Wednesday, 27 April 2016

15 Weeks - Consultant Care by Proxy

A mixed week.

On the plus side, I'm starting to feel less sick. Waves of nausea, rather than feeling constantly nauseous. This has enabled me to finally eat more vegetables, as they no longer turn my stomach, so we've been enjoying some delicious salads. Brilliant for my blood sugars.

eclair 15 weeks baby size
Baby's the size of an eclair now, which is ironic as I'm not allowed to eat them!

I think I've had some minimal breast growth, and I'm getting pains in my armpits, which could also be more breast tissue growing. I have no expectations of a full milk supply - that is highly unlikely - but I might make more than last time. I did make more with M than B, so that is a possibility.

Also, we've had our first offer of donor milk for the baby. I hadn't even started to think about getting a stash sorted yet, so this generous offer is wonderful. Now I can be sure that we will be able to supplement with breastmilk as soon as we need to.

However, it turns out that despite declining consultant care, it seems that I'm being consultant-led by proxy.
I received the following message from my midwife:

"Just a quick update from clinic. They're sending you out appointments to see a consultant,  So you'll be receiving that in the post soon. They've also asked me to ask you to stop taking your metformin tablets now,as you shouldn't need them."

Well, here we go. They obviously haven't read my notes, so I responded: 

"I won't be stopping my metformin, as there is evidence that it can help to grow extra breast tissue, and it did help with increasing my milk supply a bit last time. Also, I was prescribed metformin for Polycystic Ovarian Syndrome and the insulin resistance that is caused by it, not for any fertility issues. I have been taking it since February 2012, so took it all through my second pregnancy. There was no concern about it last time.
Can I just ask, has there been any change in the protocol on metformin in pregnancy to suggest it is no longer safe?"

And then I got the following response, that again proved my notes were not being acknowledged:

How this exchange is making me feel
"Ok, thanks for clarifying that. I'll pass that onto clinic so they're aware.  
There's been no change,  and we use metformin for pregnant diabetic ladies. The concern is that we don't know if you are or will become diabetic. Clinic have suggested 2 things. 
1: that you come into clinic to discuss your options with a consultant and
2: that you borrow a blood sugar monitor from them to continue testing at home with a calibrated machine. 
Another concern is that without an accurate bmi they are unable to produce a personalised growth chart to plot the baby's growth and to ensure optimum growth. If they are you in clinic you'll be offered scans to monitor this. 
I hope you don't feel pressured at all, I'm just forwarding what they say so you have options."

They don't know if I am or will be diabetic! It appears that either the policy has changed, or an attempt to manipulate me is taking place.

When I was pregnant with M, my consultant told me that she wouldn't send me for the GTT, because the assumption would be that I would develop GD, due to having it first time around.

Now, they're not sure if I will be. And yet, they're treating me as if I will be anyway. Which is as it should be. And as I have been saying to my midwife from the beginning. I also told her that I already have a blood sugar monitor, and am intending to test at home.

The one part of this message that I don't understand is the personalised growth chart. I'm in the process of finding out about it though. I don't feel particularly concerned about their concern though. From what I've found out recently, the personalised growth chart is a new protocol, and I've had two successful pregnancies without one.

I don't want the four growth scan appointments I've been sent through the post already either. I'm not convinced that ultrasound scans are entirely safe (midwiferytoday), or particularly accurate at later gestations, so I shall be declining them. Something else I told my midwife at Booking-In, when she used growth scans to tempt me into seeing a consultant.

person pushing boulder up a hill
The struggle is real, folks!
And, yes, I do feel pressured. I have declined, and I'm still being pushed.

My reply:

"Thanks for passing on their concerns. I have a blood sugar monitor already."

Short. And to the point.

Catch Up: 14 Weeks 
Moving On: 17 Weeks


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