So there’s not doubt about it. My weekend was SO not what I expected, nor what I hoped. Besides the personal drama that I can’t get into on such a public forum (despite my DESPERATE desire to do so!), Sunday was really a very bad day.
I started out so excited. As I’ve said before, my pregnancy has been pretty standard thus far, despite the fact that my many and various supposed medical “conditions” have put me in the “high risk” category. So when I was given an opportunity to disprove ONE of those supposed conditions, I was super happy.
Basically, I was diagnosed two and a half years ago with Type II (adult onset) diabetes. This was in large part due to the fact that I weighed in excess of 260 lbs.
After having been on eternal diets for what seemed like years, within three days of the diagnosis, I had spoken to my husband and decided that enough was enough. I booked myself in for bariatric surgery. I flew to the Czech Republic in June of 2008, and I underwent a Vertical Sleeve Gastrectomy, which basically meant that I had 70% of my stomach removed.
As you can imagine, this severely impaired my ability to eat large (or even mediocre!) quantities of food in one sitting, and as a result, over the next 18 months, I lost nearly 120 lbs.
Now it must be noted that from the time I was first diagnosed with diabetes, I literally did not have one single follow up appointment to discuss it with a doctor. After my surgery, I just focussed on getting healthy and learning to eat well. I was already taking 1500 mg of Metformin daily, due to suffering from Polycystic Ovarian Syndrome, which was the same treatment that the doctors would have put me on for the diabetes. So in a nutshell, I was NEVER treated specifically for diabetes. And since I’d lost loads of weight, I truly did not think this was a problem.
Fast forward to July 2010 when I had my booking in appointment with the midwife. This involved Mark and I sitting down and going through a whole list of our families’ medical histories, including our own specific issues. When the midwife asked about diabetes, I told her that I had been diagnosed as Type II, and that it runs in both my and Mark’s families. But I also told her of my belief that it no longer applied to me.
Unfortunately, once you’ve been diagnosed, you are pretty much boned for life. So off I was sent to the Diabetic Antenatal Clinic at the local hospital.
During my first appointment, the consultant told me that she would like to see me get a Glucose Tolerance Test as soon as possible. This is a standard test they do during all pregnancies, though it’s usually not until 28 weeks or later. In my case, she heard what I said about my weight loss and agreed that I may not need to be seen by them at all. So a GTT was booked.
Annoyingly, due to raging hormones and fighting with Mark, I missed the test. It was rebooked for a couple of weeks later, and…. well, I missed it again. Once more they rebooked, and this time, I had a nervous breakdown due to my severe agoraphobia, and since Mark was unable to take me to the appointment, I missed it for a third time.
As you can imagine, the OB/GYN was NOT happy with me and made me cry in my next appointment for being a bad mother.
However, as “luck” would have it, my diabetic consultant was not in that day, and the doctor covering for her decided then and there that a GTT was actually not necessary. He suggested an A1C test, which basically measures what your blood sugar levels have been over the last month or so. It is not a diagnostic test, per se, but it would give a great indication of whether or not I was diabetic. Plus, as my midwife told me later – if I AM diabetic, a GTT could KILL me!
So I had the A1C done, and happily it came back fine. So when I returned to see my consultant, I expected she would simply turn me loose and deem me no longer under her care. Unfortunately, she had other ideas. She was absolutely livid that her colleague had changed her care plan and cancelled my GTT. She said that it is the ONLY diagnostic test they can use and she can’t possibly release me unless/until it was conclusively proved that I was not diabetic.
So once more I was booked in for the test, though this time they allowed me a weekend spot so that Mark could easily take me.
Which brings us to Sunday morning. I’d been fasting and drinking only water since 8PM the night before, and I was excited to take the test that I knew would come out in my favour. I had been told to bring a bottle of Original Lucozade to drink, but as it is carbonated, and I have the world’s tiniest stomache, I knew that I could not possibly drink 348 mL of it in a short time. So I opted instead for the hospital’s own brand of glucose drink – the evil, lemon, sugar mix that smells like disinfectant and tastes like… well… sugary disinfectant.
As the woman mixed up the batch, I again made them aware of my lack of stomache and told them it might take me a little longer to finish the drink, but I was informed that I would have to have it all down in 5 minutes or less.
They took my first bit of blood and then handed me the drink and told me to get chugging.
Before I was even halfway through, I began to feel bad. Mark was beside me, and I was making faces and grimacing the entire time. At first, I thought it’d be fine. The taste was not pleasant, but I’ve drunk barium enough times to be thankful for the small mercy of sugar.
I kept drinking, trying to take the entire five minutes so as to make it as easy as possible. The nurse came around when I’d done and asked me how I was feeling. I told her that I didn’t feel particularly well. At this point, I felt VERY full and slightly light headed. She didn’t seem concerned. Just said that a lot of people have reactions as it’s a lot of sugar in a short time, but that I should go to the waiting room for two hours and try not to move around too much. She said I’d feel better in a few minutes. Probably.
So out we went to the waiting room, and I knew this was not going to go well. My head was spinning, my heart started palpitating a million miles a minute, and I got so hot that I felt like I was on fire. I was feeling slightly confused and out of sorts, and I finally had to stand up. I knew I wasn’t meant to move too much, but I needed to do SOMETHING. As I stood, I felt my eyes fill with tears, and I started bawling my eyes out. Mark was concerned, but not sure if this was me overreacting or not.
I seriously felt like I was going to pass out at any second, when one of the nurses came around the corner and asked if I was okay. I mumbled something about feeling sick, and she told me to come back around. She put me in a reclining chair and gave me a vomit bucket and told me to try and lay back and relax and let it pass. She warned me to try not to throw up, as if I did they’d have to have me come back and do the test all over again. She then got Mark to come sit with me.
I don’t know how long I was there, but I was feeling worse and worse. I tried sitting in different positions, but I knew that something was going to have to happen SOON. At that point, I felt my stomach contract and cramp up and I thought that I was going to have an accident in my pants if I didn’t get to a toilet. I asked Mark to find out where the toilet was, and he stood up and walked to a nurse.
But within seconds, it was too late. I heaved once and out came some of the liquid I’d swallowed earlier. Another heave and another bit of liquid. I kind of stared at it quizzically. It wasn’t very much, and it looked exactly the same as it had going down – like cloudy water. I heard Mark and the nurses talking, and I heard one of them say, “Oh no, she’s thrown up.”
And then, I really let loose. In seconds I’d filled the entire bucket with yellow bile, and someone was handing me a fresh one, which I vomited into again. One of the nurses in the background said that they were now out of buckets and needed new ones, so she went off to find some.
I sat there, hunched over my cardboard friend for several minutes, Mark soothing me, and then, amazingly, I felt fine.
My heart had slowed, my breathing was regular, I felt cooled and refreshed. The taste in my mouth wasn’t very pleasant, but other than that, all was well.
I looked up and smiled at Mark, apologising for him having to see me that way. He of course, was amazing as usual and told me not to be silly.
It didn’t take long before the nurses came back and explained that I’d have to come back in a week for another try. “THIS time,” they said, “we’ll try it with the Lucozade.”
I shuddered and reminded them that without a proper stomache, there’s no way I can get down that much carbonation, but the nurse said that I could leave the cap off the night before to let the bubbles disperse. They were adamant about re-trying.
So we went home, and I spent the entire rest of the day in and out of consciousness, feeling dreadful and even vomiting again. Six hours after the test, I even took my blood sugar and found that it was 8.1! Normal is 5!!
So now, I am in a panic about it all. Maybe I AM diabetic after all!
I called my mother, a nurse, and asked her opinion about it, and then I realised something that I hadn’t thought of before…
It’s not just my small stomache that is the problem. It is the fact that I CAN NOT digetst that much sugar in one sitting. If I have more than a couple of cookies, I will feel terrible for hours and usually will throw up. In other bariatric surgeries, this is called Dumping Syndrome. But my surgery is not supposed to have this side effect… however, over the years, it has happened to me countless times.
So now I sit here, googling away to try and figure out if there is any alternative to the GTT. And lo and behold I find out that a GTT is HIGHLY unadvisable after any type of bariatric surgery!
I’ve now got to call up my consultant and tell her that there’s NO way I will be trying again and that if she is adamant she can’t clear me with the A1C test, then she’s going to have to just treat me as diabetic for the rest of my pregnancy. That’s all there is to it.
And I’ll just have to hope that all is well and I’m not missing out on treatment that I should be having.