subtitled: Gestational Diabetes Round 2
So I got weird lab results. Let's just leave it at that and say that I passed the 3-hour GTT with no score higher than 103. This is go #6 with this particular test and I have never had numbers that good. Of course, I am already on the gestational diabetes diet and that may help, but seriously these are like getting the FSH/LH of a healthy 18-year-old after years of fertility treatments.
So I called the midwives. We use midwives to avoid an unecessary c-section or other interventions (sky high rates here in NYC). Midwives are great at getting babies out. They are not great at dealing with other complications. I want them to get my babies out, but I am happy to see other doctors for other medical issues (nutrient malabsorption, insulin resistance, other weird hormonal misbalances ...)
Voicemail #1 said: you're clear. Eat what you want.
Conversation #1: Ok, we'll refer you to the GD clinic (which would be fine except I'm worried that will trigger my being labeled a gestational diabetic and then I will yet again need a weekly 'approval' letter from the clinic to 'go into labor' (thank you no liability caps city) and will result in 10-hours a week of counseling/NSTs/BPPs)
Conversation #2: Oh, you're only 15 weeks. We can retest at 24 weeks with another 3-hour GTT and then refer you either way. In the meantime avoid simple carbs and try to do some walking (which is like telling me to start prenatals. Action plan has been in place for a good 3 years since we started this roller coaster).
So beats me what to do. The big holidays start tomorrow night and I would love to have a piece of cake or two. But we know that uncontrolled blood sugars can be fatal to fetuses. And we also know that I tend to go over the top once I start testing my blood sugars. And seriously, the last thing I want to do is be the maverick who is drawing her own blood sugar, reading the results, consulting the internet, and then making her own medical decisions. I know that information is good, but if I'm going to torture myself after every meal I want a medical professional to read the results (much as I also enjoy analzying my own).
So here we go into the holiday season with no clear directive on what/how much to eat. Is it more important to gain weight now given that I will probably not be able to eat much/gain weight later (as per the nutritionist's advice)? Is it more important to obsess over blood sugars now 'in the hopes of preventing the development of GD' (I think this theory is b.s. but it was put forth by one of the midwives)? Is it just important to eat because it makes me happy? Beats me.
Subscribe to:
Post Comments (Atom)
3 comments:
My (totally non-medically sound) advice would be to let up a little and enjoy yourself at this point. I mean, don't go crazy or anything, but enjoy your holiday and reassess post-holiday what kind of diet plan you want to be on long-term (well, "long term" meaning the next six or so months!). If it makes you feel better, go ahead and flex your google MD and test blood sugars and interpret results as you would like. Honestly, we infertile types are probably better at managing our particular conditions than many MDs, because we live these conditions every day, we research them, we know what we need to do to manage our care (mostly). Uncontrolled blood sugars can be fatal to the fetus over the long haul-- not that you want to risk injuring your baby, but it takes lots and lots and lots of sugar-abuse to result in fetal demise. And besides, like you mention, it is important to gain weight now while you can. I think I may be the poster child for Importance Of Weight Gain During Pregnancy. I managed to birth full-term, higher-than-average-singleton-weight twins, and the only thing I really did to manage their care was to eat like a pig.
So yeah. WTG passing your three-hour. Can't wait to see you!
I tend to agree with Kate- eat now & try to be happy and gain weight (because I am sure even if you tried you wouldn't be able to let yourself go too far and would still be somewhat healthy & cautious)
One holiday season of eating does not automatically mean dangerous GD levels. Granted- I am not at all well versed in any type of diabetes control or diet- but given that you passed your 3 hr test, are as well informed and in control as you are, and that you kn ow you will not hesitate to call in a professional opinion should you get some questionable self- results- I think you are fine to just focus on relaxing, eating and enjoying for a little while.
Um, yeah, I agree with Kate, too. It's a big leap from "uncontrolled blood sugars can be fatal to fetuses" to "I can't have a piece of honey cake at the holidays." By uncontrolled, they mean *really* uncontrolled, over many months (particularly during the first trimester) with numbers that are continually very very high. They don't mean that having cake during a holiday at 15 weeks is going to do anything.
Also, my (extremely paranoid) medical team, who are watching my blood sugars despite repeatedly admitting that no, I don't have GD, are also careful to admit that blood sugar maintenance during pregnancy can occasionally be "reactive" during pregnancy rather than always "proactive." "Proactive" means that you constantly watch what you eat to keep your blood sugar down. "Reactive" means that you occasionally eat something that you shouldn't, but then you go for a quick walk and bring your blood sugar back down again 15 minutes later. As long as you don't do it too often, being reactive is fine. Especially since your GTT numbers look awesome and you're unlikely to spike anyway.
Happy New Year!
Post a Comment