Questions about MFMs and/or Gestational Diabetes — The Bump
Pregnant after IF

Questions about MFMs and/or Gestational Diabetes

liz4pawsliz4paws member
250 Answers 2500 Comments Fifth Anniversary 500 Love Its
edited April 2014 in Pregnant after IF

Hi ladies,

I was diagnosed with gestational diabetes last week and my OB has decided that because of all of my "issues" (GD, MTHFR, and donor embryos - which I don't think are huge in themselves...) he wants to take every precaution and is sending me to an MFM tomorrow morning. I was freaked out by being labeled as "high risk" but I'm trying to get past the label and remember I'll be getting even better care now with the co-management by an MFM. I've already been to a nutritionist and have been following the diet for a week. My numbers are not great even with diet changed. Ugh.

So a couple of questions for you all...

For those of you seeing an MFM for anything, how has your experience been? Is anyone going to one for Gestational Diabetes and if so, what was your first appointment and follow up appointments like?

And last, does anyone know where I can find a forum or thread for GD support? Holy moly it's overwhelming and frustrating not seeing my numbers be good no matter how hard I try! I tried the High Risk board but it looks like other ladies are asking the same because there doesn't appear to be one created.

Thanks!

************ Signature/Ticker Warning ************
Me (32) DH (36) - Finding our way to baby #1
Me: POF/DOR - AMH <0.16, heterozygous c677t MTHFR, insulin resistant and gluten intolerant
DH: Severe MFI

12/2/11 - IUI #1- BFN 
8/1/12 - IVF #1 - Zero response from max stims (600iu intramuscularly)
My ovaries are just for decoration

12/6/12 - Adopted five embryos that had been frozen for over ten years!
2/11/13 - DEmbryo FET #1 Thawed four, sadly two didn't survive. Transferred two beautiful blasts. 
2/16/13 - First BFP of my life @ 6dp5dt! EDD 10/30/13
3/27/13 - After beta and u/s hell, no heartbeat ever detected. D&C at 9w1d.

6/5/13 - Adopted four new embryos that had been frozen for seven years!
 
9/12/13 - DEmbryo FET #2. Thawed and transferred two beautiful blasts
9/17/13 - BFP @ 5dp6dt! EDD 05/31/14
9/29/13 - m/c @ 5w1d. :(

11/19/13 - DEmbryo FET #3. Thawed and transferred one blast from each batch. Wow!
11/23/13 - BFP @ 4dp6dt! EDD 8/7/13
Beta #1 @ 13dp6dt - 522  Beta #2 @ 16dp6dt - 1373 
6w5d ultrasound showed one perfect baby with a beautiful heartbeat of 134bpm!

Snowflake baby is a girl! 
Our beautiful Snowflake girl arrived on July 22, 2014! 
 
 
My embryo adoption blog: Wishing on a Snowflake
 
    image      image 

Re: Questions about MFMs and/or Gestational Diabetes

  • I love the MFM! Once I was released by my RE to my OBGYN, I started to feel like one in a crowd. My obgyn was very blasse about certain issues, and I wanted more individual attention. I guess I'm needy! But we've just put SO MUCH into this, and I don't want to just be another case.

    I'm not happy about the reasons why I have to see the MFM (cervical issues, blood clotting disorder) but I definitely feel more confident knowing I'm in the hands of a specialist. The office was smaller and the staff and attention is much more like my RE's than my OBGYNs.
    ---------------Siggy Warning--------------------


    Image and video hosting by TinyPicimage
    Me: 32, DH: 34  / TTC since February 2011 / SA: all normal, HSG: all clear! / on Lovenox for anticardiolipid antibodies
    4 IUIs with Clomid, Letrozole, and Menopur. All BFN.
    9/12: lap / hysteroscopy: found and removed mild endometriosis, cervical polyp, and 2 para-tubular cysts
    5/13 IVF #1: Follistim, Menopur, Ganirelix, 10R/4M/4F, ET of 2, 5 cell and 4 cell, no frosties = BFN
    12/13 IVF #2 = November / December 2013. Microdose Lupron Protocol: 15R/6M/6F, Froze all 6 due to high E2 and P4
    FET 1: Jan 22, 2014 of one 4AB blast and one 3BB blast (3 blasts on ice!)
    BFP on HPT 4dp5dt, Beta #1 9dp5dt: 310, Beta #2 11dp5dt: 899
    First u/s on 2/17/14: TWINS!!!!! both w/HBs of 114 at 6w3d, HBs 150 and 152 at 7w5d

    5/27/2014: Team purple!!!!  EDD 10/10/2014 / 
    Delivered by c-section at 32w0d 8/15/2014 due to preeclampsia/HELLP syndrome
    Baby Boy 4lbs 1oz, 17 inches
    Baby Girl 3lbs 5oz, 16 inches

    image image
    Baby Birthday Ticker Ticker
    liz4paws
  • Liz- I have GD experience and I understand your frustration with following their guidelines and getting high numbers. I was able to control my GD with diet but it was really tough at first and then gradually got easier as my hormones stabilized. I think I started my diet in week 29 and that week through 32 or 33 were the hardest for me and then I could experiment more with foods. I basically ate the same thing every day for the first few weeks once I found something that worked.
    Some things that worked for me (but I know everyone is different) were: 1) peanut butter! If I ate peanut butter with a meal- it brought my numbers down, especially at breakfast. 2) chicken or beef tacos were oddly my lowest numbers. (Homemade with hard shells)
    3) sweet potatoes (half) killed my numbers...4) chicken nuggets, soup and a salad from CHick fil a gave me lower numbers than when I baked chicken and had it with veggies- go figure! GD makes no sense at times. I'll look through my food diary to check for more, if you need it!
    If you need anything let me know.
    If it makes you feel better, sometimes my numbers were high and sometimes I just couldn't control a craving (especially when people left cookies in our break room) and my baby was actually on the small side and the GD didn't seem to affect him. And don't feel bad if you can't control it with diet- it's nothing you are doing wrong.
    Good luck!!! Oh, also, going for a walk after a meal really helped too!
    Me 36/DH 46 Me: Low AMH (.21) DOR, mild endo; Started seeing RE 11/12
    Jan-March '13 3 IUIs Clomid + Trigger = BFN
    April '13 IVF 1 MDLF converted to 4th IUI due to 3 runaway follicles! BFN
    July/Aug '13 IVF 1.2 Long Lupron = 7R, 6F, 2T= BFP!!!
    Beta 1=512, Beta 2=1,368 Beta 3= 4,128
    It's a boy!!!!
    SUA, GD
    EDD 4/26/14

    He's Here! Arrived 4/15/14!!!!

    September 2015 - FET with remaining embryos
    Twins! EDD: 6/14/15

    PAIF/SAIF Everyone welcome!
    liz4paws
  • MFMs are great! My first pregnancy they had me see one just because of the IVF. They gave me three growth ultrasounds over there. They check my weight and urine just like the OB does.

    This pregnancy I see one for being 36, though my eggs are only 32! They've again given me growth ultrasounds to make sure baby is on track. They checked cervix length as well.

    I think you will be very happy with an MFM. They'll keep an even closer eye on you. It's like having two different teams take care of you. Nothing wrong there!
    IVF #1- BFP- DD 4/8/2011
    FET #1- 3BB and 3B-B
    Beta #1 (4w0d)- 504
    Beta #2 (4w4d)- 4,577
    Beta #3 (6w0d)- 78,399 HB 115 bpm
    U/S #2 7w0d- HB 155 bpm

    Lilypie First Birthday tickers Lilypie Fourth Birthday tickers




    liz4paws
  • liz4pawsliz4paws member
    250 Answers 2500 Comments Fifth Anniversary 500 Love Its
    edited April 2014
    PhillyJ33 said:
    Liz- I have GD experience and I understand your frustration with following their guidelines and getting high numbers. I was able to control my GD with diet but it was really tough at first and then gradually got easier as my hormones stabilized. I think I started my diet in week 29 and that week through 32 or 33 were the hardest for me and then I could experiment more with foods. I basically ate the same thing every day for the first few weeks once I found something that worked. Some things that worked for me (but I know everyone is different) were: 1) peanut butter! If I ate peanut butter with a meal- it brought my numbers down, especially at breakfast. 2) chicken or beef tacos were oddly my lowest numbers. (Homemade with hard shells) 3) sweet potatoes (half) killed my numbers...4) chicken nuggets, soup and a salad from CHick fil a gave me lower numbers than when I baked chicken and had it with veggies- go figure! GD makes no sense at times. I'll look through my food diary to check for more, if you need it! If you need anything let me know. If it makes you feel better, sometimes my numbers were high and sometimes I just couldn't control a craving (especially when people left cookies in our break room) and my baby was actually on the small side and the GD didn't seem to affect him. And don't feel bad if you can't control it with diet- it's nothing you are doing wrong. Good luck!!! Oh, also, going for a walk after a meal really helped too!

    @PhillyJ33 Thank you so much for replying! My mornings are hands down THE WORST. I don't have fasting levels below 109 EVER. And then no matter what I have for breakfast, they spike as high as 160s 1hr after and then 140-150 2 hr. It makes no sense. Then lunch I'm golden and dinner can be iffy. But because my fasting numbers suck, I'm pretty sure I'm insulin-bound. Oh well, I'll do whatever it takes! I find my appetite sucks, probably in-part due to the GD but mornings I can barely tolerate eating anything. I found a shake recipe for GD that one lady recommended with 8oz whole milk, 2 tbl whey protein, 1tbl peanutbutter, and 1tsp coconut oil and I chug it. My numbers still spike. Grr! Do you have any tips for just getting a "meal" down in the morning? I'm majorly struggling. :( Thanks again for responding and so glad to hear your LO is doing well. :)

    ************ Signature/Ticker Warning ************
    Me (32) DH (36) - Finding our way to baby #1
    Me: POF/DOR - AMH <0.16, heterozygous c677t MTHFR, insulin resistant and gluten intolerant
    DH: Severe MFI

    12/2/11 - IUI #1- BFN 
    8/1/12 - IVF #1 - Zero response from max stims (600iu intramuscularly)
    My ovaries are just for decoration

    12/6/12 - Adopted five embryos that had been frozen for over ten years!
    2/11/13 - DEmbryo FET #1 Thawed four, sadly two didn't survive. Transferred two beautiful blasts. 
    2/16/13 - First BFP of my life @ 6dp5dt! EDD 10/30/13
    3/27/13 - After beta and u/s hell, no heartbeat ever detected. D&C at 9w1d.

    6/5/13 - Adopted four new embryos that had been frozen for seven years!
     
    9/12/13 - DEmbryo FET #2. Thawed and transferred two beautiful blasts
    9/17/13 - BFP @ 5dp6dt! EDD 05/31/14
    9/29/13 - m/c @ 5w1d. :(

    11/19/13 - DEmbryo FET #3. Thawed and transferred one blast from each batch. Wow!
    11/23/13 - BFP @ 4dp6dt! EDD 8/7/13
    Beta #1 @ 13dp6dt - 522  Beta #2 @ 16dp6dt - 1373 
    6w5d ultrasound showed one perfect baby with a beautiful heartbeat of 134bpm!

    Snowflake baby is a girl! 
    Our beautiful Snowflake girl arrived on July 22, 2014! 
     
     
    My embryo adoption blog: Wishing on a Snowflake
     
        image      image 
  • My experience with my MFM clinic may be a little different due to my circumstances, but they basically do growth ultrasounds and let my OB handle everything else. This could be because they work closely with my OB and know he's handling all the other stuff. Now, if I should end up with pre-e or something else, then I think they would take a more active role in my care. I'm basically on their "maintenance plan" right now. :)

    ***signature & ticker warning***


    Me: 30 ~ Stage IV Endo ~ AMH .38 ~ AFC 8
    AMH .97 as of 4/2012! ~ AMH 1.63 as of 4/2013!?!
    Him: 29 ~ perfect swimmers

    Laparotomy w/partial oophorectomy 8/2009 to remove cysts/endo.
    Stopped BCP 4/2010.
    Multiple clomid rounds from 11/2010 to 6/2011. ~ All BFN
    IUI w/clomid 7/2011. IUI w/clomid & injectables 11/2011 & 1/2012. ~ All BFN
    IVF:EPP 5/2012 ~ (4R, 3M, 2F w/ICSI). Both embryos txfrd. ~ BFN
    BCP to manage endo from 10/2012 to 12/2012.
    FET w/donor embryos #1: 10/2013 Cancelled
    FET w/donor embryos #1.2: 11/2013 ~ ET of 2 beautiful blasts on 11/27.
    Beta 1: 503(12dp5dt) Beta 2: 1035(14dpt) Beta 3: 3001(16dpt) Beta 4: 8503(19dpt)
    Twins with an EDD of 8/15/14! Team Purple
    G&B born 6/30/14 at 33w3d via emergency c/s.

    If you're wondering about my avatar...it's a fried pickle chip shaped like a fetus!

    image

    image
    liz4paws
  • I can't really help with many of your questions and I do not have GD (*FX* it continues this way), but  I have seen threads specifically for GD support and questions.  On the June BMB board, there's a whole thread dedicated to "All things GD."  You should check out the August board and see if there's something similar.  If not, maybe you can start one!  I'm sure you're not alone.
    Me 31 ~ DH 30
    IVF/FET #1 - BFP!!
    <3 CJW 6/15/2014 <3
    DX - PCOS 2004
    FET #2 - scheduled for 11/24/15
    liz4paws
  • @liz4paws‌ my fasting and after breakfast were my challenging times too! My fasting was always in the 90s or low 100s no matter what I ate. They wanted me under 95 and allowed for a few higher numbers as long as they were not crazy high so I managed to avoid insulin. That said, the last few weeks of my pregnancy they dropped to the 80s even though I ate the same stuff.
    I struggled with the after breakfast levels and then I found that half an English muffin with peanut butter and a glass of fat-free milk or a cheese stick made my numbers below my cut off. Later on, I ate a whole English muffin with peanut butter! I rarely ate anything else because my numbers always were high if I did- bizarre.
    As far as the fasting, as I mentioned I struggled so not sure you want my advice but I would have a yogurt or milk and a cheese stick around. 8 hours before I tested. Sometimes I had ice cream- and my numbers didn't change no matter which I ate, to be honest!

    I found GD to be frustrating but once you find a meal that works- stick with it! It will be over soon enough :)
    Me 36/DH 46 Me: Low AMH (.21) DOR, mild endo; Started seeing RE 11/12
    Jan-March '13 3 IUIs Clomid + Trigger = BFN
    April '13 IVF 1 MDLF converted to 4th IUI due to 3 runaway follicles! BFN
    July/Aug '13 IVF 1.2 Long Lupron = 7R, 6F, 2T= BFP!!!
    Beta 1=512, Beta 2=1,368 Beta 3= 4,128
    It's a boy!!!!
    SUA, GD
    EDD 4/26/14

    He's Here! Arrived 4/15/14!!!!

    September 2015 - FET with remaining embryos
    Twins! EDD: 6/14/15

    PAIF/SAIF Everyone welcome!
    liz4paws
  • I know my endocrinologist stated that morning/breakfast blood sugar levels tend to be higher numbers in general due to hormone levels being higher in the morning. I know take more insulin for my morning meal than I do for any other because of this. I usually eat eggs for breakfast with some cheese and a fruit and my numbers have been much better! Good luck because it is very frustrating and overwhelming at first!!
    image TTC#1 Since 10/2011 Dx PCOS 3/2012- started on 1500mg Metformin November 2012 DH diagnosed with varicocele- surgery completed April 2013 1st appointment with RE October 2013-polypectomy to remove uterine polyp October 2013 all necessary testing completed only option is IVF with ICSI due to MFI IVF #1-January 2014 ER- 22 retrieved 18 mature 17 fertilized!!! February 2014 ET one 8aa embie transferred 13 frozen (of the 13 9 were 8aa embies)-BFP! No heartbeat at 22 week anatomy scan-Our sweet angel FET#1- October 2014 transferred two frosties -BFP! 1st beta 271, 2nd beat 6748 5 week ultrasound shows two sacs repeat in 10 days
    liz4paws
  • I saw a MFM during my last pregnancy. I had bad GD, like out of control upped my insulin every week, GD. No matter what I ate it was high. However, my morning numbers were always the best for some reason. My nurse told me to make sure I eat a good snack before bed as that would get you through the lows of the night. That seemed to help, although I did wake up a few nights with too low sugars (that's the worst). 

    TTC for 1.5 years with a crappy RE. 12 cycles with clomid (11 too many)
    New RE, 3 failed IUI's moving to IVF with ICSI
    IVF#1 BFP EDD 1/10/13
    Beta#1 51  Beta #2 148
    A/S 8/20/13 Team Pink
    Induced week 39 due to severe GD
    Baby girl born 1/4/13

           TTC #2 2 failed IUI's moving on to FET 3/2014
    ET 3/25 
    Beta #1 127
    Beta #2 845
    U/s 4/22 It's TWINS!!
    Team Purple!!

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    liz4paws
  • cc+mmcc+mm member
    Seventh Anniversary 250 Love Its 100 Comments Photogenic
    I actually starting seeing my mfm before my first ob appointment. I am a type 2 diabetic and was on oral meds until we started to prep for IVF. My RE sent me to the mfm to start insulin a few months before IVF. Once I was pregnant I started seeing the mfm monthly for grow ultrasounds and and I fax them my blood sugar logs weekly. The nurse calls with any changes to my insulin levels. I actually have loved the extra monitoring - extra ultrasounds and fetal echo. So far, I haven't had any additional issues ( beyond the diabetes, IVF, and AMA) but the extra ultrasounds helped me feel more comfortable that everything was going as it should. I was told at my last appointment that the monitoring would ramp up to weekly with the mfm at 32 weeks.

    For me, the first 20 or so weeks were easy. Since around 22 weeks, I have had to increase insulin a few times and I know my ratios will keep going up. I do end up eating the same things a lot, because I already know how many carbs/how much insulin to take.

    Breakfast is hard...I am supposed to limit to 30 grams of card and usually end up with Greek yogurt or oatmeal with peanut butter in it. For a treat I have a bagel thin with peanut butter. I eat a ton of peanut butter for the protein.

    8/2011: Diagnosed with ovarian cancer, ovaries and tubes removed

    12/2011: Finished chemo

    5/2013: Cleared for DE IVF

    11/13: DEgg IVF#1

    8/5/14: Grace was born!

    liz4paws
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