Around here lately: March 2018 edition

There were some good ones this month, y'all. Enjoy!

Mommy, I like chitting-chatting with you.

Want to know something ridicky-less?

New Baby, when you're older, we have movies called Thomas. But, you might not like season 1 because Sir Topham Hatt talks.
Claire doesn't care for the earlier seasons of Thomas the Train because they are narrated, rather than the characters having individual voices. She feels very strongly about this.

Sings "Shine, Jesus, Shine" over the monitor at bedtime.

Erin: That was beautiful, Claire!

Claire: I'm singing it so maybe Jesus will turn on a light in my room...

Claire was supposed to be prepared with a knock-knock joke for school. 
Claire: Knock knock.
Brad: Who's there?
Claire: Figs.
Brad: Figs who?
Claire: Our bell is broken! HAHAHAHA!
The actual joke ends: Figs your doorbell. It's broken. Bless it.

I'm the teacher because I'm the sparkliest.

I am very looking forward to it!

It's so beautiful, I can even not believe my eyes!

Instead of being a toddler, I'm going to be a big girl!
In reference to deciding to eat her chili.

Look! We're back to your wagon, Lily!
Upon returning to the play grocery buggy after making a lap around the first floor of our house.

Bear claws = South paw
Claire is left-handed, and Brad is trying to teach her the phrase "South paw." She calls it "bear claws."

I wish you were here, Bo! You would have loving it!

I'm trying to throw up, but Lily's just spitting in the water and making it all dirty!
Claire had vomited a couple of times and was sitting next to the toilet, in case she needed to vomit more. Lily, having watched, came up and spit into the toilet, imitating Claire. Apparently, she was dirty-ing the water...

Sorry I put snot on your coat, Daddy.
After giving Brad a hug and accidentally wiping her nose on him.

Erin: Oh, Lily will like that dress with the cat on it.
Claire: Oh yes!! Lily LOVES cats!
This is very true.

That picture is when I was a weenie weenie baby.

I just didn't want this day to come...
About my parents leaving to go home.

I like my setting.
Her play-doh setup.

Sometimes we wake up in a fragile way.
While Lily was crying for, seemingly, no reason right after nap.

Hold on, mommy, it's watering time.
Pausing our conversation to take a swig of her water bottle.

Claire: Is Lily a baby?
Erin: Lily is a toddler.
Claire: That's a kind of grown-up baby.

Since I drunk a piece of water, mine is shorter than yours. Now that yours is taller, you're going to win the high water contest!
Comparing water bottle contents with Brad. No idea why.

Daddy, you're silly, and I love your silliness!

Daddy, I love being next to you.

Does loving you help you feel better a little bit?
When Brad was battling a cold.

Look at Lily sitting so cutely for her snack!

I love Uncle Tim. He's the best jugglist.
She really admires Tim's juggling skills.

God's the one who made heaven and earth. He's the idea man who makes stuff.

Chicken on fredo = Chicken alfredo

Leprechaun bag = leopard print bag

Daddy! Be a boss to Lily! She's pulling my hair!

That smell is going RIGHT in my nose!

Here, Sweetie, let me help you.
To Lily.

You crushed it up. I can't fix it. Sorry, darling.
To Lily.

While in Tennessee in early March, Barbara took the girls to an indoor play place. The first day they tried to go, there were some field trips, and it was too busy to stay. The next time they went:
Claire to the employee: Are there any buses coming today?

While my parents were visiting over St. Patrick's Day, Claire and I had to have a discussion about lying. After she and I finished, she and Mom talked for a while about it. At the end of their discussion, through tears:
Maybe the ashes from Ash Wednesday will help. It was on Valentine's Day.

I know you miss being normal, Mommy.
She's heard me tell Brad that I'm ready to not be pregnant anymore and to feel normal again.

It takes a few days to wake up.
A church friend brought us dinner, including a whole pineapple, which Claire was very taken with. She told Claire that it still needed a few days to ripen. Claire equated that with waking up.

She also dressed it up. Obviously.

Noticed around here lately:
While playing with her remote control cars, she pointed out that she'd added a "cape" to her car. The "cape" was a clip-on Disney princess dress that she clipped onto the spoiler.

We were watching Thomas the Train, and I noticed she was plugging her ears. It was at a part where Thomas makes a poor decision. I asked if that's why she wasn't listening, and she confirmed that she didn't want to hear him make a bad choice.

Brad brought home some Mediterranean leftovers from an event at Duke. We noticed Claire eating her couscous one barley pearl at a time. It took her an hour and a half to finish supper.

I was texting with my sister, and she asked what the girls were doing. My response:
"They're playing blocks and farm animals. The pig is mad at me because I told Claire 'no' about something...Claire's not mad, but the pig it."

Little trip to Boston!

A couple of weeks ago, Brad and I got to go to Boston for a little weekend trip! Brad applied to participate in a pedagogy seminar being held in Boston, and when he was accepted, we decided to make a short trip out of it for the two of us. Not exactly a baby-moon, but as close to one as we ever get. Real quick, here's our "baby-moon" history:
1. Claire: none.
2. Lily: 2 nights in Asheville, courtesy of a credit card points hotel stay + Groupons for all meals + gift card for a movie.
3. 3rd baby: Boston seminar + another credit card points hotel stay.
None of this Cancun-ing for us, guys.

Where we stayed, thanks to Brad's seminar (and credit card rewards)!

A few various views around our hotel.

I don't have a lot of pictures from our trip, in part because almost as soon as we arrived in
Boston, a nor'easter slammed New England. For Boston, that meant really high winds and lots of rain. So, while Brad was in his seminar (at the hotel where we were staying), rather than visiting favorite Bostonian haunts of mine, I hunkered down in our hotel room and listened to podcasts (I binge-listened to Mom Struggling Well, and it was a fantastic use of my time). I ordered room service for lunch and put in a to-go order from a nearby Panera for supper. I was SUPER ashamed of myself for getting Panera while in Boston. I basically refuse to eat non-Boston-based chain restaurants while there because there are so many incredible local options (exception while we lived there: driving to a nearby town to get Chick-Fil-A on occasion. Southerners must have Chick-Fil-A on occasion.).

However, Panera was my best option because a) it was less than 100 yards from our hotel entrance and b) I poured over the nutrition facts online to pick out the best options for my diabetic diet. I nearly blew away a la the nanny applicants in Mary Poppins while walking to pick up my food, thanks to the winds. I took an umbrella, but I gave up on it, as it kept trying to blow inside out. It definitely confirmed that staying in the hotel was the best plan.

Although there was some rather bad weather, we were still able to work in supper with two different sets of friends (2 separate nights), dessert with another family, and a morning at our Boston church. Those visits all ministered to our souls, and we were so grateful for them. We also walked around Quincy Market for a little while before we had to head to the airport. Not our most "Boston" of all Boston visits but really wonderful nonetheless.

Sunday morning service at Church of the Cross! This is a different building than we met in while we lived there, due to CotC adding a morning service and therefore needing a second location. It was neat to see the new location.

Great view of the Pru just down the street from the morning service location.

And a Regina's! Sadly, I did not get any Regina's (or Mike's) this visit. The weather didn't help, but diabetes was the real culprit.

Faneuil Hall

State House. One of my favorite buildings in the city. It's so interesting to see the juxtaposition of this quaint old building next to modern skyscrapers.

We had a wonderful visit, despite the weather. Boston is such a dear place to us, and it's always a gift to get to visit. 

While we were gone, the girls went to Johnson City with my in-laws. They actually went for several days longer than we were in Boston, due to scheduling (which ended up being helpful for me, as North Carolina bloomed that week, and I was SICK. As in, stuck-in-my-bed sick.). The girls were there for Claire's actual birthday, which was my first not to be with her in person, but Gran did a great job making sure she felt loved and celebrated! As did, Nana, though she wasn't physically present. Before the girls left for Tennessee, Mom mailed a few small gifts to me to pack in the girls' bags to open for Claire's birthday (including a few things for Lily). See necklaces and socks below. :)

The glasses/crowns weren't from Nana but definitely added to the awesomeness of the birthday. 

The glasses live in our van and are worn often.

Like Boston, Tennessee had quite a bit of rain that week/weekend, too, it seems. And both girls' seasonal allergies came out to play, but before all that, they had some fun times outside!

And, of course, there was birthday partying! Barbara made a fabulous cake (I obviously did not get any, but I can venture a guess, based on my prior experience, that is was fabulous), and Claire was very celebrated by our Tennessee family.

We are so grateful for Gran and Grandpa so cheerfully taking care of the girls for us, so that we could enjoy a long weekend in Boston. The girls had a wonderful time, and we could rest easy knowing that they were having a blast.

We classy.

Good times with Grandpa. And probably Super Why.

Our March definitely got off to a great start (minus all the allergies, bless us. This is why I hate Spring. We get SO SICK. Y'all can think I'm weird all you want, but hang out around here during the worst of the temp change + pollen, and you'll get it.). Thanks, Gran and Grandpa for making this happen for us!

Some nitty gritty of of navigating my GDM

I mentioned that with my first round of gdm (with Lily), I was sent to see a nutritionist. She was very nice, but she didn't really give me a lot of hands-on, practical, day-to-day solutions. She gave me a list of snack and meal ideas, but it wasn't very, um, varied (it gave one sample day of meals. I had 7 weeks of diabetic dieting ahead of me and needed more than 3 meal options.), and it included a lot of foods with artificial sweeteners (which give me migraines). 

In the end, I left with a glucometer kit and a decent amount of frustration and confusion. Example of confusion: she told me to increase my daily calorie intake but also told me not to gain more than 5 pounds for the rest of my pregnancy. If you've had a baby before, you know that the end is when you put on weight pretty quickly because of the baby growing and, usually, decreased physical activity because of how uncomfortable you are. She did not explain to me how this was supposed to work. I cried a little more because I just didn't know what to do (and yes, I tried asking clarifying questions, but it didn't earn me any better explanations). 

Eventually, though, I stopped crying and buckled down to figure things out on my own. 

One thing I did learn from the nutritionist that gave me a place to start was that I could have 2 servings of carbs at breakfast, 3 at lunch, and 4 at supper. I also learned that I needed a mid-morning snack, mid-afternoon snack, and pre-bedtime snack (1 serving of carbs at each snack). I started looking into nutritional information on foods I usually eat and began keeping track of how much of what I could eat. One tool that I found to be extremely valuable was using the app My Fitness Pal, which is a free food diary. I had used it to keep track of my calories when I was pregnant with/losing weight after Claire, but I knew it would also tell me how many carbs per portion, as well. Any time I was about to eat anything, I plugged it into My Fitness Pal and checked the carbs per portion. It was empowering, dramatic as that sounds. Having that tool allowed me to eat normal foods/what everyone else was eating...I just had to calculate the correct portions.

One VERY VALUABLE piece of information that I learned from my research that wasn't explained well to me at my meeting with the nutritionist was the significance of balancing carbs with proteins AND fats (she only talked about proteins). This is crucial (and was why she increased my caloric intake), because the protein-fat-carb balance is what determines how well your body can break down glucose. If you don't have enough protein AND fat, your body can't break down glucose slowly enough to keep your blood sugar stable. Additionally, you do actually need to eat carbs. Cutting them out or even down too far doesn't give your body what it needs to fuel, and your body tries to compensate in unhealthy ways. The important part is knowing how to balance everything.

THIS IS IMPORTANT INFORMATION TO SHARE WITH SOMEONE NEW TO DIABETES. This bit of education was the key for me in figuring out how to keep my levels normal and balanced. Note: when a diabetic's glucose numbers are off, it makes you feel quite awful and very unlike yourself. This stands for if they are too high or too low. Headaches, nausea (in addition to pregnancy nausea), blurry vision, weakness, foggy headed-ness. I actually also get a tell-tale feeling in my chest when my glucose is too high. It feels like a pressure/higher heart rate. I can almost always predict when my glucose is too high, thanks to this.

For women with gdm in the state of North Carolina, the medical standards for "normal" glucose levels are 90 or below after fasting and 120 or below 2 hours after meals. My fasting numbers are super sketchy this second time around, but I usually have no problem keeping my post-prandial numbers under 120. Part of managing this includes a fairly strict eating schedule that I keep to: 
1. breakfast
2. snack 2 hours later
3. lunch
4. snack 2 hours later
5. supper
6. snack at bedtime
7. potential extra snack if it's a longer evening- it's pretty important to have a snack AT bedtime to give your body something to help stabilize things while you sleep

It's very hobbit-ish.

The important thing to keep in focus while eating a diabetic diet is carbohydrate portion control. The nutritionist allotted me 2 carbs for breakfast, 3 carbs for lunch, and 4 at dinner + 1 portion at each snack time. 15 grams of carbohydrates is roughly one serving. Those 15 grams look different from food to food, though, which takes a little learning. Examples:
Apple: half of an apple
Tortilla chips: ~7-8 chips (some brands are 9-11 chips)
Bread: one slice
Pasta: ~1/4 cup cooked
Grapes: ~10-12 grapes
Strawberries: one cup
Banana: half of a banana

After a while, calculating carb amounts became much easier for me, and I began to have quite a list of foods' carb counts memorized and didn't have to think so hard. Keeping my post-prandial (after meals) glucose numbers within the right range (under 120) became easier and more doable. I did feel sad that when I'd want to eat 2 pieces of pizzas...I could only eat one (and usually skip the crust). Or that I couldn't eat the same desserts as everyone. But, the the fact that I could still eat pizza, pasta, and Mexican food (in limited portions) was really encouraging and normalizing.

When I was going through gdm with Lily, I had difficulty controlling my fasting numbers until I learned a little trick: I started eating avocado toast before bed as my nighttime snack. Avocados are an excellent source of fat for diabetics. The fat content is so high that it broke down the glucose of the bread/toast slowly enough to keep my numbers stable. It was like magic! Once I started that routine, my numbers almost never went unchecked. This pregnancy is different, though, and even avocado toast can't do it without medication to help (and, I've been super sick after eating avocados on several occasions, so I can't really stomach it anyway. Such a BUMMER.).

I pretty quickly found a few things that would adversely affect my numbers on any given day: stress, nausea, headaches/migraines, hormonal surges. If I had a migraine overnight, my glucose numbers would be higher in the morning. If I was feeling stressed about something, my numbers would be elevated, regardless of what I ate. If I had a day where I just didn't feel well, my numbers would run higher throughout the day. There is no hard-and-fast solution for diet-controlled diabetes, because there are going to be factors you can't control. It took me a while to realize that and to give myself a pass; at the beginning, I would find myself stressing that I had done something wrong in managing my sugar, and the next thing I knew, my glucose was even higher. Once I began letting myself off the hook for things I couldn't control, my stress lowered and, overall, helped my sugar stay more stable.

Also, physical activity and exercise can help lower your glucose. Now, if you're 30-something weeks pregnant, having Braxton-Hicks all day and fighting sciatic nerve pain, this isn't going to be your best solution for glucose control. Likewise, if you're 18 weeks pregnant, constantly on the verge of nausea, and fighting several migraines each week, you can't depend on exercise to do your work for you...diet is super important, guys.

I wish that when I had visited the nutritionist she had shared more of these details with me. It took me weeks to pull together all of this information and figure out tangible solutions for myself. I also wished I'd known that this diabetic lifestyle is not fully formulaic; it ebbs and flows, because our bodies are constantly moving, changing, and doing things. Thankfully, I went into my second diabetic pregnancy with so much more knowledge and a lot less fear. Don't get me wrong- I was BUMMED. It is lousy to face Thanksgiving and Christmas knowing that you can't eat just whatever you want. Or that you can't eat half a sleeve of crackers when you're feeling nauseated. Or that you can't drink Coke when you're feeling headache-y/migraine-y. But it's doable. And not the train wreck I was convinced it would be.

I'm hoping to post some actual meals and snacks that I eat regularly, so that if anyone needs some concrete ideas at any point. Maybe before this baby is born...

Shall we chat about diabetes?

Oh, diabetes.

I did not have gestational diabetes when I was pregnant with Claire, so I was floored when I found that I had tested positive for gdm ("gestational diabetes mellitus" is the official name; "gdm" is the official abbreviation) when I was pregnant with Lily. I absolutely did not see it coming and was very upset about it (I blame it on the hormones). It was just so overwhelming. There were no indicators in my regular life that would point toward diabetes. How do you even start living a diabetic lifestyle? Especially when nauseated, hungry, not hungry, craving specific foods, only wanting carbs? HOW? 

Those were only a few of my many questions.

I wrote about it a little bit here and here the first time around. I was sent to a session with a nutritionist at that time which was mostly unhelpful, so I dug in to do my own research (I was an English major, so I am very comfortable with research, guys.). I gathered some really helpful, basic information about how diabetes and a diabetic diet work and then cobbled together several go-to snack options and learned how to manage my carbs during meals. I managed my blood sugar incredibly well, according to my doctor. This kept me and Lily healthy, kept Lily's birth weight to a reasonable/healthy weight (6 lbs, 15 oz), reduced/eliminated her risk of jaundice due to diabetes, and kept my weight gain in check (I only gained 2 pounds in the last 7 weeks of pregnancy). It wasn't the most fun, but I found a groove to making it manageable (and that didn't involve lots of sugar-free foods).

In normal pregnancies, doctors (or midwives) test for gdm at the beginning of the 3rd trimester. This is because it's around that point in pregnancy that the placenta begins producing hormones that can interfere with your glucose/insulin balance. When you deliver your baby/placenta, your body usually returns to normal (i.e. non-diabetic). Because each pregnancy involves a different placenta, you can end up not having gdm with one but having it with another (me, case-in-point). However, once you've had gdm, your chance of developing it again is remarkably higher. It's standard practice for OBs to run an early glucose test for women who have previously had gdm (me) at the end of the first trimester with subsequent pregnancies. 

So, I took an early test at 13 weeks. I failed my 1-hour on the early test, but rather than going back for the 3-hour follow-up test, I opted to start the diet and regularly check my sugar for a week and then go back for an assessment appointment. I was still so nauseated and fighting so many migraines that I knew having to fast for and then take the 3-hour test was a disaster waiting to happen. I also knew that the chances of me passing the 3-hour test, based on my glucose reading after the first + my history with gdm, were very low. Everyone was fine with that plan, so that's how we proceeded. I've been on a diabetic diet and checking my glucose 4 times/day since 13 weeks (this includes over Thanksgiving and Christmas). I'm currently 31 weeks, so I've been doing this for a while at this point.

During my Lily pregnancy, I was able to completely manage my diabetes with diet only. This time, my body is responding differently. During the day, I can manage my diabetes very easily with my diet, thanks to all the info about counting/portioning/balancing I gleaned last time. Normal protocol is that a woman with gdm checks her blood sugar 4 times a day: when she wakes up/before eating (fasting) and then 2 hours after each main meal (post-prandial). My fasting numbers have been my problem this time. I can't control my glucose while I'm sleeping (obviously...because I'm not snacking on a time frame while I'm sleeping). Fasting numbers are particularly important because they gauge a little more accurately how your body does regulating glucose and insulin on its own. So, my higher fasting numbers have led to me taking medication this time around.

I started out on a lower dose of metformin right at Christmas time, and it managed all of my numbers really well. Around the time I crossed the third trimester threshold, though, it became less effective, and my fasting numbers, particularly, started creeping back up. My theory is that this happened because that's around the time that the placenta begins producing the complicating hormones in earnest. My doctors recently upped my dosage for a little while to see if that will take care of things. If it doesn't help significantly, we move onto insulin until delivery (shots...every day...groan). I'll try to keep you posted.

Technically, my status as Type A-2 GDM (medication-dependent) classifies me as "high risk" (I didn't know this for quite a while), which means that I get extra ultrasounds as we near the end of pregnancy. They're having me go in for 3 extra ultrasounds to check on the baby's growth and fluid levels- just to make sure that the insulin imbalance isn't negatively impacting her environment. Around the 36 week ultrasound, they'll look at whether or not they'll want to deliver at 38 weeks, rather than 39. 

What with all the nausea and vomiting, migraines, and diabetes, I'm just livin' it up over here during pregnancy. It's a regular par-tay. The good news is that I've put on a reasonably low amount of weight (and then crash-lost some on three occasions, thanks to having stomach viruses/migraines). That will be helpful when I'm trying to fit back into my non-maternity pants. Silver lining?

I'll probably do a post or two about the specifics of what I eat and how I count carbs/fats/proteins at some point. I had a lot of trouble finding a really helpful breakdown of information my first time through, so I'm going to do my part to help a sister out, should someone in need of information about gdm stumble across my blog. All under the heading of "I'm not a professional- don't sue me," of course. :)