Twin pregnancy, diabetes, and weight gain

Wow, I’m supposed to be gaining weight! How liberating!

With a twin pregnancy, I should gain anywhere from 35 to 50 pounds, according to all the doctors and information out there. I’m at 21 weeks and one day, and I have gained 16 pounds according to my doctor’s scale this morning. Am I right on track?

The fact that I’m supposed to gain weight – and not lose or maintain it – really sunk in one morning during one of my pre-natal work-out videos. I could not help but smile when I heard one of the instructors say: “This work-out is not meant for weight loss. It’s meant to make healthy moms and healthy babies.”

I’m working out not to shed those extra 10 pounds anymore! I’m exercising for pure and absolute health.

I was grinning from ear to ear. It was like a huge load had been lifted off of my shoulders. I have made myself crazy for decades about my body – that I need to lose weight, be thin, and so on. And here I am, the first time in my life, gaining weight – on purpose!!!

After being told to gain weight, I think I felt as though I received a permission slip to eat ice cream, steak, french fries, chocolate, crème brule…I have definitely been indulging in fattening luxuries. It’s for me and the babies. I’m eating for three, right?

Well, I’m not sure. I’ve been receiving mixed messages from my array of doctors. Perhaps I’ve been indulging too much?

I had an appointment with my OB/GYN on Thursday morning and one this morning with my endocrinologist. My OB/GYN said that my weight gain is right on target. My endocrinologist does not necessarily agree nor disagree but does want me to change some of my eating patterns of late. (I can’t really blame him for telling me, “no more ice cream.”)

On the one hand, my blood sugars have been fantastic; my endocrinologist said so this morning. My blood pressure is right on target. I had a twin anatomy and fetal echocardiogram on Monday. The first is a test that determines the growth of the babies and the echocardiogram is performed on diabetics because there are risks of heart problems in diabetic pregnancies. The good news is that the babies’ growth and weights are normal, and their heartbeats are perfect.

But they tell me that the real concern comes in the third trimester. That’s when the babies’ weights can get out of control, and out of control diabetics tend to have bigger babies. We want the babies to have healthy weights so that they make it to term. It gets crowded in there, and having larger babies can cause premature birth. (Please check with a doctor for medical advice on all matters related to diabetes and pregnancy. I’m not a doctor or a nurse, and am merely sharing my experiences.)

So what this all means is that although I felt liberated in the world of eating and began to splurge, I still need to watch my diet. Gain weight in a measured and steady way. For my health and the babies’ health.

Alas, with the weight gain, many body issues have surfaced. My feelings of being fat and huge have only been exaggerated since gaining pregnancy weight. And that little ounce of liberation felt so good.

How can I feel liberated all the time? Whether I’m trying to gain weight for the babies or whether I’m trying to keep a healthy weight when I’m not pregnant? Shouldn’t I always feel good about my body?

This is a big topic for me, I must admit. I think many diabetics go through body issues. How do you love your body when you are told that you need machines, medicine, and doctors to keep it going?

I can’t say that I’m an expert on this topic. I’d say I’m still learning, but I have come a long way from where I used to be. Here’s what I’ve learned so far:

Compassion and gratitude are the keys.

There are ways to bring these feelings into your life, into my life. But from my experience, it requires daily work. Otherwise, the old habits and patterns of thought come back very easily. And that's where I think my current lesson is.

Let's start with how I have developed compassion in my life. According to psychologist Dr. Matthew McKay, Ph.D. and Patrick Fanning, authors of “Self Esteem”, compassion comes through three steps: understanding, acceptance, and forgiveness.

First, you must understand why you feel the way you feel, where you are coming from, how you were conditioned to have those thoughts. In the case of a Type 1 diabetic, it may come from the stress of managing a chronic illness. It also may come from societal expectations, not only magazines with super skinny movie stars on the cover, but also the media discourse surrounding why people become diabetic. Let’s face it: Most media messages say that people become diabetic because they are overweight. And if you just lose that weight, you’ll be cured. Well, that’s not true in all cases, and it’s not true at all for Type 1 diabetics. But we still have to hear repeated messages that say just that on TV – quite often. It’s got to affect our body image, in my opinion.

Second is accepting that we are human, and we are all just trying to survive in the best way we know how. I’m sure you didn’t choose to have diabetes. I know I didn’t. But I have it. And I have a choice – take care of it and myself, or not. Accepting that you have diabetes, or whatever ailment whether physical or emotional, is so crucial to managing a disease.

Third is forgiveness. I used to be my own worst enemy, until I understood and accepted myself better. Then, I learned to forgive myself. That is liberating.

You can work on those three steps through journaling, meditation, talking with a therapist or a trusted friend, and so on. (Please consult with a doctor if you are feeling depressed or anxious. They will know best how to guide you.)

And then there’s gratitude. I started keeping a gratitude journal a year or so ago, after going through the stages of compassion. I write ten things that I’m grateful for most days of the week. It changes my day, and my attitude. Toward myself – and others. It’s really hard to feel bad about your body, or anything for that matter, when you are feeling grateful for them. It is impossible to feel bad about your body and grateful for your body at the same time. The two feelings cannot possibly co-exist.

All of these things, plus listening to doctors, diet, exercise, meditation, and so on, have made me love my body more. And as I said, I still have work to do on this one.

I’m grateful for this pregnancy for making me even more aware of it. I have gotten a taste of liberation, and now it’s time to make it a daily part of my life.