Five weeks post partum – Return to the gym!

As I lie here trapped under a sleeping baby (you should never wake a sleeping baby) it seems like the best time to catch up everyone on my most recent achievements post partum.

Yesterday was Mother’s Day and I celebrated my first one in style – return to Zumba with my mom. Although I still have minor aches and pains in my pelvis, I decided that it was time to return to the gym. Most healthcare professionals would recommend a six week recovery time; however, I was fairly fit throughout pregnancy so I figured five weeks would be close enough.

During the past few weeks my sacroiliac joint was becoming stiffer and more painful so in true physio spirit, it was time to do something about it. I am not used to sitting for prolonged periods of time and when your breastfeeding for a large portion of your day, my body started to feel the effects of immobility.

I was nervous to return, mainly for fear of urinating on the floor during the squats in class but thankfully, that didn’t occur. But, I quickly realized that my sports bra for my pre-pregnancy less than full A cup boobs was definitely not enough support for my postnatal boobs. This is something I have never had to deal with and never even considered.

After class, my pelvis felt a little worked but that was to be expected. Within the hour, I felt much better. Physically and mentally. Exercise IS medicine.

Michelle (my Zumba instructor), me and mom after class

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Two weeks Post Partum

Yesterday was our son’s original due date. It was my 40 week mark. However, I am now two weeks post partum and have a moment to share a few updates about how the past two weeks have been going.

I had mentally prepared myself for this month to be one of the hardest months as I have heard that it is full of challenges – huge change to lifestyle, hormonal shifts, lack of sleep, minimal time to shower, eat, sleep, poop, etc. I asked my friends for the most honest accounts regarding how the first month had gone as they were progressing through it. I wanted it fresh and raw.

Jump forward to two weeks in. We have been very lucky to have a little boy that sleeps, feeds well, and is just a great bundle of joy to our lives. The first week I managed to function off of 2-3 hours of sleep for each day.  My milk hadn’t fully come in so I was feeding around the clock. I also was having a huge hormonal shifts as well as clearing the oxytocin from the induction from my body and could only sleep in one hour blocks.  It is amazing how little sleep your body requires and still feel human.  I did experience some “baby blues” but really it was just a random bout of crying for no reason. It happened a few times on day 2, 3 and by day 4 it was over. For those who know me, know that I don’t cry often so it was a big surprise but I just accepted it and let the water works flow. I think it was just from lack of sleep, hormones and overwhelming joy.

I have been very fortunate to have a village of support. Brandon has taken time off of work to help out and it has been monumental. He has taken to fatherhood like a fish to water.  My mom has also been very involved by providing us with food and assisting us in keeping our house cleaner than it has ever been. Many friends have been dropping around to visit and also providing us with food which we are ever so grateful for.  Thanks guys!

We have been taking our son out to the real world every day. Once I was discharged from the hospital, we were outside on day three. It is great that it is spring here and the weather is becoming nice enough allowing us to go outside. We have made various trips shopping, visiting family and friends, and to the doctors.

In terms of my physical recovery, my pelvis was pretty rocked after giving birth. Although I only had one minor tear, my sacroiliac joint and pubic symphysis has been pretty sad. I feel like Goldilocks and the three little bears – “this chair is too soft, this chair is too hard, this chair is just right”….for now. It has felt very loose and will have a dull ache. Walking for long periods of time is challenging. This is improving daily but something I didn’t expect for some reason. It makes total sense though, I pushed a baby out of there. Who knew?!?

I have restarted doing Kegels a few days ago which has helped a lot. I decided to do them when feeding. Since I feed every two hours or so for about half hour, it is a perfect time to do them. It has helped a lot with my pelvic pain. After all, those muscles attach all around your pelvic floor and can help stabilize those joints.

I am now 5lbs off of my pre-pregnancy weight. I can fit into clothing I haven’t been able to fit into for the past few months. It is great to get back into my lululemon studio pants! I guess that is a stomachless perk. But it is also semi-concerning as I have dropped so much weight so dramatically, I wonder what will happen over the following two weeks. On the plus side, my appetite is wild and I am eating and drinking ALL the time. I am also breast feeding which burns more calories.

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Taken at 1.5 weeks post partum

In terms of labour from a stomachless perspective, the “pushing” phase at the end was the most physically challenging. I am an active person and have great core strength but this was something else. Brandon assisted holding my head up and my legs were being held up by the labour and delivery nurses as well as myself. Every contraction, you have to hold your breath, bear down, and push like you are making the biggest poop you have ever created. Try hold your breath for 15 seconds in this position while pushing maximally and repeat three times, then take a minute rest and repeat. Repeat this process for as long as you can.

You can’t practice this while you are in your third trimester as you risk separating your abdominal muscles (diastasis recti) but you can work on your lung capacity and endurance. I feel like this was the one area I was less prepared for and could work on if I was do repeat in the future.

As time progresses, I am interested to see if pregnancy broke old adhesions from my total gastrectomy. I believe it has but I should notice it more as I become more active. I cannot wait to get back into the gym!

38 week update – He’s arrived!

Hey all,

If you are reading this now, we are enjoying our new bundle of joy.

On April 1st, I had an ultrasound as well as a non-stress test. A non stress test involves a heart rate monitor being placed on the baby while you monitor for movement. When you feel movement, you press a button and the machine links the baby’s heart rate to the movement.

During my clinic visit following these tests I received good results. The baby scored perfectly for movement during the non stress test and my ultrasound showed good amniotic fluid and blood flow through the umbilical cord. However, in the words of my Ob, the placenta still looked, “Nasty”. I was also checked for cervical dilation which was 3cm. The Ob was happy about that because it means things are on their way.

So a date for induction was set for Sunday April 7th – exactly 38 weeks and 1 day.

I had hoped to do a natural labour. But I learned last night not to be a hero. I started the oxytocin (to get contractions started) at 9:15am. Around 12:20 in the afternoon, I was around 4cm dilated so the doctors decided to break my water. Then the fun began. The contractions got much stronger and before I knew it, 3 hours had passed. It was now 3:00pm. I lost track of time or what was happening around me. Although I thought I was breathing well, my face started to go numb and my arms, along with my inner thighs. I started to get really sweaty and the shakes. Apparently I had been hyperventilating once active labour began.

I was sufferring. I asked to be checked and I was 7cm. Who knew how fast I would get to 10cm. I decided it was time to stop being a hero and get the epidural.

Best decision ever.

I was afraid to get it because it brought back memories post surgery. It caused me a lot of anxiety in retrospect. But it was time.

Insertion wasn’t bad at all as the contractions were 100x worse. Once it was in, the pain was bearable and I laboured on. It may have slowed things down but it was bearable. The oxytocin was stopped but restarted sometime a bit later. But during this time, I could talk again and rest. Around 6ish, the baby was making his way down my birth canal and I experienced a lot of rectal pain. I was given lidocane to help me out as I had only 0.5cm to go.

At 8:30pm the pressure was back and strong. The lidocane had worn off as the doctors wanted me to feel where to push and how hard. I was checked and it was time to push.

I was ready. I had trained for this. Loads of core work from Zumba and pelvic PT to help prevent major tears.

This is where my open surgery for my TG almost 5 years ago was put to the test. The pushing involved a position with your legs in the air and you do a sit up while bearing down. You do this during contractions.

At first I had some reservations because I feared creating a hernia. But I needed to push with everything I had.

Thirty five minutes later, he was out. 7lbs exactly and 38 + 1 days gestational period. I only required one stitch. He is beautiful.

I lie here while he sleeps reflecting on what I just experienced over the past day.

What a miracle and another chapter to open in our lives.

37 Weeks pregnant – Home stretch

The pregnancy bump is in full force, although most identify it only on side profile.  I am all baby.

I am now onto the final few weeks of pregnancy and it has been another adventure to add to the books.  I left off at a 33 week update and I would say that the home stretch has presented itself with a few more twists and turns.  Pregnancy is an individual experience for every woman myself included.   I always wondered what the last few weeks would bring as those are the weeks your baby is packing on the pounds, taking whatever it needs from its host.  Yeah I said it, my baby is eating me.

I last left off questioning my iron and hemoglobin levels.  I had a clinic visit on March 11th where my levels were deemed low but not so low that something needed to be done.  But let me back up a little. Previous to this visit (end of Feb) is where I learned my levels had not increased but additional blood work was run.  I received a phone call on March 4th from the dietitian that my zinc level and albumin levels were also low.   Zinc is important for immune system function and albumin is a type of protein.

So what did this mean? Start taking 10mg of zinc 2x a day.  This brought my individual supplement total up to seven.  But wait there is more!  Zinc competes with iron and calcium when it comes to absorption in your body.   So they cannot be taken together and I need to take it twice a day, along with taking iron twice a day and calcium once a day.  You can see where this is going.  So for the past few weeks my supplement regime has gone something like this: wake up – prenatal vitamin and vitamin D, 2 hours later – Zinc, 2 hours later iron, 2 hours later, calcium, back to zinc, then iron….somewhere in there B12 and Omega 3.  Inevitably, I forget one of them per day.   I’ve tried putting them all in a bowl in the morning and slowly taking one whenever I head to the kitchen.  I feel for all of those people who need to take daily medication.

I decided to finish working on March 21st.  This would be about a month prior to my scheduled due date.  This was not an easy decision and it ultimately boiled down to my inability to stand or walk for prolonged periods of time, I was down to fifteen minutes.   The difficult part was that my brain was all gung-ho but my hip was saying, “Noooo”.  The baby has been growing and started to push right onto my sciatic nerve during movements and would send shooting pain down my leg.  I was fearful of falling while treating patients and this is what ultimately stopped me from working.  Those who know me, know that I LOVE my profession and what I do so when I stopped, it was like a piece of who I am was also taken away.  Not to mention, leaving my work fam for a bit.

But in my heart, I knew that this is temporary and my physio self will be replaced with a new self, “mom self” very soon and some of this void will be filled.   I did not really want a full month  (or more) off of work though.  However, I have always suspected that the baby may come early at 38 weeks.

As people know, I am a big believer of the universe’s plan and working in certain ways for certain reasons.  Let’s now jump ahead to my March 25th appointment – Ultrasound and clinic visit (week 36).

During this visit, I learned that my Ob-Gyn is a master at the sandwich approach of explaining things.  For those of you who do not know, this is where a person will begin telling you the great things, followed by some bad things but closing with great things again.

She began by explaining that the baby is growing well at an estimated weight of 6lbs 1oz and the blood flow to the placenta was looking good. Amniotic fluid, also good.  Then she asked how I was feeling and if I had been feeling the baby moving.  I replied, that there was lots of movement.  Here I thought, she would now say, “Great, see you next week for follow up”.  But instead I got, “the radiologist called me after your ultrasound and mentioned to me that your placenta looked odd”.  She followed up with drawing a picture that demonstrated that my placenta is calcifying and was getting calcium/fibrotic deposits inside.  This is normal for someone who is around 41-42 weeks term but advanced for someone who is 36 weeks. Especially since my 32 week ultrasound was normal.  From my understanding, this means that the placenta is hardening and eventually it will stop working as it should.  This was the centre of the sandwich.

Next she went back to the good news, “but your baby is growing and the blood flow looked good”.  Followed by, “I think we will want to induce you next week or the week after before it stops working as well”.  I think after I heard, “induce next week”, I just nervously laughed and left the clinic filled with many emotions.  Excited baby is coming very soon, shocked that baby is coming so soon, happy I only get a week maybe week and a half off work, upset that I only get a week or so off work, etc.  I’m happy my mom was with me at this appointment to clarify some details for me afterwards.  I’m pretty sure I went to La La land after that news.

However, I did ask if I could keep doing Zumba (since I was still doing it…36 weeks proud!). The answer was, “umm, I don’t think we want to increase your heart rate to make your placenta work any harder than it should”.  I knew this would probably be the answer but I needed to hear, “No”.    So to my Zumba community – I will see you all after the baby is born!  However, I was cleared to continue with Yoga and general gentle exercise.

Once we left the clinic, I was booked for another ultrasound on April 1st (the following Monday) as well as a non-stress test (to evaluate baby’s heart rate and levels in utero).  Then an induction date would be set based on these results.

Now back to my belief of universe working in certain ways.  Although it was shocking to know that our baby would be here before the second week of April.  I had always said, “I hope the baby comes around 38 weeks”.  This will definitely be the case now.  In addition, my hip continues to get worse  as the baby grows and maybe this was also another way to get me back to normal faster.  Finally, my eating has become more difficult and at my last clinic visit, I actually had lost some weight.  I now sit at a 16lbs weight gain with this little guy.

So everything for a reason right?  Brandon and I are really looking forward to meeting this little guy and having a new chapter open in our lives.  I know that labour and raising him will be a challenge, but what’s life without some challenges?  The harder the challenge, the sweeter the reward 🙂

 

 

 

29 Weeks Pregnant – A well overdue update

Hey Friends!

This stomachless pregnancy update is well overdue. I made the mistake of watching “Tidying up with Marie Kondo” followed by listening to her entire audio book and have been de cluttering like mad the past few weeks. I wondered when the nesting would begin but Marie has kicked it into full gear. But today I take a tidying break to give you all a much needed pregnancy update.

Since my last update, I have seen my Ob-gyn twice. Once just after Christmas where I was referred for a blood work up for my iron levels as well as to measure my blood sugar levels, and more recently Jan 24th where I completed my 28 week ultrasound as well as got updates on my previous blood work .

Normally women who are pregnant complete a glucose test around 24 to 28 weeks to test monitor for gestational diabetes. From what I understand, this involves drinking a large quantity of a sugar beverage followed by a blood work one hour later. Due to the no-stomach-thing, I did not have to do this test. Thank goodness because I think it may have killed me. Or just given me violent diarrhea and full scale dumping. Instead, I completed some blood work.

Throughout the month of January, I continued to work my regular hours and regular duties. I continued to attend the gym 1-2x a week for Zumba and home yoga daily for about half an hour. My fatigue level started to increase near the last couple weeks of January and I started to look green and pale at the end of the day. I was falling asleep on the couch around 8:30pm every night but figured it was just regular pregnancy fatigue. I also started to have minor dizzy spells and felt slightly faint during the last couple of tracks of my Zumba class. You probably know where this is going.

On my Jan 24th follow up, I was notified that my iron level was low and I needed to double up on my iron supplements. I have been taking Ferramax 150mg since my surgery as stomachless folk often have iron absorption issues post total gastrectomy (TG). This made all too much sense after hearing my results and started doubling up immediately. Within a week my energy levels improved as well as my colour. I will likely have this level rechecked in the future to ensure I am not anemic and if it remains low – I will be referred for an iron IV infusion. This is also common post TG and in pregnancy (especially during the late 2nd trimester into the 3rd).

In terms of my blood glucose levels, I did not have gestational diabetes so this was a bonus. Continue eating ice cream, baked goods, and chocolate for me! I am convinced this baby will be 1/4 chocolate.

On this visit I also had a 28 week ultrasound. At this point in time, I had gained about 10lbs above my pre-preggo weight. The issue the Ob-gyn is concerned about with people who have TG’s is the baby not gaining enough weight. Much to my surprise, I was notified that the baby is currently in the 73rd percentile. Which means that he is bigger than average! I heard these scans are not the most accurate for actual birth weight but I’ll take it. I am hoping to have a 6-7 pound baby but if this scan is accurate, I may have an 8 pounder. Yikes! Maybe I better slow down on the sugar….

In terms of physical mobility, my right hip and pelvis continues to be an ongoing issue and although I am doing as much as I can for it (Yoga, stretching, Physio, and massage therapy) it is getting worse as the baby grows. I’ll spare everyone all the details as I do not like to complain but I am confident that it will all go away once the baby is born. I am determined to keep up with my physical activity though throughout all of this pregnancy.

In terms of eating, my appetite is the best in the morning to mid day. Although, I have been eating a lot, my weight gain has been minimal. This morning I was at an 11 pound gain. As he continues to grow, the baby is taking all the good nutrients he needs and my body composition has been changing. Less muscle mass…larger belly. I think I am all baby.  The evening is a different story. Often it is hard eat the same portions I was able to eat a month ago and I have issues with food getting stuck. Dinner time is the most difficult. I find standing and eating the easiest. Sometimes, I try to shift the baby position around as I suspect my intestines and pseudo stomach are getting all bunched up and the pipework is getting kinked. If I’m successful, I usually feel a good gurgle and the stuck food sensation goes away. I also try not to eat too late into the evening to avoid bile reflux in the middle of the night.

Believe it or not, my surgical scar looks better than it ever has and I think all this belly stretching is stimulating more cell repair. I also think this baby is breaking a lot of old adhesions from surgery. You go baby!

Anyhow, my next follow up is next week. I am down to the every two week appointments now. I am now 11 weeks off of my estimated due date. Homeee Stttreeettccchh!!

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Me at 27 weeks pregnant

Pregnancy post total gastrectomy

I have been a little MIA from the blogging world over the past few months. Not because I didn’t have any ideas but I was saving up for some big news!

After last years adventures with IVF + PGD +PGS followed by a natural pregnancy and a miscarriage, we are happy to announce that we are expecting. I write this with both excitement and hesitation. As you all know, I am an optimistic person and prefer to see the light in situations. However, after experiencing a miscarriage, it is hard not to be semi-guarded when expecting. We announced to our friends and family after the infamous end of first trimester, but I did not feel comfortable posting anything onto social media. After speaking with Brandon and thinking about it long and hard, I decided that I wanted to blog about being pregnant without a stomach as it may help many other women trying to make that tough decision about when to have their stomach removed. I know I was there back in 2014 and it was not an easy one.

I was one week out from meeting with a fertility clinic as it had been almost 1 year since our miscarriage last year. I decided to take a pregnancy test about a week before the appointment and much to my surprise, it was positive. I was four weeks pregnant. This was back in mid August.

I had suspicion that something was going on as I was able to eat some ice cream, which I shared with the world on my last blog post. This happened to me last year before the miscarriage. I was able to tolerate sweeter foods easier. That was my first sign.

I called the fertility clinic to let them know about our natural pregnancy and they still followed me for the first eight weeks. At this point, I was transferred to a high risk maternal fetal medicine clinic. During my appointments at the fertility clinic, ultrasounds were taken at the six week and eight week mark. Each one filled with nerves that we would receive bad news and then joy that things were going well.

Once I was transferred to the high risk clinic, I first met with the regular maternal fetal medicine clinic and a genetic counselor to discuss the hereditary nature of the CDH1 genetic mutation as well as how one can go about testing a fetus for the gene. We had already decided in advance that if we had a natural pregnancy the child would not be tested until it is old enough to make the decision on their own. But for those who are interested, doctors are able to test for the gene using Chorionic villi sampling or amniocentesis. At this point, the expecting parents can decide to terminate the pregnancy or keep it. It is not an easy decision for anyone, that is for sure. In Ontario, these tests are covered which adds more layers to the decision making process of IVF with PGS/PGD (costly) vs. natural (testing is covered).

Thankfully, we were already prepared for all of these decisions as my genetic counselor discussed all this with me back in the day when I found out I was positive for the mutation.

I had morning sickness from weeks six to week fifteen. It actually was afternoon/evening sickness which allowed me to get through my work day but knocked me out at night. I experienced brutal nausea from about 4pm to when I crashed at night around 8pm. I attempted vomiting hoping it would make it stop but that is one thing that I have not been able to do since my stomach removed. So it was basically like being stuck with constant motion sickness for a nine weeks. Props to all the women who have this throughout the entire pregnancy and for those who don’t, you are lucky!

Around week six, I started to develop coccyx (tailbone) pain which has progressed into right sided glute/hip pain which radiates a quarterway down the back of my leg. Thankfully, I have many great physios friends who with who have been keeping it manageable. It is a real pain in the butt!!

In week 16, I was able to feel the baby kick and in week 17, I was able to see some kicks and feel them on the outside. They say that people may not feel these things until 20 weeks or later in pregnancy but I think us stomachless people are so body aware, we pick it up faster. The baby kicks more after I eat, I am assuming because all the intestinal noises from digestion must be pretty loud in there for it. The baby is sitting on my left side and fairly low.

In terms of weight gain, I have gained about four pounds since becoming pregnant. The Ob-gyn recommended that I gain 5-8lbs by week 20. I also recently completed my anatomy scan which occurs around weeks 18-22. Again, I had some ‘scananxiety’ but thankfully, everything was normal. I have still not gained much weight and I have a small bump. My Ob-gyn was not concerned about the lack of weight gain as it is too early to tell if the baby is growing appropriately.

Anyways, I plan to keep people up to date about how things are moving along. Pregnancy post gastrectomy is not a topic that many blog about so I think this will serve as a good platform to blog more frequently again.

Hereditary Diffuse Gastric Cancer Webpage

Hey all!

Recently Karen Chelcun Schreiber (Founder of No Stomach for Cancer) started a webpage dedicated to Hereditary Diffuse Gastric Cancer (HDGC) which strongly focuses on CDH1 mutation as well as the most recent research regarding HDGC.   She works with Dr. Parry Guilford (Discovered the mutation and continues to do research for CDH1 mutations).

The mission statement:

“To support Hereditary Diffuse Gastric Cancer (HDGC) translational research that leads to improvements in the health and well-being of those affected by HDGC, and to provide relevant, reliable information and resources to help individuals and families understand their risk, make informed decisions, and advocate for themselves.”

I think this is such a great organization as the funding and donations to this group go directly to research for HDCG.   My hope is that there will be a better way to prevent HDGC for people with CDH1+ mutations than removing your stomach in future years.

Check it out:

Hereditary Diffuse Gastric Cancer

Ice cream

It has been just over two months since my last blog post. Time sure does fly! We are having a real summer here in southern Ontario – hot and dry. I have been spending much of this summer studying for an exam that involves progressing my diagnostic skills and treatment skills as a physiotherapist. But that is a whole blog in itself. Needless to say, I have been a little MIA from the blogging world.

But I’m back for another reflection post.

One food that I have always loved is ice cream. I have mentioned it many times in previous blogs and purchased the biggest cone to eat prior to saying farewell to my stomach. Not only is it delicious but often, eating a cone is associated with a fun social outing with friends or family.

Unfortunately, I still do not tolerate it well in larger quantities (i.e. greater than 1/4 cup). So every time we stop for ice cream, I am faced with a decision – eat it and risk feeling unwell (usually bloated, fatigued, and rapid heart rate) or kindly pass and often take a few licks off your husband’s or friend’s cone.

I came across a quote that states, “you miss 100% of the shots you don’t take” and I am not a person who likes using the phrase, “I can’t”.

Last night after a nice dinner with friends in Toronto, we stopped at an ice cream place called, “Bang Bang Ice Cream and Bakery“. They are a small ice cream shoppe that makes home made ice cream and apparently has some of the best ice cream sandwiches downtown. Once again, I was faced with the decision to pass or to try. This shop had a small 4oz size cup.

“You miss 100% of the shots you don’t take”

I ordered the 4oz cup of mint ice cream. Was it the best ice cream I’ve ever had. Yes. Was I scared to eat it. You betcha. Did I feel bad after? Surprisingly not as bad as I had expected.

Life is too short to pass on the things you love. Life is too short to be afraid.

You miss 100% of the shots you don’t take.

Happy August everyone!

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