gestational diabetes

17 weeks.

I’m beginning to realize that what is intended to be a story about post-HELLP pregnancy may very well end up mostly being a story about pregnancy with gestational diabetes. I guess if I help somebody along the way, it’ll be worth it.

I went to my OB earlier this week, and was told that since I’ve been unable to control my fasting blood sugars I would have to begin medication. She gave me a choice between injections and a pill. I chose the pill, because, let’s be real here: needles are awful. I endure enough pain as it is checking my blood sugars four times a day, and I really don’t want to add to that! So, she prescribed Glyburide for me. I took it for the first time last night, and my fasting blood sugar this morning was not improved. At all. In fact, it’s exactly the same that it’s been all week. We’re not talking scary, I’m-gonna-die-in-a-diabetic-coma blood sugar, so don’t get all worked up. But just knowing that my body isn’t working the way it should, and despite my best efforts (working out, eating healthy, controlled portions) isn’t coming around at all, is extremely scary and frustrating.

And come on, let’s face it: Thanksgiving is this week! All I really want to do is eat stuffing and drink eggnog! Facing the truth that I can’t eat my weight in pie in a few days is devastating. Honestly, I’m tearing up at the thought.

I’ve never been particularly athletic, but I haven’t lived a sedentary life, either. I did theater for most of my life, which may not be as intense as training for the Olympics, but is fairly physically demanding. Up until a few months ago I always worked jobs that required me to be on my feet and briskly walking around all day. I love pie, eggnog, stuffing, and the occasional Big Mac, but I also love to snack on apples, carrots and peanut butter, and I drink so much water that I pee clear all day. I’m tall and slender and everyone who first meets me assumes that I’m a dancer or a runner or some sort of athlete and while it’s true that I’m not, I’m not unhealthy.

It doesn’t seem logical or fair that this should happen to me. So many women are overweight, sedentary, terrible eaters, soda drinkers, and so on. And yet so many of them go on to have completely “normal,” healthy pregnancies. Why me?

And then I slowly pull myself out of my pity-party. I remind myself that bad things happen to good people. God uses all situations for good. And while it’s easy to judge and think “life isn’t fair,” that’s the exact opposite of what is useful, good, and right.

…Right?

one is a-walkin and... one's on the way!

I have embarked on what will be, and already is, the most challenging and nerve-wracking of my life experiences thus far.

Post-HELLP pregnancy.

All I know is what my doctor can tell me (which is helpful, but really isn't that much information), and what I've read on the internet. And the fact that my writing THIS is actually going to be a significant amount of internet information is proof that even the endless internet is sparse when it comes to post-HELLP information. (If you are clueless as to what HELLP Syndrome is, please check out my previous posts. Information galore, as well as my personal experience!)

We are set to welcome our new bundle of joy on May 4, 2014.

Alastair and I are completely ecstatic, while still nervous.

As of today, I am 16 weeks pregnant. I've had infrequent, but somewhat severe headaches, exhaustion from time-to-time, and blood sugar issues that have yet to be entirely sorted out. (I experienced gestational diabetes with my first pregnancy.) My OB has me on a low-dose aspirin regimen. As it's been explained to me, low-dose aspirin may sometimes possibly lower the severity of preeclampsia symptoms, though not enough research has been done to be sure.

Well, that's all I've got for now! I'll be posting my experiences as a high-risk pregnant woman who is concurrently a wife and mother of a toddler. It's sure to be an adventure, and I look forward to sharing it with you!

Boston Promise Walk for Preeclampsia

It was just under a year ago that many of you were praying hard for Maggie and me. Two weeks before she was due to be born, Maggie was taken by induction when I suddenly was discovered to be suffering from severe Preeclampsia and HELLP Syndrome. After a harrowing weekend, just when we thought things were about to get easier, Maggie started having fainting/ lapses in breathing spells, and my symptoms from HELLP started to get worse. We stayed in the hospital for about a week and a half. Alastair drove back and forth from his job in Burlington to Tufts Medical Center in Boston every night. We prayed, we cried, we welcomed visitors, we began to adjust to the idea of never getting a good night's sleep ever again (OH, the joys of parenthood!). Maggie got the hang of breathing regularly, and gradually my platelet and liver levels went back to normal.

I have spent the past year learning everything I possibly could about Preeclampsia and HELLP Syndrome. My doctor visits while pregnant had mentioned Preeclampsia, but never as something that was actually a legitimate cause for concern. I had never even heard of HELLP Syndrome. That first night that I felt so sick and ended up in the hospital, I almost just slept through the night. My husband insisted that we go to the hospital. Once there, my doctor and nurses almost sent me home. The pregnancy complications that almost killed me and Maggie almost got completely overlooked.

No one knows what causes Preeclampsia or HELLP Syndrome. Sure, there are some common risk factors-- being overweight, being over the age of 30, having a history of Preeclampsia in the family. I had none of these.

Preeclampsia and HELLP Syndrome affect such a small percentage of pregnancies that they're usually overlooked in educating pregnant women. Some research happens, but it's hard to research something if you don't even know it's there until you're already dead.

 

The Preeclampsia Foundation is one of the few organizations that is doing actual research and has a vested interest in educating pregnant women about the warning signs of complications like Preeclampsia and HELLP Syndrome. On September 15th, Alastair, Maggie, and I will be participating in the Preeclampsia Foundation's Boston Promise Walk for Preeclampsia. Our team is called "HELLP Awareness." The fundraising goal for our team is $2000. So far we've raised $890. I am so happy to have raised this much for a cause that is so important to our family... but we're not there yet!

Please take a moment to visit my page and consider making a donation-- big, small, doesn't matter! This cause is so unbelievably important to me that every penny counts.

http://www.promisewalk.org/pfpw/participantpage.asp?fundid=4310&uid=13507&role=3

 

Then:

 

Now:

 

Worlds Apart

I felt my Irish skin sizzling as I sat in the back of a tap-tap. I heard a chorus of “blanc! blanc!” coming from all around me. The stench of animal and human defecation, burning trash, and rotting food and flesh filled my nostrils. Billy knocked on the window to get my attention and said, “okay? okay!” He stepped on the pedal, and off we went.
***
“‘elp me?” An aged woman pulled back a blanket to reveal a tiny face, no more than a few hours old. I gasped, horrified, and waited for Sadrac to translate the full story.
“Her neighbor has five babies. HIV. No food. Baby in the trash,” Sadrac told me. I felt breakfast coming up my throat.
I rushed the premature and starving baby in to see Dr. Carter. The clinic had been set up just a week before with HIV testing facilities. Half an hour later our fear was confirmed. She needed care that our little clinic could not provide. In the US she would have been airlifted to the nearest major hospital, but in Titanyen, Haiti, she was bussed and taxied to the only major hospital. Jennifer, a volunteer nurse, a soft-spoken southerner with kind blue eyes and the prettiest blond curls, was sent to accompany the baby on the half-day’s journey to the hospital in Port-Au-Prince.
***
At 5:30 AM the fan in our room turned off, and I woke up instantly when sweat started to pool all over my body. Mosquitoes, no longer warded off by the fan, swarmed around my face. I climbed out of my top bunk and went to get some breakfast. Dr. Carter was sitting at the table talking to Jennifer, who had enormous black circles around her red-tinted eyes.
“What happened?” I asked anxiously.
She looked at me and spoke. “She…,” Jennifer choked on that one word and gasped as tears poured out of her eyes.
Dr. Carter finished for her. “She didn’t make it through the night.”
***
Anitha enunciated every consonant and puckered her lips as she spoke through her thick Creole accent. “Sawah, what do you do at home?” She sorted vitamins on the counter of the Mission of Hope’s pharmacy.
“I work at Starbucks.”
“Eh?” Anitha stared at me, raising her eyebrows in wait for me to actually answer her question.
“I work at…,” Sudden realization must have flashed across my face. “I work at a coffee…,” My eyes looked away as I thought hard. “I sell coffee. And food. Breakfast.”
Anitha nodded. “Oh! You like?”
“Yes… yeah, I like it.”
***
“Can you just drop off these de-worming meds on your way to the beach?” asked Dr. Carter, a wrinkly, retired, seventy-three year-old man with a thick southern accent who spent two weeks every other month volunteering at the Mission of Hope Haiti.
“Sure can!” said Andy, a pudgy New Englander who was, like me, on his first visit to a third world country. On the last day of our trip, our guilt-ridden beach day, Andy, the rest of our group, and I stopped at the same orphanage we’d visited a few days before. We were armed with a Ziploc bag of little white pills, and a party sized bag of Dum-Dums. At their teacher’s command, 45 orphans age 11 months through 14 years lined up for candy. The little ones cried when the medicine touched their taste-buds, but lit up when the flavor was put out by a Dum-Dum.
***
“Sarah! Get in here!” yelled Dr. Carter from the patient examination room.
I poked my head in the door. “Yes?” I asked expectantly.
“Here, take this. You’ve given shots before, right?” He extended his arms, and I saw in his hands a large syringe and vile filled with red liquid.
“What! You’re kidding! You do it. I don’t know how to give a shot.” I held up my hands in protest and started to back out of the room.
Dr. Carter laughed and said, “you have to learn sometime if you’re gonna be a nurse!”
“No I don’t! I’m not even sure I wanna be a nurse!” My eyebrows were raised sternly. “Oh, get over here. It’s easy.” Dr. Carter smiled and beckoned me into the room. Billy, the translator, spoke in Creole to the confused man sitting on the examination table, who laughed. He had yellow teeth and orange hair, a look that meant malnutrition. I stepped into the room, and Dr. Carter handed me the syringe and the vile. “Like this.” He motioned with his hands, and I reluctantly obeyed. I filled the syringe with Vitamin B12 and stabbed the needle into the Haitian man’s bony arm. He covered a wince with a gaping smile and a loud “merci!”
***
“What color is the discharge? And is there any burning or itching?”
Vena had a quick Creole conversation with the young patient, who had the saggiest A cup I’ve ever seen. “Yellow. Itchy.”
I inhaled quickly at the visual in my mind. My nostrils were greeted by putrid body odor. I wrote on my notepad and said, “anything else the matter?”
Vena again spoke to the old woman. “Diarrhea. That’s it.”
“Okay. She can go wait in there and then somebody will come get her.”
***
I wheeled my suitcase around a pile of cow dung and up a steep ladder. The stewardess smiled. “Do you need any help finding your seat?” I shook my head.
***
“I’m starving,” said Andy.
“Chili’s. I want Chili’s,” I said as I stepped into Miami National Airport.
Another member of our team said, “I don’t care where we go, as long as I can get a Bloody Mary.”
***
“Thank you for choosing Starbucks! This is Sarah. What can I get for you?” I spoke into my headset in response to the DING! in my ear.
“Ah, yes, I’d like a Venti Java Chip Frappuccino with whipped cream and extra chocolate drizzle,” said a sickly obese woman from her front seat.
“I’m very sorry, but we’re all out of Java Chips right now, so there won’t be any chunks in your Frappuccino. Is that okay?”
“What do you mean you’re all out of Java Chips? This is ridiculous. Never mind.”
I heard tires squeal, and she was gone.

Let's Talk about HELLP

            In general, it’s true that you can’t spend your life wondering, “what if?” But… what if you could?
            My experience with Pre-Eclampsia and HELLP Syndrome was much similar to that of other women: completely uneducated. My experience was different than that of other women in that both my daughter and I survived, more or less without harm.

            HELLP is an extremely rare variance of Preeclampsia that can happen with or without previously occurring Preeclampsia symptoms. It stands for Hemolysis (the breakdown of red blood cells), Elevated Liver function, Low Platelets. Since it more often than not occurs in concurrence with Preeclampsia, doctors don’t generally do a blood test unless there are other non-HELLP preeclamptic symptoms occurring. There are no risk factors, no known causes, no known reason for this complication to occur. Of the women who develop HELLP, more have Preeclampsia than not. More have Gestational Diabetes than not. More are Caucasian than not. More are over the age of 30 than not. And yet within those categories, there is no increased risk of developing HELLP, since it is still so rare. And any link between those categories and the occurrence of HELLP is completely unknown.

            HELLP Syndrome can happen anytime during pregnancy up until 72 hours after delivery. The onset is generally sudden, and symptoms severe. HELLP Syndrome was identified by Dr. Louis Weinstein in 1982. Prior to 1982, HELLP was a silent killer. You know in all those old books and movies, when a character would ask about someone’s mother, and be told “oh, she died in childbirth…?” HELLP. Seizures, bleeding to death, a shut-down liver. Dead. Oftentimes both mother and baby, in a matter of hours. The warning signs often include “feeling kinda weird.” The only cure is delivery.

 

            What if my husband and I had been driving TO vacation instead of back home? I probably would have had a seizure in the middle of a lake in New Hampshire.

            What if I had just gone to sleep when we got home?

            What if I had continued arguing with my husband about going to the hospital?

            What if the nurses and doctor had trusted their instincts that I was suffering from “food poisoning?”

            What if my blood pressure hadn’t been SLIGHTLY elevated due to stress, encouraging my doctor to order a blood test?

            What if I didn’t live near Boston, which is home to many of the smartest doctors on EARTH? What if I had to stay with my hometown OB, who had never heard of HELLP and was still using the outdated term “toxemia?”

            What if I had developed HELLP when I was 22 weeks pregnant, instead of 38? What if my daughter hadn’t been ready?

           

            My husband, daughter, and I are beyond blessed to exist as an entire family. I thank God every day for my daughter’s life and mine. I spent the first several months post-partum adjusting to being a mother and trying to forget all the pain and horror and terror that I went through in the 36 hours before my daughter was born. But now, as life has settled down a bit (or I’ve just gotten used to the madness of having a small child!), I’m realizing that it would be irresponsible and potentially murderous for me to “forget” and remain silent. If I am capable of helping someone and fail to do so, I have failed as a mother and as a human being.

            I had never heard of HELLP syndrome throughout my entire pregnancy. I read all the pregnancy books, and I obsessively scoured all the pregnancy websites, yet saw nothing about this horrible killer. Even information about Preeclampsia was rare—it’s as if doctors don’t put the information out there so as not to scare the hypochondriacs. After all, it IS rare. But what about those of us who actually get the sickness? Don’t we deserve to have some knowledge before potential sudden death?

            I’m not going to forget, and I’m not going to stop talking about it. I’m going to bug my doctors, and remind them to educate themselves as well as their patients. I’m going to talk about HELLP syndrome to every single person I can, for as long as I can.

homemade vegetable broth!

Beef broth, Chicken broth, Vegetable broth... broth, broth broth!

If you cook a lot, you probably use a lot of broth, whether it's in soups or to add flavor to rice or beans, or any number of things. I use a lot of vegetable broth, and I figured out that I was probably buying a box or two a week.

I haven't bought a box of vegetable broth in MONTHS, ever since I learned this incredibly easy way to make my own!

Whenever I cook with vegetables, I throw the extras in a medium sized pot. "Extras" means onion skins, garlic skins, carrot ends, celery ends, potato peels, eggplant ends... any part of a vegetable that you wouldn't normally eat.

Next, cover the contents of the pot and bring to a boil. Lower the heat and leave to simmer for about two hours. Add salt to taste... I'm not a fan of that "low sodium" garbage, so I add quite a bit :-)

While simmering for about two hours, continue to add water if it boils off. After allowing it to cool, strain it and store in the refrigerator until use!

homemade yogurt

Yesterday I spent most of the day thinking "what am I going to do with this milk? The sell-by date was yesterday... it's going to be bad any minute now!" I didn't feel like baking, didn't have the patience for tapioca pudding... a few google searches later, I came up with an idea that not only excited me, but also terrified me.

Homemade yogurt. Yogurt is alive. Do I really trust myself not to poison my entire family?

I figured I'd give it a go.

I found several recipes online and tweeked them to fit what I had on hand.

CROCKPOT YOGURT

you will need:

Milk. You can use nonfat, %, or whole, depending on what you have in the fridge and what you want for yogurt.

Yogurt. An individual serving size container works well. Plain is the most obvious choice for flavor, but I used vanilla and it came out just fine. It must have live active cultures!

I had about quarter of the carton left in a half-gallon that was about to expire, so I added some milk from a new carton. And I only had vanilla yogurt, so it had to do.

 

 

Pour the milk into your crockpot and turn it to low heat. Leave it for about 2.5 hours.

 

 

 

After 2.5 hours have elapsed, turn the crockpot OFF. Leave it on the counter like this for about 3 hours.

 

After 3 hours have elapsed, uncover the milk and stir in the yogurt. Replace the cover, and leaving it off and/or unplugged, wrap the entire crockpot in a large bath towel.

 

 

 

Leave it like this for 7-8 hours. After seven hours have elapsed, you can check the consistency of the yogurt.

 

And the, TA-DA! You have a ton of yogurt that cost WAY LESS than buying it in the store.

 

I was able to fill an empty quart yogurt container, as well as most of a pint container.

 

And here's the best part... it is without a doubt the BEST yogurt I have EVER tasted!