The Iron Lady
December 8th, 2007Recently, Jenny took a gestational-diabetes screen. The screening entailed chugging a bottle of “glucola,” waiting an hour, then having her blood drawn. Happily, the unnaturally orange, unimaginably sweet glucola was not nearly as horrid as she’d expected. Having been advised that it tastes better chilled, she’d put it in the fridge the night before, and it tasted more or less like a half dozen melted orange popsicles. The results were fine: The doctor isn’t concerned that Jenny might have gestational diabetes, which is great. What we didn’t know was that when her blood was checked for diabetes, it was also checked for iron — and found wanting. Like the majority of pregnant women, Jenny has developed mild iron-deficiency anemia as a result of her increased blood volume, Eggplant’s needs for iron, and other pregnancy-related factors.
Jenny got this news from a random nurse who was not her obstetrician’s nurse, under slightly unusual conditions (too boring to explain), very late on a Friday. Perhaps that explains the miscommunication that followed. The nurse explained that the anemia could easily be treated with iron supplements and went on to explain that Jenny should get the kind of iron called ferrous gluconate, taking 320mg per day. Jenny confirmed to be sure, “320mg per day?” “Yes, that’s right,” said the nurse.
Imagine Jenny’s surprise when she stopped by the drugstore after work and discovered that the only ferrous gluconate in the store came in 27mg tablets. She did the math in her head. She’d have to take around twelve pills a day to get the right dosage. What a pain! Jenny went home and popped twelve iron pills. She mentioned her concern about the dosage to John, and they agreed she’d call the doc on Monday and see if maybe there was a prescription version of the pill that comes in the correct dosage.
On Saturday, she popped twelve more iron pills. She was starting to worry that the dosage was incorrect. No one has to take twelve pills of anything — plus, the label on the ferrous gluconate says to take one a day. But she had double-checked the dosage with the nurse and had it confirmed, so it must be right! Maybe she was just really, really anemic. Still, she decided that for the next day she’d try to spread out the dosage a bit.
On Sunday, Jenny took six iron pills in the early afternoon and six at night. It was tricky to figure out when to take them, since the nurse had advised her not to take the iron within two hours of eating dairy, taking her prenatal vitamin, or taking antacids. Since Jenny eats a lot of dairy these days and has been chewing Tums wafers like they’re candy (due to the daily heartburn that’s afflicted her for the past few months), this required some tricky scheduling. She was beginning to dread having to work this out every day for the next three months of pregnancy.
On Monday morning, Jenny phoned the doctor’s office and was promised a return call by the end of the day. Late in the afternoon, the doctor’s nurse called, and Jenny explained the situation. There was a pause on the other end of the line. Then the nurse said, “320mg is for ferrous sulfate. For ferrous gluconate, you should be taking 27mg a day.”
Aarrgh! Jenny tried to remain calm while the nurse asked how many she’d taken so far, and asked some rather personal questions about her, ahem, stool. Eventually, the nurse was convinced that Jenny was going to be fine and told her not to worry. “But have I done any harm to the baby?” The nurse reckoned not but offered to ask the doc just to be absolutely sure. (Thank you, nurse!) She called back a little while later with the doctor’s assessment that no harm had been done to Eggplant. PHEW! She also assured Jenny she didn’t need to make herself crazy trying to dodge the dairy and antacids and gave her some saner guidelines for taking her daily iron.
Jenny’s still not sure whether the first nurse messed up or whether Jenny merely misheard her. It really could have been either. But she’s resolved only to take medical advice from her doc or the doc’s nurse from now on, just in case.
After megadosing on iron for a weekend, she’s back on track with a single pill a day. Any temporary superpowers she acquired as a result of the metallic mishap have surely subsided. However, it might be her imagination, but she thinks she feels a little more energetic and less breathless than before. She’s optimistic that maybe all this time she thought it was the pregnancy making her so fatigued and out of breath when it was mostly the anemia. Here’s hoping!




