Archives for: October 2013
Before I get to the topic of this blog - Pregnancy and Constipation - I have to tell you that I saw the 18 week sonogram picture of my grandbaby yesterday. When I was pregnant with my first child, sonograms were for high risk pregnancies only. When I was pregnant with my second child, they were more common, but still very expensive. I opted not to have one.
When I look at pictures of heads and feet, beautifully formed in the womb. When I hear the good news that all four quadrants of the brain have formed perfectly, that the heart is beating normally, that liver and kidneys are functioning, I am amazed. While this child weighs less than a pound, it is very much a human being.
Not only that - BC has personality. SIL raced bicycles in college. DD tells me that BC's little legs were going constantly throughout the sonogram, so much so that it was hard for the doctor to count all ten toes! He told DD, your little one is bouncing off the walls. I'll need to have lots of energy to keep up when BC comes to visit.
I have learned something about my Darling Daughter during this pregnancy. She has battled constipation all her life. How did I not know that? How did I not take action, given the colon cancer issues in our family? Constipation is just not a thing that teenage girls or young women want to talk about with their mothers. But pregnancy lowers modesty barriers, and we have had some very honest talks.
Until she found out she was pregnant at about 6 weeks, her bowels had been normal - for her - which to my way of thinking is not anywhere close to acceptable. She only had bowel movements on days when her morning routine was normal - in other words work days when the traffic got her to the office calm and on time. Nothing on weekends, nothing on holidays. Even at that, she did not have a bowel movement every day - so for years she had been having 3-4 per week.
Her diet changed dramatically at 6 weeks pregnant. At first grain and fruit were the only things that tasted good. Then she began to crave meat. Salad, which had been a big part of her diet didn't taste good at all. Neither did raw vegetables. Eventually she complained to me that she was really constipated.
Dr. D recommends wheat bran for Type A constipation. DD didn't like the way it made her feel and it didn't help. Same for larch and acacia fiber, both of which work really well for Type O me. Psyllium products irritate both of us. Chewable Calcium Magnesium made her stomach feel inflamed. She was eating 8-10 prunes a day. They tasted good but didn't help the constipation. She was drinking lots of water.
One morning I got a text that said, "I was queasy yesterday and today, but I don't think it was morning sickness. It is more like indigestion, and I think it is related to my being constipated for so long." She went on to say that she couldn't drink water that morning. She was sipping, but that if she took a big drink of water it bubbled back up in her throat.
She said she had researched laxatives on the internet and they were not recommended for pregnant women because when they started muscle contractions in the bowels it could simulate labor and could cause miscarriage.
I was starting to get worried. I had no idea that her normal state was constipated. What she was describing sounded serious to me. She certainly did not need a blockage when she was pregnant. I had exhausted everything I knew to do.
We agreed it was time to email her OB. The doctor emailed back and recommended a stool softener called Colace. It is safe for pregnancy. DD started with the maximum dose. Even at that it took several days before she had any results. It was two weeks before she felt like her intestines were cleaned out.
She tried to cut back on the dose, but the constipation quickly came back. We have accepted the fact that she will just have to stay on a stool softener through this pregnancy. Frankly with our family history, I think she may need to keep Colace on hand for the rest of her life. From what I read, fecal material remaining too long in the colon is the single greatest risk factor for colon cancer.
After the baby comes, I would like to see her give fiber products another try. However, I am glad to know about a product that works and is considered safe even for mothers and their unborn babies.
When DD was coming out of her exercise and eating disorder, we had no idea whether she would ever be able to have a baby. She told me, even back then, that if God ever allowed her to get pregnant knowing how much to exercise would be the hardest thing for her. That has turned out to be true.
Before she got pregnant, DD and SIL were doing regular, strenuous exercise. The first text DD sent about exercise came on her only bad day of Morning Sickness. She wrote, "Don't worry about me exercising. I'm more worried about eating...ever again."
As she got queasiness under control, she began to exercise again. "BC liked the exercise video we did tonight. We have a much happier baby now." Another text said, "Mental image for you: While I do an exercise video, BC is swinging around like Tarzan on the umbilical cord."
One Monday DD did an exercise video that involved a lot of jumping around. On Tuesday, she did an aerobic workout on an exercise bicycle. That night I got a panicked phone call. DD had some mild spotting. It was only a few drops, but it frightened us all.
The next day I got this text, "So far this morning, all is OK, I am just nervous. This little life was so precious to me before - and now, when something might be wrong, I realize how even more precious it is. I love BC with all of my heart. This little unexpected life means the world to me. Oh Lord, please keep little BC safe in my womb."
DD's OB has an email address where patients can ask questions and get an immediate response from her staff. By 8:30 DD had sent all of her symptoms to the office. The doctor herself called and said she was not worried unless the spotting got heavier. She mentioned several things that could cause spotting in the second trimester, and one of them was exercise.
DD sent this text, "I need to be careful. Tonight I am resting. Tomorrow, maybe some leg lifts...maybe. I think I will stay off cardio equipment for at least a week. This really shook me up."
Once the crisis was past, I sent her my comments:
When we first read about BTD, Dr. D'Adamo said that Type As should do calming, centering exercise. In the early days we noticed this was true in our family. The Type Os gravitated toward more strenuous exercise than the Type As.
During your exercise/eating disorder you pushed yourself to excel in cardio exercise. You adapted to intense physical exercise. Your muscle tone was incredible. I stopped trying to convince you to act like an A, because you were doing so well. You might want to revisit this while you are pregnant. I suggest you slow things down. Do some pilates. Walk - either outside or on the treadmill. Do back exercises - you'll really be glad you did when you get to third trimester. Focus on strength and flexibility rather than aerobic.
The book What to Expect When You're Expecting had a lot of exercises that concentrate on those goals. Eat Right for your Baby allows some low impact for Type As, but also has a list of cautions. Dr. D'Adamo doesn't recommend weights (except very light weights) for 2nd or 3rd trimester. After yesterday, I would be cautious.
DD looked up spotting on The Bump. One of the comments she liked said:
I was running, walking, and going to the gym regularly early in my pregnancy when I experienced spotting after a run. I called my OB and she told me to try a week of rest (no sex or exercise) and to call if it did not go away. It went away in a couple of days and I gradually ramped my exercise back up but stayed away from anything high impact (no step aerobics or running) and stuck to walking, elliptical machine and got a prenatal strength video. I have not had any problems since. Running was not worth the health of my child and I figured I can get back to it as soon as she is born.
Since that episode there has been no more spotting. DD has a daily struggle to find the right balance between exercising enough and not overdoing it. As she predicted long before she became pregnant, moderation in exercise is hard for her.
I've given her many ideas - it's hard for a future grandmother to keep quiet. I think two of them have been helpful enough to mention here.
DD was concerned that she could see what she thought were dimpled fat cells. It reminded her of how her legs used to look. I knew that she was eating a balanced and healthy diet. She was not overeating to the level of adding fat cells. I reminded her that during pregnancy not only was the baby growing, but she would be storing fluid. She needed that fluid for increased blood supply and other physical changes that are normal in pregnancy. I suggested that what she was seeing was more likely to be cells filled with fluid than fat cells.
Some exercise equipment shows visual patterns representing levels of intensity. I suggested that DD exercise in the shape of a pyramid. Start slow, give her body plenty of time to warm up. Gradually increase intensity. Don't stay at peak intensity for long, like at the peak of the pyramid. Gradually decrease intensity, letting her body slowly return to normal. She has tried this for several days and tells me it makes her feel good.
DD has her next doctor appointment in a few days. I'm curious to see what the doctor says about exercise. But as DD said so well in a text, "I know exercise is important, so I want to workout, but BC is even more important."