The food balancing act

One thing I am learning about my first trimester is that I have to listen to my body so much more when it comes to food. Before I was pregnant, it didn’t really matter if I got hungry and there was no food around—I could handle hunger pangs for a while—and it also didn’t matter if I ate a lot at one sitting, because I knew that I’d just feel full for a while and then eventually I’d get hungry again. Let me tell you, I do not have these luxuries now: if my body tells me I need to eat, I have about seven minutes before I turn into crazy-hungry-pregnant-woman, where I seriously consider stealing ice cream cones from small children. (Case in point: after leaving the doctor’s office yesterday, my husband and I were literally going to go across the street for lunch, but I was so hungry I made him stop first at the fruit stand three feet away from the hospital door. I just couldn’t wait.) Even weirder, I can also no longer eat too much at a single sitting. If I do that, then I am REALLY visited by the nasty nausea fairy.

For instance, yesterday, after the trip to the fruit stand and a rather large helping of chilaquiles, and I felt ill all afternoon—especially about five hours later, when the pangs of nausea were so strong I couldn’t even eat my dinner. I’m pretty sure the nausea is directly tied to the large lunch, because when I eat lighter, more moderate meals, I don’t get nauseous at all. But do you know hard it is to be absolutely STARVING—pregnant starving!!!—and be forward-thinking enough to order a salad instead of a huge plate of Mexican deliciousness? It is not easy, I assure you. But nevertheless, it is the smart option, and it is something I am going to try to do (especially because the lunch options that don’t make me feel sick are probably also healthier for baby as well).

So today, I’ve been monitoring myself carefully. I made myself my usual peanut butter-and-banana smoothie for lunch, and whereas I usually down the whole thing no matter what, I drank about three-quarters of it and then realized that I was about to cross over to the dark side. I knew that those four remaining sips would punish me for the next five hours, so I stopped and poured the rest of the drink down the drain. Sure, I may get hungry later this afternoon, but that’s OK: I have lots of healthy snacks around. It really is amazing how much this is teaching me—meals are no longer about eating as much of the delicious stuff in front of me as I can, but rather, they’re about eating as much as my body tells me to. And I’m finding there is a very big difference.

We had our first visit with the OB today, and baby is healthy as can be! The ultrasound reveals that our little bean measures just 1.29 centimeters long, which is exactly how big it should be: according to my cycle, I should be 7 weeks and 3 days along, and the ultrasound calculated that I am 7 weeks, 4 days plus or minus 2 days. Amazing!

We LOVED the doctor. He was warm, funny, and very knowledgeable, and he didn’t seem the least bit perturbed that we fired questions at him for a good half hour.  He shares our philosophy on labor—I don’t want more medical interventions than are necessary during childbirth, but I do want an epidural—and he seemed incredibly accessible. Although his is a private practice (i.e. no other doctors), he seemed readily available to answer questions in between appointments, and we feel confident that he will be the one delivering our baby (he said that out of every 100 patients, he delivers about 95). So yes: we are very happy, and the best news is that our baby seems to be developing beautifully!

As for how I’m feeling: I’m great, for the most part. Frequently a little queasy, but I haven’t vomited; I get tired, but typically not until the evenings, so I can get through the workday just fine; and I’m not particularly moody. I’ve even started showing a little bit, amazingly—although I haven’t actually gained any weight, there is discernable little baby bump in my lower belly! (Crazy considering that baby is only 1.29cm.) What exciting times! Michael and I couldn’t be happier.

The blood work gamble

Searching for a doctor has been an interesting experience so far. I managed to find an OB with good patient reviews who delivers at the hospital I like, and I have an appointment set up for September 22nd, when I will be 7 1/2 weeks along. It’s a solo practice, which I’m not that familiar with—most of my friends have had doctors in rotating practices, so they see a handful of doctors over time. In addition, my doc only has patient appointments on Wednesdays, which seems a little odd; does that mean he’s generally unavailable for emergencies (and what about delivery)? I’ll ask him all of these questions when I meet him, of course. I really don’t know how these things work.

After setting up the appointment, I asked his receptionist if I could come in earlier for blood work. She said no—blood is only drawn when it’s requested by the doctor. Hmm. Here’s my question: if you need blood work to diagnose ectopic pregnancy, among other things, then why isn’t it routine for doctors to draw it early on? Isn’t it a gamble for doctors to just assume that every pregnancy is progressing normally?

To get around the problem—I wasn’t going to take no for an answer!—I contacted my primary care physician, who is in family medicine. Based on what I read in The Perfect Hormone Balance for Pregnancy, I asked if she could give me three tests: one, a quantitative HCG test, since low HCG levels can predict ectopic pregnancy; two, a serum progsterone test, since this too can be used to diagnose ectopic pregnancy and since low progesterone levels can indicate high miscarriage risk, prompting the need for progesterone supplements; and three, a complete thyroid work-up, because I have borderline thyroid issues and my old endocrinologist told me to keep a close watch on things when I got pregnant.

Interestingly, upon asking my physician for these tests, she agreed, but then asked why I needed the progesterone and HCG tests. I’ll admit, I was surprised; she has a special interest in reproductive medicine, so isn’t she supposed to know this? How is it that I’m the expert here (if, in fact, I am—perhaps I have got things all wrong)?

I guess sometimes it’s true: you’ve just got to take your health in your own hands. I’ll let you know how the tests go.

Exercise is by far the most confusing issue I have confronted so far in my pregnancy (omg—every time when I write that word, I get so excited!). I’ve always been an avid gym-goer, and I love to run and do those crazy stair-climbing machines (the ones where you’re climbing real stairs). But as soon as I found out I was expecting, I looked more closely at the literature on safe exercise during pregnancy. Although every resource encourages 30 minutes of cardiovascular exercise a day, there is much conflicting information on just how intense it should be.

The American Pregnancy Association recommends that pregnant women keep their heart rate below 140 at all times. Now, I’ve never regularly monitored my heart rate, so I didn’t realize until now just how amazingly low that is. On Monday, I had to do my normal stairclimbing routine at half the intensity as I usually do, and I was still at a heartrate of about 150. And typically I run about an 8 minute mile, but yesterday on the treadmill even a 9 minute 30 second mile got my heart rate above 150. Exercising at such a low intensity honestly doesn’t feel like exercise at all.

But wait—other resources, such as the Mayo Clinic, disagree: they say the 140 beat per minute rule is outdated. (And still other experts openly disagree with one another, as you can see from this comment thread on BabyCenter.) The Mayo Clinic says that as long as a woman has been regularly exercising before pregnancy, heart rate limits don’t really apply. What’s really important, they say, is that you can carry on a conversation during a workout. The American Congress of Obstetricians and Gynecologists concurs:

Heart Rate

The extra weight you are carrying will make your body work harder than before you were pregnant. Exercise increases the flow of oxygen and blood to the muscles being worked and away from other parts of your body. So, it’s important not to overdo it.

Try to exercise moderately so you don’t get tired quickly. If you are able to talk normally while exercising, your heart rate is at an acceptable level.

OK, so I need to be able to talk “normally.” I don’t talk to anyone at the gym, so that’ll be a tough one to assess, but what I have been doing the last two days feels easy and moderate, so I’ll stick with that, I guess. I’ve ordered a heart rate monitor (do you know how hard it is to take your pulse when you’re running on a treadmill?) and will I try to hover right around 150. It’s rather surprising to me that there is so little consensus about one of the most important things women should do when they’re pregnant, but I’ll just go with my gut and hope for the best.

I’m having a baby!

Yes, it’s true—I’m pregnant!—although I still don’t entirely believe it. I’m writing this at 7am on a Saturday as my husband is still peacefully sleeping—at 6:55 I half-woke up and something in my head screamed “BABY” and there was just no going back to sleep. (I guess I should get used to the early rising anyway, huh.) Right now I am a mixture of awe, disbelief, excitement, fear, and occasional twinges of nausea, and it’s wonderful!!

But let me tell the story of how I found out.

As I wrote in my last post, I’ve been trying to chill out this cycle. I promised myself I wouldn’t take a pregnancy test until the day of my expected period, and I wasn’t feeling any different this cycle than I was last cycle, so I was preparing myself for more disappointment. But yesterday, after having lunch with two old high school friends, I went home and just had a feeling. I felt weird, and different weird. My back was hurting, for one. And I wasn’t exactly nauseous, but I had a kind of general malaise where my stomach wasn’t entirely happy. My abdominal region also felt a little, well, inflamed. This is actually a common feeling for me, because I have ovarian cysts that sometimes bleed, leaving me feeling a little tender, but it usually only happens around ovulation. This was a similar feeling, but also different—for instance, it got worse when I bent over. It kind of felt like there was a lot going on in my uterine area and my body was trying to figure out how to deal with it. So I thought, hey, I’ve got about 15 cheap generic pregnancy tests; why not take one? I still had two days until my expected period, but I figured that f I was pregnant, it would be fun to find out at the start of the weekend, so my husband and I could have a few days together to let it sink in.

So I took the test. And boy, was it an enigma. Immediately the control line popped up, as it always does, but slowly—ever so slowly—a very, very, faint second line seemed to be appearing. It was so faint that I thought I was hallucinating. I held it up, I held it down, I held it in the shade, I held it under a lamp, and then I peered at it for 30 seconds while holding it against the window, in the process freaking out a truck driver parked outside. I just couldn’t tell whether the line was real or not. I threw away the test. I tried to do some work. I picked the test out of the trash. Yes, now there was a very faint line, but it had been more than three minutes, and the test instructions says not to trust results that pop up after three minutes. I threw the test away again. I tried to do some more work. I picked the test up out of the trash again. You get the idea.

I decided that it was inconclusive, and that I would take another test later. I was due to meet my husband after work—it was a beautiful day and we decided to enjoy a beer outside (don’t worry, mine was a lemonade). I kept the news—if it even was news?—to myself, but I was internally freaking out. Was I pregnant? Was I not? I had an inkling that I was, because my malaise was getting more pronounced, and it was like nothing I’d ever really felt before. My husband and I returned home about a hour later with some steaks to grill. I waited, waited, waited, and then, when my husband was out manning the grill right before we were about to eat, I took two brand name tests that I had stashed away (in addition to my generic tests, I also have Clear Blue Easy Digital and First Response. That’s how obsessed I am with this whole process.)

And they were both POSITIVE! I was beside myself. I kept my cool for about ten minutes—though I was visibly shaking—and then we sat down for dinner, where I knew my husband would say a little toast (it’s a little thing we do when we sit down for every dinner). I toasted my sparkling water, thanking him for making dinner, and then as he was taking a sip of his beer, I said, “…and I’m PREGNANT!” Michael practically spit out his beer. His first words were “Are you kidding?” and I said, “no,” and he jumped out of his chair and grabbed me and hugged and kissed me and teared up, and it was wonderful. “You’re going to be the mother of my child,” he said. “And I’m going to be a daddy!”

Kind of unbelievable to think that this could be true, but it is so, so very exciting. I love my little embryo already.

Greetings, world! I apologize for disappearing these past few weeks. Work has been incredibly busy, and I’ve been patiently waiting for my next opportunity to get pregnant. Yes, I actually have been patient this time! After the disappointment of last month, I have been working hard at managing my expectations. I’m now in day 11 of my two week wait, and I’m not over-analyzing every little symptom (well—for the most part), nor have I taken a pregnancy test yet (this time last month, I had taken about five).

Perhaps the hardest part about this wait is that I just don’t know what happened last month. Did my egg get fertilized but not implant? Did my fertilized egg implant but then un-implant (what I understand to be a chemical pregnancy)? Or did nothing happen to my egg at all? I’m experiencing similar symptoms this week to the ones I experienced in my two week wait last month—increased appetite, mood swings, and tender breasts—but since I don’t have a clue what happened last time, I just don’t know what to make of them. Does it mean I might be pregnant, or is it evidence that I’m not?

The good news is that even if I don’t get pregnant this time, I think I’ll be OK. I feel much more zen about the process now; I’m just not in quite as much of a rush. I know that it can take a while to get pregnant, and hey, if nothing happens within six months, I’ll visit my reproductive endocrinologist and we can re-evaluate the situation. (To be honest, I’m lucky that there’s a chance of my being pregnant now at all: I realized at the beginning of this cycle that if I were to ovulate on day 25, the same day I did last cycle, I would be most fertile right when my husband was away on his annual boys’ camping trip. But by some amazing stroke of luck, I ovulated on day 17, when he was still here.)

Of course, I’m still secretly very hopeful. I would be over the roof if a pregnancy test came back positive this weekend. Stay tuned: you’ll be among the first to know. Until then, wish me luck at staying calm.

Facing my fears

Well all, it’s been an emotional day. This morning when I got up to take my usual daily pregnancy test, voilà: my period was there to greet me. It was strange. I had completely convinced myself that I was pregnant, because I seemed to have every symptom in the book: headaches, fatigue, breast tenderness, mood swings, nausea. I had even spent time thinking about how to break the news to my family, who Michael and I will be visiting tomorrow for nine days. I have no idea whether I actually did implant and had a chemical pregnancy, or whether I was inventing these symptoms in my head; if the latter, that’s a little terrifying. But back to this morning: when I discovered what was happening, I was more stunned than anything else. I thought, “This can’t be. I am pregnant!” Eventually, about a minute later, it sank in and I shed a few tears, but I wasn’t as devastated as I thought I would be. Yes, this means we have to wait a little longer. But that’s okay.

Honestly, the emotion that lingers with me now isn’t sadness, it’s fear. It isn’t an overwhelming fear, as I know there’s only a 20 percent chance that a fertile couple will get pregnant in a given cycle. But there’s that nagging possibility that this will happen every month. What evidence do I have that it won’t? There’s just no way to know, and dealing with uncertainty has always been a big weakness for me. Perhaps my biggest. Although I think of myself as a positive person, I tend to get negative when I consider the things I really want and can’t imagine living without. Maybe it’s because I’ve had such a wonderful life so far; somewhere deep down I feel I’m overdue for pain, and hey, not being able to have kids would sure be a doozy. It’s an irrational fear, I know, and it’s something I need to face and overcome, and today’s outcome gives me an opportunity to do that. I need to be able to deal with this kind of uncertainty and trust that things will work out. I need to be able to let things go.

So I’m doing okay. And I know that the heaviness that lingers now will be a little bit lighter tomorrow. I’m also excited to spend time with my family this week; seeing them, I’m sure, will put things into perspective. Plus, there’s the fact that now, for the first time in two-and-a-half weeks, I can sit down and enjoy a nice glass of wine. That’s not so bad, is it.