Week 15 Update

I've got to be honest: I'm pretty bummed out today. I thought last week that I was perhaps starting to come out of the morning sickness somewhat. I had two days where I was able to eat 3-4 small meals (while this was still only about 1200-1500 calories, and I should be eating about 2200 calories/day, this was a major improvement). Several people told me that their morning sickness ended around week 15, so I was kind of hoping that eating those meals was the light at the end of the tunnel. Also, I was finally able to eat some fresh fruit, which I had been unable to do without getting violently sick for 2 months, so I felt like I was finally doing something good for my body. The past 3 days, however, I started feeling pretty crummy again and was not able to eat much.

I got on the scale this morning and I had lost more weight. I have lost 14 pounds since I have been pregnant, and I am at a loss for how to stop losing weight and how to gain weight. I have a doctors appointment a week from Friday (unfortunately my OB is out of the office and it will be with a nurse practitioner who I have never seen before) and I was told at my last appointment that if things didn't turn around by this next appointment we would have to start discussing options. I don't really know what that means...I know that I can't lose any more weight, but what options are there? It's not like they are going to hook me up to a feeding tube. The hunger inducing medications I believe are unsafe in pregnancy. So what options are they talking about?

The only thing that I can think of, and what I am going to suggest at my appointment, is that they put me on a medication called Reglan (Metoclopramide) that essentially speeds up the digestive tract. I think that this medication (which I know is safe in pregnancy) will help with two problems: delayed gastric emptying and constipation. My major problem is delayed gastric emptying; this happens a lot in pregnancy, but I doubt that it happens to the same extent in many other pregnant women. Let's say I eat a 170 calorie yoplait yogurt (definitely the full fat kind - everything I have been buying is the most calorie dense, highest fat version available): it takes about 4 hours before I stop feeling full. If I eat 2 pieces of pizza, totaling 300-400 calories, I tend to be full for about 6 hours. If I eat before I become hungry again I become nauseous for the rest of the day and cannot eat again. Unfortunately, this means that I can only eat 3-4 times each day and each time I eat I get full really quickly. Normally, I should only be full for about 1-2 hours after a snack of yogurt and for about 3-4 hours after a meal like pizza. If my gastric emptying times were normal and I could eat on a more regular schedule then I might be able to get in enough calories.

I am also at a loss of if I should exercise or not. I know that it is good for me, but I am unable to meet my basic nutritional needs right now. While I entered pregnancy exercising regularly, when the morning sickness hit I stopped exercising because I felt so bad all the time. I have tried to start exercising again, but is it really advised right now? Can I stand to burn that extra 300 calories in a day? I know that part of the weight I have lost is muscle (I have a scale that does body fat percent and percent muscle, and while I don't trust the precision of the numbers that it provides I do trust the trends; also, if you lose this much weight and haven't been exercising regularly, you are almost guaranteed that a couple of pounds of it is muscle).

So, essentially, I am at a loss right now. If things don't turn around in 10 days then we will have to reassess the situation when I go to the doctor.