Wednesday, December 03, 2008

I Am Full

Everything is going well with the spotting, which means there is none.  I am taking it easy, although I'm no longer trying for full bed rest.  I'm just trying to not stand on my feet all that long at any one time.  

We go back Friday for another ultrasound and I'm really looking forward to it!  I am also imagining two little beans in my belly with two strong heartbeats as they start to grow their arm and leg buds.  

What is more on my mind, or more literally in my belly, is what I'm eating and going to be eating during this healthy pregnancy.  In the infertile world where more people than you would imagine end up with twins, I have constantly heard women sing the praises of Dr. Barbara Luke, a professor/researcher/epidemiologist/MPH/registered dietitian who runs a program to help women with their nutrition during twin pregnancies.  She is also a full professor at the University of Miami Medical school, which in my world means she's done significant research and is recognized by a prestigious university as an internationally known scholar.  

So, yeah, she has a few academic credentials.  

But because I am a critical scholar, I also checked out her academic publications through our school.  (We don't have a medical school, but we have a big school of nursing and have a ton of medical journals available to us)  The most impressive peer reviewed, academic study I found by her and her research team involves comparing 190 mothers of twins who've followed her nutritional program to  331 "regular" mothers of twins, all of whom gave birth over 6 years at the University of Michigan hospital.  These women were not randomly assigned to the program, it's one main drawback, but they are all using a university hospital, so they are not completely different populations.  

In any case, the mothers who followed her nutritional program reduced by *more* than half their chances of having preterm labor, preeclampsia and babies' time in the NICU.  They also increased their chances by more than half of giving birth after 36 weeks and increased by 2.5 times their chances of having a baby who was not low birth weight.  Those are impressive results.

I know from some of my criticisms of non-randomized research that you can often explain health outcomes by the "healthy" third variable.  For example, people who very strictly follow their doctor's advice on taking medications are more likely to have healthy outcomes.  And this doesn't matter if the medicine is real or a placebo!  So people who follow her nutritional plan may simply be part of this healthy third variable group--they are just naturally and conscientiously healthier people.  

Nonetheless, when one sees changes as big as these changes--reducing problems by one half and increasing positives by more than a half---one is more likely to believe that the results of the study are due to real program effects and not population differences.  

So yay--a way to improve the odds of us "going all the way" and taking the babies home with me when I leave the hospital.  Which just so happen to be my two main goals with this pregnancy.

What's the nutritional program?  Gaining a boatload of weight the first 20 weeks.  How much weight?  (((Gulp))) 25 pounds by 20 weeks.  She wants a total weight gain for someone my size (which I would like to point out is exactly in the middle of normal for my height.  Ha!  I keep thinking I'm really fat.  But after living in LA, maybe normal/average is fat) of between 40 and 55  lbs for the whole pregnancy.  Yes.  That *is* a lot of weight?  And how do I do it? By eating around 3500 calories a day.  

Holy. Shit.  Do you know how much food 3500 calories represents?  It is a LOT of food.  I thought that it was supposed to be just a lot of protein, but in all honesty, it's the same proportion of proteins to carbs to fats as the FDA food pyramid; it's just a boatload of food.  

Oh. My. God(dess).  I feel like Rene Zellweger gaining weight for Bridget Jones' Diary.  It is not fun at all.  It's one thing to go overboard and eat 2800 calories in one day.  It is quite another to eat 3500 calories every day and not be training for an ultra-marathon.  I am telling you right now that this is worse than any "diet" I've ever been on in my life.  

And yes, I can see why one would think this was bullshit and just eat a little bit more than normal.  But when I see that I have at least some control that is clearly within my own power to go to term with these babies, to not have them be in the NICU, and to take them home with me as fat and healthy as Conor was, I look at the clock and plan when I'm going to have that piece of whole wheat fiber toast with cashew butter and a banana for a "snack."  (That would have been a hardy breakfast a few weeks ago) 


OneTiredEma said...

Protein shakes will be your friend.


Dr. Luke is amazing. I cannot tell you how many pregnant women I have helped manage who followed her book and have great outcomes.

It's not hard gettingin 3500 calories, you just have to find the right kinds of foods.

Diary has calories, and you can have a cup of ice cream a day. The Brewer Diet for Pregnancy is a great one as well to follow if you can incorporate that into what Dr. Luke suggests you have a blue ribbon diet:)

Eggs are a great source of protein, I am not sure if you love yogurt, but yogurt, eggs, toast, cashew butter, peanut butter, meat etc...

I feel for you, but you can do it:)

Uccellina said...

I tried and tried, and couldn't gain enough weight, and delivered at 36 weeks. So yes, follow Dr. Luke and do all you can to gain the weight! And congratulations!

Carroll said...

Go, Anita, go! Scarf down those milkshakes, Kiddo. Double up on the barbecue orders. And hey, a few fries never hurt any self-respecting fetus, right? And oh, my. A cup of ice cream daily? (siiiiigh) Have some Rum Raisin for me, won't you? 'Tis the season, after all. I'm picturing those babies mainlining all that nutrition and tussling each other for second helpings :-)

What fun for all concerned!

Carroll said...

Still thinking about this "terrible hardship" you are facing.

Still having trouble mustering very much sympathy!

Not only that, but you've got me jonesing for ice cream something awful.


Anonymous said...

Hi Anita -- and super-double-plus congratulations! I know I'm late to the party, and I apologize -- I only keep up with my favorite blogs sporadically these days, but I've been thinking good thoughts for you and I'm SO glad you're doing so well. If you haven't already, you might want to read through the post & comments here on the Looky Daddy! blog:

Only anecdotal, I know, when you prefer the statistically significant and population-based - but good reading for a woman in the midst of a twin pregnancy nonetheless! How about a peanut butter-and-honey protein shake with full-fat yogurt? Mmmm...

- Veronica

Anonymous said...

hmmm, for some reason that link broke. let's try it again:

Anonymous said...

oh, I give up -- just go to and click on the right-hand link that says "The Mom Goes All the Way" (it's an image of a seated, very pregnant woman below the neck)