Fat Woman and the testing times

Now that Fat Woman has Small Baby on board she is being treated by the NHS as an unexploded bomb. Rather than being regarded as an expectant mother Fat Woman is looked upon as a series of problems waiting to happen that must be managed in the most heavy-handed way possible. Fat Woman knew she was going to be in for it when practically the first thing she was given by the community midwife was a leaflet specially written for pregnant women with a BMI greater than 30. Fat Woman has said it before and will say it again: BMI is a statistical tool that is completely unsuitable for individual case management and unless you are going to talk body fat percentage with her she doesn't care to hear it. Fat Woman scores very badly on the BMI scale thanks to all the weight lifting. Thin Husband delights in referring to Fat Woman as his dense wife. Fat Woman has actually read the policies held by the local NHS trust on dealing with fat pregnant women and is deeply unimpressed with the blinkered and frankly bigoted attitudes displayed. All this is covered in a veneer of "It's for your own good" and topped with a good slice of "But think of the baaaaaby!" Fat Woman was most unimpressed by the decision that she should be on blood thinners. This was done purely because Fat Woman is fairly old for a first time mother and fat. Fat Woman then went through a huge palaver of getting the drugs, learning how to inject them, having horrendous allergic reactions, having to try two more brands in case she was allergic to the carrying solution and not the actual heparin, trying antihistamines to alleviate the effects, and then disposing of three lots of needles. Fat Woman was deeply annoyed at the hours she sunk into this only to find out that "double the risk" of blood clots meant the risk went from one in 6000 with the drugs to one in 3000. It turns out that exercise is a much more effective predictor of danger, but of course everyone assumes that fat women are lazy greedy couch potatoes.

Fat Woman would love to be a lazy greedy couch potato but can't seem to get the hang of it.

One thing that came out of Fat Woman's visit to the obstetric consultant was the request for a hospital administered glucose tolerance test. All pregnant women get a glucose test at their doctor's surgery, but in the hospital they make you fast, give you a glucose solution and then make you sit down for two hours whilst they take blood at intervals. Fat Woman was rather pissed off at the form letter which said "You have been invited to take this test because you have shown signs of high blood sugar" because that was absolutely not true. Diabetes is the sword of Damocles that doctors and the media like to hold of the heads of fat people. It's true that being fat and diabetic is a health issue that leads to complications but there is a convenient mis-thinking of the situation that means instead of referring to "fat people who have diabetes and who drink and smoke and take no exercise" as being a drain on the health system the media and the medical establishment have shortened that to "fat people". Being fat in and of itself does not mean you have these problems, and if you are fat, have a healthy diet and take exercise you are going to be much more healthy than someone in with a lower body fat percentage who doesn't look after themselves. Fat Woman has been mostly eating a diabetic diet for years because she eats food that is low on the Glycaemic Index. This mostly affects what carbohydrates you use- whole wheat everything, and brown basmati rice instead of any other - but also affects your choice of vegetables. Fat Woman doesn't consider sweetcorn a useful vegetable because of it's high sugar content and low fibre content. Fat Woman reckons that you might as well eat a boiled sweet and take a fibre pill as eat sweetcorn, This also means that Fat Woman doesn't eat a lot of fruit usually, and certainly doesn't drink fruit juice or smoothies on a regular basis. Fat Woman has managing her blood sugar down to an art, especially since she gave up Diet Coke, which was really fucking with her blood sugars, leaving crashing into sudden hypoglycaemia. Fat Woman hasn't felt that awful, desperately empty feeling or the rage and fury that would come with it, since before Lent 2012, and is in no hurry to experience it again. Fat Woman is fairly sure that Thin Husband is grateful not to have seen it for a while as well.

Fat Woman consulted with her midwife and decided that she would take the Glucose Tolerance test at the hospital on the grounds that at least it could be properly measured whereas the one at the doctors' surgery is rather hit and miss. The thing that Fat Woman was most worried about on the Glucose Tolerance Test was drinking the dextrose mix. Fat Woman can't remember ever having had to do so before, but she really hates chemical drinks. It has been nearly fifteen years since Fat Woman was convinced that an electrolyte replacement packet (for diarrhoea sufferers) was a good cure for a hangover. Fat Woman was thoroughly ill after trying to drink the horrible stuff and avoids anything similar. There are numerous shared stories of women being similarly ill after drinking the dextrose solution at Glucose Tolerance Tests so Fat Woman was incredibly relieved when the blood tech gave her a bottle and a bit of Lucozade and said she had to drink that instead. Fat Woman fails to see the point of Lucozade as a drink in its own right, but it is at least reasonably inoffensive and doesn't make her ill.

Fat Woman had to hang out in the hospital for two hour and get three blood tests in total, but despite feeling desperately hungry by half past ten she didn't suffer too much and nor did those around her. Fat Woman had been briefed on the need to take food with her and had a careful schedule of eating and sleeping planned for the rest of the day so she could turn be functional at her shooting lesson. Fat Woman has found that low blood sugar means her shooting goes to utter shit.

Today Fat Woman got the results of her Glucose Tolerance Test. Fat Woman has learned to check the laboratory ranges for blood tests. Sometimes you can be told that you are "normal" when you are actually only just inside "normal" and will be left feeling utterly terrible when actually you could be greatly helped if your levels were considered as low or high in conjunction with how you actually feel. This is called "treating the patient clinically" rather than relying on laboratory results associated with a statistical distribution called "normal". The lab print out stated that gestational diabetes millitus in pregancy is diagnosed by one or more results at or above the following:

Fasting 5.3 mmol/l
1 hour  10.0 mmol/l
2 hour 8.5 mmol/l

"mmol/l" stands for millimoles per litre. Fat Woman had to look this up, but her grasp of chemistry isn't going much further than that so suggests you check out the wikipedia page if you want to know more.

Fat Woman's actual results:

Plasma Glucose Fasting 4.2 mmol/l
Plasma Glucose 1 hour  5.4 mmol/l
Plasma Glucose 2 hour  3.9 mmol/l

What Fat Woman didn't realise at the time was that the old blood sugar percentages are no longer used. Thankfully Diabetes UK provides a handy conversion form at http://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Testing/#HbA1c.

Plasma Glucose Fasting 2.5%
Plasma Glucose 1 hour  2.6%
Plasma Glucose 2 hour  2.5%

Fat Woman's Glucose Tolerance Test results were so amazingly good that someone has actually written "Good result" in pen on the print out sent to her, with a little asterisk alerting her to the "normal range."

Fat Woman was so pleased at this validation of her healthiness and the news that she is not any kind of diabetic that she ate a Rolo cookie and a piece of shortbread, partly because she likes cookies and shortbread but mostly because she could.