Gestational Diabetes




32 weeks- as big as house!

 

Woo, finally got the results back on Monday. But, they weren't very good! Here's the break down:
Fasting

Cut off: 95

Me: 108

1 hour

Cut off: 180

Me: 225

2 hour

Cut off: 160
Me: 229
3 hour
Cut off: 140
Me: 151

In order to get a diagnosis of GD you must fail 2 of the tests and I clearly failed all 4. Definitely no denying it. Also interesting is that my 2 hour levels went up, not by much, but enough to definitely point out that it's my body that isn't processing things correctly and not just that I'm a junk food addict.

So, since my high finger prick back on August 31st, I've been doing my best to eat a good GD diet as I've been able to find online. It looks like this:
Breakfast: 30g of carbs; 7g of protein; no milk or fruit; should be fairly small
Snack 1: 15g of carbs; eat with protein; no milk or fruit
Lunch: 30-45g; 7g; milk and fruit allowed
Snack 2: 15g; eath with protein
Dinner: 45-60g; 7g; milk and fruit allowed
Snack 3: 15g; eat with protein

So in the real world it looks like this:
Breakfast: 2 slices of whole wheat toast (28g), turkey bacon or eggs
Snack 1: 5 ritz crackers (10g), string cheese, hard boiled egg or lunch meat (I guess I'm just ignoring the listeria factor now)
Lunch: Turkey sandwich with cheese on whole wheat bread (28g), fresh veggies like carrots or broccoli
Snack 2: peanut butter and crackers
Dinner: meat serving (usually chicken), whole wheat pasta or brown rice, 2-3 veggie servings, raw is better
Snack 3: yogurt (which when flavored with fruit is actually 33g)but it seems like I"m not getting enough fruit otherwise

It doesn't sound so hard, but it is hard to be creative, or find something quickly. It also invovles a lot of measuring and making sure that I'm only eating the exact serving of carbs. It's so hard to avoid fruits, but they have sugars which are carbs. Not that I shouldn't have any either. This is why I still need to meet with a nutritionist who will give me better ideas on how to work with my lifestyle.

I also need to get excercise in, though the last few days that's been hard. I've been running around town taking care of errands and doctor appointments! By the time I get home I'm exhausted, my feet are swollen, I'm dehydrated (I need to pack a giant thermos of cold water), usually hungry (need options for snacks on the go) and in pain from my SPD. After Doug gets his pay check I'm going to see what it costs to get a membership at the Wellness Center so I can swim. Of course I don't really have anything to swim in. I guess I'll come up with something for the next few weeks. Definitely not getting a swim dress made when I'm getting larger by the day, it won't last much longer, and by the time it would be done I'd probably be at my due date!

I also need to meet with a nutritionist to learn more about what I can eat. For example, on Weight Watchers, you can save up "points" and then splurge every once in a while, such at church potlucks. But with GD, it's not like I can just fill up on meat and veggies and save all my carbs for a slice of pie. It's not good to have too many at one time and of course the complex carbs are way better than the simple ones. But I honestly don't know if it's just as simple as substituting wheat flour for white and splenda for sugar and then I can have a cupcake. Is it ok if I go over on carbs every once in a while?? I don't know!

I thought I was doing really well until Tuesday night. I couldn't sleep (not too uncommon for this part of pregnancy) and so I was awake and hungry. I had a snack of string cheese at 4:30 am and finally fell asleep around 5 am. At 7:30 am I woke up freezing and shaking. I had to wake Doug up to try to warm me up. They lasted for about 30 minutes and then they seemed to try a few more times. Later that day I looked it up and it said it could be normal, sign of infection or preeclampsia. Well, I didn't want to mess around with the other two and so I called the nurse at my new office. She wanted me to go ahead and come in, thinking it had to do with my sugar levels and that getting started on it all on Wednesday would be better than Friday. So they checked out Teddy, he was doing great. Then gave me prescriptions for a meter and sticks and set up an appointment with a nurse at RMH to educate me on GD. I had read somewhere that often times you can get the meter for free through the hospital so I called to find out if that was so and the lady was so great to me! She said that she'd try to set up an appointment for me this week and would figure out if I should go ahead and get the meter our insurance will want once it goes into effect or a more affordable model. I met with her today, got the meter for free and my lancets and test strips were only about $35 for 100 each at Target. I knew most of everything else she went over, but it was worth it just to get help with the meter and getting it for free!

So, I met with my new Midwife/OB practice: Shenandoah Women's Health Care. It's a huge practie with 6 midwives and 4 OBs. On Wednesday I didn't have to wait very long but today I did- I guess they're busier in the morning. And that's to be expected with a large practice, as was the short appointment. Those were things I really loved about my midwife experience! I think next time around I'll keep this practice. I can start off with midwife care and then go to OB if I develop GD again (good chance, by the way). It was so hard to get all my paperwork over there and now I feel 31 weeks behind everyone else when preparing for a hospital birth. But the OB assured me that next week will get me caught up.

So my appointment today was with Dr. Aamodt, I went to school with his daughter! But I will see all 4 of the OBs before birth. He didn't have much to go on since I hadn't gotten my meter yet. I will test for the rest of today and then all day on Saturday and Sunday and then return on Monday. If my fasting levels are still high then he wants to go ahead and start insulin. Most people go a whole week on the diet and with testing before deciding this but a)I'm a little behind and b) I have been trying to be on the diet so it's unlikely things will change very much and c) you can't do much about your fasting levels.

Also, I will have weekly appointments from now on, and bi-weekly appointments starting at 36 weeks. He did a mini-ultrasound and Teddy is head down! Haha, I couldn't tell if I was feeling a head or a butt down there. Hopefully he will stay that way. We'll have a growth ultrasound next week to do some measurements of him as GD babies tend to be large, and also to measure my amniotic fluid because it looked a little high. So, if my fluid stays high (which it could go down once we get the sugar under control) and/or if Teddy is big for size, they will likely induce me before 40 weeks (around 38 or 39 weeks). Hopefully I can still deliver vaginally though and with out an epidural. We'll see how it goes. I've also read that if I end up on insulin they'll do nonstress tests on the baby weekly, which just monitors his heart rates when he's resting and when he's active. Let me tell you, I'm glad we'll have insurance!

Ooh, and the cost. So, prenatal visits, labor and deliver are only $2550 with them. Well, it was going to be $2500 with my other midwife, so very comparable! The national average by the way is $7,000! They are going to pro-rate it since I wasn't there for the first 31 weeks, but I think with the extra visits at the end it will end up being the same. That doesn't include labs and ultrasounds though. I had my thyroid tested on Wednesday (keeping my same dosage) and then they tested me for Rhogam antibodies today since I'm Rh negative and Doug is Rh positive. I should have had a Rhogam shot a few weeks back but with all the glucose things it never got that far with Misty. Then mini ultrasound today and growth ultrasound next week. I guess they'll probably do another one before birth too, and if I end up needing the nonstress tests then I think that counts as an extra fee too. But all fairly affordable with insurance and Doug's new job at Applebee's!

Oh, and the best news of all: my levels 2 hours after lunch were 105, perfect range! I clearly don't respond well to straight glucose, but as long as my post eating numbers are lower than 120 we're doing good. So we'll see in the morning what my fasting level is like. I feel so much better knowing that I am doing good with the eating then. Who knows, those shakes could have been something else. They seemed more flu related (but way worse) than hunger shakes (which I've had a few times pre-pregnancy) and my throat is a little sore now and things are going around. So the week that started out with fairly bad news can end on a good note. :)