Gestational Diabetes Update

(Copied directly from an email sent out to family)

Today I met with Dr. Howard Schwartz. Apparently this guy is UBER popular. I got to my appointment at 1:10 (to be seen at 1:15). The waiting room was about half-full of sleepy looking pregnant ladies. Turns out Dr. Schwartz was running late... REALLY late. 2 and a half hours late. The curious thing is that not ONE of his "regular" patients opted to reschedule. We all just sat there and waited for our time to come. My time came at 3:20, at least my time to leave one waiting room for the comfort of a more secluded waiting area. I probably was not seen until 3:45.

Even though he was running behind, Dr. Schwartz did not "short change" me on my appointment. He took plenty of time to explain things to me.

Essentially, I am an unusual case (are we surprised?). I am not a "regular" gestational diabetic as I can get my blood sugars under control while I am awake. However the night-time/fasting numbers are too high (even with exercise) and I am going to be on a nightly injection of insulin. This unusual situation puts me in a "gray area."

Dr. Schwartz has yet to decide if I will be co-managed by the midwives and himself, or I will be absorbed into his patient load. I am guessing it depends on how I respond to insulin, and how compliant I am with the diet and exercise recommendations... Though there is probably some other factor I am not taking into account that could affect our care...

Anyhow, because of this "gray area" I have some ability to decide what I want to do. He does want me to get regular testing. He recommended Contraction Stress Tests weekly or Non-Stress Tests bi-weekly. You can read about the in the links provided, however, in a nutshell CSTs test the placenta and contraction and NSTs test the womb. Dr. Schwartz leans toward the CSTs because they give a more accurate understanding of the health of the placenta. Diabetes is a disease of the small blood vessels and the placenta is a giant web of small blood vessels. I have not decided what I am going to do just yet. More research, then I will decide.

It is common with diabetics to "take the baby" early. Meaning that at about 37 weeks, they will start testing lung function (in the baby) and I may have to be induced, or have c-section. Depending on who I am seeing at that point, induction would be my intervention of choice. A baby is technically full-term at 37 weeks, so I am hoping that she will be ready to go at that point, and perhaps she will start things on her own so I will need as little hyper-clinical attention as possible.

Overall, things are fine. Baby Bradshaw is in the 60th percentile for weight at this point. Amniotic fluid is adequate. She appears to have a little hair (according to the ultrasound).

I am doing well, though I am tired. My hope is that the addition of insulin will help and I will not need any further medical intervention. So, here is hoping.

Either way- we have 6 to 9 weeks before we get to meet the squiggle. Wheee.