Pregorexia is not for me!

I stumbled across this article yesterday while reading the Health section of the New York Times and found myself quite disturbed by it. Of course I already knew that some women start or continue their eating disorders even while pregnant, but somehow reading about this woman's story made it all the more real to me. I think what bothered me the most was the realization that that could have been me, that, as a former anorexic, there is always the potential to slip back into that mindset and those destructive habits. Now that I've experienced pregnancy for myself, I understand how it could act as a major trigger for a woman who's already struggled with an eating disorder in the past or who is at risk for developing one. It's not just about the weight gain, although obviously that does play a large part. I think it's also about losing control, over your body, your sense of self as a woman, your perceived freedom, your relationship with your partner, your emotions, your visions of the future, etc. Your life is about to completely change, and for people that dislike change, that can be terrifying.

I would generally consider myself to be a person who dislikes change, but I am looking forward to this one, and I am proud to say I have not been tempted at all to engage in any potentially harmful eating or exercise habits. In fact, the thought of doing so, and possibly putting Ziggy in harm's way, makes me feel sick. I must admit, occasionally I do feel a bit anxious about the future, about what it will be like to raise a child, but it's more like the nervous anticipation that one feels when awaiting something new and exciting, but unknown. Overall I am so happy and grateful that we'll be welcoming this new little member of the family soon!

PS--One thing I do worry about, especially if Ziggy is a girl, is her developing an eating disorder. My mother and I both suffered from anorexia at around the same age (age 12-13), and recent research seems to indicate that there is a genetic component to the illness (my mother and I actually had our blood drawn as part of a study looking at the genetics of anorexia). I can't control genes, but I can model healthy behavior (which includes not just what I eat and my exercise habits, but also how I talk about food, weight, and body image), create a loving and supportive environment where my kid feels like s/he is accepted for who s/he is, and watch out for those early warning signs of trouble to come. The earlier one catches anorexia, the more quickly and successfully it can be treated. I was fortunate enough that, since my mother had experience with it, she suspected it long before the doctors did, and I received help relatively quickly.

Week 16: In which I obsess over pregnancy weight gain and travel plans

Yesterday I had my second appointment with Dr. W at 16 weeks, and I'm happy to report that everything continues to go well. Like last time, after I peed into a cup (I wonder what exactly they're measuring when they do this--maybe I should ask next time), I had my weight taken. Warning: Long, obsessive tangent about pregnancy weight gain ahead!

I was up 8 pounds since last time! Granted my appointment was in the afternoon this time rather than in the morning, which could account for a couple of extra pounds of food and fluid, but still, I was a bit surprised. They didn't say anything so I guess it's not a big deal. Honestly I would rather be gaining too much weight rather than too little, since all the pregnancy books I've been reading state that gaining too little weight can seriously affect the baby, while gaining too much weight is usually more a problem for the mother, in terms of her discomfort in the last trimester and difficulty in losing the postpartum weight. Of course gaining too much weight for me probably isn't a great idea since excess weight will put more pressure on my lungs and make it harder for me to breathe, especially in the third trimester.

But I'm not sure there's anything I can really do about it anyway. I exercise almost every day for 30-60 minutes, I only eat when I'm hungry (which I'll admit is pretty often!), I try to eat really healthfully and avoid sweets as much as possible (sometimes I'll have a bite or two of something AC's having, but this is pretty rare), so what exactly could I change? Because of my history of anorexia, I don't want to start going down a road of worrying about my weight and what I eat. One of my fears before doing the IVF was that gaining weight during pregnancy would trigger my eating disorder. So far that hasn't been the case. For the most part I'm enjoying seeing my body expand, but still, when I read about the official guidelines for pregnancy weight gain and how much one's supposed to gain in each trimester, I start to worry that I'm gaining too much too fast. At this rate, am I going to end up a total blimp by week 40?

From talking to other women who have gone through pregnancy, my impression has been that the amount of weight a woman gains during pregnancy is practically predetermined. I've had a number of women tell me that they gained almost exactly the same amount of weight with each pregnancy, that trying to make changes like exercising more or eating less were pretty futile, that not only was the amount of weight they gained the same, but the pace at which they gained it and where they gained it was also the same. I'm sure that extremes of eating, such as starving oneself or eating tons of junk food, can have a significant effect on weight gain during pregnancy, but it seems that as long as you fall somewhere in the middle of eating and exercising normally, then your body will gain the amount of weight it wants to.

According to all the books I've read, weight gain during pregnancy for woman of normal starting weight should be about 25-35 pounds, and since I started out pregnancy at the lower end of normal for my height, I thought it would be safe for me to gain at the upper end of that amount. My mother gained 35 pounds while she was pregnant with me. I was sort of assuming I would be about the same. Well, it seems I may even exceed that! Oh well, I guess I should just get used to the idea.

Anyway, enough obsessing about my weight! Moving on...Dr. W felt the top of my uterus and measured its height, which was normal. Unfortunately I didn't have an ultrasound, but he did pull out the doppler to measure Ziggy's heartbeat. I had actually just listened that very morning with my at home doppler, which made it a little anticlimactic to hear it in the office. But it was still very reassuring to hear that familiar whoosh, and it was nice to get an official measure of the heart rate (168 bpm, which wasn't far off from my estimated measurement of 160 bpm that morning).

I had blood taken for the AFP screen (that's the maternal blood test that can identify babies with open neural tube defects) and also for the Quad screen (the maternal blood test that can identify babies with Down syndrome, Trisomy 18, and open neural tube defects), although I'm not 100% sure about that. I sure hope they did both. I probably should have double checked with them, but my scatterbrained pregnant brain didn't think to ask. I suppose the AFP screen is more important for me since I have a family history of neural tube defects (my paternal grandmother has mild spina bifida, which manifests as severe scoliosis and back pain), whereas there's no family history of Down's or mental retardation. I'm also having my TSH level rechecked to make sure I don't need to adjust my dose of Armour Thyroid. They're only supposed to call today if the AFP screen comes back positive or my level of thyroid medication needs to be adjusted.

Other than that, I discussed travel plans with Dr. W. He said it would be fine for me to fly to the wedding in June, and not to worry about the "swine flu," that it should have pretty much run its course by then. He did say I should be especially vigilant about washing my hands and trying to avoid people who seems sick, but those are things I should be doing anyway. When I asked about traveling throughout the pregnancy, he said it should be fine to fly up until the very end, but that I shouldn't take any long car trips after 34 weeks because of the increased risk of blood clots. I was surprised that he thought flying even in the few weeks before my due date would be fine (all the pregnancy books usually say no domestic flying after 36 weeks).

Since most likely AC will be leaving Little Rock to go to Albuquerque sometime in October (although we don't know the exact dates yet or if AC will even finish his training here on time), we've been trying to figure out exactly what I should do if we have to move during the end of my last trimester. Unfortunately AC can't just fly directly to Albuquerque. First he has to drive back to Corpus Christi, since that's still considered his permanent duty station, take care of all the necessary out-processing paperwork, and make decisions about our possessions (what we want shipped to Japan, and what we want put in permanent storage). Then he has to drive to Albuquerque, possibly with a trailer hitched to the car dragging some of our stuff. All in all, I'm guessing it will take him at least 10 days, if not two weeks, to get to Albuquerque.

I'll be 34 weeks as of September 24th, and I really doubt that AC will be done with his training by then and ready to go to Corpus. So the question for us is, since I can't accompany him on the car trip, do I fly to Albuquerque and wait for AC there? I wont have a car, I wont know anyone, including my doctors, I don't know how I'll be able to get to my doctor appointments, I'll be completely alone for two weeks, and basically, it will just suck. Or do I spend those two weeks waiting here in Little Rock and then fly to Albuquerque once AC arrives there? Most of the same problems will still remain. Since we're planning on loaning one of our cars to a military couple (they will probably come here to pick it up sometime this summer), I wont have a car, I wont have any of our stuff because AC will have driven it all to Corpus, and I'll be all alone. The only benefit to remaining here during that time is that I'll know my doctors, but I don't know how I'll be able to get to my appointments without a car.

The final option, and the one I think we're seriously considering, is to have me fly to California to stay with my mom while AC's on the road. Once he gets to Albuquerque, I can either remain in California and deliver there or else fly to join him, depending on my health, what the doctors recommend, and how far along I am in the pregnancy. Albuquerque is at a higher altitude, so that might have a negative effect on my lungs during the third trimester and might be a reason not to go there. Meanwhile the benefits of remaining in California are numerous: the weather and climate agree with my health, I'll have access to my mom's car, I know the area, and quite a few things are within walking distance, I have doctors (especially pulmonary) that know me there and could recommend a good MFM, I have a few friends there that I could spend time with, it would be nice to spend some time with my mom, especially since we'll be leaving for Japan in February...Anyway, really the only disadvantage is that I would be away from AC (of course that's a pretty big disadvantage). He would of course fly to California for the birth and use his 10 days of paternity leave and maybe his saved leave as well to extend his stay. Well, we have a lot to think about and decide. Hopefully as AC's training progresses we'll have a better idea of when he'll be done here.

Anyway, assuming my AFP screen is normal, I return to Dr. W's office on June 18th for my week 20 appointment and for the "big" ultrasound, where we'll get to know the sex (assuming that Ziggy is cooperating of course)! Yay! If we bring a DVD, we can also have the ultrasound recorded. I can hardly wait! Ok, this post has gotten way too long, so I'll stop here. I guess this is what happens when I don't update for a week!