My experience with gestational diabetes

afitmess
July 20, 2016
A Fit Mess

After being approached by a few friends about this, I decided I should have a post dedicated to the topic of gestational diabetes in order to share my personal experience with it and perhaps offer some helpful suggestions to others who may be dealing with this condition. If you are sensitive to pregnancy or delivery topics like this, please feel free to skip this post.

 

I was diagnosed with gestational diabetes when I was 28 weeks pregnant after failing two routine blood glucose tests. I was completely caught off guard. I’ve never had diabetes nor does it run in my family, so the news hit me pretty hard. Being pregnant with twins already had me on high alert so hearing that I had a form of diabetes was scary. I thought for sure I had put the girls in danger and I was really nervous about how the remainder of my pregnancy would go.

 

After consulting with my doctor, nurses, and doing my own research, I realized that gestational diabetes is a common and treatable condition. According to a 2014 analysis by the Centers for Disease Control and Prevention, the percentage of women with gestational diabetes is as high as 9.2%. And being pregnant with multiples can put you at an even greater risk of developing this condition.

 

It’s a common misconception that gestational diabetes results from poor eating habits and lack of exercise. While there is no concrete explanation as to why gestational diabetes occurs, research suggests that certain hormones during pregnancy can cause insulin resistance (meaning your body cannot properly make or use insulin). Without adequate amounts of insulin, glucose gets trapped in the blood and starts to build up.

 

If not properly controlled, this can pose a lot of problems for you and your baby. The extra sugar in your blood can cross the placenta and cause high blood glucose levels for your child and can be very taxing on his or her developing pancreas. My doctors closely monitored the girls’ growth to make sure they weren’t gaining weight too quickly (an indication something may be wrong) and, thankfully, things progressed normally.

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After being diagnosed with gestational diabetes I was required to meet with a nutritionist and diabetes specialist who talked with me about proper “diet” habits and how to monitor my blood sugar. Sadly, the dietary guidelines weren’t something I felt comfortable following. For example, I was told to eat low fat or fat free products and only lean proteins. This was frustrating to see since I believe whole full-fat products like avocado, yogurt, cheese, and nuts, are essential, especially for pregnant women. I understand that these items can cause weight gain, thereby making your blood sugar harder to control, however, I personally did not feel this plan was right for me.

 

Here’s what I did:

I significantly reduced my sugar, cutting out all sweets and processed foods (I had a small piece of cake at my shower!). I reduced my fruit intake and ate mostly berries and fleshy fruit since those do not spike your insulin like other fruits. And I cut way back on my carbohydrates and started to eat meat after being a vegetarian for 15 years.  I was asked to share my weekly diet charts with my nutritionist for the first 2 weeks to make sure I was eating adequately. It was a bit tedious to track all of this information, but it provided a helpful snapshot of my eating habits and it made me more confident that I was getting adequate nutrition. But man it was hard at times to stay away from sweets!

 

The real bummer was checking my blood sugar (i.e., pricking my finger) several times a day (when I first woke up, after every meal, and at the end of the night). It was SUCH an inconvenience at times and I really hated it for awhile. However, I was diligent with tracking my numbers and I was able to keep my glucose levels low to normal for the remainder of my pregnancy. The last week of my pregnancy my doctor told me I could stop checking my blood sugar which – at the time – felt like such a gift!

 

My gestational diabetes did not interfere much with the delivery (the girls were born c-section). During the birth my blood sugars sank and I was given a shot of insulin to bring me back up. I remember feeling like I was going to pass out and I got extremely cold, but I was awake and conscious the whole time. I was covered in heated blankets at the end to keep my body temperature up. The girls were born at healthy weights – just under 6 pounds each.

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The doctors had to monitor the girls’ blood sugar levels for the first 24-48 hours, but they never left my room and for that I am grateful. There was one instance where the nurse took Ashlyn’s blood sugar and said it was extremely low and that they would have to bring her to the NICU. One thing I learned while checking my own blood sugar was if you get an “off” reading you should take a second reading. Sometimes the strips are defective or the monitor isn’t acting up. I asked the nurse to check A’s sugar again and she refused saying the numbers are right and that there was nothing she could do. So off she went with my baby while I cried. Less than 5 minutes later a doctor brought her back and said they checked her levels again and they were fine so she was brought back to us. I was very thankful that the girls did not have any complications.

 

Gestational diabetes goes away after your child is born, but I still have to get a blood glucose test every year to make sure I don’t have diabetes. You are more susceptible to developing type 2 diabetes if you’ve had gestational diabetes. I’m glad to report that I have passed all of my follow up tests.

So here’s what I want to be sure to say…

Even though I knew having gestational diabetes wasn’t my fault, I still felt ashamed at times. Being diagnosed with diabetes made me feel like I had failed in some way. Like I had done something wrong. Or there was something wrong with me. But I realized there is no such thing as a perfect pregnancy. And looking back, I believe I had a pretty great pregnancy with twins. Yet, I put so much pressure on myself to do everything “right” that I was too hard on myself at times. Which is why I want to be sure to let others know – whether you are dealing with something like diabetes or another complication – don’t ever blame yourself. Every pregnancy comes with its concerns and challenges. Educate yourself, understand your options, and have faith in your ability to get through it.

In summary, here are the key things I learned from my experience with gestational diabetes:

  • It’s a misconception that gestational diabetes is caused by poor eating and exercise habits. Rather, it most likely occurs due to elevated pregnancy hormones and other factors.
  • It can be controlled through diet, careful monitoring, and exercise, but not all the time. In fact, some women need to take medication to balance blood sugar levels.
  • Consult with your doctor or health professional and make a plan for getting adequate nutrients and vitamins, but do what you feel is right for you and your baby.
  • Monitors occasionally give false readings. Double check any figure you think may be in accurate.
  • Gestational diabetes goes away after your baby is born, but you still need to have annual or bi-annual tests done to ensure you are healthy.

 

I hope this post was helpful to you. If you would like to share your experience below, it may be valuable to others who are experiencing gestational diabetes or another complication. And please feel free to share this post. 

Diastasis recti: identification and treatment

afitmess
June 21, 2016
A Fit Mess

Pregnancy is a time when you learn a lot of things about your body. It’s also a time when you realize that carrying a baby does so much more than just make your belly bigger. Often we aren’t made aware of these changes until they happen to us. One unfortunate result of carrying and delivering a baby is known as diastasis recti and it affects many women today.

 

What is diastasis recti?

Diastasis recti is a separation between the left and right side of the rectus abdominis muscle (the muscles that lie on the front of your belly). In simple terms, it’s when a gap forms between your abs, creating a “pooch” near your belly button. Although children and men can develop this condition, it’s most common in women who are pregnant or postpartum mothers. Women who have had more than one baby and those pregnant with multiples are more likely to have this happen. In fact, diastasis recti occurs in about 30% of pregnancies (according to BeFit-Mom).

Diastasis recti occurs because of internal abdominal pressure. Pregnancy is obviously a time when your mid section will experience added stress. As your uterus grows it puts more pressure on your abdominal wall. This pressure causes a strain on your stomach muscles. On top of this, pregnancy hormones cause your muscles and tissue to thin out and relax (to prepare for birth). This can cause your midline to widen and a gap to form between your stomach muscles.

DiastasisRectusAbd-SM
American Physical Therapy Association

 

Why does it matter?

Your abdominal muscles play a major role in your health and well being. They support your spine and control the tilt of your pelvis, reducing or preventing lower back pain. They help you maintain proper posture and body alignment, taking unnecessary stress off your joints and ligaments. And finally, they support you during common activities like bending, lifting, and carrying heavy objects – movements you find yourself doing when you have infants and children. Simply put: separated muscles are weak muscles and increase your odds of injury and lower body pain. They can also worsen over time.

My diastasis recti occurred after the girls were born, but it can develop at any time during pregnancy and following birth. A small separation of the abdomens is fairly normal, however, diastasis recti is distinguished by a gap that is more than two fingers wide (a rough estimate).

 

How to tell if you have diastasis recti

I like the simple test from BeFit-Mom:

  1. Lie on your back with your knees bent, and the soles of your feet on the floor.
  2. Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline- at the level of your belly button.
  3. With your abdominal wall relaxed, gently press your fingertips into your abdomen.
  4. Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
  5. Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominis muscle. Test for separation at, above, and below your belly button.

 

If you need further instruction, there are plenty of YouTube videos out there that can be used as a visual reference. It’s rather easy to check this on your own.

Contrary to what you might think, diastasis recti often goes undetected. In fact, I wasn’t aware I had it until four or five months after the girls were born. I went to see a specialist about some postpartum pain I was having and upon examination she told me that I had DR three fingers wide! I was still recovering from my c-section and in quite a bit of pain, but I wasn’t sure what was “normal” healing pain and what was cause for concern. I was also trying to take care of two infants and keep up with a hectic nursing and sleep schedule.

Luckily, my doctor gave me some exercises to do on my own which improved my condition significantly. I also learned proper body movements so as not to cause further damage. And Matthew provided great insight and instruction on what to do, and what NOT to do in terms of postpartum exercises. I had no idea that certain exercises could actually worsen my condition.

Specialty exercises and proper movement can usually improve DR (it certainly did for me), but sometimes surgery may be necessary to repair a significant gap. I still have a small space between my abs (one finger deep) and I’m not sure that will ever change, but I still try to keep proper form during my movements and reduce the unecessary strain I place on my abdomen.

Since this condition is something that deserves more recognition, I thought I’d share some of the things I did to improve my abdominal gap.

 

How I fixed my distasis recti:

  • Postural training
  • Physical therapy and targeted movements
  • Proper postpartum exercises 

 

Postural training: The physical therapist I saw during my pregnancy was an incredible resource (I wish all women would see a PT during pregnancy!). She gave me tips on how to perform daily activities using correct form and proper alignment. Movements like getting in and out of the car, getting out of bed, and carrying a child are everyday activities we rarely pay attention to, yet they are important to address when you have DR. For example, you should avoid any movements that put added pressure or strain on your abdomen. When getting up and out of bed you should always roll to your side and then use your arms to prop yourself up (rather than sitting up from lying on your back). And remember to bend your knees when picking up your children (or any heavy object!).

 

Physical therapy and targeted movements: The doctor I saw postpartum specialized in women’s health and pelvic pain. Having her examine me made me realize that my pain wasn’t normal and that I shouldn’t be telling myself to “suck it up” or give it time. Something wasn’t right. My doctor gave me exercises to do on my own to help heal my gap. I don’t have illustrations of these exercises, but this video features the activities that helped me. The compression crunch using a towel was the single best exercise I did. I noticed my gap closed dramatically after just a month of doing this daily exercise.

 

 

Proper postpartum exercises: There’s an unfortunate misconception that all women should bounce back quickly from childbirth. An expectation that by six weeks postpartum women should be back to “normal.” Sorry, but no. Childbirth is a huge physical and emotional event. And if you had a c-section (like me), that’s major surgery! Recovery time is different for everyone and should not be generalized in the way that it often is. This puts added pressure on new moms to return to their post-baby body and activity level.

That being said, I think one of the most important things to remember is that your body will recover at it’s own pace. Don’t force yourself to return to exercise or activity before you feel ready. Don’t worry – you’ll get there.

When you are ready to return to exercise it’s important to avoid movements that isolate the abdominal muscles which could cause added stress (and further separation). Crunches, sit-ups, and v-ups should be avoided. And research shows these movements are effective at targeting the abdomen anyway. Movements like squats, leg raises, and chin ups are great exercises for increasing core strength (among other things).

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I hope this article was helpful to you. Please let me know if you have dealt with diastasis recti. I’d love to know what may have worked for you. Please share this post in order to help other women gain an understanding of this important issue.

 

 

 

 

FAQ about having twins

afitmess
April 26, 2016
FAQ about having twins

As a mother to twin girls, I get asked A LOT of questions about my pregnancy, the early days with two babies, and what life is currently like for us. I thought I’d share some of the most common questions I get asked and my typical responses. If you have additional questions, I would be happy to answer those as well.

FAQ about having twins:

1. How did you carry twins? Were you huge?! I always laugh at this one and say something like I did it just like every other pregnant woman. I previously wrote about what was helpful for me during my pregnancy, but I truly believe the body is capable of extraordinary things. I will be the first person to say I oscillated between elated and terrified when I was pregnant. I tried to take it day by day and that seemed to help me immensely. Yes, I was rather large at the end. In a word: torpedo.

 

2. How did you tell them apart when they were born? Madison and Ashlyn are fraternal twins so while they do look like siblings, they are not identical. I was a bit worried before they were born that I wouldn’t be able to tell them apart. I heard stories about other parents who would paint one of their twins’ toenail, keep a bracelet on one’s arm, or draw a dot on one twin’s forehead with marker (yes, someone told me that!). When the girls were born they looked so different from each other we knew right away we’d never have an issue.

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3. Do you have to buy two of everything? Sometimes. When the girls were infants, we had to buy twice the amount of diapers, wipes, and clothes. And we had two cribs, two pack N plays, and two bouncers. Larger items, like a baby swing, we only had one. I was glad we did because the girls weren’t big fans of the swing and it didn’t get that much use. We bought a lot of items on consignment and used hand-me-downs from family which was great because the girls only used them for a short time. I still try to buy toys and clothes used when I can or shop sales.

 

4. What happened when both babies were crying? This is a question I get asked often by other moms. Truth be told, this was one of the hardest parts about having twins (for me). It was heartbreaking to be unable to comfort both babies at the same time. And this happened a lot when I was on my own. Often I would place one in a floor seat and bounce her with my foot while holding/rocking the other one.

 

5. Do you dress them alike? Before the girls were born I was adamant that I wouldn’t dress them alike. I can still remember my mother dressing my sister and I alike (we’re almost 2 years apart) and HATING it. Then I had my own kids and I wanted them to be in the same outfits all the time. When they were infants it was really easy to just pull two of the same outfits out of the closet. I didn’t have to think about it. Nowadays, I try to dress them alike, but they each have their own style and favorite colors (Maddie – anything orange and dresses; Ashlyn – blue anything). I try to let them express their individuality with their clothes.

 

6. Did you breastfeed them? HOW? Yes, this is a personal question, but I don’t have any hesitation about sharing my experience. I nursed both babies until they were just over a year. I weaned the summer after their first birthday. Breastfeeding was time consuming for me when they were young. I nursed them separately until they were around 3 months old. Then I started to nurse them together.  It got easier for me when I was able to feed both at once. It made me feel good to have the connection with both girls in that way.

Breastfeeding is challenging in general. It doesn’t matter if it’s one baby or three. And it’s a personal decision. But as my mother-in-law would remind me: at the end of the day as long as your child is getting nutrition and growing then what does it matter if you were nursing or using formula? Or doing a combination of both? Do what works for you and your family.

 

7. Are their personalities the same? Not at all. The girls are quite different from one another. Madison is insightful and imaginative while Ashlyn is spirited and very outgoing. Because they have different natures, I’ve had to adjust my parenting approach with each. I have to be more direct with Ashlyn and choose my words thoughtfully with Madison. I suppose this is how any parent would behave with their children – understanding that each has his or her own unique needs and interests.

 

8. Which one is older? Only my family and close friends know this one. Yes, one is technically “older” because she was born 60 seconds earlier, but I’m not going to disclose that information. I haven’t made up my mind if I want to let the girls know who is the eldest. You know the whole, “Well I’m the oldest!” maneuver.

 

From around the web:

THIS mom’s response had me cracking up! It’s true.

And this video of mom vs. twins (been there!)

Check out One Twin Mom blog by my friend Megan for more posts about life with twins!

 

Top 3 things I did to have a healthy pregnancy

afitmess
December 23, 2015

When we found out we were having not one, but TWO babies I lost my mind. No, really – I did. I still remember the horrible, panicked reaction I gave my doctor, immediately saying to him, “I can’t!” I was truly terrified…mostly because I couldn’t fathom being able to physically carry twins. I just wasn’t strong enough. Without missing a beat, my doctor said, “Oh, yes you can.” He then told me the best thing I could do was to take it day by day and to make sure I took care of myself. He reminded me how important it was to stay hydrated and to drink as much water as I could. I was surprised at the time and didn’t really understand how such small things could be that important, but I followed his advice and I am sure that’s why my pregnancy went so well.

 

Like many expectant mothers, I had my ups and downs during pregnancy. Carrying twins meant more check-ups and additional screenings and tests. I had a few bumps (like being diagnosed with gestational diabetes at 28 weeks and tearing my hamstring at the end <–not fun!), but overall I was healthy and – more importantly – the girls were healthy. I carried them until I was 38 weeks and then delivered them via c-section. The girls weighed around 6 pounds each. Twelve pounds of baby inside me and you can imagine how large I was at the end!

 

There’s a lot of advice out there on how to have an optimal pregnancy, but I wanted to share a few things that really worked for me. I am only speaking from my personal experience – everyone is different.

  1. I drank a TON of water! In fact, I didn’t go anywhere without my water bottle. I kept an extra bottle in my car just in case I forgot mine. I was constantly using the bathroom, but I would have been doing that anyway. If I got bored with plain water, I would throw in lemon, lime, orange, etc. Or, I would drink sparkling water. Yes, I drank a cup of coffee every morning. No judgments!
  1. I exercised almost daily. This included everything from running, lifting, yoga and swimming. I ran up until I was 28 weeks and then it just got uncomfortable for me. After that I stuck mostly with walking, lifting, and yoga. All the exercises I did were cleared with my doctor and I was cautious in my movements. I did some swimming at the end. Note: prior to getting pregnant I was exercising at a high intensity on a regular basis. I wouldn’t advise starting a new program or doing anything without checking with your doctor. Most importantly, you should always listen to your body.
  1. Physical therapy. I visited an amazing physical therapist several times during my third trimester who specialized in women’s health and pregnancy. She showed me exercises to strengthen my pelvis, legs, and back. She also showed me proper body mechanics for things we don’t even think about, like how to properly get in and out of the car as well as how I should be lifting the girls once they were born and getting their car seats in and out of the car. She also demonstrated exercises to do after the c-section to bring my abs back together. It was IMMENSELY helpful. I think every woman should visit a PT during pregnancy.

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Pregnancy – whether you are carrying one, two, or three babies – can be challenging. Everyone is different and what works for one person may not be the right thing for someone else. I wanted to share what I felt was helpful for me. I would love to know what may have worked for you.