Gestational diabetes - a serious condition - a true life story of gestational diabetes and shoulder dystocia

Sophie's story...

Following a Glucose Tolerance Test at 29 weeks I was diagnosed with Gestational Diabetes at 31 weeks into my pregnancy.

I just heard "diabetes" and "no sugar" I was devastated. I felt like I'd failed at being a parent already and not looking after my baby properly and the doctors did nothing to comfort me at all.
On my first appointment at clinic I was shown how to take and record my results. As well as testing before and after meals I was given the "dietary advice" of: cut out sugar, eat more fruit and veg and change white carbs to brown carbs.
After a week I went back to clinic. I'd lost 6lb! But my levels were too high to stay diet controlled so I was given Metformin to help stabilise my levels. I went home deflated but knew it was the best thing for both of us.

After doing a bit of research I came across this wonderful group [Gestational Diabetes UK Mums Facebook group]. It was quite clear that I had been given some quite basic and poor advice regarding my diet. After a few days experimenting it came to light that in order to keep my levels down I was unable to eat any cereal or fruit for the remainder of my pregnancy as these sent my levels through the roof, and I was also only able to eat one slice of toast in the mornings. Turns out I became really good friends with scrambled egg on toast!

At 34 weeks I'd managed to get my levels under control and rarely went higher than my set targets. I was given an induction date, April 17th and was told that I would no longer need to come to clinic every week and the next time I needed to come in was for my induction. I also had extra scans to check on Freddie's growth: at 32 weeks he was estimated at 6lb 6oz, 36 weeks at 8lb 4oz 

Freddie had other ideas and my waters broke on April 8th. Labour itself was great, 4cm dilated 4hrs after waters breaking, no pain relief as of yet.
By the time I was 6cm it was clear things weren't going quite to plan. My cervix was thinning at one end but not the other so I wasn't dilating properly. By now my contractions were well and truly kicking in but the gas and air was doing its job and we were both doing good.
Once Freddie's head was born, that's were the good stuff ended. He got stuck on my pelvis due to his size and the cord was wrapped around his neck. Freddie was losing oxygen very quickly and before I knew it we had gone from me, my mum, my partner and midwife to about 10 more doctors in the room. It all happened very quickly. I had one doctor each side holding my legs up, one doctor pushing on my tummy and one doctor who had to make a cut to make room, who then swapped over with a doctor who was pulling Freddie. As traumatic as it sounds it was a million times worse.

As a first time parent I wanted nothing more than to hear my baby cry and be placed on my chest and for my other half to cut the cord. What I got was the complete opposite. Silence. My mum whispered to me "he's out"
I was then told that Freddie was born "flat" which to you and me is dead. My son who I'd waited not just 9 months for, but years for had no heartbeat and was currently being given CPR.

After 4 minutes he was stable and taken straight down to intensive care. I'd barely seen him yet I had to wait even longer than I ever thought possible. Freddie's birth weight at 37+3 weeks was 9lb 8oz.

Freddie spent the next 13 days going through the special care units and we took him home on April 22nd, the day before he turned 2 weeks old.

Due to a very bad Shoulder Dystocia, Freddie was in special care for a total of 13 days (5 in ICU, 2 in HDU and 6 in LDU) in this picture [below] which looks scarier than it is, he is laying on a cooling mat and received Therapeutic Hyperthermia for 3 days, the belly button IV was for fluids as we couldn't feed him ourselves as he was on Morphine and antibiotics, he had an oxygen tube on his nose, heart rate and blood pressure monitors on his chest, and probes on his head to measure his brain activity......all removed within 4 days!

Baby Freddie_Sophie Dodson
After the traumatic events we went through we were all expecting Freddie to have some difficulties but we were told to expect nothing more than a weaker left arm that will get stronger in time.
I wanted to share my story with you all because GD although temporary, it is a serious condition and can have devastating results. There is nowhere near enough information for ladies and medical professionals don't seem to know enough about it to advise correctly. The Facebook group is full of ladies who have or are struggling every day to keep their levels down yet every day they advise, support and give comfort to every single member of the group. The files that have been put together are so helpful and informative. I have no idea how I would have got through it without the group but I'm glad I don't even have to think about it. And as I sit here with Freddie in my arms I know that every needle I shoved into my fingers, and every time I skipped the chocolate aisle or said no to a takeaway it was absolutely worth it.

day1, 5hrs old
day 1, 5 hours after birth
day3
day 3

 

The concerns in Sophie's story

Whilst Sophie had a GTT at 29 weeks, it is sad to see that she was not seen until 32 weeks or told that she'd had a positive test result and had gestational diabetes until this time.  Although Sophie had a few weeks to gain control of her levels, by the time she had been given the late diagnosis plus given a chance to diet control and then a while for the Metformin and dietary changes to take effect, unfortunately precious time was lost in trying to control the effects of the gestational diabetes on Freddie.

day 4, first cuddles with Mummy
day 4, first cuddles with Mummy

love

 

A new update to Sophie's story. Baby Logan!..

Back in August 2016 I found out I was pregnant with baby number 2 . Completely unplanned and a lovely surprise. We wanted a sibling for Freddie who is now 16 mths old and although we didn't plan on having another quite so soon as I was still getting used to having Freddie...we were extremely excited!

One of the biggest things going through my head is, "when will I be tested for GD?!"  Well the answer to this was at 15 weeks. I tried to get in earlier but had no luck. Using the knowledge I had from my first journey, and what I had gained since by staying in the Facebook support group (Gestational Diabetes Mums UK) made me feel confident enough to make the necessary changes in the lead up to my test.

My GTT was on 18th October at 15+1. I was absolutely shocked to find out just 36hrs later that I had a negative result!! At my 16 week appointment my midwife gave me my actual results: fasting: 4.6, 1 hr: 6.9, 2hrs: 2.7. While I was very happy to have got a negative result, I know it's a progressive condition so knew this could change at any point.

I continued with the GD diet I knew worked. Not only cutting down on carbs and unnecessary sugars, but also natural sugars like the ones found in fruit and cereals, and eating more protein and good fats.

It was also extremely helpful to have a supportive partner as well as friends and family. They've never once questioned my diagnosis and they all took it as seriously as I did, they were always on hand for support and comfort. They regularly asked how my levels were and made sure I stuck to my carb tolerances. Michael, my partner often helped out with my testing, he took great pleasure in "stabbing me" and making me guess my results. I think this was his way of bringing a little fun to GD.

Our anomaly scan at 21 wks (Nov 11th 2016) revealed we were Team Blue again and decided on the name Logan. It was also the first one to include EFW (estimated fetal weight). He was 1lb 0oz (Freddie's EFW at this point was also 1lb 0oz). I was informed that there were some concerns that Logan MIGHT be small due to resistance in blood flow to the placenta so I was told I would be having extra growth scans.

Fast forward 10wks to Jan 5th 2017. I was 26+3 and got my positive diagnosis for gestational diabetes. Results were fasting: 4.2, 1hr: 12.2, 2hrs: 6.0. My results from Freddie's pregnancy (tested at 29wks, diagnosed at 30wks, seen at 31wks were: 6.1, 7.7, 14.6)

Although I was able to get my results in 48hrs (not 2 weeks like last time) my appointment to see the diabetic midwife would be in 2 weeks due to her being busy. Luckily I was able to contact her personally rather than waiting for a referral otherwise goodness knows how long I would have had to wait.

My next growth scan was at 28wks, 16th Jan 2017 and Logan's EFW was 3lb 2oz - this was considered a normal growth for my gestation. I had a scan at 32wks with Freddie and his EFW at that point was: 6lb 6oz

It was also at this point I was finally able to meet with my DMW Katy who gave me my kit. She asked me to test before and after meals every other day. I immediately said "No, I'll be testing everyday" and she was happy for me to do so, I mentioned spike testing (which is explained on the GDUK website should a new meal/snack "treat" be tried) and Katy said I was to do whatever I needed to do to be happy and in control.

I was able to send my results to her via an app on my phone so would not need to attend clinic every week, unless there where any concerns. We made our next appointment for 3 weeks time.

I had a consultant appointment later the same week and they were happy for me to continue as I was regarding testing because it seemed that I knew exactly what I was doing and they my blood sugar levels looked very stable, so I'd obviously made a great start! The consultant and I discussed Logan's birth and I decided to have opt for an elective c-section at 39 weeks purely down to the complications with Freddie. However we agreed to review this IF my GD became harder to control.

My next appointment in the diabetic clinic was 10th Feb 2017, I was 31 wks. Katy was extremely impressed with my levels overall. She was surprised by the fact I'd only had a handful that were over targets (and that was due to testing carbs and spike tests so I was able to adapt my diet the best way possible!) She asked me how I was doing so well and of course we all know how... I proceeded to tell her about the group [Gestational Diabetes UK Mums on Facebook] and [this] website and she was very interested to hear all about it. She called me an A* star pupil and said she wished all of her ladies took GD as serious and was as committed as I was.

It was also at this appointment that Katy asked me to take part in their research study, seeing how different aspects effect levels, so I was to measure carbs NOT count carbs, but just make a note of how much I have personally due to my tolerances. I was also to weigh myself every week, not to see the numbers specifically, but to see how the reduction of sugar/carbs affects weight. I was happy to take part, it's so important that hospitals treat patients individually regarding their GD instead of a "one size fits all" approach!

As I hit 34 wks (27th Feb 2017) I saw the progressiveness of GD kick in and a week of slightly high fasting levels. I made my DMW aware of the situation and I said I would like the chance to try and get them down first before we discussed medication and because she could see I usually had good levels and knew what I was doing she agreed. I used the knowledge from the support group to try and regain control of these.

It wasn't meant to be and as of 35wks (6th march 2017) I was on 500mg Metformin with Breakfast and 500mg Metformin with dinner. I noticed the change in my fasting levels after 24hrs and I didn't have another high level after then.

A growth scan at 36wks (13th March 2017) showed Logan's EFW as 6lb 2oz (Freddie's EFW at this point in comparison was 8lb 4oz). A meeting with the DMW after my scan was extremely positive. She was very happy to see that Logan's weight had not been effected by my high fasting levels and that his overall weight had gone from 90th centile to 48th centile. My consultant was also happy with the scan and although I was now on medication my levels were extremely stable and saw no need for us to change my c-section date!

My final meeting with the diabetic clinic was on Monday 27th at 39 weeks, and other than raised BP (due to a Birth After Thoughts meeting discussing my birth of Freddie) they were happy with everything. It was a fairly quick meeting, a run through of how I was feeling, how the Metformin was working, how my levels were, how Logan was. Due to my first BP being high I had some bloods taken, and was told what to look out for regarding pre-eclampsia but they felt it wasn't a major concern as I didn't develop it with Freddie. My BP was re-checked before leaving clinic and they were much happier with that reading.

Logan Thomas Lee Timmins was born via ELCS on Monday 3rd April at 11.29am weighing exactly 8lb. There were no issues or complications, he was and IS perfect and came straight up to the ward with me. He fed extremely well from the get go. His first 2 blood sugar tests were slightly under what the doctors wanted, but after a couple of feeds and a small dose of glucogel, Logan's observations were discontinued.

Hearing him cry and being able to hold him immediately was something we never got to experience with Freddie, and is something I will cherish for the rest of my life.

 

 

 

 

 

 

 

Thanks to the Facebook support group and website I now have 2 happy and healthy boys. I owe the ladies on the admin team and especially Jo a hell of lot. There will never be enough ways to say thank you for all their support during another emotional pregnancy and just knowing they were there every step of the way made it a hell of a lot easier to deal with GD.


Sophie's two pregnancies and births show what a difference earlier diagnosis of gestational diabetes and good control of blood sugar levels can make!

Thank you for sharing both of your pregnancy and birth stories Sophie xx

More information about shoulder dystocia:

Shoulder dystocia, RCOG (Royal College of Obstetricians and Gynaecologists)