The Broken U.S. Medical System

So the latest in my gestational diabetes debacle, I was seeing Irina Norovsky at Sutter Health in Vallejo, she works under Dr. Anat Sapan, Obgyn. I felt that I was not going to get the birth experience I was after and I really didn't like the maternity ward there. So I did a lot of research and really wanted a midwife, because I believed I would get what I wanted and since my insurance does not cover home births I had to search for a midwife that was affiliated with a doctor's office. I left Dr. Sapan's office and started seeing Debbie Coleman, N.P, CNM in Oakland, California. I thought that by seeing her I would finally have the care I wished for. I didn't leave Irina's care because she sucked in any way I just didn't want to give birth in Vallejo, and I wanted a natural birth with little to no intervention. And on the plus side my husband was born at Alta Bates in Berkeley so by going through Debbie Coleman I would be able to also give birth at Alta Bates.

So as you know from my last post, upon seeing Debbie and telling her my A1c results that were given to me at 5 weeks of 5.8/120 she immediately said to me that they consider that diabetic at her office. So she then referred me to East Bay Perinatal Associates, and a genetic counselor because my sister has had kidney issues. I go to see the cunt (genetic counselor) first at some other perinatal office, and this woman can't really tell me what causes kidney issues, and that many genes are involved. She then says since you have GD you may have had diabetes before you were pregnant so your son could have a congenital heart defect. She then goes over the nuchal translucency results and the blood work saying that my son is better than normal, yet she still goes on to suggest an amniocentesis, I immediately refuse knowing that it can cause early labor. the bitch then tells me "Yes I always tell my patients to have the amnio before 25 weeks, because after 25 weeks if you do go into early labor there is a chance your son will survive and he will be severely retarded"

I could not believe she was suggesting this to me. And on top of that she was a complete bitch to me. She then says that from my ethnic background (i'm Italian) and your husband's background (Italian, Syrian, Irish and German) there is a "chance" that you could both be carriers of sickle cell anemia. Mind you I have 31 cousins on my mothers side and 7 on my fathers side and NOT ONE PERSON IN MY FAMILY has sickle cell anemia or Thalasemia and the same goes for my husband's family. So then she suggests that we also get tested for that and that my son should also have a fetal echocardiogram since I "may" have had diabetes before I was pregnant even though NO ONE in my family has diabetes except for my granddad who developed diabetes when he died (on my fathers side).

Now this isn't even the craziest part of my pregnancy, I was quite defensive of the whole stupid A1c results since the day I received it. I strongly doubted I had diabetes before I was pregnant because my BMI when I found out I was pregnant was 18.2, a number that does not even appear on those ridiculous growth charts, and I eat a really clean diet. And by clean I mean organic, no heavily processed food, and I cook food AT HOME using fresh ingredients. I grew up on a mediterranean diet and my mother grew her own vegetables, I have always been WELL NOURISHED since birth.

So I continue to see Debbie, I think I saw her one more time before she referred me to East Bay Perinatal Associates. So I go to see them two weeks ago to talk and see their nutritionist and a high risk Obgyn. My husband and I go together, both of us are fit people my husband looks amazing and he works out every day, plus he eats my home cooking. We go into her office and look at the fake sample foods she has on her desk all heavily processed shit, not one product is organic and most of them has some sort of corn derivative (i.e. maltodextrin). I haven't been eating any food with corn derivatives in it for some time now, since before I got pregnant. My husband and I were amazed that this would be the person who would be telling me how I should be eating.

She comes in and I am armed with information, I have read the HAPO study (which caused the guidelines for GD to be altered this year), I read blogs, and other research articles regarding GD. The thing is there is very little knowledge regarding GD. And although the HAPO study was well conducted I do not think that 26,000 women is representative of the 3.5 billion or so women that live on this planet, their dietary history, genetics, nutrition, or body type. And although there was a correlation between GD and birth injury the correlation was not significant. And birth injuries occurred in women who were not even diagnosed with GD. Furthermore, macrosomia (or large for gestational age infants) has been found to be much more closely related to the weight of the woman before she got pregnant, i.e. obese women.

Now having said all that, there is something left to be desired by the medical establishments need to intervene in the body's of pregnant woman and their future offspring.

Now back to the nutritionist's office, armed with knowledge about GD it was clear that even she was uninformed and that her information came from the higher ups or studies conducted and funded by government bodies, such as the diabetes association. So after showing her my excel spreadsheet of my glucose levels she recommended that I take some sort of diabetic drug, namely Glyburide and/or insulin. After telling me that my baby would get huge, and that my fasting blood sugars should be below 90 she convinced me that I needed to be on medication. After her appointment I saw the Obgyn, and she gave me two weeks to lower my FBG. So in those two weeks I tried many things to lower my morning glucose levels. They wouldn't go down at all. I still wasn't completely convinced and my husband believed it was complete and utter bullshit. He was absolutely against me being on insulin or glyburide. Mind you, insulin does not cross the placenta, however, I have no idea what the long term affects of taking insulin when you do not need it would have on my body post-pregnancy, and glyburide freely crosse the placenta, and although in small amounts, there still has been no longitudinal studies conducted on what affects taking glyburide has on a developing fetus.

I questioned both of these, so I call Debbie Coleman and asked her if she can organize another A1c. She said that she new about my high fasting blood sugars and said that she could no longer see me because I was now considered "high risk" and that from now on I would be going to East Bay Perinatal for my prenatal appointments. I couldn't believe they were classifying me as GD with only one test and with a glucometer that is known to have a 20+/- error margin.

So then I decided to go back to Irina and tell her what was going on, and at this point my husband and I had already decided to go for a birthing holiday to Australia (where I am from). I tell Irina everything that I had been told. She said you FBG has to be below 100 every morning because after 30 weeks the baby gains a lot of weight in the brain, and if he has too much glucose, all of that extra glucose goes straight to his head making him difficult to deliver. She said after 37 weeks he starts to gain about 8ounces per week before delivery, which may make him too big for delivery. Here at this office we will induce you at 38 weeks (it was the same scenario at East Bay Perinatal). In her office however, they do not prescribe insulin but they do prefer to give pregnant women glyburide. After the appointment I was even more confused about this whole mess. Was I making the right choice by going to Australia and not taking medication. Would my high morning sugars result in an enormous baby. All these questions were floating around my head dizzying me. I then finally go and have another A1c, and I leave the office hoping that it isn't super high.

Two days later I get my results and low and behold they are 5.4, which is what is considered to be normal. if I hand't missed my appointment for the perinatal fucks in Oakland I would probably have been convinced to take insulin. What effects this will have on my body would have remained to be seen. My hypothesis is however, that if you introduce a hormone that doesn't need to be introduced into a healthy body, there will be adverse affects in the future, such as onset of type 1 diabetes.

Now take this information ladies and do with it what you will, my decision is based on my gut feeling that nothing is wrong with me, and my pregnant body is doing what it is supposed to be doing, and that is to feed my baby.

So now my husband and I are due to leave for Australia in 10 days, because the medical establishment here strongly believes that my body is incapable of doing this because they have lumped me in with the hugely obese women or with women who are extremely undernourished.

One good thing that has come out of this, during my pregnancy I have watching what I eat and have gained the weight that I was supposed to be gaining.

Pregnancy progression Photos Thus Far

Gestational Diabetes

I don't know how other women handle the news that they have pre-gestational diabetes or full blown gestational diabetes. I was extremely shocked because other than eating fruit, the occasional dark chocolate, and one teaspoon of sugar in my coffee I am not really in to sweets. Not to the point where it warrants me having GD. What I found most amazing about this prognosis was that all I got was an information sheet on how to eat "properly" according to the American Heart Association's equivalent of what a healthy diet should be. I strongly disagreed with the ridiculous food pyramid which requires an absurd amount of fruit, and carbs, and other nonsense. I have always eaten a very clean diet. My ancestry is Italian and we pride ourselves in eating healthy.
Since the prognosis I took my blood sugar every day. And wrongly might I add. I was under the impression that you test you glucose level 1 hour after you have finished eating, instead the hour begins as soon as you commence eating. So for the past 5 months I had been taking it the wrong way, I guess that is what happens when you try to teach yourself something that a nutritionist or a doctor is supposed to teach you. I just figured that the nurse practitioner was over worked and really had no time to explain how to do it correctly. Nevertheless, in month five of my pregnancy I decided to cut out carbs in the form of bread, pasta, rice, grain, and potatoes and I also limit my fruit intake to 1 and a half pieces accompanied by a fat like cream or ricotta. I figured early on that the carbs actually converted to sugar, I may as well have been eating a bag of lollies. Since then my blood sugars are pretty well under control. Below 100 fasting blood sugar, and way below 140 post meal. The numbers pretty much depend on what I eat. But I figured out what causes the spikes. If I followed that ridiculous food pyramid there was no way that my blood sugar would be this low. My recommendation to anyone that is told they are on their way to developing GD should immediately cut out carbs and sugar (including fruit, only have 1 piece a day) increase their good fats (butter, olive oil, cream, coconut oil) and mix the food up, for example one protein, two veggie. 
One thing I have learned from this pregnancy is that the pregnancy process is highly medacalized here in the United Stats it is considered to be a condition. There is so much intervention during pregnancy that I began to feel impotent, as though I should just surrender my rights as a human being and let the American medical industry make all the decisions for me. Sooner or later women will have no control and we will be told to stay in bed the whole 9 months while being fed intravenously by some pharmaceutical company's new pregnant woman formula, and what they consider is best for the baby. What is more surprising is that when I changed providers from an Obgyn, to a midwife she said that my A1c levels are considered to diabetic not pre-gestational diabetes. So who the fuck is right and who doesn't know shit. Then After that I get told that I could have had diabetes before I was pregnant and didn't even know it which means my baby could have a defect, so now they want me to have a fetal cardiogram to check his heart.  I think I will say no, because I am already half way through so what could they really do to help at this stage? Lesson learned, no one is informed and no one knows anything.

Bleeding during pregnancy

I remember that morning so well, it was around the first week of June on a Sunday. Our new kitten was not adjusting well to the new environment and he had terrible diarrhea. I said to my husband we need to take him to the vet because he is not getting better. So we take him to the vet and get the preliminary bill. A whopping $400! My husband was livid, but we both new that our kitten was sick and needed the care. Still  my husband was so stressed out and I in turn got stressed out. On the way home I start bleeding heavily as soon as we round the corner to our street. I jump out of the car and run to the toilet, and immediately start freaking out as a light pink liquid gushes onto my underwear. I start crying "Did I do this?" "What did I do wrong". My husband grabs me and puts me in the car, we rush to emergency. We immediately get put in a room away from all the other patients. Hours pass by as they poke and prod me, and send me for ultrasounds. I am thinking that I have lost the baby. After 5-6 hours in emergency we are told that it is a placental abruption meaning that the placenta had torn away from the uterus. The nurse who was so kind to us asked "Did you guys have sex?" We had, actually the night before, maybe a little too rambunctiously. She then told us that the same thing happened to her and that it was extremely common. So as it turned out we freaked out for nothing and I wish I had just waited and stayed home, especially since I had no cramping or any other pain especially when you have to pay a $150 copay to visit emergency. But seeing that this was our first experience with pregnancy we naturally thought the worst right away. Lesson to be had, don't panic. 

The Stress of Being Pregnant

When I found out I was pregnant I really had no idea bout the amount of warnings and crazy crap that littered the internet. I had no idea that toxoplasmosis existed or what it was, which was scary because the week I found out I was pregnant I was due to get a new kitten. After stressing out like a crazy person I found out I was immune to the parasite having been exposed at an earlier time before pregnancy. Plus your cat can only get it if it goes outside kills an animal who has it and then shits in the kitty litter box in the house, then shedding the parasite over the next few weeks. My kitten has been an indoor cat ever since and had no weird parasite, which after weeks of stressing turns out didn't matter anyway because I was immune.
I did not know you must avoid pretty much every food because it may harm the baby. Although our pregnancy was planned, I had not planned on being confronted with all of these stressors and worries. Many pregnant women may also go through stress and worries in pregnancy or maybe they won't, I discovered that for me personally pregnancy is bloody stressful. I thought it would like movie magic, that the whole time being pregnant would be perfect bliss. Instead for me, because I am a bit of a hypochondriac I tend to worry about every disease and problem out there. Being pregnant has made me more fearful. Throughout the first trimester I had incredible morning sickness, yet I did not vomit. I only vomited  twice. The first time was because I ate a mixture of scrambled eggs, olives, artichokes and who knows what else. It didn't go down too well. The second time I ate canned tomato soup and shortly thereafter I felt so ill and vomited again. Other than that my morning sickness felt more like a my stomach was doing the rinse cycle of a washing machine. Not fun. Below is my very first transvaginal ultrasound to confirm pregnancy, as you can see there is the egg yolk sack, yay confirmed pregnancy.

This is me at about 5 weeks

I pregnant!

Well I found out I was pregnant on the 10 of May, after about 3 months of trying and thinking that I couldn't get pregnant. When I finally did pee on the stick I saw those two pink lines and was rather shocked because I had convinced myself that I probably couldn't get pregnant since I was 33 and getting on. But looking at the pregnancy stick I realized that I actually could get pregnant and that I actually was pregnant,. Which as you could imagine shocked me incredibly. As soon as I found out I sent a picture of the pregnancy stick to my husband and I asked "I think I am pregnant". So finding out was a shock even though we were actually trying to conceive. Then began the task of finding out what I should and shouldn't be doing. That Sunday I smoked some pot and felt incredibly guilty, because after those months of frustration I honestly couldn't believe that I could actually do it. So then began the process of preparing for baby. Or at least mentally preparing for baby.