Doctor Referral appointment refuse able? - Confused.

[user1476968120]

Basically, I had my 8 week appointment last week and even though my blood-sugar is perfectly fine and normal, The doctor said my weight is an ''extreme issue''. which not only embarrassed me, I felt was unfair. Yes, I am alittle bigger, I always have been, but ive always suffered with weight problems due to a hard time and childhood, I have also gone up a dress size this past year due to some difficult times.

Anyway, due to my weight, she referred me to have a diabetes test, However I don't want it. At all. I have never had any health problems and have no family history of health problems. I understand people are going to say do it, But I don't want to.

I had a letter today about an appointment following my referral, would this be for the diabetes test? It doesn't say it is, and by what I have read, there are certain things you need to do and bring before having tests done for this, and there is absolutely no information in the letter about this. It just says that its a chance to discuss things like my pregnancy plan etcetc.

I am deathly terrified of needles and injections, and have also read that diabetes tests involve two blood tests, which is also making me not want it. TBH, nothing is going to convince me to get it, ive made up my mind.

Has anyone else flat out refused diabetes tests and could give me advice? Or any ''over-weight'' or ''larger'' mum's that can give me some advice on how pregnancy will be?

Please, I don't want to hear that it will be better for my baby, just looking for helpful advice.

I hope all this makes sense, Thank you :3

If your doctor says you need the test, you need the test. Google the repercussions of untreated gestational diabetes.

Go along to the appointment. It's not a GD test, which happens later in pregnancy. If when you get there the consultant wants to do tests you are not comfortable with you can refuse, but you can do so with the information and advice you need.

And of course you can refuse any test at any point. That is your right. The impact of doing so, however, could well be serious and you need to give these things some thought.

Have you posted on this before? I remember an almost identical thread with almost identical language.

1. GD can be devastating. They are not recommending you do the test to humiliate you. I'm quite slim and small but I have a family history of diabetes and GD and I've had the GTT.
2. You can refuse whatever medical treatment you want as long as you are clear these have consequences.
3. In pregnancy you will need repeat blood tests. These are again for your safety and that of your baby. As an example, I had a catastrophic haemorrhage at 20 weeks and I had multiple blood tests to rule out a variety of things. You can obviously refuse, but without massively scaremongering these come with huge risks.
4. You can ask for a referral to deal with your needle phobia although I would assume the waiting list is quite long.

Congratulations on your pregnancy!

The appointment you've been sent is likely to be with an obstetrician in probably a high-risk pregnancy clinic. It won't be for the glucose tolerance test, that's usually done much later in pregnancy.

They may want to discuss your pregnancy and birth options which can be different when you are significantly overweight. It's not about judgement, it's about ensuring you and your baby are safe and healthy.

Blood tests are fairly routine in pregnancy and whilst not compulsory (no-one can force you to have them) they can give the doctors and midwives some very useful information, some of which is crucial especially if there is a complication in pregnancy or delivery. There are services available to assist you in coping with them if you do want to have them.

Ultimately it's your decision but please ensure any decisions you make are based on being fully informed and not just a knee jerk emotional response as a result of fears or phobias.

That's a pretty selfish attitude to take without seeming to have any regard for your unborn child. If you choose to ignore this issue and turn out to have diabetes you will have far bigger issues than a couple of
Blood tests. Take some responsibility for yourself. Grow up.

Telling worried women to grow up is so helpful

Congratulation.

Firstly. A diabetes test is a simple blood test. Not two. Nothing extreme. If you are afraid of a needle then maybe discuss this with your doctor, a blood test however isn't painful, they can use a butterfly needle, and you probably wouldn't even notice it. Child birth will sting a little more, you most likely might need some kind of injection during your pregnancy so getting this over now will make future appointments more manageable.

It's irresponsible not to take the doctors concern into consideration, do you really want to risk the health of your precious baby? Personally I'd have my leg chopped off right now to be pregnant so please, take it seriously.

Good luck.

if the letter does not mention fasting, then you are not going for the glucose tolerance test. i had mine at about 28 weeks. it sounds like you have been referred to the bmi clinic.

this happened to me too, as i have a high bmi (39). i was discharged from the bmi clinic last week, at 34 weeks. in all, i attended two bmi clinic appointments, i met with a nutritionist (where i was weighed and measured), an anaesthetist (who told me he could not see any problem siting an epidural) and i had to have a gtt. i was also given two extra growth scans (which many people have to have anyway).

i don't feel great about this, but i had perfectly reasonable conversations with all the hcps i came into contact with and i saw it as simply hoops i have to jump through to ensure everyone involved is happy with how things are progressing. i refused to be patronised and made it clear that i know perfectly well how to take responsibility for things, but i also explained that i know that there are certain measures hcps are advised to take which are not a reflection on either me or them.

the needle phobia is a separate issue. you will have to find a way of dealing with this, since the gtt is not the only occasion on which you will have blood taken. this is particularly true if there are complications (and anyone can have complications, including those with a bmi in the "normal" range).

from what you have said it sounds like this is just one more difficult issue to add to quite a large pile. i suggest that you try to keep an open mind. there are ways of taking control of this without going to the extreme of refusing to cooperate. it can seem hard when everything/everyone around you screams "obesity police" but the hcps just want a successful outcome - healthy mother and baby - and the best way to achieve that is to support you.

I can imagine the appointment you have received is not for a diabetes test but with a doctor or midwife as you will be classed as high risk because of your weight. I personally would go and discuss your fears. Gestational diabetes is a risk for your unborn baby and needs to be treated if you had it. I would discuss your needle phobia- there are certain situations where your child will be at
risk if you refuse needles.

I went through this. I am overweight. So the tests were needed. I was also had extra appointments where I was treated like a twat for being fat. It's one thing to understand how your weight could impact on your pregnancy but it's another being treated like a twat.

I had my weight shouted down a corridor to another midwife & when she saw my food diary she asked me where all the fizzy drinks, meat and dairy were. I explained I'm vegan and don't drink fizzy unless it's alcoholic and obviously I wasn't doing that since I was pregnant.

See how the me being fat and the attitude are different issues?

Go to the appointments and just accept the advice given. Because they are right.

Just to add I didn't develop any conditions off the back of being fat and pregnant. But the risks were higher. It's something you have to accept and do what you can whilst pregnant. I weighed less the day after I gave birth than I did when I fell pregnant- probably due to morning sickness for 6 months. But you can keep your weight in check whilst pregnant and that's what they'll advise you on.

Just out of interest, how do you know your blood sugar is perfectly normal?

Sorry your friends and family are not being supportive. You may well not like the advice on here because not many posters will encourage you to decline a potentially important diagnostic test. I agree with others that you need it but agree you should ask if there's any way to make it less frightening.

I have a phobia of needles, and the GTT was something my doctor recommended. You can't really get through pregnancy in a safe and healthy way for you and the baby without any exposure to needles so the best thing to do is talk honestly to your GP or midwife about it and ask to see a phlebotomist, who specialises in taking blood, as it will be a lot quicker and a lot less painful.

As others have said, the GTT is quite an important test for the health of both you and your baby, so think really carefully before you refuse - it could harm you both if you develop gestational diabetes, and it has nothing to do with how your blood sugar is pre-pregnancy, or how healthy you are the rest of the time.

If you're just 8 weeks, your appointment is unlikely to be a GTT - I had one of these, and it was after 20 weeks. The appointment letter for the GTT was also very clear that it was about testing for gestational diabetes and about what the test would involve.

I agree with pp that this appointment is probably a general appointment with a consultant or midwife to have a more general discussion about how your weight and any other issues might affect your pregnancy, and a chance to discuss any extra tests that are recommended.

No one can make you have a GTT if you don't want to, but these are offered for very good reasons, so please make sure you fully understand why the testing is recommended and the possible consequences of not being tested before refusing the tests. I know some very slim women with no family history of diabetes who developed gestational diabetes, so it's not just something that affects obese women.

You should also take the opportunity to talk about your needle phobia and find out if you can get help for this - a GTT isn't the only time health professionals will want blood samples during pregnancy, and depending on how things go towards the end of the pregnancy, there may be more needles there - for instance, I had to have labour induced, and part of that involved an IV line so that the medics could use oxytocin to start contractions. I could have refused to have labour induced, of course, but that wouldn't have been in the best interests for my baby.

OP, you need to handle your needle phobia if you're continuing with your pregnancy. Can you see someone like hypnotherapy?or speak to your GP?

A needle COULD well save the life of your baby.
E.g. I had 2 GTTs (as I was over weight)
Blood type checked
Negative blood so I had to have an injection for this
I had OC during pregnancy. I had to have bloods taken EVERY week for quite a number of weeks (I forget how many) to check the levels. OC can lead to stillbirth so has to be monitored.
I had to be induced due to waters breaking so a cannula had to be fitted.
I had 2 failed epidurals
I had a spinal block
I ended up needing a EMCS to save the life of my baby
Due to c-section I had to have an injection every day (into the stomach which you have to learn to administer at home). I think to stop a blood clot.

My pregnancy started off pretty normal and straight forward. To deliver my DC safely I had to have a minimum of 21 injections/blood tests. Although unusual this is not uncommon.

You can refuse the GTT but where does the refusal stop? You can seriously harm yourself and your baby if something goes wrong

And the GTT test is different for overweight people to people with a normal BMI (for those saying it's one blood test)
For overweight people you have to go, have your blood taken, drink and solution they give you (not one you bring yourself) then wait 2hrs before having another blood test. I think it's done at about 18 weeks and 28 weeks

The gtt is two needles even if you are abnormal weight , the drink is either lukozade or generic glucose drink.

I think it is important to understand the reasons behind your approach to the test. From your OP it sounds as though it could be a fear of needles but also you grabbing control of the situation in any way you can. Once you understand why you are reacting this way you can properly get a hold of it and take the right next steps

I'm sorry you are having such a hard time, early pregnancy is hard enough without the added stress you are going through.

If it is a fear of needles, please talk this through with your hcp's it can be managed and limited to tests that are completely necessary for the critical health of you and your little one.

If it's a control thing, I get it. You feel the world is judging you, telling you what to do and the easiest response is telling them all where to go and ignoring everyone. But please please take some quiet time, calm down, read up on the risks of GD and complications of BMI. The advice and risks are not designed for judgment they are clinical facts that are there to get you and your baby safely delivered.

Just imagine how you would feel if the worst were to happen because you didn't get the right medical care, I don't want to scare you at all but there are issues that, left undiagnosed and untreated, could be fatal for your baby or you. That sounds harsh but unfortunately it's true, is anything worth more than your lives or your quality of life.

Please read up and make your decisions based on your terms and think through how you would deal or feel about the consequences of those decisions.

Congratulations and best of luck with your pregnancy.

I know that needle phobia is a real thing and I used to be terrified of needles as well, so much so that when I broke my arm when I was 18 I refused any pain relief as they plastered it and I cried in agony.

When I had the few blood tests before my son was born my mum came with me and her attitude was "you got yourself pregnant so deal with it", which wasn't very kind but it got the job done.

However when I broke my back when I was 30 I was in so much pain that I was begging the doctors and nurses to give me injections because I honestly felt that I couldn't go a second longer in so much pain.

This won't be a popular view but sometimes you just have to force yourself to do things that you don't like.

Telling worried women to grow up is so helpful
Sometimes it is and sometimes it isn't but the sympathetic approach where people tell the OP that she has the right to refuse medical tests is just ridiculous.

'sometimes you have to force yourself to do things you don't like'

yep, that's called life. As is realising that asking a question doesn't mean you'll get the answers you want.

you are pregnant. That is your choice. If you wish to maximise the chances of the two of you coming out healthy at the end, you need to accept tests and treatments.

honestly, even if you have diabetes it's not the end of the world.
i had diabetes in both my pregnancies and through diet and medication it was managed really well and i didn't put on ANY weight in pregnancy. which meant, once baby was out I in fact lost the weigth of baby, placenta, fluid and blood which was great

being managed by a dietitian, and taking metformin or even insulin (i only needed insulin at bedtime) was easy and the best thing for me and my children

Unfortunately, if your weight is "extreme", then you and your baby are more at risk of complications throughout your pregnancy and at birth.

The obstetrician will want to see you in clinic to discuss these with you, and you will need to see an anaesthetist as giving you an anaesthetic in an emergency (like a crash section), could potentially cause delays at best, or threaten your life at worse.

You obviously CAN refuse medical appointments and intervention, but these appointments have been offered as a way of planning safe care for you, in order to give you and your baby the best outcomes.

You need to look up the risk of shoulder dystocia (a potentially very serious complication) with gestational diabetes and overweight mothers before you can categorically say you won't have the glucose test. Don't bury your head in the sand for the want of two blood tests. Seriously.