Limiting Weight Gain

I had an interesting conversation with one of our older semi-retired high risk OB docs this week. These days, we call them perinatologists or MFMs (maternal fetal medicine).  He works mainly with our diabetic patients, and he really encourages minimal weight gain in his patients.  For many of them, successfully maintaining their weight during pregnancy is an empowering experience, because it’s the first time in their lives that they’ve been successful at something related to their weight.

We also started talking about normal weight women.  He actually thinks it’s better for normal weight women to gain on the lesser side.  His thought process is this- besides the baby, one gains over 20 lbs from everything else like the amniotic fluid, increased blood volume, etc.  Until recently, food was generally scarce, which is why women have evolved to have more insulin resistance in pregnancy.  So he thinks that our bodies are better evolved for food scarcity, and therefore we probably do better if we actually are leaner than our baseline.  In other words, if a normal weight woman gains 25 lbs, then she’s leaner than her pre-pregnancy weight because she has gained 25+ lbs of baby + pregnancy-related body changes.

And by do better, he means healthier pregnancies- women feel better, have less physical symptoms, more energy.  Though I did tell him that my little guy is still sucking the life out of me, and I feel fatigued all the time.  And babies will tend not to get too big if one doesn’t gain excess weight.

I’ve never talked Paleo with him, but I did find it interesting that his thought process is similar to what those of us familiar with the Paleo lifestyle already know.  The basis of our Paleo lifestyle has in part to do with the scarcity of food as mentioned above, particularly the sugar and carbs.  It hasn’t worked for me, but many partake in intermittent fasting as well.

What also took me by surprise is that he guessed how much weight I’ve gained so far- 18-19 lbs, which was right on the money.  At 33 weeks, I’ve gained about 19 lbs now.  I suppose I’m “lucky” in that I still feel a little sick if I eat too much, so that has prevented me from excess weight gain.  But I know that is not the case for most of my patients, and I am still with everyone when it comes to pregnancy cravings/inclinations.  I’m more inclined towards carbs and sugar- maybe because my husband’s in France, I’ve been wanting pastries lately.  I try to be reasonable with that stuff, but I can see that it’s a challenge for most women.  We live in a day and age where this kind of food is all around us, easily available.  And it’s really, really hard to fight one’s inclinations toward certain foods in pregnancy.

It’s also tough because one already feels guilty for many things during pregnancy.  I try not to beat myself up too much when I have one of my carb binges.  A lot of my patients, who of course are less knowledgeable than I am, get worried about too many little things.  When I talk about excess weight gain with my patients and their partner is with them, it’s interesting how the partner will rat them out on what they’re eating too much of.  But on a day-to-day basis, the partners are trying to be supportive, and don’t want to be too mean and turn into the food police.  My own husband keeps reminding me that I’m doing a good job taking care of Little Willie, since my inclination is to feel bad when I do things I think I shouldn’t do, like down a whole bag of cheese popcorn in one sitting (hey, at least it was organic!).  I can see how it would be tough for partners to try to remind the patients to be more careful about what they’re eating- telling a hormonal woman, with various daily discomforts, to hold back on her cravings?!

Ultimately, there’s no easy answer and every woman is going to have an individual experience.  I do agree with the high risk OB doc that it’s best not to gain too much during one’s pregnancy.  Just wish it were easier for most women.

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Scent Memory

What a difference a year makes.  We celebrated our first wedding anniversary last weekend, and my growing belly is the most obvious change.  We actually didn’t move in together until a couple months before the wedding, so that was a big adjustment for us.  I had been living alone, he with roommates.  So we had to get used to sharing space, biggest of all sharing a bathroom.  My husband was horrified at all of the long hairs I’d shed all over the place.

After my trip to Iceland, now it’s my husband’s turn to travel.  He left this week for France, where he lived his dream of watching the Tour de France in person.  He gave me a heads up as to where he would be, so I actually caught a glimpse of him on TV yesterday!  He’s going to do his own bike tour of Provence, then end with watching the Tour de France finale on the Champs-Elysees.

Though I knew I’d miss him, I figured I’d also enjoy being able to leave my hairs wherever I please, and in general do what I want around the house.  But being pregnant and tired much of the time, and oh yes- still working 65 hours some weeks has made it tougher than I thought it would be to be alone.  Something small set me off into a crying fit today (damn pregnancy hormones!).  Summer tends to be busier at work since it’s a popular time for my co-workers to take vacations.  So I’m working a couple weekends in July, and even on weekends like this one when I’m not working, I feel like I have so much to do.

With our baby shower quickly approaching, I need to work on the registry.  My husband was great and did a ton of research on strollers, car seats, etc. prior to leaving.  So he has made it as easy as possible for me, but that still means I have to go to the baby store this weekend.  And I hate going shopping at prime time when it’s super crowded.  And there’s still a lot of online work to do to add the smaller items.  As anyone who’s been through it can attest to, it’s overwhelming with all of the choices of baby stuff.  Thank goodness I have friends who have been through it who can help with letting us know what we really need and don’t need.  But we still have to put the registry together ourselves.

So anyway, back to the title of today’s post.  Our wedding anniversary reminded me of something a friend suggested for our wedding.  Scent can evoke powerful memories- when I smell a tatami (straw) mat, I think of Japan and my grandparents’ houses, since they use those mats on the floors of traditional Japanese houses.  Well, a novel idea that she’d heard about and passed along to us is that you can create your own scent memory to associate with the wedding.

The bride and groom each pick a fragrance to use only during the wedding and honeymoon.  I’m not really a perfume person, so I chose a matching body wash and lotion.  We only used it when we were at the hotel we stayed at for the wedding, our mini honeymoon to Cancun later that week, and for our delayed honeymoon to Morocco and Spain.  We never used it at home.

After that, you get to bust out the wedding scent once a year during each anniversary.  The idea is that you create a scent memory, which evokes happy memories when you smell the scent.  You are allowed to sniff it once in a while if you need a pick-me-up.  While I can’t say the scent memory for me is as specific as the tatami mats = grandparents’ houses, smelling it again after so long definitely makes me happy.

I’m not planning on creating a specific scent memory to go with the baby, but I do wonder if people inadvertently end up with some.  There must be baby products- wipes, bath products, etc. that later for the parents evoke memories of when their kids were babies.

The Chris Christie Look

At 31 weeks, this is a pic of me holding on to my last days of wearing small scrub pants:

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My husband calls it the Chris Christie look, referring to the famously portly New Jersey governor.  With the scrub pants completely untied, they can still make it over my belly.  And mind you, not all smalls are created equal, so these are the looser ones.  You can also see the top of my compression leggings underneath.  When I sit down after I’ve eaten, the pants get a bit constricting, so it’s time I move on to the medium pants.

Strangely, through the course of this week, the swelling resolved.  Over the 4th of July weekend while we were in Tahoe, I ate a ton of ice cream and had Hot Cheetos for the first time in years.  And I was in the car for long hours on the trafficky drive home.  I don’t know if it helped to wear the compression gear all week and elevate my feet at night.  After eating more sensibly, I wonder if that had an effect as well.  I had ballooned suddenly several pounds over the weekend with water weight, and then lost it through the course of the week.  Thank goodness!  It feels so good for my feet to look normal again.

Though I don’t know exactly what caused and resolved my swelling, it certainly doesn’t hurt to tell my patients that anecdotally, I did better when I laid off the junk food.  And compression gear is good, just wish it didn’t get so hot, particularly in the summer.  Early in the week, I rushed and ordered some Crocs to wear with my scrubs, because the clogs I normally wear were really tight.  Guess I won’t be needing them at the moment, but it’ll be good to have on hand in case the swelling returns later.

Beef and Southern Greens Recipe

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Thanks to my inclination for carbs during this pregnancy, I haven’t been posting much Paleo-related material.  But there is one dish that I consistently find very satisfying.  It’s good for me, since I get protein and iron from the beef, plus it’s got the healthy greens.  Best of all, it’s very easy to make, particularly if you live near a Trader Joe’s.  It’s my husband’s creation, and he’s not much of a measuring type of guy, so I apologize ahead of time since the recipe isn’t super exact.  But it’s easy to adjust things to your taste.

So here it is, the soon-to-be world famous Little Willie’s Papa’s Beef and Southern Greens recipe:

  • 1 bag Trader Joe’s Southern Greens Blend
  • 1 package Trader Joe’s Braised Beef Roast
  • Beef broth, about 1-2 cups
  • Tomatoes, chopped into large cubes (optional)
  • Hot sauce (we use Cholula), about 1 oz.
  • Garlic powder, heaping teaspoon

Here are the two main ingredients that you can find at Trader Joe’s:

Southern Greens BlendBraised Beef Roast

First, take about a cup or two of beef broth, enough to cook the greens in a large pot.  Just take the bag of greens, empty it into the pot with the broth, and boil until the greens shrink down and wilt.  If you’re adding some tomatoes, feel free to add them now.

Now open the package of beef, and if you’re lazy like me I just plop the whole sucker in there, including the sauce.  I later break it up into smaller pieces in the pot.  Or if you prefer, you can cut up the beef into smaller pieces before adding it to the pot.

Now for the seasoning.  We have a 5 oz. bottle of Cholula hot sauce, and I’d say my husband adds about an ounce of it, as well as a little of the Cholula Chipotle variety we have in our kitchen.  I have no idea about the hotness of Cholula compared to other hot sauces, so if you’re working with something else, it’s always safe to add conservatively and you can always add more.  My tolerance for spice is medium- I can take some heat, but when my Indian friends say, “Don’t worry, it’s not that hot” I have learned to never trust them.

My husband likes more spice, so he’ll add a little cayenne as well.  I don’t find it necessary.  Once you’ve added the hot sauce to your liking, then add a heaping teaspoon of garlic powder.

That’s it!  Then just let the thing simmer for 20 minutes.  If you had plopped the beef in whole, then as it gets more tender you should be able to cut it into smaller pieces fairly easily.  The way we make it, the stuff does get a bit soupy with the excess liquid, but I enjoy that part as well.  Bon appetit!

Body Takeover

As my husband put it the other day, I am now very pregnant.  I’m 31 weeks, and I disagree a little in that compared to someone who’s full-term, I’m not quite THAT pregnant.  But yes, at this point there is no hiding the bump.

It’s an interesting experience having my body change so rapidly.  I think every woman must have some body image issues arise.  Although I have my days when I appreciate the beauty of the process, I think it’s unsettling for most of us to be putting on weight, even when we know it’s normal and recommended.  Since going Paleo, I had lost and kept off about 15 lbs, so there is something disturbing about going back up to that weight and exceeding it now.  If a woman is a normal weight to begin with, she should gain 25-35 lbs total in her pregnancy (less if she is overweight or obese pre-pregnancy).  Clearly the baby is only going to contribute so much to that, and you have a little contribution from the amniotic fluid, increased uterine size, etc.  So really we all are getting a little chubbier than our norm.  And I think that is unsettling for most of us.

Now, if I knew my body would go back to how it was pre-pregnancy, great.  Seeing celebrities probably makes most women think that’s possible.  But the reality is that my body will never be the same.  As my husband marvels at my rapidly growing belly, he jokes about how did I let this happen to me?  I fear stretch marks, and I already have some from previous weight gain.  But many women get them on their abdomen with pregnancy.  I think it’s likely genetic- I see some women who get to full term with pristine bellies, and others with a lot of stretch marks.  After, many women just have some light marks left, but a few get permanently wrinkly skin.  I have no idea how well the various stretch mark creams and oils help, but I have a feeling they only do so much.  Ultimately the thing we have control over is not gaining excess weight in pregnancy.  Beyond that, genetics will probably determine how bad the stretch marks will be.  I don’t recall my mom having a lot of stretch marks on her abdomen, so I’m keeping my fingers crossed.  And using some Ayurvedic anti-stretch mark oil for good measure.

This weekend, I started having a little more swelling of my feet, but I was also sitting in a car for long hours on the way to and from Tahoe.  And eating more junk food than usual.  So I thought that was why.  Well this morning, I woke up and my right foot was quite swollen and my usual work clogs were tight.  Thank goodness I did find some work-appropriate shoes that fit.  But still, makes me feel so gross to have what my husband describes as Nutty Professor feet.

Add to the swelling the extra fatigue, a noticeably more uncomfortable abdomen, and the hot summer weather.  For the first time today, I’m feeling pretty uncomfortable in general, and wonder if I’ll be able to work through my 36th week ok.  I know it’s normal, but it is annoying to no longer be able to bend over comfortably to put lotion on my lower legs and such.  Some of my colleagues had mentioned having to raise the exam table up really high to do pelvic exams.  It’s funny, but true.  We do a little hunching over on our stools to peer in for the Pap smears, and with a pregnant belly, it’s not as easy to do.

I’m realizing that the summer weather does not go well with the extra layers of maternity wear.  Most maternity pants have the bands go up the whole abdomen.  I’ve purchased some compression leggings, but haven’t been wearing them daily since that extra layer underneath my pants gets hot.

For the summer, I find that lightweight dresses are nice, since you don’t need that extra layer on the abdomen like with the maternity pants/shorts.  But it can be tough to find cute stuff.  I personally find the more fitted dresses to be more flattering.  I don’t mind showing off the bump, and frankly the looser fitting dresses just make me look fat and like I’m trying to hide something.

As this parasite further takes over my body, I’m desperately trying to hold onto my positive body image.  Not easy when you have huge sausage feet!  Elevating one’s feet is a good thought in theory, but not so easy when you have things to do, and at night you can’t sleep on your back.