Archive for the ‘Diet’ Category

My Breakfast Enigma

Something amazing happened yesterday.  Take a look:

(For the American folks, that 5.8 mmol/l is a 104 mg/dl.)

Can anyone guess what I had for breakfast?  I’ll tell you at the end of this post…

This is amazing because every every morning I eat a pretty low carb low GI breakfast, and every every morning I spike within the first two hours and then come down hard.  I’m doing everything I can insulin-wise, including an aggressive bolus (a superbolus, in fact) followed by a major decrease in basal to 0.05 u/hr for the next three hours.  Ideally I’d pre-bolus, but with 2 kids to feed and clothe in the mornings, I’m worried about the impact a delayed (or worse – forgotten!) breakfast would have.  Safety first!

When I was pregnant, I ate balkan yogurt (high protein, high fat) with berries and walnuts for virtually every breakfast, and it worked pretty darn well.  But it also made me pretty darn sick of balkan yogurt and walnuts.  (I’ll eat berries any day, any time!)  So that’s off the table, literally.

Low GI dry cereals are a disaster.  Low GI hot cereals are better, but still far from ideal.

It may be that a further reduction in breakfast carbs is necessary to eliminate that spike and reduce my insulin such that it doesn’t cause a crash, but I’ve been nervous to go below 20g of carbs.  This is partially because I’m breastfeeding and less comfortable with messing around with my nutrient profiles while doing so, but also because I haven’t yet wrapped my mind around how to get over that morning liver dump hump (why does that sound so gross?) with less insulin.  (To be fair, my version of an “aggressive” bolus at breakfast is 2-3 units for 20-30g of carbs, otherwise the mid-morning crash is even bigger.)

Maybe I’m missing something, though.  Maybe I just need to try lower carb.  But what does one eat for an uber-low, or even zero-carb breakfast that will stick with you until lunch but does not contain artificial sweeteners or involve eggs every morning.  I like eggs, but if I eat them every morning, I won’t anymore.  Also not interesting to me is “dinner for breakfast”.  No chicken breasts, thank you.

I’ve even tried a few meal replacement options – drinks and bars.  You know, Martinis and chocolate!  (Kidding.)  To be honest, this is where I’ve had the most luck.  They’re also really quick, which is great!  The downside is that I don’t recognize about 80% of the ingredients in either.  I’ve been able to avoid artificial sweeteners, but it’s hard to say for sure what else I’m not avoiding.

So I’m looking for breakfast options, preferably of the low-carb, low-GI variety.  Something really quick (or make-ahead) and healthy (including low-sodium).  I’d also play around with some zero-carb (or almost zero-carb) ideas…  Anyone?  Suggestions (of either food or food-related resources) are welcome!

So what was the breakfast that gave rise to this lack of a rise?  What perfect food was it that made me almost flatline (in a good way)?

This:

Wordless Wednesday: Temptation

Pregnancy Update – 32 Weeks

It seems that blogging during this pregnancy has been easier said than done.  I was really hoping to keep on top of things and keep everyone up to date, but clearly I’m failing to do so.  Bad, busy, pregnant me.  Anyway, today I do have an update – complete with pictures (which you may have already seen if you’re Facebook friends with me).

Maybe I’ll start with the pictures.

First of all, this one is me, taken yesterday at 32 weeks, in the classic “bathroom mirror phone photo” (thanks to having nobody around to take it for me).

Next, these two shots are from our first Fetal Assessment ultrasound three weeks ago (i.e. at 29 weeks) – one of her profile, and one of her face.

And finally, this is a close-up of the lower portion of her face (nose/mouth/chin) from this past Thursday – one day short of 32 weeks.  We can hardly believe the resemblance to her older sister already!

And now to bring you up to speed…

1. Doctors Appointments

They are ramping up big time.  I’ve been seeing the endo every three weeks (but expecting to go to every two after this coming week’s appointment), and the OB every two.  I have had two Fetal Assessments that were three weeks apart, but I’ve now been asked to come every week.  I haven’t had any recent visits with the ophtho – only two so far during pregnancy – but I have one coming up in about two weeks.  I also have phone appointments with my diabetes nurse every 3 weeks to do some more detailed problem-solving than what we have time for at my endo appointments.  So it’s busy.

The good news is that everything is going great and everyone on my medical team is really pleased!  Yay!  My A1C has been hovering just above and just below 6.0% (which I am thrilled with!), my BP is consistently under 120/80 (last one was 118/73), my weight gain is approximately 23lbs (perfect at this point), no thyroid issues, very little swelling (only a bit every few days in my ankles), and generally no sign of any problems.  The baby is hovering right around the 50th percentile size-wise, so I can’t complain about that either.  My left eye bleeds a little from time to time, but always from the same spot it did pre-pregnancy, and never very much.

All in all, I’m almost the picture of diabetic-pregnancy health!  It’s been so much work, but so worth it to have come this far already.  We don’t have a c-section scheduled yet, but my OB is still aiming for the week of April 9th-13th (i.e between 37 and 38 weeks…hopefully closer to 38).  The more confident he sounds in those dates, the more confident I’m feeling that this pregnancy is on the right track!

2. Missing Out on Important Things

No, this isn’t about “important things” like donuts, burgers and Snickers bars.  This is about the fact that, in spite of all the good stuff in #1 above, my OB asked (read: begged) me not to take a trip to Victoria, British Columbia at my 31-week mark.  The “important thing” in Victoria: my best friend from childhood.  The “important event”: her wedding.  There are few things in this world that could have kept me from watching this woman I love so dearly marry her soul mate (who I also love dearly, by virtue of how dearly I know he loves her), but this was one of those things.

While there was nothing to indicate any current health problems, my OB was worried that any additional stress of travel, etc, could start to cause that dreaded increase in blood pressure that could start the downward spiral we saw last go around.  Since my health, and the health of my baby (including the amount of time she gets to bake in my womb) is the highest priority for me right now, and since I trust my OB immeasurably (he is a very reasonable doctor, and an expert at what he does…not to mention a saint, but that’s another story), I had no choice but to heed his advice and stay home.  It was the right thing to do, but it seriously sucked.  Seriously.

3. Comparing Pregnancies

When I was pregnant with The Kid (i.e. the first one), I kept a pregnancy journal, so it’s been really interesting to look back and see the similarities and the differences.  On the side of differences, last time at this point I was having major swelling in my feet (read: compression socks and an inability to tie my shoes), and quickly rising blood pressure.  I was also significantly heavier by this point.  (For comparison, last time I gained 50lbs during the entire pregnancy and this time it’s looking like I’ll come in around 30lbs total weight gain, unless something drastic happens between now and my c-section.)

On the side of similarities, I was having some major insulin resistance (check), bad infusion site absorption (check) and was waking up every 2 hours at night to pee and/or check my bloodsugar (double check).  I was also entering “indigestion mode” again (seems to be a 1st and 3rd trimester thing), which is pretty much right on target again this time around.

It’s interesting how two pregnancies really can be so different, yet have some very distinct similarities.  I’m not complaining about any of the “similarities” though when I see how lucky I am to have the “differences”.

4. Insulin Resistance

I mentioned it above, but I’m mentioning it again.  Insulin resistance is huge in 3rd trimester!!  My bolus requirements at meals are more than double what they were pre-pregnancy.  I’m moderating my carbs a lot more with this pregnancy than I was with the last one so as to avoid massive insulin doses with the still-unavoidable (for me) bloodsugar spike-and-drop combo.  It’s really making a difference and it makes me wonder how I managed last time on a carby diet!  I’ve learned so much about my diabetes since then…  Last time it wasn’t abnormal for me to have highs in the high teens and low 20s (that’s the 300-400 mg/dl range) – not every day and not even every week, but every now and then when things weren’t working right.  This time my bloodsugar ceiling has been 17 mmol/l (~300 mg/dl), and I’m happy to say that I’ve only been that high twice in the last 7 months (making me a much less guilt-ridden Mommy than last time).  I’m at the point now where I feel high (and talk in terms of being high) when I’m above 9.0 mmol/l (~160 mg/dl).  It’s nowhere near perfect, but I feel like I’m giving this baby a much better growing environment this time than I was able to with Baby A last time, and that feels very satisfying.

Anyway, away from that tangent and back to insulin resistance.  I have it bad.  And it’s mostly around meals.  In fact, with my superbolus strategy (i.e. borrow basal insulin to add to meal boluses, and then follow it up with a 2-3 hour significant drop in basals), I’m seeing my basals drop significantly because of how much insulin I’m having to take when I eat.  So it’s this weird balancing act these days – add to the bolus, drop the basal, add a bit more to the bolus, drop the basal even more.  I find I’m pretty much assessing and re-assessing trends every 3-4 days now.  I’ve said it before and I’ll say it again – how anyone who is not an analytical Type A personality does this is beyond me.  I’m the kind of person who thrives on numbers and analysis and control and even I’m burning out!

5. Looking Ahead

Now that the end is in sight (hopefully still in as close to 6 weeks as possible and not sooner), I’m starting to think more about the time after Baby B comes, including my diabetes/diet management and my maternity leave.  I’ve realized two things:

a) There are going to be some days where I eat what I want to in spite of what I know it will do to my bloodsugar.  I don’t even mean donuts, etc.  I mean a bowl of cereal with milk, a real sandwich (on something other than skinny slices of high-fibre Weight Watchers bread), chicken fingers and french fries…things like that.  And I don’t mean on a regular basis.  I do still plan to go back to the low(ish) carb way of eating that I followed pre-pregnancy (and that I’ve only slightly modified during pregnancy), but I also plan on giving myself the leeway to have some exceptions – something I’m not really allowing myself in any major capacity these days.

b) I’m hoping I can get myself a bit further immersed in the D.O.C. while I’m on mat leave.  I see so much good stuff out there that I’d love to participate in more fully, but it’s so hard to find the time when I’m juggling work and my family and the rest of my life.  If I have a relatively happy baby (which I didn’t last time, so I’m still crossing my fingers about this for Baby B), I’m hoping to be able to participate more in online chats, diabetes blog memes, and a LOT more reading of blogs by my fellow D-bloggers.

And hopefully it will also mean more frequent blog updates here!

Thirty

December 30th, 2011 was the 30th anniversary of my diabetes diagnosis.

Thirty years is a long time.

On December 30th, 1981, I was 3 years old.  As you can imagine, a lot has happened since then – with diabetes care in general, but also in my own life with diabetes.  Here’s just a taste:

  • Blood glucose meters got a LOT smaller – and a lot faster.  I’m pretty sure my first meter took a full 2 minutes to give me a reading and was the size of about 6 of my current meters laid side-to-side.
  • I went from one shot of mixed insulin per day to multiple daily injections with both short (Toronto/Regular) and long (NPH, Lente, Ultralente) acting insulins to pumping with much faster-acting insulins (NovoRapid, Apidra).
  • I started using a technology that I once could only have dreamed of – a Continuous Glucose Monitoring System (CGMS).  I continue to dream of a day when this technology will function with more accuracy and consistency.
  • I stopped being afraid of blood tests, then stopped being afraid of injections, then stopped being afraid of infusion site insertions – but I’m still afraid of CGMS insertions.
  • I’ve developed callouses on my fingertips, and scar tissue in various parts of my body thanks to thousands upon thousands of needles piercing my skin.
  • I went from eating limited carbs that were measured precisely for me, to eating whatever I wanted using the “balancing act” method with multiple daily injections and the pump, back to limiting carbs that are precisely measured by me.  Funny how this one’s come full circle.
  • The girl who was embarrassed every day at 10:15 a.m. when her watch alarm went off and her grade 3 class tried to pretend not to notice her pull out her morning snack became the girl who writes on a public blog about her experiences with diabetes and who has trouble shutting up about it when asked a question.
  • I’ve struggled with the social aspects of diabetes: kids who taunted me with candy I couldn’t eat, how to handle Halloween and birthday parties, testing in public, learning to manage the effects of alcohol, etc.
  • I’ve been hospitalized with DKA – once.
  • I’ve never lost consciousness or been unable to be in control of myself due to diabetes.
  • I’ve struggled with anxiety.  A lot.
  • I’ve worked So Damn Hard to figure out how to make this disease my bitch instead of the other way around.  I’m close, but it’s a never-ending challenge.
  • I’ve logged hundreds (or more) of days of bloodsugar readings, insulin doses, and carb amounts.  I’ve searched for trends until my eyes hurt.  I’ve developed a serious dislike of this process.
  • I got married – to a man who wants to help me succeed at this.  I also learned that my success, my diabetes care, and ultimately my quality (and length) of life extend beyond myself to the people who love me.
  • I’ve brought my A1C down to levels I never would have believed I could.
  • My belief that diabetes complications would never happen to me has been shattered, thanks to retinopathy.
  • In spite of working So Damn Hard, I’ve still experienced blame from others, including medical professionals, for not getting it right.  I’ve also had my retinopathy blamed on my past of “too much cheating” by people who obviously don’t know what they’re talking about.
  •  I’ve met some great people, both in person (Hi Mimi! Hi Krista!) and online (Hi Mike! Hi Aaron!) who I wouln’t have met if not for diabetes.  (Please don’t be offended if I omitted your name – there are just too many of you!)
  • I’ve had a child – a perfect little girl who has no lasting effects of being created in the womb of an imperfect woman with diabetes.
  • I’ve learned to deal with retinal haemorrhages – and the ongoing possibility of more.  I no longer lift anything very heavy, put my head lower than my heart during yoga, or blow up balloons.
  • I’ve started to think a lot more about the genetics behind diabetes, and to hope I never have to learn how to manage diabetes in a child.
  • I’ve made the somewhat terrifying decision (with my husband and my doctors) to have another child and am over halfway through my second (and last) pregnancy.
  • I’ve spent 30 years working my ass off and doing the best that I could (can) with what I had (have) and knew (know).

Thirty years is a long time.

I’m tired.

Here’s hoping that the next 30 years include some pretty amazing leaps in technology, in knowledge and in the strength of all of us to apply both.

And maybe even a cure….?

Diabetes Management During Pregnancy: What’s Working for Me

Since announcing that I’m pregnant again, I’ve had a number of blog-readers contact me with questions about pregnancy and diabetes.  I’m happy to receive and respond to these emails and am honoured to be a go-to person for those of you looking for  “someone who has been there”.  At the same time, because I’m not a medical professional, I’m really not in a position to provide advice.  What I can do, is tell you about my personal experiences, including what seems to work for me and what doesn’t seem to work for me.  Your experience may be different, and what works for me might not be what is best for you.  You need to do whatever it is that you and your team of medical professionals determine is right for you.

But, with that disclaimer out of the way, I am happy to tell you what is working for me.  Here are a few of my personal strategies:

1. Moderating carbs.  I would like to say “low-carbing”, but I’ve been told by my dietitian that the recommended minimum carb intake for a pregnant woman is 175g/day.  I’m usually around there, but even a bit more sometimes, depending on how often I’ve had to correct lows.  For the carbs that I do eat, I try to keep them low glycemic index as much as possible.  Basically – avoiding those post-meal insulin spikes as much as possible.  The added benefit is that less carbs means less insulin, and less of both tends to equal less volatility in bloodsugar (I’m not as likely to go high or low if I miscalculate my bolus by 2 units as I might by 8 units – if that makes sense).  Hint 1: Quinoa is a great rice substitute that is low-carb and low GI and tastes good!  Hint 2: Adding julienned zucchini to pasta dishes bulks them up without adding more carbs.  Hint 3: Boiled or mashed potatoes have less carbs than baked or roasted.

2. Measuring carbs.  I’m pretty good at eyeballing my food, but I’ve been trying to avoid doing that as much as possible while pregnant.  I have a food scale with a database of nutritional information for most common food items, and I use it religiously.  Without it, even my great “eyeballing” can be out by 5-10g of carbs, and that’s a pretty significant difference when I’m only bolusing for 30g of carbs at a meal.  Reducing the room for error really helps.

3. Testing my bloodsugar often.  I’m already fairly obsessive about testing, but in pregnancy my obsession is bordering on extreme.  While I do try not to test if there’s no information value in doing so, if I have any suspicion that things aren’t where they should be, I test ASAP so I can correct.  It also lets me run lower overall if I know I’ll be testing frequently and am less likely to run into a surprise bad low.   Borderline obsessive testing may be a bit controversial as it’s easy to cross that line into testing when it’s not necessary or helpful, or making correction decisions too soon (which can lead to insulin-stacking or over-treating lows) – plus it’s expensive.  I’m not saying I recommend this practice…I’m only saying that the frequency (and timing) with which I test is part of what is helping me tightly manage my diabetes while pregnant.

4. Wearing a Continuous Glucose Monitoring System (CGMS).  And a pump, for that matter.  Personally, I wouldn’t do a pregnancy without a pump, but that’s just me.  I wear CGMS sensors all the time while pregnant, in spite of the high out-of-pocket cost.  And yes, I still do test frequently.  The sensors aren’t perfectly accurate, and there’s a time lag, so they don’t quite keep up with the level of management I’d like, but what they do allow is a safety net.  I can run lower knowing that the alarm will let me know if I suddenly get too low.  This is especially good at night, because I can be comfortable with pretty low levels at night (but not in hypo range), knowing that I’d be woken up if I dipped too low.  It also helps catch those unexpected highs and gives me a chance to correct them before I’ve been high for too long.  I still have highs from time to time, but generally when they happen I can catch them and correct them really quickly so that they’re very short-lived.

5. Logging results / finding trends / discussing with a Certified Diabetes Educator (CDE).  This is the biggest pain in my ass of all of them, I think.  (Not my CDE – just the process.)  I have a spreadsheet I use to track basals, boluses, bloodsugars, carbs, and any additional relevant information (e.g. activity, stress, etc.).  I log everything everyday.  I hate it, but I do it.  Then about once a week (or more often when things are changing), I take a step back and look for trends that need to be corrected.  Every two weeks I discuss them with my CDE.  These discussions don’t necessarily lead me to anything I couldn’t have come up with on my own, but they do keep me accountable and on track, so it’s definitely worth it.  (I do have a “template” version of my logging/tracking spreadsheet that I’m happy to share.  If you’re interested, feel free to email me.  Again – your mileage may vary.)

On top of these five key (for me) strategies, the other significant factor for me is that I find that the pregnancy just gives me that extra kick of motivation to take everything one step further – to eat that much more carefully, test that much more frequently, correct highs that much sooner, etc.  I may not be running an A1C of 5.9 when I’m no longer pregnant (let’s be honest – I probably won’t, especially while caring for a new baby and a young child), because it’s that added motivation that helps me get there.

So it’s a lot of work.  A LOT.  It’s not easy and I won’t for a minute pretend that it is.  But it’s 110% worth it.  🙂

I’d also like to add another plug for Cheryl Alkon’s book here:  Balancing Pregnancy With Pre-Existing Diabetes – Healthy Mom, Healthy Baby.

Another Splenda Recipe – Cookies

As promised, I have for you today another Splenda baking experience.

I didn’t include the type of cookies in the title of this post because (a) I don’t like the Splenda website’s title of “Cranchewey Cran-nutty Carrot Cookies” (really, Splenda folks?), and (b) the only other title I could come up with was “Cranberry Carrot Coconut Pineapple Walnut Cookies”, and that was too long.

My past baking experiences from the Splenda website have been delicious and I was so impressed with the recipes that I tried.  Unfortunately this one didn’t exactly follow suit.

I’m not going to re-post the recipe, because you can find it right here.  But I will post this picture of the cookies in progress:

It reminded me a lot of coleslaw.

I found this recipe to be a lot of work.  There was walnut-chopping (mainly because I buy my walnuts halved from Costco and the recipe called for chopped), there was carrot-grating, there was pineapple weighing (I couldn’t find the 8oz can that the recipe called for).  It wasn’t hard work, but it was more labour-intensive than your average batch of cookies.  Or I’m just lazy.  Anyway…

The recipe claimed to make 4 1/2 dozen cookies, but I got quite a few more out of it (about 6 dozen), based on the instruction to use tablespoon-sized scoops.  On one hand this is good because now I have more cookies, each of which is only 6g net carbs (instead of 8g).  On the other hand…my cookies are small.

Also, they really don’t look like I expected them to.

This is the picture from the Splenda website:

These are my cookies:

Mine look a lot less tasty and a lot more healthy.  Frankly, they taste healthy too.  I do enjoy them, but they’re not quite the sweet treat I was hoping for.

The final verdict (by me, who is not an expert, but more along the lines of Average-Betty-Baker):  Not bad, but not really worth the work.

‘Tis the Season…

…to struggle with my bloodsugar.

This weekend was my workplace’s Annual Dinner and Dance.  Not coincidentally, this weekend I hit both the highest high and lowest low of my pregnancy.  I thought I did a pretty good job of tracking carbs during the meal (which lasts a couple of hours and includes a few courses…and is generally extremely delicious), but I clearly erred somewhere prior to dessert.  Prior to the dessert that I thought I could manage.  Prior to the dessert that I (for some reason unbeknownst to my rational self) thought I didn’t need to pre-test for, figuring that a large estimated bolus would suffice.  (There seems to be an eat/drink first, think later trend starting here and I don’t like it.)

Shortly after said dessert, I was a whopping 16.0 mmol/l (288 mg/dl).  Before this experience, my record pregnancy-high (for the current pregnancy) was a 14.9 mmol/l (268 mg/dl).  I “enjoyed” the rest of my evening through a haze of thirst and guilt.  I thought I had everything under control when I went to bed a few hours later.  It was still higher than I wanted it to be, but coming down at a reasonable pace – not too fast, not too slow.

Before long, I was waking up to a wicked nypo of 2.0 mmol/l (36 mg/dl) – the lowest low of this pregnancy.  (In fact, that’s about as low as I ever get.  I can count on one hand the number of times I’ve been below 2.0.)  I managed to avoid eating everything in my kitchen mainly because of my lack of energy to do anything involving moving.  Apparently that worked in my favour because sticking to the dextrose tabs and soda crackers in my bedside table levelled me out to a nice 6.4 mmol/l (115 mg/dl) by the next time I woke up.

If anyone is wondering…no, I wasn’t wearing my CGMS.  Thankfully I woke up to this one on my own.  I’ve felt a real need for a couple of days off-CGMS lately.  For that reason, combined with one coming up in the point below, I did not have my semi-trusty, semi-reliable low-bloodsugar alarm on call last night.  Bad timing.

…to wish I didn’t wear an insulin pump.

This is because insulin pumps and holiday dresses simply do not mix.  While I am that woman who has resigned herself to wearing a pump on my waistband on a daily basis, I’m not that woman who is comfortable clipping her pump to the outside of a cocktail dress.  I’m also not that woman who can figure out how to hide a pump anywhere between or around “the girls” without appearing to have an odd third rectangular boob.  I’m small, so most pump-hiding places on my body result in a strange lump visible through my dress.  I also don’t have a pump remote, so no matter where Pump goes, Pump must make occasional appearances throughout the night.  This means no hiding in bicycle shorts.  And even if I could make “the girls” option above work, I haven’t wrapped my head around fishing in my cleavage at a work function, so that option gets a second “no”.

In the past I’ve resorted to wearing a formal skirt/top instead of a dress.  Then I have a waistband and I’m happy.  But right now I’m pregnant and my options are limited.  This weekend they were limited, in fact, to one dress that was borrowed from a good friend.  It was a great dress, and loose enough for my very unsexy pump thigh holster from Medtronic to sort of work.  But all night I was struggling to access the pump and to keep it from sliding down my leg.  The combination of this distraction and my thirsty guilty haze mentioned above didn’t really put me in a dancing mood.

This is also the other reason that I wasn’t wearing a CGMS.  Not only does the transmitter make for a lump on my belly that isn’t well hidden by clingy formal attire, but any buzzing/beeping/vibrating of my pump caused by my sensor would have required that pump to be hauled out of its hiding place and dealt with.  And since I’d just been on a short CGMS break, I would have had to insert earlier in the day and then would still be trying to calibrate that puppy during my 2-hour long game of carb-guessing and mistake-making.  In general, it just didn’t sound like a very good option.

…to navigate my way around holiday baking.

Usually I do an “okay” job of working a little bit of holiday sweetness into my diet, but this year my pregnancy is making me want to be extra careful.  So I figured I’d do a bit of Splenda baking to provide me with some tasty alternatives.  This weekend I made these cookies.  The experience and result were both a bit disappointing.  More in an upcoming post.

…to start thinking about my D-Anniversary.

This year, at the end of December, is my 30th anniversary of being diagnosed with diabetes.  It’s my D-Anniversary, or Diaversary, or whatever you want to call it.  I know it feels like a weird reason to celebrate, but I’ve tried to start a little tradition of celebrating some of the milestone anniversaries.  For my 25th, I bought myself a silver ring and had it engraved with my diagnosis date, leaving room for a cure date that I hope will someday be added.  I’d like to do something similar for my 30th.  The traditional 30th anniversary gift is the pearl.  I don’t normally wear pearls, so I’m thinking of going with the more modern gift option of a diamond.  I don’t want to get too carried away and spend too much, but I’m thinking a small diamond pendant.  When I get something, I’ll definitely post a picture.  In the meantime, if you have any suggestions for a good gift to get myself, let me know!