The end of breastfeeding

My babies are now six months old. The time has passed in a blur of feeding, bouncing, changing diapers. It has not been long since I began to feel as if we were emerging from our small cocoon. Part of this emerging has been letting go of my tight grip on breastfeeding my babies. It was a huge struggle. They did not nurse well, both having tongue and lip ties that needed to be revised. I, having the hormonal issues I do, did not produce well and it took drugs and herbs and pumping to make even enough for one baby. But I did, for a time. We found a rhythm where I fed them on the pillow, then they got a bottle, and it worked. Until it didn't. As happened with Caden, as their appetites and interest in the world grew, their patience at the breast dwindled, and they began to nurse for shorter and shorter times looking around for the bottle. I tried supplementing at the breast with a little tube, nursing them individually, and these things worked for a time, but I didn't have a lot of fight left in me. Having a hungry baby cry at my breast is an awful feeling, and not one I could tolerate. I began to give them bigger and bigger bottles, and offer the breast only occasionally. Through all of this I pumped. I pumped because I hoped it would turn around and I wanted them to have as much breast milk as possible, but I found that time at the pump meant I wasn't able to squeeze in one on one time with my older son, get the bottles washed, or fold the laundry. I really had to look at the health of our family as a unit, and it became clear that breastfeeding could not be the highest priority anymore. Tonight may be my last pump. Jude still nurses in the wee hours and each time I wonder, will this be it? I don't know that I have much milk left for him, now that I have stopped the drugs and herbs, the pumping and frequent nursing. I feel very sad about this chapter ending. Breastfeeding was something I looked forward to, and both times it didn't work out the way I wanted to. Both times I struggled with feelings of failure, frustration, inadequacy.

This is the end of my reproductive journey. I have three beautiful, healthy children. My body did not fail me. It grew and birthed these beautiful beings. I get to mother these incredible children. And yet I resist closing the door. Even here, 42, with my family complete it feels as if there is something I need to do, something I need to prove, some hurdle to leap before I can be free from my years of loss and infertility. But maybe healing doesn't mean being free. Maybe it just means moving forward. 

Feed the baby

I have watched so many friends nurse their babies. The baby cries, they pull a shirt up or down, grab a breast, pop the baby on, and Voila! The baby gets fed, drops off the breast milk drunk and content. When I had Caden I was completely unaware how hard breastfeeding can be, how it is a learned art, how it takes practice and perserverance and hours upon hours trapped under a newborn, and how, for some of us, it doesn't work out. Not because we are lazy or duped by the formula company, but because our bodies don't quite work right, or there has been surgery, or the babies don't ever get the hang of it, or life does not allow for the time it takes to nurse or pump or whatever needs to happen to protect the milk supply. I was never witness to the struggle.

I suppose in many ways breastfeeding worked out, as best it could, with Caden. I nursed him til he was past the 6 month mark, and pumped for a while after that. I never had enough milk, so he was never exclusively breast fed, but he had 1/2-3/4 of his food from me, and the rest was an amulgation of donor milk, home made formula, and commercial formula. I feel good, retrospectively, about the choices I made and the work I put in to give him the amount of breast milk I did. 

And yet. I was sad. I spent so much of his early infancy crying and wishing things were different. I felt like I was failing him as mother because my body could not produce enough milk. When people asked me if I was breastfeeding, I said no, even though I spent hours of every day doing so. It was as if that bottle trumped the breast, and if I wasn't doing it completely, I couldn't claim to be doing it at all.  

The other side.

Today was my due date. July 13. A date that never meant all that much because I knew they would be on the outside by now. They have been earth side for two weeks and 4 days now, each day its own microcosm of a lifetime. There was the end of the pregnancy, all the monitoring, the blood pressure scares, the sheer enormity of my belly and the challenge of moving around. Then there was the induction, the labor, the birth. And then, the other side. 

I have two babies. They are beautiful and small and sweet and strange. They do not nurse well and have floppy heads and dark blue grey eyes. I struggle to make milk for them. Ada is slender and fair and long with scrawny limbs that scare me sometimes with their skin on bone quality. Jude has a darker complexion, rounder in the face and belly and meatier all around. Jude is currently asleep in a hospital crib with an IV in his arm. Today we are in the microcosm of my baby is sick, but he is ok. He has a UTI, and because he is till so new they have to make sure the infection has not travelled to any other organs. We originally brought him to the doc for a fever. I woke at 4:00 am the night before last to feel heat emanating off his little body. Before that moment I was lost in a sea of failure around breast feeding, and now I sit on this vinyl purple rocking chair and know that I can only do my best to keep all of my children safe and cared for. There are so many decisions to be made each day, each moment, I can't possibly always make the right one. It is a horrible truth that I can't expect to get it right all the time. That I will inevitably fuck up. All I can do is try and try, and keep my heart open to the love, and accept the rest of it too: the feelings of inadequacy, the anxiety, the sheet need of two infants and a four year old. 

I fret. Should I go home now from the hospital so I am there when Caden gets back from his time with friends? Or is it more important to feed Jude once more and possibly be here when the doc comes to talk to us about the kidney and bladder ultrasound?

I go. 

Home now. The drive offered sunshine, Andrew Bird, and time to cry. I nursed Ada, greeted Caden and heard about his day, and then handed both children off so I can pump. This is the majority of my reality: nurse, soothe, pump. Nurse, soothe, pump. Maybe insert eat ice cream. It felt terrible to leave my baby in the hospital. Home is a relief. 

36 weeks

Tomorrow I will hit 36 weeks of carrying these babies. It is also father's day and the day Caden was born. I hate to admit this, but I'm ready to not be pregnant anymore. I have felt guilty for this, this desire to complain, this non-enjoyment of pregnancy. I wanted so badly to be pregnant again, and I know I will never be pregnant again, and I know I will be wistful at some point about these kicks and stretches and rolls inside me, about the sheer enormity of my body and the miracle of being a home to two babies, and I am trying to find the place where I can savor and enjoy all that, but the truth is, I am tired. I have to spend a lot of time lying down. It hurts too much to curl into my husband on the couch or make dinosaurs move across the floor with my son, or plant the starts withering away in my garden beds, and if I can't enjoy this part, then I'd like to move onto the next. Babies. Two tiny babies. Who will need constant tending and I will not sleep for the next years, so maybe I should try again to enjoy this last part.

Should. Does it ever serve us? What happens if I go back to the yes. Yes, I am carrying almost twelve pounds of baby. Yes, my bones and muscles and skin aches from this strain. Yes, my mobility is limited. Yes, I am short of breath just sitting here. Yes my blood pressure and my blood sugars are high and this is making me feel very weird and woozy a lot of the time. Yes, this is hard. Something in me does relax when I say yes, instead of fighting the experience. Yes, it has been a long pregnancy. Yes, my body has done incredible things, and is working very hard. Yes, yes, yes.

I am aware that I stand on a threshold. These babies will come soon, whether it's tomorrow or two weeks from now, it won't be long now. I am still working to embrace both the knowns and unknowns about how they will enter the world. There are times when I can approach it all with an honest curiosity, and other times when I find myself gripping to my ideas of what constitutes a "good birth." In the end the health of these babies and giving myself the best chance to be strong enough to care for them is my top priority, but I find myself tripping over my own judgments around pain medication, my own fears around lines and tubes, and surgeries. I want to let myself have a "good birth" no matter how they enter the world. I am also trying to find the balance between giving myself the best chance to labor naturally and deliver vaginally, and to follow the medical advice that is based on keeping babies safe in a worst case scenario. It's a fine line. What I know from assisting laboring women is that holding tight, clenching our fists, does not facilitate letting our bodies open, and I know I cannot grip too tightly my ideas of how I want to labor, and how I want these babies to born.

The sun rises early now. Surrounding my time in bed, there has been an awful lot of magic this spring. A robin nested in our eaves and two babies hatched, screamed for worms, grew big, and then emerged from the underbrush one day foraging for worms themselves. The two strawberry plants I carelessly threw in a latent part of the garden two autums ago have spread into a robust strawberry patch where Caden forages. Peas grew and blossomed and hang ready to eat, raspberries ripened. A flock of sparrows visits us daily eating the seeds from the grasses I never weeded out of the lawn strip this year. They perch on the fence and in the lilacs and fly up into our eaves- maybe there are nests up there I can't see. From my bed I have watched bleeding hearts emerge, Rhododendron bloom and fall, ferns unfurl new growth. Sometimes it is not such a bad thing to have your world shrink down to that which immediately surrounds you. I'd like to view this last part of pregnancy as the beginning of the journey to meet my babies. I don't know if I my blood pressure will hold steady enough for my body to tolerate labor. If I do labor, I don't know if I will be handle all the monitors strapped to me without pain medication. I don't know what the journey will be like, but it can begin now with trying to stay present in my body, in this reality.

32 weeks

25 weeks

   It is shocking to me that we have arrived here. The second trimester flew, and now I find myself with two babies up in my ribs, knocking on my pelvis, pushing their limbs against my skin. I wonder when they will be born. I wonder how they will be born. I wonder what they will look like, what they will be like, who they will be.

Time has slowed again, as has my gait, my pace, especially up or down stairs (especially up). Surrender. I'm back in the place of deep surrender as I am not able to tend to things the way I'd like and I have to ask my husband to carry the laundry, hire someone to ready the backyard for summer. I have to lie down a lot. Doctor's orders. And the truth is I'm tired, and I need the rest.

Spring continues to fluxuate wildly between cold, wet chill and bright sun, but early spring has left us and I feel the seasons shifting. In Portland, spring is a long affair: February-July,  and spring almost has its own seasons wrapped inside. Early spring blossoms, riotous cold alternating with sun, May heat, and next will come the June return of chilling rains before summer finally gets here.

Caden was born in June, rain pelting the windows of the hospital, Cameron building a fire the day we brought him home. Caden was born in the water, the Cave Singers playing, me on my knees holding onto Cameron's shoulders. I have known since the day we saw two heart beats that this birth would be different. On Thursday I will have a more definitive idea if a vaginal birth is possible. I think my girlie is head down and first in line, but she started out as baby B, slated to be second born of these two, and they've both been moving so much, I'm not sure what is going on in there. Things are getting tight though. Wherever they are, it's likely that's where they'll stay til they come on out. Main exit or through the sunroof, I can still hope for a peaceful birth. Surrender, surrender, surrender.

24 weeks

24 weeks = Viability. Of course I do not want them to come yet. It is the thing I obsess over now, yet, if they came there would be no medical question of whether or not to try and save them. Everything possible would be done to support and save them because they very well could make it. But, if you’re listening babies, keep cooking. Stay in there til the last week in June, that’s what we’re hoping for.

I’ve had a stretch of feeling pretty good. Less tired, free of nausea, diabetes under control. Hallelujah! This has coincided nicely with some beautiful spring days, cherry and plum blossoms, daffodils, birds singing.I have lumbered my large body up some hills in the gorge, and got to sit barefoot and bare armed in the sunshine the other day watching my son stand in a freezing creek throwing rocks to his heart’s content. My pasty arms tingled with the warmth filtrating my hairs, penetrating beneath the skin, drying out my bones. Behind me a cascade of misty pearls dropped from overhanging moss, half of it evaporating before it hit the ground causing rainbows. I felt that sunshine all the way into my thumping heart, trying to get air into my squished up lungs. One baby wiggled up against my ribs, another kicked at my pelvis. Joy.

The flipside of my more active days is that I get very tired and grumpy by evening, and the Braxton Hick contractions come more readily and with greater force. My kid doesn’t generally let me sit and put my feet up for long periods of time, so this can be hard to manage, but we’re getting through. This sun. It is such a luxury to sit in the backyard and be warm and dry, to let Caden play barefoot in his sand box or make structures with sticks and buckets and hoses and just be comfortable relaxing outside. We are settling in now for a long stretch of spring rain, and I’m glad my skin and heart got enough sun to carry me through.

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Embryos and Choice

A friend of mine shared with me over the phone the other day that when she received the message I wrote her about my pregnancy, her first thought wasn't "Oh I'm so happy for Katie," It was "I love those babies!" She said, "I mean I don't want to get all weird and pro-life on you, but I just felt like I fell in love with them as soon as I know they existed." I was taken aback, and have since been mulling on this. For I am pro-choice, always have been, and yet I have loved the little beings inside me all seven times I've been pregnant from the moment I knew they existed, maybe even before, and that has never threatened my belief in a woman's right to terminate a pregnancy.

I believe in the right to choose. I believe I asserted a piece of this right when I chose IVF. I asserted it again when we genetically tested the 12 embryos and donated the 9 that were chromosomally abnormal to the clinic to calibrate their machines. We will at some point make a choice about the one embryo that sits in a freezer at our clinic. Do I believe that all of those embryos were babies? Do I believe that in the five miscarriages I endured I passed dead babies? No. and Yet, they weren't just a tiny collection of cells without meaning, without import.

The embryos from which my twins grew, six days after conception.

Those little pinpricks of light, about the size of a head of a pin, carry much potential. In them are the codes for life! Human life. But it is just that, potential. There are many steps that occur between conception and birth that create a child. I wanted each of those potential babies so badly, and I felt each time that there was a baby spirit with me. I borrow from many other teachers and traditions in the idea I am about to put forth: I don't believe that the spirits that came to visit me with each of those pregnancies were fully inside their bodies. Liliana Barzola Read described it to me as a thin golden chord that connects the spirit to those early embryos, almost the way you feel connected to your partner or parent, and that as an embryo grows the chord grows thicker and stronger until sometime near birth the spirit fully inhabits the body. Peggy Orenstein in Waiting for Daisy describes a Japanese idea that we are all from the water, and that our spirits sort of gradually emerge from the water, entering our bodies more and more fully as the embryos develop, as children grow. In this tradition, the spirit doesn't fully step out of those primordial waters and fully stay in the body until about age 7 or 8. In these ideas there is not one clear moment in which "life begins." It is a gradually unfolding process of leaving heaven for earth. This idea feels right to me. Each time I lost a pregnancy, I felt like I had lost a baby, because for me, I had. I had lost, again, the child I hoped to have, and it was devastating. The physical miscarriages, although varying in intensity and gruesomeness, never matched up to the catastrophe of my emotional suffering. And each time I would try in the blood and ropes of uterine lining to find the embryo, and I never could- it was too small. I do not think the journey those spirit babies made was traumatic for them- I believe they stuck a toe out of the primordial waters, and said, hmmm, no thanks. It was me who suffered, but I do not blame them.

A private ceremony to honor one of my first trimester losses.

Do I believe that people who choose abortion are baby killers? No. Do I believe that life begins at conception? Yes, I do. Some glimmering esoteric piece of life begins at conception- possibly even before, but I do not believe that means that a woman who is not ready is obligated to nurture that speck of possibility into a child. To carry a child to term- to be pregnant for 10 months, to give birth, is a public, irrevocably life changing journey, whether or not that mother decides to keep that baby or give it up for adoption. I would argue that abortion should also carry weight, as I do see it as terminating life, but it is a private event, and small. Just as my first trimester losses cannot be compared to second trimester losses, stillbirth, or SIDs, early abortions cannot be compared to infanticide, and it is a leap of imagination to call women who choose early abortion baby killers.

I don't think there will ever be consensus on the abortion debate, but I do think that if we on the pro-choice side don't acknowledge that there is magic, potential, spirit involved in the conception of child, we are doing everyone a disservice. No one who believes that life begins at conception will ever be convinced otherwise, but perhaps there is room to talk about the life of the mother, to talk about the impossible fragility of early pregnancy, to talk the quality of life that child would have if brought into the world.

I believe that there is a way to honor an early pregnancy, and let it go. I believe that it is a woman's right to choose whether or not she wants to carry a baby to term, keep that baby and raise it as her own, or give it to another in adoption. I believe that all of those decisions are monumental and life altering and should not be taken lightly. I believe that each woman deserves the right to make decisions regarding her own body and her own reproductive future.

In looking at the Guttmacher Institute's Fact sheet on abortion (http://www.guttmacher.org/pubs/fb_induced_abortion.html), there is much that stands out to me. 89% of all abortions in the United States occur before 12 weeks gestation and greater than 60% occur before 8 weeks gestation. According to Baby Center, at 8 weeks an embryo is about the size of a kidney bean (http://www.babycenter.com/6_your-pregnancy-8-weeks_1097.bc) and weighs about four hundredths of an ounce. This is a far cry from a baby. 33% of abortions occur before seven weeks, and this number includes people who choose plan B, so it may or may not have been an actual abortion as this occurs before a pregnancy is confirmed. 42% of women seeking abortion have incomes below the federal poverty line, and 61% of women seeking abortion already have one or more children. I can imagine that giving a baby up for adoption would be near impossible when you already have children who would be cognisant of a sibling, and are you going to be the one to tell that mom she HAS to have another kid? The good news is that Instances of abortion are currently at their lowest since 1973, which is thought to be attributable to better access to and education about contraception (Go Planned Parenthood!). 

I know that there are families who desperately want children, and find it hard to stomach that other people would choose to terminate pregnancies that could result in live children. I was there, for many, many years. But even so, I would never have insisted that another woman must unwillingly give her body over to pregnancy and childbirth because I couldn't. We all have our own journey, with our own struggles, and it doesn't come out tit for tat. I know that it is better for our society that the children who come into this world be wanted and well cared for, born to women who willingly bore them, whether to parent them or give them up for adoption. There is nothing to be gained by forcing women to continue pregnancies they do not want to see to fruition. I know that some argue, adoption, adoption, adoption, but when you step back and think about what that means for a birth mother, is that truly something to force upon someone unwillingly? 

And I come back to the notion of choice. Because in the end it isn't so much a matter of wrong vs right, but a matter of giving women agency over their own bodies and futures. I am so grateful for the technology and choices available to me that gave me these two squiggly 20 week old babies moving all around inside me. I think that all women should have access to the health care they need to make choices about their reproductive future, whether that be to enable them to have children, or to prevent them from doing so. We all deserve to have a choice.

19 weeks with twins.

Anatomy Scan, Check!

Today we had our 17.5 week anatomy scan. This was a huge milestone. I have been stressing for days, worried that something would be missing: a brain hemisphere, a kidney, a liver, but lo and behold, both my little beans are normal, normal, normal. My cervix was also nice and long and closed, and measured long enough that my risk of preterm labor is greatly reduced. They are side by side right now, both head down, their feet kind of overlapping up near my ribcage. I didn't even realize my uterus had grown all the way up there already! I'm so grateful, and things feel much more real now, and yet, I am still waiting for the other shoe to drop.

What does that expression mean? Like you've got one shoe on, and the second one might fall from the sky and hit you on the head? That's what I see in my head, but it makes no sense at all. In all our years trying before Caden came, it always seemed we could manage the first shoe. We got pregnant with some medical help, but no grand heroics, and then every time, the other shoe dropped, and we lost the baby. When he finally did come, it was of his own volition. No doctors, no meds, no charting or temperatures or timed sex. I was grieving deeply during the cycle we conceived Caden, and I don't even remember having sex that month, but he came. With this pregnancy, it was a highly orchestrated act of science. We asserted our will to have more children, and at every step of the way, things went right. It has been somewhat shocking, and I keep waiting for something to go wrong. Or I keep waiting to start having more faith. Or just let down my guard. Do I really think keeping my shoulders up around my ears will keep my babies from leaving? Do I really think worry will keep that shoe up in the sky?

I am starting to trust these babies. I am starting to believe that they, like Caden, want to be here. That they chose me, chose us. That they are excited to come be a part of this life. What I am struggling with more is trusting my body. Today as the ultrasound tech was fishing around in the murky waters of my womb, and finding hearts with four chambers beating away, hands with five fingers, femur's and humerus, I was thinking what a feat my body is doing growing these beings. What a feat my body did growing Caden, carrying him, birthing him on his due date in the water, allowing me the birth I'd always wanted. I have so much to thank my body for in terms of childbearing already. And beyond making babies, this body has survived car accidents and surgeries and reckless use. This body has paddled me through rivers, carried me up mountains, skied me through snowy forests. This body has allowed me to stay up all night tending sick babies and laboring women. I've got to give myself some credit.

Thank you womb for carrying Caden to term and giving me a smooth labor and delivery. Thank you for growing such a healthy strong boy. Thank you legs and for all the dancing and hiking and moving through the outdoors. Thank you arms for all the holding and rocking. Thank you back for all the shoveling and hauling and planting. You are a strong body. We can do this. We can keep these babies safe inside until they are big enough to safely leave. We can keep my inner ocean a hospitable environment in which they can grow. I trust you. I trust me.

If I say it enough, maybe I'll get there. I set the intention now of honoring myself for what my body has done. I suppose this is a time of building relationships- me, the babies, my body. We are a team. For now, there is no separation.

Why Gestational Diabetes is a Pain in my Ass

Caden spots chickadees in his bird feeder

Last night Caden had a sleep over with his Grommy, and Cameron and I got to go on an early date. As seems to be the pattern with dates for us, I had a terrible resurgence of nausea in the afternoon that left me whimpering in bed not wanting to do anything. I took some Zofran, I slept, and around 3:00 asserted that I could do it. I told Caden he needed to put on clean clothes (as opposed to the egg, dog hair, and peanut butter covered ones he was sporting), and he cried and clutched at his clothes until he spotted in his closet a button down shirt with a little red tie I bought at some Christmas clearance sale. "I want to look fancy. I want to wear the shirt with the ribbon!" Be my guest son. So he chose his ripped and patched, but ever so soft blue corduroys, and a gray striped button down with a red pretied tie that velcros around his neck. Pretty dang cute. I ate a sandwich, Caden packed his backpack with the essentials (a mickey mouse keyboard) and we piled into the car. I entered my mother in laws condo and went straight for the fridge in a desperate search for something carbonated. Let us just pause now and consider the fact that I have gestational diabetes. Fucking gestational diabetes. Dealing with nausea, trying to catch up on weight gain, and following a diabetic diet has not been easy, and even though through these fertility struggles I have been the queen of special diets, I am not doing so great with this one. I found the carbonated stash, read the label on the lemon/lime Izzie's that looked so delicious, yikes! No way. Way too many carbs (read: carbs=sugar). I moved on to some vaguely flavored sparkling water and started munching on some gluten free pretzels she was using to make bread crumbs. Wait! Shit, carbs without protein! Pulled a cheese stick out of my purse and sat down to try and get the queasiness to settle. Caden, on the other hand, was wildly gesticulating telling Grommy about the chickadees that came to the bird feed he made, the pinball machines he played with his dad, and what he'd had for lunch that day. Then he stopped and said "Grommy, do you want to play with me?" Cameron and I left, our boy barely waving goodbye so enrapt with his Grandmother was he.

Next stop, Inside Llewyn Davis, the new Cohen Brother flick, at the Cinemagic. That theatre is in sad shape, but I appreciated that there were no weird commercials running before the show other than a little slide show of still ads for local business. I was again, totally nauseous, and bought a sprite. No, soda is not allowed on a diabetic diet, but as I have stopped carrying a little blue hospital puke bag with me, I really wanted to avoid hurling during the movie. I tried to temper it with nuts and cheese, and know what? The sprite was magic. Nausea went away! And I could settle into my broken back squeaky chair and travel through 1960's Greenwich Village without fear of vomit. I held my husband's hand and enjoyed. Sigh of relief.

Movie ended and we began to discuss dinner. I was verging on hungry, and hungry often means nausea and/or low blood sugars followed by spiked blood sugars when I eat, so I was anxious to get on it. My super smart husband had made reservations at a fancy Mexican restaurant for right that second! He called, and they said they would hold our table. At Xico, we were led to a cute little corner table with a window seat in a warm, colorful room with beautiful paper flowers, a chandelier of twisted orange and pink lights, and real calla lillies blooming within sight. We ordered appetizers, trying to temper all my needs: low glycemic index, low spice, gluten free. The agua fresca was prickly fruit, and I knew I couldn't have it, but I asked for soda water with just a splash. Delightful. We had queso fundido (salsas and chorizo on the side) with home made tortillas, guacamole and chips, and lamb barbacoa gorditas. Everything was so good, and my heart was all full and happy nestled in the corner with my husband who makes me laugh and lets me ramble about babies and other people's stories and my fantasies of travel for our ten year wedding anniversary. I tried to be aware of the carbs- not too many chips, not too many tortillas, but I was not really in the mood to deprive myself. When we wrapped up the meal I felt full and solid in my body, no racing heart or zingy limbs that can mean too much sugar in my blood. We walked for a while as that can help to keep sugars from spiking, and Cameron realized he needed to use some test card for his work so went into a convenience store and bought a couple things. when it was time to test, my blood sugars came in just within the normal range. Victory, or so I thought.

Here's the thing. With carbs, you get pretty immediate feeedback. In general they peak about an hour after you've eaten, and you've burned all the way through them in 2-3 hours. Proteins and fats are different. They burn slow, and fats raise your blood sugars slowly over the course of about 8 hours. As someone who is carrying twins and needs to gain weight to make up for what I lost in the first trimester, everyone agrees that I shouldn't follow the diabetic restrictions on portion size and fats. Being that I have for the past year or so been eating a high protein, high fat diet, this was a relief to me, and yet, those chips? That fried masa cake all that juicy lamb was stuffed into? Did that contribute to my high high high fasting glucose reading? Or was it my poor choice in night time snacks? Or maybe a combination of the two.

Remember that convenience store? I bought a Kind Bar advertised as "Low glycemic index, high protein!" When I looked at the label, it seemed alright, even though it had chocolate in it. I put it in my cooler bag I keep next to my bed at night with a glass of milk, and when I woke in the middle of the night I ate about half of it. Did it spike my blood sugar? Which was followed by a big drop, which then caused my body to dump a bunch of morning glucose? Probably. Because when I saw my blood sugar was really high this morning, what did I do? Did I get out of bed and make some eggs, which I know bring my morning blood sugar down? No. I ate the rest of that bar and finished off my milk because it was 5:30 and my son was at his grandmother's and I wanted to sleep in. Except that 20 minutes later my heart was slamming in my chest and my skin was prickly and itchy. I tested my blood sugars again. and Shit. Through the roof. I still tried to go back to sleep, but I felt all kinds of wrong, and I didn't want to have my blood sugar totally bottom out after the sugar high, so I got up, made some kale and eggs, and here I sit.

This isn't the first time I've been though a cycle like this, although this was the worst. For the most part in my day to day life I'm dong really well controlling the diabetes with diet and some mild exercise, but going out to eat, dates with friends, a night out with my husband, these are much harder for me to navigate and often leave me with whacked out blood sugars. I also pretty consistently have high numbers right when I wake up- and nothing has seemed to make much of a difference in that regard save eating yogurt and nuts around 3am, but I'm not always awake at 3am. And of course, this stresses me out. It stresses me out to think of my little turnip sized babies also going through weird sugar highs and lows, and their little pancreases working overtime to produce extra insulin because I made a ridiculous choice of a night time snack. And I worry that I will have to be induced or have a c-section early when we get near the end if I can't keep this under control. And I worry that when they are born they won't be able to regulate their blood sugars, and if they are small or early this could be another thing for their little bodies to handle in a rough transition into the world. I have been worrying.

It seems like the professionals counseling my on my diabetes don't completely know what to do with me. They are used to people with gestational diabetes being much further along in their pregnancies, carrying only one baby, and being overweight. At my first appointment the dietitian asked my with scolding in her voice "So, how much weight have you gained?" and was completely flabbergasted when I told her I'd actually lost weight since I'd been pregnant (how would she have reacted if I'd gained a lot? It seemed like a set up for some shaming, but I digress). Since then everyone keeps telling me I'll be fine, just keep eating, but my numbers are telling me differently. Also, since I'm in this for the long haul of the pregnancy, not just the third trimester, I keep getting the message that it's ok to splurge every now and then, but I'm not just not so sure. I've been so happy lately to have the energy to even go out, to see friends,  to sit in a restaurant and not find the smell of food completely repulsive, that I have been allowing myself to step outside the diabetes box from time to time, but I think as I see this pattern emerge, it is not worth the physical and emotional stress. My blood sugar is back in normal range now, but I still feel a little strange and jittery. In the end, it was a perfect date, and I don't want to ruin it with an overlay of guilt, but I have to be more careful. It was probably that bar more than dinner that whacked me out, but when I look at all the different cheats during the day yesterday, I wonder about the cumulative affect. I will probably have to go on some sort of medication soon to control those fasting morning numbers, and I can't help but feel like I've failed. And as someone who usually likes to do things naturally, I am on a lot of medication already! But then again, I suppose this pregnancy could never have occurred without medication. IVF is hardly natural.

The sun is up. I'm exhausted. Maybe I can forgive myself and sleep a while before it's time to go fetch Caden from his slumber party. Start the day again.

Gratitude

In 2013, I attempted a gratitude practice in which I wrote at the end of the day three things I was grateful for and three things I had accomplished. For me it is a retraining of the brain to focus my attention away from that which I lack, away from where I have failed, to what I have, and what I have done. At first the list of accomplishments felt silly, trivial. I folded laundry, I did the grocery shopping. But on the other hand these are the small tasks that make up my life. Then there began to be bigger accomplishments. I was about to yell at my son, but I stopped, I took deep breaths. I hid my phone for an hour and stayed present with what was happening. When I started giving myself credit for those small moments that are so important to me, I began to feel better about myself, and to have more of those moments. The gratitude practice and the accomplishments began to dovetail: "I am grateful for my connection with my husband; I put away my computer and spent time connecting with my husband." As powerful as this practice was for me, I let it lapse sometime in the fall, and with the advent of the new year, I decided I'd like to reignite some sort of gratitude practice.

 

Enter photographer Hailey Bartholomew. Right before the new year I happened upon this video that describes her journey from discontent to a place of gratitude. She decided for one year to take a picture every day of something she was grateful for. The idea spread through social media, and this year I decided to participate in the 365grateful project through instagram, in which I post one picture every day of something for which I am grateful.  I thought I'd share a small sampling of what I've noticed in the first few weeks.

Day 7: grateful for my husband's relationship with my son.

Day 8: grateful the two little satsumas in my belly are still growing strong.

Day 17: grateful for green.

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Second Trimester!

Our family configuration come spring. Photo from Fundacion Proteger. 

We made it through the first trimester! and it has been a wild ride. While I am still struggling with nausea intermittently and the remnants of the colds and the flu, I am out of bed and on my way to fully functional. After some crazy rain, I woke up yesterday to bright sunny skies. I met a friend for aqua aerobics at the gym, and joined about 30 senior citizens to splash around in the pool. Truth be told, after such a long time of being immobile, this kicked my ass! But I smiled the whole time, so grateful to feel my limbs move against the water, ecstatic to be chugging along with all these other joyful people just moving their bodies. In my head I was saying things such as "Oh, hello bicep! Hello calf muscles!" It felt like a slow reawakening. And I loved that there was nothing "cool" about it.

Cameron is going out of town for work, Becca is coming to stay with me while he's gone (!!!!!!!), and I have an appointment today to learn how to manage the newest complication with this pregnancy: gestational diabetes.

What to eat when dealing with pregnancy induced nausea

During this first trimester of nausea, I have often wished that someone would tell me what to eat. I am writing this in case there is someone out there who could benefit from my experience. Let me state for the record that normally I am a cook from scratch, whole food, low sugar kind of girl, but pregnancy, both times has put me in a survival mode of eating. At least during the first trimester. Everyone is different, but I thought it would be worth it to share my experience. There are many things I cannot eat, onions, garlic, and any kind of pepper being the worst offenders. I am also gluten intolerant, but my level of gluten free substitutes has sky rocketed in these past months. Some triggers for me for nausea and vomiting: empty stomach, drinking too much water at once, the smell of salami, getting overheated, standing in front of the fridge, coughing. Finding your triggers and avoiding them is very helpful. Also, staying hydrated and well rested can help lessen some of the symptoms. Some things that have helped have been an herbal supplement called nausea ease, psi wrist bands, hard candies, and ultimately the anti-nausea drug. Zofran. Now, without further ado, I bring you what to eat when you want to hurl.

Level one: you feel queasy, but in general if you eat you feel better. It's kind of like a hangover that goes on and on. In this state, here's what worked for me:

Tator tots

Grilled cheese

Mild lasagna

Pasta with kale sauce (read steamed kale pured with butter and cream or milk) and fresh mozzarella 

Toast with butter, almond butter, and honey

Cheese and crackers

Apple slices with cheese or nut butters

Chicken noodle soup

Nachos with no salsa

Rice and beans

Scrambled eggs

Quiches

Frittatas

Bacon

Avocados

Rice and meat

Wraps with slices of cooked chicken breast

Mild Enchiladas

Saag paneer

San Pelligrino sodas

Smoothies

Cottage cheese and canned peaches

Sushi with cooked fish (Philadelphia
roll, I love you).

Pretzels

Baked sweet potatoes with lots of butter

Papa de locro (cheesy potato soup from Ecuador)

Quesedillas

Level two:

The hangover is really bad. It's the kind where you do actually puke, but not often. You feel bad unless you are vertical, and even then...Your diet may become limited to:

Chicken broth with rice or noodles, maybe with a little avocado or well cooked carrot

Whole pinto beans in chicken broth

Scrambled eggs with cheese

Cold cheese sandwiches 

Brothy lentil soup

Plain yogurt

Toast

Electrolyte drinks

B-natal lollipops 

Hard candies

Tangerines

Jello

Sodas

Level three:

And then there is the kind of pregnancy induced nausea that can get you into trouble. In this form, it is hard to keep anything down and most of what you eat comes up. If you are not keeping anything down, you need to be in contact with your doctor or midwife, as you can get really dehydrated and that is bad for you and baby(s). In this state, you mostly want to stick with liquids with Calories:

Electrolyte drinks

Chicken broth

Instant breakfast drinks

There's my two cents. If you read this and have thoughts to add, please, fire away!

Selfie on a very nauseas day. Overall doing much better now- back in level one for the most part.

On trying to be a bear, and not a goat.

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Did you watch the little short? You should. It's good. My therapist gave me the homework of watching this video, and told me that it isn't hard to give an empathetic response to a friend, but what is really hard is to give an empathetic response to yourself. Her homework for me was to try and be more like the bear, and less like the goat with myself.

In the past two weeks, I have had moments where I have felt like I cannot possibly do this. The worst definitely came last Thursday, when my husband came home early from work not because I had been puking all day and felt terrible, but because he felt sick and needed to rest. In my head I screamed "No, no, No!!!! I cant do this. I cannot do this." And throughout that afternoon and night I had huge sobbing melt downs. What does it mean to say yes in moments like that? What does it mean to be empathetic with myself? The conversation in my head was something like this. "I can't do this. I can't. Well you have to. Buck up. BUT I CAN'T!!!!!" More tears. I was railing internally against what was happening, that I had been sick for two weeks, that I had been nauseous for a month, that I didn't have any child care for the next day, that my husband was sick and couldn't help me. And still some part of me was admonishing, "At least you are pregnant. This is what you wanted. This is what you asked for." I cried and puked and railed until I went to bed. I slept, and puked some more, and slept. In the morning, it felt like defeat, but it was really a small yes. A small leaning in. Yes, I feel terrible. Yes, I am not able to do this on my own. Caden ate cereal in my bed. He watched netflix at 8 in the morning. I called a sitter agency and paid the big bucks to get someone to come to the house immediately. I talked to my doctor and he prescribed me higher doses of anti-nausea medication. I went to see my other doctor, and she put me in the hospital for dehydration. I sank into that hospital bed and I said a big yes. To sleep, to IV fluids, to medicine to stop the vomiting, to someone taking care of me.

I sort of wanted everyone to know, "I'm in the hospital! This is some real shit!" because what I really wanted was that empathy, but the thing is, I had been getting it all along from my friends. I sat on my bed on the solstice crying and coughing and sneezing and peeing and nauseous and texted these moms that I hang out with most Fridays, and as their stories of peeing their own pants when pregnant and their stories of covering up baby pee with towels to avoid changing sheets came in. As they made me laugh and encouraged me to sleep and gave me so much love and empathy, I realized why I love them. They always do that. They are always ready to get real and love you when things are hard, and do not flinch to tell their own stories. They are bears. But I was being a goat to myself, thinking I should be stronger, healthier, more emotionally resilient, better able to buck up. It wasn't until I woke up Saturday with a fever and realized that I had caught what my husband had, and that I was looking at a brand new sickness, and then discovered that I actually had the swine flu, that I stopped beating myself up. At that point it was complete surrender.  I had to say yes. Not yes! This is awesome! But yes, I am very sick, and this is really hard, and yes, I have to rest and I need help.

I am slowly learning that this is what it means to lean in. Not to stay cheery and sunny and always optimistic, but to accept what is really happening and work with it instead of running away. For me, learning to lean in means learning to be more gentle with myself, and not judge myself for my experiences and emotional reaction. 

I am still sick, but I am starting to feel better. For now I will continue to embrace baby sitters and television and all the help I can get. I will try not to goat myself, but I do hope to be back on my feet someday.

If you want to read more about this whole yes idea, check out this post on my friend Becca's blog, Writing for Clarity.