Barb's Daily Dose

Gestational Diabetes Part 2

3 hour Glucose Tolerance Test (3 hr GTT) 

When a pregnant woman's 1 hour glucose test result is greater than 140, it means that she needs further testing.  It does NOT mean that she definitely has gestational diabetes, it just means that she may be at increased risk and further testing is necessary. So try not to panic yet. 

The next test that should be done, to be safe is known as a 3hr Glucose Tolerance Test. 

• First, she'll be asked not to eat or drink anything for 8 hours before the test.
• Next she'll have a fasting blood sugar test. 
• Then she’ll be given a bottle of sweet liquid to drink, with 100 grams of glucose in it. 
• Then her blood will be tested every hour for the next 3 hours. 

Tips

Many women schedule this test for the morning, because it’s easier to fast overnight. 

Zout & Alaska Size Stains

This summer we took a little RV trip in Alaska. We flew to Anchorage and then hopped in an RV and headed down to the Kenai Peninsula. I knew that we'd encounter lots of challenges along the way, including laundry. We couldn't pack too much, because there's not a lot of space, and we knew that we'd be at the mercy of Laundramats in RV parks. I didn't expect to see any super duper state of the art washing machines, but wanted to have clean clothes for the couple of weeks we were there.

Zout goes North to Alaska

The first thing double wrapped in plastic to get packed was the bottle of Zout. That's right, Zout. This stain remover is Kind of a Nurse's Best Kept SECRET. In the past, you could only find it in uniform shops, but recently it's been re-formulated and guess what?  You can now find it in any grocery store.  

Gestational Diabetes

Many women ask me what is Gestational Diabetes? 

Briefly, when diabetes occurs during a woman’s pregnancy, it’s known as Gestational Diabetes. 

We think that it caused by the change in hormone levels, but also by the additional weight gain that occurs. This combination of factors affects the woman's blood sugar and her body's ability to use insulin. The blood glucose levels increase and the amount of insulin available is not sufficient.

Insulin Resistance

We think that for some pregnant women, insulin resistance occurs also plays a role. In that scenario, the food that a woman eats is metabolized into blood sugar. Insulin's job is to help transport blood sugar from the circulation into the cells. When there is an insulin resistance, it's much harder for the insulin to move the glucose into the cells. 

Higher levels of blood sugar, also known as blood glucose, can have harmful effects on both mom and baby. 

Election Withdrawal

Prior to the election, I was interviewed by CNN about Election Obsession. I sent out a survey to people who might have been obsessed by the election about whether they were experiencing "Election Withdrawal"  Here's what they had to say:

Are you going through "Election Withdrawal?"

• I guess it’s withdrawal, because my nerves are shot.  I couldn’t last much longer. 

• I am because I find myself looking at various news channels and thinking, I really don't have a reason to watch the news so intently anymore. 

• I am STILL obsessed with all the election post mortem...especially the annihilation of Sarah Palin.  I have to openly admit, my competitive, combative spirit LOVES seeing this woman taken out.  It (selfishly) gives me great egoic pleasure to see this "shadow" figure of all our egos taken down.  Funny thing is, I do not feel this way about John McCain, I feel he fought a more decent battle, lost and gracefully exited the scene.

• My first reaction to the election was that I felt liberated (like the Berlin Wall crumbling!).  I feel that as people we have been belittled and somewhat philosophically oppressed by the current administration….as in “if you aren’t with me you are against me”.

• "It's good to have the Obsessive Compulsive Election Disorder (OCED) in remission.  No longer searching the blogs for polling updates.  No longer reading stories about the "Bradley effect" and Joe the unlicensed plumber.  No longer wondering how the ballots are going to be misinterpreted by voters.  No longer anxious about the long lines and how people would be turned away from voting.  No longer dreading the intervention of the courts in the vote counting process.  It's amazing how the antidote of an overwhelming electoral win cures this disorder." 

How Elbows can prevent the flu

I learned this nifty trick from some pretty astute and experienced pre-school teachers. Instead of teaching children to cough and sneeze into their hands, teach them to turn their heads and sneeze or cough into the inside of their elbows. 

Brilliant! 

This helps prevent them from spreading germs to their hands which they’re much more likely to use to swipe across other people or other surfaces than their elbows. 

There’s also a nifty soap out there, Squid Soap that helps teach children and grown ups how to wash their hands for 90 seconds. Here’s a video.

A Glimpse into a Cardiac Cath lab part 2

A few days ago, my friend and NP colleague Jenny Jin began writing about what it's like to work in a Cardiac Cath lab.  Here's part 2.

Healthy arteries look like a large wide river flowing down briskly, tapering down to more and more narrow streams with a smaller diameter. Along these 3 major arteries, there are little side branches of other vessels branching off them. Arteries are usually a little curvy but sometimes we see people with arteries that curve and turn a lot. 

If there is narrowing of the artery, it appears as if it’s being pinched. We might see pinching in one or multiple areas of the same artery. Sometimes we can see a little haziness, which means that there might be a blood clot present. If there is a complete blockage, the blood flow stops abruptly without gradually tapering and narrowing. It’s almost as if there’s a stop sign holding up the flow of blood. 

Sex Education Resources

Guest blog with Mary Buxton, LCSW 

AASECT Certified Sex Therapist 

www.marybuxton.com

In the next few weeks, we’ll be hearing a lot from Mary Buxton, LCSW, a AASECT Certified Sex Therapist. She has generously offered to write a few guest blogs on a subject most of us need help with, but may be reluctant to ask about, Sex. For more from Mary, see her website. 

Books & Websites For Parents to Use at Home with Their Children 

Is this a controversial topic? Sure. 

Is it Important. You bet! 

Your voice on sex education needs to be heard by your children. Don’t forget that the media world we live in leaves us with houses without walls when it comes to sexuality information. There is an almost constant bombardment of sexual messages and images from magazines, movies, ads, song lyrics and the Internet. And then there’s the likely misinformation of peers on the playground. Could your kids get the wrong idea or incomplete information about sex and reproduction? Sure. Even likely. 

Donating Breastmilk

Yesterday, I was on View from the Bay, talking about a new trend of sharing breastmilk among moms. A few moms are not only breastfeeding their own babies, but are also offering up a snack for babies of friends or family. This is something that breastfeeding professionals try to discourage because of the risks of passing infections on to another baby.

Incredible, as this seems, some moms wonder if this is a new twist on “Wet nurses” or a dangerous fad.

Q:  Breastmilk is undoubtedly the perfect food for babies.  But is it safe for moms to breastfeed other children?

A:  This is a both a simple and a complex issue and I wish there was an easy answer. There are risks of transmitting more than just milk Including HIV, Hepatitis B, Hepatitis C, CMV, and other dangerous microbes. Remember, breastmilk is body fluid, so sharing body fluids can be a risky exchange.

A Glimpse into a Cardiac Cath lab

This is a guest blog by my friend and fellow nurse practitioner, Jenny Jin.

It is 7AM in the Kaiser Santa Clara Cardiac Procedure Unit. This is the place where people have Coronary Angiography. A scary sounding procedure that helps diagnose heart disease and look for clogging in the coronary arteries. These are the tiny blood vessels that bring oxygen and nutrients to the heart muscle. If they don’t work right, the heart doesn’t work right. 

During the test, if there’s life-threatening obstruction, we can intervene with various tools to dilate and open up arteries that may have been blocked, allowing more blood flow to the heart. The nurses are bustling to get their anxious patients ready for their upcoming procedures. This is where I come in, to help prepare patients and their families for the procedure. I wind my way through the unit, talking to each patient, obtaining a thorough history and then performing a physical exam. This is the time I can answer questions from the patients and their families. After a while, patients are relaxed enough to joke around a little bit, some even to call us “plumbers of the heart”. 

Election Withdrawal

I was in New York last week, one of the thousands of people who gathered at Rockefeller Center to watch history unfold with the red and blue banners that rose up the towers as the electoral totals were added up. 

There was a light mist that swirled around the hundreds of American flags brightly lit by the klieg lights.  I felt a surge of patriotism and hope as I looked around the sea of faces. There were people from every corner of the world, of all ages, gathered peacefully to watch the gigantic screens set up at the corners of the skyscrapers. 

We were all looking up, and it seemed an appropriate metaphor for the position the entire world was in. Everyone, it seems was looking up and beyond, looking forward and not to the past and looking for the inspiration that has eluded us for too long. It reminded me of a line that Michael J. Fox's character said to Michael Douglas in the movie, The American President about inspiration and leadership.  I can't remember the exact quote, but it goes something like this. My apologies.  If someone knows the quote, please send it to me, and I'll correct this.

"People want leaders, they are desperate for leadership and they will crawl through a desert to find it."

Many people feel that right or wrong, red or blue, conservative or liberal, we have elected a new leader peacefully.  

Now to the questions for the day.  

Are you experiencing Election Withdrawal? 

What are you doing with your extra time?

Did you experience a Roller Coaster of emotions?  

Are you numb?  sleepwalking?  back to your old life?

Are you still addicted to news shows and websites?

Have you decreased your exposure to the news? 

 Increased it?

Are you obsessed with something new?