This is not my first rodeo.
Three pregnancies in four years and you’d think I could walk through the pre-natal care routine backwards with my eyes closed, but no. No, I made some rookie mistakes last week and I want to share them so that a) you don’t do the same thing b) I remember for the next time, if there is one.
Just writing the words “next time” right now makes me want to curl up in the fetal position and find a corner to rock in. But I digress.
The one-hour gestational diabetes glucose test: It has a reputation that precedes it, and any formerly pregnant woman anywhere will strike up conversation about that blessed orange drink. First of all, the drink for this test is not as bad as lore makes it out to be. (Isn’t that true of so many things in pregnancy and birth? Hype does not equal reality.) I remember being pleasantly surprised during my first pregnancy to discover that it is carbonated and pretty much tastes like Orange Crush soda. Even for a non-pop drinker, I don’t think it is as much of a shock to the system as we preggos like to yack about.
For those who don’t know, you drink the soda, wait for an hour, and then they draw a vile of blood and test your blood sugar level. If it is lower than 140, you pass. Higher, you fail. The one-hour test has no official dietary guidelines except eating nothing between the glucose drink and your blood draw. Most practices and online pregnancy forums will tell you to watch your sugar and carb intake the day of the test, and to stick to a lot of protein.
My appointment for the one-hour test was Monday at 2:40 (rookie mistake number one). I had eggs for breakfast, a no-tortilla Chipotle burrito bowl for lunch, and cucumber slices for an afternoon snack before leaving for my midwife’s office (rookie mistake number two). I subsequently failed my one-hour test by one ever-loving point. The lab tech ran it twice to see if she could get it to register lower, but no. I walked out of there with a blood sugar level of 141.
one. forty. one.
About my rookie mistake number one: I will never, ever have this test in the afternoon again. I failed it with my first pregnancy, which was an afternoon appointment, passed it with my second, which was in the morning, and lo, failed it with my third in the afternoon. If I had woken up, eaten just those eggs and then taken the test, I would have passed (unless I had actually had gestational diabetes, in which case there is nothing I could have done to ‘cheat’ the test). Simply put, the lower your starting blood sugar level is (in a non-gestationally diabetic person) the lower your test result will be. The less you have eaten, the lower your score will be (again, in a non-GD person). It is not to your advantage to have two-thirds of a day’s worth of food in your system when they draw your blood.
Rookie mistake number two: I ate a snack as I was walking out the door. No, this is not a fasting test and yes, I picked a pretty benign snack (cucumbers are literally 96% water) but again, when you fail by one cotton-headed point, it puts things in perspective. That cucumber was quite possible the difference between me passing and failing. Simply consuming something within a half an hour of starting the test was not to my advantage, regardless of what it was I ate. Now, I’m not saying I should have fasted for the test, but when the alternative is failing and subsequently taking the three hour version which IS a fasting test and will leave you on the verge of passing out (see: below), I would recommend forgoing the cucumber.
If I ever have this test again, I will make a morning appointment and I will pad my test by an hour or more of not eating anything.
Now let me paint for you the picture of what happens when one eats the cucumber and fails the previously discussed test.
My three-hour glucose gestational diabetes test: Not allowed to take a bite of food after 8:30pm the night before (12 hour fast), I woke up ravenous and headed to my early morning appointment. The lab technician took a baseline blood draw and gave me the even glucose-ier drink. For the three-hour test the drink has twice the concentration of sugar in it as the one hour orange soda. It was the same woman who had watched me fail by the thinnest of margins two days earlier, and she said that based on my one-hour score and my quite low starting blood sugar level that she wasn’t concerned that I actually had the condition. Then she said something that had me kicking myself, hard.
“Did you ask your midwife if you could just take the one hour test again, given your score?”
What?!? NO. Of course I didn’t. I was told if you fail, you take the three-hour and I asked no further questions (rookie mistake number three).
Rookie mistake number three: I didn’t advocate for myself. Honestly I didn’t even think to. It’s not usually my style to ask questions or seek out exceptions, but really, what would the harm have been to call and just ask if I could have a do-over?
For the next three hours, on the hour, the technician took another blood draw. Between draws I sat in marginally confortable lobby chairs and kicked myself for not asking for another one-hour test, while knitting a jumper for ODear. It was quiet and I really can’t complain about much except my poor arms.
My left arm has exactly zero visible or draw-able veins while my right arm has two nice big ones. One hour into my test and my main right vein was starting to bruise. The technician tried my left arm twice with no success, so she moved on to the secondary vein in my already bruised right elbow-pit. By the third hour, she drew from my hand because my arm was looking so abused.
In order to pass, your blood sugar scores must be below set levels at each hour. The good news was that by hour two, my score was already lower than what it needed to be at hour three. Basically, I had already passed with an hour to go. This time, I did ask if I could go ahead and go, but was told that no, in order for it to be an officially recorded test, it had to be a completed one.
The third draw was taken at exactly noon, 16 hours after I last had anything to eat. I did not stay to hear the number, but dashed out the door to a cafeteria-style restaurant across the street from the clinic. While standing in line ordering, my vision started to go grey at the edges and I felt shaky and weak. I mumbled something to the man taking my order and to DanO (who was with me at this point), abandoned my tray, and sat down at the nearest chair to put my head between my knees before there was a very pregnant woman unconscious on the restaurant floor. Once DanO had paid and I had enough strength to walk to our table, I went Augustus Gloop on my bread and chili. No talking, just eating. Quickly. About six bites in, my phone rang and I ignored it. A couple minutes and a cheddar roll later, it rang again and this time I took the call.
It was the clinic. They wanted to inform me that my blood sugar level on the last draw was defined as “critically low”. They were calling to make sure I wasn’t driving and that I was in a place where I could get some food. This amused me to no end, and I informed the caller that I had, in fact, nearly passed out a few minutes ago but I was now doing very well.
“O good,” he said, “because that’s the lowest blood sugar I’ve ever seen.”
In summary: I don’t have gestational diabetes, but almost a week later I still have bruises to remind myself what to do differently if there’s a next time.