Hydration, Weight Gain, and Pregnancy

I have this theory, based mostly just on my personal experience with pregnancy, that a lot of the avoidable problems and discomforts of pregnancy are related to excess weight gain or to dehydration.

Heartburn is a good example. When my week-to-week gain has been very high, I've been particularly bothered by heartburn. My two friends who gained 40 and 60 pounds while pregnant had a lot more heartburn. So while I certainly don't mind gaining weight while pregnant, I think pregnancy weight gain needs to be moderate for my non-heartburn comfort. I know not to eat less while pregnant (or nursing), but I'll go for another walk or otherwise add more light exercise.

One suggestion to stop preterm labor is to drink 2-3 glasses of water or juice. (The other tip is to lie down on your left side.) Pre-eclampsia (dangerous high blood pressure while pregnant, often resolved by delivering early) could also be related to hydration. My friend who delivered her first son when her prenatal appointment indicated pre-eclampsia said, Yes, actually, she was thirsty when she got to this appointment, and no, the hospital didn't offer her water while waiting to see if her blood pressure would go down. When I got the "we don't like your blood pressure" routine, I made myself much more comfortable (I went to the bathroom, then I drank 3 glasses of water and went again), sat still a few minutes more, and my blood pressure dropped dramatically. I'm sure all of what I did helped, but I think drinking water is the most overlooked simple resolution for blood pressure issues.

I also notice that I'm more likely to have heartburn or swelling when I'm dehydrated. So drink some more water already!

Prenatal Visit

Another quick and easy prenatal appointment! I was late since Karston needed many extra cuddles (hard to resist!), but I still didn't have to wait long for my (8 AM) appointment. Blood pressure 94/62 (no pre-eclampsia here! I was putting my water bottle to good use too), and The Bump measures 37.5 (still growing, no worries, but the classic would be to measure 39 at 39 weeks).

The Upside of Pregnancy

I'm not that good at being pregnant; morning sickness takes me down for the first trimester to first half. Then, after an all-too-short respite, I'm bulky with the large complaints of pregnancy like heartburn. Despite that, there are a few nice things. It's atypical, but my skin clears up and my face breaks out less. My thick hair gets softer and less unruly. (My hair also gets much darker and straighter, so I go from dark blonde and wavy to brown and straight.) For some odd reason, since I would expect the relaxin and imbalance of pregnancy would not mix well with my benign hypermobility, my joints hurt less. Yes, my feet and knees ache from carrying extra weight when I stand a lot. Sure, my lower back is aware of that big belly. But I ache less overall if I exercise sensibly, and that's a pleasant surprise. People, even strangers, are exceptionally considerate. So it's not all a miserable waddle to the finish. Plus this baby rarely kicks, although he moves a lot, so I'm less uncomfortable this time.

Labor in a nutshell

Finally! I found a reference that isn't too touchy-feely for me. The childbirth cheat sheet for dads-to-be at BabyCenter is just the basics. Whew!

Labor Timer

I installed a Labor Timer just to get ready for the big day when we meet Karston's baby brother! Hopefully it'll be a while before we use this, but I don't want to have to rush to install this either. Looks easy to use ... we'll see if it's useful! (I didn't have any contractions to time last time.)

Prenatal Visit

Very quick prenatal appointment this morning: I was in and out in 15 minutes! We measures 33 inches (a bit small, but not unusual) and 140 bpm. Next appointment is in two weeks. After that, I'm down to weekly appointments, ugh.

I asked about my glucose numbers, and they were much improved. My fasting glucose was 61 (last June, pre-pregnancy, it was 76), and my 1-hour challenge was 109 (below the worrisome threshold of 135 to 140, and even below the 126 during my first pregnancy). I attribute it to improving my diet and exercise since the first test with this pregnancy when I hit 139.

Personality

Even with six weeks to go in this pregnancy, I can already tell a personality difference between my sons. When I was large-pregnant with Karston, he would get his feet under my ribs and kick. This time, the kicks all have a reason. Thumper kicks when I get hungry (he's hungry too), when cold touches my belly (he doesn't like to be cold), and when I lean into something (he doesn't want to be cramped anymore); he doesn't kick just for the sake of kicking. He's a very sweet boy!

I had no idea I would be able to tell something about his personality before he was born, but I learn new things all the time.

Sleeping, 3rd Trimester Style

Well, I'm not alone in waking up all night every night. Lately, I sleep about two hours at a time. I feel fine, though; so it could be worse.

Nighttime Heartburn

Certain foods can cause nighttime heartburn, including: soda pop or beverages with caffeine (which you shouldn't be drinking before bed anyway!), alcohol, garlic, chocolate (sorry!), citrus fruits, tomatoes and tomato-based products.

Guess why I'm awake? I had a tasty Penne Julia italian dinner with a clementine (citrus) for dessert tonight. I like the banana-a-day approach, though; I could see eating that most days.

Prenatal Appointment

I had yet-another prenatal appointment this morning. (Prenatal visits are strongly correlated with healthier babies, so I know it's important. On the other hand, I've also seen a research study that you don't need nearly as many prenatal visits as are standard for that benefit as long as there's a nurse to call with any questions between appointments. So I'm not kicking about prenatal visits in general, but every other week seems frequent especially since I know we don't need that many visits.) I took the 1-hour glucose challenge first thing in the morning for the last appointment, and my reading landed in the gray zone. Given morning cortisol levels, a very early glucose challenge is the most challenging. The doctor wanted to do the 3-hour challenge, but going without breakfast until lunchtime would trigger a migraine for me. So instead I came in for a fasting glucose draw, and took the 1-hour glucose challenge in the afternoon. I did not feel right for the morning glucose challenge; I felt as fine for the afternoon glucose challenge as you can after drinking something that's way too sweet when you normally drink water.

Ironically (since the point was to avoid how long I went without breakfast), I sat in the waiting room for half an hour this morning before my appointment, so I was pretty hungry when I saw the nurse for that blood draw. The nurse started with the usual routine of taking my weight. The rule of thumb is that I should gain a pound a week in the third trimester, so she started with, "You're down half a pound since two weeks ago." I gave her a withering look (sorry, but I was hungry, cranky, and bored from sitting for half an hour) and said, "I'm here for a fasting glucose draw, and I'm starved." Bless her, she skipped the rest of the routine and sent me straight to the blood draw.

This doctor is herself 14 weeks pregnant, and I heard her from down the hall saying, "What? Get that girl some food!" So I started eating the cereal bar I made last night just for this morning. Don't know if it were hunger or just that good, but that bar tasted great! The doctor apologized for her cold hands when she started to measure me. At first she was worried that Thumper was very big, but he was just getting as far under my ribs as he could for some reason. Thumper ran away from the cold touch, and then I measured normal (32 inches at almost 32 weeks, and the rule of thumb in third trimester is to measure in inches where you are in weeks). The heart rate monitor was also cold, so he kept kicking it and trying to get away from it, so the monitor never got a lock on his heart rate. However, it sounded like 150 bpm to both of us, and what with moving all around, he sure seemed healthy, so that was good enough.

Yeah, that prenatal visit got a lot better once I got some food. So let's stop the fasting tests!

Help for Morning Emesis

The problem with morning sickness, particularly the all-day variety I get, is that it puts me in such a fog that I have a hard time thinking of a way to get out of the sickly haze. However, I did find one more effective trick for my morning emesis other than avoiding sucralose (and sugar, to a lesser extent). After breakfast, I brush my teeth. Depending on the morning, if I haven't yet (probably because I was cuddling our toddler earlier), I also wash my face. What do those have in common? Bending over the bathroom sink! That seems to be a trigger for my throat to want to reverse gears, but I found a way to head it off. If I blow my nose before brushing my teeth, I'm much better off. The other aspect, of course, is to spend as much brushing and washing time standing upright, and not bending over the sink. But blowing my nose before brushing my teeth while not as obvious seems to be very effective.

Speaking of brushing teeth and morning sickness, most toothpaste (read the labels on Crest and Colgate!) contains saccharin. When I have morning sickness, I can't handle any amount of saccharin, even when I'm not eating it. Luckily I still have the tube of Tom's of Maine mint flouride toothpaste from the first pregnancy, so I can still brush my teeth with toothpaste (although using no toothpaste is better than not brushing at all!). I prefer plain baking soda right now, though. The less sweetness in my mouth in the morning, the better.

Pregnant Twitter

I have a friend who was pregnant, and at work we were all watching her IM status since she was updating it with baby messages. No updates in several days (she's offline), so I assume that she's in the hospital and that everything is fine. And it made me think, as a blogging mother, is there some other technology, other than IM status, to use to update all of your friends on your status instead? That answer seems obvious: Twitter! To reduce duplication, there's a script to update Twitter with your iChat status message. For a nice Mac application to read and post, there's Twitterrific. But using a Treo is the best way to send an update when you're in the car driving to the hospital, so there's TreoTwit (en). Or web toTwitter2Go for a small-screen-friendly site.

Of course, she's already done (I think), but it's amazing what you find!

First Kick

I felt the first kick, a good solid kick followed a few seconds later by a second kick, this afternoon while showing Karston how to take a nap!

We're just into Week 13, second trimester, too. This is early for the first kick, but it was such a solid kick that there's no doubt.

Morning Sickness Again

I really don't do pregnant well. I feel crummy all the time (except when I just get out of bed) with morning sickness. This time it didn't start until the classic 6 week mark; before that, I kept saying, I don't feel pregnant. However, this time it's also worse. Last time, I was queasy all the time. This time I have three warring symptoms: queasy, heartburn, and sickly small doses of emesis. Ick. Many of the food-related items that ease my queasiness, namely citrus, are heartburn triggers! So not only am I dragging, not only do I feel terrible, but fixing one symptom makes another worse. The queasiness starts about 30 minutes after I wake up and lasts until after I fall asleep. The heartburn generally starts after dinner, although sometimes it starts after lunch, and lasts most of the night. The emesis usually happens when I'm brushing my teeth after breakfast, so at least I'm already in the bathroom.

So I looked for another guide to manage morning sickness this time. Possible underlying causes are dehydration or excess saliva. I can't argue with either theory since water (and other beverages) taste nasty right now. One suggestion (Book of Home Remedies, Rodale Press) is to munch on almonds. That tastes good, and might ease it a little, but it doesn't help much and it doesn't help with thirst. One thing that has helped is switching what I eat for breakfast. Recently my favorite cereal was Fiber One Honey Clusters; it's low sugar but tastes enjoyably sweet thanks to sucralose. Well, when I switched to grits with no sweetening at all, I skipped the emesis. That still leaves me with the contradictory pair of queasy and heartburn, but it's a start on relief. I wonder what the anti-morning-sickness diet looks like? Probably bland and unsweetened.

So I looked for that as well, and found a dietary suggestion for morning sickness. Following it, I asked myself which of the following flavors sounded appealing, on a +/./- scale for yes yummy / whatever / no nasty. It's not encouraging!

salty .

sour -

bitter -

sweet -

crunchy .

fizzy -

mushy .

wet .

dry .

hot .

cold .

bland .

tangy .

spicy -

fruity .

earthy -

That's right, nothing at all sounds appealing. I thought I was just too worn out to have a tasty idea, but given a list, I still can't find anything I want to eat. This is going to be tough.

Books for Pregnancy

In retrospect, these are the books that I'm glad I read while pregnant:

• What to Expect When You're Expecting by Murkoff, Eisenberg, and Hathaway (even recommended to me by my aunt the OB as well as everyone else; make sure you have the latest edition),
• Pregnancy, Childbirth, and the Newborn: The Complete Guide by Simkin, Whalley, and Keppler,
• Pregnancy Fitness by Ginny Graves, and
• Baby Bargains by Denise and Alan Fields.

If you end up with morning sickness (I'm so sorry), try avoiding the foods with natural toxins (that don't affect adults but could affect embryos) mentioned in Pregnancy Sickness: Using Your Body's Natural Defenses to Protect Your Baby-To-Be by Margie Profet. My crude empirical evidence is that of the three women who had terrible morning sickness whom I know personally, this diet worked. See The Virtual Birth Center for a list of foods to avoid following Margie Profet's advice.

Third Trimester

Oh, my aching sciatica! That's how my third trimester started. If it hurts, ask your OB to refer you to a physical therapist! The single most helpful exercise for me was the modified wall sit. I press (flatten, neutral spine) my back into the wall with my thighs at about 30 degrees from the wall. Repeat as needed. The sciatica went away when I followed the right set of exercises. One such set (I'm only using the wall slide) is here.

Each day I say that I've never felt so stretched ... and then the next day comes. I think the shea and cocoa butter lotions I use do help, but that could be in my head (still helps!). My first trimester visitors of thirst and fatigue are back. This time when I drink water, I can feel my belly expand. And since there's tremendous growth, I assume that explains the desire to nap.

It's cruel irony, but my sleep patterns have already changed for the worse. I now measure how well I slept by the length of the times I stayed asleep. It's usually 90 minutes, but sometimes half that. One night I got two batches of three hours each (and then a sound two hours on the couch), and that felt heavenly!

Favorite food: grapes! and still eating half a grapefruit for breakfast as long as the citrus season holds out. (Still can't handle fat and salt.)

Almost done! Keep exercising, and get as much sleep as you can (both to reduce pain).

Total weight gain: up 16 pounds.

Peanuts

Here's an odd one for you. Ever since I got pregnant, especially after the morning sickness hurdle, I have had a difficult time with peanut butter. Normally, I like it. But lately, a little bit of peanut butter makes my stomach feel like it's not going to be very happy with me if I eat any more. Normally, I'd chalk this up to my own quirk.

However, out of the blue, a co-worker said his wife couldn't eat peanut products while pregnant and while breastfeeding, but his daughter doesn't have a peanut allergy. Like me, his wife didn't have a BAD reaction, just a clear indication that less is better. (They love Chick-Fil-A food that happens to be cooked in peanut oil. My pregnancy has told me in no uncertain terms to avoid as much fat and salt as possible, so I don't eat out in places like that. In fact, it's really hard to eat out. Can't take me anywhere! *grin*)

Second Trimester

The second trimester, since I was lucky enough that my morning sickness ended, was mostly smooth sailing as everyone says. I felt fine, I wasn't showing (as long as I didn't wear belly-tight clothes), and I could do what I wanted (although I got winded easily). The challenge here was to fight the fuzziness of "pregnancy brain." Since I just finished an engineering Ph.D., people think my brain works. Well, pregnancy trumps a degree, and I had to work hard to keep my brain as sharp as possible. It was tough, but the payoff is that it "sticks" and I'm pretty functional brain-wise. Still, I have been a better multi-tasker. I used to take on 4 different tasks at work, not more like 2 at a time. My co-worker Chuck says the other two threads are talking to the baby even if I don't know it.

In the second trimester, I noticed that I felt a whole lot better with light daily exercise. I did stretches, light free weights (I've never seen 5 pounds free weights change my arms in two weeks, a pregnancy bonus! I usually lift a lot more too), and (if not too tired) elliptical trainer. I was slower and needed more sleep, but I pluged away at it, and exercise is a priority. I recommend it!

Least favorite foods: anything with much fat (no fried food) or salt. Fat/grease upsets my stomach, and salt makes my chest feel tight. On the other hand, my blood pressure is fine and everyone says I look healthy. Fat and salt aren't much of a loss, although it's difficult to eat out.

Favorite food: half a grapefruit for breakfast!

You can fight pregnancy brain fuzziness, and I think it's worth it in the long run as well as the short term. Exercise is good, and goes well with feeling better.

Total weight gain: up 5 pounds.

Morning Sickness

I had terrible morning sickness in the first trimester. No really, I've won every "I was so sick that ..." so far! Honestly I wish that weren't the case. The only time I wasn't sick was first thing in the morning, so let's call it pregnancy sickness instead. My pregnancy sickness started before the fourth week (probably at implantation), lasted through the first trimester, and came back for three weeks early in second trimester after I endured some airplane turbulence. I thought it would never end! I have some tips that worked for me, and I suggest that you do a web search and try all sorts of ideas that don't neglect nutrition and exercise.

1. Wear loose waisted pants.        
2. Don't slouch, but sit at 90-degrees or more (reclined, no belly compression) or stand.
3. Take a nap (naps rule! no nausea when I wake up!).
4. Take an almost-brisk walk outside in the fresh air.
5. Eat an orange (or almost anything else I can stand; I feel fine while eating, and citrus seems to last after eating too).
6. Never get full or hungry. Snack frequently. In first trimester, I needed 150-200 calories every two hours. By second trimester, I tapered off to more food every four hours.
7. Eat bland food that's high carb and low fat, eat high protein and low fat, and drink fluids especially water and lemon-lime Gatorade. Look at the dietary suggestions from Margie Profet because I felt better when I did not eat the suspect vegetables (and I love my fruits and veggies; I just switched to fewer of some while eating more of others).
8. Drink fluids between meals, not during.
9. Don't hold your breath. I sometimes hold my breath when concentrating, but don't.
10. Smell a lemon. Don't ask me why, but I'm fine while smelling a lemon scent. I'm told that sucking on a lemon slice will also get your mind off of pregnancy sickness, but I didn't need to go that far.
11. Switch to a prenatal multivitamin without iron in it. GNC has one. This made a huge difference for me. (I also get lots of iron in my diet, so I need to worry more about iron toxicity than iron deficiency. Since the deficiency is common, this one may not apply to anyone else.) Do continue to take a multivitamin!

Good luck, best wishes, and it does end!

Nosebleeds

The first question from one of my friends, after discovering I was pregnant, was, Have you had many nosebleeds yet? And the answer was, All the time. The medical reason I heard was that the nosebleeds are from the extra blood, but I don't think that's the whole story.

The other part of the problem is that we were both pregnant during winter months when it's drier. I took two trips to humid coastal Florida, one in January and one in March, and I didn't have any nosebleeds while there. Also, my friend who was pregnant in Florida didn't get any nosebleeds.

So nosebleeds during pregnancy are common if you're not in a high-humidity environment that helps protect your nasal membranes.