20-10-2009 - And the medical condition of the day is........Gestational Diabetes

My mood while writing this blog: yipee - its official- not going passed 38 weeks!

Quelle surprise! I failed my Glucose Tolerance Test spectacularly, so was carted off to hospital today to be put on insulin.

I saw a gestational diabetic specialist midwife (bit of a mouthful), she sorts out all the diet, meds, liaises with the consultants, calculates how much insulin you have drip-fed to you in labour, aswell as being a specialist in delivering the whoppers/toddlers that Gestational Diabetes causes.

She was a bit miffed that when I started spilling ketones out all over the place at the beginning of summer, that I wasn't looked after more carefully as it was a clear indicator that my body wasn't producing enough insulin. Just because someone has a higher than average BMI doesn't mean that they dont deserve careful looking after, nor does it follow that a fat mother is deliberately using her unborn child as a method of liposuction to make herself thin.

In hindsight, I should have been put on Metformin tablets which could helped kickstart my body producing more insulin especially considering the extended period of bedrest that I intially had to have and it may have lessened the severity of the other complications that I have had to get on with.

She had a look through all my charts, and is going to come and find me next Wednesday after I have had my next growth scan. She reckons that if I knuckle down with the insulin and be super strict, I can hold his abdominal growth steady at 42 weeks on Wednesday's scan (allowing for growth since the last scan).

She is has prescribed me a combined long and short acting insulin in one syringe, which I will take 10 minutes before my breakfast and evening meal. She is hoping that with the insulin I am taking, 3 square meals a day, plus 3 snacks in waking hours (including my chocolate milkshakes!) I should be able to avoid the 2am and 5 am breakfasts and keep myself on an even keel without feeling like I am being eaten alive by ketones from the inside out.

My glucose monitor can also accept sticks for measuring ketones. When I attend hospital on Wednesday, if there are still any ketones in my urine she will add ketone sticks onto my prescription and show me how to calibrate my meter for those, and tweak my insulin levels at the same time.

Because DH is diabetic, it made a nice easy session for her as I knew how to use the blood monitor, blood prickers and injection pens. Once she saw me inject the squishy practice ball with saline like I had been doing it all my life, she asked me if I had given thought to where I might want to inject the insulin.

I told her I was very reluctant to inject into my abdomin, one because its so large but the skin has gone very thin and shiny, but also I didnt want to risk it going grainy and lumpy using the same site over and over. I said I favoured my thighs and arms, although not very convenient if eating out.

She said that I still have enough fat to inject my butt! or on my sides between the ribs and hips. DH was twitching in his seat, ready to leap in to offer to inject it for me! Yep, I could squeeze a little bit between ribs and hips, so I pumped in my first 10 units in there all by myself, no leaks no fuss. I could barely feel it even though I dont like needles. As she was happy with my technique I didnt have to stay for hours and hours, so we covered off how dealing with my potential hypos differs from DH's and how to ramp up my insulin to get best results to keep Zach out of the Guinness Book of Records for largest baby!

Best news is she said Zach will be born by fair means or foul by 38 weeks, but given everything else I have to contend with and his size, the risk of shoulder dystocia is very great, and in her opinion it would be foolhardy to attempt a natural delivery even with all the special manoevers that she does day in day out for these large babies, as she believes that it would almost certainly result in him having a shoulder fracture, if not something very serious such as Erbs Palsy, and cervical tearing and haemorrhage for me.

She will make her official recommendation on Caesarean as the preferred delivery method on Wednesday once she has seen the growth scan result, with a follow up appointment on 5th November when I will be 36 +2. Once I get to 5th November, she has promised me that I will have the baby within that fortnight.

I can't wait to hold Zach in my arms, the end is in sight at last!

Lots of contraction dust and labour dust to us all

xxxxxx