Hi,

My wife is 8 months pregnant. One of the routine tests taken during a
pregnancy is for gestational diabetes. If you have it, a special diet must
be followed to ensure the baby is not born with or gets diabetes later in
life. Also a baby could be born substantially larger resulting in a C
Section. Here is my problem:

My wife took the test on June 4th. We were told if the test came back
positive that a doctor or nurse would contact us. We did not hear anything
back from the office. We assumed everything was ok. My wife has had at least
one scheduled doctor office visit since the initial test and at no time was
it indicated to her that she tested positive for gestational diabetes.

However during today's visit (July 2nd), another doctor asked if she was
made aware of the results because it was not listed in her file. Seeing that
her file did not have the test results, the doctor checked with the lab and
found out she tested positive for gestational diabetes. Apparently the nurse
did not follow up with the lab and update my wife's file. The doctor is
sending my wife to a nutritionist tomorrow (almost a month later) so that a
strict diet can be followed.

My concern is that if my child gets/has diabetes and it could have been
prevented, the practice is at fault for not following up on the test results
from the lab and communicating it to the patient.

My question is can I file a complaint/report so that it is on record that
the doctor's office was at fault for not verifying the test results? I fear
if I report it over the phone no action will be taken, and the same issue
might happen to other parents. Also if a report is documented, it could be
referenced later as proof that the doctor's office did not perform their
job.

I live in the state of NC. Any advice would be appreciated.


thanks,
RH

"RH" <nospam@aol.com> wrote in message
news:fNLMa.133435$_w.6748101@twister.southeast.rr. com...
My wife is 8 months pregnant. One of the routine tests taken during a pregnancy is for gestational diabetes. If you have it, a special diet must be followed to ensure the baby is not born with or gets diabetes later in life. Also a baby could be born substantially larger resulting in a C Section. Here is my problem:
My wife took the test on June 4th. We were told if the test came back positive that a doctor or nurse would contact us. We did not hear anything back from the office. We assumed everything was ok. My wife has had at
least one scheduled doctor office visit since the initial test and at no time
was it indicated to her that she tested positive for gestational diabetes.
However during today's visit (July 2nd), another doctor asked if she was made aware of the results because it was not listed in her file. Seeing
that her file did not have the test results, the doctor checked with the lab
and found out she tested positive for gestational diabetes. Apparently the
nurse did not follow up with the lab and update my wife's file. The doctor is sending my wife to a nutritionist tomorrow (almost a month later) so that
a strict diet can be followed.

how about repeating the test to verify the result ?
My concern is that if my child gets/has diabetes and it could have been prevented, the practice is at fault for not following up on the test
results from the lab and communicating it to the patient.
My question is can I file a complaint/report so that it is on record that the doctor's office was at fault for not verifying the test results? I
fear if I report it over the phone no action will be taken, and the same issue might happen to other parents. Also if a report is documented, it could be referenced later as proof that the doctor's office did not perform their job.

to whom would make this complaint or file the report ? what action would
you have them take ? the dates of the office visits and the test results
should be well-documented; the issue would be whether they told your wife
and whether they timely recommended the appropriate course of intervention
.... (should also be documented)

I'm not sure I see what you have to gain at this point by making
reports/complaints; personally, I would think it most appropriate at this
stage to see after the health of your wife and the child she is carrying as
best you can; rattling their cage at this delicate moment could possibly
compromise your wife's care ..

if these circumstances raise the possibility of a child developing a disease
later in life the prospects or likelihood of which are not ascertainable at
or near the time of birth, it might perhaps be prudent to take steps to
assure that the records are preserved [after the child is born]; if there
are available diagnostics to make this determination it might be a good idea
to insist that they are administered [again, after the birth]

[in the interim, if you have not done so, why not see if you can ease your
mind a bit by finding out more about the medical aspects]

not being expert in medical malpractice nor in OB/Gyn I would suggest you
seek qualified medical and/or legal counsel in your locale as you deem
necessary

I hope you have a healthy baby rather than a good lawsuit .... best of luck
.....

BoatMan wrote in message ..."RH" <nospam@aol.com> wrote in messagenews:fNLMa.133435$_w.6748101@twister.southe ast.rr.com... My wife is 8 months pregnant. One of the routine tests taken during a pregnancy is for gestational diabetes. If you have it, a special diet
must be followed to ensure the baby is not born with or gets diabetes later in life. Also a baby could be born substantially larger resulting in a C Section. Here is my problem: My wife took the test on June 4th. . . .(snip). . .
and at no timewas it indicated to her that she tested positive for gestational diabetes. However . . .the doctor checked with the laband found out she tested positive for gestational diabetes. Apparently thenurse did not follow up with the lab and update my wife's file. . . .(snip). .
..how about repeating the test to verify the result ? My concern is that if my child gets/has diabetes and it could have been prevented, the practice is at fault for not following up on the testresults. . .(snip). . .


Your opinions about Gestational Diabetes are very distorted.

Some points to ponder:

1. The problem with Gestational Diabetes (G.D.) is miscarraige.

2. If your wife consistantly displays blood sugars about 120 mg/dL, her
risk of miscarraige sky-rockets.

3. You can go to any pharmacy and buy a home blood testing meter and test
her blood sugar yourself.

4. With a meter, your wife would "eat to the meter", i.e. she would
select slowly digesting carbohydrate, and eat small meals several times a
day in order to keep her blood sugar below 120 mg/dL. See

http://www.mendosa.com/gilists.htm

for a discussion of "slowly-digesting" carbohydrate suitable for
diabetics.

5. If she consistently fails to stay below 120 mg/dL, she should use
insulin shots. The oral medications used to control blood sugars are
considered too risky for pregnancy by ** some ** doctors, not by others.

6. You cannot "catch" diabetes.

7. Diabetes is a genetic condition. Your child may inherit the genes
which cause diabetes, or it may not.

8. Gestational Diabetes is considered to be a forerunner of full-bore
Type 2 diabetes. The odds are that your wife is in the "Standard Type 2
Diabetic Progression"

See slides 6, 9 and 10 in

"The Progression and Natural History of Type 2 Diabetes" at

http://www.medscape.com/viewprogram/145

Your wife is somewhere on the "left side" of those graphs.

9. After delivery, your wife has some difficult work ahead of her.

She must change her lifestyles drastically lest she continue to
progress towards "full-blown" or "frank" Type 2 diabetes.
(Take my word for it, she doesn't want that to happen! ! ! !)

She must:

a. Lose fat lb
b. Gain muscle lb (Yeah, weight lifting, Nautilus, etc. . .Ugh)
c. Exercise regularly and vigorously for the rest of her life.

10. If you want more information, go lurk or post at

alt.support.diabetes
misc.health.diabetes

There are quite a few posters there who have been in your wife's shoes.

11. For anybody else reading this. . .

Type 2 diabetes is increasing at exponential rates in developed
countries.

It's genetic and cued by improper levels of body fat and improper
amounts of exercise

If you have the genes, or the lifestyle which puts you at risk,
you should

a. Lose fat lb
b Gain muscle lb
c. Exercise regularly and vigorously

Otherwise, you'll be sorry. Lurk on the diabetes newsgroups to
find out "how sorry"

Regards
Old Al

>>"RH" <nospam@aol.com> wrote in message
.. . .snip). . . My concern is that if my child gets/has diabetes and it could have been prevented, the practice is at fault for not following up on the testresults. . .(snip). . . Your opinions about Gestational Diabetes are very distorted. Some points to ponder: 1. The problem with Gestational Diabetes (G.D.) is miscarraige. 2. If your wife consistantly displays blood sugars about 120 mg/dL, herrisk of miscarraige sky-rockets.

Oops. . .should read:

2. If your wife consistantly displays blood sugars above about 120 mg/dL,
her risk of miscarraige sky-rockets.

Regards
Old Al

BoatMan,

Thanks for the quick response and advice.
My first concern is for my wife's well-being. After discovering their
mishap, they sent my wife to a nutrionist. An ultra-sound has also been
scheduled for peace of mind. (next week) I thought filing a complaint/report
with the doctor's practice would alert them of the problem on an official
level. Perhaps they can follow up with the nurse who did not verify the test
results, or fix the contact procedure to ensure this does not happen to
another patient.

I have documented everything. Hopefully everything will be okay and I'll
never need to reference it back.

thanks again,

RH



"BoatMan" <BoatMan0609@aol.com> wrote in message
news:n6NMa.3223401$uT2.473533@news.easynews.com... "RH" <nospam@aol.com> wrote in message news:fNLMa.133435$_w.6748101@twister.southeast.rr. com... My wife is 8 months pregnant. One of the routine tests taken during a pregnancy is for gestational diabetes. If you have it, a special diet
must be followed to ensure the baby is not born with or gets diabetes later
in life. Also a baby could be born substantially larger resulting in a C Section. Here is my problem: My wife took the test on June 4th. We were told if the test came back positive that a doctor or nurse would contact us. We did not hear
anything back from the office. We assumed everything was ok. My wife has had at least one scheduled doctor office visit since the initial test and at no time was it indicated to her that she tested positive for gestational diabetes. However during today's visit (July 2nd), another doctor asked if she was made aware of the results because it was not listed in her file. Seeing that her file did not have the test results, the doctor checked with the lab and found out she tested positive for gestational diabetes. Apparently the nurse did not follow up with the lab and update my wife's file. The doctor is sending my wife to a nutritionist tomorrow (almost a month later) so
that a strict diet can be followed. how about repeating the test to verify the result ? My concern is that if my child gets/has diabetes and it could have been prevented, the practice is at fault for not following up on the test results from the lab and communicating it to the patient. My question is can I file a complaint/report so that it is on record
that the doctor's office was at fault for not verifying the test results? I fear if I report it over the phone no action will be taken, and the same
issue might happen to other parents. Also if a report is documented, it could
be referenced later as proof that the doctor's office did not perform their job. to whom would make this complaint or file the report ? what action would you have them take ? the dates of the office visits and the test results should be well-documented; the issue would be whether they told your wife and whether they timely recommended the appropriate course of intervention ... (should also be documented) I'm not sure I see what you have to gain at this point by making reports/complaints; personally, I would think it most appropriate at this stage to see after the health of your wife and the child she is carrying
as best you can; rattling their cage at this delicate moment could possibly compromise your wife's care .. if these circumstances raise the possibility of a child developing a
disease later in life the prospects or likelihood of which are not ascertainable
at or near the time of birth, it might perhaps be prudent to take steps to assure that the records are preserved [after the child is born]; if there are available diagnostics to make this determination it might be a good
idea to insist that they are administered [again, after the birth] [in the interim, if you have not done so, why not see if you can ease your mind a bit by finding out more about the medical aspects] not being expert in medical malpractice nor in OB/Gyn I would suggest you seek qualified medical and/or legal counsel in your locale as you deem necessary I hope you have a healthy baby rather than a good lawsuit .... best of
luck ....

"RH" <nospam@aol.com> wrote in message news:<NX4Na.166849$nr.7781631@twister.southeast.rr.com>... Old Al, Many thanks for the wealth of information and links on gestational diabetes. You are a great help! My wife's health and well being is my main concern right now. The nutrionist gave my wife a self-test device that measures mg/dl, which we have begun using today. (avg is around 90 with an 'adjusted' diet) We both have lots to learn, so I would like to thank you again for the great information. As an added precaution, we are going for an ultrasound to see if the baby is within normal size, and weight. RH

Some more points to ponder.

1. In most cases, the best person to consult in a G.D. case is a
female Certified Diabetes Educator (C.D.E.), preferably one who is
also a RN. They live and breath stuff like this, each day, every
day, all day. They are much better than 95% of the doctors for the
day-to-day "stuff" which will dominate your wife's life over the next
few months

(e.g. My young G.D. friend had the C.D.E. nurse's phone number and
called often. When she called, they had discussions. Try that with a
busy doc.

One C.D.E. answer to one of my friend's many daily problems of G.D.
was: "Set your alarm for 3 A.M., get up, test your blood sugar, eat
1/2 cup of peanuts, go back to bed" Sounds dumb but I can give you a
couple of paragraphs explaining how "good" this advice was, and how
infrequently you will get it from a standard doctor.

Look for C.D.E. nurses at diabetic clinics in Hospitals. Almost all
C.D.E. are employees of a hospital.

2. The G.D. syndrome is caused by a sudden jump in the need for
insulin caused by the pregnancy. That means two things:

a. As soon as the placenta is delivered, the G.D. will likely
disappear, almost as if by magic. My young friend had her husband
bring her favorite cookies and a bottle of her favorite sugared-soda
pop to the delivery room! She enjoyed a hitherto forbidden snack
within minutes of delivery, tested her blood, and observed total
normality.

b. Unfortunately, the G.D. syndrome is almost always caused by
prior destruction of a portion of your wife's beta cells. The reason
the increased insulin needs of pregnancy cause G.D. is because she is
in the "Standard Type 2 Diabetic Progression" and some or much (? ? ?)
of her insulin capacity has been irreversibly lost.

If she continues to lose more beta cells, she will soon become a full
blown Type 2 diabetic. She can freeze the loss by the "lose fat/gain
muscle/exercise regularly and vigorously" technique.

3. After delivery, her risk of full blown Type 2 diabetes will be
very high, essentially for the rest of her life. The Research Medical
Community likes to use formerly G.D. ladies as new-drug-test subjects
because so many of them become full-bore diabetic within 5 years. By
using the ladies, they can discern effective anti-diabetic effects of
new meds, i.e. they observe the reduction in percent of the G.D. women
who become full-blown diabetic over the course of the clinical trial.

BTW: Metformin prevents or delays full-blown diabetes, as does the
"lose fat/gain muscle/exercise vigorously technique. That isn't a
standard God and Motherhood ploy by the doctors, there is solid
statistical evidence that it works.

4. Gallows Humor: After the delivery, your wife should become a
Step Aerobics instructor, then check back for diabetes testing on her
85th birthday. . .like two of the Step Aerobics instructors at our
local Community Center who have essentially stopped all symptoms of
diabetic progression that way.

5. After delivery, your wife should continue spot testing with the
home blood sugar testing meter, perhaps for the rest of her life.
Type 2 diabetes sneaks up on you. The standard once-a-year test at
the doc's office is not very good at catching the "sneak up". You
can test sorta OK at the doc's office, then spend a year undergoing
irreversible diabetic damage to your body.

One symptom of "sneaking up" is the sudden development of chronic
pain in the feet; 24/7 pain which can lead to a need for morphine to
sleep.

Spot tests should look for a Fasting Blood Sugar "always" below 125
mg/dL, and a two-hour-after-eating blood sugar "always" below 140
mg/dL. Any violation means that the Type 2 diabetes is very active
and it's time for serious medical intervention.

If your doctor doesn't think such numbers are serious, you need a new
doctor.

Good luck at keeping her out of my club (diabetes), the club nobody
wants to join!

Regards
Old Al