Can a Pregnant Mom Trust Modern Medicine?

Pregnant Woman Belly. Pregnancy Concept

The beauty of medicine is that it can fix most things. No, it’s not perfect, but modern medicine saves countless lives. In addition to saving lives, it dramatically improves the quality of the lives we live. Without modern medicine, my 18 month-old daughter and I would not be here today. After sailing through 32 weeks of a healthy pregnancy, I developed sudden and severe onset preeclampsia. I’m a high achiever, so my body decided it needed to start setting records. My blood pressure soared to stroke high levels. The protein in my urine topped the charts at 12 grams (5 grams is considered severe preeclampsia), and I gained over thirty pounds of fluid, becoming the Michelin man overnight. A simple tap on my arm or leg would send my limbs flying into the air. My nervous system and reflexes were in overdrive. The pounding headache, spotty vision, and abdominal discomfort were icing on the cake.Pregnant woman sitting on sofa looking at her unborn baby's ultr

Overnight, I became one sick mamma to a 3 lb. 2 oz preemie. As soon as my daughter was cut from my belly, she required urgent resuscitation. A tiny tube was placed in her airway, and she was whisked away to the neonatal intensive care unit. It took me two days to even make it up to the NICU to see her. Even then, I was hooked up to IVs, countless medications and could only manage to hold her for a few minutes. Although the textbook answer to treating preeclampsia is to deliver the baby, for some women this doesn’t solve the problem immediately. My blood pressure continued to top the charts, my reflexes remained in hyperactive mode, my mind was very confused, and I was pretty sure I had, or was going to have a stroke. My concerned OB/GYN consulted a cardiologist to manage my unimproved condition. She was amazing. She listened, investigated, and made the necessary changes (mega doses of several blood pressure medications), which eventually helped normalize my blood pressure. But, even she didn’t have all of the answers. It wasn’t until three weeks after I delivered that I was able to cancel home nursing and stop my blood pressure medications.Close up of doctor writing on a medical chart with patient lying

Through this experience I started asking questions about why this was happening. What was the physiology behind this crazy multisystem condition affecting my nervous system, cardiovascular system, kidneys, liver, and reproductive system? What caused preeclampsia? What could I do to prevent it in the future? What was my chance of having it happen again? Why couldn’t we prevent it or at least treat it more effectively? I didn’t like any of the answers that I was hearing or reading. They were all just theories, nothing concrete. This condition, which landed me in the hospital for eight days, forced me to have an emergency c-section at thirty-two weeks, placed my tiny baby in the NICU for nine weeks, and which put me at risk for having high blood pressure and a stroke later in life was still not understood.Care For A Sick Child In The Pediatric Icu

One out of every twelve pregnant women will develop preeclampsia according to data from the Preeclampsia Foundation. One in twelve! I don’t like those odds. How is it possible for a condition that is so common and potentially life threatening to mom and baby to continue to mystify us? We have mapped the human genome. We have eradicated small pox. We can identify breast cancer at its earliest stages, ensuring early treatment and amazing survival rates. Why haven’t we identified the true cause of preeclampsia and developed earlier and more efficient and effective screening tests for this condition? If prevention and earlier identification are not yet possible, then why haven’t we developed more effective treatments that will allow for a continued healthy pregnancy?

I have a fifty percent chance of developing preeclampsia again and at an earlier gestation in future pregnancies. I’m not a fan of my chances. I did everything right during my pregnancy. For goodness sake, I was the crazy lady who gave up all caffeine even though it probably wasn’t necessary. I didn’t drink a single soda, and I verified that every item entering my mouth was pasteurized. I was a paranoid pregnant mama! And, although following all of the recommendations probably prevented me from having other complications, it didn’t protect me from preeclampsia.

In a world where I count on modern medicine to fix most things, I have decided that modern medicine has failed to meet my expectations. Yes, it definitely saved my life and my daughter’s, but not all women are as fortunate as I was. Globally, preeclampsia is listed as one of the leading causes of mother and infant morbidity and mortality (illness and death). Worldwide, the United Nations reports that more than 500,000 women die each year due to pregnancy related causes. In the United States alone, preeclampsia causes 18% of maternal deaths. In short, preeclampsia is a killer.

As with any horrific and life threatening disease, the way to beat it is to study it. Research and clinical studies require interest, money, mental power (the scientists), and patients willing to participate. In most cases, it takes years before the results of clinical trials can be used in every day medicine. With only a short window left for my childbearing years, I’m hoping that new preventions and treatments will be available quickly. In the meantime, I’m doing my best to raise awareness and money, educate other women, and save the lives of women and their future babies (myself included). Join me by putting on your tennis shoes for the Promise Walk for Preeclampsia in your area. Or, take a look at the Preeclampsia Foundation or the March of Dimes for other ways to get involved. Push modern medicine to meet our expectations as women, mothers, and future mothers.

Both March Of Dimes and the Preeclampsia Foundation have their annual walks in May! Head to either of their websites to sign up and get involved.

From,

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It’s a Hush, Hush Word…Infertility

SHHHHHHHH…..I’ve got INFERTILITY ISSUES! People put autism puzzle stickers and breast cancer survivor stickers on their cars, but I have yet to see an “Infertile Couple” awareness sticker. Is the diagnosis of infertility any less of a diagnosis? Insurance companies lead us to believe this by their lack of coverage for medically necessary infertility services (a blog for another day).  Although infertility may not be life threatening like breast cancer, it is a painful and limiting condition that profoundly impacts many lives.NEW YORK - MAY 24: Actress Sarah Jessica Parker attends the prem

I assume that the stigma of infertility in part stems from the fact that SEX is broken. Who wants to admit that their sex doesn’t “work”? And, although Sarah Jessica Parker may have normalized talking about explicit sex over the dinner table, many of us don’t want to share the intimacies of our relationship with friends, let alone strangers. In my mind, one of the beauties of intimacy is that it is something shared just between my husband and me. And, although I don’t shy away from joking about sex with friends now and then, I don’t make it a habit to share what I do in private. Talking with girl friends about periods, child-birth, and boobs is no big deal. But, infertility doesn’t naturally or comfortably fall into that “normal” girl talk.

Our culture is inundated with sexuality, but the idealized kind filled with Victoria’s Secret Angels, Tatum Channing physiques, and Ryan Gosling charm (okay, and physique!) Infertility is poor performing sexuality. Who wants to talk about that? Not men, and not most women. No, men hate bringing up (sorry for my choice of words here) their struggles with erectile dysfunction. Most aren’t even able to verbalize their complaint. Instead, they just point at their crotch and stutter, “I can’t, umm,” followed by a fill in the blank. And, in the past 15 years I have only had one woman come to me concerned over her lack of orgasmic ability.Lovers

Thus, infertility falls into the hush, hush sensitive topic category. It is sensitive, but the shame and stigma associated with it prevent women and men struggling with infertility from getting the resources and support that they need. Breast cancer used to have a similar stigma associated with it. Women should not openly talk about their breasts! How improper! Yes, it was cancer, but the “unmentionable” kind. Thankfully, the shame that used to accompany the diagnosis of breast cancer has been diminished due to proactive campaigns encouraging and empowering us to embrace our womanhood, “feel our boobies,” and kick cancer in the butt. This change in culture has led to life saving advancements in breast cancer research and treatments.

Can a similar cultural revolution transform how infertility is viewed? Yes, but only if people are willing to step outside of their comfort zones. If thirty year olds still refer to their genitalia as their “junk,” how are we going to have a real conversation about infertility. Using real words and talking about real life problems is a good starting place. Acknowledging that the human body often fails us, and that infertility is one of these physical and biologic failures that is out of our control, lessens the stigma, even if slightly. Normalizing the idea that infertility is incredibly common may also empower men and women to open up more readily about their struggle toward parenthood. The more that people talk about this culturally uncomfortable issue, the less uncomfortable it will become.Group of multiethnic babies crawling isolated on white backgroun

Reducing the stigma of infertility will positively and powerfully impact the infertility world. Infertile couples will have a larger support system if more people are willing to share their stories. This in turn will lead to increased social networks and social capital. With increased unity focused on the cause of infertility, more money will be raised for research, leading to improved infertility treatment options. Awareness campaigns may lead to political activism, forcing insurance companies to take infertility seriously and cover necessary treatments. Imagine a world where people have increased fertility because of improved infertility treatments and insurance coverage! If population control is your thing, then this may not excite you. But, for those of us hoping to add to the human race, this thought is utopia!

From The Mom in Me, MD

 

Coconut Oil: Is your body really all that crazy about the “Craze”?

Coconuts And Organic Coconut OilWhen my mother-in-law informed me that coconut oil was part of her new diet plan, and my husband announced that he wanted to try a coconut oil chicken recipe from a men’s health magazine, I began to wonder if olive oil really should get the boot from a new-found “healthier” option. Instead of joining the coconut oil craze, I decided to do some hardcore research on the subject for myself-Nothing better than a little reading on the organics and biochemistry of fats!

Plain and simple, coconut oil is a FAT! It is not a weight loss food. It has the same amount of calories as any other fat. Yes, it is a better option than butter and other trans fats because it doesn’t contain any cholesterol, but it doesn’t beat olive oil or other plant-based oils. In fact, coconut oil can still potentially increase your risk for heart disease because it is high in saturated fat (the “bad” kind of fat that you should avoid in your daily diet). Not only is it high in saturated fat…it has the HIGHEST amount of saturated fat of any fat at 92%. I am not saying to avoid all fat in your diet. Fat is necessary for our bodies to function, but in the right daily amounts.IMG_2043

So, why the “Craze”? Does coconut oil really cure cancer, lead to immediate weight loss, and give you a fool-proof immune system? If only!  Coconut oil is an interesting little fat. Although it is high in saturated fat and should be limited in the diet for this reason, it does have some unique properties that may offer some health benefits. Coconut oil is made up of fatty acids. Unlike other fats, the main contributors are a mix of short and medium chain fatty acids, predominantly lauric and myristic acids. It is thought that this mixture may be the reason why coconut oil actually helps to increase HDL (or good cholesterol) in the body. Even though it may give your good cholesterol a strong boost, it will also increase your LDL (or BAD cholesterol). Another positive of coconut oil is its plant-based origin. Plant based products offer antioxidant properties, and coconut oil probably also contains some healthy chemicals that researchers haven’t yet identified. Studies are currently looking at coconut oil’s impact on Alzheimer’s and other diseases, but it is far too early to say that it is a “cure-all”.IMG_2041

So, although it may be tempting to dump your olive oil down the drain, DON’T DO IT! Olive Oil is still a healthier fat option for your heart and your waistline as far as we know. It’s okay to use coconut oil every now and then for a flavorful treat, but DON’T make it your “go to” fat. If you love to bake and are looking for a healthier alternative to butter, then coconut oil is a good alternative. This won’t make your double chocolate chip cookies low-fat, but it might make them just a little bit healthier!

Check out the hyperlinks for more supporting evidence from Harvard, The Cleveland Clinic, and Johns Hopkins.

From The Mom in Me, MD

Our Preemie Journey: Delivery Day…8 Weeks Early!

young pregnant woman sitting on the windowMy mind was fuzzy, my vision blurry, and my body on fire from the magnesium! I felt like I was going to burst like a water balloon from even the tiniest poke. I could barely move my fingers due to the swelling, and I was scared. I was terrified for my unborn child and for myself. Preeclampsia had taken over. It didn’t care that I was just shy of 32 weeks pregnant. It didn’t care about what I had already gone through just to get pregnant! It was mocking my plans for a perfect delivery. I asked myself, “Who attacks a mother and her innocent unborn child? How could a disease be so sadistic…so ruthless?”

I waited for Dave to arrive for what seemed like hours. I was alone, alone with my unborn baby…uncertain of what was going to happen next…uncertain if my child would survive…uncertain if my body would fail me…uncertain of what the future held. A sense of relief washed over me when Dave walked into my hospital room. He hadn’t realized the severity of the situation until he saw me. I was barely recognizable from even the night before. Dave had raced from work, stopping at the house to take the dog out and to throw some overnight clothes together. Little did he realize that our overnight bag would need to get us through the next nine weeks.Fetus 7 Month In The Womb. Visible Head And Arms

The next several hours were filled with ultrasounds from Maternal Fetal Medicine, discussions with the neonatologist (NICU doctor), and constant blood pressure checks and rechecks. I was reassured that 32-week old babies can do very well. They can still have major complications including bleeding in the brain, respiratory distress syndrome, vision problems, and much more; but according to my Ob/Gyn, making it to 32 weeks was a great accomplishment. It didn’t feel like an accomplishment. It felt like a failure. My body was failing my baby and me. Once again, my best efforts could do nothing to change the situation.

Because our baby’s lungs hadn’t gotten the chance to fully develop, I was stabbed with the first of two steroid shots to speed up the process. A plan had been put in place. We were going to wait for my 24-hour urine protein to come back, and we were going to try to get both steroid shots in before delivery (these had to be spaced out by 24 hours).

I was a little nervous about a C-section, but I was willing to do whatever it took to keep my baby safe. Because my blood pressure was so incredibly high, an attempt at a vaginal delivery was out of the question. Starting an induction would be too hard on the baby and on my already stressed body.

The minute that my 24-hour urine protein results arrived the conservative timetable was thrown out the window. I was loaded into a wheelchair and told that the C-section was happening NOW! My urine protein was the highest that my Ob/Gyn had ever seen. The baby was starting to have some dips in her heart rate, and we couldn’t wait any longer. Delivery was the only “cure” for preeclampsia. My leg was stabbed too early with the second steroid shot in a last ditch effort to give our baby’s lungs every chance to mature. The magnesium and blood pressure medications continued to run into my veins, in an attempt to prevent me from having a seizure or stroke.

As the nurse wheeled me down the hallway, I pleaded desperately with God. He had answered my heart’s longing for a child. I had watched my belly grow with awe, wonder and gratitude. This baby was my answered prayer. He had to protect her! If not, then why had he given her to me in the first place? I loved this little being that I had never met more than my mind could comprehend. He couldn’t take her from me now…not after we had made it this far.

The spinal was more unpleasant than I had imagined. For some reason the idea of a huge needle poking into the nerve track in my back freaked me out more than just a little. I wasn’t worried about having my belly cut open with a scalpel, but a giant needle wasn’t my idea of fun. I hunched, I hugged the pillow, and I hunched some more. After three attempts, the needle was finally in the correct position. I was transferred to the operating table, and prepped for surgery. I had assisted in numerous emergency C-sections during residency. I had reassured many panicked mothers that everything would be “just fine”. Now I was the panicked mother, and I found that my own advice fell flat.

I remember the tugging and pulling during the c-section, and that the spinal was just as unpleasant as patients have described. My blood pressure dropped fairly rapidly at one point, causing me to vomit.

My C-section!

The C-section felt like an eternity. Just as they were pulling the baby out of my belly, my blood pressure dropped precipitously from the anesthesia, and I began to vomit. I vaguely remember the attending physician showing my baby to me before she was whisked to the resuscitation table. Her skin was dusky. She wasn’t crying! Was she breathing? I couldn’t see. What was happening? And, then I heard her. I heard her first cry. It was a small cry, but it was fierce. She was a fighter. She was in the lightweight division at 3 pounds 2 ounces, but she was a fighter!

My baby was born at 3 lb. 2 oz. She was whisked away to be resuscitated.

Ayla in the Delivery Room being Resuscitated

Before I could catch another glimpse of my precious baby, she was rushed to the Neonatal Intensive Care Unit with her daddy close behind. I felt physically sick, helpless, and alone. I was her mother, but I had yet to hold my baby. I wanted to be at her side, but I could barely keep my eyes open. I wanted Dave at my side, but I knew that he needed to be with our baby. My mind was heavy, clouded by painkillers, anesthetics, and magnesium. As the last stitch was placed in my belly, I drifted off. When I awoke to a soaring blood pressure and splitting headache, I realized that I was in a fight for my life. Preeclampsia was still my master, and it wasn’t finished with me yet. Delivery had only made it more determined to destroy me, but I was a fighter too!

From The Mom in Me, MD

Getting an Even Better Body Back After Pregnancy: 11 Tips and Health Tricks that Work

Woman Jumping On The Sand Of The Beach

Most women are longing for their body to return to its normal shape and condition the moment after they deliver. I certainly expected my stomach to magically shrink to a bikini ready state in just a few weeks. Although a select few are blessed with the genetics and metabolism to fit into their skinny jeans postpartum day 2, for the majority of new and repeat mommies this is unfortunately an unrealistic expectation. For those who have had a c-section, this is even more unrealistic due to the exercise and movement limitations recommended for the first six weeks postpartum.

I am a strong advocate for breast-feeding, and I was sure that breast-feeding alone would liposuction my plump frame into something at least resembling my old self. It never occurred to me that losing weight after delivery would be challenging. Although I was nursing every 2-3 hours, the scale was barely budging. I wasn’t allowed to exercise for at least six weeks due to my c-section, and to be honest, I hardly felt like moving the first several weeks. Having battled preeclampsia, my brain and body were still pretty out of sorts. My blood pressure remained elevated for several weeks after delivery and my cardiovascular system wasn’t cooperating. Just walking down the hall made me short of breath. My endurance was negligible, and my frustration was rising. I’m sure that living in the NICU for nine weeks with a preemie had also sent my cortisol levels soaring, hindering my weight loss.

In the midst of having had preeclampsia, a STAT c-section, and a premature baby requiring resuscitation and a NICU stay, you may wonder why I even cared about something as “superficial” as my weight. Well, when everything around me felt like chaos, I wanted something familiar and comfortable. I wanted myself back. After all that I had been through, I wanted to feel normal. I don’t think that is superficial. I think it’s a natural reaction.

So, for those of you who were running marathons a few weeks after delivery, you can skip this blog, but for those of you struggling to lose the first 30 lbs or the last five, I thought I would throw out some tips that helped a very frustrated mommy! Here is my top list of things that worked for me. Take them or leave them, but I do provide a little evidence to say why they may be effective for most women after delivery.

11 TIPs and Health Tricks: 

 1. Revise Your Goal: Best Shape Ever

Although many of you are fixated on a goal weight (often your pre-pregnancy weight), fixating on this number may mean selling yourself short. Instead, aim to be in the best shape of your life. This shift in perspective from weight to shape can transform your lifestyle and boost your progress. I stopped staring at the scale and instead started to notice how my clothes fit. I started caring more about how strong I was rather than how skinny I was. I reminded myself that muscle weights more than fat but looks a heck of a lot better. (I’ll take toned arms and a tight butt any day over a dip in the scale.) Having the goal of being healthy and in shape is not only more attainable, but it will push you to remain healthy and to continue exercising long after you reach your weight goal.

2. Get Excited and Get Addicted

Although many women struggle with getting excited about exercise, exercising after delivery has major perks. Most mothers feel obligated to hold their infant 24/7. After having that little one physically attached to you for nine months, it seems strange to break that bond in any way. Even so, having a break from that adorable little one who is demanding feedings, diaper changes, and middle of the night cuddles, can make you a better mother. Exercise provides the perfect opportunity (and excuse) for you to focus on yourself for a few moments daily. Letting off steam through physical activity is therapeutic for a tired mom. And, although you may be physically exhausted before you hit the treadmill, the endorphins (feel good hormones) that your body releases during exercise will make you happier, energized, and healthier.

Finding what type of exercise you like and getting addicted to it is another good way to stay in shape longterm. If Zumba is your thing, then swing those hips. If Pilates is more your style, then chatarunga and down dog away. The only way to find out what you might love is to try new things. Last week I gave Pure Barre a shot! This week was YoPI and TRX. Not only can trying new things be fun, it can also help you meet other moms with similar interests and goals.

3. Move to Your Heartbeat 

Hand heartEveryone knows that cardiovascular exercise is an essential part of any weight loss program. In addition to helping you lose weight, exercise is great for keeping the pounds off. Pregnancy changes your cardiovascular system dramatically. Even if you exercised during pregnancy, you may not feel back to your normal endurance level immediately. Give yourself time to build back up. One of the best ways to monitor your efforts is by paying attention to your heart rate. There are specific heart rate zones that are best for losing weight based on your age. The good news is that the target heart rate for weight loss is not all that high (meaning that walking may actually be a better option than running). If you are pushing yourself too hard too soon, your heart rate may be out of your fat burning/weight loss zone and in your calorie burning zone instead. This may limit your results.

There are several ways to monitor your heart rate to ensure that the time you spend working out is quality time (in your fat burning zone). If you are working out at the gym, most of the machines have heart rate monitors built into the handrails. If you are enjoying the great outdoors instead of the gym or want something more accurate than the handrails, you can purchase a heart rate monitor at most sporting goods stores. The best monitors come as a small strap that you connect around your bra line. These monitors include a watch that shows you your heart rate. Some of them are pretty fancy, but you can definitely find basic ones for a limited budget. If you want to go a step further to guarantee that your workout time is all about fat burning, you may be interested in having a simple metabolic test done to let you know your specific fat burning zone. Most gyms offer this exercise test in which you walk on a treadmill wearing a vented mask and heart rate monitor. This test measures your oxygen usage compared to your heart rate and is able to determine your specific ideal heart rate for fat burning. Having this test done greatly altered my workouts. The age based formula was not nearly as accurate as the metabolic test, and I found that I wasn’t working out in my ideal zone most of the time. I was usually either below it or above it. After adjusting my workouts based on my target heart rate, the scale finally started to budge! I wasn’t wasting my breath without results anymore! On a side note, for those of you interested in the metabolic test, make sure that you have it repeated several months down the road because your target fat burning heart rate zone can change as you become more fit and gain endurance.

Push-ups fitness woman doing pushups outside on beach. Fit femal4. Weight Training is not just a Man’s World.

I already mentioned that muscle weights more than fat, but it looks a lot better! Not only does it look better, muscle can be your best friend when it comes to shedding the pounds. Muscle burns three times more calories than fat, even when you are sitting still. By building muscle, you will increase your metabolism and firm up your shape. Once I started incorporating weight training into my workouts I started to notice that my pre-pregnancy clothes were starting to fit again. The scale wasn’t moving much, but my waistline was shrinking! Women are often intimidated by weight training, but we are also mislead to think that building muscle means pumping large amounts of iron in the weight room surrounded by Hulk like men. Weight training also includes using your own body weight in exercises like Pilates, Yoga and TRX. If weight machines and free weights are your thing, go for it, but many women love the long lean muscles produced from classes that focus on using their own body weight instead.

5. Look Stupid=Look Good (Body over Pride)

Be willing to try new things. Don’t worry if you don’t know what you are doing in an exercise class. Everyone else is caring far more about themselves than they are about how you are performing. You are going for you, not to impress them. If you keep that in the front of your mind you will push yourself to try new things that just might make the difference in helping you reach your fitness goals. So what if you look stupid in the studio. A few months down the road you are going to look pretty hot in your skinny jeans! Besides, you might just find a class you love and in which you will eventually excel. Keep everything in perspective.

6. Don’t Starve Yourself

Many women think that they have to cut out every calorie in order to lose weight. Fact is, YOU CAN EAT and still lose weight! Actually, you have to eat in order to lose fat. By starving yourself, your body simply holds onto the fat and gets rid of your hard-earned muscle. Eating enough food is a must for keeping your metabolism pumping. Try one of the calorie counters like My Fitness Pal that incorporates your exercise into the equation to track and see how many calories you should be consuming in a day.

7. Breast Feed for Yourself

Although breast-feeding wasn’t a miracle weight loss solution for me, for many women it works wonders. So in addition to giving your little one some great nutrients and bonding time, breast-feeding may be a great weight loss solution for you. But remember, it only gives you 500 extra calories a day. You need to eat more, but you aren’t supporting a baby elephant (sorry, was reminding myself of that fact). Don’t diet if you are breast-feeding (it can drop your milk supply), but do be aware of your choices.Young Mother Breastfeeding A Baby In Nature

8. Stop Sipping Your Calories

One of the simplest ways to cut out calories is to stop drinking them. Limiting the calorie laden beverage can liquidate the pounds quickly. Even the calorie free drinks that use artificial sweeteners are now thought to be adding to the American bulge. If you’re like me, this is going to be a tough one. I love my daily caffeine! Actually, I rely on my daily caffeine! Don’t most moms? Give yourself some cheat days, but at least try to cut back. My motto, “Cutting out a Latte a day helps the skinny me stay.”

SCARSDALE, NY - SEPTEMBER 15, 2013: A tall Starbucks coffee in f

9. Drink Beyond Your Thirst….Load up on the WaterPouring Water Into Glass On Blue Background

Drinking more water is good for your body in more ways than one. Not only does water hydrate us, it also fills us up making us less hungry. Often times when we think that we are hungry, our body is actually just thirsty.So, instead of reaching for a snack,  try some water first. If you wait until you feel thirsty to drink, you are most likely already dehydrated. So, keep a water bottle on you at all times, and keep sipping.

10. Stop Comparing Yourself to Other Women and Be Realistic

Remind yourself that your primary goal right now is to care for a tiny little person who demands everything from you. Don’t expect more from yourself than you can realistically give. Remember why you gained all of this weight in the first place. You were growing an amazing little person. It was worth every pound! As women, we come in all different shapes and sizes. Fact: My hips will never be a size zero. If my best friend has the hips of a pencil, great for her! Work with what you’ve got. Frustration from comparing can sabotage your success. Applaud other women and their bodies, and then give yourself a pat on the back for how your body is reshaping.

Set a realistic timetable and attainable goals for yourself. Not only is losing 15 pounds in a week unhealthy, it is CRAZY! Often people reporting this much weight loss are simply losing water weight and lean muscle instead of fat.  One to two pounds of weight loss a week is considered healthy. If you are breast-feeding you may lose more than this, and that’s okay. Breast feeding revs up the metabolism in a lot of women and naturally sheds pounds.

11. Doctor’s Orders

If everything you are trying still doesn’t work, consider consulting your physician to get your thyroid checked. Ruling out an underlying medical condition may be necessary if you are putting in the work and not seeing the results.

Final Thoughts for Every Mom!

In an effort to feel more normal in my skin using the above steps, I have also had a revelation about my post pregnancy body. My body isn’t “perfect” since having had a baby. My tummy is not quite as flat, and I wouldn’t call the stretch marks on my upper thighs desirable, but these changes are a reminder of how amazing the human body is. My body was able to create, protect, and nurture another human being. If I look at my few stretch marks and c-section scar with this in mind, they actually start to look a little pretty. Besides, who’s to say that they aren’t. As long as I am healthy and comfortable in my body, I refuse to let our culture with its airbrushed “perfection,” set my standard of beauty. Work hard to be healthy, strong, and fit, but don’t forget to thank your new post baby body (whatever shape it’s in) for giving you the most beautiful gift of all, motherhood!

From The Mom in Me, MD

destigmatizing infertility in a baby booming culture

Beautiful young woman with pregnancy test. In bathroom.

In my previous blog I alluded to the fact that the inability to get pregnant is laced with stigma and shame. People put autism puzzle stickers and breast cancer survivor stickers on their cars, but I have yet to see an “Infertile Couple” awareness sticker. Is the diagnosis of infertility any less of a diagnosis? Insurance companies lead us to believe this by their lack of coverage for medically necessary infertility services (a blog for another day).  Although infertility may not be life threatening like breast cancer, it is a painful and limiting condition that profoundly impacts many lives.

I assume that the stigma of infertility in part stems from the fact that SEX is broken. Who wants to admit that their sex doesn’t “work”? And, although Sarah Jessica Parker may have normalized talking about explicit sex over the dinner table, many of us don’t want to share the intimacies of our relationship with friends, let alone strangers. In my mind, one of the beauties of intimacy is that it is something shared just between my husband and me. And, although I don’t shy away from joking about sex with friends now and then, I don’t make it a habit to share what I do in private. Talking with girl friends about periods, child-birth, and boobs is no big deal. But, infertility doesn’t naturally or comfortably fall into that “normal” girl talk.

Our culture is inundated with sexuality, but the idealized kind filled with Victoria’s Secret Angels, Tatum Channing physiques, and Ryan Gosling charm (okay, and physique!) Infertility is poor performing sexuality. Who wants to talk about that? Not men, and not most women. No, men hate bringing up (sorry for my choice of words here) their struggles with erectile dysfunction. Most aren’t even able to verbalize their complaint. Instead, they just point at their crotch and stutter, “I can’t, umm,” followed by a fill in the blank. And, in the past 15 years I have only had one woman come to me concerned over her lack of orgasmic ability.

Thus, infertility falls into the hush, hush sensitive topic category. It is sensitive, but the shame and stigma associated with it prevent women and men struggling with infertility from getting the resources and support that they need. Breast cancer used to have a similar stigma associated with it. Women should not openly talk about their breasts! How improper! Yes, it was cancer, but the “unmentionable” kind. Thankfully, the shame that used to accompany the diagnosis of breast cancer has been diminished due to proactive campaigns encouraging and empowering us to embrace our womanhood, “feel our boobies,” and kick cancer in the butt. This change in culture has led to life saving advancements in breast cancer research and treatments.

Can a similar cultural revolution transform how infertility is viewed? Yes, but only if people are willing to step outside of their comfort zones. If thirty year olds still refer to their genitalia as their “junk,” how are we going to have a real conversation about infertility. Using real words and talking about real life problems is a good starting place. Acknowledging that the human body often fails us, and that infertility is one of these physical and biologic failures that is out of our control, lessens the stigma, even if slightly. Normalizing the idea that infertility is incredibly common may also empower men and women to open up more readily about their struggle toward parenthood. The more that people talk about this culturally uncomfortable issue, the less uncomfortable it will become.

Reducing the stigma of infertility will positively and powerfully impact the infertility world. Infertile couples will have a larger support system if more people are willing to share their stories. This in turn will lead to increased social networks and social capital. With increased unity focused on the cause of infertility, more money will be raised for research, leading to improved infertility treatment options. Additionally, awareness campaigns may lead to political activism, forcing insurance companies to take infertility seriously and cover necessary treatments. Imagine a world where people have increased fertility because of improved infertility treatments and insurance coverage! If population control is your thing, then this may not excite you. But, for those of us hoping to add to the human race, this thought is utopia!

From The Mom in Me, MD

Sex at its Worst

Distressed Couple Finding Out Results Of A Pregnancy Test

The worst sex is baby-making sex. It starts off romantic, even inspired, but it quickly loses its charm. Some lucky couples may be exempt from my assessment. For example, the “oops couple” may have been having the time of their life only to find out that they are unexpectedly pregnant. Or, the “let’s stop the pill for one day and see what happens couple” may really enjoy the added benefit of being off of a medication that has a tendency to stifle orgasms and intense sex drive. For most of us, baby-making sex is timed, routine, get it done sex. It is layered with the stress of, “Will I ever get pregnant?” It may start off fun because the thought of making a baby together is beyond incredible, but when months start to pass and periods keep coming, the giddy gitters are replaced with a nervous question, “Will it ever happen?”

It would be nice to tie a bow around fertility and say that most of us have it. Realistically, one in eight couples struggles with infertility according to The National Survey of Family Growth from the Centers for Disease Control. That indicates that if more than eight of you are reading this, at least one of you is struggling with or will struggle with infertility. Not to rain on the stork’s parade, but this is something that women should be aware of so that they aren’t blindsided in their journey toward motherhood.

Knowing that you may struggle with infertility may be hard to acknowledge, but it may push you to seek help a little more quickly. Many women have embraced the career path, pushing back their nesting days into their thirties. In our culture this is more the norm than the exception, myself included. Although the typical rule of thumb is to try for at least a year before worrying about infertility, this doesn’t apply to those of us with ticking fertility clocks. Those of us desiring to enter the motherhood arena past the fertility prime of our twenties should be aware that the timetable is quite different. Women in their mid-thirties should actually consult an infertility specialist after only six months of unsuccessfully trying to make a baby the old-fashioned way based on current recommendations.

Although this may seem like a very short time to let nature take its course, the infertility workup path can be quite protracted. Many infertility clinics are booking out several months down the road. Completing a full infertility workup takes at least a month for all of the blood work, testing, follow up appointments, and decision making on how to proceed. So, if you haven’t gotten pregnant in six months, you most likely won’t even start infertility treatments for several months more. And, who is to say how many infertility treatments you will need before you actually get pregnant? Going into baby making in your thirties or forties with this knowledge may improve your chances of getting pregnant by encouraging you to be more proactive in investigating your fertility status sooner.

On a side note, some of you may be offended that I mention your twenties as your prime fertility years. Don’t start chewing me out. Biology and genetics are the ones running the show. I’m only stating the facts. Besides, it’s not like I’m in my twenties either. It is a confirmed fact that our ovaries have fewer and fewer healthy eggs with each passing year. Acknowledge it. Accept it. Embrace the fact that you are no longer in your twenties!

In addition to seeking an infertility evaluation sooner, knowing that one in eight couples struggles with infertility may also make you feel just a little bit less broken. People who are getting pregnant share the news. This is why it may seem like you are the only one not getting pregnant. People who are infertile often keep it to themselves. Infertility is a heavy word. It is weighted with shame, embarrassment, and feelings of inadequacy, despair, and desperation. Even the most optimistic couple can’t help but feel a little defeated when faced with this diagnosis. The possibility that parenthood may never be in their future can be world shattering. Knowing that you aren’t an anomaly can soften the blow…just a little bit. And, in the midst of an infertility diagnosis, any softening helps immensely.

In addition to knowing you aren’t alone with your infertile status, being aware that infertility is common (6.7 million women in the United States alone struggle with infertility according to the Centers for Disease Control) may nudge you to find a support system sooner than you would have. When my husband and I realized that making a baby the natural way was most likely unattainable for us, I struggled with the reality that I was an infertility patient. I went to most of my appointments alone, and even though I was in a waiting room filled with other women struggling with similar experiences, an uneasy silence filled the space between us. This silence was laced with pain, fear, and cautious hope. Why we didn’t reach out to each other always confused me. I assume that we wanted to respect each other’s privacy. We didn’t want to overstep the invisible barriers that each of us had build around us. Looking back, I would do things differently. I would risk a little more. I would trade in my pride for the support that these women could have offered. Maybe they didn’t need me (doubtful), but I needed the support that they could have offered. I now realize that enormous support exists for those of us carrying a diagnosis of infertility including online support groups such as Resolve, community support groups, and wow, probably one of our eight friends who is in a similar predicament. If we would be willing to share our story with others, they may just be willing to share their story with us.

If you find that baby making sex isn’t your forte either, embrace the fact that you can throw your birth control pills down the toilet for good! Sex can be entirely recreational and for passion and love’s sake alone. And, although the infertility journey may be the most difficult one that you take, starting the process sooner may increase your chances of success. You are not alone in this journey. Reach out early, and the stamina and strength you garner from other women’s stories may surprise you. Nothing is more powerful than women empowering other women in their journey toward motherhood.

From The Mom in Me, MD

Where Modern Medicine has Failed the Pregnant Mom

Pregnant Woman Belly. Pregnancy Concept

The beauty of medicine is that it can fix most things. No, it’s not perfect, but modern medicine saves countless lives. In addition to saving lives, it dramatically improves the quality of the lives we live. Without modern medicine, my 18 month-old daughter and I would not be here today. After sailing through 32 weeks of a healthy pregnancy, I developed sudden and severe onset preeclampsia. I’m a high achiever, so my body decided it needed to start setting records. My blood pressure soared to stroke high levels. The protein in my urine topped the charts at 12 grams (5 grams is considered severe preeclampsia), and I gained over thirty pounds of fluid, becoming the Michelin man overnight. A simple tap on my arm or leg would send my limbs flying into the air. My nervous system and reflexes were in overdrive. The pounding headache, spotty vision, and abdominal discomfort were icing on the cake.

Overnight, I became one sick mamma to a 3 lb. 2 oz preemie. As soon as my daughter was cut from my belly, she required urgent resuscitation. A tiny tube was placed in her airway, and she was whisked away to the neonatal intensive care unit. It took me two days to even make it up to the NICU to see her. Even then, I was hooked up to IVs, countless medications and could only manage to hold her for a few minutes. Although the textbook answer to treating preeclampsia is to deliver the baby, for some women this doesn’t solve the problem immediately. My blood pressure continued to top the charts, my reflexes remained in hyperactive mode, my mind was very confused, and I was pretty sure I had, or was going to have a stroke. My concerned OB/GYN consulted a cardiologist to manage my unimproved condition. She was amazing. She listened, investigated, and made the necessary changes (mega doses of several blood pressure medications), which eventually helped normalize my blood pressure. But, even she didn’t have all of the answers. It wasn’t until three weeks after I delivered that I was able to cancel home nursing and stop my blood pressure medications.

Through this experience I started asking questions about why this was happening. What was the physiology behind this crazy multisystem condition affecting my nervous system, cardiovascular system, kidneys, liver, and reproductive system? What caused preeclampsia? What could I do to prevent it in the future? What was my chance of having it happen again? Why couldn’t we prevent it or at least treat it more effectively? I didn’t like any of the answers that I was hearing or reading. They were all just theories, nothing concrete. This condition, which landed me in the hospital for eight days, forced me to have an emergency c-section at thirty-two weeks, placed my tiny baby in the NICU for nine weeks, and which put me at risk for having high blood pressure and a stroke later in life was still not understood.

One out of every twelve pregnant women will develop preeclampsia according to data from the Preeclampsia Foundation. One in twelve! I don’t like those odds. How is it possible for a condition that is so common and potentially life threatening to mom and baby to continue to mystify us? We have mapped the human genome. We have eradicated small pox. We can identify breast cancer at its earliest stages, ensuring early treatment and amazing survival rates. Why haven’t we identified the true cause of preeclampsia and developed earlier and more efficient and effective screening tests for this condition? If prevention and earlier identification are not yet possible, then why haven’t we developed more effective treatments that will allow for a continued healthy pregnancy?

I have a fifty percent chance of developing preeclampsia again and at an earlier gestation in future pregnancies. I’m not a fan of my chances. I did everything right during my pregnancy. For goodness sake, I was the crazy lady who gave up all caffeine even though it probably wasn’t necessary. I didn’t drink a single soda, and I verified that every item entering my mouth was pasteurized. I was a paranoid pregnant mama! And, although following all of the recommendations probably prevented me from having other complications, it didn’t protect me from preeclampsia.

In a world where I count on modern medicine to fix most things, I have decided that modern medicine has failed to meet my expectations. Yes, it definitely saved my life and my daughter’s, but not all women are as fortunate as I was. Globally, preeclampsia is listed as one of the leading causes of mother and infant morbidity and mortality (illness and death). Worldwide, the United Nations reports that more than 500,000 women die each year due to pregnancy related causes. In the United States alone, preeclampsia causes 18% of maternal deaths. In short, preeclampsia is a killer.

As with any horrific and life threatening disease, the way to beat it is to study it. Research and clinical studies require interest, money, mental power (the scientists), and patients willing to participate. In most cases, it takes years before the results of clinical trials can be used in every day medicine. With only a short window left for my childbearing years, I’m hoping that new preventions and treatments will be available quickly. In the meantime, I’m doing my best to raise awareness and money, educate other women, and save the lives of women and their future babies (myself included). Join me by putting on your tennis shoes for the Promise Walk for Preeclampsia in your area. Or, take a look at the Preeclampsia Foundation or the March of Dimes for other ways to get involved. Push modern medicine to meet our expectations as women, mothers, and future mothers.

From The Mom in Me, MD