You Wouldn’t Like Me When I’m Angry.

  So I’ve mentioned a couple times this week some ongoing medical stuff that has been making me…cranky.  I thought it was time to share what’s going on.

  Last Friday morning I got a phone call from my OB’s office about some blood tests I’d had done.  If you’ve never been pregnant you may not know, but at a couple of different times throughout a pregnancy it’s standard to do blood draws and check levels of certain things.  As you enter the third trimester there is a blood test to check for, among other things, gestational diabetes.  If you develop it and don’t control your blood sugar, it can lead to excessive growth of the baby and other complications.  Turns out, my results had come back positive…and an exceptionally emphatic positive.  A flurry of phone calls ensued with them setting up appointments and having diabetes supply companies contact me for a blood sugar monitor, ect, ect, ect.  It was overwhelming and frightening to say the least.
  Once the phone calls died down and I had a moment to think though, I realized that those results didn’t make a whole heck of a lot of sense to me.  The following is the list of requirements which, if you meet all of them, you can be considered to be so low risk that they don’t even bother testing you:
You’re younger than 25.
Your weight is in a healthy range.
You’re not a member of any racial or ethnic group with a high prevalence of diabetes, including people of Hispanic, African, Native American, South or East Asian, Pacific Island, and indigenous Australian ancestry.
None of your close relatives have diabetes.
You’ve never had a high result on a blood sugar test.
You’ve never had an overly large baby or any other pregnancy complication usually associated with gestational diabetes.
  …I’m 30, so obviously I don’t meet that first one, but I meet every single other requirement…  There are other, additional risk factors that could up your chances, such as high blood pressure or a previous pregnancy with gestational diabetes…but all of those are so far from applying to me it’s laughable.  My results on this test when I was pregnant with G were exceptionally low, and when I had fainted 2 weeks before and they had tested my blood sugar at the hospital it had been in a perfectly healthy range despite my having just eaten a handful of candy.
  I asked to do the test again.
  …this is the last point that I spoke to anyone in my doctor’s office beyond one specific nurse until my appointment, a week later.  That nurse has been a huge portion of my frustration with this situation and I will absolutely be taking measures to be sure that her employers know that I feel her behavior has been unhelpful and unacceptable, but I don’t want this to be a rant about one person doing their job poorly.  It’s the bigger picture that concerns me.
  I took the glucose-screening test a second time…as if it wasn’t miserable enough the first time… heading to my local lab early Saturday morning so I’d have fasting results (usually lower) and have them as soon as possible.  The paperwork that was supposed to be sent through Friday afternoon had not been called in and so I had to wait for the call center to find and push it through.  The lab told me the results would be ready that afternoon.  It was 2pm Monday before I heard from the nurse, despite the fact I called their office as soon as they opened that morning.
  My levels came back even higher.
  So I left my appointment with the nutritionist scheduled…called the diabetes supply company and confirmed my order…and basically said “now what?”  The response was “wait”.
  …now, I don’t know about you folks, but when I’m told that there is an issue with my health, I want to act on it RIGHT then, like, that instant…not ten minutes later, certainly not a full week!  I was given absolutely no information, no direction…nothing.  Essentially an implication that I eat poorly (which I found extremely insulting) coupled with no guidance.  So I hit Google.
  I researched and the more I found, the less made sense.  I’ve still been struggling with what at least seem to be episodes of low blood sugar leading to dizzy spells…haven’t gained any more weight than I had at this point with my pregnancy with G…haven’t had an increased appetite…already follow what I was finding as the recommended diet…and on and on.
  I called the office, was redirected to the troublesome nurse and was essentially told “you’re fainting because you’re pregnant, it’s expected” (NOT true, and if it were there’s no way I’d have been held at the hospital for over 5 hours after my episode!) and “there’s no possible way your blood sugar is low”.
  After being given no directions and being left to twist in the wind I was basically being called a liar for calling to ask about conflicts in information I was finding.
  Again, this is mostly a problem with one person, but I do think it’s somewhat indicative of an overall issue with medical treatment.
  My appointment with the nutritionist was Friday afternoon.  She laid out a diet plan to “keep carb levels low” and hopefully keep my blood sugar on an even keel.  It took me all of about 30 seconds to recognize that there was no way I was taking that many carbs in during an average day, even if I used the low end of the spectrum she laid out…and I said as much.  We discussed my fainting and she said that coupled with my diet being lower in carbohydrates, it was possible I was experiencing hypoglycemia (low blood sugar) and that it should be something we kept an eye on.  She was very respectful and responsive, helpful and professional.  The problem cropped up when we started talking about grains.
  Part of what the nutritionist gave me was a list of common foods and the grams of carbohydrates usually found in them, so I would be able to tally up what I was eating and try and keep it close to the levels they were suggesting for me.  We were discussing how to tally foods that weren’t on the list, reading the nutrition labels and what not when my Mr. brought up high fiber foods.  Certain kinds of fiber can’t be digested by the body, so obviously they aren’t going to effect your blood sugar, but those are still added into the overall carbohydrate percentage on the labels.  These are in things like whole wheat breads and pastas.  The dietitian’s take was that if there was something that was like that, then we should subtract the fiber, but that “not a whole lot of what people eat is like that, so it’s not really something we pay attention to.”  …we don’t eat bread that’s not whole grain and I do my best to only buy whole wheat pasta.  That means that carb intake score that I tallied in my head?  The one that was too low?  It was, in actuality, even lower.
  Being diagnosed with gestational diabetes is annoying.  It means I have to take my blood sugar 4 times a day (all my levels have been nice and low so far, btw) and that I have to kee
p a diary of everything that I’m eating for at least the next week.  It means that I now have a big, red “watch this one” mark on my chart, and it means a lot more red tape.  But what’s really scary is how the whole thing has been treated as if there’s only one way this could come about and one set of behaviors around it.
  I understand, I’m unusual in being thin, with low blood pressure and actually following the guidelines that say “eat more whole grains, eat vegetables, eat fruits, drink water!”, and that doctors and nurses are used to seeing people who struggle with their weight and fight against giving up their Coke or their Pepsi or their Wonderbread…. but it’s terrifying that when I say “I do those things, and I have complications anyhow” that the standard answer seems to be “you’re lying”.  
  This will be fine.  I’ll use the blood monitor to reassure the office my levels are never above where they’re comfortable with them and I can see if low blood sugar is causing the fainting spells.  If it is, I’ll know for sure that I can “fix” them by snacking more.  But it doesn’t seem like it should be this much of a fight to find answers that accept that I may, in fact, be following the recommendations the medical community makes.  I understand why the assumption is that “nobody” eats whole grains, but it’s concerning to me that it’s such an assumption that they’re not even discussed.  I understand why the assumption is that I couldn’t possibly have low blood sugar while also having a type of diabetes (and not taking insulin)…but it turns out it’s perfectly possible that I do.
  I don’t have an explanation for why the results of my glucose screening came back so high.  Neither do the doctors.  Nobody actually knows what causes gestational diabetes.  What I did know was that further lowering the carbohydrates in my diet sounded like a really bad idea to me when I was already having issues with what seemed like low blood sugar.  Because I had the misfortune of only being able to get in contact with the one nurse I was left in a position where I was essentially being told that regardless of what I felt, I was going to have to lower them or hurt my baby.  That wasn’t true, and thankfully I didn’t make any real changes to my diet before talking to the dietitian…but I struggled through the entire week, worrying about every bite of bread I took.
  The assumption is that you’re not healthy and that you’re not trying.  It makes being an advocate for yourself incredibly important if that isn’t true (and even if it is!).  Doctors and nurses are people, and so of course, they make mistakes and sometimes they fall into routines that they shouldn’t, as every human does…so be kind, but ask questions, and ask for retests if your results don’t make sense, and don’t let yourself be put off with statements of “that’s normal” if it shouldn’t be.
Updated:
  After about 24 hours of forcing myself to mow down (even the low end) of their recommended number of carb grams I felt terrible, was forcing myself to eat when I wasn’t hungry to try and fit everything in…and spiked a high blood sugar number.  Am now back to following my usual diet (making sure I don’t ever go above their suggested number of grams at any one meal of course) and seeing what happens.  Dinner and first-thing fasting numbers were both improved with this approach, we’ll see how it goes for the rest of the week!
IMPORTANT: If you’re pregnant and follow a low carb diet, please click through and read.
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