No One Knows You Like You Know You

Another pregnancy post, just because I need to rant about it.

Got a call earlier this week from the diabetes center at the hospital my OB uses – not from my doctor – saying that she’d sent orders for me to go in for a consultation. So…I guess I failed the 3-hour glucose test? Doctor never called me to discuss the results. I spent the day I got that call alternating between freaking out and being royally pissed off. A pretty perfunctory Google search of “GTT false positive” turned up at least one piece of advice she gave me wrong – the WORST thing you can do to avoid a glucose meltdown in testing is avoid carbs beforehand, which she advised. Sigh. Basically at this point I feel like everything she tells me is just a guess and I should just look the condition up when I get home. As one of my friends put it, “Well, you wanted an alternative care model that would really let you own this pregnancy….”

Anyway, I¬†assumed the diabetes center would have my results so I could at least know if we were looking at true GD or a testing conditions issue. Ha! They didn’t have my labs, either. I had to request they call my doctor and get them so we had some idea what my baseline was to begin with. I had two high marks, one at the one-hour and one at the fasting draw (only by like 5 points each time, but still). The fasting number being high tells me maybe I do have some issues. Good to know. Let’s deal with them.

The center has me doing blood tests 4x per day – first thing in the morning and 2 hours after each of my major meals. So far every reading has been within the acceptable range, even when I ate more carbs than I was supposed to for that meal. My fasting blood sugar is still a little high, though not as high as it was last weekend and now back within the “target” range – just at the upper end of it – and I don’t know whether the lab blood draw was high because of being a little sick, very tired, and completely stressed out, or if changing my eating patterns even the little bit I have has already started correcting the problem.

At the very least, now I have the means to actually experiment and see if particular foods crash my results, and if I really need to follow their guidelines or if I can modify them to better suit my lifestyle and body-driven eating habits. (The main issue I have with their plan is low carbs in the morning. I have never been the sort who can face a full breakfast until I’ve been up for 3-4 hours; the only things I want in the morning are starchy fruit and milk or cereal and milk, either of which are more than my carb allotment for breakfast. So the real-world scenarios I am looking at are skipping breakfast or having more carbs than I am “supposed” to in that time slot even if I then have fewer at my next snack and meal. Personally, I think the less detrimental option for a pregnant woman is the latter, especially since – so far, at least ¬†- my body seems to be processing those particular carbs just fine.)

I do know that if anyone wants to do a late ultrasound to see if my baby is “big” that I will refuse it, because I am not going to be induced or bullied into a C-section for fear of a 9+ pound baby, especially given the ultrasound gets it right about 30% of the time – so statistically speaking, no better than flat out guessing. Even if my little guy grows big…fat squeezes. His head isn’t getting bigger even if he is, and the primary risk of vaginally delivering a large baby (shoulders getting stuck) is mitigated by my refusal to be strapped to a bed and forced to deliver on my back.

Right now I will confess myself annoyed at the amount of work I am having to do to feel educated about my specific pregger issues, even working with a doctor in general philosophical alignment with me, but that seems to be status quo in patient-provider relations these days. Hear the doc’s advice and then do your own research and mythbusting, because not all of their advice is going to really be suited to your unique situation.

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6 Comments

Filed under Rants and Storms

6 responses to “No One Knows You Like You Know You

  1. Ah this is perfect advice! I think people forget sometimes that doctors aren’t gods, or legislated rule makers, they’re advisors. You pay them for their advice, and to outsource having to go to med school yourself, but ultimately you’re in control. You’re the decision maker. If you agree with them, great! If something doesn’t quite feel right, take some time, mull it over, ask more questions, then don’t be afraid to say “what else you got?”. Good luck getting your GD issues sorted.

    • Yes, I think we do tend to venerate “experts” like doctors a bit too much…and some of it is driven by laziness or disinterest in learning a bunch of new information. So much easier to just pay someone else to give you an answer.

      That said, I feel like a lot of the pregnancy-specific frustrations I’ve come across are due to the care provider’s SOP being a literal standardized approach…pretty much one-size fits all. I find myself surprised to be saying this about the OB I’m with, because she came highly recommended for her natural-birth-friendly approach (she’s the only doc in town who will catch a breech baby, for example), but I suppose her delivery room demeanor/expertise may not translate into the prenatal care. I do know she freaked out about my thyroid and had NO idea how to deal with it…maybe she’s just really good a the boring pregnancies and iffier on those with any wrinkles.

      That said about my OB, I can only imagine how frustrated I would have been going to an OB whose reaction to breech presentation, or twins, or GD, or anything else is “section!” That probably would have resulted in my hiring a midwife after that first appointment. I am still debating switching my care to the midwives at a different hospital, but…on the other hand, at least I have this woman figured out.

  2. Frustrating being at the mercy of the medical establishment, but at least now you can test.

    Just think a bit about the type of cereal – look for the ones that digest more slowly (lower glycemic index I think) – rather than the total carbs. Stay away from Cptn. Crunch, no matter how much you normally eat.

    I’m a protein shake for breakfast type; and eat low carb all the time (wonderful Cheesecake Factory no-sugar-added cheesecake available, btw).

    You can do all sorts of things to balance out your breakfast carbs IF they cause a problem, but eating is more important here.

    Anyway, go do your research – there’s more than one way to manage all these things. Best of luck – and it’s probably all very temporary.

    Keep ranting – you don’t want to keep all that inside.

    Alicia

    • I generally don’t go for the captain crunches of the world (much as i might sometimes like to!) but I confess myself shocked at the carb values of what i thought was a decent choice due to its having lots of whole grains. i also picked it up between my 1-hour test and 3-hour results, so i hadn’t yet had the conversation with the diabetes center about what I should be looking at on the label aside from basic sugar content.

      I am mostly pleased to be able to experiment. Hopefully things will continue to stay in check but i’d rather be safe than sorry…

  3. Oh, and don’t forget to vet your doctor’s backup – I didn’t, and ended up with a midwife who was elsewhere (sole practitioner). I should have thought of it – her backup was a male doctor. Not good.

    A midwife group might be a good alternative – or your doctor may have a perfectly adequate backup plan.

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