Because life and this pregnancy have not mounted enough hurdles in my path yet, today I found out that I “failed” the GDM (Gestational Diabetes Mellitus) test I took last week as requisitioned by my MFM (maternal fetal medicine specialist). The cut-off for “normal” is 7.7 mmol/l. Anything equal to or greater than 11.0 results in an automatic diagnosis of GDM. Mine was 10.7. Not great.
I was uncharacteristically upset about this all morning. I have taken the previa and even the risk of placenta accreta diagnoses more-or-less in stride, but this GDM news had me throwing a pity party and angry with the Universe and God (why me? why now? why this? can’t you cut me a break for a few weeks here?). Things may not be as bad as I feel right now, apparently. I asked Dr. Braverman if he thinks there is any chance this could change (assuming I fail the second test, the fasting 2-hour test, this Thursday, which my Ob considered somewhat likely given I’m still on 40 mg of Prednisone until at least next week) assuming I can get off the steroids or remain stable immunologically on a lower dose (say 20 mg). He said that he’s not a fan of testing and treating GDM before 24 weeks as a firm diagnosis because many patients no longer have blood sugar metabolism issues after they stop Prednisone (which he aims for by 24 weeks if possible).
We saw my ObGyn for the first time this pregnancy this morning. He was awesome at its finest, being supportive of the work we’ve done with Dr. Braverman, explaining what the MFM wrote in her report on last Wednesday’s ultrasound, and generally discussing in a calm, non-alarmist fashion the pros and cons of everything we are doing to keep this pregnancy going and my health risks and those to baby as low as possible. He is always non-alarmist and never condescends to the LP and I, which I appreciate. Today was no exception. He said he will be doing his job and is comfortable letting Braverman call the shots on the immune meds front and to work with the MFM in any further recommendations she may have as she monitors baby and me going forward.
Do you hear that, Azulito/a? We have a team in place for you!
Even though my GP has not yet transferred my care so my OB’s nurse had to look up some of my test results and reports, I decided immediately after our appointment this morning to cancel my last scheduled appointment with my GP and say so long to the stress that is having to wrestle with her disbelief and exasperating “not medically necessary” nonsensical comments at each appointment. Hasta luego o casi nunca, doctora! There is a headache I can live without.
It is such a relief to have a team of doctors taking us seriously and all aiming for a common goal – to support me and this baby to be as safe and healthy as possible until the optimal time for Azulito/a to make her/his entrance into the world outside my womb.
In closing out this wee update, I want to give the Miracle Toddler and the LP a big shout-out.
The LP has been very loving and kind and trying hard to parent as a team with the novel challenges the Miracle Toddler has been mounting of late. Despite having four trials (one lasting over two months) scheduled in March through June and a crazy busy practice generally, he has come with me to all of the scary appointments lately. For this I am deeply grateful. Even if he says almost nothing, his presence lends me strength and a calm I dearly need (the irony of this is lost on most of you but given that the LP is one of the most highly-strung humans I have ever met, trust me when I say there is some irony in this).
The Miracle Toddler has made generous and heartfelt offerings of his own. He has moved me to tears (only rarely of frustration). His newest thing is to tell me multiple times every day that (a) he loves me (and his daddy); and (b) he loves this baby. When I talked to him on the phone from New York yesterday he said “is baby still in your tummy?” and “I love your baby” when I confirmed that baby was still there. I think he likes it when I tell him that I believe he will be the best big brother ever (in case anyone wants to challenge me for using hierarchical language, please note that as the MT’s mother I own without shame or reservation that I will – without hesitation – award him first place even if your kid is a more capable or equally loving sibling. In case you’re wondering, I would expect no less of you.). It melts my heart every time he says “I love your baby” and “I love you, Mom.”
And that, my friends, is enough to keep me going, potential GDM diagnosis and all of the other hiccups and messy stuff being what they may.