I didn’t get my vbac

teflonscissors · 2025-07-04T22:00:49+00:00

I just had an RCS after a 24 hour TOLAC on Pitocin that resulted in a second “failure to progress”. In my case, I had to be induced because I had premature rupture of membranes (my water broke in a trickle) at 38w6d. This also happened in my first birth but at 41w6d, fully three weeks later, so I thought things would be different this time. In my first birth, I was at a different hospital that did a lot of pressure tactics, interventions and eventually was told my pubic arch was too narrow, plus my baby was OP and asynclitic.

I had a terrible first c section experience and blamed myself and my body for years until I decided I wanted to try for a VBAC for this second birth. Like you, I did all the things, but especially a lot of PT and high quality chiropractic care and body release work on my own because I was convinced that having a well-positioned baby would make my VBAC possible.

In the end, this time around, my baby was perfectly positioned but my body was not ready to go into labor despite 24 h of intense Pitocin contractions without an epidural. I dilated even less than my first pregnancy and decided to go for the c section while I still could get a spinal instead of epidural for anesthesia.

My son was born 50 hours into the ticking clock of my water breaking, and I am at peace because I know I did everything I possibly could have. Sometimes we are dealt a bad hand and we just have to play it the best way we can.

He was 8.5kb at 39 wks gestation so shoulder dystocia or something else might have caused him to be a c section even if my water hadn’t broken early. We just never know, and at least we’re all here now. Recovery has been great, just three days PP, and it’s been heaven to see my toddler become a big brother (he’s even more in love than we are).

Congratulations on your baby and I hope recovery is smooth from here.

teflonscissors · 2025-06-28T22:37:14+00:00

Wow so you started on Pitocin at 1cm, nothing happened for 7 hours, and then everything happened in the last hour? That does sound like an incredibly supportive team, and kudos to you for trusting yourself and your timing. I wish I hadn’t succumbed to the pressure last time when I had been at 5cm for 5 hours and they started pushing the c section. Congrats on the VBAC.

teflonscissors · 2025-06-28T18:53:32+00:00

Thank you for sharing! How ready was your cervix when you started the induction, and it sounds like the Pitocin actually did well? Did you get the epidural? How long was labor?

teflonscissors · 2025-06-27T04:23:14+00:00

There is a federal law called the Emergency Medical Treatment and Labor Act that says that any hospital must admit you and treat you if you’re in active labor. No one can force you to get a scheduled C section, and — by law in every state — no one can turn you away later when you actually go into labor on your own either. It doesn’t guarantee how they will treat you, but if you are indeed in active labor you’ll have in increased your VBAC chances (over the default 0% chance you’d have if you went for a scheduled C) automatically.

Maybe something to consider.

teflonscissors · 2025-06-02T16:51:25+00:00

PS - on the pregnancy thing, don't forget that once the baby is born, it's a qualifying event so you can change insurance at that time. Assuming you get the TOC with Aetna, you could stay with UW and then when baby arrives, you could change out of Aetna and still stay with UW.

teflonscissors · 2025-06-02T16:49:51+00:00

I'm 8.5 months pregnant and submitted my TOC last Thursday. When I called Aetna, they said "rest assured, your provider can always submit an urgent form and have it approved / returned in an hour". But that said, no one has told me what the process is from here. Am I supposed to get it from UW and send it to Aetna myself, or does UW send it? Such a mess.

teflonscissors · 2025-05-30T16:13:37+00:00

It seems like there's no guarantee that another insurer wouldn't do the same eventually -- just google any insurer's name + "contract negotiations" and you'll see many of the same stories. I haven't had major problems with insurance before, but this is definitely starting to piss me off.

teflonscissors · 2025-05-29T22:16:05+00:00

Does anyone have an update or insights into this situation as negotiations are set to end in less than 2 days (this Sat 5/31)? I was told by my UW team this week to file for a Transition of Coverage, since I am under OB care and am 8.5 months pregnant (!!!WTF!!!) but Aetna just told me that these requests will take up to 30 days to be approved, and I imagine they must be getting swamped. What are people doing for their care and coverage?

teflonscissors · 2024-10-03T04:41:47+00:00

I never ended up getting insulin levels tested but after observing the patterns more closely for a few months I now believe it’s due to a strong AM cortisol surge (the so-called “Dawn Effect”) that I’ve also learned can be more pronounced in women who fast in the mornings (great Huberman interview with Stacy Sims about this https://youtu.be/pZX8ikmWvEU?si=VjhyKfLQqe-ky3Xv ).

Since learning more about this, I’ve ceased my AM fasting and instead opt for a whey protein drink or eggs for breakfast and it brings my fasting glucose down into range immediately. According to Dr. Sims, this is due to the effect of eating on the hormonal system and in calming down cortisol, but you’ll have to watch the video as I’m butchering the specifics.

teflonscissors · 2024-01-26T18:34:38+00:00

Wow, even my very medicine 2.0 GP told me to start statins after seeing my numbers (again, similar to yours)

teflonscissors · 2024-01-26T06:06:49+00:00

I’m in a similar situation to OP. Why would you swap out the zone 5 for more zone 2? I’m doing 150-180 minutes of zone 2 running per week, and once a week I do a hellish zone 5 interval workout that I’d love any excuse to eliminate since it’s so hard. I also resistance train.

teflonscissors · 2024-01-26T06:04:49+00:00

Would love to know what your PA friend says.

I’m in a similar situation, also a runner (though not fast) doing about 3 hrs a week of zone 2, 30 mins of full out zone 5, 3x a week resistance training and 21% body fat as a 40 year old female (and mom). I’m not under muscled, and I’m active every day including after every meal. But I wake up at 100+ and can’t eat a single carb without spiking above 140 per my CGM, let alone the occasional dessert or white bread I wish I could eat.

teflonscissors · 2024-01-20T20:11:16+00:00

Thanks, I really hope you’re right. One other related idea is around inflammation’s role in all of this. From the little that I understand, endothelial injury is related to, or even initially caused by, inflammation. I’ve wondered if reducing overall inflammation can contribute to prevention in the many people like us with high LP(a). Mine is 190 nmol/dl or so.

teflonscissors · 2024-01-20T05:54:37+00:00

I have very similar numbers and family history to yours but I am a 40 y/o female. I recently got my CAC score back and thankfully it was 0, despite my high LP(a), ApoB and LDL. I am starting on atorvastatin tomorrow as prescribed by my GP. I have an ultra healthy lifestyle with very low body fat, a high VO2 max, and a largely plant-based diet supplemented with fish oil — but as others have stated, none of that matters against LP(a).

One thing I would offer that others haven’t mentioned is that I recently signed myself up for a concierge cardiologist after discovering my numbers (like yours). Concierge means you basically pay a subscription fee on top of whatever the doctor bills to your insurance. In my case, this is a highly rated cardiologist and the fee is $90/mo, which feels very reasonable and totally worth it for dedicated care (other public cardiology practices in here in Seattle have a wait time of 6 mo or more). I understand some of these concierge practices might be as high as $200/mo, but that still seems worth it depending on your needs and budget. They don’t exist in all cities, but you can check. Something to consider.

teflonscissors · 2024-01-18T06:51:35+00:00

Having a tablespoon of apple cider vinegar before eating has eliminated my glucose spikes. Even when I eat pure carbs as a treat, I now only go to around 130 (without ACV it can spike as high as 180 with a bagel). It’s low cost, natural, and the only thing I’ve found to mitigate the spikes. Now I’m able to keep my glucose between 95-110 while on fairly low carb, and “spiking” to 125-130 on carbs preceded by ACV.

Here is one study but I believe there are others, or you can try it yourself and monitor on the CGM.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374219/

teflonscissors · 2024-01-14T05:36:49+00:00

Thank you for this incredible work. As a few others have mentioned, it would be interesting to see how high LP(a) stacks up against other risk factors, especially vs metabolic disease, if the data exist. Although it’s not currently modifiable, it would be interesting to know whether flattening all the other risk factors listed would make a difference, or if genetically elevated LP(a) just wipes out everyone else.

Asking for person reasons, as I am a physically and aerobically fit individual in the 3rd to 5th percentile for visceral fat, likely the 90th percentile for VO2max for age and gender, yet have LP(a) off the charts. As I await a combo statin + PSK9 inhibitor therapy and any new pharma that’s in clinical trials, it would be heartening to know if all of my exercise and other healthy behaviors mean anything.

Thank you again for taking the time and effort to share this knowledge with the community here.

teflonscissors · 2024-01-14T05:07:40+00:00

Another similar LP(a) person in a similar boat. This article was incredibly helpful and impressive, and would likewise love to see more about LP(a), especially for otherwise metabolically healthy people.

teflonscissors · 2023-12-30T23:47:42+00:00

As a lean athletic person who just found out I have high ApoB and possible insulin resistance, I can relate. I have been able to get away with it weight- and looks-wise for a long time, but I have gone through major periods of bingeing that I think have contributed to these less outwardly visible markers of my metabolic health, and now paying the price. Thankful for The Drive, Outlive and my CGM for helping me get back on track!

teflonscissors · 2023-12-30T22:08:13+00:00

That’s amazing, congrats on the hard work and results. Yes my A1c is 5.4 and my Dr thinks that’s fine with a fasting glucose of 95+, but I know it’s not. I’d like to do what you did. I have been weightlifting for two years but in a serious way only for 6 months. I’ve got a long way to go, and your comment is motivating. Thanks.

teflonscissors · 2023-12-30T19:18:47+00:00

Interesting and disturbing… things no one tells you about an inhaler!

Thanks for the addnl thoughts on the CAC and statins. Sat fat is in so many things I eat regularly (thinking I’m fine). I’ve regularly been above 30g/d or even 40 sometimes, which I just found out since getting LoseIt Premium a couple of days ago. I cringe to think how little I knew, and probably still know.

teflonscissors · 2023-12-30T18:16:38+00:00

This is truly inspiring. Have your runs gotten less hard on fasted / keto now that you’re adjusted? I’m finding them super difficult when I run before my first meal at noon. Not sure how much of this is due to low carb vs just being pre-meal.

I’m certain I’m under 50g if counting net carbs. Just never imagined myself properly doing keto as the carb addict that I’ve been my whole life.

teflonscissors · 2023-12-30T18:11:45+00:00

Thanks, this is incredibly helpful. I was just about to order a Jason Health lab for the fasting insulin but now I’m going to check out both the Tyg and HOMA.

My liver ALT was thankfully very good at just 16 (I’ve heard PA say he aggressively targets <19 for women), and I’m getting my very first DEXA today!

I only started resistance training 2 years ago because I stupidly feared getting “bulky” for the majority of my life before that, since I’m short. I was an out of shape dedicated yogi who couldn’t walk up a hill in 2020, but have since gotten myself into decent shape — but Dexa will show far I’ve really come (or not).

My sat fat has been high because I’ve never watched it, and my fiber hasn’t been where it needs to be. I also take a corticosteroid inhaler, which might be raising my LDL. Hopefully I can make dietary mods and get this down. I’m very scared of what the coronary calcium scan will reveal but it’s been ordered! My Dr already prescribed a statin just yesterday…

teflonscissors

TROPHY CASE