Thirty-two weeks pregnant: a diagnosis

A silent sonographer in a pregnancy scan is always unnerving. We have Robert for our 32-week scan and apart from the briefest hello in a strong Scottish accent, then an invitation to lie on the bed, we don’t do small talk. Phil sits in the plastic chair beside me. We hold hands and look up at the monitor, excited to see our space baby beamed on screen.

We have this scan at 32 weeks due to my age. Our hospital like to keep tabs on the over 40s and to be honest, I’m happy about that. Robert gets down to his measurements. He draws lines across our baby’s head. He draws a circle around the stomach. He traces the length of the femur bone. I recognise all those parts easily.

Then Robert measures top to bottom in dark pockets. I ask what he is measuring and he says amniotic fluid: click, click, reposition, click, click, reposition.
“Does everything look okay?” I say.
Robert plays us the reassuring pulse of our baby’s heartbeat – swish swoosh swish swoosh – a flood of relief seeps from my head through my heart to my stomach. Robert switches position to the umbilical cord. He flicks on the bright red and blue blood flow. Two colours good, I think to myself.

I am dying to ask Robert, “please can you show us our baby’s face?”
I really want a long look at the face, as I’d been told by a friend that features are really defined at this stage of the pregnancy, even on a 2D ultrasound. We do get a quick glimpse of full lips and nostrils as Robert moves up again, a breathless moment of wonder for me – but then the ultrasound wand moves away and I can’t quite bring myself to ask Robert to show us the face.

For the rest of the scan, Robert returns to the abdomen and those pockets of amniotic fluid. He finishes up and walks over to his computer.
“I’ll be a few minutes writing up my notes,” he says.

Holding hands, Phil and I look up at the monitor for clues. The screen is now displaying a table of figures. My eyes fix on the estimated weight – 5lb 3oz – confirmation we’re in for a big baby. I had expected it with a family history of 9 and 10 pounders. I whisper the weight to Phil and laugh.

I can’t help but ask Robert another question. “I have been leaking fluid every few days since week 24. Was there enough amniotic fluid?”
A new, long word flies our way – polyhydramnios – like a boomerang, the word wraps around my head and flies back across the room at Robert, who offers up the definition.
“Actually, your fluid is too high,” Robert says. “It’s increased since your last scan.”

A dozen competing questions ping into my head.
“Is everything okay with our baby?” I say.
Robert says he’s referring us to the diabetes team.
“I’m recommending a gestational diabetes test,” he says. “And we’ll see you for another scan at 34 weeks.”
My stomach shrinks. I feel instant guilt.
Phil takes the referral form from Robert.
All I can think is – god, have I harmed my baby?
I want to ask Robert so many more questions but everything about his body language says his job is done. He encourages us to phone the diabetes team in the morning, to speed up getting an appointment.

Outside the scan room, we sit down. Phil says it’s taken the wind out of his sails and I agree. We had both expected another dose of reassurance and a final takeaway scan pic. I do a rapid internet search on my phone – stupid, I know! In Google Images, I am led immediately to the most extreme cases of gestational diabetes. There are pictures of enormous babies – 13, 14, 15 pound babies – so swollen, some of them wired up.

Stop!

Breathe!

Put down the internet!

Gestational diabetes testing

Early the next morning, I phone the diabetes team and ask to be tested as soon as possible. A lovely nurse, Christine, squeezes me in the next morning. They are fully booked, she tells me, but she makes it happen. Christine is ‘minor miracle number one’!

On test day, I arrive with an empty stomach to an empty hospital corridor. I’m early, a sign of my nerves. I wait for the locked doors to open, then I go through the blue doors to the Diabetes & Endocrine Unit.

8.30am: I am called through to the nurses’ station for a fasting blood test – as luck would have it, Christine is my nurse. I thank her for such a swift appointment. She has lovely round cheeks when she smiles.

After taking my blood, Christine gives me a sachet of Rapilose OGTT Solution. She says to drink all of it, fast. It is incredibly sweet and thick and heavy. My lips and tongue and throat are coated with a syrup snail trail. Yuck!

Christine tells me to wait for two hours in the waiting room. I sit next to another pregnant woman (though you can’t tell she’s pregnant to look at her). We get chatting and I find out she’s also here for gestational diabetes testing. She has a German accent and is wearing a smart green office dress – I find out later she works in the City for Lloyds. This is her second pregnancy. She had gestational diabetes in her first pregnancy, so they are testing her early this time. I’m calling my German friend ‘minor miracle number two’ in this tale, because she is very reassuring about being able to manage the condition, if my test is positive. She is completely as you would assume a German banker would be – practical, logical, unflappable! Those sucking thoughts – mainly “have I completely screwed up this pregnancy?” – they fade away as she shares her experience.

9.30am: An hour after the sickly Rapilose and I have to excuse myself from the chat with my German companion. I close my eyes and lean my washing machine head back against the hard wall. I feel sick, yet I am also craving soft boiled eggs. I think about the first scoop of white from the top of the shell. I drink some water and sit with the fuzzy whirl of nausea. I’m a reluctant passenger on a waltzer, the fairground attendant madly spinning me round.

9.50am: Phew, my head whirl subsides and I start to feel human again. I vow never to eat sugar again!

10.30am: The clock hits the two hour mark and almost to the minute, Christine calls me through to the nurses’ station.
“How are you feeling?” she says.
“I’m okay now,” I say, “but I felt pretty out of it in the middle.”

Christine nods her head and draws a kind smile up her face. I feel relaxed in her care. She plugs a test strip into a digital meter. She pricks my finger, pressing out a bead of blood. She dips the test strip and sucks the red up the strip. The device beeps to confirm enough blood has been drawn in. The result takes a few seconds to display…

9.9

“It’s high,” Christine said. “I thought it might be after how you’ve been feeling. We’ll take some blood too, just to be sure, then you can go and get something to eat. Please come back in half an hour for your results.”

10.50am: The German pregnant lady and I head down to the ground floor of Guy’s Hospital. We stake out the café bar. They are ten minutes away from starting lunch service. I scan the menu, ruling out pasta carbonara, chips and everything below the dessert heading. There’s beef chilli on the menu and broccoli, which seem safe enough. I decide to pass on the white rice. My German friend wants the same as me.

We wait for feeding time like two ravenous zoo animals.

11.30am: Back in the clinic, Christine confirms my diagnosis of gestational diabetes. She takes me through to another nurse, Yolanda, who explains the next steps. I need to test my blood four times a day – once when I wake up and then two hours after breakfast, lunch and dinner. She shows me how to use the blood glucose monitoring kit.

As Yolanda speaks, I scribble down notes, as if it’s my magic superpower. Note-taking has always been my coping mechanism when I feel clueless. The nurse tells me to attend an education session on Friday about nutrition, effects on the baby and implications for labour and birth. She says the baby may have to come early, depending on how things go over the next few weeks. Yolanda gives me leaflets to read at home, quickly paraphrasing their contents. I begin to feel like I’m being left behind in a running race, with speedy Yolanda sprinting ahead of me, calling back instructions that I can’t hear.
“Please, can you slow down?” I blurt out.
I think I hear sarcasm when Yolanda says, “of course, I’ll slow down for you. What don’t you understand? Please, tell me.”
She’s not being sarcastic. I am definitely being over-sensitive, because in the silence of the pause, in the small consultation room, my cheeks get hot and tears come.
“Look, I’m sorry,” I say, “it’s just taken a lot of time to get here. We lost our baby in pregnancy last year. I just want to make sure I understand what you’re telling me to do.”

Yolanda goes over the information again, slower. I can sense she’s running late for the next appointment but the information does go in better this time. Essentially, if I get two high blood glucose scores, over 5.5 first thing in the morning or over 7.0 after meals, then I should phone the diabetes team and they will discuss medication. She hands me a little book to record my scores. She gives me a prescription to pick up at the hospital pharmacy for metformin – just in case I need it. I already have a monitoring device, which Christine gave to me earlier.
Yolanda checks, “is everything clear?”
“Yes, thank you,” I say.

I leave the small room with my red cheeks and paperwork. I say goodbye to the German lady in the waiting room – I never did get her name, which is unusual for me. She’s next in with Yolanda and I know I have kept her waiting, but she smiles cheerily. We wish each other good luck.

Going down in the lift, out of the hospital, I feel an overwhelming urge to sleep. I could kick myself for messing up on food, an area I’ve always considered myself to be knowledgeable.

As always, there’s lots for me to learn…

(To be continued)