Miracles

*L&D unit, wee morning hours, mom presents in labor.

Mom: This child is my miracle baby

Nurselochia: Yeah?

Mom: Absolutely. We tried for year for a baby. Finally we had our daughter and we were on top of the world. But we wanted her to have a sibling. Someone to share life with. And we felt like our family wasn't quite complete. We wanted another child. So we tried, and tried and finally we got pregnant. Then I lost it. So we tried again. And again I lost the baby. This happened 3 times and I finally told my husband that I would try one more time. But if I miscarried another child, I couldn't do it again. We gave it another go. And I was happy but terrified when that second line came up. We waited until I was about 8 weeks to see the doc. We went in, both of us on edge and Doc did a sono to verify that I was pregnant. We saw the baby...but there was no heartbeat. No blood flow to the baby. We were devastated. Doc suggested we go home and give my body time to naturally miscarry. He wanted to see me back in a week just to check on me and we'd go from there if nothing was happening. I didn't want a D&C. So we went home and cried and started praying that God would allow my body to do what it had done with the 3 prior losses. But nothing happened. We went back a week later and saw Doc. He did another sono to see if anything was starting to happen, and the look on his face told me nothing had. He looked at me and said "I don't know how to tell you this..." and I interrupted "I know, I can tell nothing is happening". He said "No, that's not it at all. Here, look here". So I looked at the screen and there was this little flickering where there hadn't been a week ago". Doc said "See? This baby is alive. I don't understand it, but look at that!" And here we are, 40 weeks and I'm going to get to hold this little boy that I thought I'd never have!


I wasn't sure why her doc would have done another sonogram after the initial but I've never worked in an office before and that early pregnancy stuff I'm not so good with. I thought maybe she didn't quite understand everything, maybe she had been too early to see a heartbeat and that's why her doc wanted to recheck in a week. I also knew at 8weeks there should be a heartbeat. I also had no reason to doubt her. It just seemed so unlikely. I was skeptical until I looked at her prenatal record the office sent over. And right there, documented in this pregnancy history just as she had told me. "IUP at 8w. No cardiac activity noted." And then an entry that estimated gestation to be 9 weeks with a healthy heartbeat, followed by a long list of appointments that outlined her prenatal care, and verified that her dates were absolutely correct. Her doc affirmed her story at delivery. Maybe there was a more logical explaination as to what happened. Maybe they just "missed" the heartbeat, etc. But I choose to believe that they didn't miss anything, that this truly was a miracle. Why question something that had such a positive outcome? There wasn't a dry eye in the L&D department that night. A prayer was said as this little boy entered the world screaming and healthy. Very much full of life.

Who says God doesn't perform miracles?

One sign it's the end of a busy, busy night.

On one particularly busy, crazy night, I had a patient who we were watching for labor. She had an IV running for no other reason than to have it in "just in case she went into labor" and she decided wanted to get up and walk the halls. I saline locked her IV and just attached the end of the tubing to another port on the IV line, above the IV pump. She got up, walked for awhile and then decided she was ready to lay down. I flush her saline lock. About that time, I was called out of the room to go to the ER for a patient who came in by ambulance who was crowning. I quickly turn my pump back on, and make a mad dash to the ER where got the pleasure of catching a baby down in the ambulance bay while the ER staff stood as far away as possible. (They don't do labor...we don't do traumas. We have an understanding). Exhilarating. Anyway, I go in to check on my other patient who had been up walking, who was now asleep, and I'm surprised to see the IV bag looks suspiciously as full as it was when she went back to bed.* I use my clinical skills and I realized why...I never hooked the tubing back up to the saline lock. The fluid was just cycling through the pump, thus explaining why my bag volume looked the same...because it was. *Dumb* Thankfully, it was change of shift.

*no harm was done, before someone blasts me. Fluid was a *just because* order, so we'd have the line in if she went into labor and I was given "permission" to saline lock her if she got up and walked. I could have left her IV site saline locked or hooked fluid back up, and she was a little on the dehydrated side and I figured the fluid wouldn't hurt her.

High risk or Homebirth?

I've decided that I'm a schizophrenic labor nurse. Let me explain. I love high risk OB. I like having to be extra vigilant, looking for subtle changes in a patients condition. I even like when a patients condition means they need delivered RIGHT NOW and we have to get her ready immediately to deliver. Now, before anyone blasts me for hoping for emergencies (which I don't), lets look at what I really mean by that. If an ICU nurse says she likes taking care of her patients, does that mean she hopes for people to be critically ill? No. Emergencies in obstetrics do and will happen. Do you want a nurse who loathes taking care of emergencies, or someone who likes it? I would want someone who doesn't mind because she knows how to handle herself and take care of the woman, not forgetting that there's a scared mother there. I always pray before coming on shift that there are NO emergencies, but I'm ready if one should happen. At the same time, the more high risk patients I care for, the more I want to take care of someone with minimal or no interventions. A nice all natural birth. A mom who comes in at the end of labor just ready to push her baby out...no time for anything but to catch the baby. Love that! My attitude toward home birth has changed drastically during my time as a labor and delivery nurse. When I first started in OB, I couldn't imagine why anyone would want to deliver at home. Now, I understand. At times, I wish I could get out of the hospital setting with continuous monitoring, epidurals, hospital policies, etc and support women birthing their children at home. Just to get back to good ole' fashioned birthing of babies. Maybe I'm glorifying it a bit, but it just sounds like fun. The woman surrounded by the comforts of home and friends/family. See what I mean? How can I like high risk AND think attending a home birth or a no intervention birth at a birthing center? I guess it comes down to the fact that I just like taking care of pregnant women. The majority of the time, there's no need for all the interventions. But I also see that there are times that interventions are necessary to ensure the health of mom and baby. So, there you have it. I'm a labor nurse who enjoys high risk OB but would love to support women in an out of hospital setting as they have their babies.

Work, running, life

Long time, no blogging. It's been a little busy around here and I'm finding that juggling 4 kids, 3 in school, activities, work and all the extra meetings I've been going to, and running...really just life in general has made it hard to keep up. We're only a few months away from moving into our new building at work and we're working very hard to make sure we're ready. It's been pretty slow at work because the other hospital opened it's new birthing center about a month or so ago. It really stinks that we've been slow because I'm craving deliveries and every time the phone rings, we hope it's ER. More often than not, it's the other hospital, calling for prenatal records for patients who have gone over there for the new building but had initially planned to come to us. We're fairly certain once we open, it'll swing back because everyone wants the "new", but right now, we're able to do one on one care, which is every nurses dream. Anyway, with it being slow, it's also allowing us to work on the process of going from a LDR to a LDRP. I have concerns. I just don't know how it's going to flow, how we're going to know what's going on in the department, but part of it is I haven't taken a tour of the new building. I figure I'll wait a month or two when all they'll really be doing is putting in finishing touches and I'll be able to visualize the department. It's just going to be different and it will take some getting used to. We'll adapt because we're a pretty flexible staff and we're already making big strides in the right direction. We now are doing skin-to-skin with almost every delivery (unless mom doesn't want to or the baby needs some extra stimulation), I'm on a tachysystole group and we're working on developing standing orders for how to deal with tachysystole, either spontaneous or pitocin-induced tachysystole. Along with this, we will have a pitocin checklist that must be filled out prior to starting pitocin and thankfully, we have good support from the physicians so far.

Outside of work, I've been running, working towards my next race. I had been debating on whether I should run a half marathon or a full marathon in April. I've decided that I just don't have the motivation to run in the cold, so I'll just be doing a half marathon. Ok, so I know that sounds ridiculous, "just" a half. I am running the marathon again next October and I already have my training plan. My hope is that I can really train properly and shave off a decent amount of time. I *think* I may be able to finish in 5 hours if I really start working slowly towards that goal now. But even just finishing in 5:30 or 5:45 would be fine. We'll see where the next 11 months take me.

New Father

A couple was admitted when the mom-to-be started labor. Labor progressed nicely, and then it was time for delivery. She wasn't my patient, but I had interacted with the very nervous, excited father to be, answering his many questions, reassuring him that everything looked fine, etc. The doctor arrived and after about 10 minutes, I head this loud whoop come from the room. Not like what you would hear at a graduation, but a loud excited yell, you could say. A couple minutes later, the excited father emerged from the room, found his father and mother that were waiting in the hallway, grabbed his father and sobbed for he was so overjoyed that his child, his son was finally here. I couldn't stop the tears that came to my eyes. The pure overwhelming joy was evident. I was witness to the most "amazing moment" of this man's life. I've seen many overjoyed couples, families in my time in L&D but never to this extent. It was very touching, and I was honored I was able to witness that moment in this family's life.

This, my friends, is one reason I have the best career on the planet.

Chapter closed

Last week, I emptied my cabinets of all the empty breastmilk storage bottles that have been sitting there, collecting dust. I put them in a bag, packed up all my breastpump pieces and put them away for the last time. I have officially closed the childbearing/lactating stage of my life. I had been holding on by a thread, hoping that Caleb was going through a phase, that he'd start nursing again. My plan all along with him had been to let him nurse as long as he wanted. Well, I guess up to 2 years, maybe a month or two more, because he would be the last baby I nursed. He nursed for the last time in early September and I pumped religiously, trying to keep up my supply, trying to make enough milk for one bottle on my 4 days off. I finally tired of pumping and not getting anything more than half an ounce from the right side and drops from the left. Honestly, I am a little sad, but not like I thought I would be. I held out and he did get breastmilk until he was 1 year, but he's been done. It was so much easier to just nurse him in the middle of the night. Now if he wakes up and wants a drink, we have to go downstairs and get him a bottle. No more falling asleep as my sleepy baby falls asleep nursing. While a little sad that phase is over, I also feel free. I finally have my body back to myself...no more supporting someone else, either through pregnancy or breastfeeding. I enjoy not having to hook myself up to a pump. Its nice that I can give Caleb a bottle and he will drink it an fall asleep for his nap. I do miss that connection, that feeling of being very feminine, womanly, motherly. But, here I am, looking back at that chapter of my life, satisfied and very happy. Since October 2002, I have either been pregnant or nursing, with the exception of 16 months. I breastfed for about 5 years. I have been pregnant for about 156 weeks, or 3 years. I will look back on those years with joy, pride, tenderness and much love. I look forward to the next chapter eagerly.

Marathon!

What a fantastic experience! I'm still enjoying the feeling that I finished a marathon! The week leading up to the marathon, I packed my bags, and made sure I had everything as organized for the weekend as I could. I was scheduled to work Friday night and I had hoped to get out of that shift, but ended up working the entire 12 hours. I came home Saturday morning, went to bed until 10am and then decided I needed to get up and get the van packed. We left about noon for the expo, picked up a friend who was coming with us and we were on our way. I did manage to sleep for about 2 hours on the way. It was about 3:00 when we got to the expo, picked up my timing device, packet, and signed up for the pace team then we headed to the hotel. I was exhausted and really wanted to sleep, so we ordered food and I went to bed about 6:30 while Husband and his friend went to the hotel lobby and watched movies on the laptop. I expected to not sleep well at all, but surprisingly, I was pretty relaxed. I managed to sleep right up until the alarm went off at 4am. All of us were up and ready to go and headed to the train station that was just 4 blocks away at about 4:45. I'm such a small town girl, so it was exciting in a way to just ride the "L" downtown...something I've never done before. It was still dark when we got downtown and shortly after 6:15am, I said goodbye to Husband and went to go check my bag, stretch and find out where my start corral was. The energy before the start was amazing. There were people from all over the world there, milling around, all hoping to accomplish the same thing. Most people think marathon runners are crazy, and even ask "Why would you want to do that to yourself?" But everyone there that day knew why. Finally, I headed down and got to my start corral and was amazed at how many people were behind me in the open corral. I couldn't even see my pace team sign they were so far behind me. I knew that would be trouble, especially since 3:50 was the slow pace team in my seeded start corral. I positioned myself in the back and off to the side. About 6 minutes after the signal to start, I crossed the starting line and we were off. I knew I was running too fast but with as many people that were running, I didn't have much choice, otherwise I'd be trampled. The crowd was amazing! The cheers, the clapping and excitement was incredible. The first 5 miles flew by. I kept looking for others in my pace team, but at this point, the slowest pace team member I saw was 4:00. My plan was to run 4miles, walk 1 mile and I decided I better try to stick with that plan, so i walked a tad at mile 5. I felt silly because everyone around me was running, so I only walked maybe a quarter mile and took off again. My pace team average mile pace was supposed to be 13:10...my split the first 10K was 11:18. Way too fast. I tried to slow down, knowing I'd never hold that pace the entire way. I did manage to slow a little and my split from 1oK to half was about a 12 minute mile pace. Still too fast, but I was still feeling pretty good. Saw Husband at mile 12 and he managed to get a few good pics of me still smiling and running. Mile 16, it started to get tough, and decided I needed to walk a mile and used one of my energy gels. It help a bit. I hit the wall at mile 18. I expected this because the longest training run I had done was a very unpleasant 17.4 mile run, and second longest run was 14 miles. I managed to run(slow)/walk on and off until about mile 20. At this point, my shoulders were sore and my left hip was bothering me, so I started to walk, and managed a good clip, but walking. I saw Husband at I think it was between mile 20-21. I was walking and he tried to encourage me on, asked if I was going to start running at mile 21. I said yes, and he and his friend took off to meet me down the line. I got to mile 22 and my muscles started cramping up like nothing I'd ever felt before. They were so tight, it felt like they would snap. I knew I had to keep moving or I'd never be able to finish. The mental part of the race was very tough at this point. Here I've come so far, covered more miles than I ever have before, but I still had a long way to go. I did a lot of praying at this point. Most people at this point were walking more than they were running. I also had given up on finding my pace team. I did see someone with a 5:00 pace team bib, but I didn't care...I just wanted to get to the finish. Mile 23 was the worst. I was so sore, my muscles were tight, I was tired and I wanted to be done. Saw Husband at this point and I told him "no more marathons. This sucks, I want to be done, I think I'm in Hell." The guy walking just ahead of me kinda smiled that smile that said "yep, I feel the same way". Husband tried to walk with me for awhile, but I wasn't in the mood to talk. I was focused only on finishing, even if that meant I had to walk the rest of the way. Mile 23 I think really is the devil's country because your energy is spent and you still have a 5K left to cover. In normal circumstances, that never seems too far, but after putting in 23 miles, it seems like a million miles. I used my last energy gel, hoping for a boost. I jogged a bit here and there, not much, but got to mile marker 24. A lot of people were off on the side of the road trying to stretch out their taut calf muscles. I just kept moving, stretching my legs as I walked. When I saw mile marker 25, I almost cried because I knew I would make it. With 1 mile left, I finally saw my pace team. A lot of good it did me to sign up with a pace team. With 800meters to go, I saw my 2 cousins who came out to support me and they walked with me a bit and I thought, "Ok, I can run a half mile to the finish". I tried and my muscles seized up and my legs weren't working properly. My right leg went out to the side and my left foot cramped up with my toes pointed out. I realized then I wouldn't be able to run anymore if I wanted to finish. So I walked fast. Finally, finally I saw that beautiful banner that said "FINISH". Yes, I walked across the finish line, along with several others, but I finished. They gave me one of those space blankets, a bottle of protein enhanced drink and put a finishers medal around my neck. It felt awesome. After getting my picture taken, I walked to get my bag and meet up with Husband at the mile 27 post race party, where I had a ticket for a free beer. After walking there, I finally felt that maybe I was safe to sit. Finally, Husband and his friend found me and I stood up to go get my free beer and suddenly it didn't sound good at all, and I was slightly nauseated standing up. So for about 5 minutes, I sat and changed my shoes and just tried to enjoy the moment. We met up with my cousins for a bite to eat. My legs were sore, I was walking very, very slow, but I was moving. After eating a bit, we went back to the hotel and headed for home. That's when the exhaustion set in and I was in and out of sleep the whole way home. After we pulled in the drive, I realized I was going to have to get up the stairs in order to get inside my house. It was a challenge. My legs were so sore and tight. I took some ibuprofen and after winding down and talking with the kids I went to be. The next day, the soreness was worse. Holy cow, was I sore! It was all I could do to get up and down the stairs and to just walk. Thankfully my MIL stayed to help with the kids. By Wednesday, I felt fine. Today, my legs are itching to go for a run.

My official time was 6:07:34. Not fast, but faster than I had hoped. I hoped only to finish in less than 6:30 and I did. And I came in right behind my pace team. I know it sounds corny, but it was a very empowering moment for me when I finished. It was something I always said I wanted to do, but never thought I actually would run a marathon. It was the toughest thing physically I've ever voluntarily done, and the mental aspect was equally difficult. But the reward is so sweet. Yeah, I had to walk the last 6 miles, but I finished, and finished faster than my goal. It was something that I did on my own, no one could train for me or run it for me. I made a lot of mistakes in training...like not training enough. Being placed in a seeded start corral was also a big factor. If I had been in the open corral, where I belonged, I could have started out slower and not worn myself out as fast as I did. Maybe I could have finished faster. But I'm happy. And even though the words "no more marathons" came out of my mouth several times that day, I want to run another one, but this time train the proper way with enough time. If I can do that and hold my usual pace, I think I can finish in 5 hours. The pace I ran at the beginning of the marathon was a comfortable pace for a 6 mile run...if I can train to that pace, my estimated finish was a little over 4 hours. I don't know if that's doable or not, but 5 hours I really think I can do with proper training. Anyway, I finished, and now I can say I've done a marathon!