Morning Walk

I have incorporated a morning walk into my routine to help control my blood sugar. I started with an evening walk with Thom and Aaron, but since my post-breakfast blood sugar was often too high, I began walking for about 15 minutes in the morning, too. Over the weekend, Thom went with me, but during the week, I take Aaron out by myself.

Since he is often playing contentedly when I want to go for a walk, I entice him by asking him who he wants to take for a ride in the stroller. This usually gets his interest. The other morning, he decided to take his two monkeys (formerly oo-ahs) along. (Technically, the big one is a gorilla and the smaller one is an orangutan, but when you are 2, they are all monkeys.) But when we got to the stroller, we discovered octopus and moose were in there from the night before. So of course Aaron wanted to take everyone. You can't see, but under the dark-colored gorilla is another monkey. The light blue animal on the right is moose. He managed to hold onto all his friends during the walk, although I think I had to rescue gorilla one time because he was sliding under the safety bar.

Aaron's latest obsession on our walks is reading numbers on people's mailboxes. It started one morning on our way home. He was trying to read the numbers and I didn't realize and as soon as I passed the mailbox, he arched his back and whined and said "go back. turn around." Now we know to pause at each mailbox while he reads off the digits. He typically reads the first 3 somewhat quietly, but the last digit is read out loud with excitement as he realizes he has read the entire number. Sometimes, something like 3134 goes like this: "Three. One. Three. TWO THREES! Four!"

Potty Training 101

We had bought and installed this new toilet seat that has a built-in potty seat for Aaron several months ago. It is basically a seat with a smaller opening so he won't fall in. He sat on it a couple times when Thom first installed it but lost interest.

But Thursday night, after coming back from our evening walk (a new tradition prompted by gestational diabetes), Thom asked if he wanted to sit on the potty. We knew he hadn't had a bowel movement all day and he's pretty regular, going at least once a day, and usually after dinner. Since it was already late Thom thought it might speed things along if he just went in the potty. Surprisingly, Aaron readily agreed. So we put him on. I sat on the step stool in front of him and read him a book.

I had briefly remembered my sister telling me that she had to teach her twin boys to "point it down" when they were potty training, but it kind of looked like 'it' was pointed down so I didn't think too much about it. Until I suddenly saw a urine stream heading at me. I guess it is sort of like when you turn a fire hose on - even if it was pointing down, the water pressure raises it up. I quickly reached out to point it into the toilet. Thom helped wipe up the floor and the step stool and my leg.

After that, Aaron requested the octopus bath book he is holding in the picture above. It's waterproof, so it's safe for potty training, and it could potentially help avoid future occurrences if he takes awhile to figure out how to point it down. I think I'll pick up a few more waterproof books for potty training. Unfortunately, despite what seemed like some effort on his part, nothing else happened on the toilet. It was well after 8pm (his usual bedtime) at that point and he'd been on the toilet for 10-15 minutes, so we took him off, put him in a diaper and gave him some time to play in the dining room, where he proceeded to fill his diaper. But we still praised him for peeing on the potty.

Today, we tried him on the potty again. He seemed to enjoy it and we took several pictures to document it, but unfortunately, this was about the only one decent enough to post online. I say unfortunately because Thom caught some really great looks on his face, like when he was smiling at me while I sang the ABC song. I'm sure he'll still be embarrassed by it one day, as it is. But maybe I'll take this blog down before he's old enough for that.

Baby 2.0 Update

I saw my OB today. I lost a pound since my last weigh in with my OBs office 3 weeks ago due to my gestational diabetes diet. Prior to that, I had been gaining about 5 pounds between my 4 week visits - a little more than the goal of no more than a pound a week. I must have mis-remembered my prior weigh in because when I was weighed at the dietician's office (on a different scale), I had thought it was 4 pounds lighter than my previous weight, so I haven't really lost that much. I'm not worried about the baby since I know I am getting plenty of nutrients and eating good foods for the baby and that the baby will take what it needs anyway.

When I saw my OB two visits ago, he said he'd take another look at the baby and see if he could tell us the gender with certainty. So I asked about it today and he did an ultrasound. I had Thom and Aaron with me in hopes that we'd find out. I think the picture above is easy to understand, but just in case it's not, the baby is facing you, with the head on the left. You can see the eye socket on top and then coming up from the bottom is an arm. It's not the clearest picture because the ultrasound machine at the OBs office is older than the one we had our 20 week ultrasound on. But on the monitor, we could see the baby pretty well. He said the baby's eyes were closed and it was sleeping.

The picture below reveals the gender. I had read about the 3 lines, but we didn't see them at the 20 week ultrasound.

Apparently from this fact, the OB was confident we are having a baby girl. So Baby 2.0 is Baby Girl 1.0. It is adorable hearing Aaron say "baby sister". When we tell him he is going to be a big brother, he now says "baby sister". Even before, he would say "baby", since he connects his being a big brother to there being a baby. My OB printed out a copy of the top picture for Aaron to hold. This evening, after we got back late from a neighbor's house, he was sitting at the table having some milk before bed and he saw his picture. He said "See sister." So we gave him the picture. And then he said "Doctor B--" (my OB's name) because he remembered that is who gave it to him.

I know he's going to have a hard time adjusting and will ask for the baby to "go away", but I also think he's going to be a good big brother. We've been around other babies a lot lately (two friends had daughters in January, and his cousin Clara is 11 months old) and even though he tells them "no cry" and even told one to "go away", he is also good about giving them pacifiers and toys.

Gestational Diabetes Follow-up

I went to a class on managing gestational diabetes yesterday. It was really just 3 pregnant women in the office of a dietitian with my medical group, so it was very personalized. She showed us a power point presentation all about gestational diabetes, gave us some hand-outs on diet and answered all of our questions. It was definitely informative.

The first thing she assured us was that it wasn't our fault. We didn't get GD because we had a hot fudge sundae. I was feeling guilty about having too many sweets, so this was reassuring. Apparently, pregnancy hormones suppress the effectiveness of insulin and this causes GD. Although I'm not sure why it only happens to about 3-5% of pregnant women. Age plays a part, but I forget some of the other factors. Unfortunately, she said getting GD increases your risk of developing Type II diabetes by 50-60% in the next 5 years. I'm already at increased risk due to family history. But she covered ways to prevent or delay developing Type II diabetes, which basically involves eating healthy (which also means eating frequently) and exercising.

I need to eat 3 meals and 3 snacks a day, with prescribed amounts of carbs at each meal. No milk, yogurt or fruit before noon - because pregnancy hormones interfere with insulin the most in the morning which can lead to glucose spikes. I need to eat some protein with each meal and snack. And there is a list of things I can't have, including soda, fruit juice, cookies, ice cream, etc.

Once I had gotten the news from my OB last week, I had started to make adjustments. I didn't know exactly what the guidelines would be, but I stopped drinking juice and this blood orange soda we get at Trader Joe's (which was usually just a glass a day with a meal). I stopped putting sugar in my coffee and using cream instead of milk (no carbs in cream, lots of carbs from lactose in the milk). And I generally tried to eat fewer carbs and to eat snacks with protein. I had been feeling hungry more often, but not too bad. So I was surprised that when the dietitian weighed us, I was several pounds lighter than my last prenatal visit. It was a different scale, so I'm not sure if I really lost 4 pounds or not. She said she wants to keep track of our weight because people tend to drop weight on the GD diet and they don't really want you to do that. But it's a natural response to eating healthier.

I also got a glucose meter and need to test my blood sugar upon waking in the morning and 1 hour after breakfast, lunch and dinner. My fasting BS should be between 60 and 95. The post-meal readings should be under 130. Last night, I was 134 after dinner. It was tough because I hosted my book club and made dinner from the snacks I provided - which weren't too bad, but it might not have included enough protein. This morning, my BS was 80, right in range. After breakfast it was 131, so pretty close to target. And after lunch it was 118.

Finding things to eat will be a challenge, especially given my lack of appetite this pregnancy. For breakfast, I had a vegetarian sausage patty on a half sandwich (made with whole wheat toast), with one fried egg with some cheese and tomato. I was so hungry afterwards that I was counting down the minutes until my snack. Which was a handful of almonds and 3 crackers (only allowed 15 g of carbs at breakfast and snack time). I was so weak and hungry, I barely had energy to make lunch. I had a chicken sausage sandwich with avocado at noon, served with a pile of carrot and zucchini sticks and some dip. With a glass of milk. Oh, and 3 crackers to make my total carb count 45 g. Although I felt full afterwards, I still felt hungry, although I'm starting to not feel so bad. I'm looking forward to a snack of cottage cheese and 12 fresh cherries in another hour or so.

I think the diet will take some getting used to. Hopefully I won't continue to feel hungry all the time. It makes it hard to concentrate and I've had no motivation to get anything done today. Except prepare food. I'm also supposed to exercise (walk) 10-20 minutes after each meal. I didn't have the energy after breakfast and by lunchtime, it was in the low 90s. Maybe after dinner it will be cool enough.

Gregarious Aaron

We had two birthday parties this weekend. One for Gabe (turning 3) at the beach on Saturday and one for Grant and Oliver today (both turning 2). Aaron had a great time at both. But on Saturday, at some point, he latched onto Oliver's mom Jenny (pictured above). He wanted to sit in her lap and had fun while she buried his feet in the sand. Again and again. And later, if he couldn't see her, he wondered "Jenny go?"

He played with some of the kids, too, trying to give a toy to 1 year old Bridget who was more interested in eating at the time, which upset him. But another boy took the toy and he was happy. At one point, he was trying to get the attention of various adults (who were carrying on conversations with each other at the time) but going up to them and saying "Hi!" in his most charming (and loud) voice.

Thom and I were both shy as children, so I'm not sure where he gets this aspect of his personality. But I hope it lasts so that he makes friends easily when he is older.

Today's birthday party had a train theme and we got to take Aaron on a miniature train for the first time. (You can see pictures on Facebook, where many of you will probably recognize the location.) The picture above is from today, when Aaron wanted to sit on Jenny's lap again. Since it was her son Oliver's birthday and they were starting to open presents, we coaxed him over to our blanket in the shade so she could assist with gift opening. But later, I saw her carrying Aaron, presumably at his insistence. I think he's found a backup mama. Fortunately, Oliver was playing with his dad, Chris, and wasn't bothered by the fact Aaron was stealing his mama.

The only downside is that it was miserably hot. Well, in the low 90s, I would guess. Everyone was roasting, even in the shade. But there was a nice breeze during the train ride.

Helping with the Crossword

I used to do the Wall Street Journal crossword puzzle on a regular basis. But some time after Aaron was born, I didn't keep up with it. But I found an old puzzle in the magazine tote and took it with me to my 3 hour glucose test and made enough progress on it that I wanted to finish it. Aaron saw me working on it yesterday at the table, probably the first time he's seen someone doing a crossword puzzle. He of course wanted to help. I took these pictures today. He was having a snack and saw the puzzle sitting on the table and requested it. He looked so serious about it, I had to take pictures. It would look more impressive if he was working on the puzzle and not on the previous week's solution.

Is he right-handed? Is he left-handed? I still can't tell. He switched hands several times working on the puzzle. And he eats with both hands. I think he's leaning towards being right-handed, but he hasn't started to show a definitive preference.

Gestational Diabetes

After failing my 1 hour glucose tolerance test last week, I had to do the 3 hour fasting test yesterday. I stuffed myself with chicken and some rice the night before hoping the protein would keep me from starving the next morning. I don't think anything can counter the ill effects of drinking 10 oz of glucola on an empty stomach, but I didn't feel overly hungry at least.

On the first blood draw, the woman jabbed me pretty hard and I flinched. I've had blood drawn lots of times and I don't flinch easily. Most times, I hardly feel the prick. But this woman made me flinch and to add insult to injury, when my arm moved she said "Don't move. I don't want to miss it."

The 3 hours passed fairly quickly considering I felt sick from the glucola. My appointment was at 7:15am so I was done by 10:30. My OB's nurse called me the day after the 1 hour test so I was expecting results today and was surprised when my OB called me himself yesterday just before 5pm. He said I have mild gestational diabetes. Three of the 4 tests were elevated. (2 abnormal test levels diagnose GD. With Aaron, just one of the tests was elevated.) Here were my results (and the levels that he told me were considered normal):

Fasting: 83 (under 100 is normal)
1 hour: 197 (under 190 is normal)
2 hour: 192 (under 165 is normal)
3 hour: 148 (under 145 is normal)

(In an article on BabyCenter, they list the cutoffs for fasting through 3 hour as slightly lower: 95, 180, 155, and 140 respectively. I think different labs have different standards, but I'm not sure why.)

He said it was mild and he wasn't worried, mostly because my fasting level was fine. But also because the 1 hour and 3 hour levels were only slightly elevated. He doesn't think I'll have any problem controlling it through diet. He is enrolling me in a program they have for gestational diabetes. Someone is going to call me by the end of the week with details. But he said there would be a class I need to attend where I will learn about GD as well as how to use a glucose monitor to test my blood sugar levels at home. When I asked if I'd have to test my blood on a daily basis, he said probably at first, but then it would probably just be a few times a week. I had read online that some women with GD had to check 4 times a day, so this was a relief.

He said the baby doesn't have diabetes and shouldn't suffer any problems. But he said he would probably do a few extra ultrasounds and that they would test the baby's blood sugar after birth. My glucose tolerance should return to normal within a few weeks after the baby is born.

I'm a little disappointed, but not overly worried. The hard part is that my appetite has never returned, even though I only occasionally get nauseated. But without an appetite, the things I tend to eat are high in carbs and sometimes sugar. So I think I might have to make some significant changes to the way I eat, including better meal planning.