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High-Risk Pregnancy
While were talking GD...long sorry
Anybody not happy with their dietician?
I spent what seemed the most useless hour of my life today - aside from the fact that I lost yet another 1/2 day PTO with my baby- due to their scheduling issues...
She asked for my numbers, what I eat for breakfast, lunch and dinner and proceeded to give me the "ALL PREGNANT WOMEN SHOULDN'T..." and then a list of all sorts of processed foods that I can have...which I wouldn't consider eating under normal circumstances.
My fasting numbers are great - yet she suggests that my snack of Goldfish and string cheese at night should be replaced with Ice Cream...I HATE ICECREAM! - OK maybe not softserve - but I'm not gonna trek to DQ for Softserve at 10 PM...
My breakfast numbers - even with having a Carnation Chocolate Milk -40 carbs- are great...I have been eating fruit on the road to work - no spike...yet she says not to eat fruit in the morning...she instead wants me to have 30 carbs for snack, 45 carbs at lunch and dinner when those are the numbers that are significantly higher when I eat to many carbs...WHAT GIVES???
At this point they are looking to schedule me for this and that meeting every week it seems when I barely have enough hours in the day to get my work and home life balanced between daycare drop-offs and a commute that's been taking me 1.5 hrs each way lately...How often do you guys see your Dieticians and various Nurses and Doctors associated with GD?
I feel so frustrated and just want to tell them to go to hell...I feel like the only reason they want to see me this often is to insure the Hospital keeps getting paid by my generous insurance plan...as I'm not getting anything out of this other than bruises from being stuck with needles....
Can I politely decline further counseling and commit to monitoring my numbers and get in touch with them when I feel I'm loosing control of the situation? Has anybody done this? The nurse just picked up the phone and started scheduling appointments for me like my schedule wasn't even a concern for her...I was so upset she had me in tears...
OK VENT OVER...any of your experience is much appreciated!
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Re: While were talking GD...long sorry
I don't like my nutritionist either! I was diagnosed early in the pregnancy and took a weeks worth of numbers to her for our first meeting. She told me that my numbers were too low and that I needed to bring them up while decreasing my portion sizes. What????
She never gave me the number of grams of carbs that I should have at breakfast, snacks, lunch, dinner, etc. Just gave me the number that I should have in a day. I don't follow her guidelines much. I've been doing this for over 14 weeks and my doctor says my numbers are fine, the baby is growing well, and all is going good. I told the doc that I eat larger portions than the dietician told me to eat and that the one day that I really tried to eat her portion sizes, I had a headache for 2 days. The doc told me that she is fine with things the way they are and to keep doing what I'm doing.
I don't know about the schedule for seeing her as I don't have to see mine another single time unless shots become necessary.
I also felt the the nutritionist visit at the diagnosis of GD was useless. She showed me what the appropriate serving looked like and that was it. However, some foods I need more of and some less to keep my numbers in check. I've never met with her since that appointment and I dont even have to let her know my numbers (which I think is odd).
My doctor is happy with the progress thus far and hasn't said anything about what I'm eating so that I'm ok with it! I go with the flow but still make sure to try to stay within carb limits.
The biggest waste of time was the lady that told me about diabetes and how to use the checker. I was using the checker for almost 2 weeks at that point so I didn't learn anything! I was dreaming of a nap the whole time I was listening!
So neither one of you is getting pressured into more appointments but seems to be managed by your OB-GYN Office?
I truly feel like I'm just a paycheck to them...did you just tell them you were not interested in further counseling or was it not even a question?
For my nutrition counseling, it was done out of a center that is above the doctor's office- I had to sign a commitment letter of attending 3 times - once for the half day class/initial appointment, a follow up 7-10 days later, and a follow up 6-12 weeks postpartum. I also have not been that happy, as I feel like I don't have anyone to talk with regarding my lunch/dinner numbers- which are also 45g of carbs and are always my higher numbers. I am just figuring it out on my own. Initially they had my lunch at 30g, dinner at 45g, and evening snack at 30g - I was starving all day and then by evening snack I was completely stuffed and could barely eat anything.
I also commute 1.5 hours each way - it's very tough - and I don't think you should be pressured into going to more appointments unless you are having problems with your numbers. I would have no problem calling up and cancelling appointments if you are doing alright and your doctor says that you are within normal range of everything.
My OB does nothing as far as my GD is concerned. That is handled by my MFM specialist's office. I see him for every single visit. The nutritionist/certified diabetes educator just pops in to say hi and that she saw that my numbers were great. She asks if I have any questions or concerns. The MFM also goes over my numbers with me. Regardless of how good your numbers are, his policy is to do 2 growth ultrasounds in 3rd tri, biophysical fetal profiles weekly (3rd tri) and weekly NSTs starting at 32 weeks. He dictates a letter to my OB in front of me. They also test my urine, weigh me and take my BP.
This is my second pregnancy with GD and I am not being seen very often yet. My numbers were low my first visit and the anatomy scan showed no problems, so I was scheduled for a visit 3 weeks out. I am sure that the visits will increase in frequency. FTR- I have never waited at the MFM's office. He will always see me on time or even a little early.
I am sorry that your dietician is not helpful. Are you seeing an maternal fetal medicine specialist or just the nutritionist? If you aren't seeing a specialist, I don't see why your OB can't go over your numbers. Maybe they don't have the software to download your numbers at your OB's office? I was told in my first pregnancy that seeing the MFM was not a choice. I either went to my appointments or my OB would drop me as a patient.
That was what I expected - as it seems to be the experience for most.
My OB checked my numbers in the morning at my 31 week Appointment and said that her key concern in general are my fasting numbers - which have all been under 85 if not 80 - and that if they go up we'd talk about insulin.
I guess really I'm just frustrated as I have no idea who manages my diabetes care...the Nurse at the Hospital gave me a "new" Glucose Meter that she was sure of my insurance would cover the strips but then she said I'd have to call my OB Office to get a script for the testing supplies...
But next week I'm supposed to see a Dr. who will look over my numbers...I just don't have the time to hang out at this bloody hospital 2 days a week from now for something that seems (and I may be wrong 2 weeks from today) completely under control...It just feels like I'm getting bullied into things I don't want or need...
You are not going to like my answer
My first pregnancy, I saw my dietitian once a week and my OB on their high risk patient schedule (once a week from 34 on, always with a BPP and NST). This time, I am seeing a new OB so it's different. OB every four weeks for now, then every 2 or 3 starting at 24 or 28 weeks, depending how things are progressing. From there we'll determine any extra monitoring needed.
To manage the GD, I see the dietitian as often as he feels necessary. For a while, it was every 2 weeks, and I saw the endocrinologist every 4, but at the same time as the dietitian. Now he's willing to see me only when I come in for endo appts as long as my numbers are under control. I also do a phone consult with him if I have any issues - random high numbers more than two-three times a week or high ketone readings several days in a row, and based on the info I give him he may or may not have me come in.
Personally, this is my second time with GD, and I would much rather be going to appts that might seem unnecessary than be ignored. I want my management team to be proactive and on top of things, because with GD things can change overnight. If my team and I are checking in often we can get things back under control more quickly when necessary.
I do think your dietitian could have done a better job explaining what the appts are for, why you need them, and been more considerate in scheduling them. She sounds like she might need a refresher in relating to her patients. And if you really can't take time to go to an appt in person with your dietitian, ask if they'd be willing to do a phone consult every other appt. For example, instead of going in person every 2 weeks, you go in person every 4 weeks and call her to check in in between.
DD1 Feb 2010
DD2 Sept 2011
I absolutely hated the dietician that I saw. To the point where I switched endocrinologists completely! I am still following the diet that she gave me because my numbers are great when I follow it, except my fasting numbers. I see an endo (which happens to be the same endo that I saw before getting pregnant for my PCOS and thyroid) and then my OB. My endo also said that I really don't need to see an MFM specialist or other high-risk doc because I'm not high-risk, just a "soft risk" and that is fine by me!
I will only see the endo when/if my numbers warrant it. I am only 2 weeks in, but so far, I just fax over my numbers every week. If there is a concern, the doc will call me with instructions to come in and see him. As long as baby is growing right on track and not getting too big and my weight and blood sugars are in check, I don't see a reason to have to see the endo or dietician.
Now, later in my pregnancy, I know there will be more appointments with my OB for NSTs, growth ultrasounds, etc.
I feel your frustration. When the Diabetic case manager called me, she had me in tears too because she wouldn't listen to a word I was saying. At my hospital, the only GD "class" is at 8am. I am a teacher out of sick days, so I asked if I could meet with someone else in the afternoon or on the weekend. She basically shamed me for not taking time off, but I don't have it to take. I asked a few times, "There has to be someone else I can see."
So now I'm kind of flying in the wind with a "diet" they gave me that listed 1 egg and 1 piece of toast for breakfast. I would starve on that! I researched the diet myself and have set some general carb limits until they can see me. The whole thing has me incredibly frustrated and hurt. I hate being seen as a number and not a person.
I'm so sorry for your experience, and hope you can figure it all out.
The saga continues - after more tears and waiving GD care via the phone yesterday - because the scheduling expectations of the Hospital are just insane (3 days a week if I'm to meet with everybody who wants to see me) I finally got somewhere...the Dietician called and left me a heartfelt (phony) message and than later I heard back from the Nurse as well as my OB Office...I have been able to convince them that my care can be managed from afar via e-mail and phone as long as my numbers are good. Once there is a change in that - or I start seeing Ketones in my tests I will go see them...
I wish these people would bump! That's about the only site not blocked at work!
Sorry it is so rough for you. My OB office seems to handle GD completely different than everyone on here. I didn't see any spexialists. I wsa told I had GD at about 30 or 31 weeks. I had to go tot he class (4 hours) with the dieticians and nurses on how to use the meter at the hospital (which I was also shamed as to why I couldn't take more time off work to meet with them when their only class was noon on Wednesdays).
I then started seeing my doc every 2 weeks and having NSTs once a week. I was supposed to email my numbers to the dietician once a week and bring my numbers printed out to my doctor appointments. I also had a 32 week growth scan.
Then at 34 weeks they decided they wanted me to have NSTs twice a week and see the doctor once a week for the duration of the pregnancy. I never saw a special doctor, never saw the dietician again, never had to deal with a lot of this stuff. I'm not sure if that is bexause my GD was diet controlled or not. I do know it was a huge PITA though because my work is almost an hour from my doctor's office and the apt times for NSTs were only as early as 9am or as late as 3:30pm so I had to go in late or leave early twice a week for the last month, which sucked.
I was induced at 39w1d and was so glad to get rid of carrying that meter around! Hope I never see it again.
I still don't understand why everyone's doctors are so different.
Yeah, my dietician also sucked. I only had to see her three times, but it really wasn't helpful at all. She was really into GD scare tactics and kept pushing crappy processed foods over natural ones.
If I have GD with #2 (whenever that may be), I'm going to decline her services. Such a waste of time. I learned a lot more from the American Diabetes Association's website.