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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.
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.
