No genetic mutation!

Happy days. Seems like this is a good news week for me.
In other prego news - Rebecca continues to be a vigorous kicker.
There are two girls in the office now who have just returned from mat leave. They recommend Strollercize classes and library storytime. Whether or not the baby is old enough to appreciate these things seems to be irrelevant. They said that what was key was the opportunity to connect with other mothers.
There was also a brief discussion of baby blues - not full blown post-partum depression, but the short term blues that many women experience for the first week or week and a half after delivery. One of the girls expressed it as a feeling she was mourning the pregnancy. Even though she had her new baby, she was feeling as though she missed having that more intimate connection. At first, that sounded a bit strange to me, but the more I think about it, the more it makes sense. Right now, I have Rebecca with me all the time. A day doesn't go by that I don't feel her moving. Greg and I talk to her continuously, and feel very protective of her. It's a very special time and right now, and we just operate on the assumption that she is perpetually happy and safe. Despite any physical discomfort I may experience, it is generally a wonderfully positive thing for both Greg and I. Anyhow, I think it must also be a bit like Christmas. There are days and days of anticipation and preparation, and then one day, you have to take the tree out of the living room and put the decorations in their boxes. I always find that day very sad. Yes, you did experience Christmas and it was great, but now it's time to go forward with normal life. Of course, this is just my sorry attempt to understand something I have not yet experienced. Maybe I'll be dead wrong. Hopefully I won't run into major post-partum mood problems but, I'll just have to wait and see.

No diabetes!

When I got home from work, there was a light flashing on the answering machine. The message was from my GP. It appears that all my results on the 2h glucose test were perfectly normal. I do not have gestational diabetes! I am so relieved - I hated to think of Rebecca being harmed by me (however inadvertently or indirectly). Of course, given the weight issue, I will still have to be careful with my diet.
So now, it's just a matter of waiting for my genetics testing result. Maybe it will come this week too. I would hate to think that it might require an entire month.

Frustration

3 weeks since my test at CHEO and still no results available, and nothing yet received at my clinic about the Friday morning 2h glucose test. I'm tired of waiting, I want information. How long will it take?

Back for more testing

So... less than 24 hours after my glucose tolerance test, I got a call from my GP. My result was borderline pass/fail. Therefore, a second, more amusing test, was required. This second test, which I dutifully underwent this morning, required at least an 8 hour fast, and involved drinking an even sweeter drink (hard to believe). Three blood samples were taken: baseline, 1 hour post drink, and two hours post drink. It was horrible to consume that godforsaken beverage as my first food of the morning. I never want to see it again. The puncturing was not all that bad - of course, they had to alternate arms, which meant repuncturing the arm that was punctured on Wednesday. In fact, by the time they got to the 2h sample, the needle they inserted on the left side wouldn't draw blood anymore (although, to give them credit, they certainly tried to shove it in until it could). So, that's five punctures in the space of about two days.
Now I wait for results (hopefully negative ones).
But in a worst case scenario - i.e. gestational diabetes, I expect there will be some dietary changes for yours truly. The incidence is 3.5% in non-Aboriginal women, 18% in Aboriginal women. Risk factors include: a previous diagnosis of GDM, age over 35 yrs, obesity, a history of polycystic ovary syndrome, hirsutism, acanthosis nigricans, being a member of a population considered to be at high risk for diabetes, including women of Aboriginal, Hispanic, South Asian, Asian or African descent. Clearly, I don't have a single listed risk factor (which is no guarantee of anything). If you have gestational diabetes, you can easily end up with a mega-size baby :( (I think they are actually referred to as "macrosomic"), and the baby can have a few problems with breathing and hypoglycemia.
The bottom line is: I have to wait and see. But I am keeping my fingers crossed.

25 weeks, 4 days checkup: No more ice cream

Despite my elephantine swelling, my blood pressure remains perfect, so no one is worried. I called CHEO to see if my genetic test results are in, but no dice. Rebecca's heartbeat is fine, my pee test is fine. Apparently it is quite normal for babies to be lethargic on some days and hyper on others (good, because I was beginning to be concerned).
My rate of weight gain over the last few months has been normal (1-2lbs./week) but... it would seem at this point that I have put on about 39lbs. since the start of the pregnancy. This is not good. My doctor originally anticipated that I would put on about 40 lbs over the course of my entire pregnancy. There are still three months to go boys and girls, and I won't be getting smaller. Obviously, there is some variation between individuals but... no more fruit juice or ice cream. My GP will now be monitoring my weight a little more closely. I could potentially gain another 12 or 14 lbs (and please note, Thanksgiving and Christmas, New Year's and my birthday are still on the way). I fully admit that I have been indulgent on occasion. Overly so? I didn't think so. I still get in a half hour of walking per day, plus lane swimming and prenatal aquafitness. I was probably the worst about indulging at the beginning of the pregnancy when I was mega hungry. But you can't go back - you can only go forward. The worst part is, Greg just bought me some truly excellent creme caramel vanilla ice cream. He said he is going to give it away now. :( I suppose it's for the best. I don't want a behemoth baby!
On an unamusing side note, the dry skin on my belly that I have been religiously moisturizing about five times a day - well, it's not dry skin, it's either a fungal infection or a yeast infection which developed as a result of a nasty, humid, hot summer and changes in my skin chemistry. I don't think my skin has ever previously harboured conditions friendly to living things, but there you have it. My moisturizing has only been encouraging it to spread. I have never had any infection of this type before, so I didn't know any better. I based my actions on my extensive experience with eczema, which was not that relevant (as it turns out). So all this pain has been for nothing. I now have a custom Rx cream and hopefully, it will do the trick and I can prevent future suffering. As for the weather - I can only pray that these abnormal temperatures go away soon.
After my checkup, I went for blood testing (hemoglobin and glucose tolerance). For the glucose tolerance test, I was given a bottle of something that is nearly indistinguishable from Orange Crush. I had to drink the contents in the space of 5 to 10 minutes (not too hard), and then remain immobile for an hour. At the end of the hour, they took my blood. Why didn't they take my blood prior to consuming the beverage too, to establish a baseline? I suppose this is just a gross measurement where they check to see if my blood glucose returns to a normal range.
My next appointment is in 2.5 weeks. I am drawing close to the time when I will switch over to my obstetrician.

Too posh to push

I recently heard this expression and it struck me as funny. It is applied to those women (most often celebrities) who elect to have a Caeserean for non-medical reasons (i.e. to avoid the labour of labour). I guess the fact that's it's major surgery is not a concern.

Prenatal Aquafit

Last night I had my first class of prenatal aquafit. I really enjoyed it and I recommend it to those who become pregnant. In a way, it was more of a return to my former fitness routine than the lane swimming has been. In aquafit, I take punching and kicking instructions from someone and follow them, and classes occur at a set time. :) Almost like TKD, except that these girls are big slackers. At any rate - it was strange and amusing to see so many pregos all in one spot. I am certain it was the largest assembly of pregnant women I have seen in my lifetime. And of course, the women were in bathing suits, so it was a panoramic of the stages of pregnancy (and the shapes of pregnancy). Mind you, it also hammered home how much pregnancy varies between individuals. One woman was only a few weeks behind me (in terms of due date), but didn't even look pregnant at all. Where is she hiding her baby? I would say that most women there were in an earlier stage of pregnancy (some were maybe only a month along) than I am - but there were certainly a few other ladies of comparable size to myself. I had high hopes of making prego friends - but it seems that a lot of the girls came with a pre-established prego companion. That's o.k., not all of them did. Obviously, the time to make friends is prior to the class, because we don't get a break at any point in the 50 minutes. It was a lot of fun - not overly challenging, and I think it will be great for my arms. The instructor must be barely 17 and is very chipper. She demonstrates everything on the side of the pool, and then we struggle to copy her at even a quarter of her speed. The class is just packed - there must be 25 women there. At one point we got to use foam dumbells - it takes more strength than I thought to work with those under the water, because they are so small and buoyant. Generally, the instructor gives us options, so depending on size and comfort, we can perform variations on an exercise.
The bottom line is - if you are pregnant, give it a try. The cost of taking these classes through the City recreation programme is really pretty decent, and certainly, the motivation to exercise in the tail end of pregnancy is going to be low without a break from gravity.
I have almost reached the third trimester (two weeks to go)!

Belly watching and leg cramps

Once again my body has woken me due to pregnancy. This time with middle of the night leg cramps. This is the second time I have had the pleasure of waking up screaming due to the cramping. Poor Greg - I hope I don't give him a heart attack. At any rate, due to many years of martial arts over-exertions and the like, I am quite accustomed to handling this type of problem. The trick is to flex the leg (in particular the calf muscle) and hold it. It is also extremely helpful to bend the foot back from the ball of the foot until your heel is "in the lead" so to speak. I used to be able to do this myself, but now, the belly gets in the way so Greg has to assist me. This technique corrects the problem almost immediately. In this case, I released the flex too soon and the cramp came back, including those little muscle behind the knee. Unfortunately, while the cramp may be gone, the leg will stay sore for the next few days and make the walk to work a little less pleasant. According to my sources, calcium is a temporary solution (oops - it was my usual one), which may aggravate the problem in the long term. Suggestions for prevention included taking vitamin E supplements, using sea salt in my food, or taking a magnesium supplement. Basically, this is an electrolyte issue. For some people, the danger is confounding a leg cramp with a leg thrombus. While I don't have my genetic test results in hand, I don't think this is the case, because other telltale signs of a thrombus are completely absent.
On a sillier note, Greg and I amused ourselves last night by belly watching. During a time when Rebecca was particularly active, we just watched the bare belly. It was pretty amazing to see the surface deformations (more extensive than I would have thought for 24 weeks - but what do I know), and of course, Greg took advantage of the situation to yet again feel baby kicks.

Dental health and the Prego

One of the things that can happen during pregnancy is the engorgement of tissues such as gums and the increase in sensitivity of teeth. There is actually a name for this: "red brush syndrome". It isn't an official name of course, but now you know. I have definitely noticed a slightly higher propensity for my gums to bleed, and I have tried to be a little gentler with my oral hygiene as a result. So, it was with some trepidation that I went off to the dentist this morning for my annual checkup. As per usual for me, everything in my mouth was "perfect" (that's a quote from my dentist btw), but I will say that I felt a little tender afterwards. On a positive note, I was able to ask the hygienist some questions and she was able to dispel some "old wives tales" (yet another quote), and provide some information. For Rebecca, I wanted to know when children are first supposed to visit the dentist. Apparently - age three. Prior to that time, they are supposed to use special baby toothpaste and baby tootbrushes. They are NOT supposed to use toothpaste which contains fluoride, because the concentration is too high (and ixnay on the whitening agents of course). This information is actually on the tube in very fine print (in fact, I think it says not to use it if you are under 12). At any rate, this prompted me to ask about fluoridation in our water - and I was told this was not a concern. They actually gave me a toothbrush for Rebecca when I was leaving - and it's pretty adorable. For myself, I wanted to know about the dental problems that can arise during pregnancy. The wife of one of my grad school friends had tremendous cavity problems during pregnancy despite a lack of previous troubles. I had also heard about people just plain losing molars (dissolving???) during pregnancy. The hygienist informed me that there are a lot of these types of rumours that go around. Damage to teeth can occur secondary to morning sickness due to repeated exposure to stomach acids (the same for gagging). This seemed fairly logical - when I took pathological chemistry, this was certainly cited as a frequent problem in cases of bulemia. Also, those experiencing morning sickness often consume unusually large amounts of gingerale (added sugar) or have trouble effectively cleaning teeth near the back of their mouths due to the gag reflex. And of course, there is an increased requirement for calcium during pregnancy which should not be ignored. She also mentioned that with the fatigue and the freaky sleep schedule, sometimes women would miss out on brushing their teeth, which doesn't help the situation. Apart from that, I did discuss the increased bleeding with her and she told me that the experience is very common. In fact, this was the thing that made her suspect she was pregnant! As a hygienist, she naturally flosses like a masochist, and has numbed her gums to pain and bleeding. One day, she noticed bleeding when she flossed - and since it was so unsual for her, it made her wonder if she was pregnant.
The bottom line is - for pregnant women, it's a catch-22. If you are too gentle or avoid taking the necessary measures due to your increased sensitivity or bleeding, you actually make the situation worse. Therefore - just suck it up (this seems to be a theme with pregnancy). Eventually the baby will arrive, and some of these issues will disappear.

Kicking

After making my early morning blog posts, I returned to bed. Rebecca seemed to still be kicking hard, so on a whim, I put Greg's hand on the belly hoping that he would finally be able to feel something. And he did! He felt three strong kicks without any prompting from me. He identified the movements before I could even come out with a "Did you feel that?". It was a very nice moment for us, and extra special for Greg. Seeing the ultrasounds was amazing, but feeling the baby move is a lot more intimate (even at 5 something in the morning).

Pre-pregnancy face. Please note obvious presence of bones in face and the ability to wear rings on fingers. Crazy demeanor is bonus.

Second trimester pudgey face

It's 5 in the morning

At 4:30 am most days, I am up and taking the habitual prego pee break. There is no sleeping through the night anymore. That's o.k., they say it helps prepare you for dealing with the baby (who will also not sleep through the night).
I may have mentioned previously that being pregnant has meant (in part) for me, a lot of congestion paired with the inability to take sinus tylenol. So, at 4:30am, wishing to return to bed, I find that I am stuffy. My attempts to remedy the situation via the simple act of nose blowing provoked yet another nosebleed (this has happened recently). Apparently, "High levels of reproductive hormones circulating in your body increase blood flow to the delicate mucus membranes of the nose and mouth. This can bring easy bleeding when you stress these areas — by brushing your teeth too vigorously or by blowing your nose too hard". "Too hard" is a little sujective to me, but it's pointless to argue these points with a cold face cloth blocking off the very air passages I was trying to fix. Anyhow, Rebecca is kicking me and I am hoping that yummy iron smell/taste is going to go away soon. Seemed like a good time to do something semi-productive, so here I am.

This is taking forever

Seriously!!!
Tragically, I am fully cognizant of the fact that I have 3 months and several weeks left (presuming prompt baby arrival).
My trip to CHEO was fine. I spoke to the very friendly genetic counsellor for about an hour and ultimately the testing decision was left up to me. I opted to be tested because ignorance doesn't afford me any peace of mind, and there seemed to be no great disadvantage to knowing the truth of the matter (and some disadvantages to not taking this opportunity). Feeling that I had taken action was the most soothing thing possible. Now I wait a few weeks for my results. If I test positive I know exactly what steps I can take - and if not, well... all the better!
When they take your blood at CHEO, you get special bandaids. Mine was Tigger - thank god. I shudder to think of some of the alternatives (Eyeore! blech!).
I continue to have squashed organ pains (I also read somewhere that very active babies can actually bruise maternal tissues - but who knows the truth of these matters) and back pain. Greg and I went to see "the Constant Gardener" last night and I squirmed in my seat the whole time. It comes and goes. How will I endure this for the rest of the year? I guess I will just suck it up. I am having more difficulties sleeping at night due to back pains, but generally I catch up by having early evening naplets. Rebecca continues to be very rambunctious- I am beginning to feel her move at higher locations. It's a little disconcerting and I have visions of her gnawing on my ribs, but most of the time she stays down where she is supposed to.
I read an interesting article on fetal psychology today:
http://www.leaderu.com/orgs/tul/psychtoday9809.html
Rolling into January!

The special testing saga

So, I discovered that there is a genetic mutation that runs in my maternal line. This is a single point mutation in a gene encoding a blood clotting protein known as Factor V (most of the clotting cascade are named in this fashion, using roman numerals). The mutation results in an aberrant form of the protein - called Factor V Leiden. This condition is autosomal dominant - to put it simply, a normal gene copy will not cancel out the bad gene. The mutant protein is harder for the body to deactivate - therefore - clotting can continue when it's not supposed to. The resulting condition is known as thrombophilia, and can be exacerbated in a person with 2 mutant genes, or mutations in other important clotting genes (such as the gene encoding prothrombin). As it happens, even if you are heterozygous for the mutation (have one copy of the mutant gene), your risks of thromboembollism are increased over the general population, and major risk factors are oral contraceptive use, surgery and pregnancy! In fact, in means your pregnancy moves from the "low risk" category to the "high risk" category. Anyhow, this condition occurs in 5% of the caucasian population in north america (and is almost non-existant in the non-caucasian population).
All this to say that I'm going to CHEO on Tuesday to have a blood test done and to meet with a genetic counsellor. Even in the worst case scenario - where I have the mutation, it is quite treatable - even during pregnancy with anticoagulants (heparin) or baby aspirin. The important thing is to know - because then, the necessary precautions (if required) can be taken to protect both Rebecca and myself. Right now, my chances of being positive are at approx. 25%.
I had to fill in a ten page family history questionnaire and fax it over to CHEO genetics labs today. It demanded a lot of detail, and I'm not sure how helpful it will be, but it allows them to build a genetic family tree for me.
Anyhow, this whole process this week (getting in touch with doctors, getting requisition, back and forth communications with CHEO, contemplating possible worst case scenarios, and assembling familial data) has been a little stressful but... I will wait and see what I find out, and work from there.
Other than that, the baby is fine, still kicking. Her favourite time of day is 10pm (for some odd reason).