Things We Don’t Talk About: booze edition

Sometimes I loathe our reactionary medical system and the social pressures that go along with it. Tonight is one of those nights.

I will freely admit that I’ve had drinks since becoming pregnant, knowingly and willfully. The American Puritanism that insists any amount of alcohol during pregnancy is bad-bad-bad has been debunked by studies in Europe (not to mention 50,000 or so years of human existence). My feelings on it have been to drink when it sounds good and stop when it no longer tastes good. I have had one drink on a lot of occasions, two on a few, and three on I think two nights. Nothing beyond three, by my own (physical) inclination as much as a desire not to push the boundaries of moderation.

The medical information and advice available to most women is to abstain completely. There is no useful advice for how much is too much, and most women would never broach the subject with their OB – certainly in my doctor’s office I have played the pearl-clutching part of “oh, no, of course I would never drink in this condition!” because I have my own advised opinion that her propaganda isn’t going to influence.

Tonight, though, I am running into an actual medical issue where I feel like I cannot get decent advice, even from the internet, and it pisses me off that I cannot take this question to my doctor for a realistic answer without being lectured or lied to.

I came back with an “abnormal” reading on my OGTT (oral glucose tolerance test) which is the 1-hour screening that all pregnant women are recommended to get. If you fail this test, then you get the 3-hour screening to definitively determine if you have gestational diabetes. I am not sure what to make of my abnormal result; for the OGTT you have to shotgun the sugar equivalent of a 12-oz can of soda. I accidentally did mine after fasting for about 14 hours (you only have to fast for 2 for this one, and I planned to get up early enough to eat breakfast beforehand…didn’t happen so I had to do it on an empty stomach), and while I don’t avoid sugar or bread-like carbs, I do try to limit them. I doubt I have enough of the paleo lifestyle issue with sugar to affect my results, but considering I rarely to never bomb my system with that much sugar in a short period (especially first thing in the morning!) I do have to wonder if that affected my results. I guess I’ll find out for sure this weekend.

In the meantime, I have spent tonight freaking myself out about how to handle GD if it turns out I have it, not to mention that my OB’s perspective was to treat my diet like I could develop GD at any time since clearly (to her) I have *some* sort of problem processing glucose.

One of the things I wanted to know was whether alcohol will affect blood sugar levels in a way that I need to be aware of, should I be diagnosed with GD or take my doctor’s advice to restrict my diet as a precautionary measure. This is not an unreasonable question. However, four entire Google results pages yielded nothing but a repetition of the propaganda: “if you are pregnant you should never drink alcohol ever under any circumstances because it will kill your baby or make it come out all fucked up and shit and you are a horrible mother for even considering drinking a single drop or even making chicken marsala because that has cooking wine and all alcohol is bad-bad-bad while you are pregnant!” Not exactly helpful information – not even a single “we advise against alcohol consumption but if you must do it, then know this…” type of page. Nothing. Not a fucking word about how alcohol interacts with GD.

Then I found this gem on a diabetes management site:

“Alcohol has the opposite effect. The body normally stores excess glucose in the liver and muscles in the form of glycogen and converts the glycogen back to glucose when your blood sugar levels fall too low. But alcohol interferes with the body’s ability to make that conversion…”

“…Women with gestational diabetes should avoid alcohol altogether, though for reasons unrelated to their diabetes.”

So what I’m gathering is that I should have a glass of wine when my blood sugar gets too high?

I kid. I realize that an inability to release additional glucose is not the same as a means of lowering a too-high glucose level. But my original question remains unanswered, and my point remains: how the hell AM I supposed to know what effect a beer or a couple fingers of scotch will have on my GD if the medical establishment is so afraid of any pregnant woman drinking anything that they won’t even release information on its effects when they are actually potentially most harmful?

I’m going to go try not to throw up and attempt to sleep now. Fuck yeah tests with a false positive 75% of the time that are making sleep-deprived stressed out pregnant ladies lose even more rest and feel even more stressed unnecessarily!

4 Comments

Filed under Rants and Storms

4 responses to “Things We Don’t Talk About: booze edition

  1. While I am all for taking care of your health, and your baby’s, I will tell you that sometimes the testing and precautions Western medicine advise are unnecessary and cause people a lot of stress. And stress and the resulting cortisol that floods your system and your baby’s is way more worse than a glass of wine. You are in charge of your body. You are the baby’s mother. Follow your instincts.

    • I absolutely agree that stress about what to (not) do is worse than almost any of the behaviors pregnant women are supposed to avoid. That, as much as data research, was what tipped me into being willing to have drinks when it was what my body wanted – the thought of how stressful it would be for me to deny myself the one thing i know would relax me after a long shitty day at work. ultimately i had to decide what my risk assessment for each was.

      and this whole glucose screening for everyone i think adds a lot of needless stress. apparently 75% of the people who fail the 1-hour test pass the 3-hour test. plus, according to what i was reading last night, something like 9 out of 10 women who have GD have 2 or more risk factors so, again, the whole “test everyone” vs just testing those with risk factors catches a very small minority of affected women.

  2. We’ve gotten so obsessed with safety we don’t want to cross a street.

    You can’t find the information on a French site? Or ask an American blogger in France? There must be some – I had one woman, but lost the link. I bet French women go with moderation rather than abstention. In case you don’t speak French well enough to follow or search.

    American doctors are afraid of getting sued. So they try to wrap us up in cotton wool and bubble wrap, which of course doesn’t work. And they’re so patronizing and paternalistic (yeah, even the women) about all of it that you want to scream. An occasional drink does not Fetal Alcohol Syndrome cause.

    I avoid them as much as possible; unfortunately, I depend on one prescription med (and don’t particularly want to die of something preventable), so I need to go back, and soon. But they have never been helpful for my chronic illness, and it takes so much time and energy just to go see them.

    Your real problem is your current inability to monitor your own blood sugar and do your own experiments. IF said doctor decides you have GD, you will at least be given the means to test your blood sugar – which are prescription only – and that would be the only good thing about the diagnosis (unless you actually have it, in which case it’s good to know).

    It’s like they want to put you in a diagnosis box so they know what to do. The neurologist keeps insisting that, even though DH tests negative for diabetes on every test they keep doing, he MUST be prediabetic – because that’s the only reason the neurologist can come up for to explain DH’s feet numbness and tingling – instead of figuring out what is wrong and fixing it.

    Good luck – and don’t let them get you all riled up – stress isn’t good for you (remind them of that).

    Alicia

    • I could not agree more that doctors are more concerned with their own liability than they are with giving accurate information to patients on understudied topics/topics that run contrary to current medical opinion.

      I know there are programs that will make it look like you are running a web search from a different country. If i get an actual GD diagnosis i’ll run a search on the topic from the UK and have my husband run one for germany (since he reads german). if I pass and the recommendation to watch my diet is just my OB trying to be proactive/cautious, then i’m not going to worry about it and just continue to pay careful attention to my own body and instincts. As to being able to monitor my own blood sugar – i think that would give me a *much* more realistic picture of whether this is a problem (firm diagnosis included) in my actual real life versus the lab-controlled and unrealistic setting of a sugar-bomb like i would never ever ever eat after fasting in the real world.

      this whole pregnancy thing, starting when we were still trying to conceive, has really made me cynical about modern medical practice. it is, as you suggest, a necessary evil…and that’s pretty damn sad.

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