Showing posts with label GTT. Show all posts

6 week post partum check-up

Monday, June 3, 2013

I can't believe that I already had my 6 week OB appointment today.  B will be 7 weeks on Thursday!  Where has the time gone?

I was really nervous for my appointment this morning for a few reasons.  The first reason was because I had to go alone with B.  I have gone alone with him to appointments before, but never to the hospital and never for 4 1/2 hours.  I had to go early this morning to first get my 2 hour GTT and then for my OB appointment afterwards at 11:20 AM.  So yeah, I had to entertain B for several hours, in a hospital setting, by myself.

Turns out it wasn't as bad as I thought it would be.  I nursed him a total of 2 times and changed 3 diapers in the family restrooms.  Luckily everything in the hospital is wheelchair accessible!  I hate the nursing covers and would prefer to just "free-boob" it, but I am not sure how legal that is in my state (or anywhere for that matter).

The 2 hour GTT test wasn't as bad as the 3 hour, but the drink was by far worse.  It wasn't the orange flavored one, it was no flavor other than sugar water.  I choked it down and it threatened to come back up for several minutes.  Luckily I could drink water to take the sticky, sweet taste out of my mouth.  GROSS!

After chugging the gross drink, B and I did several laps around the hospital.  We walked past the fertility clinic.  I wanted to go in and thank my RE and their staff, but didn't think they would even remember me since it was September that I was there last.  I saw the doctor that delivered B and I also saw a few other doctors that I remembered walking the halls.  It was weird to be back there again for what will be the last time for quite a while (or until I try to get pregnant again or get pregnant again on my own).  The site of so many heartbreaks and bad memories, now has a bunch of great memories for me.  They helped me conceive and birth my son.  I am forever grateful.

After my last blood draw, I headed over for one last visit to MFM.  I am not sure what my BP was, but my weight is 133 (down from a high of 164 plus).  I still have 13 lbs to lose to get back to my pre-pregnancy weight, or 15 lbs to lose to get back to my goal weight.  I realize that this weight should not come off until I stop breastfeeding and I am ok with that.

I talked to my doctor one last time.  We discussed birth control, as he gave me the all-clear for sex (which I still have no interest in right now...sorry hubby!).  I am going to start the mini-pill on Sunday.  Not really excited about that, but I also do not want to get pregnant for at least a year and having something put into me like an IUD sounds completely unappealing.  We also discussed exercise and my diastasis recti.  I told him about the marathon and he told me that I can start running...slowly.  I am surely going to be at the pace of a turtle for some time.  As for the ab situation, he told me that he has never seen anyone have luck with physical therapy, but he agreed to write me a prescription if I agreed to call him and let him know if it worked or not.  He also told me that if I choose to have another baby and a c-section that he will stitch my abs back together as part of the surgery, if that was going to be my last child.  I love this man!!  He also checked my incision, which he said looked good and he gave me a pap smear which hurt like hell.  He told me to give them a call if I get pregnant and we'll do it all over again starting at 8 weeks.

I really felt like hugging him, but I thought that would be weird.  Seems like so long ago that I walked in there for the first time, crying and so scared.  He really always helped to calm me down.  He never tried to blow smoke and sugar coat anything, but he also didn't unnecessarily scare me either.  It is crazy that you spend so much time at their office when you are pregnant and then you just stop going.  It sounds weird to say that I will actually miss going for regular check-ups there.

When I handed the receptionist my paperwork and told her that I did not need to schedule a follow-up it felt like I was graduating.  I now have my healthy baby that I worked so hard for.  Quite a surreal feeling.  I did it.  I overcame whatever issue I had.  I fought and I won.

When I got home I already had an email from the nurse giving me the results of the 2 hour GTT.  I PASSED!  NO MORE DIABETES!!  My fasting was 87 and my 2 hour was 112.  I breathed a sigh of relief, but know that I will forever have changed my eating habits and will always be thinking about diabetes.  I know that I am at a higher risk now for type-2 diabetes, so I have even more incentive to stay healthy.

Today was a good day.  B has been doing better the past few days.  I have a more thorough update of him that I need to write, but I hear him stirring from his nap so I need to get back to mommy duty.  

For fun, here are some before and after shots of my mangled belly.  Something to work my ass off for.    I am jealous of my old body!  Enjoy!

Before baby

40 weeks 

       6 weeks pp...oye

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Frustration :(

Thursday, January 17, 2013

Today was one of those mornings that I would like to request a do-over or wish that I would have stayed in bed to avoid completely.  I'll give a little background first before I start, yet another, depressing post.

I got my test results back from my 3 hour GTT yesterday.  The results were rather inconclusive.  The nurse who wrote the letter stated that, in their MFM practice, one failed test is borderline and not a flat out GD diagnosis.  She said that I barely passed the second screen (and my 3 hour was just weird) so that I should think about self-testing.


Details of other blood chemistry tests as follows: 
GTT - 1 Hr Glucose: 218 (Normal Range = 54 to 179): Out of Range
GTT - 2 Hr Glucose: 152 (Normal Range = 54 to 154)
GTT - 3 Hr Glucose: 61 (Normal Range = 70 to 139)
GTT - Fasting Glucose: 87 (Normal Range = 54 to 94)

To me, these results are an utter failure.  I clearly have an issue because normal pregnant women's bodies can process all of that sugar in an hour and get to acceptable levels.  Mine cannot.  I also know that I have an issue because my self testing has shown me that I have an issue, especially with fasting.

I called the nurse back immediately and told her that I had already started monitoring myself at home and I asked her for a prescription for the test strips and lancets.  She liked that I was being proactive and happily put in a prescription.  Too bad I told her the wrong monitor.  I called her back later to have her switch to the correct one which she said would be an issue.

Last night after work I decided to go to the gym then the to pick up the prescription.  The gym was miserable.  I felt like crap the entire time I was walking.  My stomach felt heavy and gassy and I was having shooting pains down my right side.  I only walked for a painful 40 minutes when I wanted to try for an hour.  I was pissed.

Afterwards I went to C.VS.  The girl at the counter wasn't especially nice.  I told her my last name and spelled it 3 times before she got it right.  She brought over the prescription, I signed for it, and paid for it.  Then I noticed it was for the incorrect strips.  I told her this and she said I'd have to go wait in line at consulting.  Of course there was a line of 3 people.

The pharmacist was really nice and said that the nurse hadn't put in the prescription for the other brand, but that she would do an override and sort everything out.  She mentioned it would take 20 minutes.  Awesome.  Meanwhile I could feel other people looking at me and judging me and I felt terrible about myself. Just awful.  Like a complete failure.  People probably see me buying this stuff and think that all I eat is sugar and that I don't care about my baby.

I didn't get home until late.  Luckily my husband did not workout last night so he had made an awesome diabetic-friendly meal.  Organic boneless-skinless chicken stuffed with pesto and wrapped with prosciutto, plus sauteed kale and garbanzo beans.  It was delish.

I tested an hour after dinner and my number 1 hour after dinner was good, 107 (should be under 140).  I then had what the nutritionist had suggested, a 1/2 cup of full fat vanilla ice cream with 1/4 cup crushed almonds on top right before I hit the hay.  It was awesome.  I figured this would help my number this morning...WRONG.

I woke up this morning and did my usual hair/makeup and then attempted to test.  Of course my fingers just would not bleed.  I went through 3 lancets before I finally got some blood out of my pinky finger.  My number was 97.  It is supposed to be under 90.  This immediately threw me into a bad mood.  WTF?!  I am doing EVERYTHING right and I still can't get this under control.  I am at a complete loss.  I don't know what to do now.  I am now planning my life around meals and testing.

I got ready for work in a huff, throwing things around and being short with my furbabies and husband.  I had to hustle to eat breakfast and get my lunch ready because I had to test (literally) on my way out the door to catch the train.  I scarfed breakfast then made my lunch then got my last minute things together so that I could test an hour after my first bite.  I am sure this was not a good idea, but I don't know what else to do other than eat as soon as I get up at 4:30 AM.  I tried pricking one of my fingers, no luck.  I tried again, no luck.  Then I tried a third time and must have hit something bad because I got a shooting pain up my finger and now it was throbbing.  NO FUCKING BLOOD.  I am using the deepest setting, mind you.  Seeing that clock tick away and the fact that I was going to miss the train made me even more frantic and I started crying.  Like hysterically.  My husband didn't know what to do other than tell me to calm down which only made me more upset.  My eye make-up was streaming down my face.  I tried one last attempt and finally got enough blood for a test.  My number was acceptable at 131.  My face was a mess.  

I called my endocrinologist (I see her for my thyroid and I love her) this morning to see if she could give me some advice or maybe get me an appointment before my next one in February.  She is out sick with the flu, but a nurse is going to call me back in the mean time.  

I should be used to this by now, right?  Things not going my way no matter how hard I try to control them.  Shouldn't I have learned from my miscarriages that some things are just out my control?  Why should I ever have thought that pregnancy would be easy when getting pregnant was not?  I guess I still have not come to terms with things.  I am still trying to fight for my belief that when I do things the right way, I'll be rewarded (or at least not punished).  Obviously this is not the case.  I am frustrated beyond belief.  I am seriously doing everything I can and it isn't working.  I am eating healthier than I ever have in my life and exercising even when I feel like shit and it isn't fucking working.  I read about what gestational diabetes can do to a baby and it makes me even more upset.  I don't want to do anything to hurt him or make him sick.  My body is failing me once again and I am, once again, powerless to fix it on my own.

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Drinking the (Glucola) Kool-aid

Tuesday, January 15, 2013

So I am in the waiting room at the hospital.  I decided to do a little timeline of events since so many people have asked what the 3 hour GTT is and how it affects people.  I am going to be the real life guinea pig for anyone that wants or cares to know.  Here goes:


8:20- Got dropped off at the hospital by my husband and had my first blood draw which was for the fasting.  I asked if I would be able to discontinue the test if I failed the fasting portion and they said, no.  They won't know the results until the afternoon so I have to take the whole thing either way.  Awesome news!

My fasting blood draw caused a small hematoma, of course and I bled through a whole gauze so they had to re-do it.  Why can't the tips of my finders bleed like that?!

8:22- I choked down drank the bottle of the Glucola solution in about 4 minutes (did you know that shit has 450 calories??...gross!).  Set up in the waiting room with my laptop and huge bottle of water.  The baby is going nuts right now.  Poor thing is experiencing sugar shock.

9:26- First test blood draw.  They drew from the same arm (left).  Next time the will draw from the right arm.  So far I feel ok.  Mainly tired.  I would love to take a nap, but I would feel weird sleeping in the lobby so I am trying to work instead.  

10:06- Boooooring.  Working isn't really going so great because I am not in the mood.

10:26- Second test draw.  They drew from the right arm this time.  Starting to befriend the ladies in the lab.  Still feeling ok.  No shakiness, or sweating, or upset stomach.  Just tired!

10:30- Met with the nutritionist and her assistant.  They weighed me first.  I was about 138.  So I lost a pound since last week.  I was expecting this with the changed diet and they were ok with that.  She mentioned a weight gain for someone my size and starting weight of 119 would be 25-25.  She thought I was on track to hit that.  

The nutritionist was very nice and very impressed with my knowledge and preparedness.  She wasn't concerned with my numbers, but asked that if I am diagnosed and continue to test regularly that I test 1 hour after meals instead of 2 hours after.  They would like my levels under 90 for fasting and under 140 an hour after meals (if testing 2 hours after, lower than 120).  She was impressed with my 2 hour numbers.  She went over the diet that I already started and was quite happy with it, but wanted to make a few modifications.

She would like to see me take in 2100 calories a day, 40% of that being carbs (210 grams a day).  She wanted to see the carb breakdown in the following manner (in grams):

Breakfast- 30
Snack- 30
Lunch- 45
Snack- 30
(extra snack with exercise, if necessary)
Dinner- 45
Snack- 30   

A few other things she mentioned were making sure to pair protein with any carbs.  She also let me know that if a serving has more than 5 grams of fiber that I can subtract the grams of fiber from the carbs.  She considers the following "free" foods since they have so few carbs: asparagus, beets, broccoli, cabbage, carrots, cauliflower, celery, cucumbers, all greens, mushrooms (yuck), onions, pea pods, peppers, radishes, salad, tomatoes, zucchini, lean meats, low fat cheeses, fish, egg whites (yuck), beans (black, lentil, garbanzo), soy products (yuck), avocados, nuts, peanut butter with no added sugar, oils (olive, canola, corn are preferred).

She said that even if I did not fail the test that she would recommend I stick with this diet.  I was fine with this.  I left the appointment feeling good, but wicked hungry after seeing all of the fake foods.

11:20- Got a call from my husband saying he could pick me up if I was done.  I had been expecting to take the subway/train and was overjoyed that my last draw was in 6 minutes!  Still feeling ok, physically.  Starting to get really hungry though.

11:26- Third and final test draw.  I went for the right arm one last time so I was balanced with 2 on each side.  Both arms are sore now.  :(  So happy to be done!

11:40- Husband picked me up and I ate my snacks: Kind Madagascar Vanilla Nut bar, a few whole organic wheat crackers (similar to T.riscuit), string cheese, clementine, some organic pepperoni slices.  Oh man that was the best thing I ever ate.  I started to feel a little sick after eating it because I ate so fast and then I got really sleepy.

12:30- Got home and decided to take a nap since I decided to take the rest of the day off.  I slept for 3 hours.  Very nice. 

5:00- No call from the hospital, so I guess I'll have to wait for tomorrow to get my results.  I am armed and ready to face this failure (not sure my fingers are though)!!!

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By the numbers

Sunday, January 13, 2013

So I might be jumping the gun here (or maybe not), but I went out on Friday afternoon and bought a blood glucose monitor.  When I went to C.VS to purchase this monitor, I had no idea that there was more involved than just the monitor.  I saw the O.netouch Mini on sale for $9.99 and I was sold.  I then realized that you also needed lancets for $12.79 (ouch), control solution for $10.99, and test strips for a whopping $29.49.  Oh and you only get 25 test strips for that amount of money.  The total at C.VS was $64.48 after my $6.50 in "E.xtra B.ucks".  They keep the test strips behind the counter because they are so expensive, small and thus and easy to steal (I feel for the poor diabetic with no insurance coverage that tries to go in and steal test strips only to find that they are locked behind the pharmacy counter).

The pharmacist asked if I was sure I wanted to buy the test strips without a prescription.  I told him that I wasn't diagnosed officially yet and just wanted to get a handle on things in advance.  He started making some jokes and then could tell that I was not really in the mood so he stopped.  Nothing really funny about diabetes, my friend.  Thanks, though.

I took my diabetic goodie bag home and dumped the goods on the table.  I opened the instructions and found them to be the size of a AAA map with tiny writing.  I was way too overwhelmed so I asked my husband if he would learn how to use it and then show me in the AM.  He agreed with no complaints.  Just a hunch, but I think he might feel bad for me.  He is much better with directions to complicated devices than I am.  How do old people figure out how to use these things (and see the instructions)?!

The schedule that I found for testing on most GD websites has been, first thing in the AM and then 1 or 2 hours after each meal.  I decided to adopt this pretty basic plan.  Based off of ADA guidelines the following is true: Fasting blood glucose should be 95 mg/dl or less and one hour after a meal, glucose levels should be 140 mg/dl or less. Two hours after a meal, blood glucose levels should be 120 mg/dl or less.

On Saturday morning I decided to start my experiment, already several days into my new diet.  I decided to test fasting and 2 hours after each meal since I read on one of the forums that this is what most MFM doctors suggest.  The worst part if getting my fingers to bleed enough, especially in the AM.  I sometimes have to prick my finger 4 times to get enough blood.  I have already developed a hematoma under one of my fingers.  Here are my numbers so far:

Saturday
Fasting- 88 (8 hour fast)
2 hours after breakfast- 107
2 hours after lunch- 100
2 hours after dinner- 86

Sunday
Fasting- 95 (10 1/2 hour fast)
2 hours after breakfast- 107
2 hours after lunch- 97


The only numbers that are of any concern to me are the fasting numbers, namely my Sunday fast number.  I would say that this definitely points to GD.  95 is the fasting cutoff for GD.  Seems like the longer I go without food, the higher my blood sugar.  I don't understand it all yet, but it definitely concerns me.  Normally, I only fast for about 8 hours, but I wanted to sleep in on Sunday, since I know I am running out of time to do that.  :(

So now I have my meals documented, my blood sugar readings documented, and will take the 3 hour test on Tuesday.  I am sure this will help the nutritionist out.  That said, I am fully prepared to fail the 3 hour test.  Will I still be upset, yes, but at least I can see it coming and won't be blindsided.  This is so much fun

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When it rains it pours

Wednesday, January 9, 2013

The past week or so has not been one of the greatest on record for me, so I apologize in advance for this post because it is a rant with lots of whining.  It started with me coming down with shingles (or not...I'll get to that), then me coming down with a horrendous head cold that I can't seem to get rid of, to my last MFM appointment yesterday.

Last Thursday, I had an appointment with my PCP to diagnose the weird rash on my neck that I had since NYE.  She was fairly certain that is was shingles so she put me on A.cyclovir (5 times a day for 10 days) and also on an antibacterial ointment, M.upirocin (3 times a day), in case I had impetigo or another related infection.  She also did a viral and bacterial culture on it to be sure of the diagnosis.

Yesterday morning I got a call from her office telling me that both of my cultures came back negative. The nurse said that the doctor was still fairly confident that it was shingles and I just didn't have a raging case and to continue taking the meds until they run out.  She also said I should continue the ointment, as well.  Lovely.

Now on to the head cold.  This started on Friday.  In the matter of a few minutes I went from feeling fine to feeling like I had to sneeze to being all stuffy.  I went out and bought B.reathe R.ight strips, a humidifier, and V.icks V.apo R.ub.  I know that they say you can take T.ylenol C.old during pregnancy, but I am already on so many other meds that I don't want to take anything else.  I have not slept more than an hour at a time since Thursday night.  I missed work Monday and today.  I feel like total crap.

Next I'll discuss the MFM appointment.  The ultrasound went great.  In fact, they used me and my little boy in a teaching demonstration.  His heart, brain, arms, legs, spine, kidneys all looked great.  He measured in the 63 percentile (~2.5 lbs) with a HB of 155.  Here is a pic of him (scroll to the very bottom).

After the ultrasound I went to the MFM office.  They checked my blood pressure and of course it was high as it usually is in their office, 133/66.  My weight was 139, which was better than I thought.  So I am up 19 lbs.  Then they gave me the orange drink for the 1 hour GTT and I chugged it in under 2 minutes.  Totally gross and more sugar that I have had in quite some time.

I saw the doctor and he was happy with the ultrasound and everything else.  He checked my rash and concurred that it was most likely shingles.  He explained that if it is a low level infection that your body is already fighting successfully that the culture could very easily come back negative.  He told me to continue the meds.  He said he didn't need to see me for another month and that was that.  I then peed in a cup (as per usual) and once the hour was up I got my blood drawn.

This morning I had a message telling me that I (quite miserably) failed my 1 hour GTT and to call and schedule a 3 hour test.  

GTT Screen (GLT): 163 (Normal Range = 54 to 139): OUT OF RANGE

After another night of no sleep and another day of calling in sick to work this was just too much for me to handle.  I called my mom and sobbed to her.  Half the time she couldn't tell what I was saying.  I was embarrassed and upset.  I eat so healthy 99% of the time.  I don't drink soda, ever.  I NEVER eat fast food.  I eat so little processed food and what I do eat that is some what processed is usually organic.  I eat a very high fiber cereal at breakfast.  I eat lots of fruits and veggies and I was of a healthy weight when I got pregnant.  Up until I got sick I have been exercising 4-5 times a week with 2-3 mile walks and some light weight-lifting.

I seriously feel like a failure.  What did I do wrong?  I called the nurse to set up my 3 hour test and they forced me to schedule an appointment with the nutritionist as well.  She told me to stay away from food products where the first ingredient ends is "ose" and simple carbs and to "start eating healthier".  I started crying on the phone with her because I already do that.  My friends make fun of me because I eat so healthy.

I told her that I already eat healthy and exercise and that I haven't gained an obscene amount of weight.  I think she felt bad for me because she could hear how congested and nasally I was.  She told me that she sees 300 lb women pass the test with flying colors and 90 lb vegetarians fail miserably.  She said it doesn't have to do with weight, but how your body handles sugar during pregnancy.  Yeah, yeah, yeah.  That didn't really make me feel better.

So now I have to further restrict what I eat.  No more cereal or wheat crackers for me.  Back to the lovely world of constipation.

I have spent my day feeling down and miserable.  This cold is kicking my ass and now I have to worry about diabetes, too.  How is it that some women get pregnant by sneezing, share their wet pee-stick with their 5,000 FB friends, buy nursery furniture before 12 weeks, eat McD.onalds every day, don't exercise, and have completely healthy babies (over and over and over again).  Then others have a hard time getting pregnant and have problem after problem during their pregnancy?  It isn't fair.

Sorry for the vent and kudos to you if you read this whole thing.  I am not feeling great today.  Hopefully tomorrow will be better.

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