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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

to refuse this test?

90 replies

toddlerama · 13/02/2012 15:53

I'm 28+ wks pregnant and measuring 33. By my own dates, I'm actually 30 weeks, but whatever.

I have been asked to make an appointment for a glucose tolerance test which I have declined to do. My midwife isn't worried, but my consultant just shuts me down and states "make the appointment". Wont discuss it at all.

My reasons for declining it are these:

They want me to spend 2.5 hours at the hospital for it. I can't go home and I can't bring my children (aged 3 and 4). No negotiations on this, and I have no childcare available.

I will be having my 3rd elective section. My understanding is that the biggest risk relating to gestational diabetes is "a big baby". So what? I don't have to push it out. My last 2 were 9 and 10 pounds respectively. I know I'm having a big baby. This isn't news.

Because my last 2 measured large, I had the GTT with both of them. Negative both times. With DD2 I actually had to have it twice because they couldn't believe I was having a child that size for any other reasons.

The fasting nature of the blood test means I will be vomiting into the cardboard bowler hat until I can eat and drink again (from waking up until after midday if previous waits are anything to go by).

I can only have blood drawn from the back of my hand. The vacuum-tube things don't work as they pull too fast and I have to have it done with a manual syringe and squirted into the tubes afterwards. They can rarely get enough for what they need. This is due to really low blood pressure/crap veins/genetics - my mum and grandfather have the same issue. My sister has had to have it drawn from her ankle, so could be worse....

Because it's so hard to get into the vein, at my last section we nearly reached an impasse as my hand veins were so scarred on both sides they couldn't fit a canula. I don't know what would have happened if they hadn't called in another anaesthetist. I had one hand split right open and the other no-one wanted to try in case it happened again. They just stood there looking at each other. Another guy poked his head round the door, yelled at them, made the original anaesthetist stand in the corner (!!!) whilst he did it. Thank God he turned up, but honestly... I don't want to have any blood work I don't absolutely need because of this. I don't want a repeat performance. I want my veins in tip top shape on the day.

I have to have the 28 wk bloods done asap anyway, and I think 3 blood tests in this space of time is going to cause the same problems.

I invariably faint when they take blood. Don't know why. Just fade out as it goes on. I don't want to. It makes me feel sick and then I have to drive home all woozy.

I have no symptoms of diabetes at all. Except the big baby, which I always have!

Sorry for the epic post but I'm trying to articulate all the reasons to give a full picture. I don't just 'think I know best' (well, maybe a little bit ) but with these factors, would you bother?

OP posts:

flyingspaghettimonster · 13/02/2012 17:24

Your body, your choice. I refused the test you are talking about and got nagged and moaned at by the consultant. I Tod him politely and firmly that I had none of the symptoms for gestational diabetes and was having a c section so would not do the test unless I deemed it necessary. They were grumpy, but backed down.

If I did everything hospital folks told me to my son would be circumcised and would have spent the first few days in the nursery rather than bonding with us. Doctors have very strange ideas sometimes!

theDevilHasTheBestMNNames · 13/02/2012 17:33

Well I did ignore a consultants advice as he was talking absolute crap about conditions I had no risk factors for with a clear agenda and no consideration about my actual circumstances and actual risk factors and had a home birth but I wasn't under him and transfered to another MW.

I'm not sure if they can get rid of you if you don't take their advice. Is the consultant really that good though if they are saying just do what I want with no discussion?

BagofHolly · 13/02/2012 18:03

I could be wrong but isn't a Hba1c an alternative? Still a venous sample but more indicative of long term control. You can't actually diagnose or discount GD on a capillary sample (fingerstick) IIRC.

DamnBamboo · 13/02/2012 18:06

No. Hba1c takes weeks to change (fairly long half life). If you want to know about the glycaemic excursion, you do need glucose tolerance testing.

It's not that useful in this case.

Panzee · 13/02/2012 18:06

If you're having a section, where are they going to fit your canula?

Panzee · 13/02/2012 18:08

Also, I have had the GTT. I sneaked off home in the middle (I live very close and nobody said I couldn't!) I thought it was going to be horrendous not eating but it really wasn't. They did the finger prick for the 'before' reading but a full one after - but I think I was due a blood test anyway. Does this mean that the finger prick can be used for both?
The diabetic child in my school does finger prick for her readings, surely if it's good enough for her it's good enough for you? :)

Try not to worry about the 2.5 hour wait, it's not as horrible as it sounds (if you can escape somewhere anyway!)

TheGrandOldDuke · 13/02/2012 18:09

In our area y ou don't go to hospital at all. You drink the lucozade at a set time before the blood test, then go to your GP for the blood test. Smiles. Tell your GP you'll do it this way, thank you very much. Absolutely ridiculous they won't be more flexible.

I know this is at odds with what I first posted, but like you, didn't know the risks of GD!!!

TheGrandOldDuke · 13/02/2012 18:09

Simples! Not smiles. Predictive text, grrr!

Panzee · 13/02/2012 18:09

Sorry ignore my canula question. I've read your OP properly again (I knew I'd missed something but couldn't work it out!)

EdnaClouds · 13/02/2012 18:26

I got GD with dc 3. It was well controlled but after dd was born she had to spend a few days in special care as her sugar levels were all over the place, she was not well at all.

Have the test. For your babies sake.

Gwlondon · 13/02/2012 18:30

The risks I know about GD are big babies and poorly functioning placentas. There are two problems with a poorly functioning planceta; head sparing, the babies head grows well but the organs don't and secondly the birth is more risky because the placenta is not coping well. I have no idea how early they would induce you if they were worried though. Also you are having a CS already so no idea if they would bring that forward.

I reckon go back to the consultant if you can, and ask more about all the risks and possible complications. I think ask for help with childcare from the family member you help or you mum. Get them to come to the hospital with you? I think it is worth the hassle to have the test but you need more info.

Gwlondon · 13/02/2012 18:30

Can you ask your other half to take a day off?

EdnaClouds · 13/02/2012 18:35

I was induced at 38 weeks because of GD. Because of the excuse fluid in my womb caused by the GD dd had a lot of room to move about and managed to get herself wrapped up in the cord. I ended up with an emergency section and dd was flat when they finally managed to get her out. Thankfully the excellent nurse got her breathing again and she's now a happy 2.5 yo.

Original poster

toddlerama · 13/02/2012 18:43

Thanks to those who shared their experiences. I have had the test twice before in previous pregnancies. The GP surgery wont do it because they can't get my blood, only the blood clinic at the hospital will try and they wont let me leave in the middle. I went home in between no problems the last times. I think my mum probably would make the drive if I really needed her to, DH started a new job in January and as a result has no paternity leave and very limited annual leave available. We were hoping to save it all for post-section. The practicalities could be worked around at a push. Pain in the arse, but probably solvable, even if I end up using sitters.co.uk, but the damage to my veins prior to the surgery is a problem and I don't want to chance it. The consultant just ignored this entirely and I wish she had seen what went on. It wasn't a minor inconvenience. No-one knew how to proceed and it was bloody disastrous. DH doesn't want me to have it for this reason alone. We don't know whether the caesarean could go ahead without the canula, but what's the alternative?? What would happen??? My sister had to be put out with gas and woke up with the canula fitted. Apparently when she was unconscious, it was easier to get in, but she didn't have any scarring issues. Just small veins, low blood pressure. GAH!!

OP posts:

YellowDinosaur · 13/02/2012 20:21

Surgery couldn't go ahead without some sort of venous access, a canula being the most straightforward. There are other, more invasive, ways to get venous access if a canula is a problem. The reasons you could not have your section without it is because hard as it is to get one in it will be harder if you bleed excessively because your veins collapse. Having an epidural also causes your blood pressure to drop, sometimes quite significantly, and they will need to give you inttravenous fluid to counteract this. (Doctor in a surgical speciality not obs / gynae)

In your situation I'd be pushing for another consultant appointment asap to go through what actual difference it will make to get a positive result in your case. You are already having a section at 38 weeks - if there is no other interventions they would make then you may decide there is no need or you to have the test, especially with no hard signs of GD. If there is, or there is a risk to your baby through not knowing, then you may be swayed - like you say all the inconveniences can be got round if necessary.

Good luck with whatever you decide

GrahamTribe · 13/02/2012 20:25

As someone who has refused the test in her pregnancies YANBU. I would be furious with any medical staff who went beyond advising me to have any treatment but then shutting down and repeating "Make the appointment" isn't advice, is it, it's rudeness bordering on wankerdom.

NatashaBee · 13/02/2012 20:34

This reply has been deleted

Message withdrawn at poster's request.

thebabywife · 13/02/2012 20:36

You don't have to have it. You will be having a section before 40 weeks anyway, so the risk of stillbirth due to GD is minimal. The treatment for a baby born to a mother with GD is to feed it - which is what you do with all babies - so there is no need for them to know for sure one way or the other. The GT Tests are all flawed anyway - Sarah Buckley wrote a great piece about it and she's a bloody doctor. I would say no and don't let them beat you down

aurynne · 13/02/2012 20:38

I completely agree with NatashaBee... In order to make an informed decision, you should have been presented with all the information available, and allowed to ask as many questions as you wanted. You definitely haven't. I would complain and demand an appointment to get all that information. Don't let them fob you off, it's your health and your baby's we're talking about here!

Original poster

toddlerama · 13/02/2012 21:29

yellow, what are the more invasive ways to get venous access?

OP posts:

Original poster

toddlerama · 13/02/2012 21:30

I did need fluids at several points in the last section. I lost quite a lot of blood and was fading in and out, but I did not need a transfusion.

OP posts:

Original poster

toddlerama · 13/02/2012 21:34

Oh god, just realised it would be my neck wouldn't it???

OP posts:

fullofwoe · 13/02/2012 21:37

I have had to take my kids to hospital appointments in the past, it's uncomfortable, but I just ignored the glares, no one actually said anything. It's not like you can leave them in the car. I was being tested for a cancer scare too, stressful enough.

I had to have GTT when pregnant with DC2, and they let you jump the blood test queue - you're sure you can't jump the queue?

Megatron · 13/02/2012 21:45

A fingerprick test would only give you the blood sugars at that particular moment, so that wouldn't be any good. Hba1c is generally a 3 month (approx) average so again, would be inaccurate as one may not have had GD for that long. I think you'd be better to have the test, but def complain about the lack of info you've been given.

maddening · 13/02/2012 21:51

if they're testing in 3'weeks anyways could they not just do the testing all together then? Also as diabetics test with just a thumbprick could they not test you this way to save your veins?

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