Posts tagged ‘GD’

June 6th, 2011

Perinatology Appointment # 1

I’m sure that some people are probably getting sick of my constant baby appointments.

If you’re not… I am! haha!

Friday was my first appointment with the perinatologist. While it was informative, it felt more frustrating than anything else, as I felt like the doctor I was talking to was quoting old information.

The appointment was at 3:00. Around 4:30 they took me back and we started with the usual. My weight and BP were umm… the same as two days ago. Go figure.

Then back to the waiting room. Around 5:00 pm… yes… two hours after we arrived… we were taken to the ultrasound. It was good to see the little girl. The tech confirmed that she is in fact a little girl. They measured her head size and the size of her abdominal cavity.

She’s (supposedly) weighing in at 5.16 pounds. That is the 60th percentile for her “age”. lol. So much of this is based completely on speculation, I can’t take it seriously. For all they know my due date is a week off and then she would be measuring small.

Okay, back to the appointment. So she’s measuring fine.

Then the tech turned us over to the doctor. He didn’t say anything I didn’t already know. He seemed to imply that she was measuring big (which… I dunno… 60th percentile seems pretty average to me). It all was rather impersonal, the doctor was foreign, and has a funny habit of saying things, asking himself “Now why would I say that?” and then answering his own questions. lol.

All of the people at this office also assumed I was on insulin. Glad they read my file!

So really I paid $40 in copay so that a strange old man could tell me he thinks my baby is fat (I’m sticking with 60th percentile being pretty average), and then tell me that having gestational diabetes is dangerous and that I will have to be induced if I don’t have the baby by some arbitrary date.

I tried to not let him frustrate me. If they didn’t know I had gestational diabetes, they probably wouldn’t have said anything negative about the baby’s size.

A Question For You All

Should I post the baby pictures I get during the following weeks? I don’t want to bombard people’s readers with black and white ultrasound pictures… but I dunnoooo… she is kind of cute. We got a picture of her nose today. It’s actually pretty cool. lol.

Also, at the end of the appointment I was scheduled for three more appointments. So much for talking to them about putting some more space between the appointments. This doctor definitely had an air of  ”I’m the professional and this is what you will do.”

What evs. I’m a big girl. I’ll just be a bit whiny. lol.

 

June 2nd, 2011

Appointment # 9: feeling better… but also worse.

You would all be so proud of me!

I didn’t cry at my most recent doctor appointment. I had kind of decided I wasn’t going to ask any questions or umm… talk… because that usually leads to crying. But I saw a new doctor on Wednesday. I was nervous – to be honest.

At the office I am going to they have 4 doctors that the patients rotate between. That way when you go to have your baby at the hospital you already know whichever doctor is on-call. I don’t know how common this is, but I guess it works. I would prefer to have one doctor – I think it would help with my anxiety if I could build a good relationship with one doctor, instead of semi-good relationships with 4.

The appointment started with the usuals.

Weight: hasn’t changed since my first appointment with them.
Blood Pressure: Good
Baby’s heart rate: 152 (good!)
Blood Glucose Numbers: good!

The nurse asked how I was doing, and if I was having any problems. I have been experiencing more pain in odd places, and some vaginal discharge that is new. The first  was explained away as normal pregnancy aches and pains and a 1-finger exam of my cervix (still closed). The second involved a swab test to see if I have a yeast infection. I don’t usually find these types of exams painful, but despite the amount of lubricant used – the speculum bit was super painful.

TMI. Sorry.

I showed her my blood glucose numbers, and she said that they looked fine. Other doctors in the practice had said my upper fasting limit could be 95 (instead of 90), and since 95 is the number recommended by the ADA. She seemed to think that I should still be shooting for 90. It’s not even a big difference (glucose meters have a 15 pt margin of error). Since two other have said 95 I’m not going to worry about it.

So I talked with the new doctor about the afore mentioned issues. Then she asked if I had any questions.

I said nothing. I was worried about crying in front of a new doctor again.

Then I laid down so she could measure my fundus.

And this is when I realized I liked her.

She says “You’re measuring about 1 week big, but that’s fine because as long as you are within 2 weeks either way of what’s you’re supposed to be it’s fine.”

HA! SEE!!! I knew that last doctor was just saying that to try and scare me into submitting to this planned induction thing.

At that point I asked about waiting to try and let my body start labor naturally, and she said that was their goal – that generally they try to avoid inductions unless absolutely required. We talked about the different methods of inductions, and that depending on my numbers I could possibly go to 40 weeks, or even a day or two past that.

The cherry on top of this is that I realized afterwards that I was the last patient of the day. But the doctor patiently, kindly, and fully answered all of my questions. Unlike the last doctor, I didn’t feel like I was imposing, and I didn’t feel rushed at all.

Win.

So, liking 3/4 doctors is pretty good… right?

The that’s the good part. Having her seem more willing to work with me really made me feel better about my choice in OBGYN practice.

The worse part is that I am feeling pretty crappy recently. I won’t go into too much detail – I have a 3rd trimester symptoms post planned for… soon.

And in other news… I am exactly one week away from being done with work!

Double win!

 

 

May 4th, 2011

GD + me.

There is going to be a picture with a speck of blood in it. Like really… you could pretend it isn’t blood if that makes you feel better.

So I wanted to write a little bit about what having GD means for me. There are several ways to manage GD, but the specialist I saw is having me count carbs. I did a lot of research, and people often say that you should definitely do the 3-hour glucose test because the diet they put you on is super strict and ridiculous.

This is a lie.

I actually eat *more* now that I am doing this. It can get a little tricky at dinner time, but unless you are constantly gorging yourself, I wouldn’t call this “diet” restrictive in the least.

My Target Carbohydrate (g) range:

Breakfast: 30 carbs

Snack: 15-30 carbs

Lunch: 45-60 carbs

Snack: 15-30 carbs

Dinner: 45 – 60 carbs

(This is the fifth column of the chart below)

And my Target Glcose Levels are:

Fasting: 60 – 90

1-hour after meal: less than 140

2-hours after meal: less than 120

(This is the last column of the chart below)

Here is what an average day’s worth of food looks like for me right now:

(Date–Time–Meal–What I ate–# of Carbs–Testing Time–Blood Sugar Level)

The hard part for me is actually remembering to eat. For a good portion of my life I was definitely an over-eater. I would eat when I was bored, when I was watching TV, at the computer, doing home work, in class, hanging out with friends. I just always had something to eat. So something I had decided to do was to only eat when I was hungry, or when I was starting to feel like I would be hungry soon. It took a long time to hone these skills. When I would want a snack, instead of going for food I would get a big glass of water.

I kept this up through-out pregnancy. I ate healthier food, and had snacks when my body told me it wanted them, but in general I kept the munchies down and focused on staying hydrated.

With this GD diet, I am supposed to eat every 2-3 hours. You would think that it would be easy for me to re-incooperate snacks, but it has been really difficult. It requires thinking ahead, and often involves eating even though I’m not hungry. But, the point is to prevent spikes and valleys in my blood sugar levels. I am actually eating more calories now than I was before!

I am having a few technical issues with the program. I have a difficult time eating enough food to even get into the 45-60 carb range. Part of my “no-snacking” plan has been to slow down and enjoy my food. It can take me up to an hour just to eat a salad and some soup! This is where the second problem come in, because I am supposed to take my blood sugar 1 hour after the start of my meal… but some times I am still eating at that point! I don’t know how to rectify this last problem, so I intend to ask the doctor next time I am there.

I can’t be the only slow eater in the world!

So now onto the fun stuff!

This is my meter pouch. It keeps everything nice and organized.

This is the Pokey Thing.

The cap twists off, and I insert a little “lancet”. It really is tiny.

Then the cap goes back on!

The lancet point does not go past the end of the cap. The middle “button” slides back, “loading” the needle, and then the blue button releases it. The springs forward, barely poking the skin.

Honestly, this is the part people probably worry most about, but it really doesn’t hurt too much. Plucking your eyebrows, fixing a hang-nail, and paper cut all hurt a million times worse than this little poke.

So I push the tip against the side of my finger, push the blue button, and it’s over! And actually… no blood comes out. I had to squeeze my finger quite a bit to even get this little speck:

Next I put a test-strip into the end of the meter, and just set the edge of the strip next to the bit o’ blood. The end of the test strip just sucks it up.

That little image means it is waiting for blood. If you ever have to do this, make sure you squeeze out a bunch of blood before doing the test... because if you get an error you may have to prick another finger to get enough blood. Not like I've done that or anything...

Then you just wait for the meter (mine takes 5 seconds) and then it gives you the number:

I write down all of my numbers on this sheet, since it isn’t practical to carry my computer around (though I do prefer my spreadsheet to this poorly organized mess of chart!).

And then the little pokey thing and the test strip go into my “sharps” tin. Apparently it is illegal to just throw away things with blood on them. They must be contained, in a sealed something, and then they can be thrown away. I dunno… I don’t think people put their menstrual pads into little containers before throwing them away… and there is a lot more blood involved there… but whatever. Carrying this little tin makes it easy to take my levels any where, with out having to find a trashcan.

Yes, it is an Altoids Tin. I will be moving these items to a different (water-tight, completely sealable) container when one becomes available!

And there you have it! Not terribly complicated, not terribly painful, and it takes me less than 3 minutes to take my levels.

I’m not really an expert at this, but if you have any questions, feel free to ask!

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April 27th, 2011

GD: Two perspectives.

So I had my diabetes management class thingy today. And there are two ways to look at this.

I could go with the emotional side… or the informational side.

Right now I’m going to complain a bit… since ya know… it is Wednesday. And then tomorrow or maybe Friday I’ll write about what actually went on at the appointment.

First of all… I don’t know why I was so upset. I have been known to have panic attacks, especially when I was in college, so maybe this diagnosis was just what put me over the edge. I don’t know. But I’m feeling a lot better about it.

The finger pricking doesn’t hurt. I don’t know if people will believe me when I say that though.

It was a TWO hour appointment. And honestly… it felt like a complete waste of my time, and my husband’s time. I had already learned all of the information they were giving me through my own readings, and from my doctor. They could’ve showed me how to use the meter and explained the dietary limits all in about 30 minutes. Instead I just got really frustrated over how annoying it was. lol. I’ll explain this more tomorrow.

Just wanted to offer a quick update.

Meeting was fine, albeit frustrating and a waste of my time.

How was your Wednesday?

April 27th, 2011

Wish me luck

On my way to my first appointment with the diabetes specialist.

Kind of. I’m on my way to get off the computer, shower, and then go to the doctor. But ya get the picture.

I’ll let ya’ll know what’s going on in star-ville when I’m done. Ya know… if I don’t die of anxiety first!

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April 22nd, 2011

appointment # 7 – GD

This is wordy. Please hang-in with me, because I’m having a very bad day.

***

I don’t know what you all think of me. But if I had to describe myself I would say that I am a well educated, smart, independent woman. I know how to do my own research and figure things out for myself.

My last post about my recent experience at the doctor’s office was fueled by frustration. Mostly frustration with myself, and my severe anxiety caused my being in the doctor’s office. Just typing that sentence made me tear up.

I did feel very bullied after my last appointment, because of the few things I was able to choke out between tears, the doctor pretty much just said “no” like I was a toddler asking for more cookies.

But today I saw the same doctor, and despite my anxiety, he has redeemed himself.

This appointment was supposed to be about my slightly elevated blood pressure. I guess if blood pressure is over 140/90 , then it is considered prehypertension. Last time my BP was 140/80, so I had this appointment today to take the BP again and see if it was high because of stress (did I mention I did a lot of crying at that appointment) or because of hypertension.

But the numbers they got today were probably useless.

For all of you future nurses out there – don’t give people stressful information while you’re taking their BP to see if they have hypertension.

So my states today?

Weight: the same as it has been for 7 months.
Baby’s heart rate:  154 – perfect!
My blood pressure: 140/79

still elevated. Of course, I don’t think she realized that my BP was the reason I was there, because as I was saying “I’m just here for my BP” she said “So you 3-hour test results came back…” but as she heard me talking to paused, and then let out a little grimace. I knew it wasn’t good. So as she took my BP I tried to maintain steady breathing, as she tried to offer words she probably thought we comforting.

Maybe it will be better next time.

She finished taking my BP and said the doctor would be in shortly.

I just paced around the room trying to not cry. But I failed. I had told B-man to stay home because I thought it would be a really short appointment. By the time the doctor came in I was hyper-ventilating and crying like a little baby.

Last time he was very quick. He just gave me information, and when I said I was fine he shook my hand and left. To be honest I was glad for him to walk out of the room last week because it allowed me to breath and calm down.

But this time he came in, shook my hand, and then waited. He passed me tissues, and patiently waited for me to calm down. He let me ask my questions. It was a very slow process, but good… I guess.

We talked about what a diagnosis of GD means.

The one thing that really upset me was that it automatically means an induction at 38 weeks.

<rant>

Considering that I was planning to not use any medication, this is particularly upsetting.

I want to share some numbers with you, and maybe you can see why it is even more frustrating than just have the label:

Gestational Diabetes
Fasting 95 89
1-hour 180 184
2-hour 155 160
3-hour 140 105

So on the left are the thresholds set by the American Diabetes Association for the diagnosis of GD. The right are my numbers. The go from perfectly normal, barely over, barely over, perfectly normal. If either of those two bold numbers had been 5 points lower, I wouldn’t have this label. I wouldn’t be considered “high risk” and I would have to put up with all the crap.

I guess I should just avoid drinking 100 grams of sugar for every meal.

But seriously. The test shows what my body does when it is put under stress… which is not what happens everyday. So instead of trying to get a more realistic of what my body can do, I am going to have this “high risk” label slapped on me, and now I have to go to doctors appointments every day and through my plans of a natural childbirth out the window.

Which makes me mad.

</rant>

After talking about the “diagnosis” he brought up another topic. He mentioned that every time he has seen me I have been super stressed and crying. Okay, it doesn’t take a rocket scientist to notice that. But then we had a good discussion about my past anxiety/depression problems and that he realized this situation was stressful for me. We talked about the possibility of postpartum depression and that if I wanted to start taking anti-depressants before the baby is born so that they are active by the time of the birth, then that is an option.

I would prefer not to. I would rather not screw up my child’s hormones before they are born. I am very blessed to have a lot of support and help. Maybe I’m pushing myself too much, but while ADs are an option, they are my least favorite option in the entire would and I really want to avoid them unless I have to.

And I am the one who decides when I have to.

So semi-thoughtful doctor gave me plenty of things to think about.

It’s probably good that B-man wasn’t there, because without him there I was able to calm myself down and actually get some productive talking done.

***

The diabetes specialist called to make an appointment. Of course, it wasn’t really to make an appointment. It was to inform me that the diabetes education class meets on Thursdays at 9:30.

When I said I couldn’t attend a class every Thursday for five weeks because of work, the woman on the phone said “Well, this is kiiind of important, don’t you think your employer would understand?”

Well… to be honest… no. It’s not that kind of job. It is a BRAND NEW JOB, one that I am very lucky to have, and I wish she would’ve kept your snotty attitude to herself instead of being rude.

After lots of “hmmm” and “aaahs” she gave up on trying to find an appointment that would fit into my schedule, and said she would call back.

And ya know what I have to say to that?

Boo. I’m paying you, so stop making me feel crappy.

***

I kind of wish they would just tell me what I need to do so I can do it, instead of sending me to these stupid group meetings. Grrr.

April 15th, 2011

appointment # 6 – cry baby

I did a lot of research after my first glucose screening. One could say I “freaked out”. But I compiled it all into a list of questions and information I had found through all reputable, trustworthy websites/books. Information about the validity of the glucose testing being used, the other things in my life that could cause high glucose levels, and my worries about being “labelled”.

Then as B-man and I are sitting in the waiting room, I ask him “So, do you want to see my questions for the doctor?”

I usually go in with a list because of the severe anxiety that builds up when I am in the doctor’s office.

My husband reads my well prepared questions (all about testing and gestational diabetes) and he says “Looks like you’re in denial.”

At which point I started crying and the rest of the appointment was a bust. I didn’t get to ask any of my questions, I didn’t get to explain why I didn’t want to do the 3-hour test. I just sat there and cried while the doctor explained why they do glucose testing and blah blah blah.

I’m really mad at myself because I just shut down. I didn’t even give the doctor my paper and or ask any of my questions.

Needless to say, my heart-rate was a little high. I have to go back next week and take the 3-hour test before next Friday.

So yah. I’m stressed, and pissed. Maybe I’ll just go back to bed and pretend nothing every happened.