A Day of Counting and Finger Pricking

Well, we are into the third trimester and eager for the arrival of our little bundles of joy – though also determined to make them feel welcome in the belly for as long as possible to give them plenty of time to develop those lungs and grow. Still, the third trimester brings with it new challenges – challenges that I am willing to embrace for our two little boys.

Third Trimester Challenges

• The Hugeness of Me:
  Now, as my belly starts to exceed the size of a regular full-term belly, it’s more difficult to find comfortable positions when sitting and sometimes when sleeping. With enough pillows and shifts in position, I can still keep my back from aching much. Now, when Puck and I venture out together, more and more people are giving me the smiles, knowing nods and questions about when I’m going to pop.




• I’m No Elastigirl:
  While my skin was generously willing to stretch to accomodate an extra 15 inches of waist, it has begun to reach its limit. My first stretch marks are starting to appear on my underbelly (how bizarre to have an underbelly) and sides. Though my belly button has proved quite stubborn on not becoming an outie and has chosen the status of flattie instead.




• The Ebb and Flow of My Inner Tides:
  Swelling arose as a problem in early May and gave me carpal tunnel. Later, my ankles and feet began to noticeably swell (especially around the time of the move and as the weather turned warmer). By reducing salt, making sure I’m drinking the insane gallon of water a day that I’m supposed to drink, sitting and sleeping with my feet raised, sleeping with my hands raised, and not overdoing activities using my hands and feet, I’ve been able to manage the swelling. My feet and ankles quickly return to normal if they’ve started to swell after walking too much. Plus, the carpal tunnel has been reduced to a tingling in my fingertips.




• Waterworks:
  I do appear to be more weepy as the pregnancy moves along. Tears flow freely when I watch sad or emotional scenes in movies or TV shows, when I’m stressed, when I think of us holding our boys after they’re born, when I watch videos of my brother-in-law with his newest son (born just this week), when I think of the generosity of people like a certain anonymous 19-year-old young man who has donated his bone marrow to give new hope to one of our nieces, etc.




• Waddling, Rocking and Grunting:
  With approximately 35-40 pounds of added weight (mostly in the front-belly region), walking has given way to waddling, and to get up from a couch on my own (or even to shift positions much) requires a certain amount of scooting, pushing, rocking and grunting. I’m still quite capable of getting around, and once I start waddling, I can waddle for quite awhile. Still, I am less likely to turn down an empty chair or a hand up when they are available. The arch of my left foot has also been aching the last few days, though I’m not sure if it’s from the added weight or sciatica (caused by compression of spinal nerves in my lower back).




• Disgruntled Digestion:
  Indigestion is back with a vengeance. It seems to be worse in the middle of the night or when I haven’t eaten in an hour or two, but Tums or Alkamints soothes the beast – at least for awhile. I haven’t been using the candied ginger as much for indigestion this trimester.




• Sugar Wars:
  Finally, after 2 weeks of waiting, I had my appointment with a nurse and dietician about the gestational diabetes yesterday. They armed me with California’s dietary plan, a glucometer and a daily diary of my meals and glucose levels that I have to e-mail to them twice a week. I started my testing this morning, the first official skirmish in the sugar wars. For more detailed information, read on below.

Sugar Wars Continued

Today, I have been absorbed by figuring out how to correctly use my glucometer and counting the number of carbohydrates in everything I eat as well as counting the number of servings of dairy, protein, veggies, fruits, starches, fats, etc. It’s proven to be extremely time consuming, though it will get easier. At present, I’m actually having trouble making sure I have enough carbohydrates in my daily meal plan to meet their targets, and I’m exceeding their recommended servings of protein.

The particular gestational diabetes plan that they use here in California is set up for a woman pregnant with 1 baby, so I’m also a bit concerned about how that should be adapted for me as a mother of twins. Moms of multiples tend to have increased needs for calories, calcium, vitamins, protein, etc. Still, we’ll muddle along and do our best.

Here’s how the day has gone:

Fasting Glucose Test:
When I woke up this morning, I had to correct the time on my glucometer (Accu-Chek Aviva). Then, it was time to prick a finger.

• Attempt #1: I dutifully put a test strip in the glucometer, and then I used the lancing device to prick a finger. Unfortunately, I hadn’t squeezed enough blood out of the tiny pin-prick before applying my finger to the test strip, so it gave me an error message (not enough blood). Solution: Squeeze out more blood before applying it to the test strip.
• Attempt #2: Okay, so I pricked another finger, squeezed out a decent-sized drop of blood, applied it to a new test strip, and put the strip in the glucometer. I got another error message (it thought I had removed and reinserted the same test strip). Solution: Put the test strip into the glucometer before applying my blood.
• Attempt #3: The third prick of the finger finally went smoothly – a correctly prepped test strip, a goodly amount of blood, and…a result! Whew! Now, I could think about breakfast.

My post-fasting glucose tests have gone smoothly now that I’ve worked out several things not to do, and I even changed the lancet drum in my lancing device.

Targets:
Their targets are for me to eat 3 meals (breakfast, lunch and dinner) and 3 snacks a day. For each of my snacks, I am supposed to eat 30 carbohydrates. For breakfast, I have 15 carboydrates allotted, and for lunch and dinner the target is 45 carbohydrates. However, they don’t count single servings of vegetables in their carb count (though I have been counting them in mine). So far, my numbers have been good, though my meals are a bit behind time-wise from the planning, counting, preparation, and post-eating glucose readings. I’ve also not completely satisfied my hunger.

Acceptable numbers:
Fasting glucose level: 70-90
1-hour-post-meal glucose level: 90-130

My current results for the day: (I decided to test post snacks today as well)
Fasting: 81 (10 hours of fasting/sleeping)
Breakfast: 97 (18-19 carbs consumed)
Snack: 100 (31 carbs consumed)
Lunch: 106 (45.5 carbs consumed)
Snack: 92 (30 carbs consumed)

For today, I have not added post-meal exercise as I wanted to see what my numbers were before adding exercise into the mix. So far my pancreas seems to be holding its own. One of our good friends who is diabetic named her pancreas Bob. What should I name my pancreas? I’m thinking it should be 1-syllable name, perhaps female? Any ideas? June? Ann? Bess?