The food aversions have begun (dun dun dun)

If I had to eat one food for the rest of my life I have always said it would be salad, especially seeing as how salad comes with endless possibilities of toppings. If I said that today I would starve. For the last 6+ months I have eaten a gigantic organic fancy greens salad with a ridiculous amount of veggies in it. But now the greens make me gag, they are suddenly very acidic and I cannot swallow a forkful. Yesterday I ate half a bag of carrots and some romaine without hating life. At least I'm getting in some vitamin C! Just to clarify I have not actually thrown up, but the idea or more often smell of some foods really turns me off. and now in the a.m. I can't eat my red beans, somehow they are okay in the evening but not in the morning. I think I need more vitamin supplements, now to work up the energy to go buy them...

As for cravings, my little grape sized fetus really likes carrots, toast, milk, bananas, tamales and veggie soup. How much milk does one have to drink to gain 25lbs? I might be able to do it with a few tamales a day! I had my first appointment with the midwife the other day, she said "Since you are underweight we would hope you would gain 30-35 lbs." To which I broke into hysterical laughter. First off I'm not underweight for a normal person, just for a pregnant lady. My BMI is 19 something and I'd have to lose 7 lbs minimum to be underweight for my height, which wouild leave the pancake bottomed girl with nothing to sit on, so I think not to any weight loss. 

Speaking of weight, I bought a scale the other day. To which I must point out I have never owned a scale, we never had one in the house growing up and I have generally never desired to buy one. It's yet another thing to move for this frequent mover. Upon trying them out in Target I weighed 160, 112, 127. I went with the latter scale as I'm about 124 unclothed. Scales are weird, they get you fixated on what you look like, they could lead to eating disorders, and they can definately be off if even the basic kilter of your house' foundation isn't perfect.

"Do you smell pee?"

To preface I do work in the hospital and am around alot of bodily fluids. I had been thinking it was too soon to be have super smelling power...until today.

Case #1:  I am discharging the nice old gal who heart turned out to be just fine. We are in her room, I am explaining test results to her and a friend when I smell pee. Like how it smells if you are a "yellow mellow, brown flush it down" type of person. But she isn't wearing an incontinence pad and does not have a bedside commode. Hmmm. I lean closer to her, explaining her new meds. Still no smell. I give up on my amateur detective skills because it's time to send her home. I wheel her out to meet her friend to go home. Her friend comes around to her her get into the car, and like a wave the urine smell flows all over me. I hold my breath a little, it is the nice old gals friend who smells like pee. Luckily they are excited to go home so my smeller does not get tortured.

Case #2:  A coworker's patient motions for me to help him. I smell pee. Again no diaper, no urinal, no bedside commode. This nice guy who might have had a heart attack (or more likely just has acid reflux) smells like he passed out in an alley and wet himself.  I ask my coworker about the patient, "Doesn't he smell like urine?" "Not to me, we checked his blood alcohol level and there wasn't any."  I think this is confirmation that my smeller is super sensitized by this blueberry sized creature growing inside me.

Also: yesterday I bought cheese (gouda and havarti). I ordinarily love havarti and have a smell induced craving for gouda (Noel came home smelling like gouda, but swore he doesn't use any at work, but then I had to have some, although it was disappointing because in my hurry I hadn't realized that I actually wanted smoked gouda). But the havarti "smells funny," if something can smell "mushy" it does. So I cannot eat it, but haven't given up quite yet. Maybe I can bake it with something stronger smelling?

Things I am dreading smelling: the ER nurse who wears Lolita Lemptika (it gave me headaches before being pregnant), ER cheeseburger parties (there is something about the way a McDonalds wrapper smells), the coworker whose deodorant does not work, bowel movements of any patient.

"Panchito"

I am "finally" pregnant! It feels like a "finally" statement because we have been talking about it for so long, but in reality I knew I was by the 88th day off birth control (Saturday). Woo hooo!!! I actually did do little celebratory dance in the shower before I told Noel.  I am thrilled and refer to our embryo as "our little alien" as that big black dot of an eye and neck/body really do make it look like an alien. Noel refers to the embryo as "Panchito" and refuses to pick a less terrible name. I am trying to think of the name as a way to say "our little revolutionary." But seriously, "Pancho"???!!!  Noel is still in shock and is very worried about being a good dad and how we will afford a baby. Seriously, they aren't that expensive (are they??!!). Kind of like having a new car with the upkeep and whatnot, at least milk is free compared to gas ;)

Speaking of 88th day, dating a pregnancy from the first day of your last period is crazy, it adds about two weeks to your pregnancy. I mean take the first day of your last period, add a week and then add 9 months and that is your expected due date. But what if you don't ovulate on day 14 (like 80% of the female population). For me, who did not ovulate until day 32 (yes 32, not 14 like most people or up to 22 like the occasional other, but 32 due to, I feel, the weirdness of stopping the pill). So while the nurse practitioner at Planned Parenthood (Noel wanted "confirmation", like two positive home test weren't enough, so off I went to PP, the quickest place to get tested) said I was 8 weeks and 2 days, I am more like 6 weeks and 2 days (who do you think will be going wayyy over their estimated due date???).

As for pregnancy symptoms:
- nausea...nope
- sore breasts .... oh yes, ouch
- super sensitive to odors .... see next blog
- headaches ...none
- weight gain ... way too early for that, but I did buy a scale
- weird craving ... "Noel, were you cooking with gouda tonight? (sniffing clothes) "No, definately not"... next day I buy gouda cheese, all other cheeses smell funny

Pregnancy Vibes (Are you doing magic fingers for me?)

I quit taking birth control 3 months ago. Actually 85 days ago to be more precise. I actually wanted to be pregnant longgg before I stopped the pill but my dear hubby was less child bearing inclined.

Side note: Every week until we got married, especially when I was meeting his family in Honduras, he would beg, "why can't we have a baby now, tonight? to which I'd replay "I'm in nursing school, you're in Honduras, and anyways the pill stays in your system for awhile so tonight is not an option dear." But of course men are strange strange creatures and the day we got married he decided that he actually did  not want a little half him-half me yet. More on my outrage with this later.

Of course I was hopeful we'd get pregnant the first month. Even better on our anniversary 2 weeks after quitting the pill. But it is one of those catch 22s. Most women avoid pregnancy like the plague, and when they finally are ready and have a willing partner you find it just isn't as easy as many people make it look. I have a dear friend who struggled with endometriosis and infertility so I had a heads up that it might not be as easy and fun as it seemed. And of course it hasn't been, 85 days later my Noel will talk to my non-pregnant flat belly, but it's too soon to know if any of those little swimmers took hold this month. So now after two haphazard 'cycles' (if they can even be called that) I finally have more than 7 high temperatures in a row, proud to say actually 15, which means if my waking temp stays low for 3 more days I am most likely pregnant, downside is I have felt like I am getting my period for days. I am trying so hard not to take a pregnancy test for at least two more days. The potential is killllling me (figuratively).  As are the gazillions of pregnant coworkers at the hospital. There are at least 4, two of whom are in my teeny tiny unit. At least the baggy scrubs hide the bellies of the others so I do not die of bump envy. Grumble grumble.

The only people who even know I stopped the pill are Noel, and a couple of my close girl friends. I didn't want to tell my parents and have them ask allllll the time if we are yet. My friends are bad enough, let alone two almost 60s whose friends all have grand kids already. My close friend and fellow nurse Jade always says she is doing magic finger baby vibes for me. I will take anything that helps :)

Weird thing about trying to make babies and the whole associated not drinking alcohol thing. I have never before wanted a beer or wine sooo much until we started procreating with purpose. Trying so hard to be good.

I have been off and on the pill for years, blessedly it did shorten and decrease pain during my teen years. But I had not idea it made my hair thicker (although this makes common sense), as lately my hair looks dirty faster.Unfortunately the mask of pregnancy melasma is not going away. More on my 'mask' later, as pregnancy will most definately make it much worse.

Side note: Noel realllly wants twins. I gasped "Oh God I hope not" when he told me (there are none on my side anywhere and he has some second cousin with one set of twins). He thinks the best way to grow up would be with a permanent buddy who goes through all the same things. Whereas I cannot imagine how my 5'8 123 frame could handle this. Please swimmers, don't be too competitive, one will do just fine.

Pill Pusher

Most days at work I feel like a pill pusher. "Take this orange pill for your high cholesterol, this little white one to lower your blood pressure, these two big white ones for your chronic lower back pain, a big green one for calcium supplementation and this injection goes into your stomach to help prevent a blood clot from forming in your legs that could potentially travel to your lungs or heart and cause huge problems." I got into nursing because I am passionate about preventive health care. Yet here I am "pill pushing," granted I will say when patients question that they need a certain med, after educating then I do inform patients if they are uncomfortable taking some of there they have the right to refuse. But they rarely do because 1) they were already taking all these meds at home, 2) the doctor prescribed all these for them, so aren't they important?

Which leads back to doctors education and the huge HUGE influence US pharmaceutical companies play in which meds people take. Have you noticed the insane amounts of TV and magazine ads offering a pill to treat high blood pressure, atherosclerosis (say that ten times fast), high cholesterol, and depression? I will stop myself here because I could write for hours about all of this. If you are really interested consider reading "Overdosed America" or "The Truth About the Drug Companies", but take a different spin on how drug companies do not report all the research trials they do, just the ones that support the use of their, and these results are published in respected journals that doctors read to learn about the latest and greatest.

Back to the preventive education idea...Instead of giving the aforementioned pills I'd love to say (assuming this is not a critical patient) "Here are some supportive running shoes, walk a mile a day to decrease your blood pressure, lower your cholesterol, and stop eating high fat, highly processed foods, increase your calcium intake through leafy greens. And in 2+ weeks your lower back should not hurt as much, you should feel your mood has improved and additionally you may see you have lost weight, which would make all the problems you were taking pills for better as well. Oh and as for anticoagulant, if you are over 60 or have a history of heart problems take a baby aspirin everyday (as long as you do not have a clotting issue). By eating well and exercising you should see that you save well over $1000 a year in medication costs."

But why don't we do medicine like this? Because it takes more time to counsel someone on lifestyle changes than it does to write a prescription for a pill that might solve the problem at hand. It is not just the doctors and nurse practitioners that are to blame (and some really do benefit form pills). The vast majority of people do not want to put forth the energy to change their lifestyle. Taking a pill is easier, it is culturally acceptable, even encouraged, especially by our media heavy society. But the most healthy are ordinarily those who take the least amount of pills, using diet and exercise to achieve health.

Every few weeks I have a patient in their late 90s. I love them and think we really need to honor older people more than we do. The healthiest older patients I have generally take less than 5 medications, of which 3 of these are vitamin supplements and at least one is a prescription eye drop. They are at the hospital because of an infection that needs IV antibiotics or because they broke their hip, but we don't expect them to stay long.

Sad case: I had a patient who came in with chest pain, so we were working him up as a "cardiac rule out" to see if he had a heart attack or not. He had all the risk factors for multiple health problems: heart attack before he turned 50, high cholesterol, insulin dependent diabetes, high blood pressure, smoker. This man benefits from meds for his conditions. But his health would be greatly improved by diet and exercise. I had a long talk with him about changing his diet to minimize his risk factors for illness. What broke my nurse heart was his response, "I want to eat better, I do try, but with how little money I make I cannot afford to eat fruits and vegetables daily because they are expensive while my meds are covered by insurance." For me this is a reality check. I am so fortunate to be in good health, with reasonably healthy genes, with the financial means to all the fruits and vegetables I want (albeit I cannot afford organic). I do take 3 pills daily: a prenatal (kidless at present, but I plan ahead), folic acid (I was anemic years ago), and Vitamin D (because all people in Washington are deficient in D).

The Dreaded Pansa

My hubby is getting a panza, a little belly, and it bugs me. He joking calls me his flaca vacita, skinny little cow, which I do not take to heart as I am not fat. But my formerly flat stomached man is approaching 30 and I am afraid is on his way to getting the dreaded panza. 

Ever since I first started interacting with Latinos I have noticed that males over 30 years are afflicted with a terrible condition. THE DREADED PANSA. Not that it seems to bother them. But by the time they turn 30 they have a belly, not necessarily big, but enough to stick out over the waist line. Noel grabs his little panza, saying "Where did this come from? I eat healthy!" to which I respond "Chelas (Honduran for beer), it's a panza de chela," and launch into telling him about how many calories a beer has, how many calories a day the body needs, and that a panza is what happens when you drink beer and go straight to bed. I am sure the fact that we eat late at night plays a role as well, but I can't help it as I am always hungry when I get home from work at 12:30 at night and when I eat he does too. But primarily I blame the panza on chelas.

Me: "If you drink 3 beers before bed that is roughly 600 calories, which is at least 1/3rd of the caloriesyou need for the whole day. To gain one pound you have to consume 3500 too many calories (blah blah blah)"
Noel: "Ehhh (nonchalant grunt with shrug), no me importa, no me molesta la panza (takes drink of beer)."
But I know it bugs him, as he grabs it weekly while looking in the mirror. Unfortunately, there is no energy left for working out when you work 6 days a week. Thank goodness he walks alot at work! Clearly my years of nursing training and daily on the job patient education on how to eat a heart healthy diet to minimize risk factors do not apply to him. No way I am an expert or anything. In one ear, out the other.

Does anyone else have this experience with their Latino? Does the dreaded Latino panza just show up at age 30? If so Noel has two more years of full ability to see his toes. The one exception I know of in Noel's family is his brother, who turned 30 last year. But he is incredibly superficial about looks, does not have a girlfriend, does not drink and doesn't like to cook, so his panza inducing factors are pretty well minimized.

Spanish words for belly: panza, panozona, timbon, timburiaco/a, barriga 
How to use them:
"Jose es muy timbon" ---- Jose is big bellied
"Amanda es timburiaca" ---- Amanda has a little belly
"Que panza tiene Manuel" ---- What a belly Manuel has!
"A los 6 mese Elena tiene barriga pequena" ----- At 6 months Elena has a little pregnant belly