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Monday, September 29, 2008

One more battle to hurdle (Haaaay...)

Just barely five more weeks to go but the challenges we are forced to hurdle seem to be endless. Saturday morning we went to take my Oral Glucose Tolerance Test which was actually ordered by my OB only as a sort of precautionary measure. She never requested to me to undergo testing because she found something unusual in my recent check up. Neither of us expected that it would usher in additional worries.

Per my OB’s instructions, I woke up at around 5am Saturday to fix myself an early breakfast. It was a light one consisting only of a cup of oatmeal and milk. After that I went back to sleep till 830am. My OGCT appointment was at 9am and we arrived at the clinic 5 minutes early. I took the glucose concoction at around 930am and was asked to come back at around 1025 so the lab technician could take a sample of my blood for testing. We were to come back for the results in the afternoon, just in time for my regular weekly check up with the OB.

At 4pm, the Hubby went up to the Lab to get my results. We got the shock of our lives when we saw the results. My sugar level was almost double the normal range. My initially reaction was of disbelief. How could this happen when I was very careful with my diet all through out my pregnancy. I still kept thinking the lab just screwed up with the test. I told myself not to panic and wait for my OB’s advise. The hubby was quiet all this time. I guess, he was also caught in a web of disbelief himself. He was after all the main witness of how cautious I was with my diet. He knew this was one of my worst fears. He’s probably thinking of how he can comfort me when the panic sets in.

A few minutes past and my OB came in. She called us in and had this to say, “What happened????!!??” I could only shrug my shoulders in response. She asked me if I ate or drank anything before the lab gave me the glucose mixture and told her the last time I ate was at 5am, just as she told me to. All this time, she had this worried look plastered on her face. By then I realized we are again facing one more crisis on this pregnancy. That was when I blurted out my earlier thoughts. How could this happen, I was so careful with my diet. I could count the times I ate dessert since I became pregnant. I was a dessert monster before but I gave that all up upon confirming my pregnancy. All this time, I told myself to stay away from chocolates because they were poison. And I did stay away from them as much as I can. I might have snuck in a morsel or two. But they were literally morsels and I only did that twice in the past 8 months. But then my OB told me, it was probably because of the genes knowing that my aunt is currently having a tough fight with diabetes. Then she told us, all we can do now is find a way to treat the diabetes before I go into labor. We have roughly about 5 weeks to do that. It’s gonna be tough but we just have to stay optimistic that we get this fixed before our baby comes out.

So she went to get me an appointment with a diabetic specialist. Monday came, I went off to see this doctor. And just as I expected she too was worried upon seeing my OGCT results. Normally, she said they would really suggest insulin shots for sugar levels that high. But thankfully, she too was doubtful of the results. So she’s ordering more tests before she prescribes the insulin shots. Now, she’s placing me on a stricter diet. But this same diet is almost similar to the diet I have been observing the past 8 months. Come Thursday, I will again take two more tests to confirm/(un)confirm the earlier findings.

While we count the remaining days before Maia’s arrival, all we can do is hope and pray (really hard) that it does not get more complicated than this. I can only wish that my baby won’t suffer much at birth. Prayers and a stricter diet are the only weapons I have right now for my baby and me. Haaay...I am really trying my best to stay strong and not let worry overcome me.

Baby center article on Gestational Diabetes

Long read but definitely loaded with information:

What is gestational diabetes?

This is a type of diabetes that some women develop during pregnancy. Between 2 and 7 percent of expectant mothers develop this condition, making it one of the most common health problems of pregnancy.

When you eat, your digestive system breaks most of your food down into a type of sugar called glucose. The glucose enters your bloodstream and then — with the help of insulin, a hormone made by your pancreas — provides fuel for the cells of your body. Like the type 1 and type 2 diabetes you can get when you're not pregnant, gestational diabetes causes the glucose to stay in your blood instead of moving into your cells and getting converted to energy. Why does this sometimes happen when you're pregnant?

During pregnancy, your hormones make it tougher for your body to use insulin, so your pancreas needs to produce more of it. For most moms-to be, this isn't a problem: As your need for insulin increases, your pancreas dutifully secretes more of it. But when a woman's pancreas can't keep up with the insulin demand and her blood glucose levels get too high, the result is gestational diabetes.

Most women with gestational diabetes don't remain diabetic once the baby is born. Once you've had it, though, you're at higher risk for getting it again during a future pregnancy and for becoming diabetic later in life.

How is it diagnosed?

Your blood sugar will be evaluated during glucose screening and tolerance tests.

How does having gestational diabetes affect my pregnancy?

These days, most women who develop diabetes during pregnancy go on to have healthy babies. Your practitioner will monitor you closely and you'll most likely be able to keep your blood sugar levels under control with diet and exercise, and by getting insulin shots if you need them. But poorly controlled diabetes can have serious consequences for you and your baby.

For most women with gestational diabetes, the main worry is that too much glucose will end up in the baby's blood. When that happens, your baby's pancreas needs to produce more insulin to process the extra glucose. All this excess blood sugar and insulin can cause your baby to make more fat and put on extra weight, particularly in the upper body.

This can lead to what's called macrosomia. A macrosomic baby may be too large to enter the birth canal. Or the baby's head may enter the canal but then his shoulders get stuck. In this situation, called shoulder dystocia, your practitioner and her assistants will have to use special maneuvers to deliver your baby. Delivery can sometimes result in a fractured bone or nerve damage, both of which heal without permanent problems in nearly 99 percent of babies. (In very rare cases, the baby may suffer brain damage from lack of oxygen during this process.) What's more, the maneuvers needed to deliver a broad-shouldered baby can lead to injuries to the vaginal area or require a large episiotomy for you.

Because of these risks, if your practitioner suspects that your baby may be overly large, she may recommend delivering by cesarean section. Fortunately, only a minority of women with well-controlled gestational diabetes end up with overly large babies.

Shortly after delivery, your baby may also have low blood sugar (hypoglycemia) because his body will still be producing extra insulin in response to receiving extra glucose from you. Your delivery team will test his blood sugar at birth by taking a drop of blood from his heel. If it's low, you'll want to feed him as soon as possible, either by breastfeeding or giving him some formula or sugar water. (In severe cases of hypoglycemia, he might be given an IV glucose solution.)

He may also be at somewhat higher risk for jaundice, polycythemia (an increase in the number of red cells in the blood), and hypocalcemia (low calcium in the blood). If your blood sugar control is especially poor, your baby's heart function could be affected. Some studies have found a link between severe gestational diabetes and an increased risk for stillbirth in the last two months of pregnancy. And finally, having gestational diabetes makes you about twice as likely to develop preeclampsia as other pregnant women.

Will my baby be monitored during my pregnancy to avoid complications?

Your practitioner may want to monitor your baby more intensively during your last two to three months of pregnancy, depending on the severity of your diabetes and whether you have any other obstetric problems. She'll explain how you should begin counting your baby's movements during your third trimester so you can alert her immediately if you sense that your baby is less active.

If you're unable to keep your blood sugar under control or it's high enough that you need insulin, or if you have any other risk factors, you'll probably begin to have fetal heart monitoring (nonstress tests or periodic ultrasounds around 32 weeks to check on your baby's well-being. (This kind of ultrasound is called a biophysical profile.) If you can keep your diabetes well under control without insulin and you have no other problems, you might not begin these tests until your last few weeks or until your due date.

Your practitioner may also order an ultrasound around 29 to 33 weeks to measure your baby and estimate his weight. At that point, if your baby is already getting too big, you might be started on insulin. She may order another one closer to labor if she suspects your baby is large, but ultrasound is not usually very accurate at determining a baby's size late in pregnancy. Depending on your circumstances, you might be induced before your due date, or your practitioner may recommend delivering by c-section.

NOTE: If your diabetes was diagnosed in the first half of your pregnancy, it's more likely that you had unrecognized diabetes before you conceived. In this case, your provider may order a fetal echocardiogram (an ultrasound that focuses on your baby's heart) because the risk of birth defects, especially heart defects, is higher if your blood sugar was high during the first eight weeks of pregnancy, when your baby's body was being formed.

How will I know if I have gestational diabetes?

You may notice that you're more thirsty, hungry, or tired than usual or that you have to urinate more frequently, but these are common, normal symptoms during any pregnancy. The fact is that gestational diabetes often has no symptoms (WHICH WAS EXACTLY MY EXPERIENCE). That's why almost all pregnant women are given a glucose screening to test for it between 24 and 28 weeks.

However, if you're at high risk for diabetes or are showing signs of it (such as having sugar in your urine), your caregiver will recommend this screening test at your first prenatal visit and then again at 24 to 28 weeks if the result is negative. If this test result is positive, it doesn't mean that you have gestational diabetes, but you will need to take a longer follow-up test for a diagnosis.

What factors would put me at risk for gestational diabetes?

According to the American Diabetes Association, you're considered at high risk for this condition (and should be screened early) if:

· You're obese (your body mass index is over 30).

· You have a history of gestational diabetes (you've had the condition in a previous pregnancy).

· You have a strong family history of diabetes.

Some practitioners will also screen you early if:

· You're found to have sugar in your urine (your urine is tested at each prenatal visit).

· You've previously given birth to a big baby (some use 8 pounds, 13 ounces as the cut off; others use 9 pounds, 14 ounces).

· You've had an unexplained stillbirth.

· You've had a baby with a birth defect.

· You have high blood pressure.

Keep in mind that many women who develop gestational diabetes don't have any risk factors. That's why most practitioners will order the screening at 24 to 28 weeks for all their pregnant patients as a matter of course. On the other hand, a small number of women may be considered at such low risk that they don't need to have the screening test at all. You're part of this group if you meet all of the following criteria:

· You're younger than 25.

· Your weight is in a healthy range.

· You're not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.

· None of your close relatives have diabetes.

· You've never had a high result on a blood sugar test.

· You've never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.

How is gestational diabetes managed?

It depends on how serious your condition is. You'll need to keep diligent track of your glucose levels, using a home glucose meter or strips. Eating a well-planned diet can help you keep those levels where they should be. The American Diabetes Association recommends getting nutritional counseling from a registered dietician who'll help you develop specific meal and snack plans based on your height, weight, and activity level.

Your diet must have the correct balance of protein, fats, and carbohydrates, while providing the proper vitamins, minerals, and calories. (Plan on little or no candy!) To keep your glucose levels stable, it's particularly important that you don't skip meals, especially breakfast.

This may sound daunting, but it's not so hard once you get the hang of it. And don't think of yourself as being on a "special" or restrictive diet. The principles of the diabetic diet are good ones for everyone to follow. Think of this as an opportunity to get yourself and your whole family into healthier eating habits. If everyone in the house is eating the same foods, you won't feel as deprived.

Studies show that moderate exercise also helps improve your body's ability to process glucose, keeping blood sugar levels in check. Many women with gestational diabetes benefit from 30 minutes of aerobic activity, such as walking or swimming, each day. Exercise isn't advisable for everyone, though, so ask your practitioner what level of physical activity would be beneficial for you.

If you're not able to control your blood sugar well enough with diet and exercise alone, your provider will prescribe insulin shots for you to give yourself as well. About 15 percent of women with gestational diabetes need insulin. It sounds scary, but remember that it's the high sugar and not the insulin that's dangerous for your baby. Recently, some practitioners have been prescribing oral medications (such as glyburide or metformin) instead of insulin for gestational diabetes, but the safety and effectiveness of these drugs is still a matter of debate.

Will I continue to have diabetes after my baby is born?

Probably not. Only a small percentage of women with gestational diabetes remain diabetic after delivery, and experts suspect that most of these women actually had undiagnosed diabetes before they got pregnant. To be sure, you'll need to have a glucose test about six to 12 weeks after delivery. This test requires an overnight fast and can be done at your six-week postpartum visit.

Does having gestational diabetes put me at higher risk for diabetes in the future?

Yes. About two-thirds of women who have the condition will go on to have it in future pregnancies. And a few studies have found that about 50 percent of women who get gestational diabetes will develop type 2 diabetes within the first five years after delivery. Your risk is highest if any of the following apply to you:

· You're obese.

· You had very high blood sugar levels during pregnancy (especially if you needed insulin).

· Your diabetes was diagnosed early in your pregnancy.

· The results of your postpartum glucose test were borderline (that is, they were relatively high, but not high enough to classify you as a diabetic).

Your practitioner will let you know how often you'll need your blood sugar tested, usually every one to three years if the results of your postpartum test are normal. Keeping your weight down, making healthy food choices, and exercising regularly can help you ward off the disease. You may also want to avoid using the progestin-only Pill for contraception after you have your baby. In women with recent gestational diabetes, it has been associated with an increased risk of developing type 2 diabetes.

Your child will also have a higher likelihood of childhood and adult obesity, and of developing diabetes. It's important to help him eat a good diet, maintain a normal weight, and stay physically active. Be sure your child's healthcare practitioner knows that you had diabetes during pregnancy.

For more information on diabetes, contact the American Diabetes Association.

Thursday, September 18, 2008

Books, books, and books =)

First time ko ata mag post ng meme (not even sure if this qualifies as such). pero natuwa lang ako sa kanya (reposting from tintin's lang actually) realize ko dami ko pa kelangan basahin...or tapusin basahin...

1) Look at the list and bold those you have read.
2) Italicize those you intend to read.
3) Underline the books you LOVE.
4) Reprint this list in your own Multiply so we can try and track down these people who've read 6 and force books upon them. ;)

1 Pride and Prejudice - Jane Austen
2 The Lord of the Rings - JRR Tolkien
3 Jane Eyre - Charlotte Bronte
4 Harry Potter series - JK Rowling
5 To Kill a Mockingbird - Harper Lee
6 The Bible
7 Wuthering Heights - Emily Bronte
8 Nineteen Eighty Four - George Orwell
9 His Dark Materials - Philip Pullman
10 Great Expectations - Charles Dickens
11 Little Women - Louisa M Alcott
12 Tess of the D'Urbervilles - Thomas Hardy
13 Catch 22 - Joseph Heller
14 Complete Works of Shakespeare
15 Rebecca - Daphne Du Maurier
16 The Hobbit - JRR Tolkien
17 Birdsong - Sebastian Faulks
18 Catcher in the Rye - JD Salinger
19 The Time Traveller's Wife - Audrey Niffenegger
20 Middlemarch - George Eliot
21 Gone With The Wind - Margaret Mitchell
22. The Great Gatsby - F Scott Fitzgerald
23 Bleak House - Charles Dickens
24 War and Peace - Leo Tolstoy
25 The Hitch Hiker's Guide to the Galaxy - Douglas Adams
26 Brideshead Revisited - Evelyn Waugh
27 Crime and Punishment - Fyodor Dostoyevsky
28 Grapes of Wrath - John Steinbeck
29 Alice in Wonderland - Lewis Carroll
30 The Wind in the Willows - Kenneth Grahame
31 Anna Karenina - Leo Tolstoy
32 David Copperfield - Charles Dickens
33 Chronicles of Narnia - CS Lewis
34 Emma - Jane Austen
35 Persuasion - Jane Austen
36 The Lion, The Witch and The Wardrobe - CS Lewis
37 The Kite Runner - Khaled Hosseini
38 Captain Corelli's Mandolin - Louis De Bernieres
39 Memoirs of a Geisha - Arthur Golden
40 Winnie the Pooh - AA Milne
41 Animal Farm - George Orwell
42 The Da Vinci Code - Dan Brown
43 One Hundred Years of Solitude - Gabriel Garcia Marquez
44 A Prayer for Owen Meaney - John Irving
45 The Woman in White - Wilkie Collins
46 Anne of Green Gables - LM Montgomery
47 Far From The Madding Crowd - Thomas Hardy
48 The Handmaid's Tale - Margaret Atwood
49 Lord of the Flies - William Golding
50 Atonement - Ian McEwan
51 Life of Pi - Yann Martel
52 Dune - Frank Herbert
53 Cold Comfort Farm - Stella Gibbons
54 Sense and Sensibility - Jane Austen
55 A Suitable Boy - Vikram Seth
56 The Shadow of the Wind - Carlos Ruiz Zafon
57 A Tale Of Two Cities - Charles Dickens
58 Brave New World - Aldous Huxley
59 The Curious Incident of the Dog in the Night-time - Mark Haddon
60 Love In The Time Of Cholera - Gabriel Garcia Marquez
61 Of Mice and Men - John Steinbeck
62 Lolita - Vladimir Nabokov
63 The Secret History - Donna Tartt
64 The Lovely Bones - Alice Sebold
65 Count of Monte Cristo - Alexandre Dumas
66 On The Road - Jack Kerouac
67 Jude the Obscure - Thomas Hardy
68 Bridget Jones's Diary - Helen Fielding
69 Midnight's Children - Salman Rushdie
70 Moby Dick - Herman Melville
71 Oliver Twist - Charles Dickens
72 Dracula - Bram Stoker
73 The Secret Garden - Frances Hodgson Burnett
74 Notes From A Small Island - Bill Bryson
75 Ulysses - James Joyce
76 The Bell Jar - Sylvia Plath
77 Swallows and Amazons - Arthur Ransome
78 Germinal - Emile Zola
79 Vanity Fair - William Makepeace Thackeray
80 Possession - AS Byatt
81 A Christmas Carol - Charles Dickens
82 Cloud Atlas - David Mitchell
83 The Color Purple - Alice Walker
84 The Remains of the Day - Kazuo Ishiguro
85 Madame Bovary - Gustave Flaubert
86 A Fine Balance - Rohinton Mistry
87 Charlotte's Web - EB White
88 The Five People You Meet In Heaven - Mitch Albom
89 Adventures of Sherlock Holmes - Sir Arthur Conan Doyle
90 The Faraway Tree Collection - Enid Blyton
91 Heart of Darkness - Joseph Conrad
92 The Little Prince - Antoine De Saint-Exupery
93 The Wasp Factory - Iain Banks
94 Watership Down - Richard Adams
95 A Confederacy of Dunces - John Kennedy Toole
96 A Town Like Alice - Nevil Shute
97 The Three Musketeers - Alexandre Dumas
98 Hamlet - William Shakespeare
99 Charlie and the Chocolate Factory - Roald Dahl
100 Les Miserables - Victor Hugo
101 Haunted - Chuck Palahniuk
102 Dream Jungle - Jessica Hagedorn
103 Gangster of Love - Jessica Hagedorn
104 Dogeaters - Jessica Hagedorn
104 The Words of Every Song - Liz Moore
105 Hairstyles of the Damned - Joe Meno
106 Tender as Hellfire - Joe Meno
107 The Snows of Kilimanjaro - Ernest Hemingway
108 As I Lay Dying - William Faulkner
109 The Brothers Karamazov - Fyodor Dostoevsky
110 Tuesdays with Morrie - Mitch Albom
111 For One More Day - Mitch Albom
112 A Wrinkle in Time - Madeleine L'Engle


Heading for the home stretch....

Today marks the completion of 8 long months of my body manufacturing its own version of tiny bones, organs, and muscles. Sometimes, the hubby and I can’t help but stare in awe at my very swollen belly. All the fears we have when we were just 3 to 4 months along seemed to have just melted away. Haha. At long last, just one more month of uncontainable excitement and we will finally see the tiny version of our genes combined. 

After confirming my pregnancy, I have been rigorously educating myself on how to keep myself healthy all through out my 40-week journey to motherhood. As my pregnancy progresses, so does the readings. Sometimes, the hubby would comment that this seemed to have become an obsession for me especially since I would always share with him whatever knowledge I have acquired during the day. There were days when what I read would really fascinate me. And then there were days when they would stir up the neurotic in me. But regardless of the mood that they were able to set me on a particular day, I always felt those things I learned were really fun, helpful and useful facts of/on life.

My greatest realization though is that through out this whole experience…I have become more patient, more cautious, and a lot more cheerful. This pregnancy has sort of led me to finding the better version of me. I guess, I might not be really consciously aware of this before but I think it is now the right time for me to affirm that this is one experience where I found the real purpose of my existence. J

Sunday, September 14, 2008

Hospital Ocular at 33 weeks

Good morning Maia!

Last weekend, Mommy and Daddy went to check on the hospital where they're expecting you to be born. It was okay. Met Mom and Dad's expectations added bonus was most of the people who knew Mommy's planning to give birth there has nothing but good feedback to share so that takes away Mommy's worries.

Doc Chie was a bit surprised when she realize you're homecoming is just about 6 weeks away. Mommy thinks she's just as excited as she and Daddy is. She was kidding Mommy though about Caesarean birth...but no...Mommy will prove she can do this. You're helping her right???

Last night, Mommy also packed up more of the stuff both of you will be needing come D-day! She's almost about 90% done. Good thing she made a list of all the stuff she needs to pack. Mommy's getting really forgetful lately. She sometimes wonders if she's transferred all her brain cells to you. But that's okay...anything to make Maia better is okay with Mommy.

Now that we're almost done with the packing, it's only Daddy who's still got a long list of to-dos. Let all hope he gets them all done before you come home. We can't wait baby...we are just soooo excited to welcome you.

Just 6 more weeks to go...

Fetal development in pregnancy week 33: fetus in eighth month for all the weight and bulk you’re lugging around these days, you’d think your little champ should weigh much more than a mere 5 lbs and measly 17 inches in height, but nope, that’s about the average size for a baby in its thirty-third week. In terms of appearances, they’re getting cuter and pudgier every minute as they pile on the baby fat for those adorable little wrist rolls and chubby toes. And as we’re sure you’ve already noticed they’re getting stronger with every passing day. Nowadays, it’s possible to observe a well-placed kick just by watching your belly—but you already knew that didn’t you? Although they’re getting stronger, your bigger-by-the-day baby is losing space to move around, so the actual rate of movement will drop off in the last few weeks, despite that powerful drop-kick they’ve been working on. Hey, did you know you’ll continue feeling their movements even during labor?

And how's mom doing? Here’s a good way to deal with your mounting impatience: map out your plan of action for the big day. It’s an important and necessary step that’s also pretty soothing and fun. So, get out a piece of paper and pen. If you think about it, planning all the details now can be a real saving grace once Massaging the perineum (the area around the vagina) can reduce your chance of it tearing during delivery the chaos and pain of labor starts up. This would include having a packed bag with a change of comfortable clothes, reading material, maybe an i-pod and your camera or camcorder (whichever you decide, if any at all). Know your driving route to the health center. Or if you’re delivering at home, make sure you have the delivery room prepared (equipped with your most favorite soothing music), and all necessary instruments and materials ready for use. Of course, get your doctor or midwife on speed-dial. Massaging the perineum (the area around the vagina) can reduce your chance of it tearing during delivery and there’s no time like the present to start. Be on your toes (not literally, just mentally) as it's now totally conceivable you might have to spring into action any day! Then again, it might still be another seven weeks

Wednesday, September 3, 2008

Approaching the home stretch...

Just 57 more days to go! For several weeks now you have been keeping Mommy awake on the wee hours of the morning. Daddy discerns you are indeed a night person and 3 am is when you start making your stretches for the day.

But Mommy cannot complain. When she was just 3 months along, she was already wishing she could feel you move so she'd always be assured that you are indeed growing inside her tiny tummy. Now the tummy's not that tiny anymore. It has swelled up to great proportions and Mommy cannot deny, she sometimes feel like a penguin when she walks. Sometimes you would start poking her near the ribs and she can't help but cry out. She was pretty sure you heard her so she makes a mental note to stifle the cries next time. Just so you won't get offended or anything. Because the pokes maybe painful but Mommy welcomes them whole heartedly.

Only thing is, Daddy gets upset when Mommy tries to wake him up too at 3am. But then Mommy assured him it's gonna be that way soon anyways so he might as well get used to it. But Daddy does not yield. Despite Mommy relentless call for him to wake up, he's only response is a louder snore. But Mommy knows he will come around pretty soon. Maybe sooner that expected. *wink*wink.
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