Happy Thanksgiving! Happy Birthday to Me! And 33 Weeks!

It has been a lot of celebrations this past week, with, in the order I shall set out in this post, Thanksgiving, my birthday, and my hitting 33 weeks.

We celebrated Thanksgiving in our apartment on Thursday evening, with two Peking ducks and all the trimmings (cucumbers, spring onion, wraps, plum sauce), cranberry sauce, mashed potatoes stuffing, brussels sprouts, a chocolate pecan pie and a pumpkin pie.  Everything was made from scratch! And Michael bought a lovely bottle of Chateauneuf du Pape to pair.  I allowed myself a small half glass of wine and generally watched my carb intake, but it was a great meal.

 On Friday morning I was awakened by Michael and Lola coming into my bedroom with presents and flowers!  It was so cute and sweet.  I was given a lovely bouquet of flowers, a beautiful set of Japanese bowls, and two airy, light, beautiful cashmere and cashmere/wool blend scarves.  I love them!  He also got me a desk chair for the small desk in my bedroom, although that isn't coming for another 2 weeks because they have to custom make it with the cream/gold fabric that I want.

 Then I was treated to a lovely lunch at beefbar with my coworkers and secretaries.  I had a really delicious kale salad with anchovy dressing paired with a beautifully cooked ribeye.  They turned it into a birthday party and baby shower, and I got a sweet card with vouchers to mothercare.  They were also very thoughtful and set me up with a candle lit cheese platter rather than a cake, although none of the secretaries who arranged it have children/have been pregnant/were aware that I couldn't have unpasteurized cheese or blue cheese.  Nonetheless, it's the thought that counts!

 I indulged and had a ricotta cheesecake dessert which was really not very sweet.

 I also got a beautiful bouquet of flowers from work, which I would argue surpassed all the ones from previous years in freshness and quality.

 

For dinner that night, given it was my choice of food, it was a no brainer - hotpot!  We got a non-spicy and a spicy pot going and had several kinds of beef, pork, shrimp and fish, as well as my favorite vegetables (frozen tofu, white radish, and chrysanthemum leaves).  Lola is already a hotpot fan, clamoring from her chair, "I want my meat!" and "I want my wagyu!"

Jovie outdid herself considering she had only made pumpkin pie and chocolate pecan pie for us the night before - by making me a most beautiful and delicious strawberry (low sugar) cake.  Truly, it was so yummy.  I'm not sure if I've ever had a cake made from scratch!  They all sang happy birthday to me, including Lola, which made me very happy.

And finally, I've hit 33 weeks!  I feel bigger than ever and my stretch marks are now out with a vengeance.  Unlike last time when the marks were mostly on the sides, now it's not only on the sides but also directly in front, where my belly is probably stretched the most this time because the shape is so sharp.  

Also, it's official, I am bigger now than I was at nearly 39 weeks with Lola, because I went back and checked out this blog and the shirt I was wearing at 38 weeks barely fit me last week.  Yikes!  Check out the belly:

 

This one is particularly comical because it's just all belly and projectile belly button!

 

Big Kid Transitions and Staffing Up

As we near Lola's 2nd birthday (oh my gosh!) we are heading for some big kid transitions.

We remain 0-24 or some similar and not at all exaggerated insane ratio of success to failure on Lola's potty training.  I don't know how Lola has managed to rule us all with her tiny iron fist but she has succeeded.  We bow down to her in awe of her prowess in evading our every attempt to get her to go to the bathroom on her potty.

But we have had good luck this week in getting Lola into a big kid bed! 

I have been terrified of transitioning her and picturing all kinds of nightmare scenarios of her not sleeping, or wandering into our bedroom - and with the twins newly arriving to boot. But I finally decided it was time to bite the bullet, and we had best do it now before the twins show up.

I spent a lot of time trying to find a bed that would be flexible and allow this transition, because I know she is an incredibly active sleeper who would need side guards.  However I still wanted her to have a little bit of autonomy to get in and out of the bed on her own, as the point was for her to leave the crib. I also didn't want the jump to be too big and I was worried she would lose some security in a full twin.  But I also didn't want to spend all this money on a toddler bed that she would likely outgrow within the year.

After a lot of agonizing, I bought Lola a Stompa convertible bed that goes from a toddler bed (the size she is at now) to a twin.  The mattress is a bit wonky shaped and is comprised of 3 bits (the main part and two equally sized add-ons) that together make up the toddler bed and then eventually the twin bed.  I had to get custom sheets made at a fabric store in Wan Chai, but luckily we live in Hong Kong and that is one of the easiest things to find and have made here.  I picked a very luxurious light pink silk linen blend that is the softest fabric they had, but I will likely go back and have a couple more sets made that are more fun and colorful.

On Monday we started in earnest with Lola's afternoon nap, by having her nap on her mattress on the floor.  When she saw it, she was so excited and immediately shrieked and jumped on her "new bed."  She was so excited it took her over an hour to fall asleep.  She was clearly testing her autonomy and relishing her ability to just pop up and run and bounce onto her mattress by herself.

Ditto sleeping on just the mattress on Monday night, but with towels and blankets on the sides.   Ditto Tuesday nap and bedtime, but this time with her foam playmat under the mattress as she kept rolling off.  She didn't get to sleep until nearly 9:30 pm on Tuesday night, an epic 2 hours after we tried to get her to sleep - ouch!  She spent so much of Tuesday night sleeping on the playmat on the floor that she woke up on Wednesday morning with imprints on her cheek.  ...As I said, she is a very active sleeper.

Overnight, in an act of utter fatherly devotion (I think I woke up to the sound of hammering and banging at 3 am) Michael put her bed frame together so that it would be ready for her Thursday afternoon nap.

So far, the bed frame seems perfect because it has a slight ledge around almost all of the sides, a high headboard and a medium sized footboard, ensuring that Lola is prevented from rolling out on almost all sides.  It is also relatively low to the ground.  The only danger would be if she decided to stand up and jump or somehow vault over the edge of the bed in her sleep or during playtime.  To proof that, we currently have her crib mattress laid out on the floor next to the bed just in case.

The verdict so far seems to be that Lola loves it.  She told her teacher at playgroup today that she has a new bed.  She likes to climb up and wiggle down from it by herself.  She has room for her bunnies (all 3 or 4 of them) and her small pillow and light blanket (which she kicks off and never uses anyway).  So far so good and please, fingers crossed, may this transition be smooth and safe.

The other huge development in our lives is that we have hired a part time driver.  I expect this to be life changing.

He had his first day on the job today (still on a temporary and trial basis) but I think, barring any mishaps that pop up over the next couple of days, we will proceed.  He is a former police officer (now retired) who served in various departments in the police department for over 30 years, including a special security unit for visiting diplomats and VIPs.

He is only driving for us for a few hours each morning during the week, but essentially that takes care of getting our nanny to our apartment from the MTR station, Lola's round trip journeys to classes or playgroup, my morning commute to work, and picking up or helping with delivery of groceries.  He is super professional, responsible, polite and neat, and so far seems a very steady and smooth driver.

Only time will tell but I am pretty sure having a driver is a luxury we will be loathe to give up!

32 Weeks

I am 32 weeks!  Just trying to make it to at least 34 weeks, and anything after 36 weeks would be gravy (for the babies, but probably not for me).  I feel huge and heavy and it's very unwieldy getting around. But my belly is incredibly sharp - all pointy and no sides.

One of the moms in my twins group got scheduled for a C-section at 37 weeks and she said she never thought she'd get so uncomfortable that she was happy to be cut open, but I guess that's the kind of relief all moms of multiples are looking forward to.

At the latest ultrasound appointment I went to, we could barely make sense of heads or stomachs or legs and arms, it was just a blurry mass of black and white and grainy gray.  But there was one part that had me laughing, which was when my whole belly was shaking and you could clearly see one twin kicking the other twin - but I just wasn't sure where the foot was landing - maybe the stomach? The neck?  Gosh, already wanting more privacy and space, poor things.

I am definitely running out of room in there - my stomach looks like a torpedo and my belly button not only has become an outie but is basically a mini-projectile itself.  I don't know where the babies will find more room!  But overall I am still feeling pretty good, just a lot more easily tired and I often find myself accidentally scraping my belly on a door or a chair because I underestimate the size of my belly.

I feel the babies' movements a lot more "sharply" this time around than last, if that makes sense - I can't tell which baby is moving but sometimes there seems to be a lot of movement that happens all at once.  I suspect this is when both babies are moving (or fighting or kicking or bouncing off of each other).  And then of course because they're so packed in there, I have felt a few very sharp scrapes and kicks in some inopportune places, like my ribs and my bladder.  I have had way more freakishly knob-like protrusions on my stomach this time around than last.  They are particularly active right before I go to bed and sometimes, sitting on my bed, I just watch my belly shift up and down and undulate with their activities (visible through pajamas).

The babies are on track (for twins - there's a different scale for size that will help you compare to a singleton) size-wise and weight wise, and are a little over 3 pounds each.  They're pretty close in size to one another, which helps relieve everyone's worries about twin-to-twin transfusion (TTS) or other issues.  (Quick background, basically, very early on my doctor here was pretty sure that they were DCDA twins (each in their own amniotic sac, each in their own placenta) which is the least risky combination of twins to have, and a pretty good indication that they are fraternal.  But the only time you can really clearly be certain is during the nucal translucency scan in a very short time during weeks 10-12.  And I got my scan at Weill Cornell in New York over the summer, and I have not been able to get access to my sonogram pictures from there to verify.  But the sonographer who did my scan at the time seemed very confident that there were two placentas and put that in the report.  So we're going with that.  If the twins did share a placenta, however, then there would be additional risks of TTS which is when one twin grows and the other doesn't, perhaps because one is siphoning off all of the nutrients from the other.)

Otherwise, all well here.  The gestational diabetes are still a pain but I have some psychological relief knowing that the end is near now.  The insulin shots, as awful as they are, are actually manageable once you become used to it (and you have to inure yourself to it pretty quickly, because it happens every meal) and I am feeling much less stressed now that my numbers have steadied and are a little more predictable.  The only thing is that I've managed to bruise up my right thigh completely from the shots - probably because I'm right handed and just much more forceful than I need to be.  Unfortunately going on insulin doesn't mean you're allowed to eat whatever you want - it's still eating the strict GD diet but with more needles and finger pricks in addition.  I think my worst cravings have been when I sit down next to Lola for breakfast when she has a thick, fluffy, hot pancake drizzled in honey and paired with fruit or fresh squeezed orange juice, while I sit with my egg omelette and 1 slice of multi-grain wheat bread with peanut butter.  Auuuugh! Today I cheated and ate a whole apple instead of half of one - yes, this is the kind of guilty indulgence we are talking about!

The End of My QMH Saga and Some Recent Lola-isms

WELL.  Thankfully I made it out of QMH on Friday afternoon, finally.  I was discharged at around 4 in the afternoon.   It took so much longer than expected.  I had been told that as soon as I posted a good post-lunch number I could leave.  At that point I was prepared to lie about my number to get out, so that didn't bother me.  But when I finally posted my number, I couldn't find any of my usual nurses on duty.  I think Friday must be big shift change or something.  So I had to explain to a nurse who was unfamiliar with my situation that I needed my insulin pens, stat.  I was already prepared to buy the needles at a pharmacy outside of the hospital, so wasn't going to let that keep me. 

I was really confused why it was taking so long - I had seen the insulin pen the night before and I thought it was being kept with the nurses in the OB ward.  But then it turns out that my pen had to be prescribed to me, and picked up in the pharmacy in another building.  So I guess the pen they showed me the night before was just a dummy, or else not really intended for me.  The nurse babbled something about their making a distinction between inpatient and outpatient use.  But that doesn't make sense because the pens are personal - once you use it you can't share it with someone else.  The hospital is so cost conscious that they only allow you once piece of paper towel each time, don't have any paper cups, and don't serve any napkins with the meals.  If they had given me a full insulin pen just for inpatient use, I would have only been able to use it one or two times before it would have had to be thrown away, which I cannot imagine that they would allow to happen. And if it was really my pen and they were giving it to me, then why when it was time for me to be discharged did I need to go get a new insulin pen from an entirely different pharmacy?

Anyway, I finally managed to go to the pharmacy, pick up my pens, buy the needles (they managed to find a locksmith after all), and settle my hospital bill.  The bill for 5 days and 4 nights of torture?  HK$555, or approximately US$70.  That comes out to less than the needles and glucose test strips that I had to buy and is about a quarter of the cost of a consultation with a private endocrinologist.  Admittedly, that is pretty astonishing.

Jumping into the Uber at the hospital felt like freeeeeedom.

Now that we have (somewhat) put the saga of my hospital stay behind me, and I have successfully injected myself a few times (the first time was the worst), I'm prepared to discuss much better and funnier things. 

Like Miss Lola.

Birthday Dress Rehearsal

She is almost 24 months, it is just 2 weeks away!  She has been anticipating her birthday for a while now and last week Jovie made her a strawberry cake so she could "practice" her birthday.  She did great - she sang happy birthday to herself, in English and Chinese, then blew out the (imaginary) candles, and giggled profusely.  When Michael offered to cut the cake with her, she refused because she wanted the whole cake and couldn't bear to see it cut up.  She loved the icing and pronounced the cake "so sweet".  Her birthday party is being held in a room at Maggie and Rose with a transportation theme, which we fully expect her to love because it should consist of a lot of ride-on vehicles.  Hopefully she has fun and doesn't decide she wants to do something else on the day (very much known to happen when she makes up her mind).

 I Cry!

So far, Lola has gone to a few assessments for kindergarten for next year.  At the first one we went to, she refused to go up the stairs because she was panicked that Michael wasn't coming with her (they only allow one parent in the classroom), then refused to go into her assigned classroom (she liked that the classroom next door had buses), then cried when they closed the classroom door in her face.  Needless to say, it could have gone better. But at the second one we went to, she sobbed her eyes and heart out as soon as we approached the threshold of the door for kindergarten and kept beseechingly pointing to the (completely closed and shuttered) indoor playroom, saying she wanted to go there to play.  I could not, through any force of will, power of persuasion, bribery, or physical force, get her to stop crying or to calm down.  She finally made a very shy and shaky appearance at the end of her 25 minute assessment, with about 2 minutes left, and answered in a monosyllabic whisper some simple questions from the teacher.  So that made me think the first assessment actually went swimmingly well.  When we got home, Michael asked her, "Lola!  What happened?!"  She said cheerily, "I cry!"  And he said, "But why, Lola?  Why did you cry?" And she chirped, "Because! I want to go home!"

Where Lola Goes 'Bleeaaargh'

Last weekend we planned to go to the American Club on Sunday afternoon/evening as is our custom now.  We had gotten into the car and were about halfway there when I noticed that Lola had suddenly gone very still and was swallowing and acting a bit odd.  Then suddenly, without any warning, she opened her mouth, gagged, and threw up all over herself, her car seat and the car.  She was bewildered by what was happened and started crying about halfway through, her little hands coming up to touch her mouth in shock.  She is generally a very healthy baby and has only thrown up violently once before, when she was much younger and coughing so hard when she was sick that she threw up all of her milk.  Michael pulled over as quickly as he could and we got her cleaned up quickly, hurriedly reassuring her all the while.  Thankfully we had a spare change of clothes (diaper bag packing for the win!) and she calmed down pretty quickly.  We still don't know what caused it as she had no fever and didn't present any other symptoms - my only thought was that she hadn't been eating well and had too many fruits and foods with acid (passion fruit, banana, strawberries, plums) in quick succession. Later, we asked her, "Lola, what happened?"  And she said, "I went 'Blaaaaaaargh'" and made very dramatic (if not quite realistic) noises that was very much akin to her barfing. 

On "Borrowing" Things

Lola is really quite shameless when it comes to approaching strangers for things that she wants.  She is super gentle and polite about it, but she won't let embarrassment or uncertainty get in the way.  When she saw an older girl and boy playing basketball at the public playground in Wan Chai, she went right up to them (never mind that they were in the middle of a game) and asked if she could play with their ball.  And another time, when three boys were playing soccer in Victoria Park, she went right up to them (never mind that they were in the middle of a game) and asked if she could kick their ball.  Then when she came to visit me in Cyberport last week, she was obsessed with all of the scooters and bicycles that all the older kids were whizzing around on. We told her she had to ask permission first.  Undaunted, she went right up to the little boy, reached out her hand and said, "Please, may I borrow?  I want."  She was refused.  Undeterred, she found another pair of siblings and said the same thing.  This little boy was much nicer and let her try his scooter.  She then saw a tricycle in another part of the park and tried to take it.  We told her to ask, which she did, very nicely, and was granted permission.  Lola got in, looked at us and said, "I want to take it home."

"I'm a Little Shy"

The foregoing is also what makes this anecdote quite amusing.  Lola will repeat or mimic anything we say, including, to Michael's great amusement, saying, "Mama, what's your deal?" or "Daddy, what's your issue?"   She also tattles when Michael says "Oh my God."  I'm sure it will be less amusing when she picks up his curse words or our bad habits, but for now it is pretty hilarious to hear her say and apply words or phrases she picks up.  She has this knack for using them in exactly the right situation, I don't know how.  When we were at the park and told her to ask for permission before using the tricycle, she murmured sweetly, "I'm a little shy."  We burst out laughing at that.  She is shy, but perhaps not in the situation of asking for toys that she wants.  She must have heard us say that before when she clams up in front of strangers, but how did she know to apply that phrase right then?

"You Stand Here.  You Sit Here.  You Hide Here."

Lola loves telling us where to go.  I think I've mentioned if we are in her way she will issue commands like a little battalion commander - "Mommy go to sleep," "Daddy go to work," "Tita/Auntie go to the kitchen."  Well in addition to that, she also likes to tell us where to stand.  When we were at the park, she placed Michael and me next to each other and essentially commanded us to stay in the spot she directed.  Then she ran away from us and doubled back around to run toward us.  The funniest of all of this is how bad she is at hide and seek.  She loves to play "hiding," but refuses to hide and instead runs out toward the seeker giggling.  And when it's her turn to seek, she will first point to the exact spot that she wants you to hide, never mind that it defeats the purpose of the game.

A Week in Queen Mary Hospital

Thank you all so much for your outpouring of support and thoughts for my ordeals with GD this past week.  I tend to be a bit dramatic and I know I am making a bit of a mountain out of a molehill, in the whole scheme of things of what could be wrong, but on a personal front it has felt really awful this week.  This has not been a good mental and emotional period for me.

Aside from 15 hours that I was allowed home leave on Tuesday night, I have spent 5 entire days in this godforsaken public ward at Queen Mary hospital, pretty much pacing its fluorescent lit halls, choking down inedible paste and sulphurous eggs, working (working on an iPad and mobile phone with no WiFi I might add), stalking Lola over the home video-cam, and trying to entertain myself with whatever I can coax to download over my hotspot.  Oh, and fighting with the nurses and doctors at every turn trying to get them to release me. 

This hospital needs some goddamn WiFi.  They also have insanely strict visiting hours, limited to an hour at lunch and two hours from 6 to 8 in the evening.  They also do not allow any visitors under 2. Also, this is a general ward with no doors or walls.  Everything is separated by curtains.  And as far as I can tell, this is where all pregnant women come for ailments, including if they have started the birthing process but have not progressed far enough to get into an actual labor and delivery room.  So many times during the night and day I had had to deal with a whole range of distressed sounds, from light groaning to mid pitched moaning to loud sobbing and wailing as women began labor. I mean, is that your idea of a relaxing and calming place to rest?  When I had to do a few conference calls, I was really praying that there would not be a cacophony serving as my background noise... it would be perhaps a bit awkward to explain.

I already ranted about this for nearly half an hour nonstop to my sister while furiously pacing in the hospital parking lot this morning, but the amount of roadblocks that the hospital and fate have devised to prevent me from being discharged are, at this point, bordering on ludicrous.  I feel like I’ve checked into an insane asylum where I cannot get out, and it’s like the harder I try the more things pop up to thwart me.  Someone is having a good laugh at my huffy expense.  

Basically I returned to the hospital on Wednesday morning to be informed we were finally starting insulin.  But we missed the morning dose and so I would have to stay overnight.  I bore that with some semblance of grace and resignation, because I figured that was fair and I had understood it would take probably a full round of meals for them to properly adjust my dosage.  I started on 4 units of fast acting insulin before lunch and 4 units of fast acting insulin before dinner.  On Thursday morning, I had promising meetings with both the endocrinologist and the DM nurse.  The endocrinologist said I could be discharged after I had my meeting with the DM nurse who would teach me how to use the insulin pen and change out my needles.  He said I was cleared from his perspective but because I was in the obstetrics ward I would need the OB’s sign off.  The DM nurse taught me the technique and I was on my way back to the ward before lunch.  I was foolishly and hopefully ecstatic that I would be home after lunch, ready to hang out with my family.  

I asked to be discharged, but the nurses were hesitant to just let me go and needed a final sign off from an OB, who I was assured was doing rounds between 4 and 5 pm.  Defeated, I sat down to wait, and thought perhaps I could get sign off and still make it home for dinner.  The OB showed up at 5:20 pm, then was somehow shocked and surprised that she had the power to determine my discharge and tried to push it to the endocrinologist. When I adamantly stated (and it was in my records in black and white) that the endocrinologist had already gave me clearance to be discharged, she switched track and said that because one of my numbers was still a bit high from after lunch, she would feel more comfortable letting me go the next day, ideally after they had a general meeting in the morning and after they saw my post lunch numbers.  I pushed back so hard that I thought I was pretty much assured of a home leave.  I made some very convincing arguments, no doubt one of which was that they were not going to do anything overnight anyway except check my numbers, which I do by myself via finger pricks.

Finally, I thought.  

But in an epic fail of miscommunication, laziness and bureaucracy, no one ever prepared my insulin pen!!  How is this possible?!  I wanted to howl.  I kept asking who was responsible and where my pen was.  But apparently the obstetrics ward thought the DM nurses would do it, apparently the DM nurses thought the endocrinologists would give further instructions... apparently the DM nurses really really screwed up.  Without my insulin pen, they were not going to let me leave.  

Hope rose in me again when at a little after 6pm, they miraculously found my pen!  But I needed needles which I would have to buy by myself for the pharmacy.  I nearly ran down there to buy the needles, only to be told there were 3 different sizes and did my nurse tell me which one?  Uh...nope.  The DM nurses left no instructions and were gone for the night.  The OB nurses were clueless and had no idea.  The OB nurse and OB shrugged and said, “Oh well guess you have to stay.” I wanted to punch them in the throat. The nurses injected me with a syringe before dinner, and I settled in for the night stewing and trying not to think about the injustice of it all.  

I missed seeing Lola entirely on Thursday.

Then, this morning, Friday, finally dawned bright with hope and promise.  Honestly, at this rate, I was prepared to starve just so my numbers looked good enough so I could be discharged.  I knew I just had to get the needles.  The OB nurse already promised me that once I purchased them, showed them how I would use the pen and got a good post lunch number, I could go.  I went down to the pharmacy as soon as I could, only to see a sign that it was closed until noon.  Then I returned at noon, only to learn that the lock in the pharmacy door had malfunctioned and they cannot locate a locksmith and they “hope” to have it open by “no later than 2 pm.”.  

YOU GUYS.  Is this crazy or what?  Now I am sitting here venting, helpless, looking at Lola on the videocam, seeing the beautiful weather outside, and waiting.  The OB nurses are already trying to get me to stay until the afternoon or dinner and I just cut them off and said NO.  I am leaving as soon as I test my post lunch number.  If they still won’t let me go, I am just walking out of the hospital by myself.

I think what both disheartens and frightens me is the disconnect between the two departments.  The endocrinologists already have said that the insulin levels have to be adjusted and monitored over time.  It’s a fact that these numbers will change.  Getting perfect numbers now does not guarantee they remain perfect.  But it’s like the OB and OB department have never dealt with a GD patient before.  They don’t want me to leave until they see a full set of blood glucose readings firmly within range. Both departments pass me back and forth like a hot potato when it comes time to calling the shots.  It. Is. So. Frustrating.  

I came to QMH this week as a last resort and because it seemed the best option at the time (the private endocrinologist  I previously saw was out of town this week) and I figured it was better to get on insulin earlier rather than later.  But for the love of all that is holy, after this week, I need to get out of the public system.  I am so done.

I miss Lola terribly, and I think she also really misses me.  When I managed to make it home on Tuesday night to tuck her into bed, she was so excited that she squealed and sat up in bed clapping.  Most of my frustration at being locked up in QMH stems from the fact that I feel like I’ve reneged on a promise to hang out with her, or be there for her, like we usually get to do at least twice a day.  It’s one thing if it’s work or a work trip and I know I have to be somewhere else.  It’s another thing if I am in the hospital because I am caught in a web of bureaucracy between the obstetrics and diabetics department neither of which want to release me because they are so busy covering themselves from liability.  Probably nothing manages to get my blood boiling more.

At least there were the two times that Michael managed to come to the hospital and take me out for a walk.  One time I got to hang out with Lola at the Cyberport park and waterfront, which was great until she realized I had to go back to the hospital and nearly lost her mind screaming and crying.  That was awesome. The other time Michael came late at night and we went for a walk at night by the water, which was great - a super, much needed break from the stifling confines of the ward.

This week has been rough on Lola’s general routine as well.  In addition to my being in a hospital, she has not had any of her regularly scheduled activities due to all of the protests going on, and schools officially shutting down starting Tuesday.  I am sure Lola misses her routine and feels that things are off.  Our nanny also had a lot of trouble getting to our place given almost all of the MTR and buses are down, and all of the road closures affecting traffic.  

The protests are too sensitive a topic to take on in my blog, but suffice it to say it has now reached the point where we are concerned and scared.  It has posed beyond just an inconvenient change to traffic patterns or school closures, but gotten to the point where we worry about our and Lola’s safety while walking on the street.  Bystanders are getting beaten up, attacked, and in one instance even lit on fire.  Tear gas was openly used in Central in the light of day during business hours when thousands of people are out and about.  No one knows what the future holds, but it is clear that Hong Kong is at a point of no return.

Update on My Struggles with GD

My struggle with GD continues, an epic battle of time, diet, contrasting advice from doctors and nutritionists and just trying to manage it all within the realistic timeframes of a busy life.  I met with an endocrinologist after I returned from London to get a second opinion on my GD numbers and at the recommendation of my GP.  Then while there, I met with a nutritionist who walked with me through my daily diet to try to help me figure out if I was getting enough of the right nutrients.

My numbers had been really good, but she thought maybe it was because I had not been eating enough carbs, which I need in order to grow two babies.  They recommend a 2000 kcal diet for a pregnant woman with twins, and especially because I was "lean" pre-pregnancy.  She seemed particularly concerned whether I was getting enough and if the babies were growing on track.  I was pretty surprised by this because I had never gotten any indication of issues from my doctor and I always eat until I'm full.

At her advice, I started trying to include more carbs in my meals, which I was previously avoiding (not entirely, but definitely taking in moderation), like pasta, rice, bread, crackers.  I also tried to include more dairy, like soy milk or milk, to get more carbohydrates and calcium. 

It's worrying because for the last three weeks I have had to test myself a lot more often to check what foods "trigger" me, and my numbers have been all over the place. 

I scheduled another follow up appointment to see if I'm just doing the meal planning and testing wrong, or if these numbers aren't as bad as they look, or whether it's time to throw in the towel and get insulin.  This is when things get frustrating, because I am getting a lot of conflicting and backtracking advice which makes me wonder if anyone in the medical establishment actually knows what they are doing.

Since I've been diagnosed, I've gotten the following zig-zagging and often mis-matching advice:

The private endocrinologist recommended a fasting number of no more than 5.5 mmol/L and a 2 hour post-meal number of no more than 7.5 mmol/L.  The public hospital recommends a pre-meal number of no more than 6 mmol/L and a 2 hour post meal number of no more than 7.0 mmol/L.  My private OB thought for my fasting number I should really be around 5.0 mmol/L, which I have never been at.  I don't really know whose guidance to go with here...

My private OB had told me to cut down on carbs so as not to spike my numbers.

The public hospital dietician told me carbs were still important for the baby's growth.


I was told by the private nutritionist that I should significantly increase my carb intake because she thought I should be gaining more weight, even though others had never focused on my weight.  Then after my second meeting she told me I could cut back on my carb intake and eat less than the recommended number of "exchanges".  She even told me to seek out Greek yogurt instead of regular yogurt, which is exactly the opposite of what she told me the first time I met her!  Grrrr.

Last week, I had a very unpleasant meeting with the OB at the public hospital, who basically frowned at all of my numbers and diagnosed it as "poor diet control" which, I know she meant nothing personally by it, but had me bristling at the implication that it was my poor management of my diet.  They wanted to check me in to the hospital for a couple of days to test my numbers and see if I needed to get insulin, which sounded absolutely insane to me.  Perhaps it's a cultural and social difference, but in the US you do not just voluntarily check in to a hospital as an inpatient so that someone can monitor your glucose levels?!  Well here they practically insisted on it.  She was ready to check me in the next morning.  I was in disbelief.

After much consideration, I actually did reluctantly check into the hospital earlier this week, to establish this "baseline" to see if I needed insulin.  I thought, better safe than sorry, and maybe it's worth a loss of 2 beautiful days (weather wise, not political wise) and my regular life to be shunted into a hospital room to gain certainty over this condition.  Well, I cannot say that I have been impressed with the system.  I would argue that the stress alone of dealing with the hospital has been enough to give me a severe setback on my GD.

Infuriatingly, they missed my urine check for the first day, then served me bland soda crackers as a snack (the only option available), then (a LOT) of white rice with a small side of vegetables and meat.  I pretty much lost my shit when I saw these meals.  Breakfast was congee made with white rice paired with an egg.  Lunch and dinner were both white rice with a side of vegetables and meat.  My numbers were pretty high after my lunches and dinners.

Then they had the gall to point out that I was a likely candidate for insulin given how high my numbers were.  When I said it was because of the type of food they were serving me, a nurse had the gall to respond, "but usually patients don't spike like you do when eating our food" and another asked, "Well do you think you can bring your own food?"  That does not even begin to make sense.  Clearly if I am already on a GD diet and having trouble with my numbers, I will spike when eating an even more inappropriate diet.  And if I am eating my own food, what is the point of being in a hospital to do it?

A dietician came to review my meal and told me nothing new - try to walk more after eating and don't feel the need to force down carbs if you don't feel like it, and try to space out your snacks better.  Gee, really?

A very young endocrinologist came to see me the first day literally to take a photocopy of my numbers and to come back with a plan the next day.  That was it.

On the second day he came back with a half baked diagnosis that I could likely continue on a diet controlled plan but that it would also be highly likely I would need insulin in about 2-3 weeks time.  Then he saw the spike in my numbers from the lunch I had and said he needed to revise his thinking and speak to his superiors and come back to me the next day.  Then he said that I needed to stay at least another day because they needed a urine sample to test my ketones, and then maybe 2-3 days after that so they can make sure my insulin is at the right dosage.

I also could not get a straight answer on just how bad my numbers are, how I actually get started on insulin, why I had to be physically checked into the hospital to get this done (I am almost positive in no other country in the world is this a requirement) and why they couldn't have just used my nearly 2 months' of finger-pricking records to decide whether or not I needed insulin.  I could not understand how forcing me to be in the hospital, eating their inappropriately highly refined carbohydrate diet, could possibly help.

I mean, is this like something out of a Catch 22 novel or what?  It'd be comical if I weren't so freaking upset and frustrated.

The only good thing that has come out of the hospital stay is that I finally got to watch Center Stage (I know, how could I have missed it), started watching Riverdale, and read three books, one of which was the very interesting (but not perfect) book "The Farm" by Joanne Ramos.  I recommend it.

I have also spent some time thinking about why I am so resistant to the idea of insulin.  I think whether people mean to or not, it's kind of treated as a "taboo" thing - for example, a lot of GD moms will report proudly that they were "entirely diet controlled" and, while not shaming anyone on insulin, inherently assumes that being on insulin is a bad or negative thing.  I think most of my own resistance came from the idea of having to inject myself, as I really hate needles, and the thought of having to do that every day, maybe multiple times a day, was cringe-worthy and shudder-inducing.  I think there is also a fear that having to use insulin with GD would somehow lead to my having to use insulin post pregnancy, like I didn't "pass" or do it "right" or somehow be deemed to have a more "severe" case of GD, and would be at a higher risk to have this ailment for the rest of my life.

Also, finger pricking doesn't sound like a difficult task, but it's really proven impossible for me to do it at exactly 2 hours after I've eaten.  My weekdays are full of calls followed by meetings followed by drafting or working or trying to get documents done asap -  I have tried to set alarms but it's frankly a lot of alarms to keep track of.  I inevitably lift my head and realize it's been a full half hour or hour too late.  I sometimes also can't control my hunger - if I don't have time to fully plan out a big meal at lunch, or get hungry too quickly after breakfast and then need to snack, either before the two hour window or else too late/close to my next meal, I mess up my numbers.  And I never quite manage to squeeze in the 20 or 30 minutes of time to walk after I eat, which is also something that is supposed to help.  And so I wonder if my guilt and turmoil over the GD/insulin debate also stems from the fact that I feel like I haven't been as vigilant as I could have been with a diet controlled plan.

I've been reading up on insulin more, and I was heartened to see that many women who did go on insulin found it to be such a relief.  While that doesn't make me any more excited about potentially packing needles, it certainly made me feel a little bit better.

I keep telling myself that, ultimately, if I do need to take insulin, it's not because I failed to eat properly or manage this right - it's simply that my hormones are completely out of whack and cannot be fixed without medication.  But that doesn't fully address my anger at my body for failing me for the time being.  I feel really betrayed somehow, even though it's not my body's fault and my body has been more than kind and tolerant of the abuses I've heaped on it thus far.  But I'm still struggling to come to terms with it.

Women and Wine Tasting Event and Nightmare at 28 Tai Tam Street

Going back to late October, I realize I never forgot to post some great happenings that took place at the end of the month. 

I along with a few other female colleagues organized a wine tasting dinner at Belon for women in the private equity industry, which was really wonderful.  We had the whole restaurant, a charming French sommelier, great food and very good service.  I eyed the glasses of champagne and white and red wines of my colleagues and clients, and the gorgeous millefeuille dessert that everyone was enjoying, very enviously. 

 

Separately, I know I mentioned Lola's Halloween parties at her schools and playgroups in a previous post, but she got to come along with me and Michael to a party at the American Club.  It was great.  I would never have joined this club without a family but I can see why, with kids, it all becomes worth it.  Lola was so excited to be dressed up as a witch with her broom and hat, and she carried a little pumpkin jack o lantern throughout the night.

 

The club was super crowded but they did pull out some great stops on the decoration of the place. 

The best part was probably all of the booths and stands with activities for the kids, such as making creepy wax hand molds, little clay Halloween figurines, trick or treat bags, foam glasses, and paper cutouts.

 

 There was an old man who was manning a booth with paper cut outs, but his true skill was cutting, directly with scissors and no pre-drawing, profiles of the little kids that sat for him.  Michael and I were in awe at how jaw-droppingly good the paper profile was.  We thought it captured Lola to a tee, from her perky forehead to her spirited nose and lips and her long eyelashes.  It's amazing how a little piece of paper really captured her energy and enthusiasm.  What a talent.

 

 Separate from Halloween, we have also been trying to take Lola to the club to enjoy weekend dinners with mommy and daddy.  She likes going to the Forty Niner at the town club and being a little adult.  This time we sat near the TV booths in the back where she got a great view of the AIA Central waterfront cable car, which she simultaneously loves and fears.

Looking out with Michael at the nightscape - the cable car really stands out!

30 Weeks

I made it to 30 weeks!

Now it's T minus any day now, but hopefully we have a while because we have not yet purchased quite a few things that we need, heh.  I find the kicks have been relatively more intense this time around, probably because the babies are more cramped in there and already running out of room - sometimes my belly is just roiling with their movements.

When I go in for my scans, it's hard to tell what anything is or where anything is - there'll inevitably be a somewhat disembodied thigh bone floating on top of a head or a fist randomly appearing between two legs.  It's a much less enlightening experience compared to when you just have to keep track of one baby.

In a bit of really depressing news, I went to my check up and the OB at the public hospital wants me to check into the hospital and get my blood sugars tested to see if I need better compliance with the glucose testing guidelines or if I need to get on insulin.  My numbers have been a bit high since I went into my last appointment because I have been consciously trying to eat more carbs and cheese, at the advice of the dietician.

That sounds nuts to me - checking into a hospital?!  I want to avoid hospitals because I associate them as very dirty places where you can pick up a staph infection, and I associate public hospitals in Hong Kong as incredibly brusque, fluorescent circles of purgatory where you just wait and wait and wait.  But setting personal prejudices aside, I am now registered to check in as an inpatient at 7:45 am on Monday.  I was told I will be in the hospital for at least 2 days for them to administer their food to me, to see if I really have baseline issues. 

Words... fail me to express how dismayed and horrified I am at this prospect.  The weather has been beautiful in Hong Kong as of late, and the only break I get out of the routine cubicles of my office, my commute, my apartment... is this?

This whole process has been so frustrating and the contradictory advice I have received to date makes me think that no one in the medical profession really knows what they're doing. I've been told to eat less carbs, to eat more carbs, to put on weight, not to worry about my weight, to meet a 2000 k/cal diet which includes 3 big snacks on top of 3 big meals a day, to skip my nightly snack to try to fix my fasting number. 

Pictures of Playtime and Parties

Lola has been getting acquainted with the neighborhood and as part of that, going to the race course more frequently.  It's a really nice space for her to run around and play, kicking the ball and running to and fro to burn some energy.

I got Lola a little peacock qipao that she really enjoys wearing.  She wore it to her school for Diwali, and I plan for her to wear it for Chinese New Year.

 

Sometimes we take car rides together in our beautiful new car - mommy and Lola!

Last week while I was having a terrible week, getting into the office in the early morning on both weekends and trying to figure my way into drafting a tricky implementation agreement, this picture pinged through on my phone.  How sweet is this?  For those of you who know Michael, you will know that this picture has captured the impossible.  How happy and carefree do they look here?  I don't think I'm exaggerating when I say I have never seen a picture of him smiling like this!  And a selfie?!

Love.

 Here is Lola reading in the little armchairs in the club.  How cute and earnest does she look here?

She still enjoys going down slides, particularly in the small playground near our apartment.

Lola's music playgroup had a Halloween party in Causeway Bay where she got to dress up and play with all kinds of colored scarves.  I think she had fun!  Her Baby Buddies playgroup also had a Halloween party which she thoroughly enjoyed.