Monday, September 12, 2022

The Second Trimester (Part Two)

I'm now close to the start of the third trimester! Alas, in the past three or four weeks, I've started to experience bigger challenges from certain side effects and symptoms of pregnancy. I'm maybe a little - or a lot - worried about what the entire third trimester will feel like, if I'm already starting to have a hard time. 

Physical Symptoms: Thank goodness, the itching I mentioned in late July went away by itself pretty quickly in the following three to four weeks. I've asked the doctor about it, and they aren't worried. My acne is a bit better for now. Most of the disruptions to my digestive system have also improved, though are still noticeable. I've been very fortunate in that the worst nausea I've had during this pregnancy in the first trimester still wasn't that bad, definitely not enough to throw off my eating habits. That symptom seems to have disappeared now in the second half of the second trimester.

Sadly, what is more difficult for me now in terms of physical symptoms is that I've started experiencing all kinds of aches and pains. I currently live walking distance from my office, with my commute on foot taking 18 to 20 minutes each way. As of three weeks ago, I've started taking public transit to and from work instead of walking - even though it doesn't actually save me any time - because I was experiencing too much pain and discomfort. 

I normally love grocery shopping - it's my favorite chore and never feels like an imposition - but I've found I pretty much need to stop running that errand alone as well, as I can't really carry a not-particularly-heavy full bag of groceries - and definitely not two such bags - for 10 to 15 minutes while walking home anymore. I end up sore all over for more than a day afterwards. I'll really miss doing this basic task on a whim for the rest of my pregnancy. (I can still maybe grab a few lighter items at a time from the nearest grocery store to home or work in a pinch, but no more big shops unless K is there to carry most of what we buy.) 

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In order to try and manage the discomfort, I've been using a fairly large pregnancy pillow, the LeahCo Snoogle, for quite a while now, since week 12 or so. I didn't really need it at first, but now I definitely do, and I've particularly appreciated having the pillow since week 15. I also bought a much smaller and more easily packable Boppy wedge-style pregnancy pillow (also here or here) for K and I's recent vacation, which also worked fairly well to keep me sleeping on my side and was reasonably comfortable. When I'm laying down and using my computer in bed, I use both the Snoogle and Boppy to lay down on an incline. 

Much more recently, I've also started wearing a pregnancy belt under my clothes, and it definitely helps a lot and is even necessary for me now, even with a bus commute and sedentary desk job. I picked one fairly randomly on Amazon, sizing up to account for how I have a few months of pregnancy and growth to go, and it works pretty well. 

One-Hour Glucose Test: My OB-GYN's office has patients take the one-hour glucose tolerance test ("GTT") for gestational diabetes during their 24th week appointments. A lot of people say the glucola drinks used for the tests taste gross - the one-hour version contains 50 grams of sugar in 10 oz, compared to, say, the 39 grams in a 12 oz bottle of coke - so I felt some trepidation, especially because I basically never drink soda or juice and only rarely get sweetened lattes. They also instruct you to drink the entire thing in five minutes or less.

In actuality, I didn't find the drinks for either the one-hour glucose test or the three-hour glucose test (100 grams of sugar in 10 oz liquid) to be too bad. And I actually thought they tasted equally sweet to each other - a  manageable amount - even if the three-hour test version has double the sugar content in the same volume! I got the orange version each time - lemon-lime and fruit punch flavors also exist - and I'd describe it as being like a flat orange soda, or maybe like how I'd imagine Squeezits or those little barrel-shaped juice bottles with foil tops to taste, if anyone else remembers those from the 1990s. It helps with the flavor if the glucola is refrigerated/cold. 

Though I totally understand that patients who are experiencing nausea might have trouble keeping down the glucola. And it certainly isn't something I'd ever seek out for fun, though I really didn't mind it and won't feel any further trepidation about it during any future pregnancy, if that's in the cards. My energy and hunger levels were a bit all over the place for the rest of the day after each test, however, which wasn't terribly fun.

I don't think all doctors out there instruct patients to fast before starting the one-hour test, but mine did, for two hours beforehand (water was allowed during that two-hour window, but nothing else). I was asked to drink the glucola at home one hour before my appointment time, keeping track of the exact time I finished, within five minutes of starting to drink. They do a blood draw at the one-hour mark. 

Unfortunately, I failed the one-hour GTT, which is not uncommon as the cutoff before they make you take the three-hour test can be quite conservative. I think I read that up to 25% of patients fail the one-hour, but many - maybe even most - go on to pass the three-hour GTT. 

Three Hour Glucose Test: While I didn't end up minding the taste of the 100 grams of sugar glucola, the three-hour GTT is definitely more onerous than the one-hour test. I was told to fast for 12 hours before starting the test, and couldn't have any water after drinking the glucola. They take a blood draw before starting, then additional draws at one, two, and three hours, for a total of four blood draws, and I needed to wait at the doctor's office the entire time in between. I brought my laptop so I could work, but found that I couldn't really focus - especially with my first hour sugar rush - so I mostly just browsed the web. 

Alas, I failed the three-hour GTT, and it was not at all a borderline or ambiguous result. I officially have gestational diabetes ("GD"). 

In general, I'm not as upset or worried as I could be. I have some very strong genetic risk factors for diabetes in my family, so I'm not fully surprised by my test results and had been mentally preparing myself since I failed the one-hour test. (Being Asian-American of Chinese descent is also a risk factor by itself.) I know this diagnosis is mainly due to my placenta and hormones, it's not a reflection of my health from before the diagnosis. Based on my numbers so far, it also seems likely I can control the condition with diet and exercise for at least a few weeks. 

There definitely are some really dangerous and scary potential side effects and complications from GD if it isn't well-managed. I certainly don't look forward to potentially needing medication or insulin later on, since I know the condition sometimes gets more difficult to manage later on in pregnancy based on hormonal changes. 

I'm still waiting for my first consult with a specialist after getting my GD diagnosis last week, though one can easily buy blood sugar testing supplies over the counter and research the basic guidelines for trying to manage the condition with diet and exercise. I'm having a pretty hard time figuring out the finger-sticks for blood sugar testing, alas. We'll see how difficult I find the new dietary restrictions. I wasn't really craving sweet foods very much throughout this pregnancy, I actually think I eat less candy and less sugar than I did before. But I'm nervous about other carbohydrate-containing foods and figuring out what I can eat...

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