Around here lately: April 2018 edition

This girl is still hilarious. Can't wait until next month when she says hilarious things about our new baby...

Hello! I'm Belle Beast.

It's Easter? Yay! Then, it's Pentecost. That's a red hot day. That's when we start using our fans.

Mommy, I'm Ninja Elsa. I really am a ninja now, and I really can fly.

Lily finds Claire's missing watch.

Lily has SHARP eyes!

I counted all the way by counting on my teeth.

After singing "Christ the Lord is Risen Today" at church.

I bet Jesus liked that.

C'mon, Mommy- let's go have a feast!

I have too many hands full.

It's not hard at all for me. Because I'm 5.

I saw an ant in the bathroom. I wanted to be friends with it.

The smell goes in my nose and to my brain and that's where the race ends.

I'm the director!

There's 2 ways in the pockets, and I can feel hand-to-hand.

Discussing whether or not she still says "Jofuss" rather than "Joseph."

Brad: Hey Claire, what's Mary's husband's name?

Claire: Joseph.

pause

Claire: Did you guys forget the name?

I would rather dance with Lily. (than boys)

I have to learn to make that click sound with my fingers. (snap)

Erin: What have you been doing?

Claire: I've been practicing school.

Claire: Look at my dragon. (a stuffed dragon we brought her from Krakow)

Gran: Oh, I know. He came from across the ocean.

Claire: No, he didn't.

Gran: Yes, he did. Mommy and Daddy brought him back for you.

Claire: Did they find him wet?

Gran: No, they didn't find him IN the ocean...

Bye, Lily! I love ya!

Erin: After the baby comes, and I do yoga again, you can do it with me.

Claire: Whoa, Mommy Mommy. You can do yoga, and I can hold the baby for you.

Claire: I'm going to Middle School

Erin: What?

Claire: I mean Middle Church.

Erin: Do you mean Children's Church?

Claire: Yes!

Amiee: What do you tell New Baby when you talk to her?

Claire: Hi, New Baby! When you come out, you have to do what they tell you. And what your big sister tells you to.

I'm pretty right about that.

I hope you can come down soon, because I really do need to talk to New Baby.

She wanted me to get out of bed and go downstairs with her.

Buckle = Belt

"Old McDonald had a farm...g-i-g-i joe!

I have a milk-stache.

I'm the birthday girl pal!

On Lily's birthday

Erin: This breaks my heart.

Claire: It makes me feel the same.

Brad: Do you remember what we call lefties in baseball?

Claire: The bears?

Brad: No...remember? South____?

Claire: South bears!

He's been trying to teach her "South Paw."

Erin: What is Lily crying?

Claire: Because Gran ruined her life.

Barbara had told Lily "no" about something.

There's pink peeking through!

She was eating something she didn't particularly want to and was really excited when she'd eaten enough so that the bottom of her (pink) bowl was visible.

Praying about Amiee (Bo) preparing to move to Kenya.

Help Bo to be so so so good. And help her not miss me too too much.

Guys, stop fighting at each other.

Brad and I were NOT fighting. We were just disagreeing about something.

Erin: Who threw that?

Claire: Our stinker-boo. (Lily)

Erin: It was a gross poop diaper.

Claire: Are you still thinking about that? Don't think about that- think about something happy!

Erin: Well, yes, you're right.

Claire: Oh yeah, girl!

Well, caterpillar, I guess this is goodbye.

And then there was insulin.

I've posted several times about GDM recently, so the fact that this pregnancy is fairly eclipsed by diabetes is no secret. I've written quite a bit about my eating protocol, but I thought I'd record a little about all the other stuff that goes into treating my GDM this time around, as it is quite different than my experience with Lily. Maybe this will help someone...maybe it will just be something I show New Baby for the rest of her life when she complains about doing chores and constructively participating in the life of our family. It works out either way.

The tricky part with this round of GDM has been my fasting glucose (the sugar you check first thing in the morning before you eat anything). I tried all the tricks that I used last time plus several other things in order to lower it overnight, and none of it worked. In December, I started oral medication (including many experiments with dosage changes) + careful dietary choices, which worked until I hit third trimester (when the placenta begins producing the complicating hormones in earnest). At that point, there was nothing between diet and oral medication that would keep my fasting glucose within the desired range. So, I was classified as having GDM with IFG (impaired fasting glucose). This led to starting insulin.

You should know that I had been dreading starting insulin for a couple months before it actually happened. Insulin is administered via injection, so I was reluctant to be put on daily injections. I mean, no one looks forward to that, right? In addition to all the finger pricks, to boot. To say that I was determined to try everything I could before starting insulin would be an understatement. Starting insulin also puts pregnant gals into a higher risk category, which I also wanted to avoid. Every time I went for an appointment, I held my breath until they put it off once again. 

Eventually, though, they just kinda ran out of other options and had to pull the insulin trigger. Funnily enough, I had been dreading it/thinking about it for so long that, apparently, I'd made my peace with it. I started wrapping my mind around what my new nightly routine would look like.

Does anyone reading this remember way back when I was expecting Claire and had to have the initial tests run for preeclampsia? I ended up with this story where I had the weirdest conversation with a health care professional about what supplies I would need to a 24-hour urine collection. And where I wasn't given a hat for said urine collection.

I had another weird "how do you expect me to know what I'm doing" experience with insulin.

First note: I was given zero instruction by the office staff on how to administer these injections. I assumed a nurse would come in after the doctor to explain the process or that the pharmacist would explain at pickup.
Second note: I was told nothing about what supplies I would be receiving at the pharmacy. Once again, I assumed the pharmacist would know all the things and would provide me with that information.
Third note: Should you find yourself given an insulin prescription, do yourself a favor and learn from my assumptions. ASK BEFORE LEAVING THE DOCTOR'S OFFICE.

Otherwise, you might end up with a sack full of 100 empty syringes and nothing else. 

No instructions from the pharmacist, no INSULIN to put in said syringes, and no idea of what you don't know.

Brad stopped by to pick up my prescription and was hurried along with no information from the pharmacy. When he got home and I opened the gigantic sack, expecting pre-filled syringes (which is what my doctor said she was going to try to get for me) and a detailed sheet of instructions on how to administer my injections, I was a little confused that all I found was 100 empty syringes. 

I called the pharmacy:
"I was just prescribed insulin injections today and don't exactly know what all that entails...but there was no insulin in my bag, and I'm pretty sure I need that."

Pharmacy: "Uh, what kind of insulin do you use?"

Me:"Well, I was just prescribed insulin today, so I know almost nothing. Is that information not included in the orders from my doctor?"

Pharmacy: (deep sigh) "Let me check...oh...yeah, we don't have that in. Do you need it today? Are you out of insulin?"

Me: "Ok, I was just prescribed insulin today, so I currently don't have ANY, and I'm sure they want me to start today."

Pharmacy: (impatient sigh) "Well, we won't have it until tomorrow. Can you pick it up from a different pharmacy? It looks like they have some at [a different nearby CVS]."

Me: "Yes, I can get it from there."

Pharmacy: "Ok, they should have it for you in an hour or so."

Wow. Really?

I got a text from the other CVS not long after, indicating that my order was ready. Brad went to pick it up, and I called my brilliant and informed father who is an ACTUALLY HELPFUL HEALTH CARE PROFESSIONAL (if you happen to be reading this and don't know my dad, he's an incredible pediatrician, a fact I for sure took for granted until I was in my 20's) to ask the questions I should have asked earlier.

I started with just asking..."um, so how do I give these shots?"

Dad: "Did the nurse not give you instructions?"

Me: "No..."

Dad: "Or the pharmacist?"

Me: "No...the pharmacy actually only gave me 100 empty syringes." (filled him in on the above story)

Dad: "Ok, well, the basic process is to start by wiping off the insulin bottle with one of the alcohol pads."

Me: "Alcohol pads?"

Dad: "They didn't give you those?"

Me: "No, just the syringes."

Dad: "Make sure they give you alcohol wipes when you pick up your insulin. Use those to wipe the bottle before you fill the syringe. Before you puncture the bottle with the needle, pull the plunger down to your prescribed unit so you can push that air into the bottle, otherwise, there's a vacuum when you try to fill the syringe. Pinch a fatty area of your thigh or back of your arm. Then, use alcohol to wipe your skin. When that's dry, just breathe out and give yourself the shot."

Me: "And what do I do with the used syringe?"

Dad: "Put it in the Sharps Container."

Me: "100 EMPTY SYRINGES, Dad. I know nothing about this container of which you speak."

Dad: "They just failed all the way around, didn't they? Make sure they give you a Sharps Container."

Brad walked back in near the end of my conversation with Daddy and said, "Well that first CVS failed all the way around. This pharmacy gave me these alcohol pads, insulin, and this container for you to collect your used syringes in. The pharmacist also told me about how you need to fill the syringe with air before you puncture the insulin bottle..."

Guys. What in the world?? How do these things happen?

Despite all these little setbacks, I successfully started giving myself insulin injections and have been for almost a month. I'm a survivor of incompetently-handled situations. 

I've had to have my dosage increased several times to find the right amount, but it seems that, with 2 weeks to go, we've landed on the right combo of dieting and medication.

In addition to the insulin update, my number of visits to the doctor increased A LOT around 33 weeks. Because of my new, higher risk classification, I earned Frequent Visitor Status with twice weekly appointments until the end of the pregnancy. I go either Monday/Thursday or Tuesday/Friday, and each time, I have a non-stress test (NST), an amniotic fluid index (AFI), and a check-in with an OB to evaluate my glucose readings and medication dosages (I'm still on an oral medication in the mornings, as well as insulin before bed). I spend a big chunk of time there these days. 

For anyone who may not know, an NST means I recline in a chair with monitors wrapped around my stomach, and I click a sensor every time I feel the baby move. NST's are supposed to last 20 minutes, but I regularly get left in there for 30-40 minutes, depending on when a doctor or midwife can come read my measurements. Before my first NST, I thought, wow, I can get reading done while I just sit and chill. Then I learned that I have to track her movement. Can't really read and track at the same time. So, I listen to podcasts instead (which works out, given that my reading motion sickness is back in full force).

An AFI is a quick ultrasound to check and make sure the baby's fluid levels haven't gotten too low. Apparently, that can happen really quickly with GDM babies and can be really dangerous if it does. I'm becoming good friends with the Ultrasound Tech. She's lovely.

So that's my Diabetes Update this week. Kind of a long one, but a lot has transpired, it seems. 

I'm less than 2 weeks out from my scheduled c-section, so there's not too much longer of insulin and Metformin and NST's and AFI's...

My diabetic go-to snacks and meals

I've mentioned a few times that one of my big frustrations after meeting with the nutritionist during my first round of gdm was that I didn't feel like I left that meeting with a lot of practical food options that didn't include foods with artificial sweeteners (which aggravate my migraines and headaches). I thought I'd make a list of some foods that I've found work for me while on a diabetic diet (remember: this is NOT prescriptive or exhaustive, and I am NOT an expert. This is just some stuff that works for me.). If you find yourself needing some ideas for a diabetic diet, maybe this could give you a place to start?

A normal eating schedule for me (and my allotment of carbs-per-meal/snack) looks like this:
1. Breakfast: 2 carbs
2. Snack: 1 carb
3. Lunch: 3 carbs
4. Snack: 1 carb
5. Supper: 4 carbs
6. Snack: 1 carb*
7. Pre-bedtime snack: 1 carb
*This snack isn't officially on the usual recommendation for diabetics, necessarily, but I find that I usually need it. 

Breakfast ideas:
1. Homemade freezer breakfast burrito ("recipe" at bottom of post- I literally eat this every single morning because I know exactly how my sugar reacts to it)
2. "Egg McMuffin": Thomas whole wheat English muffin + egg + cheese + sausage or bacon
3. Yoplait yogurt (I think the 6 oz is around 1 carb serving- but you have to check labels), bacon, one slice of whole grain toast with butter (real butter- it's a good fat)

4. Greek yogurt + cup of berries + sliced almonds on top (I like the Chobani Greek yogurt that has fruit on the bottom. It's got a good carb-protein ratio.)

5. Peanut butter or avocado toast (one slice whole wheat bread) + sausage or bacon or egg + fruit that equals one serving of carbohydrate (half banana, half apple, cup of berries, 10-12 grapes, or a clementine)

Lunch (I usually rotate through the same options for lunch because it's convenient)
1. Crispy chicken salad wrap (recipe at bottom of post) + large side salad
2. Pimento cheese sandwich + salad/green veggie
3. Large cobb/chef salad with plenty of chicken and veggies
4. Tuna or salmon salad sandwich or wrap + low sugar cole slaw
5. Large taco salad (ground beef, cheese, sour cream, salsa, avocado on lettuce, careful serving of tortilla chips- usually 8-10 chips)

You can do a lot with sandwiches/wraps. It's best to use whole wheat bread/pitas/tortillas (again, read the nutrition label, remembering that one serving of carbs is around 15g). If you want to eat deli meat (even though it's not generally recommended for pregnant women), put it under your broiler for a few minutes to heat it up/melt cheese over it, and that will help kill off any listeria bacteria. You can do a lot of sandwich (or wrap) variations which are pretty easy and can keep you from getting too bored (you still might get bored...fair warning).

Supper
1 Cup-cup and a half of homemade chili + half of a grilled cheese sandwich + large side salad
2. Pot roast + veggies (roasted brussels sprouts, 3/4 cup roasted sweet potato, spinach salad) + 1/2 cup cooked brown rice
3. Meatloaf + broccoli + sweet potato
4. One slice of pizza (preferably with meat) + roasted veggies (go light on carrots- they have a higher sugar count. Try broccoli, brussels sprouts, squash/zucchini instead.)
5. Mexican restaurant: fajitas (only one tortilla but you can eat basically as much meat/veggies as you want) + one serving of chips and salsa (about 8-10 chips) + plenty of guac
6. Chick-Fil-A 4-count chicken strips + superfood side (I was so excited to realize I could still eat CFA!)
7. This grilled chicken and balsamic tomatoes with grilled veggies or a salad side

There are lots of meals that can fit into a diabetic diet, as long as I am mindful of portion sizes. For example, my mother-in-law made a spaghetti pie for us last week. I measured out a little less than a cup of spaghetti and filled the rest of my plate up with vegetables (and 2 deviled eggs). I've learned not to stress about not preparing my own meals, especially if it's at someone else's home or out at a restaurant; before I fill my plate or order, I put options into the My Fitness Pal app, and it calculates the carbs of what I'm thinking of eating. I then determine what/how much I can eat. Measuring out smaller-than-usual amounts of food can seem restrictive at first, but in reality, it untethers me from having to eat at home for every meal.

Snack ideas
Chobani Greek yogurt (with fruit on the bottom) + sliced almonds
Sargento Balanced Breaks packs (or make your own version of this if you're not struggling through pregnancy...)
Berries + nuts

Babybel cheese rounds/Cheese stick + serving of fruit
Cheese toast
Avocado toast
Hummus + veggies or pita chips
Caveman bars

Graham crackers + peanut butter

Good protein options to pair with a carb
Nuts
Whisps (I buy these little cheese "crackers" at Costco. They are not cheap, but they are HIGH in protein.)
Hard boiled egg
Deviled eggs
Peanut butter
Babybel cheese rounds/Cheese stick

For "desserts," Breyers makes a carb control ice cream line that is quite good. I can eat a half cup, based on the serving portions, and that usually works for me. I also eat a reasonable amount of dark chocolate (not only is it allowed, there is some research that dark chocolate actually HELPS diabetics with their sugar control!). I crave sweet stuff while pregnant, so if everyone else is eating real dessert and I just really want a taste of what they're eating, I'll let myself have one bite. That usually won't ruin anything for me, but it does take self-control. So, if you can stop yourself from eating more than 1 or 2 bites, that's an option, too. I don't usually do too much with sugar-free dessert options from the store, but that's personal preference. 

For beverages, I mostly drink water, but I do like to drink unsweetened tea + Chick-Fil-A diet lemonade mixed together if I need caffeine. While I miss sweet tea terribly, this is a really good stand-in, guys. I will also have Brad make me some of his cold brew coffee sometimes, using a little sugar-free syrup (I like the Torani English Toffee).

These are some of the things that I eat on a regular basis and have good results with. Sometimes they can become repetitive and boring; I try new things periodically, but it's also just nice to have a bunch of fall-back things that I can trust. As a rule of thumb, ALWAYS read labels and check serving sizes until you have a good repertoire of food that you know works for you and your sugar (your glucometer will let you know, for anyone sticking their fingers multiple times a day). Use My Fitness Pal liberally to check on carbs when you're out and about. This awareness of portion sizes and carb counts is key to sticking to a successful diabetic diet. Knowledge really is power. 

Is this a helpful kind of post? Would anyone out there be interested in my keeping a food diary for a while and recording it for ideas? Let me know in the comments! (or email or text if you have my contact info!)

I'll do an update soon on my current diabetic status. Hint: it currently involves daily injections. :/ But, I'm still learning a lot, so there's something in that.

A few recipes (/methods) I use:
1. Chicken salad wraps
2. Salmon salad
3. My freezer burrito method:

24-ish eggs
1lb cooked, crumbled breakfast sausage
2-ish cups shredded cheese (I use sharp cheddar)
15-ish tortillas (depending on how full you fill your burrito
plastic wrap + gallon freezer bag (or 2) OR snack size ziplock bags

In a LARGE, greased pan, add all eggs (beaten), sausage, and cheese. Scramble until eggs are fully cooked. Allow egg mixture to cool. Spoon several spoonfuls of egg mixture into the middle of a tortilla, fold two sides of the burrito in toward the middle (sort of envelop-style) before rolling the tortilla up into a burrito. Ensure that the tortilla is fully encasing the egg mixture so that nothing slips out. Wrap burritos individually in plastic wrap (or zip up in snack-size bags) and store in gallon-size freezer bag in the freezer. When you're ready to eat one, unwrap the burrito, re-wrap in a paper towel, and heat in the microwave for 1.5-2 minutes. I eat one every single day.

Salad ideas to help fill up your plate:

1. cup (or more) of lettuce (or spinach) + 4 or 5 sliced strawberries (or  blueberries) + sprinkle of feta + sprinkle of sliced almonds + raspberry vinaigrette

2. cup of lettuce (or spinach) + shredded cheddar + bacon bits + tomatoes + balsamic vinaigrette

You can also trade in a few chopped carrots, red bell pepper (this is a good veggie for diabetics), avocado on these salads. Or you can turn them into entree salads by making it bigger and adding chicken/turkey/salmon. When you are carefully portioning your carbs, it can often seem (to our traditional American diets) that our plates are kind of bare. A salad that takes over half of your plate will help. :)

Birthday Fun with Nana and Poppy

Because the girls' birthdays are only about 6 weeks apart, my parents decided to visit over St. Patrick's Day weekend this year to split the difference and spend time with the birthday babes. Unfortunately, Mom caught a nasty respiratory bug right at the beginning of their visit and ended up spending most of their long weekend trip in bed. Poppy got in plenty of play time, though (and the girls made several trips a day to the guest room to check on Nana and dole out kisses and love).

Watching Planes together.

These shots are actually rather difficult to get, but Dad managed to get this one. Matching dresses courtesy of Nana, and there's a tiny one waiting for New Baby!

Mom has, historically, been at all of the girls' birthday celebrations during their little lives but wasn't going to be able to make that happen exactly this year because of various scheduling issues. So, she decided to throw them a birthday party while she was here. Even though she felt pretty lousy, she and Daddy orchestrated a fun little dress-up party that the girls adored!

The decor.

Posing in her new party dress. Not sure what Peter Rabbit was doing, but he seems to be posing nicely, too.

There is very little that Claire loves as much as a well-decorated party, so this glittering doorway curtain was just magical.

Nana and Poppy gave the girls a dollhouse for all of the princess dolls to live in, and it has been such a HUGE HIT!

Both girls have spent hours playing dolls and rearranging furniture, and it has been marvelous.

Because Mom was sick, Daddy was tasked with party foods, and boy, did he deliver! Pigs in a blanket, cheese and crackers, deviled eggs, dainty fruit kabobs, and a birthday cake (he bought that one). Excluding the cake, everything even fit into my diabetic diet! Lily, particularly, appreciated all of his work.

I don't remember what prompted it, but Lily decided she needed to "cheers" Nana with her fruit kabobs. It was hilarious.

It's always sad when Nana and Poppy have to go back to Alabama, and this visit was no exception (there was a solid 10 minutes after they left for the airport where both girls were weeping and wailing). But, it means lots of cuddles and kisses!

Lily gives the smack-iest kisses. It's great.

Seriously, Dad was on a roll getting decent pictures of the girls this trip. It's so hard!

I spoke too soon. Please note Lily's face...

Thank you for the fun visit and party, Nana and Poppy! So sorry you were sick, Nana. We're looking forward to seeing you soon- when New Baby gets here!

Claire turns 5!

It is killing me to have to say "I have a 5-year-old," but alas, it is true. Claire turned 5, much as I tried to talk her out of it. But she is SO HAPPY about it! It's been a month since her birthday, and she's still greeting people with, "Hi! I had a birthday and now I'm 5!" She spent her actual birthday in Tennessee with Bill and Barbara while Brad and I were in Boston, and I didn't think I was actually going to be up for having a party here. My physical capabilities are just extremely limited these days, and my stamina is even less reliable. Claire's preschool strongly requests that if you have a birthday party to which you invite anyone from class, you invite everyone from class. I knew I wasn't up for that, so I decided I would try to do something really small with just a few church friends. 

I picked a Saturday, texted several moms on the Tuesday just before to see if I could get a quorum of guests, and invited everyone to meet us at a local park, where my plan was to let the kids run and play and then stop briefly for cupcakes. It was the most low-maintenance plan I could think of, and I was fine with that. I told Claire NOT ONE THING about her "party" (if you can call it that) until after I picked her up from school on Friday afternoon (if you've ever met Claire, you know that any remotely sensitive information is not safe with her. I couldn't risk her knowing about her party and then going to school and telling everyone about it- when none of them were invited.). 

And then, within 24 hours of the party, the weather forecast changed. Saturday morning ended up being wet and 40 degrees. I had to text everyone again and tell them to come to our house instead. And we had to prep our house for a party, which I had been so proud of avoiding in the first place. I decided we were having a "Thomas the Train" party. What does that mean, you ask? Well, this:
1. We set up the girls' Thomas pop-up tent and our vast collection of toy trains (that is not a facetious statement: we have a RESPECTABLE collection of trains).
2. We picked a Thomas movie on Amazon Prime to watch.
3. We popped popcorn and laid out blankets for the kids to watch the movie.
4. Claire wore her Thomas shirt (and tulle skirt #trainprincess).
5. We hung a few streamers and blew up a few balloons.
6.. I'd already made cupcakes (Funfetti. From a box.), and I cut up some fruit. 
DONE.

Claire was happy, and all the kids seemed to have fun, so we're calling it a good party. I'm going to have to up my game in years to come, as she becomes more aware of things (like how other moms have games and crafts at their kids' parties), but this year, I'm just happy we had a party at all and that she was happy when it was all said and done. She really is such a happy and easy-to-please little girl. For that, I'm grateful.

Our little birthday party crew. Lily insisted on wearing an Elsa gown to the party, and when I texted my friend, Katie, about it that morning, she said her daughter would totally join in on that.

I love this picture! They were both having fun...these are just their "cheese" faces.

Richie was Claire's guest at her 2-year-old birthday party, which was her first one in Durham. They've grown up a little since then...

In 2015. They were SO LITTLE!

With our train-loving friend, Toby.

And I remembered to get a picture with MY friends.

Claire is the very best bear, and we love her to pieces. Even if she insists on growing up every year...