Tuesday, February 12, 2008

Gestational Diabetes Part II: The test

So, Lillian the midwife told me the following.

There's actually another way to do the gesational diabetes test, instead of the nasty glucose drink. It's called the fasting and consumption test. You fast from midnight the night before, they take your blood at 8am, then you leave and go eat your breakfast and come back two hours after you eat for another blood test, then they compare the two. Doctors like the glucose test a lot better because they are controlling everything: they know exactly what you are ingesting and when, and they keep you in the waiting room for an hour, they don't even want you to walk around and work off any of the glucose. With the fasting and consumption test, you are eating what you would normally eat, which is more accurate to your reality, instead of making you drink something you would normally never drink. The glucose drink results in a high number of false positives, too, so the other one is actually more accurate.

After asking a few more questions, I felt doing the test was the pertinent thing to do, so I agreed. After talking over my fears with Chris and getting lots of positive reassurance, I took the test on Friday. Only -- in the way that only I can do -- I think I might have screwed it up.

I didn't eat anything in the morning. I was at the hospital lab before 8am. I gave them my requisition and they took my blood. They told me I could head off, eat my breakfast, and come back two hours later for the second test. They also suggested that I go to the SAT lab instead of the hospital. I was wary of this, because usually when I go to the SAT lab I am there for upwards of 45 minutes before they even call me up to the desk (it's on a take-a-number system there). But I agreed to do so.

Went to my office, getting there right on time (so convenient to live and work right near the hospital!). Ate my breakfast of fruit and yogurt and got to work. About an hour later, the queasies hit, because of course it was 9:30am and that's prime time for the queasies. I really didn't want to throw up (who does?) so I had to eat another little something. Okay, I didn't necessarily *need* to eat a mini Kit-Kat bar, but I did, so let's move on, okay?

I ate the mini Kit-Kat bar (well, since we're being honest, I ate two of them), the queasies eventually passed without incident, and about an hour later it was time to head to the SAT lab for the second part of the test. I arrived to find the waiting room packed as always, but when I went up to the counter I told the nurse that I was here to do the second half of a glucose test. "Oh, you're on a timed collection, then?" "Umm, yeah, I guess that's what you'd call it." I was pleased that she was so receptive to my conversing with her, as the nurses there are often incredibly "talk to the hand" until you get your number and wait your requisite hour to be seen. Anyway, she started asking me questions, and took my requisition form, and confirmed that I'd fasted the night before, that I'd had my blood taken once already, that I'd eaten breakfast, and so on. Then asked me what time I figured would be two hours since breakfast. "In about 10 minutes," I told her. "Great, I'll set a timer and call you up then. Just have a seat."

I was walking back to the waiting room when she called out, "Oh, and you've been fasting since breakfast, right?"


As I was recounting this all to Chris later, he said, "So, you told her that you had eaten something in between, right?"

"No!" I wailed. "I totally lied, because I want to make everybody HAPPY by telling them what they want to hear."

(I know, I'm a wimp, it's a problem.)

Anyway, I did totally lie and tell the woman what she wanted to hear, then went into the waiting room and commenced panicking and rationalizing. I swear, I never heard Lillian *or* the lab tech this morning tell me that I had to fast in between breakfast and the second test. I thought once I had breakfast I could proceed as usual with my often-bizarre eating habits. Dammit! Oh well, there was nothing to be done about it now, the test was half-done and the wheels were in motion.
The second blood draw went without incident, and I went back to my office for the rest of the day's work (well, puttering around and surfing the net; I have a pretty boring job). I reasoned that if I failed the test, I could request to take it again (or get some other kind of confirmation); and that if I passed, well, then I'd pass with flying colours, considering the chocolate intake throwing things off. And really, what's the worst that could happen - a false positive, which would result in me being forced to eat healthfully for the next 12 weeks? Obviously, I could use a little discipline in that area!


yagowe said...

I'd have totally lied to the nurse as well.

Kat said...

Yes you will get a false positive. By asking you to fast after breakfast they are looking for your blood sugar levels to return to normal by the time the second tube of blood is drawn. By eating again, and especially a chocolate bar (or two), you spiked your sugar again just before they drew the sample. I would be greatly surprised if you don't get a false positive.

This does not mean that you will necessarily get a false positive because your genuine positive could be masked by your massive chocolate-bar sugar rush.

adequatemom said...

Hey Kat, yeah I was thinking about this last night. I think I will have to ask for another test/confirmation because otherwise I will spend the rest of this pregnancy (possibly the rest of my life, a-feared of Type II setting in) wondering if the results were genuine or false. What a pain. I really wish they'd been more clear with the instructions about fasting after breakfast.

Anonymous said...

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And according to this article, I totally agree with your opinion, but only this time! :)


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