April 2015 Thread 9: Let the chatting continue!

[cinnamongreyhound]

Quick new thread as only 2 posts left on old one! Any newbies or lurkers please join us!

I can't give any insight to gestational diabetes as such but I am however a type 1 diabetic and so might have some insight in more general terms. In my clinic type 1, type 2 gestational diabetics are treated in very similar ways, though the treatment options vary.

For me, my care started 6 months before we even started trying at a preconception clinic to make sure my levels were optimum before getting pregnant. I have been seen fortnightly at the diabetes antenatal clinic since I was 5 weeks pregnant. (Other women have weekly appointments if their levels are off track). The fortnightly clinics will continue all the way through although will likely become weekly by around 32 weeks.
The blood sugar targets they set are much tighter than the non-pregnancy ones, being type 1 there is no option but for me to be on insulin but for others it could be just diet or diet and tablet controlled. It's difficult but certainly achieveble to reach those targets, although I have greatly reduce my carb intake to get there I haven't really found it that limiting.
At my fortnightly appointments I will have my BP and urine checked and then see a diabetes midwife, a diabetes consultant and an obstetrician, and there is an option to see a dietician too. I am also now having regular growth scans, every 2-4 weeks. My clinic induces diabetics by 38 weeks, although it can be earlier depending on how the baby's growth and your blood sugars are going. I have heard other clinics have different cut off points though.
It is a lot of hard work controlling diabetes and pregnancy, but it really is achiveable and not as scary as it sounds (in my opinion). I feel I have had amazing care from my medical team all the way through and really cannot fault them.
As I say, my experience as type 1 may be different from those with GD but there are loads of similarities, if I can help with any tips or suggestions I'm very happy to ....

Re visitors and bf, keep a muslin handy to cover up a bit. But I do suppose it depends on you, if your a loud and proud you'll get your boob out anywhere but if your more modest your lively to feel uncomfortable which your baby will pick up on and make it a stressful event. It's one thing to find a quiet place if your the one visiting but I wouldn't be forced out of your comfy spot in your own home. If your visitors are uncomfortable they would soon make their exit.

Hope that helps.

chicken I got through tonnes in the short period of time that I was BF / expressing, I've got 120 disposable ones, less now that one of the boxes got found and used as giant puffy stickers all over the bed by DD and I think 9 pairs of reusables if I can find the reusable ones from last time.

I was buying a bumper box (of breast pads) every time we went shopping. Once supply was established I didn't leak too much just when DD was overdue a feed and eventually once she was weaned and I was only feeding her at bedtime I didn't wear any at all.

I've got my GTT test Monday, really hoping it comes back negative as If you do happen to have it. There is a chance after pregnancy of developing type 2 (and rarely type 1 diabetes).

I really don't fancy the added stress of being monitored for the babies weight, then having to restrict my diet when I don't eat any meat other than fish as it is. If it's not managed you are more likely to have a big or small bag, be induced/cesarean or assisted delivery. Then of course the worry afterwards of whether it's going to go away.

I have a type one diabetic in the family and my gran was type 2 so I'm not feeling too lucky about this up coming test.

Anyone know how long it takes before you get your results back?

Bag! Haha sorry that was meant to be baby, I don't mind having a big or small bag!

Thanks Lauren I really want it to work out and I feel like it's not always understood that it can take hard work and people can maybe unwittingly undermine the process. Guess I'm just a little bit anxious.

Siarie I had my test yesterday and got the call today.

Choco thanks that's useful. I expect it will be diet controlled for me as I'm only literally just over the limits, normal weight and no family history. How do you monitor your blood sugars, do you have a thumb prick test kit or something? And what sort of foods do you have to be careful with - guess it's sugar and simple carbs mainly? (I do tend to live off pasta...) I am not too worried about restricting diet, it will be a hassle but at least it's just hassle.

I'm more upset about the idea of being induced and especially induced early, I will wait to see what my hospital does, maybe they will let me go to 40 weeks. After DD at 34 weeks I was really hoping to get to term and possibly even go overdue with this one (I know it sounds odd to want to go overdue!!). I really was hoping I'd manage a waterbirth in the MLU but if I'm induced that's out the window. And I was also hoping for just gas and air but induced births are supposed to be more painful so... Also the midwife also said on the phone they'd want to keep me and baby in for 24-36 hours to monitor sugars, so that means more time on the notoriously horrible post natal ward. And then there's the extra risk of developing diabetes later as Siarie says. So am feeling a bit down, though I do appreciate there are much worse things that could happen, and I could have ended up induced or not allowed the MLU anyway for lots of reasons...

Sorry bit of a self indulgent post.

Boo do you know if you're likely to be early again? and why DD was early?

I had gd last time and have it again. Will write more later but I have fortnightly appointments and my issue is the fasting and breakfast levels. Lasagna gave me good readings at dinner...

That sucks IveGotaCaveTroll! Hope you feel better some days or are you nauseous all the time when travelling?

My mum was the opposite ChickenMe! She was very stand off ish, despite me asking. I think it came from me saying we were doing things the way Dh wanted as he'd done it before and it was quite different to what she thought should be done. Made my first few months with a difficult baby much harder . Mil is too far away to be a bother. Re breastfeeding, if they're in my house and I need to feed the baby I will!!! I have been asked to go upstairs at relatives but wouldn't in my own home. My mum was anti-bfing as it meant she couldn't feed the babies but Dh was very supportive and knew how determined I was!

It's annoying as it'll mean more appointments and probably an induction but not the end of the world minipie . I was induced with both of mine and it's not the end of the world. Looking like I will be induced this time too!

Fantastic news Phryn, I remember you well. So glad it has all worked out for you.

Had my 28wk apt, all fine with urine and bp. Not too fussed about baby as I had scan yesterday but I'm Measuring 32weeks!!! Whooping cough jab hurts! But I think the nurse was a bit rubbish.

29w+2

phyryn! oh thats such lovely news! Congratulations!

Re the GTT, im hoping that my no news is good news and ive not got it. They said they would only ring me if the tests showed positive and I cant imagine they will ring so late in the day.

I had my GTT yesterday and the nurse said here in Surrey they take 2 days to process then they'll only call if there is a problem otherwise it's added to your notes at your next midwife appt. Obviously it's different depending on where you are and what kind of test you had

mini they induced me because she measured small at 32 weeks and there was no discernible growth between 32 and 36 week scans, though they estimated she'd be about 3 and a half pounds and ended up being 4lb7 so she was much bigger than they expected, and our only time in nicu was after they'd discharged us and she lost 12% of her body weight and had to go back to the hospital. This time round they're keeping a much closer eye, scans have been booked for 28, 32 and 36 weeks and if she'd small at 28 / 32 week scans they'll then do them weekly with the plan to not induce me till 37 weeks if possible. They have no idea why she stopped growing, the placenta was seemingly fine though they didn't check the cord bloods or anything afterwards. It's more than possible that bump will be fine and they won't induce me (in which case I'll be replying on my family history of early births and Hypermobility Syndrome associated risk of premature labour to ensure I don't go overdue because I'll go stir crazy if I end up going overdue!)

Chicken re BFing and interference/visitors: I have no shame about getting my boobs out for BF purposes (especially after 3 weeks of trying to get DD to feed in hospital) so I basically just BF wherever and whenever and didn't worry too much about trying to be discreet, aside from turning away from people a bit. Never had any negative comments or interference. It wasn't easy because DD was tongue tied (didn't find out till 4 months) - her bad latch made it even harder to be discreet!

My top tip: if you are struggling, try to see a decent BF counsellor as soon as possible, as there are quite a lot of difficulties with BF that can be fixed if you get the right help asap but get worse/harder to fix the longer you leave it.

thanks cinnamon I know it's not the end of the world, at the end of the day the most important thing is DD2 arrives safe and sound and loads of people are induced. Just grieving a bit for the lost "ideal" birth I was hoping for (which I think has become more important to me because of what happened with DD1).

Question for those who have had inductions: was it more painful than a non induced birth (as far as you can tell) and did you have an epidural?

Siarie I was told to ring up the day after to get my results. It must vary from area to area but I'm sure you'll get instructions on the day. My mind went completely blank when I rang for mine totally forgot what I was asking for but the lovely lady on the phone guessed what I wanted and helped me out a bit. Very embarrassing but it does happen quite a lot to me on the phone even if I'm not pregnant. I guess it stems back from having a phone phobia when I was little. (Still hate ringing people for things now especially in am official capacity)

Ah thanks Boo that makes sense and I remember now about your EDS. It's odd when they have no idea why something happened isn't it - hard to know whether to worry about it this time round or not. Good that you get lots of growth scans anyway.

squatting I think i can kind understand where you are coming from. Ever since that BFP im so scared that something will happen to me or OH. OH transferred to Manchester city centre for a few weeks just after we found out and he enjoyed the city life a little too much! After years of working in the sticks he made full use of the pubs/bars and I was so scared that he would injure himself or something would happen to him that i forgot to even be mad when he rolled in at 2am absolutely paraletic! Even going to the corner shop at the moment, I worry he will slip on ice and whack his head and ... totally irrational given that im the one more likely to fall as im really clumsy at the mo!

siarie I have the same family history of diabetes as you and I dont think ive got it. Despite being convinced I would due to the extra poundage ive packed on!

Sorry you didnt get the result you hoped for mini. I hope that you're allowed to go to full term and dont get interfered with too much!

Minipie I was induced with DD and my contractions came out of no where and were so painful I spent my labour throwing up. I have heard others who were induced say it's more painful but as I've not had a 'normal birth' I couldn't comment one way or the other. Thinking logically with normal labour it builds gradually so you become accustomed to the pain, with induction it just happens very quickly.

minipie
Measure bloods with a home blood test kit, you have a little finger prick device to get some blood to test, most kits take 5 seconds for the result. Because I carb count and match that to different ratios at different times of day I have a meter that does all the calculations for me, but other machines are a lot smaller and more straightforward. The numbers they are most interested in are your morning fasting reading, pre meal and 1hr post meal. If on medication you need to watch out and test for hypos too, but that's not something that's likely to be much of in issue in diet controlled only.

Carbs are what you need to account for so reducing them is a good plan, of those you have lower GI is best, so smaller amounts of brown pasta rather than white for example. Most people tend to be more insulin resistant in the morning, so can tolerate fewer carbs then. But everyone is different of course, and things change as you go along! My targets are for no more than 20g or carbs for breakfast and no more than 40g each for lunch and dinner. As I've been type 1 for years I'm pretty good at carb counting by sight, but there are good books and apps that help. I'd recommend one called Carbs & Cals as pretty easy to use as it gives you photos of portion sizes as well as weights.

Sorry diabetes is my 'specialist subject' so I can ramble on!

also to answer your induction question mini I had unproductive contractions for about 12 hours and despite banshee wailing all they'd give me is paracetamol that I got told off for throwing up due to the pain and gas and air because I wasn't dilating, then I went from

I'm trying to steel myself cinammon. I agree, I will not be dictated to in my own home. Other homes, I will go somewhere private if I sense opposition.
mini thanks for supportive comments.
I think I just need to surround myself with people who have BF. My best friend, her mum and my mum did and are very pro.

Me too minipie!! I'm fine this time and baby is scuppering it! It's hard as the most important thing is you and baby is healthy but there's still more that comes with it. I was induced with ds2 and it was much quicker and easier than ds1 and did help with healing the grief over ds1's labour.

Catching up with today's activity.

Great news about your 20 week scan Phryn, I was wondering how you were getting on the other day.
Do come and update us again!

I thought we were pretty organised but we still have some big bits left to buy: cot bed and mattress, bouncy chair, breast pump, and car seat and base. Pretty sure we've decided which we're going to go for, I've just been waiting to see if I can find any better prices. Got some John Lewis vouchers left from our wedding that we are planning to use for the car seat and base.

Hiding I would be very fed up if someone let our name slip. We've purposely not told anyone the names we're considering for this reason. Plus I don't want opinions putting me off the couple we do like.

minipie sorry to hear about your GTT but good that it was only borderline. Fingers crossed it won't affect your birth options etc. do you mind me asking why you had the test done? I know we're at the same hospital and wondering whether I should expect to do one soon.

Chicken I plan to have a large muslin to hand for more discreet feeding but won't be leaving the room etc unless I want to. I think most friends and family will be supportive anyway, I'd just rather not flash my dad and other male relatives if I can avoid it!

Off to yoga soon after a hectic day at work - time to relax!

Thanks choco! I guess I will have to get more familiar with what's high GI and low GI. Is Carbs & Cals an app or a book?

cinnamon that's reassuring re inductions - boo and lauren not so much! Sorry you had such a tough time. I have one friend who was induced and it was awful and another who was induced and had a great 2 hour labour and birth so really hard to tell I guess.

Wow, thread 9! I predict we will become ever chattier as we get further along and by the time the babies start arriving we will be on thread 36

Phryn that's such fabulous news! I'm so pleased for you.

I was induced and had an epi fairly early on, so I couldn't tell you how painful to be honest. I wasn't being a screamy wuss, honest, I was just squeezing DH's hand at first and breathing out when contractions came (which really does make a big difference). But when the midwife asked about pain relief plans I said well, I was originally planning a water birth, so I suppose that's out of the window now? And she agreed that it was. So I suggested gas and air. But midwife was quite pro epidural and said the anaesthetist was ready now and might not be if I wanted one later on; I couldn't think of a good reason not to have an epidural so I went ahead and did it. although they did fuck it up and site it in the wrong place which made me ill later I didn't feel a thing for ages until it was time to have a top up. Can recommend epidurals, it is rare that they go wrong like mine did and they do take the pain away completely. I spent my labour chatting and dozing.

I still need to buy a double buggy, planning to do that in a couple of weeks. MIL already talking about babysitting this baby and have had to remind her that he won't be leaving my side for the first 6 months.

"Rush of love" - I never experienced this, I was so exhausted by the time DD came out (23 hours between waters breaking and c-section), hadn't eaten because of likelihood of c-section and all drugged up because of epidural, I just felt pretty out of it to be honest, one of the reasons I want to have an elective this time is to feel more alert and in control. I was worried because I didn't really feel like I was bonding with DD, this was partly because I was really upset because someone had had a go at me when I was 39 weeks pregnant and I cried for the next 6 weeks solid... I think what I'm trying to say is I was so upset and emotional that bonding was difficult. It came to me eventually, again I realised one day I would do anything for her. I'm hoping for a better time of things with DS.

BF wise, I would still bf when visitors came round but used a bf apron. It took me around 4 months to gain confidence (and her head got bigger!) and I stopped using the apron in public around then. It made bf much easier! I'll see how I feel this time wrt using the apron again, no one I know has a problem with bf, it was purely down to how comfortable I felt.

Think that's all points covered! Sorry for epic post! x