As I come into my third trimester of pregnancy, I have many updates to report on. This post will be about my continuing nausea, my tearing pelvis, and how I probably, maybe have gestational diabetes. As well as whether those pregnancy hormones are making me go coo-coo crazy or not. Here we go!
NAUSEA/ HYPEREMESIS GRAVIDARUM
My first pregnancy post was mostly about how hard I was struggling with severe nausea (read about that HERE). Though my debilitating nausea has MUCH improved, my prescription medication is still a MUST! For the most part I have convinced myself to succumb to the fact that I have to take it, though I have put much effort into weaning from 4 pills a day, to 3, and I am currently trying to get down to just 2 pills a day. A few weeks back I accidentally forgot my morning dose because I was wrapped up in the excitement and festivities of a friend’s wedding, and consequently got sick at the reception and spent some time dwelling in the stairwell (practicing breathing techniques), after making an emergency dart to the bathroom after eating. It took about four days to get back to normal. So yes, even towards the latter part of my second trimester, it was evident that I was still sick and in need of medication to control it. But the good news is that since 20 or so weeks, as long as I’ve had my medication, I’ve been feeling pretty good.
PELVIC GIRDLE PAIN/ SYMPHYSIS PUBIS DYSFUNCTION
Also around the halfway point of pregnancy, I started noticing some pain. It wasn’t very noticeable at first. In fact, it was just a little discomfort in my pelvis when getting out of the bed in the morning. But soon I started feeling it when getting off of the couch or out of a chair or out of the car. And then it started affecting my evening walks, and I was having trouble putting my pants on. And before too long it wasn’t just a discomfort, it was actual pain that would stop me in my tracks and sometimes make me cry out. Kyle was literally having to get me out of the bed and help to dress me. Sometimes I would go to take a step and my hips would lock up and I couldn’t move. We had to completely stop our evening walks. And forget stairs. Don’t even say the word to me. At my next appointment, I brought it up to the doctor and soon after I began physical therapy. Just in time because when I started PT, it literally felt like I was ripping apart (which actually, is an accurate description of what was really occurring) any time I got out of bed, dressed, or walked. I wasn’t sure if PT was going to help, but I was hopeful it would. I did my “homework” exercises each day in between appointments, and although I was very sore and stumbling around the house initially, the exercises began to pay off. Just a few weeks into therapy, I am feeling an improvement.
Pelvic Girdle Pain is a sort of umbrella term for several conditions. None of which are terribly uncommon. The culprit to the condition is the hormone Relaxin (which is responsible for relaxing your joints & ligaments in your pelvis in preparation for birth). However, the problem exists when too much Relaxin is produced and too soon. This causes your pelvic joints to become unstable, causing pain. Many women have some type of pelvic pain during pregnancy at some point and to some degree. Some people seem to experience it earlier in pregnancy than others, and in some severe cases, the muscles and ligaments in the pelvis can tear completely apart and you can end up in a wheelchair before your pregnancy becomes to an end. That’s why it is critical to be proactive if you are experiencing pain and to diligently do your exercises that your therapist assigns you. The funny thing about PGP conditions is that there is a fine line between moving too much and moving too little. Moving too much or doing the wrong activities can be dangerous, as rest and not overdoing it is important–but not moving enough can be just as harmful to the condition. It’s about finding the right balance of activity and doing specific exercises that help keep the condition from getting worse. Essentially, I was being taught exercises to build core and glute muscles, so that those muscles could pick up the slack from my misbehaving pelvis. Thank goodness for a trained therapist because I was in the dark before going to therapy. I was still doing yoga every day, thinking that stretching would be the easiest form of exercise for me, and therefore was safe. However, I learned that part of the condition is that I was “too loose”, and some of the stretches I was doing could be exacerbating the condition. Probably those early months where I was literally not moving from the couch or bed did me a lot of harm because my muscles were weakening that whole time.
GESTATIONAL DIABETES, maybe?
Before I jump into talking about gestational diabetes, I need to give a short preface. This section is a bit tricky for me to write. If you follow my blog, you know I have a bittersweet relationship with the medical community, or at least the more western or less natural approaches to medicine. Nonetheless, I have respect for all professions, and I understand most people are just trying to do their job. At the same time, I’m just trying to live my life in a way that is true to myself. In my local, rural community, there aren’t any options for an alternative when it comes to an OBGYN type doctor (or at least none that I’m aware of.) Ideally, I would love to have a midwife. I don’t wan’t a home birth, but I would love to have a midwife and still give birth in a hospital or hospital-like birthing center. At the beginning of my pregnancy, Kyle and I talked about traveling to a bigger city to explore our options, but with how sick I was, I truthfully didn’t have the physical or mental energy to do my diligent research and staying local was just the easiest and most convenient thing to do at the time.
As a result….It has been frustrating for me though because I feel like I have NO VOICE in regards to my body or my baby. I feel like I’m viewed as a “difficult patient” because I ask questions and seek alternatives that I am more comfortable with. Sometimes I may request something that may be considered “off the wall”, but are quite common in other areas, and I’m looked at like an alien for it. For example, granted I have a normal birth, I would really like delayed cord clamping to be a part of my birth plan. This is simply waiting an extra 30 seconds to a minute (until the cord stops pulsating) to cut the umbilical cord. There is mixed research on this practice, but as I said, with a normal birth, the health benefits are tremendously positive, and this is a way for the baby to receive it’s stem cells instead of them being dumped away. It is a common request at many hospitals throughout the US, but I suppose not something that is practiced locally, and I have already been told that it is highly unlikely to happen, which again leaves me feeling frustrated because no one is willing to discuss it or consider it.
Another example is that I probably, or maybe have gestational diabetes? (Yes, it’s currently under question.) And the testing for a diagnosis is something I have really struggled with for two reasons. Now I know, it is super important to be treated for GD if you have it, which is why I’ve had such a hard time deciding how to go about this. At the end of the day, I’ve decided I have to do what is best for the baby, but I am still very frustrated that I am not given any kind of alternatives as a patient. You know my whole thing with this blog is about having a voice and being a self advocate for your own health, but I feel stripped of this currently. My issues with the GD screening are 1.) The glucose drink has very bad ingredients in it and 2.) I’m flabbergasted that there are no controls for the testing. How can I trust the results when the controls vary from doctor office to doctor office?
Let me explain in more detail. So I’m willing to get over the bad ingredients for a one time thing. And I did just this. I took the 1 hour glucose screening without a complaint because I really do try to not be difficult and to pick my battles. Some doctor’s offices give you an alternative, eating pancakes or jelly beans, for those who are more health conscious and want to find an organic alternative to the drink–as long as they contain the same amounts of sugar, many offices are willing to oblige. Though as I said, I let it go and figured one time wouldn’t hurt anything, even though I wasn’t exactly happy with it. (But just so you know, seizures are just one possible side effect of the drink, and it is loaded with artificial colors/ ingredients/ preservatives.) It’s a bit like toxic sugar water, which hey so is soda, so it’s probably not a huge deal for most people, but it’s just weird to me that doctors give this drink to pregnant people without thought each and every day when there are many, healthier alternatives out there. Still, I knew if I asked for an alternative, I wouldn’t be given one, and I would only be judged, so that was that, I took my 1 hour test with my mouth shut.
My second issue is that I was told I wasn’t allowed to walk around after drinking the glucose beverage. In fact, I could only sit. And I wasn’t allowed water, despite the beverage making me super dehydrated and nauseous. I wouldn’t have a problem with this being the rule, if it were a rule for the test at all doctor offices. Yes, drinking water and moving will make your body process the drink differently than if you are deprived of water and not moving. (That is why if you have GD, you are encouraged to walk after meals and to drink lots of water.) So then why are some patients at other offices allowed to do both? That could make all the difference in passing or failing the test! The lack of controls for the test drives me insane. There is also no control for fasting. Some doctor’s offices do not require the patient to fast for the 1 hour test. I was required to, even though a fasting blood draw was not taken. And again, whether you have food on your stomach, and the type of food you’ve eaten, makes a difference in how you process the glucose drink.
And of course I would have these same feelings, but I suppose none of them would matter, except for the fact that I FAILED my 1 hour test with a pretty high number. Which means that I am supposed to go back and take the 3 hour test–the same test except the beverage contains twice as much glucose and you have your blood drawn 4 times, over the course of a three hour period (sigh). In the meantime, my thoughts have had time to ruminate, and I’ve gotten quite worked up about having to do it all again. My thought is that I probably do have GD. My score was high (174), and although people do get high numbers, and go on to pass the 3 hour test, I assume that I probably really do have it. Why? Gestational diabetes is a hormonal issue–and I have Hyperemesis Gravidarum, PGP/SPD, and pregnancy gingivitis (which that alone puts me at higher risk for GD)–all conditions caused by my hormones, so I don’t think it’s far fetched to assume I’d have GD, too. And what is the protocol for someone who is diagnosed with GD? To get a home glucose meter and monitor it from home. And guess what I did when I learned that I had failed the initial test? I used a family member’s meter to see how my blood sugar ranked after meals. My numbers were PERFECT, but that doesn’t mean I don’t have GD. It just means that my current diet isn’t spiking my blood sugar numbers. If you have GD, it’s important to monitor your blood sugar every day because at some point diet and exercise may not be enough to control the condition, and at that point you would need insulin injections. So I called the office back and told them that I wished to decline the 3 hour test, and asked if they would be willing to write me a prescription for my own home glucose meter (since my insurance would cover it, all I needed was a prescription). If I failed my 3 hour test, this is the protocol I would be asked to follow anyway, and I preferred to just go ahead and do so because I did not wish to subject myself to further testing, more money on labs, the toxic sugar water, four blood draws, and the nausea that comes from me having to fast, then skip my morning nausea meds, and chug down a bunch of sugar. I am human, we are all different, and we all have things that we are comfortable and uncomfortable with. This was the one thing I was begging for an alternative for. Well, I wasn’t given that option. And again, I was left feeling powerless because I was given the option to take the 3 hour test or be left with with a possibly undiagnosed condition that would harm my baby because I would have no way to monitor it without a meter that could have easily been prescribed to me. So given the ultimatum, what choice do I really have? None. It’s utterly frustrating, and I don’t know why it has to be this way. Deep down I know it doesn’t have to be this way.
Aside from the nausea, by far the issue that has caused me the most emotional turmoil is my weight gain. As someone living a health and wellness lifestyle, going into this I truly believed that I would be able to stay within the recommended 25-35lb weight threshold. Controlling my weight before pregnancy is NOT THE SAME as controlling my weight during pregnancy. My body does whatever the hell it wants to now. I don’t even know how else to put it or how to understand it. I legitimately feel like it is out of my control. I can eat healthy, I can exercise, but after that there’s nothing more I can do. I wonder how much of my gain could be water retention because I do drink between 1 gallon and 5 liters of water each day, but even still, I have gained A LOT. I’m just entering my 3rd trimester and I have already gained the 35lbs…so what, can I get a metal or cookie for that?! It’s not like it just started tacking on either. I gained 15lbs in the first trimester alone (recommendation is 5lbs)…when I was deathly sick…how does that even happen? So with a few months left to go, I feel I will easily gain 50lbs, who knows, maybe more…I hear the last stretch is a real doozy for weight gain.
But emotionally, it has been really hard for me to cope with the weight gain. Obviously, I’m growing a baby, and being pregnant means you gain weight, but it’s still hard. And I’m sure a lot of you know exactly what I mean. I keep thinking about how badly I want it to be October, so that I can have the baby and maybe my body will stop being such an asshole, and I can get somewhat back to normal. Maybe it’s in my nature to want to have a sense of control over my body. Before if I ate sensible, my body responded accordingly, and now, it just gives me the finger and goes on it’s jolly way doing whatever it wants to do. So it’s been hard to cope with that change. Which reminds me, I had a nurse tell me that it didn’t look to her that I needed my nausea medication anymore since I was gaining so much weight. Perhaps I’m just sensitive because I’m pregnant, but comments like that don’t seem truly necessary, do they? It was in the way she said it, that made it come across as being a genuinely snarky remark. That remark was a sort of double-whammy for me because 1.) It implied that I was saying I was sick when I wasn’t or that I’m too dumb to know when I’m in fact no longer suffering from nausea and 2.) It was pointing out that I was gaining a lot of weight, a fact that I knew and obsessed about at each of my appointments. 3.) And lastly, isn’t it the sole purpose of the medication to work, and therefore enable me to not be nauseous? Saying that you shouldn’t be on a medication because it is working and making you better makes ZERO sense. That’s like telling a heart patient that they don’t need their heart medication because taking it keeps them alive.
Anyways, despite what I consider a massive weight gain for this point in my pregnancy, I feel like I’m holding the weight relatively well considering. The weight has been distributed pretty evenly. My bump is slightly smaller than average, so that goes to show that the weight has been spreading to other areas (dear lawd, the cellulite is blinding on my butt and thighs). I feel a huge difference when I exercise or really just move around–it’s a lot harder. Just a lot of bodily changes to get used to, but I imagine they are much easier to accept once you get to hold your baby. I don’t like getting fat, but I sure do love watching my bump grow.
Let’s see, what else? Well, I’ve only had one stranger make a terribly rude remark to me. One day I wanted to get out of the house, so I went with my mom who was buying a pair of sandals at a shoe store. I was beside my mom at the counter when the sales clerk asked me when I was due, and I responded “October”. Then the lady literally screamed out loud enough for the entire store to hear “GRIEF! You’re so big.” I was completely speechless. But she continued “You still have so long to go” and “Do people tell you a lot that you are big?” and my favorite, “Are you pregnant with a baby” (No it’s not a baby, I think it’s an elephant). I barely made it out of the store before I bursted into tears. I still can’t believe people say things like that even if they are thinking it! It made me so self conscious, but at least I feel like this was canceled out by another person the following week who remarked that “I looked small to be in my third trimester”. Just goes to show that everyone has opinions and who’s to say that any of us know what the hell we are talking about…
Well this has been good therapy for me, but that’s all I have for now. Until next time…