Thursday, June 17, 2010

More GD Frustration

I had my follow-up appointment with the nutritionist today, to see how I'm doing with the GD. What an unbelievably frustrating experience!

The whole appointment started off bad. I have a written log on which I'm supposed to write down everything I eat, and what my four-times-a-day glucose levels are. I dutifully filled in the entire log. The first thing the nurse did was take the log from me, then ask for my glucose monitor. The monitor has a memory function, which stores a month's worth of values. She then proceeded to go through all the numbers in the monitor to verify that I didn't lie on my written log. She did this for the entire week's worth of values. Then she eyed me suspiciously and asked if I was sure that all of my numbers were from my blood and not from somebody else in my household. Nothing quite like the feeling of knowing, without a doubt, that the person sitting across from you is convinced that you're a liar.

Then we had this conversation:

Nurse: Wow, your numbers look great!
Me: Thank you. Given my weird initial test results, and my low monitoring numbers, do you think it's possible that I don't have GD, maybe ease up on some of the restrictions a bit?
Nurse: No, you definitely have GD. Otherwise you wouldn't have failed the test.
Me: But, by the ADA criteria, I didn't fail the test. And my monitoring numbers kind of back that up.
Nurse: Now you're just arguing semantics.

Note to the world: I don't think that she knows what the word "semantics" means.

Next, we talked about exercise. At the GD class, we were told that if our blood glucose levels after eating were too high, they can usually be lowered by exercising a bit during the hour immediately after eating but before testing.

Nurse: Are you exercising after meals?
Me: I do exercise every day, but it is very hard with my schedule to exercise within an hour of starting a meal, because I'm commuting after breakfast, and I'm in meetings after lunch.
Nurse: Oh, okay. Then we should probably put you on insulin.
Me: Pardon me? I thought that my numbers all look great?
Nurse: Yes, they do. But if you're not willing to exercise, we'll need to put you on insulin. Your choice.
Me: You would put me on insulin even if my levels are completely under control without it? What would you possibly accomplish by doing that?
Nurse: We just want to help you to protect your baby.

As an aside: does implying that a pregnant woman doesn't care about her baby really motivate her to change behavior? Because it honestly just pisses me off. So does threatening me with completely unnecessary medical interventions.

The exercise discussion also included this bit:

Nurse: There's lots of ways to exercise. Don't you play with your toddler?
Me: Yes I do, but not after meals.
Nurse: Why not?
Me: An hour after breakfast, I'm at work. Same with lunch. And an hour after dinner, my toddler is in bed. I play with my toddler a whole lot during the day, but it tends to be before breakfast and before dinner, and there isn't much I can do about that.
Nurse: (with a disapproving look) Okay....

And finally, there's this gem:

Nurse: Is there anything that you had trouble with this week?
Me: I found it difficult to test after breakfast, because I'm commuting to work one hour after breakfast.
Nurse: Maybe you shouldn't go to work for a while.
Me: Um, I don't see how that is possibly an option.
Nurse: We just want to help you to protect your baby.
Me: My baby seems pretty well protected without me dropping out of school and quitting my job.
Nurse: Well, I guess that's your choice.

Yeah, not the best medical experience I've had in my life. At a minimum, I was looking for a little support and advice about how to fit all this monitoring into my life. I was not looking for threats, or implications that I'm a bad mother, or being treated like a liar. And yet, after all the disapproving comments during the appointment, she concluded by telling me that I seem to have things so well under control that I can go several weeks between appointments.

And yes, I made sure to make my next appointment with a different nurse.

5 comments:

  1. Yeah, in addition to scheduling with a different nurse I would absolutely file a written complaint. Threatening you with insulin because you can't exercise when your numbers are excellent is incoherent and just pure bullying.

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  2. That is ridiculous. I would definitely complain!

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  3. that is a bad bad nurse. I would probably let someone know about her inappropriate bedside manner

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  4. I would definitely complain! Can you imagine what kind of impact that sort of interaction could have on someone that was totally clueless about what was going on? It sounds like everything she said was completely inappropriate!

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  5. I'd find it hard not to slap her with all the "protecting your baby" comments.

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