Saturday, June 23, 2012

Gestational Diabetes

"Apparently", I have gestational diabetes. Sense the sarcasm. I'm feeling like one of the midwives at the practice was trying her hardest to give me this diagnosis based on my weight and the fact that Livi was a big baby. I'm very frustrated right now.

I've only had one appointment with one of the midwives at the group I went with. The appointment had gone well. Knowing that I was thinking of a home birth the midwife wanted to do a little extra monitoring on me because I am overweight. I was fine with this. The extra monitoring was basically only some extra ultrasounds to monitor the size of the baby. She acknowledged that I already had a big baby, with out having gestational diabetes, and pushed her out in less than 30 minutes. She even made the comment that I was "made to have big babies". Which apparently I am! Livi was 9.11 lbs. I was 9.10. My mom was over 9 too. I have numerous cousins who have also been and birthed 9 and 10 pound babies. 

Anyway, one of the initial blood tests ordered, which I didn't really realize was an extra precaution, was a fasting blood glucose test. It came back at 5.1, which is high but after some research I discovered it was still in the normal range. A midwife called me and told me that it was over the threshold and she wanted to retest me. Having not researched it all yet, I redid the test. My numbers came back at 5.5, which is over the threshold. She referred me too the diabetes clinic and started talking about possibly having to send me for an OB consult to make a care plan. I asked if that meant I couldn't have a midwife anymore and she said she didn't know. She also wants me to have a consult with an anesthesiologist 'in case' I have to have a c-section. I felt very discouraged. 

I chose to have a midwife this time because I had a really easy pregnancy and birth with Livi. I figured that midwives were less invasive and more laid back. I also really like the fact that midwives come to the mother's home after birth instead of the the mom having to pack up all the kids to get to the appointment. I would like to try and see if I could have a water birth this time too because they can be so much calmer and relaxing. 


The more I've been researching and thinking about it I believe this midwife is being way to premature and even prejudice. The Canadian Diabetes Association Clinical Practice Guidelines for during pregnancy recommend the fasting glycemic target to be under 5.2 mmol/L and even has a line that states "Values are higher in obese women." The first test was under this threshold but she retested me anyway. I asked the diabetes clinic why she would have retested me and they said maybe the midwife was suspicious of my first big baby. If this is the case, the midwife completely disregarded my family history of having big babies, disregarded the possible higher values for being overweight, and disregarded the fact that I was tested for GD with Livi and it was negative. 


Yes, my levels were higher the second time. I asked the diabetes clinic about this too and she said that any given day the level may be higher and the next it may be lower. So, in my mind, one time of catching my glucose high just doesn't seem enough to diagnose me and possibly put me under the care of an OB who will most definitely want to induce me early to ensure not having a big baby. A big baby with jaundice and low sugar levels is the biggest complication with gestational diabetes. 


The diabetes clinic has me monitoring my glucose levels 7 frickin' times a day. I've been doing it because I want some leverage to go back to the midwife and show her this is a misdiagnoses. Each day since starting my numbers have been WELL within the normal range. Yes, I've cut out a lot of the extra sugar that I'd been indulging on since learning about all this... but not completely... and my numbers are still within normal. I'm just eating healthy on the whole, which is what I should be doing anyway. 


I don't know what all this means. I have an appointment with one of my midwives in a few weeks to discuss everything. Hopefully find out what this all means for my birth experience and see if I can get this diagnosis reversed. I made a consultation with the Maternity Group that I was happy with the first time. They have three midwives and two doctors working alongside each other. The only thing with that is I might end up with a doctor if they are the ones on call and I would have to have a hospital birth and give up the home visits after birth because I live outside their jurisdiction. I'd be giving up my hopes for a water birth if I went with them. 


If I have it, I'll deal with it properly and make sure the baby and myself are healthy. I'm not fighting this because I just want to eat sugar. I just  really don't think I have it to the extent they are treating me. I may be borderline. I may eventually get it. But right now, this seems very premature. She tested me 12 weeks earlier than normal and my numbers were only high once! Okay, I think that's it for my rant. Pray that this can be reversed and I don't have to fight for a natural birth. I want this to all be as stress free as possible. 

3 comments:

Katie said...

Katie, this totally sucks! The whole GD testing thing aggravates me to no end! I declined taking the tests during both of my pregnancies. It just seemed so pointless, because the methods and results are so dubious at best! And it's such a waste of time and energy for you; I know you have your hands full with your two girls, and this is the last thing that you need. Anyways, there's my rant! Hang in there, eat well; you're doing a great job! I'll be praying that you get your water birth :)

LeAnna et David said...

I thought it was too early for you to have GD anyway. My understanding was that it didn't show up until the 3rd trimester--I know someone who had it but it went undiagnosed because they were tested too early. Of course, if your numbers are already to the higher end of the safe spectrum, it could be that they are trying guard against it becoming a full blown problem in the 3rd trimester.

Some stuff may also depend on the type of test you had. In the UK they offer two--one is a simple one on your fasting blood sugar (one reading) and the other is a full blown glucose tolerance test (three readings and about 12 hours of fasting, even from water). The latter, which I was sent for, is the more accurate one and the first one is only used to screen people for the second.

I do feel like a lot of the time the healthcare system uses a BMI reading to just decide that people are going to have x, y, & z. It might help if you can go in and talk to an actual obstetrician. The one I saw mostly snorted, said I was tall, and laughed off my referral as he thought I was low risk (and he was right). Talking the GD results through with a doctor might give you some reassurance and some definite 'evidence' to bring back to the midwives and fight for what you want. Then just use your blood sugar results as a good excuse to modify your diet and dodge the GD bullet towards the end of your pregnancy. Good luck!

emily said...

I'm so sorry you are going through all this stress Katie! It sounds very premature to me too. Well, good thing you are a smart women and you have done all your research and can come prepared to fight for the birth plan you want at your next appointment. Hang in there!