Foods I've Been Digging

So, between diabetes with ever-increasing insulin resistance due to pregnancy and just typical pregnancy stuff, some things about my diet have changed.  Here are some things that I've really been digging and that seem to work well for me...

1. Strawberries.  Freaking yum!  These are also one of the lowest-carb fruits so, as long as my blood sugar is at good levels, I can pass through the kitchen, grab one, and nom it without thinking of insulin.  I couldn't do that with, say, a slice of apple.
2. Raw veggies.  Baby carrots have been really nice to snack on, even without any dip, though I do have to bolus a little for them if I'm having more than a couple.  Celery?  If I'm willing to take the time to cut it up, this is one of those no-insulin snacks for me.  Or if I want some peanut butter without a ton of carbs, this is a better option than crackers or toast.  And for our weekly RPG nights, I usually grab a bag of raw broccoli and cauliflower at the store and dump it in a bowl with a little side of ranch.  I do bolus a little for this, but it's mostly a good nosh-all-night kind of snack.
3. Those little single-serving snack packs, the kind that are usually marketed for being 100 calories.  If I want something junky, these keep me from going overboard.
4. The turkey burger from Carl's Jr.  No fries, just the burger.  For some reason, of all the fast food options I've tried when just desperate for fast food, this one has been the kindest to my blood sugar.  No spikes, and no fat-related rise later on.  Awesome.
5. Peanut butter.  This is a comfort food for me, it's not high carb, and it's about the right amount of fat (good fat!) and protein that it helps smooth out sugar rises without causing a fat-related rise later on.  I've been eating a lot of this stuff since getting pregnant.
6. Low fat milk instead of skim.  I love milk but, sadly, lactose is one of the faster-acting sugars out there.  But add a little fat to a meal and that helps chill things out.  I also made this switch early on because I kept being told I wasn't gaining enough weight.  This was an easy way to add some fat and calories.
7. Vanilla Soy Slender.  When I want milk but my blood sugar isn't doing so great, or if I just feel like drinking a big glass of milk without all the carbs, I'll drink this stuff.  It's only 4 carbs a cup, and it totally satisfies my milk cravings.
8. Diet Rite, especially the funky flavors.  In addition to being diet (and therefore carb free), it's also aspartame free and sodium free.  The cola is decent, but I love picking up their funkier varieties, like tangerine or cherry cola.

These have all been good choices for me.  Maybe they aren't all the best choices I could make (I could surely be better off without any fast food or junk), but they work.

Two things I'll soon be adding, with hope that they also "work for me," are prunes and watermelon.  Prunes are just to help keep things closer to normal now that I'm at a point where my digestive system is naturally running more slowly, and the watermelon is an experiment to see if it helps with swelling (something I was told and have read a couple places online).  I figure that, even if it does absolutely nothing for my swollen ankles, at least it's a good summer time fruit that's very low in carbs.

But honestly?  I can't wait to be able to eat real pizza again!!!

No. More. Food.

I'm pretty sure I'm hitting the phase in pregnancy where I start slowly becoming more and more insulin resistant.  At the same time, I've been "trying to gain weight" for the past few days and need to rule out the possibility that it's the higher fat in my food that's causing the change.  So today is a good, angelic food day.  A high fiber muffin and skim milk for breakfast, cheese for snacks (provided my blood sugar doesn't head downhill), and a salad (with chicken) and reduced fat cottage cheese for lunch.  Dinner might not be quite so angelic, but it's primarily late afternoon when my blood sugar gets higher than it used to.

Speaking of, I'm totally fed up with my own weight-gaining attempts.  My first thought was, "Gaining weight?  That means larger meals, more carbs, and more fat."  So I attempted this, and can I just say: "Puke!"  OK, no actual puking, but a strong desire to puke.  Let me also say "Holy freaking crap!" regarding how my blood glucose reacts to high fat these days!  It's always caused a rise at the 3 or 4 hour mark, but not like this!

So, I'm moving on to what I think is a better plan anyway:  More snacks that I already know work for me.  More cheese between meals at work (along with carrots), and more no-sugar-added ice cream in the evenings.  Or crackers and hummus (because, YUM!).

If this doesn't do the trick, I'll go to a dietitian at the diabetes center for a plan.  I don't want my next weight gain plan to include blood sugar battles like the first one.

More and more female friends are surprised my OB is at all worried about the lack of weight gain, particularly other women who were overweight going into pregnancy.  One friend only gained 3 pounds through her entire pregnancy, and her OB was just fine with it.  I probably need to gain more than she did, but still, I've decided not to stress about this.  I'm going to assume the baby is just fine until there's reason to believe otherwise.

My Chubby Brain is Blown

Never before, in my entire life, have I been told to gain more weight. If anything, I’ve always been told I need to lose a few pounds. I’m overweight, and have crossed the line into “obese” a couple times.  But now?  I'm an overweight pregnant woman.


So, it’s just so utterly baffling to this chubby chick that my OB tells me I’m not gaining enough so far in my pregnancy.

Me? Not gaining enough? Unheard of!!!

Oh. Wait. That was before I had to count carbs and avoid too many really high fat foods.

I’m not restricting carbs or calories at all, except that I don’t choose to sit down and eat three breadsticks then order and eat a giant bowl of pasta with artery-clogging sauce. One breadstick and half a giant bowl of pasta (then maybe another half breadstick!) will do, thanks. And that’s usually already more calories than I’m “supposed” to eat in one sitting.

I am not a conservative eater by any means and, though I know better than to “eat for two” and double my food, I’ve felt sure that I've been eating more calories a day now that I’m pregnant.  I mean, I'm always hungry!!!

The nurse (or medical assistant?) who wrote down my weight at today’s weigh-in at my OB’s office said, “Just half a pound. You’re going to have to come back and weigh again next week.”

"Really?!" I said. "This is just the first day of my second trimester. I thought a lot of women don’t gain in the first trimester!”

“Maybe if you’ve gained two or three pounds by next Thursday, she won’t make you come back in. Just go to Braums every night until then!”

Braums is a regional fastfood burger and ice cream joint… really known for their ice cream. A twinge of annoyance passed through me as I remembered my last stubborn high blood sugar that happened despite a carefully calculated bolus. “Yeahhhh, that’s a little tough for a diabetic.” I got a look of sympathy, but no further suggestions.

I’ll be trying to add in more calories, but there will be no milkshake prescription for this mother-to-be. How frustrating that I need to gain weight right when blood glucose control is both more important than ever and more difficult than ever.

Not. Fair.

Tantrum

I was wandering the supermarket, which means that I was thinking about carbs.  By the time I wandered onto the "lunchbox" aisle, my thoughts had begun to turn sour.  All of those adorably portioned carby goodies stared at me.  Cookies, crackers, little crunchy bread sticks that come with their own suspiciously shelf-stable fake cheese dip, boxes containing cute little 100-calorie pack snacks.

A friend's old criticism bubbled to the surface of my memory...  People think those 100 calorie packs are a good idea, but they're not.  They're still not healthy, and you can just take a portion out of a regular sized box.

I (and she) did not know that I was diabetic at the time (I'm fairly sure it was already developing then), but now I realize that individually packaged snacks make it easier to eat snacky stuff with diabetes.  No counting crackers necessary, just grab a pack and punch the listed carbs into the insulin pump.

But my slightly sour thoughts didn't lead me to find this fact interesting.  Instead, I found it infuriating.  Other people eat straight from the box of crackers, no counting, no calculating.  That's how almost everyone else does it.  Why do I have to do it?  Why do I?  Why me?!?!

The words rang in my head with the sort of angry, distraught tone I used as a child, the one that I felt certain would illustrate to my parents just how grave an injustice it was that I couldn't do what I wanted to do, the one intended to pull at heart strings, infuse guilt, and drive home just how incredibly strong my emotions on this subject were.

Whoa.

I was so taken aback by this inner tantrum that I stopped right there in the aisle.  Where had that come from?  I normally don't ask "why me?" when it comes to diabetes, because I don't think there's any kind of answer other than genetics.  It occasionally strikes me as very strange to think of myself as diabetic, because I spent so much of my life without serious health concerns, but it usually ends there.

And all because I miss eating out of a full box of crackers?  I'll admit that I am readily frustrated by anything that makes simple tasks like eating more complicated, but was it really this that inspired the strongest emotional reaction I've had to diabetes in quite some time?

It's no secret that I'm under a lot more stress than usual and that my mood swings more easily, because I'm pregnant.  Maybe it was this added volatility.  Maybe I was really throwing an inner tantrum over my pregnancy being 100 times more complicated due to diabetes (as in "oh my gosh this is complicated," not "this pregnancy is full of complications").  Or maybe this tantrum was buried deep beneath the conscious logic and practicality I've held to since diagnosis.  Maybe that was my inner child finally shouting loud enough for me to hear her, finally striking that exact tone that would make the adult me stop, pay attention to her, and reconsider.

Only, dear Inner Child, I cannot reconsider diabetes.  I'd gladly change this for you if I could, because I agree, diabetes isn't fair.  It does suck.  And that big box of crackers?  I do want to blindly eat fistfulls of them on the couch without even thinking.

*tantrum*

In Which I Lament the Loss of My Turkey Sandwiches

Pregnancy food restrictions make me realize, sheesh, simply eating with diabetes is nothing.  Yeah, you have to figure out carbs and either avoid or account for high fat, and you may find certain foods that don't work well for you individually, but you can still more or less eat anything.

Let's count out anything diabetes related first and take a look only at the four pregnancy related food restrictions that bug the hell out of me:

• No deli meat.  At least, not unless you heat it up to the point of "steaming" first.  It's more likely to have listeria, a bacteria (that causes food poisoning) that's pretty deadly to an unborn baby.  (From what I've read, the chances of it happening are incredibly low, but the consequences are so dire that the risk isn't recommended).  By extension, cold meats that you wouldn't think of as "deli meat" are similarly restricted.  No more turkey pepperonis as my mindless, carb-free snack on the couch.  I tried microwaving them first, as I have tried with cold cuts for sandwiches, but the texture becomes way gross.
• Big or predatory fish, including tuna, is to be avoided or limited due to higher levels of mercury (recommendations from different sources vary, but one serving a month seems common).
• Anything with raw eggs, including Caesar salad (traditionally, the dressing will have raw egg).  The chances of salmonella is the problem here.  I still eat Caesar salad on occasion though, because I love it so very much, because I think salmonella is a crap shoot (I've heard about more outbreaks from vegetables, like spinach, than from pre-made products like dressing!), and because raw egg is in more foods than you're likely to expect.  Ever had a really high-end frosted cake, like at weddings?  You may have eaten raw egg in the frosting.  Good mayo or aioli?  Raw egg.  Eggnog?  Raw!  Eggs Benedict?  Raw egg in the Hollandaise sauce.  I won't even go into the many desserts.  Unless you're allergic to egg (or are a vegan), you probably have no clue how to completely avoid raw egg.  In the grand scheme of things, I doubt a Caesar salad with properly handled dressing is more dangerous than simply not being vegan.
• Soda.  I'll also include caffeine in general here, but aspartame (ick!) in diet soda is also a general concern for women who didn't avoid it before pregnancy.  These are not on the universal "don't" list, and my own OB says that having one or two a day is fine (though some OBs recommend against it entirely, and any visibly pregnant woman drinking soda or coffee is probably going to get some uninvited advice!).  My biggest issue with this one is iced tea... I love the stuff!  It's my drink of choice when dining out, and I've started carrying Splenda in my pocket since not all places offer it (neither the pink or blue packets are recommended during pregnancy).  But since I start my day with a cup of tea or coffee, no refills for me.  (On the soda front, Diet Rite is a sanity saver.  It has neither aspartame or caffeine.  I keep some in the house at all times, if I can.)

There are a million other little restrictions.  Soft cheeses that aren't pasteurized (unpasteurized cheeses don't seem as common as the APA seems to think, though), unwashed produce, sushi with raw fish (understandable, though Japanese women continue to eat it!), undercooked or rare meats, etc. etc. etc...  Add to this anything that causes my blood sugar to spike (which is somewhat unpredictable these days), like pizza or white rice.  Eating "not good for your blood sugar" foods on rare occasion isn't so horrible... until you're pregnant.  (Then it's both bad for your baby and filled with guilt and stress.)

Those don't sound so terrible, right?  I didn't think so either... until I realized it counted out most of my convenient lunch options.  No deli meat sandwiches has been the biggest issue, for my lunches.  Also, the little pre-made salads you can buy in stores usually have deli meat in them.  We don't have a break room here at work, and I probably wouldn't stay if we did (psychologically, I just need to get away from work for an hour), so this leaves very few no-cooking options for me.  Combine this with the fact that I've had like, zero energy or motivation (due both to typical pregnancy fatigue and to some depression), and that results in lots of fast food lunches.  Not nutritious, but at least it means getting out for a little while, almost no effort, and not consuming something on the kill-your-baby list.

Diabetes?  It's not easy to live with, but it's not so bad on the diet front.  It didn't eliminate my convenience foods at all.  Convenience foods come packaged with a nutrition label, and I just opted for the versions that helped avoid blood sugar spikes (like whole grain Lean Pockets instead of the non-whole grain ones).  But pregnancy?  It's thrown a major wrench in my lunchtime convenience.  I have to figure out a super-low-effort solution.  Maybe zap a Lean Pocket before I leave for lunch?  Use bagged salad and veggies on Sunday to make a week's worth of little salads to eat along with my lunches?  Keep chicken salad around for sandwiches?  I have to figure it out, because I do think fast food makes me feel more like crap.

It's just awful timing.  Depression has been a major issue for me lately, and this makes me lethargic and supremely unmotivated.  I need a new game plan until I'm able to pull myself out of this emotional mess.

What to Eat?

Since diagnosis, I've struggled with what I should eat in my overall diet. I don't believe anything is 100% banished from my kitchen, but I have struggled with whether or not I should limit carbs in general.

I already eat far fewer carbs than before I was diagnosed, but that's largely because:
a) I was so freaking hungry all the time!
and
b) You can't mindlessly snack on carbs as a diabetic. You have to be deliberate enough to measure and bolus. So no box of crackers next to me, thanks. I'll count out my portion and put them on a napkin.

And I'd probably have gained way more weight if I'd kept eating the way I used to... now that my body can use and store carbs.

Which brings me to one reason why I think a lower carb diet is a good one to consider...

Fewer carbs helps maintain (or lose) weight. Aside from a potential reduction in calories, and the theory that our bodies' metabolisms work "properly" when we consume fewer carbs, fewer carbs also means less insulin. I am skeptical of this next point, but I've read over and over that "insulin causes weight gain." I'm not so sure about that... It seems more likely, to me, that insulin allows us to gain weight from what we eat. After all, you take more insulin because you're either eating more carbs, or because your carbs aren't being properly absorbed with smaller doses. But still, it's a theory that worries me.

And the other significant reason for considering a lower-carb diet...

Smaller mistakes. If you're eating something high-carb, that calls for more insulin. So if you get the portion size wrong for something carb-dense, your dosage error could also be pretty significant. Take that piece of cake I had yesterday: I was guessing at the carbs, based on how many carbs are in other frosted cakes I've had before, and gave myself three units of insulin for the piece I ate... but I guessed wrong, my BG (blood glucose) dropped quick, and I struggled for the entire afternoon to keep my numbers up (which meant consuming a lot of unwanted calories, tying back to my first reason!!!). Let's compare that to if I'd eaten, say, a sugar free cup of yogurt. If the nutrition label was torn and I couldn't look up the brand, I'd remember that my usual sugar-free yogurt cups are about 7 carbs and (assuming this cup is the same size) given myself anywhere between .65 or .8 units of insulin (depending on my insulin-to-carb ratio for that time of day). My guess might be off, but I doubt it would be by more than .2 of a unit. As long as my BG was at a pretty safe number in the first place, an error of that size isn't going to hurt things much. Unlike the cake, for which I probably gave myself one whole extra unit (if not more).

I love carbs, and I believe everyone should be able to enjoy cake once in a while... but I know from experience that I can eat a generally lower-carb diet and feel satisfied. But that was a few years ago... If I can just get back into that mode!