Transcript: Pregnancy Symptoms: The First 20 Weeks

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Preggie Pals
Pregnancy Symptoms: First 20 Weeks

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Your pregnant, you may or may not even know it yet, but from many women it is the pregnancy symptoms that give it away. So what specific symptoms can you expect within the first half of your pregnancy? What triggers these symptoms and are there ways to overcome them?

Today we are joined by one of our featured experts Dr. Nick Capetanakis, he is an OBGYN and right here in San Diego. This is Preggie Pals, episode 70.

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Sunny Gault: Welcome to “Preggie Pals” Broadcasting from the Birth Education Center of San Diego. Preggie Pals is your weekly online on-the-go support group for expecting parents and those hoping to becoming pregnant. I am you host Sunny Gault. I am joined here by Stephanie Saalfeld, she is our Preggie Pals producer.

Hi Stephanie!

Stephanie Saalfeld: Hi!

Sunny Gault: So before we get started why don’t you tell our listeners a little bit about our new virtual panelist program that we are so excited about?

Stephanie Saalfeld: Okay! So basically we would love for you to join our conversations from anywhere in the world. If you like our Preggie Pals’ facebook page and follow us on twitter, we will be posting some preview questions before our recording and we would love to have your answers so that we can read them on the show when we record.

Sunny Gault: Yeah! It is a great way to ask our expert, even your own question.

Stephanie Saalfeld: Absolutely!

Sunny Gault: Also if you got experienced with something or you know you just kind of want to share your own two senses; it is a great way to do it on facebook and twitter. We actually have a page on our website, right, that talks about our Virtual Panels program.

Stephanie Saalfeld: We do! If you go to www.preggiepals.com, under the community tab you can find be a virtual panelist and I will give you all the information you need.

Sunny Gault: Alright! Thanks Stephanie! Well have you joined out Preggie Pals’ club our members get extra bonus content after each new show plus special give away and discounts and you also get a free subscription “The Pregnancy” magazine. Visit our website www.preggiepals.com for more information. Thanks everyone who is listening to this episode through our awesome Preggie Pals’ Apps, they are available in the Apple and Android market place but actually on Google Play and Windows Phones too. It is like we have go all this Apps out, pretty cool! We are taking over the world, it is pretty fun. So I think personally this is the best way to listen to our show if you are mom that is on the go, you are going to your parietal appointments or whatever, sometimes it is hard to just listen in-front of a computer, so the Apps are really good opportunity. They are absolutely free, so download our Apps today.

So let’s meet some of the panelist that are here in the studio. You guys know me, I guess I am a panelist, kind of moderating this whole but I consider myself a panelist to. I am the host of the show, I am Sunny, I am 35 years-old, my due date technically is December 16th although I am pregnant with twin girl and we never make it to the due day when you are pregnant with twins. So we actually just said we are going to have a C-section with this due to some complications with my first, I have two boys at home. I have a 3 year-old and I have a 15 month-old. With my first we had some complications, so my second was C-section and the twins are going to be C-section too. We just scheduled the date for December 2nd which is a Monday. So fingers crossed that I will actually make it that far. I actually had some pregnancy scares this week which really kind of threw me off. But it is just kind of a sign that I need to take a little bit better care myself, to sleep more and all that is kind of hard to do when you have two little boys running around your house. But I got to make it happen. So that is a little bit about me.

Destiny! Go ahead and introduce yourself.

Destiny Bochinski: My name is Destiny, I am 34, I am physical therapist and actually specialize in Pelvic Floor therapy.

Sunny Gault: And you have been an expert.

Destiny Bochinski: I have! So I am pregnant and I am due Novembers 2nd with a little girl. We didn’t find out the first time with my son but we decided that planning was a little bit more important this time around. So we are going to have a little girl and my son would be 3 in October so it will be right around his birthday, who knows. He was 2 weeks early so I don’t know if she will be early to, we will see. I am planning my second home birth with her as well, we a midwife.

Sunny Gault: So you had a home birth the first time.

Destiny Bochinski: Yes.

Sunny Gault: Okay, everything went well, you didn’t have to be transferred or anything...?

Destiny Bochinski: It was fabulous!

Sunny Gault: That is awesome! We just recently did an episode on home birth so if you guys are interested and be sure to check it out. Welcome Destiny.

Jessica!

Jessica Blagg: My name is Jessica and I am 29 and I am a medical biller and my due date is March 8th and we don’t know the baby’s gender yet, but we are going to find out as soon as it is possible. I have one other child, she is 8 and we are hoping this time for a VBac.

Sunny Gault: Okay! Good for you. Last but not least.

Brigid Santiago: I am Brigid, I am 28 but I think by the time you hear this I would be 29, and I am a great rider and fund raiser for a non-profit health clinic network. I am due December 19th with a little boy. It is our first baby. So I am really excited and we are planning a natural child birth with the midwife but in a hospital birthing center type thing.

Sunny Gault: Okay! Good for you guys! Well ladies thanks so much for been part of your show today.

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Sunny Gault: Before we get started with today’s show there is a pregnancy headline that I want to share with you ladies, we tried to grab headlines that are making line around the internet and this is one that definitely caught my eye a lot when we are talking about this. This is a new book project that is coming out, it is called “A Beautiful Body” and there is a photographer, here name is Jade Beall. I am just going to read a portion of this to you she published a series of self-portraits of her semi-nude postpartum body online. Basically people so some of these photos and thought it was so refreshing. I guess she posted some stuff to facebook. And, they thought it was so refreshing that she didn’t do a lot of touch up on these images, it was just her and her baby, and it was very real. She is getting all this great feedback, and so women are basically contacting her saying, “Will you photograph me in that same manner?” I wanted to get you guys’ feedback on this because I think she’s doing this, and she’s going to publish a book.

Destiny Bochinski: I think it’s refreshing. I think especially in our culture, in our society, there’s way too much emphasis to get back to everything pre-pregnancy, like, within the first 24 hours, you know? And it’s really sets up this impossible expectation for women to try to be supermom and look the way they did before they ever got pregnant, which is completely unrealistic. Like you are ever going to look exactly the way you did before you got pregnant. It’s part of becoming a mom, and it sets us up for failure.

Sunny Gault: Bridgett, what do you think?

Brigid Santiago: I completely agree! I think it’s wonderful to see. You don’t see a lot of that, especially, I mean I think, out here on this coast too. There’s so much emphasis on having a perfect body at any stage in your life, and it’s wonderful to see women in a more natural way because, I mean, I don’t think you even get a lot of exposure to that no matter where you live, so it’s refreshing to see.

Sunny Gault: That’s a really good point! I don’t know, prior to having my own children, I don’t remember really even having an idea of why, you know, a postpartum body looked like. So, you know, you hear again all these things, and you see these supermodels walking away with near-perfect bodies, and we have this idea that that’s what it should be, but I don’t know if I had any real examples, and I think that’s what this provides. Alright ladies, thanks so much for sharing your opinions. We’ll link to this on our website.

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Sunny Gault: Today, we’re discussing pregnancy symptoms, and this is the first episode in a two part series. We are exploring what to expect during your “First 20 weeks of Pregnancy”, and then next week we’ll focus on the “Last 20 weeks”. So, Dr. Nick Capetanakis is a featured expert on our shows. He’s an OBGYN, and he’s joining us via phone. Doctor Cap, welcome back to Preggie Pals’.

Dr. Nick Capetanakis: Thank you very much! Very excited to be here!

Sunny Gault: Let’s start with talking about early pregnancy symptoms in general. When do they start? I know a lot of women, that’s their first indication that they’re even pregnant, right?

Dr. Nick Capetanakis: Absolutely! Pregnancy for everybody can be different, and every pregnancy can also be different for every woman. Some women start feeling things as soon as six to eight weeks after their last menstrual period. Some women don’t have any symptoms, but unfortunately there is a 50-70 percent chance that some women are going to have some nausea and vomiting, which would probably be the most common pregnancy symptoms early on in your first trimester.

Sunny Gault: What usually triggers these symptoms? Is every symptom triggered by something different, or is there a way to kind of classify this in one big bunch?

Dr. Nick Capetanakis: That’s a great question! We’re not 100% sure! We definitely think that a hormone called beta hCG, which is produced early on in the pregnancy, causes the vast majority of those symptoms. Progesterone is another hormone that also causes some of the GI symptoms, including constipation that can occur. But most of it is the beta hCG hormone.

Sunny Gault: So let’s just dive into this list and ladies here in the studio as we’re talking about these symptoms, I know we’re all pregnant, with the exception of Stephanie – not yet, again, she already has a little girl at home, but when we go through these symptoms, feel free to kind of chime in and tell us what your personal experience is with this. So, Dr. Cap, the first one I want to talk about is high basal body temperature and I’m assuming you may not know that your basal body temperature is high, unless you’ve had some conception issues and you’ve been tracking this before. But, tell us a little bit more about that.

Dr. Nick Capetanakis: Some women do have some increase in temperature in pregnancy, but like you said, most of the basal body temperature that we look at is for patients that are trying to conceive. You know, when you’re ovulating your basal body temperature does go up a degree to two degrees, and that’s when most women will then try to conceive around that time. Once you get pregnant, you do have feelings of an increased temperature, but not necessarily that you’re going to read on a thermometer. Some people complain of some hot flashes and things like that, but overall I would say that’s probably a less common symptom than the other ones that most women feel in the first trimester.

Destiny Bochinski: So are you saying that the basal body temperature is not necessarily responsible for that uncontrollable ability to regulate your temperature that I’m certainly feeling?

Dr. Nick Capetanakis: It’s kind of hard to say, you do have an increase in blood flow, there’s a lot of changes going on hormonally, so you have that sensation that you’re running hot. But, if you were to necessarily take your temperature, you wouldn’t necessarily see an increase in your normal body temperature if that makes any sense. It’s more of a hormonal flux and an increase in blood volume that makes the woman feel like they’re running a little bit hot. But I remember when my wife was pregnant during the winter, she was like a heater. We didn’t even have to turn on the heater at night; I would just cuddle up with her. So there is a sensation that you’re probably running a little bit hot.

Destiny Bochinski: Especially in August!

Sunny Gault: Oh yeah, right, depending on when you’re due, for sure! Let’s move on to the next one. I’m sure most of us have experienced this one, nausea, and combined with that, I’m just going to call it morning sickness, although we all know it doesn’t just happen in the morning. So, Dr. Cap, what trigger’s this?

Dr. Nick Capetanakis: Again, we think it’s probably the beta hCG hormone that triggers that reflux. For my patients, when I talk to them about their first trimester, I kind of tell them it's almost like you feel hung over but you didn't have a good time the night before. You've kind of got that feeling of that queasiness, like you said, can go on through the whole day. Some women do have vomiting or they feel like they need to vomit but they may not and then, other women, unfortunately, have that vomiting aspect of it. It's something that varies from pregnancy to pregnancy; and, sometimes, it can be almost debilitating for some people. But for most people, it's just kind of that underlying nausea and not-feeling-well-all-day kind of feeling.

Sunny Gault: So, ladies, let's open this up here in the studio. What has been your experience with nausea and morning sickness?

Destiny Bochinski: All day hangover! Just like what he said. I didn't have a huge amount of vomiting parse except for a few specific triggers. But, all day long, I just felt awful. And if I hadn’t eaten for about an hour and a half, then, it would escalate and I would feel like on the verge of throwing up. So I had to eat, literally, every hour and a half to two hours, and eat lots of protein in order to keep that away. Otherwise, I just felt completely hung over.

Jessica Blagg: That was definitely the first symptom I noticed and I swear it started the day I got my positive pregnancy test.

Sunny Gault: At least, you were more aware of that.

Jessica Blagg: Exactly! It may have been somewhat psychosomatic. I don't know. But that was definitely the one that was the most irritating, for sure and the morning sickness, whatever, it was all day. I didn't have a lot of vomiting, either, but I just didn't feel well for about 14 weeks.

Sunny Gault: When did it taper off for the rest of you here?

Brigid Santiago: Actually, my second pregnancy felt like a lot earlier, when it was just a week. But it was right around 10 to 12 weeks.

Sunny Gault: Okay! What about you, Jessica?

Jessica Blagg: I didn't get it this time. My first pregnancy, I definitely had morning sickness all day. As soon as I wake up, I'd feel horrible; I go to bed, I'd feel horrible. But, this time—magic!

Sunny Gault: Nothing at all?

Jessica Blagg: Maybe a couple of days. I think it was more related to my blood sugar, though.

Sunny Gault: Dr. Cap, what makes the difference between someone just kind of feeling nauseous and then actually throwing up? In my personal pregnancies, I rarely got to the point that I was throwing up but it was kind of that all day: I need to lie down. I need to eat. I need to do whatever.

Is there something that triggers it more? Is it just the higher levels of these hormones? How do you explain that?

Dr. Nick Capetanakis: I wish I could tell you because, then, we could actually do something to prevent that vomiting reflux. Everybody is very sensitive or insensitive to the hormone and some people, unfortunately, can't control it and they end up vomiting. So there's nothing really that you could measure parse that's going to tell you who's going to get it and who are not going to get it, if that makes any sense?

Sunny Gault: Sure.

Dr. Nick Capetanakis: It's just everybody is sensitive in a different way. Sometimes you don't have it, that feeling and then another it's overwhelming.

Sunny Gault: So what is your recommendation when women come in with this type of nausea? I know there's different levels and stuff like that but what do you usually tell them to do first to kind of overcome this?

Dr. Nick Capetanakis: I talked to patient about this. The first trimester is kind of survivalist mode. You know, you do whatever makes you the most comfortable. But you guys had brought up some good points, frequent meals. You need to eat, you need to be in constant gazer and that means everyone, and after two hours you need to put something in. You have to carry with you team absorb; some kind of protein or some cheese or some yogurt and really eat everyone and after two hours. Some people do better on high protein diets, other people come in and say, “I can only eat bread” and I said, “Fine, just eat bread.” I mean, you kind of just have to survive.

Destiny Bochinski: That's funny because the thing to m the biggest difference from me was when my midwife told to get 80 to 100 grams of protein a day, like massive amounts of protein. Once I started doing that and being really religious about it and how often I had it, it made a huge difference.

Sunny Gault: Have you heard of that Dr. Cap? Increasing your protein in addition to Carbs?

Dr. Nick Capetanakis: Yeah! Absolutely! I mean, some people respond better with Carbs, some people respond better to protein; proteins takes a little bit longer to burnout so probably stabilizes your blood sugar a little bit better and for some people that I can definitely help are with those symptoms.

Destiny Bochinski: What is it with the gag reflux sensitivity? What, is that a hormonal thing? Because I don't know if anyone else experience...I could not even brush my tongue at the first time trimester without and then, I got a terrible cold the very first, my night with my son. Between post nasal drip, and I gag reflux. I was like throwing up in the shower every morning.

Sunny Gault: So what is that Dr. Cap?

Dr. Nick Capetanakis: That's another tough one! I mean, which think that probably that progesterone affects that, that's sphincter kind of… that separate your esophagus and your stomach and maybe doesn't close as much contributing to some of the reflux that you get in second trimester and later half of your pregnancy. That then irritates the esophagus which then causes maybe a little bit more of that sensational gag reflux but it's not tough for one to kind of a pin point exactly why it, you know again I remember my wife was brushing her teeth that she would gag too. So it's probably a combination of some hormonal thing that is causing that reflux to increase.

Sunny Gault: Alright! I know we could talk about that symptom forever but we're going to move on in our list. “Tender Swollen Breast”; at what point does this happen and what are your recommendations for women who can't even touch their breasts anymore because they hurt so much?

Dr. Nick Capetanakis: Again that's a tough one because what happens is the breast tissue actually gets engorged. And most women would tell you that their breast cup size does go up along with the circumference around their back. Their bra’s size actually goes up because the rib cage does extend but early on in the 1st trimester, that breast tenderness is probably from the actual (unclear) breasts that are getting swollen. And it’s a tough symptom to manage. I mean, some people take warm shower that actually irritates that but you try not rubbing them or stimulating them. Some people put little nipple pads to kind of protect the nipple from rubbing the inside of the bra which can kind of help with irritation. Unfortunately, there’s no magic to that one. That one usually comes on pretty quickly and also disappears pretty quickly. It usually doesn’t last the whole 1st trimester and it’s more of managing the discomfort than actual treatment for it.

Stephanie Saalfeld: That was actually my 1st symptom, that’s how I knew, I mean like, wait, something feels not quite right. We also have one of our Preggie Pals’ virtual panelists, Chelsy commented on this question from facebook and she said that she felt the breast tenderness about a week before her missed period and she kept thinking that she felt different and pretty much knew she was pregnant and she said it lasted about 3 weeks. So do you know that’s about right Dr. Cap, about 3 weeks, about, I would say, for me, it’s closer to maybe 5 weeks or so?

Dr. Nick Capetanakis: Yeah, I would probably see an average most people on prior of 2 to 4 weeks marks with that discomfort.

Sunny Gault: Anyone else experienced it? Go ahead!

Jessica Blagg: Yeah, I think mine went on along longer. It felt like it was not constant but off and on throughout my 1st trimester and I’m already kind of busted to begin with and it felt like, I don’t know.

Destiny Bochinski: I definitely had to wear sports bra, like I couldn’t, I didn’t want blankets touching me, I didn’t want the wind blowing on me.

Sunny Gault: I took that a lot actually, I don’t think about it, you know, this is my 3rd pregnancy, but with my 1st, I did a lot of wearing, they have special bras, they don’t have the wires and stuff like that, they’re a little bit more comfortable to wear at night and I think I did that in the beginning and I haven’t done it since and I wonder, actually this is a good question for Dr. Cap. Dr. Cap, after you’ve experienced breastfeeding and in your boobs, quietly you’ve been through a lot more when it comes to kids, do you think, is it possible for them to become less sensitive to some of this breast tenderness and stuff and pregnancy? Because I felt like mine have been through to the ringer already and like, you know, and then me getting twin chair, but I’m not experiencing what I did with my 1st pregnancy.

Dr. Nick Capetanakis: Yeah, I mean, it makes sense right at the body wall with that discomfort, it’s the same with breastfeeding, the 1st one is usually the toughest one and then you know, for the subsequent pregnancies, you think it’s a little bit easier. I don’t want to say that the nipples get a little bit more desensitized. But probably due to some respect and that probably includes the breast tissue and those feelings that you get once the swellings probably do go down.

Sunny Gault: Okay, that sounds fair, it makes sense. Okay, let’s move on to the next one, “Mood Swings”. Now I know we can use this as an excuse with our partners a lot but I think it also only makes sense that the more weight you gain, the more aches and pain you experience in different parts of your body, the more prone you may be for your mood to change very quickly and especially if you don’t feel someone else is understanding your position. So Dr. Cap what do you have to say about mood swings?

Dr. Nick Capetanakis: Yeah, that’s like a three hour conversation. Mood swings are a concern because really I mean it comes down to women are very complex creatures and when you put them in a situation where they are not feeling great, they are not able to work out, they are not feeling understood they are having this nausea, the vomiting, the breast tenderness and nothing makes it feel better, you put that on a platter and that’s a tall order to tackle for anybody.

So you know you got hormonal issues, you’re constipated, you’re bloating, why am I showing at 12 weeks, what’s going on, there’s so many different things that go in to that that does affect people’s moods, when you are not able to exercise and get that anxiety out and feel good about your body then that does affect you. So it’s really so multi complex that you couldn’t even begin to scratch the surface on.

But what it really comes down to is voicing you concerns with your partner, hopefully you have a partner who can empathize with you and do the best that he or she can to kind of make you feel as good as you can. Doing little things for yourself to try to make yourself feel better whether that’s getting a massage or trying to get a little bit of exercise, you’re getting some sunshine, going for little walks and just doing whatever can bump up your mood will definitely help that. And really it’s just one of those things that if you are aware that your mood is that labile then also just being able to kind of check that and say, okay, now I feel like it’s kind of getting out of control I need to like step back and re evaluate how I am feeling and remove myself from the situation for a couple of minutes and then come back in to it with more focus. Does that make any sense?

Sunny Gault: Yeah, no I think it does.

Destiny Bochinski: I feel like I’m constantly re evaluating everything that’s going through my head, like I have to qualify each statement I make or if I am going to bring something up to my husband I have to say, okay I know I’m pregnant so maybe this isn’t the best perspective but what do you think? Because I find that my opinions they vary in scope from one end to the other so much more than they… I’m a pretty consistent person and not so consistent when I’m pregnant, so I have to constantly check myself and…

Brigid Santiago: It can go to the extremes very quickly.

Destiny Bochinski: Yeah! Easily! So I have to check myself a lot.

Jessica Blagg: I think it's at least that I have been unreasonable or that I am quicker anger, I'm just quicker to beeing sad about something and the crying. I am a sensitive person. I cry about pretty much everything and my husband is very understanding, he knows what to expect. He is used to me not pregnant and been a little bit like that. But that's been a problem, but I snap back out of it failry quickly, so it's not a big issue. But it's been my gift, like the 2nd trimesters as soon as the nauesa went a way it was like suddently I was crying about everything.

Brigid Santiago: You know, I am 8 months postpartum and on the way here I heard a song and in the car that made me cry. So, it does not go away. (cross talking).

Sunny Gault: Okay, so, the last one on our list before we take our quick break here is food aversions. That's funny, Stephanie came into the studio this morning and said that she had an aversion.... It was a smell aversion, wasn't it?

Stephanie Saalfeld: Yeah, well...

Sunny Gault: And you are not pregnant, but...

Stephanie Saalfeld: The other one, when I walked into a building I sort a smell like in the dentist office and it made me sick.

Sunny Gault: Exactly! My husband made dinner last night and garlic... Oh my god! Just filled the house and really... sometime I dont think he is a sensitive....like he needs to be to like understanding that somethig could just totally switch in my brain and I could just go crazy and that was one of those things like "Can't he smell that garlic?!" I just wanted to run out of the house and just get away from the smell, so I'm more than half way through my pregnancy and I still have this smell and food aversion, so ladies, what is been yours experinces?

Destiny Bochinski: I couldn't stand the smell of my own home. I'm a very clean person. It was comin' home from work when the house have been shutup all day, windows closed, the warm day, and just like that stagnent air smell. So the first thing I would do is run in the back door and take a big gulp of air before I went in, I would open all the windows wnet straight out the front door and turn the fan and I have to air it out before i could actually stay inside the house. I could take the trash out, do all the dishes, vacuum clean, all that before I left in the morning and it would still be the same thing when I got home.

Sunny Gault: Really? Wow!

Destiny Bochinski: Yes! There were a couple a times where I came in the front door and I wnet right out the back door and puked.

Sunny Gault: Oh, Jesus!

Destiny Bochinski: Not fun!

Sunny Gault: Anyone else, smell or a taste aversion?

Jessica Blagg: At work people bring their lunches. I can't see it, but I can smell it and I swear that was one day I thought there was a skunk in the office. It was just someones lunch.

Sunny Gault: Or perfume… something like that. Something that is really intense.

Dr. Nick Capetanakis: I mean it all sounds like you guys are averted the thing that you don’t want to do anyway.

Sunny Gault: Are you saying that it is an excuse?

Dr. Nick Capetanakis: You don’t want cleaning. You don’t want to vacuum…

Destiny Bochinski: No! I did extra cleaning.

Dr. Nick Capetanakis: …Somehow I ended mopping all the floor whole day.

Sunny Gault: You’re on test, aren’t you?

Dr. Nick Capetanakis: I’m on to you guys and your trickiness. You guys are smarter than what I first thought, very sneaky. No! You know, people just become hypersensitive, the nose buds get hypersensitive, the taste buds get hypersensitive. I remember when Angie found out that she’s pregnant with our first; we went for dinner at our Aunt’s restaurant. We had a glass of wine and she was like “Oh I think that wine is corgis, we opened another bottle and she said this one is corgis and I was like Oh man I think we got another baby coming. Best thing to do is like you guys are doing, just try to avert it as much as possible and go from there.

Sunny Gault: Good advice and when we come back we grab up our list of common pregnancy symptoms during thirst 20 weeks of pregnancy. We will be right back.

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Sunny Gault: Welcome back! Today, we’re breaking down the most common pregnancies symptoms, you may notice within the first 20 weeks of pregnancy. Dr. Nick Capetanakis is an OBGYN and he is also featured expert for Preggie Pals’ as well as our sister shows, he is joining us via phone. So Dr. Cap; “Abdominal Bloating”, so obviously this is that intense like bloating feeling we feel even when our bellies aren’t sticking out due to pregnancy yet we feel like they are. So, what’s causing this?

Dr. Nick Capetanakis: We think partially as it’s fluidly retention. Its two-folds, we do know that you do start retaining more fluid and if it is your first pregnancy, it’s hard to say how much you’re going to retain as you have more pregnancies. It also shows a little bit earlier what subsequent pregnancy. It is also progesterone. Progesterone slows down the intestine a little bit, causing some of the constipation and the GI bloating, because the system just doesn’t move quickly as it did when you weren’t pregnant. So the combination of both are the symptoms.

Sunny Gault: Okay! It makes sense! So, ladies any bloating that you’ve notice, it’s harder to tell I think the bloating once you develop a pregnancy tummy and then you start to see swelling, we will talk about that in the next week’s episode but any bloating that you guys noticed really early in your pregnancies?

Jessica Blagg: Couldn’t button my pants.

Destiny Bochinski: I didn’t have that so much…not that early…definitely later on the pregnancy tummy and I feel bloated on top of it which would be you know another front pants thing but the two in combination were more noticeable to me like any of the first trimesters stuff.

Sunny Gault: Stephanie any experience?

Stephanie Saalfeld: I definitely had bloating from “Oh Gosh” I would say started 7-8 weeks and it lasted until I was showing.

Sunny Gault: So it wasn't like a daily thing. I am trying to understand. Like it wasn't like you felt bloated and then later in the day you were fine.

Stephanie Saalfeld: No.

Sunny Gault: You know how like when you're not pregnant you feel bloated and stuff like that too.

Stephanie Saalfeld: No! It went along with like my nausea, I mean I just, I was just nauseous the whole time and I just felt like a blob. A nauseous blob!

Sunny Gault: A nauseous blob! Anybody else experience with bloating? No? I think it is one of those hit or miss kind of symptoms.

The next one I am pretty sure we all have some experience with “frequent urination”. So Doctor Cap, when does this typically start? Could we see this before we even realize we're pregnant?

Dr. Nick Capetanakis: Typically not! I mean, most of the frequent urination…well, I will just say everyone else is different. But most of the frequent urination that comes about is usually a symptom that we usually see more or later on in pregnancy and that is usually due to the growing uterus putting pressure on that bladder. The bladder can't expand as much as it can and so you get that space issue and so it puts pressure on that bladder and then you feel like you've got to urinate more frequently. One other thing that we do worry about is OBGYN's is also urinary tract infections. That's why we do a urine culture early on in pregnancy because sometimes you can have what is called a “symptomatic bacteriuria” where it is basically you have bacteria in the bladder because pregnancy you may not have the same symptoms. You don't necessarily have all the burning and things like that you have early on in pregnancy, but it does cause some frequent urination and so we do check that in the first trimester to make sure there isn't a urinary tract infection.

Sunny Gault: That actually happened to me during this pregnancy. I have actually had two believe it or not since but they were a symptomatic. I didn't even know. They did cultures and stuff like that. They found it and they put me on some medication for it. It wasn't like I felt that burning sensation or anything like that is associated with UTIs. But I have personally experienced it. It concerns me too because I am pregnant with twins so I am already at risk. I am a high risk pregnancy as is and I know that UTIs have gone untreated, can result in preterm labor; right, Doctor Cap?

Dr. Nick Capetanakis: Correct!

Sunny Gault: So it is something that I am more aware of because it's happened to me. But ladies, let's talk about frequent urination and getting up in the middle of the night to pee and all that fun stuff.

Jessica Blagg: I had it! I totally had it in the first trimester. It went a long with the whole breast tenderness thing. It started early. It didn't last as long as the morning sickness stuff did, but it was also one of the first things that I noticed. In ever get up in the middle of night to go to the bathroom and I was getting up, like, twice. So I knew something was off because it was just very unusual for me. As soon as the first trimester stopped and I was moving on, it went away, and is coming back now. Space issue!

Sunny Gault: This is one of those symptoms that rear its ugly head again in the third trimester. So…

Jessica Blagg: I am hoping mine leaves soon because I get up, like, five or six times a night. I am not sleeping at all. I miss sleep. I miss it a lot.

Sunny Gault: I think I am on an average of one or two times in the middle of the night, you know, so it's okay. But I am having a hard time sleeping anyway so it's not really waking me up, right.

Jessica Blagg: It's more of like once you wake up from something else, other child or discomfort, then your brain starts thinking, Okay, doing checks. Oh, my bladder is full. I got to pee.

Brigid Santiago: I actually have not had this issue at all. Like, it's starting to pick up a little bit now that I am, you know, finally getting a little bit bigger and, I guess, the baby is putting a little more pressure on my bladder. But the first trimester I had none of it, but I was so concerned about getting a urinary tract infection that I made myself a schedule during the work day of when I had to go pee.

Sunny Gault: That can be bad for your bladder though too. I know, it's one of those tough ones. Let's move on, “Fatigue”. So, Doctor Cap, what is causing at this point, I mean, I know later in the pregnancy it makes more sense as to why you are so tired. We do know our bodies are working overtime because let's face it; it is a pretty amazing thing. We are creating, you know, another human being. So our bodies are doing some amazing things behind the scenes that we are not even aware of. But what is causing specifically the fatigue that we are experiencing early in pregnancy?

Dr. Nick Capetanakis: Again, we think it's all hormonal. I mean, the fatigue kind of goes with the nausea and the vomiting and just the overall sensation that you're not feeling well. It is probably the gain of the pregnancy hormone beta hCG that is causing that. You are creating a life. If you think about it from a cellular level, everything is multiplying very rapidly. Even though it is on a small level, it is something that is not necessarily, for a first time mom it is a sensation that they've never felt before. It might be just a way that the body, kind of, says, “Hey, you need to slow things down, take some rest”. Make sure we're taking care of ourselves instead of running around doing a million things. Give yourself some time.

Sunny Gault: I think that's a really good point to make. We say this a lot, but really following through is a whole other thing, and that is really listening to your body. It is trying to take care of the baby; it is trying to take care of us. If you push it too far, something's got to give, you know. So I think those cues are really important.

Ladies, fatigue early in pregnancy. Did you guys experience that?

Destiny Bochinski: Yeah! But it could be related to me not sleeping at night to get up to go to the bathroom.

Sunny Gault: Or for those of us who have other kids as well. Taking care, I mean that's a whole other thing. That's a whole other Preggie Pals’ topic, is pregnancy when you already have children which actually I think we have done that topic before. But it brings on a whole new set of things to consider, right?

Jessica Blagg: One of the bigger things for me has actually been brain fatigue. Like, not so much the physical, I mean, definitely physical fatigue, but more it is just my brain not working; that stereotypical pregnant brain and forgetting things. Then that makes you tired because you are trying to work harder and think harder and so that was and that even started early, it seemed like or maybe it just never left from the first time – who knows?

Sunny Gault: It’s hanging out still.

Jessica Blagg: I felt like I’ve been hit by a truck and backed over and then hit again.

Sunny Gault: Well, sometimes too for me, it happens all at once like I’ve got tons of energy and then it’s like I hit a brick wall and I am down for the count. And, and, for me, it’s really scary too because I can’t predict when that’s going to happen.

The other day, I was actually coming back from a perinatologist appointment and it happen in the car and my kids weren’t with me, my boys aren’t with me but I got super sleepy. I was like, you should see me, I was like, you know turning up the air in my car, trying to figure out how do I stay awake. I’m driving and I have to get myself back home but it was fatigue. The moment I hit the door, I crushed on the couch.

Thank God, someone was there watching my kids because there was no way that I was going to attend to them in that moment. But, it’s kind of scary sometimes you know?

Okay, well that is all I have for our pregnancy symptoms at least for the first 20 weeks Dr. Cap, thank you so much for joining us on today’s episode.

[Theme Music]

This conversation continues for the members of our Preggie Pals’ Club. After the show we’ll discuss another common early pregnancy symptom which is “spotting”; how can you determine what’s normal and what could be a sign of complications within your pregnancy.

Sunny Gault: We have a question from one of our listeners. You guys can ask our experts questions anytime you’d like, just go to our website, you can leave us a comment. This comes from Carrey. Carrey writes, “My husband and I are pregnant with our first child. We’ve been discussing how much time you should take off work after having the baby but we’re not quite sure on what to expect. We don’t have much family in town to help but we need my husband to be working as much as possible since I’m on maternity leave. How do other people handle situations like this?”

Rosemary Mason: Hi, this is Rosemary Mason. I’m certified Postpartum Doula. Carrey, you know it’s really up to the company or the group that he’s work with. I know that a lot of dads will take half days instead of taking full days. So, that seems to work when it just come in a little later or they leave a little later or earlier so that they can spread out their time that they have at two weeks… like their off for two weeks. Maybe they can spread out for two weeks or six weeks or just by taking shorter amount or leaving earlier for coming in later. Well, I hope I’ve answered the question for you. Thank you so much. Bye-bye.

[Theme Music]

Sunny Gault: That wraps up our show for today. We appreciate you listening to Preggie Pals’. Don’t forget to check out our sister shows, Parent Savers “for parent with new ones, infants and toddlers” and our show The Boob Group “for mom’s who breast feed their babies”.

Next week its part two of these series focused on “Common Pregnancy Symptoms”. Dr. Cap will rejoin us for a discussion on what to expect during your last 20 weeks of pregnancy. This is Preggie Pals’; “your pregnancy-your way”.

[Disclaimer]

This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

[00:39:40]

[End Of Audio]

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Episode Transcript

Preggie Pals
Pregnancy Symptoms: First 20 Weeks

[00:00:00]

[Theme Music]

Your pregnant, you may or may not even know it yet, but from many women it is the pregnancy symptoms that give it away. So what specific symptoms can you expect within the first half of your pregnancy? What triggers these symptoms and are there ways to overcome them?

Today we are joined by one of our featured experts Dr. Nick Capetanakis, he is an OBGYN and right here in San Diego. This is Preggie Pals, episode 70.

[Theme Music]

Sunny Gault: Welcome to “Preggie Pals” Broadcasting from the Birth Education Center of San Diego. Preggie Pals is your weekly online on-the-go support group for expecting parents and those hoping to becoming pregnant. I am you host Sunny Gault. I am joined here by Stephanie Saalfeld, she is our Preggie Pals producer.

Hi Stephanie!

Stephanie Saalfeld: Hi!

Sunny Gault: So before we get started why don’t you tell our listeners a little bit about our new virtual panelist program that we are so excited about?

Stephanie Saalfeld: Okay! So basically we would love for you to join our conversations from anywhere in the world. If you like our Preggie Pals’ facebook page and follow us on twitter, we will be posting some preview questions before our recording and we would love to have your answers so that we can read them on the show when we record.

Sunny Gault: Yeah! It is a great way to ask our expert, even your own question.

Stephanie Saalfeld: Absolutely!

Sunny Gault: Also if you got experienced with something or you know you just kind of want to share your own two senses; it is a great way to do it on facebook and twitter. We actually have a page on our website, right, that talks about our Virtual Panels program.

Stephanie Saalfeld: We do! If you go to www.preggiepals.com, under the community tab you can find be a virtual panelist and I will give you all the information you need.

Sunny Gault: Alright! Thanks Stephanie! Well have you joined out Preggie Pals’ club our members get extra bonus content after each new show plus special give away and discounts and you also get a free subscription “The Pregnancy” magazine. Visit our website www.preggiepals.com for more information. Thanks everyone who is listening to this episode through our awesome Preggie Pals’ Apps, they are available in the Apple and Android market place but actually on Google Play and Windows Phones too. It is like we have go all this Apps out, pretty cool! We are taking over the world, it is pretty fun. So I think personally this is the best way to listen to our show if you are mom that is on the go, you are going to your parietal appointments or whatever, sometimes it is hard to just listen in-front of a computer, so the Apps are really good opportunity. They are absolutely free, so download our Apps today.

So let’s meet some of the panelist that are here in the studio. You guys know me, I guess I am a panelist, kind of moderating this whole but I consider myself a panelist to. I am the host of the show, I am Sunny, I am 35 years-old, my due date technically is December 16th although I am pregnant with twin girl and we never make it to the due day when you are pregnant with twins. So we actually just said we are going to have a C-section with this due to some complications with my first, I have two boys at home. I have a 3 year-old and I have a 15 month-old. With my first we had some complications, so my second was C-section and the twins are going to be C-section too. We just scheduled the date for December 2nd which is a Monday. So fingers crossed that I will actually make it that far. I actually had some pregnancy scares this week which really kind of threw me off. But it is just kind of a sign that I need to take a little bit better care myself, to sleep more and all that is kind of hard to do when you have two little boys running around your house. But I got to make it happen. So that is a little bit about me.

Destiny! Go ahead and introduce yourself.

Destiny Bochinski: My name is Destiny, I am 34, I am physical therapist and actually specialize in Pelvic Floor therapy.

Sunny Gault: And you have been an expert.

Destiny Bochinski: I have! So I am pregnant and I am due Novembers 2nd with a little girl. We didn’t find out the first time with my son but we decided that planning was a little bit more important this time around. So we are going to have a little girl and my son would be 3 in October so it will be right around his birthday, who knows. He was 2 weeks early so I don’t know if she will be early to, we will see. I am planning my second home birth with her as well, we a midwife.

Sunny Gault: So you had a home birth the first time.

Destiny Bochinski: Yes.

Sunny Gault: Okay, everything went well, you didn’t have to be transferred or anything...?

Destiny Bochinski: It was fabulous!

Sunny Gault: That is awesome! We just recently did an episode on home birth so if you guys are interested and be sure to check it out. Welcome Destiny.

Jessica!

Jessica Blagg: My name is Jessica and I am 29 and I am a medical biller and my due date is March 8th and we don’t know the baby’s gender yet, but we are going to find out as soon as it is possible. I have one other child, she is 8 and we are hoping this time for a VBac.

Sunny Gault: Okay! Good for you. Last but not least.

Brigid Santiago: I am Brigid, I am 28 but I think by the time you hear this I would be 29, and I am a great rider and fund raiser for a non-profit health clinic network. I am due December 19th with a little boy. It is our first baby. So I am really excited and we are planning a natural child birth with the midwife but in a hospital birthing center type thing.

Sunny Gault: Okay! Good for you guys! Well ladies thanks so much for been part of your show today.

[Theme Music]

Sunny Gault: Before we get started with today’s show there is a pregnancy headline that I want to share with you ladies, we tried to grab headlines that are making line around the internet and this is one that definitely caught my eye a lot when we are talking about this. This is a new book project that is coming out, it is called “A Beautiful Body” and there is a photographer, here name is Jade Beall. I am just going to read a portion of this to you she published a series of self-portraits of her semi-nude postpartum body online. Basically people so some of these photos and thought it was so refreshing. I guess she posted some stuff to facebook. And, they thought it was so refreshing that she didn’t do a lot of touch up on these images, it was just her and her baby, and it was very real. She is getting all this great feedback, and so women are basically contacting her saying, “Will you photograph me in that same manner?” I wanted to get you guys’ feedback on this because I think she’s doing this, and she’s going to publish a book.

Destiny Bochinski: I think it’s refreshing. I think especially in our culture, in our society, there’s way too much emphasis to get back to everything pre-pregnancy, like, within the first 24 hours, you know? And it’s really sets up this impossible expectation for women to try to be supermom and look the way they did before they ever got pregnant, which is completely unrealistic. Like you are ever going to look exactly the way you did before you got pregnant. It’s part of becoming a mom, and it sets us up for failure.

Sunny Gault: Bridgett, what do you think?

Brigid Santiago: I completely agree! I think it’s wonderful to see. You don’t see a lot of that, especially, I mean I think, out here on this coast too. There’s so much emphasis on having a perfect body at any stage in your life, and it’s wonderful to see women in a more natural way because, I mean, I don’t think you even get a lot of exposure to that no matter where you live, so it’s refreshing to see.

Sunny Gault: That’s a really good point! I don’t know, prior to having my own children, I don’t remember really even having an idea of why, you know, a postpartum body looked like. So, you know, you hear again all these things, and you see these supermodels walking away with near-perfect bodies, and we have this idea that that’s what it should be, but I don’t know if I had any real examples, and I think that’s what this provides. Alright ladies, thanks so much for sharing your opinions. We’ll link to this on our website.

[Theme Music]

Sunny Gault: Today, we’re discussing pregnancy symptoms, and this is the first episode in a two part series. We are exploring what to expect during your “First 20 weeks of Pregnancy”, and then next week we’ll focus on the “Last 20 weeks”. So, Dr. Nick Capetanakis is a featured expert on our shows. He’s an OBGYN, and he’s joining us via phone. Doctor Cap, welcome back to Preggie Pals’.

Dr. Nick Capetanakis: Thank you very much! Very excited to be here!

Sunny Gault: Let’s start with talking about early pregnancy symptoms in general. When do they start? I know a lot of women, that’s their first indication that they’re even pregnant, right?

Dr. Nick Capetanakis: Absolutely! Pregnancy for everybody can be different, and every pregnancy can also be different for every woman. Some women start feeling things as soon as six to eight weeks after their last menstrual period. Some women don’t have any symptoms, but unfortunately there is a 50-70 percent chance that some women are going to have some nausea and vomiting, which would probably be the most common pregnancy symptoms early on in your first trimester.

Sunny Gault: What usually triggers these symptoms? Is every symptom triggered by something different, or is there a way to kind of classify this in one big bunch?

Dr. Nick Capetanakis: That’s a great question! We’re not 100% sure! We definitely think that a hormone called beta hCG, which is produced early on in the pregnancy, causes the vast majority of those symptoms. Progesterone is another hormone that also causes some of the GI symptoms, including constipation that can occur. But most of it is the beta hCG hormone.

Sunny Gault: So let’s just dive into this list and ladies here in the studio as we’re talking about these symptoms, I know we’re all pregnant, with the exception of Stephanie – not yet, again, she already has a little girl at home, but when we go through these symptoms, feel free to kind of chime in and tell us what your personal experience is with this. So, Dr. Cap, the first one I want to talk about is high basal body temperature and I’m assuming you may not know that your basal body temperature is high, unless you’ve had some conception issues and you’ve been tracking this before. But, tell us a little bit more about that.

Dr. Nick Capetanakis: Some women do have some increase in temperature in pregnancy, but like you said, most of the basal body temperature that we look at is for patients that are trying to conceive. You know, when you’re ovulating your basal body temperature does go up a degree to two degrees, and that’s when most women will then try to conceive around that time. Once you get pregnant, you do have feelings of an increased temperature, but not necessarily that you’re going to read on a thermometer. Some people complain of some hot flashes and things like that, but overall I would say that’s probably a less common symptom than the other ones that most women feel in the first trimester.

Destiny Bochinski: So are you saying that the basal body temperature is not necessarily responsible for that uncontrollable ability to regulate your temperature that I’m certainly feeling?

Dr. Nick Capetanakis: It’s kind of hard to say, you do have an increase in blood flow, there’s a lot of changes going on hormonally, so you have that sensation that you’re running hot. But, if you were to necessarily take your temperature, you wouldn’t necessarily see an increase in your normal body temperature if that makes any sense. It’s more of a hormonal flux and an increase in blood volume that makes the woman feel like they’re running a little bit hot. But I remember when my wife was pregnant during the winter, she was like a heater. We didn’t even have to turn on the heater at night; I would just cuddle up with her. So there is a sensation that you’re probably running a little bit hot.

Destiny Bochinski: Especially in August!

Sunny Gault: Oh yeah, right, depending on when you’re due, for sure! Let’s move on to the next one. I’m sure most of us have experienced this one, nausea, and combined with that, I’m just going to call it morning sickness, although we all know it doesn’t just happen in the morning. So, Dr. Cap, what trigger’s this?

Dr. Nick Capetanakis: Again, we think it’s probably the beta hCG hormone that triggers that reflux. For my patients, when I talk to them about their first trimester, I kind of tell them it's almost like you feel hung over but you didn't have a good time the night before. You've kind of got that feeling of that queasiness, like you said, can go on through the whole day. Some women do have vomiting or they feel like they need to vomit but they may not and then, other women, unfortunately, have that vomiting aspect of it. It's something that varies from pregnancy to pregnancy; and, sometimes, it can be almost debilitating for some people. But for most people, it's just kind of that underlying nausea and not-feeling-well-all-day kind of feeling.

Sunny Gault: So, ladies, let's open this up here in the studio. What has been your experience with nausea and morning sickness?

Destiny Bochinski: All day hangover! Just like what he said. I didn't have a huge amount of vomiting parse except for a few specific triggers. But, all day long, I just felt awful. And if I hadn’t eaten for about an hour and a half, then, it would escalate and I would feel like on the verge of throwing up. So I had to eat, literally, every hour and a half to two hours, and eat lots of protein in order to keep that away. Otherwise, I just felt completely hung over.

Jessica Blagg: That was definitely the first symptom I noticed and I swear it started the day I got my positive pregnancy test.

Sunny Gault: At least, you were more aware of that.

Jessica Blagg: Exactly! It may have been somewhat psychosomatic. I don't know. But that was definitely the one that was the most irritating, for sure and the morning sickness, whatever, it was all day. I didn't have a lot of vomiting, either, but I just didn't feel well for about 14 weeks.

Sunny Gault: When did it taper off for the rest of you here?

Brigid Santiago: Actually, my second pregnancy felt like a lot earlier, when it was just a week. But it was right around 10 to 12 weeks.

Sunny Gault: Okay! What about you, Jessica?

Jessica Blagg: I didn't get it this time. My first pregnancy, I definitely had morning sickness all day. As soon as I wake up, I'd feel horrible; I go to bed, I'd feel horrible. But, this time—magic!

Sunny Gault: Nothing at all?

Jessica Blagg: Maybe a couple of days. I think it was more related to my blood sugar, though.

Sunny Gault: Dr. Cap, what makes the difference between someone just kind of feeling nauseous and then actually throwing up? In my personal pregnancies, I rarely got to the point that I was throwing up but it was kind of that all day: I need to lie down. I need to eat. I need to do whatever.

Is there something that triggers it more? Is it just the higher levels of these hormones? How do you explain that?

Dr. Nick Capetanakis: I wish I could tell you because, then, we could actually do something to prevent that vomiting reflux. Everybody is very sensitive or insensitive to the hormone and some people, unfortunately, can't control it and they end up vomiting. So there's nothing really that you could measure parse that's going to tell you who's going to get it and who are not going to get it, if that makes any sense?

Sunny Gault: Sure.

Dr. Nick Capetanakis: It's just everybody is sensitive in a different way. Sometimes you don't have it, that feeling and then another it's overwhelming.

Sunny Gault: So what is your recommendation when women come in with this type of nausea? I know there's different levels and stuff like that but what do you usually tell them to do first to kind of overcome this?

Dr. Nick Capetanakis: I talked to patient about this. The first trimester is kind of survivalist mode. You know, you do whatever makes you the most comfortable. But you guys had brought up some good points, frequent meals. You need to eat, you need to be in constant gazer and that means everyone, and after two hours you need to put something in. You have to carry with you team absorb; some kind of protein or some cheese or some yogurt and really eat everyone and after two hours. Some people do better on high protein diets, other people come in and say, “I can only eat bread” and I said, “Fine, just eat bread.” I mean, you kind of just have to survive.

Destiny Bochinski: That's funny because the thing to m the biggest difference from me was when my midwife told to get 80 to 100 grams of protein a day, like massive amounts of protein. Once I started doing that and being really religious about it and how often I had it, it made a huge difference.

Sunny Gault: Have you heard of that Dr. Cap? Increasing your protein in addition to Carbs?

Dr. Nick Capetanakis: Yeah! Absolutely! I mean, some people respond better with Carbs, some people respond better to protein; proteins takes a little bit longer to burnout so probably stabilizes your blood sugar a little bit better and for some people that I can definitely help are with those symptoms.

Destiny Bochinski: What is it with the gag reflux sensitivity? What, is that a hormonal thing? Because I don't know if anyone else experience...I could not even brush my tongue at the first time trimester without and then, I got a terrible cold the very first, my night with my son. Between post nasal drip, and I gag reflux. I was like throwing up in the shower every morning.

Sunny Gault: So what is that Dr. Cap?

Dr. Nick Capetanakis: That's another tough one! I mean, which think that probably that progesterone affects that, that's sphincter kind of… that separate your esophagus and your stomach and maybe doesn't close as much contributing to some of the reflux that you get in second trimester and later half of your pregnancy. That then irritates the esophagus which then causes maybe a little bit more of that sensational gag reflux but it's not tough for one to kind of a pin point exactly why it, you know again I remember my wife was brushing her teeth that she would gag too. So it's probably a combination of some hormonal thing that is causing that reflux to increase.

Sunny Gault: Alright! I know we could talk about that symptom forever but we're going to move on in our list. “Tender Swollen Breast”; at what point does this happen and what are your recommendations for women who can't even touch their breasts anymore because they hurt so much?

Dr. Nick Capetanakis: Again that's a tough one because what happens is the breast tissue actually gets engorged. And most women would tell you that their breast cup size does go up along with the circumference around their back. Their bra’s size actually goes up because the rib cage does extend but early on in the 1st trimester, that breast tenderness is probably from the actual (unclear) breasts that are getting swollen. And it’s a tough symptom to manage. I mean, some people take warm shower that actually irritates that but you try not rubbing them or stimulating them. Some people put little nipple pads to kind of protect the nipple from rubbing the inside of the bra which can kind of help with irritation. Unfortunately, there’s no magic to that one. That one usually comes on pretty quickly and also disappears pretty quickly. It usually doesn’t last the whole 1st trimester and it’s more of managing the discomfort than actual treatment for it.

Stephanie Saalfeld: That was actually my 1st symptom, that’s how I knew, I mean like, wait, something feels not quite right. We also have one of our Preggie Pals’ virtual panelists, Chelsy commented on this question from facebook and she said that she felt the breast tenderness about a week before her missed period and she kept thinking that she felt different and pretty much knew she was pregnant and she said it lasted about 3 weeks. So do you know that’s about right Dr. Cap, about 3 weeks, about, I would say, for me, it’s closer to maybe 5 weeks or so?

Dr. Nick Capetanakis: Yeah, I would probably see an average most people on prior of 2 to 4 weeks marks with that discomfort.

Sunny Gault: Anyone else experienced it? Go ahead!

Jessica Blagg: Yeah, I think mine went on along longer. It felt like it was not constant but off and on throughout my 1st trimester and I’m already kind of busted to begin with and it felt like, I don’t know.

Destiny Bochinski: I definitely had to wear sports bra, like I couldn’t, I didn’t want blankets touching me, I didn’t want the wind blowing on me.

Sunny Gault: I took that a lot actually, I don’t think about it, you know, this is my 3rd pregnancy, but with my 1st, I did a lot of wearing, they have special bras, they don’t have the wires and stuff like that, they’re a little bit more comfortable to wear at night and I think I did that in the beginning and I haven’t done it since and I wonder, actually this is a good question for Dr. Cap. Dr. Cap, after you’ve experienced breastfeeding and in your boobs, quietly you’ve been through a lot more when it comes to kids, do you think, is it possible for them to become less sensitive to some of this breast tenderness and stuff and pregnancy? Because I felt like mine have been through to the ringer already and like, you know, and then me getting twin chair, but I’m not experiencing what I did with my 1st pregnancy.

Dr. Nick Capetanakis: Yeah, I mean, it makes sense right at the body wall with that discomfort, it’s the same with breastfeeding, the 1st one is usually the toughest one and then you know, for the subsequent pregnancies, you think it’s a little bit easier. I don’t want to say that the nipples get a little bit more desensitized. But probably due to some respect and that probably includes the breast tissue and those feelings that you get once the swellings probably do go down.

Sunny Gault: Okay, that sounds fair, it makes sense. Okay, let’s move on to the next one, “Mood Swings”. Now I know we can use this as an excuse with our partners a lot but I think it also only makes sense that the more weight you gain, the more aches and pain you experience in different parts of your body, the more prone you may be for your mood to change very quickly and especially if you don’t feel someone else is understanding your position. So Dr. Cap what do you have to say about mood swings?

Dr. Nick Capetanakis: Yeah, that’s like a three hour conversation. Mood swings are a concern because really I mean it comes down to women are very complex creatures and when you put them in a situation where they are not feeling great, they are not able to work out, they are not feeling understood they are having this nausea, the vomiting, the breast tenderness and nothing makes it feel better, you put that on a platter and that’s a tall order to tackle for anybody.

So you know you got hormonal issues, you’re constipated, you’re bloating, why am I showing at 12 weeks, what’s going on, there’s so many different things that go in to that that does affect people’s moods, when you are not able to exercise and get that anxiety out and feel good about your body then that does affect you. So it’s really so multi complex that you couldn’t even begin to scratch the surface on.

But what it really comes down to is voicing you concerns with your partner, hopefully you have a partner who can empathize with you and do the best that he or she can to kind of make you feel as good as you can. Doing little things for yourself to try to make yourself feel better whether that’s getting a massage or trying to get a little bit of exercise, you’re getting some sunshine, going for little walks and just doing whatever can bump up your mood will definitely help that. And really it’s just one of those things that if you are aware that your mood is that labile then also just being able to kind of check that and say, okay, now I feel like it’s kind of getting out of control I need to like step back and re evaluate how I am feeling and remove myself from the situation for a couple of minutes and then come back in to it with more focus. Does that make any sense?

Sunny Gault: Yeah, no I think it does.

Destiny Bochinski: I feel like I’m constantly re evaluating everything that’s going through my head, like I have to qualify each statement I make or if I am going to bring something up to my husband I have to say, okay I know I’m pregnant so maybe this isn’t the best perspective but what do you think? Because I find that my opinions they vary in scope from one end to the other so much more than they… I’m a pretty consistent person and not so consistent when I’m pregnant, so I have to constantly check myself and…

Brigid Santiago: It can go to the extremes very quickly.

Destiny Bochinski: Yeah! Easily! So I have to check myself a lot.

Jessica Blagg: I think it's at least that I have been unreasonable or that I am quicker anger, I'm just quicker to beeing sad about something and the crying. I am a sensitive person. I cry about pretty much everything and my husband is very understanding, he knows what to expect. He is used to me not pregnant and been a little bit like that. But that's been a problem, but I snap back out of it failry quickly, so it's not a big issue. But it's been my gift, like the 2nd trimesters as soon as the nauesa went a way it was like suddently I was crying about everything.

Brigid Santiago: You know, I am 8 months postpartum and on the way here I heard a song and in the car that made me cry. So, it does not go away. (cross talking).

Sunny Gault: Okay, so, the last one on our list before we take our quick break here is food aversions. That's funny, Stephanie came into the studio this morning and said that she had an aversion.... It was a smell aversion, wasn't it?

Stephanie Saalfeld: Yeah, well...

Sunny Gault: And you are not pregnant, but...

Stephanie Saalfeld: The other one, when I walked into a building I sort a smell like in the dentist office and it made me sick.

Sunny Gault: Exactly! My husband made dinner last night and garlic... Oh my god! Just filled the house and really... sometime I dont think he is a sensitive....like he needs to be to like understanding that somethig could just totally switch in my brain and I could just go crazy and that was one of those things like "Can't he smell that garlic?!" I just wanted to run out of the house and just get away from the smell, so I'm more than half way through my pregnancy and I still have this smell and food aversion, so ladies, what is been yours experinces?

Destiny Bochinski: I couldn't stand the smell of my own home. I'm a very clean person. It was comin' home from work when the house have been shutup all day, windows closed, the warm day, and just like that stagnent air smell. So the first thing I would do is run in the back door and take a big gulp of air before I went in, I would open all the windows wnet straight out the front door and turn the fan and I have to air it out before i could actually stay inside the house. I could take the trash out, do all the dishes, vacuum clean, all that before I left in the morning and it would still be the same thing when I got home.

Sunny Gault: Really? Wow!

Destiny Bochinski: Yes! There were a couple a times where I came in the front door and I wnet right out the back door and puked.

Sunny Gault: Oh, Jesus!

Destiny Bochinski: Not fun!

Sunny Gault: Anyone else, smell or a taste aversion?

Jessica Blagg: At work people bring their lunches. I can't see it, but I can smell it and I swear that was one day I thought there was a skunk in the office. It was just someones lunch.

Sunny Gault: Or perfume… something like that. Something that is really intense.

Dr. Nick Capetanakis: I mean it all sounds like you guys are averted the thing that you don’t want to do anyway.

Sunny Gault: Are you saying that it is an excuse?

Dr. Nick Capetanakis: You don’t want cleaning. You don’t want to vacuum…

Destiny Bochinski: No! I did extra cleaning.

Dr. Nick Capetanakis: …Somehow I ended mopping all the floor whole day.

Sunny Gault: You’re on test, aren’t you?

Dr. Nick Capetanakis: I’m on to you guys and your trickiness. You guys are smarter than what I first thought, very sneaky. No! You know, people just become hypersensitive, the nose buds get hypersensitive, the taste buds get hypersensitive. I remember when Angie found out that she’s pregnant with our first; we went for dinner at our Aunt’s restaurant. We had a glass of wine and she was like “Oh I think that wine is corgis, we opened another bottle and she said this one is corgis and I was like Oh man I think we got another baby coming. Best thing to do is like you guys are doing, just try to avert it as much as possible and go from there.

Sunny Gault: Good advice and when we come back we grab up our list of common pregnancy symptoms during thirst 20 weeks of pregnancy. We will be right back.

[Theme Music]

Sunny Gault: Welcome back! Today, we’re breaking down the most common pregnancies symptoms, you may notice within the first 20 weeks of pregnancy. Dr. Nick Capetanakis is an OBGYN and he is also featured expert for Preggie Pals’ as well as our sister shows, he is joining us via phone. So Dr. Cap; “Abdominal Bloating”, so obviously this is that intense like bloating feeling we feel even when our bellies aren’t sticking out due to pregnancy yet we feel like they are. So, what’s causing this?

Dr. Nick Capetanakis: We think partially as it’s fluidly retention. Its two-folds, we do know that you do start retaining more fluid and if it is your first pregnancy, it’s hard to say how much you’re going to retain as you have more pregnancies. It also shows a little bit earlier what subsequent pregnancy. It is also progesterone. Progesterone slows down the intestine a little bit, causing some of the constipation and the GI bloating, because the system just doesn’t move quickly as it did when you weren’t pregnant. So the combination of both are the symptoms.

Sunny Gault: Okay! It makes sense! So, ladies any bloating that you’ve notice, it’s harder to tell I think the bloating once you develop a pregnancy tummy and then you start to see swelling, we will talk about that in the next week’s episode but any bloating that you guys noticed really early in your pregnancies?

Jessica Blagg: Couldn’t button my pants.

Destiny Bochinski: I didn’t have that so much…not that early…definitely later on the pregnancy tummy and I feel bloated on top of it which would be you know another front pants thing but the two in combination were more noticeable to me like any of the first trimesters stuff.

Sunny Gault: Stephanie any experience?

Stephanie Saalfeld: I definitely had bloating from “Oh Gosh” I would say started 7-8 weeks and it lasted until I was showing.

Sunny Gault: So it wasn't like a daily thing. I am trying to understand. Like it wasn't like you felt bloated and then later in the day you were fine.

Stephanie Saalfeld: No.

Sunny Gault: You know how like when you're not pregnant you feel bloated and stuff like that too.

Stephanie Saalfeld: No! It went along with like my nausea, I mean I just, I was just nauseous the whole time and I just felt like a blob. A nauseous blob!

Sunny Gault: A nauseous blob! Anybody else experience with bloating? No? I think it is one of those hit or miss kind of symptoms.

The next one I am pretty sure we all have some experience with “frequent urination”. So Doctor Cap, when does this typically start? Could we see this before we even realize we're pregnant?

Dr. Nick Capetanakis: Typically not! I mean, most of the frequent urination…well, I will just say everyone else is different. But most of the frequent urination that comes about is usually a symptom that we usually see more or later on in pregnancy and that is usually due to the growing uterus putting pressure on that bladder. The bladder can't expand as much as it can and so you get that space issue and so it puts pressure on that bladder and then you feel like you've got to urinate more frequently. One other thing that we do worry about is OBGYN's is also urinary tract infections. That's why we do a urine culture early on in pregnancy because sometimes you can have what is called a “symptomatic bacteriuria” where it is basically you have bacteria in the bladder because pregnancy you may not have the same symptoms. You don't necessarily have all the burning and things like that you have early on in pregnancy, but it does cause some frequent urination and so we do check that in the first trimester to make sure there isn't a urinary tract infection.

Sunny Gault: That actually happened to me during this pregnancy. I have actually had two believe it or not since but they were a symptomatic. I didn't even know. They did cultures and stuff like that. They found it and they put me on some medication for it. It wasn't like I felt that burning sensation or anything like that is associated with UTIs. But I have personally experienced it. It concerns me too because I am pregnant with twins so I am already at risk. I am a high risk pregnancy as is and I know that UTIs have gone untreated, can result in preterm labor; right, Doctor Cap?

Dr. Nick Capetanakis: Correct!

Sunny Gault: So it is something that I am more aware of because it's happened to me. But ladies, let's talk about frequent urination and getting up in the middle of the night to pee and all that fun stuff.

Jessica Blagg: I had it! I totally had it in the first trimester. It went a long with the whole breast tenderness thing. It started early. It didn't last as long as the morning sickness stuff did, but it was also one of the first things that I noticed. In ever get up in the middle of night to go to the bathroom and I was getting up, like, twice. So I knew something was off because it was just very unusual for me. As soon as the first trimester stopped and I was moving on, it went away, and is coming back now. Space issue!

Sunny Gault: This is one of those symptoms that rear its ugly head again in the third trimester. So…

Jessica Blagg: I am hoping mine leaves soon because I get up, like, five or six times a night. I am not sleeping at all. I miss sleep. I miss it a lot.

Sunny Gault: I think I am on an average of one or two times in the middle of the night, you know, so it's okay. But I am having a hard time sleeping anyway so it's not really waking me up, right.

Jessica Blagg: It's more of like once you wake up from something else, other child or discomfort, then your brain starts thinking, Okay, doing checks. Oh, my bladder is full. I got to pee.

Brigid Santiago: I actually have not had this issue at all. Like, it's starting to pick up a little bit now that I am, you know, finally getting a little bit bigger and, I guess, the baby is putting a little more pressure on my bladder. But the first trimester I had none of it, but I was so concerned about getting a urinary tract infection that I made myself a schedule during the work day of when I had to go pee.

Sunny Gault: That can be bad for your bladder though too. I know, it's one of those tough ones. Let's move on, “Fatigue”. So, Doctor Cap, what is causing at this point, I mean, I know later in the pregnancy it makes more sense as to why you are so tired. We do know our bodies are working overtime because let's face it; it is a pretty amazing thing. We are creating, you know, another human being. So our bodies are doing some amazing things behind the scenes that we are not even aware of. But what is causing specifically the fatigue that we are experiencing early in pregnancy?

Dr. Nick Capetanakis: Again, we think it's all hormonal. I mean, the fatigue kind of goes with the nausea and the vomiting and just the overall sensation that you're not feeling well. It is probably the gain of the pregnancy hormone beta hCG that is causing that. You are creating a life. If you think about it from a cellular level, everything is multiplying very rapidly. Even though it is on a small level, it is something that is not necessarily, for a first time mom it is a sensation that they've never felt before. It might be just a way that the body, kind of, says, “Hey, you need to slow things down, take some rest”. Make sure we're taking care of ourselves instead of running around doing a million things. Give yourself some time.

Sunny Gault: I think that's a really good point to make. We say this a lot, but really following through is a whole other thing, and that is really listening to your body. It is trying to take care of the baby; it is trying to take care of us. If you push it too far, something's got to give, you know. So I think those cues are really important.

Ladies, fatigue early in pregnancy. Did you guys experience that?

Destiny Bochinski: Yeah! But it could be related to me not sleeping at night to get up to go to the bathroom.

Sunny Gault: Or for those of us who have other kids as well. Taking care, I mean that's a whole other thing. That's a whole other Preggie Pals’ topic, is pregnancy when you already have children which actually I think we have done that topic before. But it brings on a whole new set of things to consider, right?

Jessica Blagg: One of the bigger things for me has actually been brain fatigue. Like, not so much the physical, I mean, definitely physical fatigue, but more it is just my brain not working; that stereotypical pregnant brain and forgetting things. Then that makes you tired because you are trying to work harder and think harder and so that was and that even started early, it seemed like or maybe it just never left from the first time – who knows?

Sunny Gault: It’s hanging out still.

Jessica Blagg: I felt like I’ve been hit by a truck and backed over and then hit again.

Sunny Gault: Well, sometimes too for me, it happens all at once like I’ve got tons of energy and then it’s like I hit a brick wall and I am down for the count. And, and, for me, it’s really scary too because I can’t predict when that’s going to happen.

The other day, I was actually coming back from a perinatologist appointment and it happen in the car and my kids weren’t with me, my boys aren’t with me but I got super sleepy. I was like, you should see me, I was like, you know turning up the air in my car, trying to figure out how do I stay awake. I’m driving and I have to get myself back home but it was fatigue. The moment I hit the door, I crushed on the couch.

Thank God, someone was there watching my kids because there was no way that I was going to attend to them in that moment. But, it’s kind of scary sometimes you know?

Okay, well that is all I have for our pregnancy symptoms at least for the first 20 weeks Dr. Cap, thank you so much for joining us on today’s episode.

[Theme Music]

This conversation continues for the members of our Preggie Pals’ Club. After the show we’ll discuss another common early pregnancy symptom which is “spotting”; how can you determine what’s normal and what could be a sign of complications within your pregnancy.

Sunny Gault: We have a question from one of our listeners. You guys can ask our experts questions anytime you’d like, just go to our website, you can leave us a comment. This comes from Carrey. Carrey writes, “My husband and I are pregnant with our first child. We’ve been discussing how much time you should take off work after having the baby but we’re not quite sure on what to expect. We don’t have much family in town to help but we need my husband to be working as much as possible since I’m on maternity leave. How do other people handle situations like this?”

Rosemary Mason: Hi, this is Rosemary Mason. I’m certified Postpartum Doula. Carrey, you know it’s really up to the company or the group that he’s work with. I know that a lot of dads will take half days instead of taking full days. So, that seems to work when it just come in a little later or they leave a little later or earlier so that they can spread out their time that they have at two weeks… like their off for two weeks. Maybe they can spread out for two weeks or six weeks or just by taking shorter amount or leaving earlier for coming in later. Well, I hope I’ve answered the question for you. Thank you so much. Bye-bye.

[Theme Music]

Sunny Gault: That wraps up our show for today. We appreciate you listening to Preggie Pals’. Don’t forget to check out our sister shows, Parent Savers “for parent with new ones, infants and toddlers” and our show The Boob Group “for mom’s who breast feed their babies”.

Next week its part two of these series focused on “Common Pregnancy Symptoms”. Dr. Cap will rejoin us for a discussion on what to expect during your last 20 weeks of pregnancy. This is Preggie Pals’; “your pregnancy-your way”.

[Disclaimer]

This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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