A completely unexpected diagnosis...

As I discussed in our previous post, I had a follow-up visit with my gynecologist to discuss my blood test results. Fully expecting to receive a diagnosis of PCOS, I was very surprised to find out that my ultrasound was completely normal and my blood work was all within the normal range, with the exception of my prolactin level. I was officially diagnosed with "Hyperprolactinemia" (fancy term for elevated prolactin level). This likely explains my irregular cycles.

What causes prolactinemia?
There are a few different reasons why the level might be elevated. One of the reasons can be an enlargement of the pituitary gland or a pituitary adenoma. Due to that, I have to have an MRI to rule-out this possibility. I'm waiting on my doctor to complete the pre-authorization process with my insurance company to get the MRI scheduled.

I have also been referred to work with a reproductive endocrinologist. I really like my gynecologist -- the doctor she has referred me to is the endocrinologist who helped her with her own infertility issues.

...Infertility?
Yeah... there really is no sugar-coating the fact that an elevated prolactin level suppresses ovulation. And, if I have a pituitary adenoma, it can make pregnancy more complicated (pregnancy hormones can cause the tumor to grow). I honestly thought I had PCOS, but that is often resolved with fairly simple medication to achieve pregnancy. This is a potentially more complicated diagnosis.

I hope this MRI can be scheduled soon, just so that I can meet with the reproductive endocrinologist soon.

I'm honestly feeling fairly defeated today. Pregnancy has been a constant and happy discussion in our home. Several of our friends have recently welcomed new babies or announced pregnancies. Of course, it is hard to not get caught up in the "why me?" and "why us?" We are also trying to avoid jumping to conclusions or relying on Google for answers before meeting with a specialist.

I will likely post again after I feel like I have my own emotions processed a little more around this situation.

Rule Out: Polycystic Ovary Syndrome (Part 1)

Well this post is not an easy one to write, but necessary to document our journey to parenthood. We also questioned about posting about it -- we aren't sure if we would ever share this blog with people we know (i.e., our parents, siblings), but we want to make sure anything we share here is something we would feel comfortable sharing with those people. Therefore, we will be limited in the healthcare information we share. Some people feel fully comfortable in sharing intimate details of their TTC journey -- things like temperature charts that include things like cervical mucus charting. That's great some people can be so open about things, but we think some things should remain private.

That said, we are currently waiting on a diagnosis to explain A's irregular cycles. A had a regular check-up in September and she shared a concern with her doctor that she could have PCOS, based on irregular cycles. A has some of the symptoms, but not all (e.g., it is a condition often considered for women who have trouble losing weight, while A has trouble gaining weight). However, PCOS can still occur in slim women.

What is PCOS?
From the PCOS Foundation: PCOS (Polycystic Ovary Syndrome) is the most common endocrine disorder in females. There are many signs and symptoms that a woman may experience. PCOS cannot be diagnosed with one test alone and symptoms vary from female to female. Early diagnosis of PCOS is essential since it has been linked to an increased risk of developing several metabolic diseases such as diabetes and high cholesterol.

A's diagnostic testing included an ultrasound and extensive blood tests. We have the preliminary results from the ultrasound, which indicated she was in the "very high" range of follicles. While this does not definitively confirm a PCOS diagnosis, it is consistent with hallmark signs of PCOS.

I received a call from the doctor to indicate that something came up "abnormal" in the blood test and the doctor would like to meet with her to discuss this further. I have a doctor's appointment scheduled for Monday (November 30th) to find out what showed up in the blood test. While I am feeling a little nervous, my gut feeling is that the blood test is just confirming the PCOS diagnosis I had already suspected.

What would it mean if I have PCOS?
PCOS involves an increased level of testosterone, which can suppress ovulation. This means that even though I am having cycles, the irregularity of the cycles may mean they are anovulatory cycles. If I'm not ovulating, that means we will have a much harder road to achieving a natural pregnancy.

If I do have PCOS, the likely recommendation will be the use of medication to achieve normal ovulation. This involves the use of medications such as Clomid or Femara. While women with PCOS often successfully conceive with the use of these medications, there are many possible side effects associated with those medications.

One of the side effects to consider is the increased potential for conceiving multiples. The reason for this is because when ovulation is artificially stimulated through medication, multiple eggs can be released. The risk of multiples is about 1 in 10 pregnancies achieved through this medication, compared to 1 in 100 of pregnancies occurring without medication to stimulate ovulation.

Watch for an update tomorrow after the appointment.

Pre-Conception Genetic Testing (Part 2)

The results are in! After a short wait, we received a 7-page report detailing C's genetic testing results (see part 1 here).

Here's a copy of one page of the report we received with identifying information redacted:

You can see under "clinical notes" that we requested the screen because C's family has a known history of Tay-Sachs. C ended up not being a carrier of Tay-Sachs, but is a carrier for 21-Hydroxylase-Deficient Congenital Adrenal Hyperplasia.

The recessive trait C carries is the "non-classic" type, which is the least severe genetic strain. Affected children would produce excess androgen, which may put them at risk of decreased fertility (and this would only be the case if A also carries the exact same strain, which is rare). This disease does not have major health implications and is non-fatal. Therefore, we would not seek the cost of pre-implantation testing and IVF to avoid the possibility of children inheriting this trait -- a choice we would have made if we were both carriers of diseases with high risk of morbidity and mortality, such as Tay Sachs or Cystic Fibrosis.

We were very interested to read all of the disorders C was actually tested for. Targeted DNA mutation analysis was used to simultaneously determine the genotype of 394 variants associated with 100 diseases.

In terms of next steps, this test basically served as a "green light" to conceive when we are ready. We both feel relieved and very grateful that C is not a carrier for a fatal genetic disease.

Based on our experience with JScreen, we highly recommend them for pre-conception genetic testing!

Eating Healthy, Easy Recipe

As we are beginning to plan improving our health prior to pregnancy, we are looking to increase easy and healthy options we are eating. This one is great because all of the ingredients are fresh and healthy, including the pasta (it's whole-wheat!). Plus, this recipe is so quick to throw together -- eating healthy is definitely easier when it is fast.

Ingredients:

13 oz. Whole-wheat spaghetti

10oz. Grape or cherry tomatoes 

1 Thinly-sliced white onion

3 Garlic cloves, thinly sliced

1/2 tsp. Red-pepper flakes

4 Fresh basil leaves, chopped

2 T Extra-virgin olive oil

1 teaspoon Sea salt

1/4 teaspoon Black pepper

5 cups Water

Parmesan cheese

1. Use a large, straight-sided skillet with room to hold the liquid for this recipe. Combine spaghetti, tomatoes, onion, garlic, red-pepper flakes, basil, oil, salt, pepper and water. Turn on high heat and bring the pot to a boil. Remember to stir this mixture frequently, as the spaghetti will quickly stick to the bottom of the pan on high heat. Boil for approximately 9 minutes, until the water is mostly evaporated and the spaghetti is cooked. 

2. Serve immediately in bowls. Top with parmesan cheese.

That's it! 

We also recommend adding chopped mushrooms or bell peppers to add even more texture and flavor. Try it out and comment to let us know what you thought!

Pre-Conception Genetic Testing (Part 1)

We have known since the time we were first married that we would be seeking pre-conception genetic testing. C's family has a history of carrying Tay Sachs Disease. Due to his Ashkenazi (eastern and central European) Jewish heritage, we knew that this increases the risk that he carries several recessive genetic disorders in addition to Tay Sachs, including Cystic Fibrosis (1 in 24 Ashkenazi Jews carries this recessive trait), Gaucher Disease (1 in 15), and Niemann-Pick (1 in 115). 

As we began our journey to prepare for pregnancy, we researched different options for completing the process for completing this genetic testing. We learned that for insurance to cover it, C would be tested first. If his test reveals that he is a carrier of any recessive genetic disease, A will then complete her own test to see if she also carries the trait.
We chose to go through the company JScreen for the pre-conception testing. Our kit arrived just a few days ago -- we took a few pictures so you could see what the kit looks like:

The tube in the picture here is for saliva collection. Once filled with saliva, the top of the cap has a solution to stabilize the saliva for shipping (this is released when the tube is sealed).

Here is a close-up of the instructions on the lid of the box.

We received confirmation that C's saliva sample was received by the lab this week. JScreen then sent him a "quiz" to make sure he understands the basics about recessive traits in case anything comes up positive. If any of the diseases are positive in his panel, we also have to meet with a genetic counselor.

Watch for Part 2 once we receive the results!

A letter to our future child(ren)

Dear future child(ren),

At this point in our lives, you are considered a "twinkle" in our eyes. Despite your status as not-yet-conceived, your father and I discuss you daily. I'd be lying if I said we didn't dream about you often. When we're at the park, we quietly talk about what it will be like when you are here to push in a stroller, catch at the end of the slide, and give "under dogs" on the swings.

Underneath that, we wonder about how you are going to bring your own sense of self into our team. In six years of marriage, if we've learned any sage advice worth passing along, it is that we are strongest as a family when we approach challenges and struggles as a team. Celebrations also mean more when you share them as a team.

Our team is very curious to know what kind of factors you will bring to the team. We know your early days may challenge the existing team a bit. We hope we have the endurance and teamwork to work through the early days of sleepless nights, seemingly-endless diaper changes, and hours of bouncing, swinging, rocking and soothing. We are also told that it is during these sleepless nights that we will also begin getting to really know you and witness your little personality emerging. I hope we have the right bounces and lullabies to soothe you. I hope we give you a sense of warmth and security. Most of all, I hope you feel fully welcomed into the team. I know it will be a process of getting to know you, but I hope you give us a little grace as we slowly learn what you like and what you need.

We can't wait to see our littlest team member begin to gain a little sense of independence. We know it will be hard at first to let go of little hands as you take your first unsteady steps. We hope you will let us know when it is safe to let you go. We can't wait to plan adventures. We're also big on stories, so I hope books and imaginative play are cool with you. We also love kids movies and museums -- we're glad you'll finally give us an excuse to go have fun, without looking like those two weird childless adults in the theater.

I wonder what you will be like as you start school. What your favorite subjects will be, and which ones will be your least favorite. If you'll be disciplined about finishing your homework after school or will need constant reminders. Although your father and I didn't get ourselves in too much trouble, I know we may need to field a phone call or two from your teachers. I hope we have the problem-solving skills to help you navigate whatever comes into your path. One bonus you have with our team -- your mom has reading and writing covered, while your dad is great at math. Be patient with us when you have to explain lessons to us. Although our team is enthusiastic, we will have forgotten a few of the things you're bringing home for homework. Google is everyone's best friend in that situation.

As you enter high school, we will probably be understandably shocked when you go on your first date at 15, and realize that I was that ripe old age when I started dating your father. Although we will only joke about locking you in the attic until you're 30, we will be equal parts scared and ecstatic when that time comes. I hope you know that we will want to ask a few questions of your date and get to know him or her a bit -- and you'll think we're doing this just to embarrass you. We'll be just as worried that we're making fools out of ourselves by asking questions but we know we have to do what we can to ensure your safety. While at the same time rapidly continuing to help you construct sturdy wings to flee our nest. There is no manual for this. We will make mistakes. We don't make any promises to be the "cool" parents, but we will be there -- always -- when you need us.

We know you will make mistakes, too. And we will search our hearts and minds to balance our worries with your yearning for independence. We hope we can deliver those hard conversations successfully. You'll probably go through a period of hating us and thinking we haven't done enough. This will understandably break our hearts. Your mother will know this is the painful growing process of individuation, but I promise you she will shed a few quiet tears about it anyway. We will wait up for you when you're out with friends, partly because we're worried and because we hope you'll share stories with us when you come home. We will be thrilled when you still express interest in participating in family activities, even when we know you'd rather be with friends.

Then the day will come to move you away to college. Since you're still a twinkle in our eyes, I wonder how long this will be from now -- 18 years? 20? 18 years seems like such a short time to enjoy your youth while also preparing you for the next 70+ years of life that lies ahead of you. We will move you into your dorm, gathering all of the parent info cards, making sure to talk to your RA and finding out about all of the resources on campus. We will put on a brave and confident face for you that day and try to save our tears for when it's just the two of us on the long drive back home.

Did you know we have talked about these dreams for each phase of your life before you're even here? We wonder how your life will play out. We know you will teach us more about development and ourselves than we could even pretend to know now. It feels like so much pressure to plan for the next 18 years without even getting to know you first. Maybe you'll figure out college isn't in the cards for you. Maybe you'll be born with something unique about you which radically changes the original script we set for your life in the "you will... and I will... and we will..." conversations your father and I have had on long drives, and in the park, and while waiting at the airport.

You are not even conceived yet, but we talk about you so often. We hope we're ready to be your parents. We both have wellness visits scheduled with our doctors to begin planning the process to start our family. Which feels very scary.

We've planned for you for the past 13 years we have been together. But being this close to meeting you feels like we've entered completely brand-new territory. We know you will challenge us, turn our hair gray, and pull from us a sense of love and purpose that we cannot even begin to understand at the present moment.

We're ready to add a new addition to our team. We're waiting. We hope to see two little pink lines soon, but we also know that the best things in life are worth waiting for.

With Love, Your Anxious Parents

Thoughts on recent loss and child-rearing...

Sorry I have not been updating nearly as frequently as I had hoped this summer. I accepted a new job, we moved out of state, and now I have started my new job. All-in-all, it has been a good (but very busy) summer.

However, we had a bit of a rough week this week. My husband's best friend was let go from his job at the beginning of the week. He and his wife are expecting a baby this winter. While she continues to work, they budget based on two incomes. His sudden job loss had a huge impact on planning for their baby's arrival in a few short months. We were heartbroken to learn this.

This was also a terrifying thought as we think about planning for our own family. We are working on paying off some debt (a car loan) before we begin saving money to grow our family and beginning trying to conceive. This whole experience of our friends' was an excellent reminder that 1.) income can never be taken for granted and 2.) we need to plan ahead for the potential of job loss and job search while pregnant or parenting. Although we had already planned to begin growing our savings pre-baby, this made us re-evaluate our thoughts about timing conception. I think I would like to wait until we completely have the car paid off before we begin trying. The fewer monthly bills we have, the better position we would be in to survive on one income if we had to during a pregnancy or during the time we have a newborn.

As I mentioned previously, I also just started a new job. This experience reminded me of the importance to opt-in for short-term disability coverage, as this coverage would provide income for up to 26 weeks maternity leave. It is important to note -- for anyone job-hunting while also trying to conceive -- my short-term disability coverage with my new employer would not cover a "pre-existing condition." This means if I was pregnant when I was hired, this benefit could not be used to cover maternity leave (yikes!). Without this coverage, I would be able to use any accrued vacation and sick time, plus they add on 10 additional paid days. But anything beyond those 3 - 4 weeks would be completely unpaid. If you are job hunting while planning to start a family, it is important to find out what coverage they offer for pay during maternity leave -- otherwise, you might have to take a very short maternity leave, drain your savings, or try to live solely off your partner's income. Find out how long the waiting period is also. My short-term disability coverage has to be carried for three full months before I can use it.

The other loss we experienced was the sudden death of an old co-worker (and close friend) of my husband. He briefly became ill and died within just a few days. This news came as a complete shock, as he was only in his early 40s. He leaves behind a wife and 3-year-old little boy. The day he died, we were both at a complete loss for words to explain our grief. He was a wonderful father, who was very committed to loving and raising his little guy. My heart is still grieving for his wife, mother, child and all those who knew and loved him. You hear about people suddenly passing away at a young age from rare complications and illnesses, but you never expect something so tragic to hit so close to home. When it hits so close to home and you can picture his wife and son in your mind, the tears just flow freely. You also feel a sudden sense of urgency to do something for his family, although you know that there is not anything beyond comforting words to lessen the devastating pain associated with this loss.

This loss also significantly affected me as I thought about raising a family, in that sudden, devastating losses can sometimes completely change the plans and goals you have for your life. I have taken a significant amount of time thinking and journaling this week about how to even plan or think about this magnitude of loss, and how we would even possibly plan for something like that to happen. I even felt a twinge of guilt writing that down, because it sounds so selfish and egocentric. But it made me realize that once we become parents, it is not just the two of us we have to worry about anymore. If I were to lose my husband tomorrow, I could just focus on my own grief. If we had a child, I would be the one solely responsible for caring for that child while actively grieving, helping the child make sense of the loss and begin their own process of grief, and planning how to care for that child for the next decade or more without my partner. While I logically knew all of this, watching this type of loss unfold before you is inexplicably difficult.

This reminded me about the importance of life insurance while I was opting-in for benefits through my employer. With this new job, I will be the primary "breadwinner." If something were to happen to me and my husband became a widower with a young child, it is important to me that he could take care of my funeral expenses, pay off his remaining student loan debt, and have a cushion to at least support himself for the next several months (if he felt he needed to take time away from work). My employer automatically covers 1.5x my salary in life insurance, but I opted to take out a smaller supplemental policy through them to bump that coverage to 2x my salary. Because of my age, that additional bump was very affordable and is worth it for the piece of mind to know that he could be financially stable if something happened to me.

I recognize this post is very different from the more fun and light-hearted posts I have posted to this blog previously. However, planning to start a family also takes emotional and financial work and planning. Although I think it is difficult to emotionally plan for either of the situations we unfortunately witnessed friends experience this week, it is an important reminder to consider those things (e.g., short-term disability insurance, life insurance) that may help slightly cushion the blow of a sudden loss. Whether that loss more minor and replaceable (a job) or priceless and devastating (a partner), pre-planning a basic strategy allows the immediate aftermath to just focus on emotional grieving and healing, rather than scrambling financially and adding additional stress.

I questioned whether or not I should add this, when I realized that I do not hear many people my age talking about loss often. And if they do, even less time is devoted to thinking about planning or anticipating possible loss in the future. Prior to being in this stage of our lives, I thought about pregnancy and parenthood in more general and abstract concepts. Now that we will hopefully have the reality of raising a child soon, these important considerations will allow us to hopefully care for that child financially. While we also are not in what I would consider an absolutely ideal financial situation (as we still have student loan debt), I recognize our jobs afford us the possibility of preparing for this stage of our lives in a much different manner than people who do not have access to these benefits.

Regardless of your financial situation, I believe all couples who are seriously considering trying to conceive take out a life insurance policy. At the very least, I believe you should consider taking out enough to cover funeral and burial expenses and a few months' living expenses for your partner (so that he or she can take bereavement leave from work, if necessary).

Packing Breakables

We're moving! As our apartment is quickly filling with boxes, I thought I would share my techniques for packing breakable items for an out-of-state move. This is our FOURTH out of state move in six years! All of the items in the picture were packed in one box along with 6 picture frames and two small photo albums.

There are two items I find very important for packing these items are packing foam and Packing Paper. I linked to the packing paper I've used for our last two moves. The pack of 120 sheets is typically enough for packing nearly all of my breakables and picture frames.

To start, tape the bottom of the box shut and place it on top of the foam. Cut two strips the width of the box to line the sides, like this:

For each vase and other breakable, I wrap them first with packing paper, then secure with a layer of foam. Make sure the foam is taped flat on the bottom so that the items can sit upright in the box.

For smaller items, place on opposite sides of the packing paper. Roll towards the center and wrap the ends like a burrito. Tape shut. I placed it in a plastic bag to keep it from rolling around in the box:

For picture frames, place tape across the glass. This helps keep the glass from breaking -- and if it does break, it keeps the glass of completely shattering. Finish by wrapping the frame with packing paper to prevent the frame from being scratched.

When packing breakables fill the box to prevent items from moving in transit. Empty spaces can be filled with crumpled packing paper.

Here's what the box looked like partially packed. Place frames on their side to prevent pressure being placed on the glass. 

Place the lightest items on the top to fill the box. I had silk flowers in two of the vases, which I used to fill the remaining space. And tape shut!

Make sure to label the boxes! Clearly mark FRAGILE on the top and the sides.

That's it! We're planning a new series to roll out while we are in the middle of the moving process. There are also a few new posts in the works for the Summer Reading series.

Happy Independence Day!

For this installment of the Simple Saturday Project series, I chose a Patriotic-themed monogram! I love monograms and enjoy finding any way I can to incorporate them into decor. Lucky for me, monograms are very "in" right now so they are easy to find anywhere! Target has even been carrying unfinished wooden letters for this very purpose. 

This project is relatively simple, just takes some time to allow the paint to dry. Here are the supplies you will need:

• Wooden letter. I recommend a "Block" style letter (rather than script or cursive), as it is easier to paint if the letter is wide and square.
• Blue, Red, and White  acrylic paint
• Masking Tape ("Painters tape") -- this is what you will use to create the stripe effect
• Star stickers (I found these in the scrapbooking section)
• Burlap ribbon -- I recommend wired ribbon, as it helps the bow keep its shape.

Here is an image of the colors I used -- Cobalt Blue, White, and Bright Red. These are cheap paints -- 69 cents each! 

To start, choose which area you want to put the blue square. Be careful to use the tape in very straight lines and press firmly to prevent the paint from bleeding through the lines created by the tape. Wrap the tape all the way around the letter as you will also paint the back.

Here's what it looked like with just the blue quadrant painted. I let the first coat dry, then added a second coat 30 minutes later. 

Leave the tape in place and paint the rest of the letter white. I used two coats. 

Taping out the stripes is the most labor-intensive part of this project. Make sure you're carefully placing the tape to allow for clean, straight lines. Allow the white to dry at least 90 minutes or the masking tape will lift the paint off. 

To make sure my red stripes were the correct size, I used this little piece of tape to measure them out. I recommend taping the whole letter before you begin painting with the red. (I forgot to take a picture of this part of the project, so I captured it after I started the red).

Before you begin painting the red, place tape over the edges of the blue quadrant to prevent overlap. Then cover all exposed white areas in red. You don't have to completely cover the tape. I just got a little over zealous with the paint!

Allow the red stripes to dry for several hours. I left mine to dry overnight, but it probably would have been fine after 2-3 hours. Remove tape. Place stars in the blue quadrant. If you plan on leaving this outside for an extended period and it will be exposed to the elements, I recommend placing a dot of hot glue to place the stars. 

Just add your ribbon and you're all finished! I used a command hook to attach it to the door. I love how it turned out.

Hope everyone has a safe and happy 4th of July!! 

Also, we have a new series that we will be unveiling soon -- stay tuned!

How do you know when you're "ready?"

With one of us working as a psychologist, and the other working in radio, I think our perspectives on being "ready" to be parents is somewhat different. I've had this conversation with many partnered friends of ours, trying to figure out when others determined they were ready. It turns out we know several people who had surprise pregnancies, so their situation decided for them! For those of us with the luxury of choosing when to start a family, it sometimes feels like a heavy responsibility to choose the "right" time (knowing that no one seems to ever be 100% for the difficult journey of parenthood).

For me, I wanted to make sure we were ready as a couple to handle the stress and sleepless nights. I'm still not sure I'll ever be ready for the extreme sleep deprivation described by the majority of mom friends I have with newborns. I'm going to just hope that by the end of my maternity leave, the baby will be sleeping for at least 4-hour stretches at night (I can at least dream, right?). Over the last 13 years, we have encountered quite a bit in terms of stress, and I feel confident that we can face things head-on as a team. 

As a future mom-to-be, I also feel it is important to be able to have a patience necessary to deal with things diverging from my set plan significantly. I do think working as a therapist helps with this, as I constantly have to alter my plans for treatment based on constantly changing variables with my clients. While I consider myself a fairly patient person, I was raised by a mother with the patience of a saint -- seriously, cool, calm and collected when it came to anything involving her kids. I hope she will be able to help my continued growth in this area. I'm also working on mindfulness practices to help further enhance this. I'll plan to make a post all about mindfulness in the future, because I think it can benefit anyone (even those of you who aren't planning to have babies and toddlers),

The other major variable I considered important in evaluating my own "readiness" was financial stability. Initially, I considered the possibility of having a child while in graduate school. This ended up being a completely irrational plan because I was required to "work" year-round as an unpaid intern to gain experience as a therapist. Currently our timeline to conceive is completely dependent on my job search. I'm finished with school now and actively job hunting. I anticipate finding a new job in the next month or so.

I'm happy to have this space to share these thoughts. If you'd like, comment about what your thoughts are about being "ready" to conceive and ready to become a parent.

Seeking Hydration

In some ways, it seems like some of the most simple lifestyle changes to prep for pregnancy are turning out to be the most complicated. Case in point: Trying to increase my fluid intake.

I've never been a big drinker, of any liquid. I already don't drink alcohol (We both choose to abstain, actually -- maybe I'll write a post on that choice at some point). We also both have been pop-free (or soda-free, coke-free, insert-your-preferred-lexicon-for-carbonated-beverages-here-free) for the last 12 years. You would think that would mean I would naturally drink more water. Well, my preferred drink of choice when we're out to eat, at the movies, etc. is water. But I'm not drinking anywhere near 8+ glasses/day. In fact, C even developed a nickname for me related to this very issue -- he calls me "dixie" (as in, those tiny shot glass sized dixie cups) because anytime we're out to eat, he goes through multiple full glasses of water, while I drink maybe 1/3 to 1/2 of a glass over the course of an entire meal. 

I know this is a problem. I really like water and it isn't as if I have some aversion to drinking it. I just don't gulp it down like most people I know. It's unfortunate that C isn't able to carry the baby, because he gulps down so much water you'd think he was preparing for a drought. I know that pre-pregnancy and during pregnancy, my body is going to need substantially more fluid. 

So, I'm trying to figure out just how I'm going to manage to drink a lot more water throughout the day. My current office has a nice water cooler just a few feet from my office door. The water is nice and chilly. But how can I remind myself throughout the day to be drinking more?

Today at Target, I found the nice "glass sipper" photographed at the top of this post. I love the bright yellow accents on it, and I also like that it is glass instead of plastic (the straw is still plastic , but still seemed like a healthier option?). I've heard of a newer trend to "infuze" water with fruit. All that seems to mean is people are slicing up fresh lemons or placing a few berries at the bottom of the glass to add some fresh flavor to the water.

How are you increasing your fluid intake? Any recommendations to track fluid intake?

Chapter 1: Preeclampsia, Epigenetics, Stress, and Flu Shots

I'm finally getting the chance to start off the summer reading series with a review of Chapter 1. If you're just joining and would like a chance to read the book, I placed a link to purchase it at the bottom of this post! 

Chapter 1 of Dr. Lu's book gave a general overview of what to expect in the book! Starting off the chapter, the reader learned about how preeclampsia develops and what it means in terms of health of the mother and viability of placenta. I was interested in learning more about preeclampsia (formerly known as toxemia) as I know a few mothers who suffered from it and had to deliver babies early via emergency c-section. I realized I did not know what symptoms of preeclamsia were beyond elevated blood pressure, and the only symptom mentioned in the chapter by Dr. Lu in the chapter was high blood pressure.

I did some reading on the Preeclampsia Foundation website to learn more about signs and symptoms of the condition. I've detailed some of the symptoms below:

• High Blood Pressure: "High blood pressure is traditionally defined as blood pressure of 140/90 or greater, measured on two separate occasions six hours apart." I was interested in seeing if the website had anything to say about pre-pregnancy planning, and found the following useful... "Know your blood pressure prior to pregnancy, especially if it's normally considered low.  Ask, "What is my blood pressure?" during each prenatal visit with your healthcare provider."
• Protein in your Urine (Proteinuria): Readings of 1+ or greater can be indicative of preeclampsia developing, even when blood pressure is within the normal range. I did not know that you can purchase test strips to monitor protein in the urine at home, if you're concerned about develop preeclampsia. 
• Swelling: From the website, it sounds like mild swelling (particularly in the feet) is expected as a common occurrence in pregnancy. Swelling consistent with preeclampsia appears to often present as excessive facial swelling or pitting edema. Pitting edema is identified by swelling where an indentation from pressing with a finger "holds" for a few seconds, instead of immediately returning to its normal position.
• Headaches: Painful, light-sensitive headaches are a cause for concern. Headaches accompanied by any changes in vision are immediate cause for concern. Any sudden changes in vision (seeing "auras," sensitivity to light, or blurry vision/seeing spots) should be immediately evaluated.
• Nausea/Vomiting: GI problems are common in early pregnancy, but sudden onset of nausea and vomiting in the 2nd or 3rd trimester is not. It's recommended women who experience that have their blood pressure and urine checked immediately.
• Pain in the Liver Area: This can either occur around the liver directly, or as "referred pain" in the shoulder or lower back. 
• Sudden and excessive weight gain: Defined as 2+ pounds within a week. Prior to pregnancy, it is helpful to maintain a BMI of 30 or less, as obesity increases the risk of developing preeclampsia. Drinking an adequate amount of water is also important.
• Sudden shortness of breath: May be indicative of fluid accumulating in the lungs.

As highlighted by Dr. Lu, these symptoms cannot be ignored because preeclampsia can quickly lead to life-threatening emergencies or even maternal death. The Preeclampsia Foundation noted that "by conservative estimates, these disorders are responsible for 76,000 maternal and 500,000 infant deaths each year."

What can be done pre-conception to decrease risk factors of preeclampsia? Adopt a healthy weight-management routine (if your BMI is above 30), reduce sodium intake, and know your typical blood pressure. 

Overall, the chapter made an excellent case for why it was so important to attend to several variables of maternal health prior to conception. Dr. Lu pointed out that many women don't see a doctor or even know they are pregnant until a few weeks after conception. At that point, the baby already has developed the beginnings of a cardiovascular system and the neural tube (which will later develop into the brain and spinal cord). 

Another important factor Dr. Lu briefly highlighted was epigenetics and maternal stress, and how this contributes to the overall long-term health of the fetus. For example, women who experienced influenza during pregnancy increased the risk three-fold that their baby would develop autism or schizophrenia later in life! 

Questions to reflect on in the comments:What did you think about Paula's decision to wait to have a c-section despite having serious symptoms of preeclampsia? Are there any pre-conception lifestyle changes you have thought about implementing to help prevent pre-eclampsia?

For myself, I have been trying for some time now to reduce sodium in my diet, but will be focusing more seriously on this goal as I get closer to TTC (trying to conceive). I also strongly agree with Dr. Lu's conclusions about the negative impacts of stress on the fetus; I'm working on mindfulness and other stress reduction techniques I hope to reflect on in future posts!

Want to join in the reading series but haven't purchased the book yet? Click the image of the cover below to purchase it! 

Get Ready to Get Pregnant: Your Complete Prepregnancy Guide to Making a Smart and Healthy Baby

Simple Saturday Project: Burlap Love Letters

I have been searching for a simple wall hanging for our bedroom, but could not find just the right thing to hang above our bed. I ended up creating this easy Saturday project -- and thought I might turn it into a series on the blog! I'm going to call the series "Simple Saturday Project," posting easy 1-day craft projects. 

This project is as simple as can be, as long as you can paint light, thin coats of acrylic paint and manage a glue gun. It is also inexpensive. I purchased all of the supplies for less than $15! For this project you will need:

• 4 burlap canvases. I took a picture of them in the package so you can see what they look like (they come 2 in a pack):

• Four wooden craft letters. I recommend purchasing the letters and canvas at the same time -- hold the letters up to the canvas to ensure the letters you're purchasing can be centered well on the canvas.
• Acrylic paint and a small paint brush. I recommend a matte finish paint, as it does not show the brush strokes as prominently as a glossy finish. The small brush makes it much easier to paint the edges of the letters.
• Glue gun and glue sticks. I have a "high" heat mini gun. 

Step 1: Paint the front and edges of all four letters. The wood does soak up a bit of paint and it is easy to forget the little edges and sides of the letters. Don't worry about painting the back of the letters -- that side will be firmly glued to the burlap. Let dry 20-30 minutes in between coats. Remember to use thin coats and watch for bubbles in the paint. A professional looking finish takes a little bit of patience but is preferable to one thick, gloppy coat. I also recommend purchasing a small paintbrush for this craft. The letters below were painted with a glossy paint and you can easily see the brush strokes. A matte finish dries a little better:

Step 2: After your letters have dried for about 2 hours (should no longer feel "tacky" to the touch), plug in your glue gun and prepare to place the letters on the canvas. Use several large dots of hot glue to firmly affix the letters. Also, once you've firmly pressed the letter into place, flip the canvas over and push on the letter from both sides. I didn't do this at first and the bond was much looser. If it fails to bond well, let the glue dry, peel off the glue, and try again. 

Step 3: Place the canvases together to make sure the positioning of all of the letters looks okay. I used the natural lines created by the wood behind the canvas to make sure the letters were centered properly. 

And that's it! Very simple project you can complete in just a few hours. I chose a pale yellow and gray color scheme because it matches our bedroom. Here is the finished product hanging on our wall.

Happy Saturday! We'd love to see this project if you make it -- 

please comment with a photo if you do!!