she wouldn't believe me. She said she knows her dad's eyes anywhere."

My 5-year old Juliana is seemingly more gullible, more naive about these things. Benji told her the Santa secret, which she relished, saying in her high-pitched singsong voice, "I know the Santa secret!"


Interestingly, Benji and Juliana surprised me. One night before Christmas as we drove home in cold twilight, Benji (the skeptic, the big brain) proudly announced, "I hear Santa's bells! I see Santa's sleigh, up there in the sky, look!" Juliana, as expected, oohed and ahhed at his proclamation.

When Benji and Julie raced to the tree on Christmas day, I was not sure what their reaction might be. They both jumped for joy of course, tearing off the wrapping paper like lions ripping apart their meat. "Santa came! Santa came!" they both cried in unison. Then there was the kicker. Juliana pulled me aside and said, "Mommy, I'm so glad Santa came. He even used our wrapping paper!"

So far, the Santa secret has only been partially revealed. Let's see what happense next year. For now the Santa magic still remains.

Help, I'm Leaking!

I'm 21 weeks pregnant and now I'm in the midst of the Mother of All Head Colds. Sick as a dog, body aches and pains, and what's worse coughing and sneezing my head off.
That only means one thing.

DEPENDS!

I'm not quite there yet -- I thought this wasn't supposed to happen well into old age. But whenever I sneeze or cough, which is like, all the time, the flood gates burst open. Stayfree Maxipads don't always help either. Sometimes they're as useless as coffee filters.

Bladder control, hey, what's that?! Apparently this leakage is quite common in pregnant women, especially induced through sneezing, coughing or bouts of hysterical laughter.

Oh boy. Now I'm inspired to write a rap song about it:

Help! I'm Leaking (or I'm Not an Old Lady, This is Driving Me Crazy)

Whenever I'm coughin' or a sneezin'
You know it means I'm leakin'

Refrain: I'm not an old lady, this is drivin' me crazy.
This is supposed to happen at 80, not to a nice young lady!

Get me a diaper, or a windshield wiper
After you have babies, your bladder leaks like gravy

Refrain: I'm not an old lady, this is drivin' me crazy.
This is supposed to happen at 80, not to a nice young lady!

Stop the flood from spillin'
So this girl can be chillin

Refrain: I'm not an old lady, this is drivin' me crazy.
This is supposed to happen at 80, not to a nice young lady!

I want to stop feeling like a freak
And more like fresh meat!

Refrain: I'm not an old lady, this is drivin' me crazy.
This is supposed to happen at 80, not to a nice young lady

Such is the life of a pregnant woman. More to come...stay tuned!

Halfway along...are we there yet?

I finally reached my halfway point in the pregnancy. 20 weeks...yippee!
But does this mean I have to wait ALMOST FOUR MORE MONTHS till this is over?
My back is killing me, I can't sleep at night -- tossing and turning trying to get a decent position. It's hard to sit at an office chair for more than 20 minutes without feeling the baby pressing on my body, challenging my equilibrium and my back.
If I eat too much I expand like a balloon, and then feel so full I could burst. Can't complain too much about that, though, it's like a stomach valve -- natural weight control! I think I gained the most weight in the first trimester -- thank God for small things.
The cravings have subsided, but I still get pretty nauseous and queasy at times, even while sleeping.
Give me the strength!

Almost 13 Weeks: Hey, My Body's Changing

Yay! I reached the end of my first trimester.

I've been on the other side (the side of the second trimester) for almost a full week now.

The moodiness has subsided, but my body is going through lots of changes.
By 5 or 6 o'clock the idea of food (besides home-baked bread) makes me feel like puking. My stomach gets upset easily. I had a craving for milk late this afternoon, so I downed a glass of skim milk from the fridge. After I dropped off the kids at Tae Kwon Do, I stopped at a cafe to get some Nestle chocolate milk. I gulped that bottle down in record time.

Then my stomach started feeling weird. The noises. The cramping. Slowly but surely I was becoming Charlotte in the first Sex and the City movie, after accidentally sipping the shower water at the resort in Mexico.

About an hour later, I picked up the kids from Tae Kwon Do. Right outside the studio, I got a phone call from a girlfriend. We were gabbing about the pregnancy, and I told her about the morning sickness, the testing, and the baby's sex ("Yay! Another girl!" she cheered) among other things. I was careful to make sure no flatulence escaped in the presence of passersby, then let it rip when a particularly loud truck was making its way to the Jackie Robinson Expressway.

After we said goodbye, I raced to the basement of the martial arts studio, to that heavenly toilet god. I won't go into too much detail, but that milk beat the crap out of my system.


Then there's my body shape that keeps shifting more rapidly than playdough. On Friday night, two fun girlfriends took me out for dinner in Manhattan as a belated birthday present. I had my hair blowed out at the salon, put on my new $170 worth of Mac makeup and slipped on the funky little pregnancy skirt I got from Pea in the Pod maternity (overpriced but cuter than cute). I put on the pregnancy slimmer shorts and man, I did not look pregnant at all. My stomach was as flat as a board. I had to tell them I was pregnant, because even though I hinted at it a few weeks before, they wouldn't dare ask me because I didn't look a lick pregnant in my getup.
I was great at dinner, and even had half a glass of red wine. After dinner they took one look at my stomach and agreed, unanimously, "Yeah, you're pregnant."

We headed over to the CRT Lounge for 80s night and danced up a bit of a storm to favorites like the Human League's "Don't You Want Me," Young MC's "Bust a Move," Culture Club's "I'll Tumble For You," among many others. By 11 o'clock I was beat and had to sit down. That little baby was pressing on my stomach and making me breathless. Even my weak Shirley Temple couldn't get me grooving much longer.

Look, I'm glad I can groove and keep up with my normal routine and my fun adventures, after that whirlwind of a first trimester. But these times, my friends, they are a changin'!

Pregnant again? For the third time? You must be shitting me!

The news was confirmed.
Holy crap, I'm pregnant!
This wasn't supposed to happen.
I'm 41, I haven't used any birth control since my daughter was born over 5 years ago and nothing ever happened.
But it happened.
Now.
When I visited my doctor, he asked, "Was it planned?"
"No, not at all," I replied.
"Well it was planned if you didn't use any birth control," he smartly retorted.

Now here I am, 10 1/2 weeks into the pregnancy, with a 1.5 inch fetus dancing happily in my uterus while I battle nausea and bloating.
There are the cravings. The garlic knots bathed in olive oil from the local pizzeria under the subway. Pizza, Grandfather's style. Bread -- hunky chunky rolls. Dark chocolate. Organic milk.
Even my baby bump is starting to show.
Some of my friends and family know, some know nothing, intentionally so.
At 41, I'm electing to do the testing for Down's syndrome, mental retardation and for about 20 Jewish Azkanazi diseases that no one has ever heard of, like maple syrup disease (What the heck is that? Do you get that when you eat too many pancakes?!) To top it off, I'm a carrier of a genetic disorder that killed my brother at 20 years old. My children were lucky to be born healthy and disease free, but I remember what it was like being tested when they were still blips on the sonograms, waiting up to two painstaking weeks to get the results.

My husband and I fight constantly, I am so moody that I cry hysterically at least once a day for at least one hour, and I don't know what the hell I got myself into.
I want the child-to-be to be healthy, that's for sure, but I am scared shitless. Our marriage and finances are on the seesaw constantly, and I don't know how I'll handle having a personal life and a career with an extra kid around.

Somehow I'll get through. Whatever doesn't kill me has to make me stronger. Something like that.