December 30, 2007

Isaiah

I finally got a chance to sit down at the computer this morning. Husband took the two older kids to church and was going to get groceries after, and Isaiah has decided that his sleep time is in the late morning. He really is a good baby. He doesn't cry that much (yet), he nurses great, and really he sleeps pretty good so far. Jacob and Clara seem to have taken to him. There is some jealousy, of course, but they want to hold him, help change his diapers and they try to give him his paci when he's crying. It's pretty cute. Anyway, here's a run down of Isaiah's birth

It was about 5 degrees and windy the day we went in to the hospital, and of course, OB was busy. There weren't any postpartum rooms open, but there would be as people were discharged. I was really surprised at how nervous I was. Nervousness was to be expected, but it was hard for me to relax. Anyway, my co-workers had made me a diaper cake and had gifts waiting for us in our room. They got me ready and then checked to see if he was still breech. He had flipped around the right way. Of course. We decided to go ahead with the c-section anyway because we had planned on that day, I had a c-section before, I didn't want to be induced, and I was just anxious to meet my son. So, I walked back to the OR, everyone did their thing and I was finally able to relax once they started the surgery. They had a heck of a time getting Isaiah out because of the way he had wedged himself into my pelvis. My old incision was too small for him because he was more than 1.5 lbs bigger than Clara was. It seemed like eternity for me because I know the usual time frame it takes once they've gotten to the uterus. The scrub tech said "he's got an inch of dark hair" so I figured any second now. But, it was a bit longer. They pulled and tugged, cut the incision larger and used forceps to get him out. (needless to say I'm sore) It probably wasn't that long but when you're waiting, it seems like forever. Husband went with the pediatrician and baby to the nursery while I was stitched up and moved back into the labor room I had to stay in until a postpartum room opened. One of the things the anesthesiologists do here is they give a form of morphine in the spinal called astromorph, and it lasts about 18-24 hours. One of the side effects is itching and last time, I itched until I'd broken out into a rash. It was miserable. I hoped to avoid that this time and anesthesia said he's make sure I had medication to counteract that side effect. Well, I started itching before I left the OR. So I kn ew I was in trouble. Over then next 24 hours, I was given multiple meds to help with the itching. The only thing that really helped was narcan. It reverses the effects of morphine, but it takes away some of the pain control. But, I wasn't hurting and I'd rather hurt than itch. I felt better after the narcan, plus Benadryl, Zofran and Nubain for breakthrough itching. After I got over the itching, I started having right shoulder pain, which was referred gas pain. I walked, a bit too much which I paid for later on that night, drank prune juice (nasty, by the way) and took a suppository to help. It wasn't until the day I went home that I really was able to pass gas. But, back to baby. He was 7lb 15 oz and 20 inches long. He has dark hair like Jacob, but looks more like Clara in the face, but sometimes I can see Jacob in his facial expressions. The first hour, when most babies are in the "quiet alert phase", where they just look around, he decided he wanted to scream. All he did was cry, and we thought we were in trouble. I finally got him to calm down and nurse and things were better after that. Out of the three kids, he's the most laid back.
Recovery this time has been a bit more difficult. Part of it is having a 3 and 4 year old to tend to. Husband has been great with doing all the household things, and lettting me rest. My incision is really ugly. It's still swollen, mainly on the left side where the most pulling was happening trying to get the baby out and that's where they cut it a bit larger. Doc assured me that the swelling would go down eventually. Even though I had hoped that things would have gone smoother, I'm ecstatic that Isaiah is here. I know that I was very uncomfortable the last few weeks of pregnancy, and the first 48 hours post-op sucked, but I can't really remember the pain or itching. And I would even do it again. There's nothing like meeting your child for the first time, seeing the recognition of your voice in the baby's eyes, or watching your older children with their new sibling, or seeing your spouse be overly gently when handling the baby so as not to hurt him. This pregnancy went by so quickly, and I know it wont slow down now that he's here, so I'm really trying to savor this time before its gone. Here are some pictures. I did include a picture of the actual surgery, so I hope I dont gross anyone out.


December 23, 2007

He's Here!

Here are a couple pics until I get a chance to actually write his birth story. Everything went well and he is the picture of health as well as a very sweet baby. God truly is great and we've been very blessed.

Isaiah Edward
December 20, 2007 at 7:39 a.m.
7 lbs 15 oz, 20 inches




December 19, 2007

Tomorrow, tomorrow

Tomorrow is the big day. I can't believe that it's here already. I tell ya, this pregnancy went by so fast. It seems like just a couple days ago I took the pregnancy test, it came out positive and I sat there looking at it in awe and shock. Now in less than 24 hours, I'll no longer be pregnant but holding my son in my arms. Crazy. I will say that if I had my way, I would have gone into labor, just so I didn't know exactly what day and approximately what time he'll be here. But, really, it doesnt matter. I can guarantee tonight I won't be able to sleep because of nerves. My mom is coming up today and is staying overnight since we have to be at the hospital at 5:15 a.m. and we don't want to get the kids up that early. I'll try to post again with pics of the little guy once we're home. Wish us luck! Here's a last belly pic at 38.3 weeks. No one thought I'd carry this long (except for me) :)



December 17, 2007

Officially off work

3 days to go... This past weekend I was scheduled to work, but I had to bite the bullet and start my maternity leave. Saturday I was so achy and I had already felt like I had worked for 4 hours. I almost went ahead and went in because, hey, if something happens I work in L&D, but then I had to think about the patients I would be taking care of. I realized that I wouldn't be providing good care, possibly not safe care with as slow moving as I am, so I didn't work. Huge blow to my pride because for some reason most nurses feel the need to work until they are dead, and even then would request for CPR so she could get back to her patients, and I apparently am one of them. I figured no one at work really thought I'd still be pregnant (I sure showed them) at this point, so no harm done. Thankfully they weren't busy this weekend. I called and talked with one of my co-workers and she said they had a crazy woman come up by ambulance for abdominal pain. Normally we get a phone call giving us a heads up that a patient is coming, but I guess there was no phone call. The EMT's apologized and said they just found out that she was pregnant. After talking with the woman, she said she had an ultrasound last week, but she didn't have any idea of last period, EDC, etc. So they pulled up her records hoping to find out how far along she was and it turned out her ultrasound was for gallstones. She wasn't even pregnant. So they sent her back to ER. There are some crazies out there. It's scary because its those people who are likely to fake a pregnancy and take someone elses baby.

December 15, 2007

Well, its a waiting game at this point. We are as prepared as we can get for this little guy.
1. The nursery is ready- diapers, vaseline, wipes, all lines washed and folded
2. My bag is packed.
3. C-section scheduled, pretesting scheduled, complete with requested anesthesiologist available.
4. Small gifts bought for Jacob and Clara, complete with new big bro/sis t-shirts.
5. Various baby-sitters to occupy Jacob and Clara, entertain them and to help them feel they are still special.
6. FMLA set up, daycare set up, several meals frozen for reheating.
7. I even have all the Christmas presents for the kids wrapped and hidden.
I wish I could say my house is clean from top to bottom, but I didn't want to get too carried away. All we need now is the 20th, or for labor to commence on it's own, which I would be just fine with at this point.
Last night we had our night shift Christmas party. It's always good to hang out with people outside the hospital. We always end up having a lot of fun. People who have gone to other departments, have retired or quit usually come back for the party and it's nice to see old faces and catch up. The girl who hosted the party has this game called Dance, Dance Revolution (I think that's the name). It's a video game where you follow dance moves on the screen and move your feet on a mat in sync. I did not partake, but it was funny to watch grown women gettin' down!

December 13, 2007

Days go by

Man, the days are just dragging by. Today I lined up the anesthesiologist I want to place my spinal. It seems weird that 1 week from today, I'll no longer be pregnant and I will be holding my son. Amazing, but it seems so far away at the same time. I know as soon as he's here, I'll feel like time has flown by, but the last few days of pregnancy last forever. What makes it worse is false labor. Last night I actually thought that it was going to be the day. 3 hours of regular contractions, 3-5 minutes apart, didn't feel real good and I thought were getting stronger (but was probably in my head) and kept coming after a bath and moving around. So I decided "Ok, lets make sure we have everything packed and squared away before we head in" and then...they quit. Okay, so they didn't just abruptly quit, but it sure seemed like it. Very frustrating. I know it happens because I see it all the time at work, but it really sucks because you get all jacked up thinking this is the day, and then, alas, no. Soon enough, though, soon enough.

Tonight I have to work, and after looking at our staffing earlier this week, I'm not excited in the least. We're 2 nurses short. And these days, although I'm the size of 2 nurses, I'm really only worth 1/2. (ha ha). So hopefully we aren't crazy busy. I'm sure we have a couple inductions, a scheduled c/s for the a.m. on top of anything that comes through the door. So probably a typical night. We'll see.

December 11, 2007

The final countdown

3 more work shifts to go. Not that I'm counting or anything! Last night was one of my call shifts and of course, I was called in. When we started doing these mandatory call slots this summer, I knew what was going to happen. When I was early-mid pregnancy and felt great, they'd never call me in, but when I was in the third trimester uncomfortable, waddle stage, I would. And I was correct. I think the evening charge RN felt bad about calling me in because she hemmed and hawed for 2 hours with multiple phone calls of "I don't know, maybe we'll be okay, I'll call you in 30 minutes". I just wanted her to make a decision. And when I got there, I'm not sure why she was having any question to call me or not. Oh well.
I took care of a girl last night that was a frequent flier during her pregnancy. She was a week further along than me, and lived at the mission with her 18 month old son. It's really easy to be judgemental with patients like her and I'm not exception, but with her I felt bad for her. She'd come by "cab-ulance" in with pain, and finally they figured out it was gall stones. I had her so many times that she'd come through on the cart and say to me "I figured you missed me so I came to visit". She'd alway have her poor son with her, and he was always in a dirty diaper, never had shoes on and was frequently filthy. So I'd get her a couple diapers, wipes, some crackers and juice, call for pain medication and get her a cab fare back to the mission. I'm not sure exactly how she ended up homeless, quite possible a string of bad decisions, but I kept thinking about how scary it must be to have a child, pregnant with another and have no one for support. She was hooked up with everything she could and she was working with the mission people to get work after she delivered so she could get an apartment within a few months. She delivered the day before, so when I went in to check on her, she first commented on the size of my girth, and then told me she'd come visit me to see how I was a patient. Maybe I'm a sucker for her act, but I really hope she gets back on her feet.

December 9, 2007

December 7, 2007

This was posted at work and I thought it was pretty appropriate for labor and delivery

I wish I were a fetus.
I never would be bored.
Sitting in my uterus,
Swinging on my cord.

To worry obstetricians,
I'd be a proper beast.
I'd change positions on the hour,
Transverse, oblique then breech.

To student midwives I'd present
A mystifying case.
I'd hide myself inside the os
And leave an empty space.

I'd tie my cord into a knot,
And wave it through the cervix.
I'd give the midwives such a shock
And laugh off all my vernix.

And when my membranes rupture,
I'd be a right ol' pest,
Presenting large diameters
I'd transversely arrest.

I'd tell my pal placenta,
To get himself detached.
To theatre then the lot of us
Would pronto be dispatched.

And when they start to Caesar,
I'd laugh and think "Tee hee!"
When no one else is looking
I'll come out vaginally!

-Pauline Bryant

December 6, 2007

Work and D-day

Monday I worked and was charge RN. I actually thought (how naive) that it would be good, ince I wouldn't have to take patients (yeah, right) and the night had started out slow. We actually sent one labor nurse home on call. So, of course, the flood gates open and I end up admitting an induction. No biggie. Well, 30 miutes after I start pitocin, I have a huge decel. A 10 minute decel in the 60-70's to be exact. About the time I started to unhook her bed to take her to OR, the FHR came back up. Thank God. The last thing I wanted to do was run my pregnant butt down the hall pushing bed for a crash c-section. Plus we don't have in-house OB's or anesthesia, so it would have been ugly. I called the doc, let her know what happened and the baby again looked perfect, and luckily stayed that way all night, but we didn't restart the pitocin. Then, another patient came in, plus our second induction and I needed to call the labor nurse on call in. Nice of her, she never answered the phone. So it ends up I have two labor patients, luckily neither really active, one labor nurse has a delivery and another active labor patient and my second labor nurse has a delivery and a 21 week patient. Usually the charge nurse does "baby care" but I couldn't do it because by this time it was about 5:00 a.m. and I had to do day shift staffing, take care of my labor patients, and watch the other monitors while we had deliveries. It was nuts and hard on this ole preggo.
I'm still doing my NST's 2 times a week at work. I had to actually complain last night about how things were being handled. The last two NST's I had, my co-workers didn't do anything. Last night, I hooked myself up and the RN didnt' do an assessment, didn't ask how I was feeling and wanted to discharge me before I even had a reactive strip. She actuallly told me to unhook myself when I was done. On Monday morning, the RN said to me "I'm taking you off the monitor before I see any more contractions." Now, I know they don't do that with regular patients, but come on. I shouldn't have to do it myself. And lets remove the monitor so we don't see anything we don't want to see. It was a bit frustrating. I mean, I'm paying like every other patient and just because I work there doesn't mean I'm going to analyze my own strip and do my own assessment. I can't be the patient and the labor nurse.
We scheduled a c-section at my appointment Tuesday because the ornery boy is still not in position. So December 20th at 7:15 a.m. is D-day. Only 2 weeks. Unless of course I go into labor, water breaks or something else comes up. It seems so weird to know when he's going to be born. I wont sleep the night before because I'll be able to be nervous, as opposed to if I went into labor, then I wouldn't be thinking about being nervous because I'll be in pain. But, like I know very well, you never know what can happen when it comes to pregnancy and delivery.

November 30, 2007

My wish list

Back a few months ago, I posted my "birth plan". Since labor nurses tend to be superstitious when it comes to things, it was really all the things I wanted to avoid. And now that I'm in the home stretch here, I've finally figured out exactly how I would like this labor and birth to go, although I'm prepared for anything to happen. Maybe when we take the kids to see Santa Claus next weekend, I'll give him my wish list.

1. I hope this baby is head down by the time labor starts on it's own after at least 38 weeks.
2. That labor progresses as nicely on it's own like it did with my first baby.
3. That I'm able to ignore the fetal monitor while I'm laboring and just be a patient.
4. I hope I deliver on the night shift (inconvenient for everyone else but me, but those are my girls ! Plus a reason to not call the in-laws while i'm laboring)
5. I want to delivery vaginally.
6. I'd like an epidural that doesn't make me completely numb to the world.
7. But most of all I want to hold my healthy baby right after he's born.

I know this seems pretty basic, like what everyone wants for a birth. Everyone wants a term healthy baby. I'm preparing myself for him to come a bit earlier just with the number of contractions I've been having. But, I could just have lots of fun contractions and still be pregnant at 40+ weeks. And if he is still breech, I'll be ok with another c-section, but hopefully he'll be in the right position for a vag birth. I just hope that there's no issue with bad heart tones, or the scary uterine rupture that scares people away from a VBAC. I'm really positive that things will go fine.

November 28, 2007

Remembering Mirabel Ozara

Just when I was wallowing in self-pity for how uncomfortable I've been, I looked at the calendar and realized that December 1 is coming up. December 1, 2003 my niece Mirable Ozara was stillborn. She is my SIL and BIL first child, and they've not yet had another child. I've been blessed with two beautiful children, and have another who will be here within a month or so. I've really had easy, pretty uncomplicated pregnancies that have resulted in healthy babies. My SIL was due Dec 5 and called me (Sat)Nov. 30 to tell me she was in labor and heading to the hospital. I was going to be her labor coach. So I got in the car with Jacob (5 mos at the time) and my FIL and MIL who happened to be at our house. We drive 2 hours to the hospital where she was to deliver. My MIL walked into her labor room and my BIL was crying and my SIL was lying quietly after getting an epidural. My MIL said to her son "You should be happy". That's when he completely broke down, I looked at the fetal monitor and saw it wasn't tracing anything but contractions and then my SIL said "She didnt make it". It was like everything went into slow-motion. It was horrible. I left the labor room to get my FIL from the watiting room because I felt he was needed at the time. It was a long day and I sat with her the whole time for support. She was fully dilated at 7pm and wasn't able to deliver her until after 1:30 a.m. I'll never forget when the baby was out, my SIL asked the MD "Is she breathing?". SHe knew the answer and you could her it in her voice, but something made her ask, just hoping it had been just a bad dream. Maybe it was because she was my niece, but she looked perfect. She didn't look like she had been gone for 2 days. She just looked asleep. Afterwards, I went to the waiting room to let people know that she finally delivered, and I grabbed my son and just held him and cried, thankful for him and very sad he wouldn't know the cousin that was just born. I never held the baby. It was more than I could handle that morning after the long day and now I wish I would have. They never found out the cause. There wasn't anyting wrong with the cord or on autopsy. My SIL said that on that prior Thursday, the baby was moving like crazy, then she didn't feel anything, but just thought she was sleeping. I figure the baby moved and rolled onto the umbilical cord. Every year, we've gone up to visit, baked an angel food cake and lit a candle for each birthday she would have had, and remember. This year we won't be ablet o make it. This is a poem I found and gave to my SIL. I don't know the author. SIL says she reads this when she needs to cry but the tears won't come. So here is to my SIL, BIL and Mirabel, as well as everyone who has lost child/pregnancy.

I Thought Of You

I thought of you and closed my eyes and prayed to God today.
I asked what makes a Mother and I know I heard him say.
A Mother has a baby this we know is true.
But God, can you be a Mother when your baby's not with you?
“ Yes, you can ” He replied with confidence in His voice
“I give many women babies; when they leave is not their choice.
Some I send for a lifetime and others for a day.
And some I send to feel your womb but there's no need to stay.”
I just don't understand this, God, I want my baby here.
He took a breath and cleared His throat and then I saw a tear.
"I wish I could show you what your child is doing today.
If you could see your child smile with other children and say"
"We go to earth and learn our lessons of love and life and fear.
My Mommy loved me oh so much I got to come straight here.
I feel so lucky to have a Mom who had so much love for me.
I learned my lesson very quickly. My Mommy set me free.
I miss my Mommy oh so much but I visit her each day.
When she goes to sleep, on her pillow's where I lay.
I stroke her hair and kiss her cheek and whisper in her ear
"Mommy don’t be sad today, I'm your baby and I'm Here".
"So you see my dear sweet one, your child is OK.
Your baby is here in My home and this where she'll stay.
She'll wait for you with me until your lesson is through
And on the day that you come home she'll be at the gates for you.
So now you see what makes a Mother - it's the feeling in your heart.
It's the love you had so much of right from the very start.

November 27, 2007

I got the okay to go back to work yesterday under the condition that if I started contracting more than 6 in an hour that I would be off until I'm 37 weeks. I worked last night, and of course I contracted, but I never stopped to count to see if it was too much, but I will say that I was pretty miserable. My abdomen is constantly rock hard and gets worse when I walk. It makes it hard to move, hard to breathe. I must say I wasn't this miserable with the other two kids because I would remember this. I made it through an 8 hour shift (barely) but I'm not so sure how well I'm going to do this weekend on a 12 hour shift. I've turned into one of those whimpy, whiny pregnant women. My patients last night were great patients. One was a primip who was afraid she wasnt doing anything, although she had been contracting for 7 hours before she came in, was in and out of the tub 3 times and had bloody show. She even told her husband to stay home until she called him. She was 8 cm when she came in. My other patient's water broke and her due date was the same as mine. She was pretty nervous and shaken up about it happening this early. And unfortunately, she'll probably end up with a long labor that end isn a c-section because no one could get to her cervix. Her MD couldnt get a good feel in the office and I could just barely get to the edge of it. I have pretty long fingers and there isn't a cervix I havent been able to get to. Hopefully everything goes alright for her.

November 25, 2007

Counting flowers on the wall...

It's day 3 of bedrest and oral terbutaline and I'm going crazy. I've never been able to sit and relax for any amount of time. I get bored and antsy. It drives me crazy to sit around and do nothing when I see all sorts of things I could be doing. Laundry, dishes, dusting, putting up pictures in the baby's room...etc. Especially since I'm on terbutaline, which gets me all jacked up like I'm on speed or something. I have a new respect for all the women who get put on this medication when they're 20 some weeks and have to continue it until they are 36weeks. I just can't function well when my hands are shaking and I'm all jittery. I even split the 5mg tablet and took half and it to see if I could function better, but it still had the same effects. I thought maybe, just maybe, I wouldn't really need to take it, but my uterus hates me and I start contracting like a banshee once it's worn off. Probably not strong enough to do anything, but contracting nonetheless. But, as much as it sucks, I'll do whatever I need to do to keep this baby gestating for awhile longer. I'm hoping that next weekend (I'll be 36 weeks) that my doc will let me go back to work, even if she won't let me do 12 hours shifts. We'll see what she says tomorrow. One good thing about not working is I'm actually going to make it to church today. When I work Sat. nights, I just can't stay up until 10:15 for church.

We're actually making progress on our rewiring. We almost have Clara's room rewired. We just have to figure out if one wire actually goes to a light somewhere in the house, or if it's just kind of there, hanging out. Once we do that, we can insulate over her room and put the floor back down in the attic over her room. We'll start on the baby's room after Clara's is done, and we'll have it insulated before he's actually sleeping in there. We'll do our bedroom and the bathroom last. Jacob's room is essentially done, but with the way the wires run, we can't put the floor completely down because his room ceiling is the access to the other rooms upstairs. I don't really understand all of it. I'm just glad that we are getting closer and that we'll at least have insulation over the kids rooms before the end of the year, if not over the whole upstairs. It would've been a lot easier to pay someone to do it, but we're saving SO MUCH MONEY doing it this way.

November 23, 2007

And a happy birthday to me

Well, I'm officially on bedrest until at least Monday. I went into work tonight and started contracting every 2-3 minutes. Really all day I'd been uncomfortable, having a lot of pelvic pain and pressure and having stronger contractions. But, once the contractions got more regular, more uncomfortable and I started bleeding a bit, I decided to have things checked out. Cervix still essentially closed and thick, and after 4 shots of terb, a script for the oral form and an order to take in easy until I see the MD Monday, I got to come home. Now it's about 3:00 a.m. and I'm completely wired from all the terb. And to make it even more special, today is my birthday. Happy birthday to me. Thankfully, everything is fine and although I hate to miss out on work, I don't want this little guy here yet. I did have to give my husband a swift kick in the ass for not answering the phone when I called him. We don't hear the house phone when we're upstairs asleep so any emergency calls go to the cell phones. But he didn't take his phone upstairs with him. I think this will probably be the last time he forgets because I let him know that if I would have been calling to tell him I was having the baby, he would have missed it.

When I got home, I noticed that there were a couple messages on the machine that weren't there when I left for work. They were from the town police about our barking dog. They called at about 1:00a.m. Funny thing is is that we don't have a dog. This summer, I had gotten a phone call from a lady saying she had our dog. Whoever had our phone number before left the old number on their dogs tags. I figured surely by now they had changed the tags. Apparently not. So I called and had to leave a message for the officer that called (small town) letting them know that we don't have a dog, explained this has happened before and hopefully that will take care of it. It's kinda funny because my husband slept through the call (as well as my phone call that I was being monitored at the hospital). But had I been sleeping and would have been woken up, I would have been pretty ticked. And it's not the police dept. fault the dogs owner didn't get around to changing the tags. Oh well. Well, maybe I'll try to go to sleep. We'll see how that goes.

November 21, 2007

The progression













34 week belly pics




Good times

When I was growing up, fall meant raking leaves. My parents have 5 trees in their backyard and we would end up raking leaves up at least 3 times every fall. My dad's rational was that if we waited untila ll of the leaves were off of the trees, it would be really difficult to rake. The last house my husband and I lived in only had 1 small tree in the front yard. We would get some leaves int he backyard from the neighbors trees, but not enough that we would rake. This house we live in now is a completely different story. We have a large yard with several HUGE 100+ year old trees that dropped most of their leaves all at once. My husband spent basically all day outside yesterday raking and blowing the leaves into piles. He didn't actually get all of the piles combined into one big one behind the garage for the city to pick up yet, but man, you should see the pile so far...and there are still leaves on the trees. I got out of helping this year, but I can't justify being pregnant every fall to get me out of raking leaves. When we do get all the piles put into one, I may have to post a picture just because I've never seen a pile of leaves this huge.

We're still struggling with potty training Clara. Everyone says that girls are easier to potty train than boys, but I have to strongly disagree. I'm sure it has nothing to do with her stubborn, bullheaded, I'm going to do it my way personality she gets from her mother. I could also use some patience I suppose, but it's still frustrating. Part of the problem is that Jacob was so easy. We just took him out of diapers, put him in the underwear he picked out and that was that. We had a small handful of accidents, even at night. I think with Clara we've tried every tactic from just putting her in underwear to rewarding her with candy for using the potty and several in between. The week we had her in underwear was a nightmare for my furniture. I had big dreams that she would be out of diapers by the time this baby gets here, but unless we have an epiphany, that's not going to happen. I know she won't go to kindergarten in diapers, but a little progress would be nice. What's frustrating is that she knows what to do, because we'll have days she does really well. She just doesn't consistantly want to do it. Well, I guess when she's ready she'll do it.

November 19, 2007

Pubic hair inhabitants

I think I can speak for a lot of labor nurses out there when I say that we generally don't pay any attention to your nether regions - really it's just another part of the body and the place where your baby will make it's entrance into the world. But, if there is something funky going on down there, it will get our attention. Like perhaps shaving a design into your pubic hair or dying it a funky color. Piercings down there also will catch my attention. It makes my hurt just thinking about going to a piercing place, asking for a clit or labial piercing and then having some dude put a piece of jewelry there. I've seen one woman whose labia were practically hanging halfway down her thighs and I had a hell of a time getting in between the labia to find her vagina and do my exam, and she probably wondered what the hell I was doing. This weekend I saw something that I've never seen before and hope I never see again. I had a young grand-multip (I'm talking mid twenties, pregnant with her 10th baby) come in complaining of back pain and cramping. She was very dirty to the point that you could smell her "aroma" when you just opened the door to her room and she was obviously high on something. She had listed a permanent address, so as far as we know, she has a home. I knew I was going to have to muster all the willpower I had to keep from making a face at the smell when I had to pull back the sheet to check her cervix. So, I get ready to do an exam and notice something move in her pubic hair. I look and, I kid you not, I saw a couple bugs crawling around. I about came off of the bed it startled me so much! I managed not to scream, regained my composure and then got her into the shower to "help get her labor going a bit". It turns out that it's something the office has been dealing with this and the little critters were actually fleas. This mama took her shower, and then came out to the desk and announced that she was leaving and left before I could talk her into waiting a bit. I felt sorry for her and I guess she was just looking for a place to shower, I don't know. I will say that if I go the rest of my career and never see another bug, I'll be a happy labor nurse!

November 16, 2007

Heads Up

I had another appointment today and everything still looks good. Contractions aren't increasing in intensity or frequency, cervix is perfect, but the baby decided to sit up. That's right, we are no longer in a vertex position. I guess I never really had confirmation that he was head down, but he's definately not now. There's still time for a flip, but we'll see. I really thought I'd be able to tell if he changed positions, but I guess not. Unless things change, I'm looking at a repeat c-section. I guess I could request an external version, but from the one's I've seen, it really doesn't look like a whole lot of fun, and honestly, I guess I don't care how I deliver. Oh, I'm sure there will be days that I wish I VBAC'd, especially the first few days post-op when I'm itching like crazy from the astromorph (long lasting pain med given in the spinal) or when I'm having incisional pain, but nothing is set in stone yet. If I go into labor or come in scheduled, she will check to make sure the baby is still breech, and if he's flipped, we won't do a c-section unless I want to proceed with one. We'll see what happens. A lot could change in the next few weeks. I'm still crossing my fingers that he flips back. With as active as he is, surely he'll move again before the end of December.

November 13, 2007

Surprise

Usually you can tell when a patient comes in for possible labor if they really are laboring. Usually. I had a 15 year old 8th grader come in laboring this weekend and I would have sworn she wasn't doing anything. She was 35 weeks, and acted like I was really annoying her texting while I was assessing her. You never would have been able to tell she was even having contractions because she kept talking, texting, and never even made a face. I checked her cervix, expecting nothing spectacular and surprise! she was 9cm. I've never been this shocked before. I called the doc and I'm not sure he believed me when he walked into the room and saw that she was on the phone. We did a drug screen, which was negative, because her behavior was so bizarre. No one had ever seen anyone appear to be this comfortable without an epidural. Anyway, we start pushing after she's 10cm and only then did she ever act like she was uncomfortable, but she was still more interested in talking on the phone. She was very rude once the head was crowning, and not the justifiable rude, but inappropriate. What should have been a quick delievery took awhile because she wouldn't listen to how to push and wasn't really trying. After about 40 minutes of pushing, and texting on the phone in between contractions, she delivered her daughter. Since she was early,the baby was having some difficulty breathing, so the nurse needed to take her to the nursery for further assessment. Mom was on the phone as soon as she came out, never even looked at her. The baby care nurse held the baby up so she could see her. The grandmother told her "Hey, the nurse is trying to show you your daughter" and you know what she said? "I see it" with the nastiest tone of voice and look on her face. It. She then went back to talking with her boyfriend on the phone, and she told him the baby was ugly. I know she's only 15, but who says that about their baby? The fob was there, but wasn't the boyfriend, and was significantly more interested in this baby than she was. And I would have pinned him as being one of these 15 year old dads who never had anything to do with the baby. It's just such a sad situation. Maybe she'll be more interested in the baby as time goes on, but I doubt it. She's only 15. I'm sure the grandmother will raise the baby, and believe me when I say that that probably won't be a whole lot better. But man, I wish you could have seen this girl and how whe acted during labor. It was unbelievable. It does seem that the young one either do really well with labor pain and have short labors, or they are extremely out of control and end up with a c-section. Who knows, maybe biologically, (not emotionally) our bodies were made to birth babies at a young age. But I can tell you that I sure wouldn't have been ready. Hell, I wasn't ready when I had my first and to be honest, I'm still not ready (ha ha).

November 9, 2007

A day in the life a mother

I love being a mother, I really do, but man, today was very trying. Here's a quick run-down of my day:

Bad: Jacob started coughing last evening. He has a nebulizer, but he isn't wheezing, and his chest doesn't sound tight, so the albuterol won't help. I cant' give him cough medicine with all the recent news about the dangers of cough medicine. He is awake coughing all night...and so am I.

Good: He starts to sound tight in his chest about 5:00 a.m. so that means I can use his nebulizer and albuterol to help with the coughing. The albuterol helps. Praise God.

Bad: I look at the expiration date, after I've given it to him (bad nurse), and the albuterol expired 10-2006. Oops.

Good: Call the peds office and they call in a refill without wanting to see him. Plus we get scheduled for flu shots. Not a good thing according to the kids.

Bad: Drive 15 miles to Pharmacy, as they said they would have it ready for me, and they in fact need another hour. Now what do I do with 2 kids for an hour at 11:00 a.m., one of which is coughing and the other is screaming that she's hungry? I don't want to drive home just to turn around and go back, what with gas at $3.20 a gallon.

Good: See a McDonald's, and the neighbor and her 6 year old daughter are there. Good, maybe they'll behave.

Bad: See a McDonalds. Kids refuse to sit still, Jacob spills entire jug of milk on floor, Clara fills her diaper and since I anticipated a quick trip to town, I don't have a spare. I pray that someday she'll not think the potty is an alien wanting to suck her down and want to use it. After eating, and I use that term loosely here, I get the kids in the van, only to find I'm blocked by crazy people wanting in the drive-thru. They've formed a line in a place there wasn't supposed to be a line. I sit there for 15 minutes as people continue to pull right behind me to get into line and block my way. I finally start backing up until someone is forced to let me out before they pull up behind the next car. Damn people.

Good: Get to pharmacy, meds are ready and the insurance paid for the entire amount and the box of premixed albuterol looks like it'll last forever.

Bad: Get home to lay kids down for a nap, Jacob gets to the top of the stairs and vomits...and it travels ALL THE WAY DOWN. I ask him if he is going to vomit again, he says no, then promptly vomits an even larger amount all over my feet.

Good: I manage not to vomit, give Jacob clean clothes and a much needed breathing treatment, lay the kids down, clean up the vomit and get to take a nap myself. They sleep for 2 hours.

November 8, 2007

32 week pictures


I'm not sure if there is a whole lot of different between last week and this week's pictures. Today I went to a co-workers house and had maternity pictures taken. Just seeing them on her camera file, they look pretty good. I'm not good at having to smilr for the camera. I end up feeling fake and silly. I'm better focusing on something else, or being caught in action, but even the one's where I'm looking at the camera aren't too bad. She got a couple really good one's with Clara hugging my belly. Jacob was too busy playing with her toy tractors to be interested, but she got one with him looking up at me laughing and all you see is him and my belly.
Everything was fine yesterday at my appointment. Little booger cooperated great for the NST, and I only had 2 contractions during the 20 minutes. Cervix exactly like it should be, long, thick and closed. The doc said that if they continue, they become painful, or don't go away with rest adn water, then she'll do a fetal fibronectin test (a cervical/vaginal swab to check for the presence of fetal fibronectin, a substance that acts like glue to hold the fetal membranes to the uterine lining. It is high in the first part of pregnancy, and in the last couple weeks before delivery. A positive test for it means you are at risk for delivering in the next couple weeks). She also said she would probably restrict me to 8 hour shifts if after this weekend my NST shows my uterus contracting every 2-3 minutes again. Things have been pretty quite yesterday and today, so I'm crossing my fingers my uterus cooperates this weekend.





November 6, 2007

JCAHO, competencies and bleeders, oh my!

Last night I worked my 4th night in a row. That may not seem like a lot, but man, working night shift, 12 hours shifts a 32 weeks pregnant just was almost too much. Plus today I had to stay over for our annual competency day. And I LOVE competency. (catch the sarcasm). I know we have to do it and show that we are doing things correctly, but really it seems like we're just going through the motions to look good. Oh, and JCAHO paid us a surprise visit the last two days. We've been waiting for them to come to the hospital because apparently, they've hit every other hospital in the state before coming to us. It shouldn't be such an ordeal when they come, but the level of stress goes up about 300% while they are around, just making sure we are doing things we are supposed to be doing. Work last night wasn't too bad. I had a patient come up about 0330 that ER said was 40+ weeks, was gushing blood and they were bringing her up. Now when ER brings the patient up themselves instead of having us send or tech down to get her, usually that means bad news. I was all prepared for a quick assessment, call to doc, prep and c/s delivery because gushing blood is bad news. Thankfully, she wasn't gushing blood and was stable. She did say she had a lot of blood with clots at home, but was only spotting. All the labwork was normal, baby was fine, etc so we watched her overnight. I just wonder what exactly happened and what they decided to do.
This morning, I also made an appointnent to see the doc after my NST tomorrow afternoon. I've been contracting quite frequently, and although they aren't getting stronger or painful, they are pretty intense. I've also bee feeling A LOT of perineal pressure /aching, which is weird, as well as having a low backache, which is also new. I really think that everything is fine, but I decided to do what I would tell any patient to do with the same symptoms. So, I'm going to let my MD know. We'll see what happens.
32 weeks pictures coming soon. Last night, one of the nurses I work with told me at 5:00 that my belly looked bigger than when I first came on shift and asked it that was possible. Um, thanks, I guess, but I don't think it can grow quite that fast. It was kinda funny. On Thursday, another nurse I work with is going to do maternity pictures. She's into photography and her stuff is really good. I'm a difficult person to photograph because I usually end up feeling silly, but she does such a good job, I'm positive they'll look great.

November 5, 2007

Nurses are such bad, bad patients.

I started my biweekly NST's this past Friday. I have one scheduled at the office once a week and then one at the hospital Monday a.m. after my 12 hour shift. This probably wasn't the best time to schedule an NST because I've been on my feet, not drinking enough water at work, then I'm going to be monitored. I'm still not thrilled about all this monitoring because it could just show us things that we wouldn't have seen otherwise. I feel that if we knew what babies did all the time, we would have a stroke seeing all the dips and flat heartrates, etc. But I'm trying to be a good patient and not the pain in the ass pregnant labor nurse. And I do trust my doc's judgement. So this a.m., I was monitored and guess what, I was contracting every 2-3 minutes. The little booger was textbook perfect, though. Now if I was a regular patient, I would have had to stay, and I'm sure would end up with some terbutaline to stop contractions and possibly end up not being able to work anymore. Since I wasn't feeling all those contractions, and I had just worked a 12 hours shift, and because I'm a labor nurse, I came home. I felt 1 contraction out of all of them on the monitor strip. But, probably because I knew I was contracting, I started noticing more. I had 7 contractions in a 45 minute period. Not painful, but pretty intense in the tightness. That is outside our general rule of calling the doc if you feel more than 4-6 in one hour. So I just drank a huge glass of water and laid down once I got home. And things are fine. I'm sure I probably did the same thing with my other two kids, but I just wasn't ever monitored. I'm such a bad patient. I would have told anyone else who had that to call their doc, but I didn't. I do plan to not pick up any more extra shifts and to be a bit better about keeping hydrated. And if it continues, I will be a good patient and let my MD know. I have no intentions of having this baby early or taking any chances.

November 1, 2007

Belly pics and Halloween pics

Jacob and Clara were a princess (it was an "Elegant Witch" technically) and Spiderman. Jacob told his teachers at daycare that he was going to take his baby brother Isaiah trick-or-treating with him and help him get lots of candy. I guess he did in a way because I did go with them and ate more candy than I should have! The town we moved to this year seems to go all out on holidays and celebrations. They had the high school marching band playing a spooky song, parading through town dressed up, and everyone in town falls in behind them and marches through downtown and back to the H.S. Then everyone goes out trick-or-treating. The kids really had a good time. Here are 31 week pics:










October 30, 2007

A big 'ol pile of Sh*t

First I want to say I love my job: taking care of labor patients, helping new mothers learn to care for themselves and their babies. But, I hate the people running the show. Maybe hate is a strong word. I am very unhappy with their decisions. I've mentioned that I work a weekend option: work 50 out of 52 weekends a year, no holidays unless they fall on the weekend. Which means that occasionally, there will be a year I have to work Christmas Eve, Christmas, New Years Eve and New Years day. That sucks, but it's part of the deal. Plus, all the other years, I don't have to work those holidays. I also work one day during the week. Every shift I work is paid at time and a half. That's the perk. There is an option where I could only work on the weekends and not do the weekday. Well, the schedule through the holidays came out and guess what? They am scheduled Thanksgiving night and Christmas night for my day during the week. Technically, those aren't the holidays on night shift. The night before is the holiday. So they didn't schedule me for the "holiday", but they did screw me over. As a regular employee on nights, if you work the eve, then you don't work the night, and vice versa. So both nights are treated as the holiday, but only one technically the holiday. I said something to the day shift charge nurses who did the schedule, and all I can do is find someone to work for me. Right. Who is going to volunteer to work the night before and the night of? What else sucks is that the other weekend option person who does the extra weekday, didnt' have any changes to her schedule request, and I was in the group whose schedule request should be honored first this time. Mine was not only changed for the holidays, but they made three other changes. And I only work one freakin' day during the week! I made sure the two who did the schedule know that I was not happy and if this was how it was going to be, then why should I work the weekday when I don't have to. To that, one said "Well, it's your job". I then reminded her that I could easily switch to the other category. It's just some crap. I feel like I'm being punished for working the extra day. I may seriously consider dropping that day after I come back from maternity leave. Or since it's just a regular day, doing a request off. I'm sure I'd be called in at least once a week if I did drop the day. That is time and a half also. The other nurse who does the weekday said she's been looking for a reason to drop the weekday and said she would have one if they didn't change my schedule. So, really, they are screwing themselves in the long run because they may lose their 2 most experienced night shift labor nurses from 2 shifts during the week.

October 29, 2007

The good and the bad

Out getwaway to visit friends this past weekend was a lot of fun. it was nice to catch up on everything going on in each others lives and just hang out like old times. Every time we hang out with them, we end up wishing that we lived a lot closer or could get together more often, but a 2-2 1/2 hour drive makes that difficult. I also managed to survive another weekend with the inlaws without much hassle. Had to put my foot down about my mil not sleeping in bed with the kids, not telling Jacob that he doesn't need to nap anymore (he needs that nap), and not touching my belly without asking just because "that's my grandson." My response to that was "Well, it's my body, and if you think you are entitled to touch me because that's your grandson, why don't I give you a glove, take my pants off and let you feel do a vag exam and feel him directly." The baffled look I got was priceless. Yes, it was a little over the top, but I got my point across.

Work this weekend wasn't too bad Saturday night. I spent 12 hours watching someone do nothing all night. Last night was a different story. I had another "first" last nihgt. We had just enough patients to give us the perfect amount of work. Then a call from ER came that someone was down there with decreases fetal movement. Now some people I work with thing "okay, no biggie, it's just a decreased fetal movement", but not me. It's either going to be nothing , or it's going to be very bad. A lot of times you can tell by looking at the patient, face before you even get them into a gown because they know deep down if the baby is gone. I had to take this patient because the other nurse was in the middle of something. So, I put on my jacket and head in. I spent about 8 minutes looking for the heartbeat and nothing. You still hope that maybe you just aren't geting the monitor in the right place. So I call the doc and let her know the situation and that I'm not getting a heartbeat. It takes her only 6 minutes to get to the hospital to do a sono. And believe me, it felt more like 6 hours. The sono confirmed no cardiac activitiy. She was 32 weeks pregnant. It was absolutely heartwrenching. I've never had someone come in for this and not be able to get a heartbeat. The waiting and hoping that maybe, just maybe it's okay, but really knowing deep down that it's not is one of the most helpless feelings I have ever experieced. I just pray this family finds the comfort and strength they need to get through this.

October 25, 2007

Final Getaway

Tomorrow, husband and I are going up to see some friends for the night. This is the couple who is responsible for introducing us. Mike was husband's roommate and Julie was mine. They have a Halloween party every year, and it is this weekend. I unfortunately won't be able to go because the party is Saturday night and I couldn't get the weekend off, but we're going to hang out tomorrow night. Husband is staying the extra night for the party. This will probably be the last night away until after the little bean is here. I'm somewhat worried about sleeping at their house. I get up to empty my pea-sized bladder about every 2-3 hours at night. I just hope I don't wake them up everytime I get up. My parents are taking the kiddos overnight tomorrow, and against my better judgement, my in-laws will be staying here at our house Saturday night while I work and Sunday while I sleep. I'd prefer if the kids just stayed with my parents, but his parents just invited themselves down that weekend and husband said it was okay. His mom wants to see the kids in their Halloween costumes. I told my husband that they could come the follwoing weekend as we'll still have their costumes the weekend after the holiday, but to no avail. I'm sure everything will be fine, but I just don't trust my mother-in-law. She undermines me every way she can and, oh, there's the drinking thing. If my sister-in-law was going to come, I'd be okay because she can babysit both the kids and the alcoholic, but she's not coming. Maybe my father-in-law will keep an eye on her. We'll see.

October 23, 2007

4 year old insight

The other morning right after the kids woke up, my son asked me a question I wasn't quite prepared for. Let me just preface the question with this: I am not a morning person. I never have been and never will be. That's why night shift agrees with me so well. It takes me a good 30-60 minutes to be fully functional and with it cognitively when I wake up. I'm grumpy and don't like to talk, but I've had to learn to do this after having 2 kids, one of which is a morning person. In college, my roommate and I had the same class schedule (same major) and she wouldn't speak to me until I had spoken first. Just to give you an idea of me in the morning. Back to my story. The kids and I were eating breakfast and Jacob asks me, out of the blue, "Mommy, why can't I go see God now?". Um, uh oh. There's me, half awake with a very loaded question. I stumbled through, telling him he has to live here for awhile before he can go see God, that Mommy wants him to stay here for a long time and that God decides when we go. He then said "but Clara, and the baby and you can come too, Mommy, and Daddy, too. Can I go now?" I can't remember exactly what I said after that due to my morning brain, but he quickly got bored with me and went back to his cereal. How do you answer a question like that? Honestly, I'm not sure even if he had asked me when I was fully awake that I would have done much better with that question.

October 22, 2007

A good weekend

Had a beautiful delivery this weekend. First time parents, Bradley method (can I just say I really love the Bradley method?). She came in at 6 cm, progressed seemingly easily to 10 cm in 2 hours, pushed for about 5 and delivered a beautiful baby boy. I did "baby care" so mom was able to do skin to skin contact immediately after birth (instead of having the baby taken away for an assessment as soon as the cord is clamped, like some of our nursery nurses do if they do baby care), and man did this baby nurse like a champ. I'll tell ya, the people who take the Bradley classes really do very well with labor. You can barely tell they're in labor. If I couldv'r followed my own advice and trusted my body to do what it can do, I think I would have loved to have taken the Bradley classes. But, it's too late for that, and like I said, I'm a wuss and I think I would doubt myself. I really didn't know too much about the Bradley method when I had my first baby either. Anyway, it's been kinda nice. We've had a run on patients delivering without epidurals, pitocin or internal monitors. I just wonder how long it will last.

October 20, 2007

Work and the Potty

The last three nights, work has called, asking me to come in and work. I felt a little bad, but I didn't go in. I know that at times, it just gets crazy, but part of the problem this week was avoidable. We have mandatory call hours we have to take. When it started this summer, it was supposed to be a short term thing, but I doubt it goes away. We have so many 4 hour blocks on each schedule that we have to take call for, but not everyone is doing that. So those of us who do our time are still getting called when its busy to come in in addition to the call we've already taken. Of course the people who don't sign up for all the call hours don't come in on blind call in. I'm not sure how these people will be reprimanded. I mean, they can't very well fire them when we need the staff. Threatening their annual raise won't do anything because our annual raises are pathetic to begin with. I'm sure this isn't an isolated problem at my hospital, but man it sucks. I usually go in when work calls, but sometimes I just want my time off. I still work as many hours as all the other people. I just do it over 3 days instead of 4. I think they forget that sometimes. And not to use it as an excuse, but I am pregnant. I don't want to work 6 days a week.

We've been trying to potty train Clara, and man it's just not working. Jacob was easy. We just took his pull-ups away and put him in underwear. He has had manybe 5 accidents total since we did that. It was sooo easy. And people say girls are supposed to be easier. But, nothing is working with her. She'll pee most times when she sits, but still goes in her pants. We tried the same tactic we used with Jacob and she just pees/poops anyway. We tried reward, talking up getting to wear big girl underwear. I've even tried asking her to sit on the potty every 45-60 minutes. That didn't work because she gets tired of me asking and refuses to sit on the potty. I had high hopes of having her out of diapers before the little bean arrives, but I don't think it's going to happen. Sigh. Maybe she'll decide she's ready before she goes to kindergarten.

October 19, 2007

My views on c-sections

Today I had another appointment and I had hoped to get out of some of the NST's that Doc had mentioned last appointment. Didn't happen. I'll have a NST every week starting in 2 weeks until 36 weeks, then twice a week. Which is better than 2 a week starting at 32 weeks. Oh well. At least I tried.

I've been doing a lot of cruising around on-line and man, I can't believe the attitudes some people have about c-sections. I understand that an operative delivery isn't the ideal, I dont really like c-sections and there are probably too many c-sections done. Elective c-sections seem ridiculous to me. Why have your abdomen cut open for no reason? And I admit that I felt a bit cheated when I had my c-section, but all that really mattered in the end was that my daughter was alive and healthy. If it came down to it, I would let them cut me open without any anesthesia if it meant saving my baby. And my favorite type of delivery is the unmedicated, no intervention birth. Our bodies were made to do that. Women give birth out in the middle of rice paddies, without any doctors, nurses or hospitals or prenatal care. But there are some people who take it way too far in my opinion. People who come to the hospital and refuse to let us intervene at all, regardless of how the baby is doing. If you don't want any interventions regardless, why are you at the hospital? I don't have this picture of a perfect birth that I must have in order for me to feel complete as a woman, or to bond with my baby. I know what kind of birth and labor I want, but if that doesn't happen, I'm okay with that. I'm probably gonna piss some people off here, but which is more important? A healthy baby or your perfect birth? Some people get so wrapped up in what they want, that they forget the real reason they became pregnant. To bring a healtly child into this world to love. There are legitamate reasons for c-sections. Babies have been saved because of c-sections. Mother's lives have been saved because of c-sections. No one should feel like less of a woman just because she had a c-section. And no one should look down on women who have had one, or think she is less of a woman. A mother is a mother regardless of how she gave birth. A baby is a baby regardless if he/she was pushed out of a vagina or pulled out of an abdomen. I guess I think people should be thankful for what they have, instead of only regretting what they lost in this case. I love both my children, and felt equally attached to them, regardless that one was born vaginally and one was not. I did miss out on holding my daughter and nursing within that 1st hour when they are wide awake and checking out the world, and sometimes I wonder if I really needed a c/s, but at the same time, I love her as much as my son. And I'm glad she's here, healthy and alive. I never cried over not getting to labor and deliver her. Ok, there's my rant on c-sections. I feel better now. Let any tongue lashing begin.

October 18, 2007

Relaxing, planning and remembering

Monday night I went into work, but got to come home after 2 hours. It was kind of nice. I don't usually like to be "flexed" and put on call, but it hasn't happened for a long time, and honestly, now is a good time to have a bit of a break. The only bad thing will be when I have to go back to work Saturday after being off for basically 5 nights. I was there long enough to hear about a sad situation. A 17 year old gave birth to a baby. Mom has a mood disorder and attempted suicide several times, the first time at age 9. She seemed to have a lot of family support, but come to find out, her mother has only supervised visits with her niece, and her stepdad cannot have any contact with his niece. This patient lives with them. And the probable father is a registerd sex offender. I dont know how this situation will play out, but it doesn't seem fair that this little innocent baby was born into this sad mix. Between cases like this, the pregnant teenageers and homeless pregnant, I can't help but wonder why there can possible be people out there who would make great parents but aren't for reasons out of their control. It's God's plan, and I'm not supposed to understand I guess. I just have to take care of my patients, make sure that when the mom and baby are discharged that they will be cared for and try not to pass judgement as it's not my place.

If anyone knows me, they know that I love making lists and being prepared. Doesn't mean that I am incredibly organized, but I try. Back in college when my roommate and I would make our almost weekly weekend trip to visit our boyfriends (now husbands) at a campus 1 hour away, we would sit in class on Thursday and make a list of what clothes and accessories we would be wearing for the weekend. We would then paint our nails that night, pack our bags according to our lists so we could leave straight from class. After having kids, I'm not quite that anal retentive about lists, but as close as I can be with 2 preschoolers. Now that I have the baby's room set up for the most part, I'm able to move on to more planning. The day I ended up delivering Clara, I had planned on cooking several meals and freezing them so we would have decent meals while we adjusted to 2 kids. But, I obviously never got to do it because I went to my appointment and didn't come home until 4 days later. So I'm going to try again. I'm not sure what I'm going to make though. I plan on making a pan of lasgana, and a batch of italian beef. But beyond that I'm not sure. Anyone have any recipes that freeze well?

This past week on October 15, was a day to remember all the babies that families have lost. This Saturday we have our annual Walk to Remember. It's nice to go and show respect for the families, but also to see former patients and see how their lives are going forward, if they've had children since. I also walk in memory of my niece, Mirabel, who was stillborn at 39.4 weeks December 1, 2003. My sister-in-law went into labor, didn't realize anything was wrong until they got to the hospital and couldn't find a heartbeat. She had called me to be her labor coach and I was on my way and didn't find out until I walked into their labor room and saw my brother-in-law crying and saw the blank fetal monitor. It was the worst feeling in the world. I can't even imagine the pain parents feel when I remember how my heart broke that day. Mirabel would have been 5 months younger than my son and man, did we have plans for these children. Every year on the day she was born, they bake angel food cake, light a candle and say a prayer for her. My sister-in-law and brother-in-law are just now at a point where they plan on starting to try again. So here's to all the babies that have gone on to be with God before us - you aren't forgotten.

October 15, 2007

29 weeks

29 weeks:


27 weeks:

21 weeks:


Quite a difference 8 weeks makes! I'm really glad I decided to keep a record of my waistline progression this time. It's quite fun seeing how this little guy is growing. I really wish I had done this with my first two pregnancies. Sadly, I have very few pictures of me pregnant with Jacob and Clara, especially Jacob since he was my first. I was funny I guess about having pictures of me when I was pregnant with him. And I got really large, but I don't have a good picture of my belly. I have I think maybe 5 pictures, and I'm sitting in all of them so you don't get a good shot. To all of you pregnant ladies out there, here's my advice: Let the pictures be taken. You can't go back after it's over, and you will regret not having good pictures. Especially important: get that last belly shot at the hospital or shortly before you go.

Irritating

This weekend at work was like most - either really busy or really slow. Saturday it was like we had a revolving door with outpatients - all of them were due in December. I would no more than get one admitted, assessed and discharged and another would be on her way up. Three times I heard the phone ring at the desk as I was giving discharge instructions and it would be ER with another patient. I did a total of 6 outpatient discharges. Out of the 6, only 1 really had anything going on and it was only a UTI. One patient came in because she had a few contractions here and there all day, hadn't felt any for awhile, but wanted to make sure everything was okay. She asked me how far along I was and we actually had the same due date. She asks me "And you're still working?". Um, yeah. One patient thought she was having contractions at 30 weeks, but after about 45 minutes, she realized it was only gas. I didn't ask how she figured it out :) The others thought they were having contractions, but were not. I think I probably was having more contractions and back pain than they were, and I was taking care of them. I guess it's better that people come in to make sure everything is okay rather than waiting until it's too late, but man, I can't believe what brings some people in. Sometimes I think people want to use their pregnancy to get out of work, etc. A nurse I work with is due 4 weeks after me and she's one of those. She is not high risk and has had no problems so far with this pregnancy. She asked 2 girls to turn her patient for her since she's pregnant and can't. I had just finished boosting my epiduralized patient up in bed, but she couldn't turn hers?. I realize lifting should be limited, but seriously. What's she going to do if she has an emergency and needs to turn a patient or push a bed down the hall for an emergency? Is she going to wait until she can get help? "Sorry, your baby is crashing, but I can't do anything to help because I'm pregnant, so let me go get help". I'm really not unsympathetic and there are times pregnant women can't do these things. It's the one's who milk it for all its worth that get a bit annoying. Sigh. Maybe I do too much. Maybe I'm just not doing this pregnancy thing right and could be using it to get out of working too much. Hmm.....

October 11, 2007

Home improvement and expanding girth

I've been pretty busy the last couple days. We're in the process of trying to get our house insulated before winter sets in, but before we can do that, we have to replace all the old wiring. Otherwise, putting insulation on top of the old stuff would create a fire hazard. We thought we'd have all the rewiring done, but, alas, no. Husband is having a buddy come over tonight to loosen all the floor boards up in the attic. Sounds like great fun. Then we'll have our dads come spend a couple days just working on the wiring and laying the insulation down. Since they won't let me help with any of that stuff, I got to go buy the insulation. Boy was that fun. Nothing gets a Menards employee's attention like a pregnant woman standing in the insulation aisle. It was a bit ridiculous. I had to hunt someone down after 3 guys passed me up. Then the guy I cornered treated me like a moron. Now, I have thoroughly researched insulation and knew what I wanted and was very clear about this. He kept questioning me until I told him I knew what I wanted and if he wouldn't help me get the number of rolls I needed, than I would do it myself. So, after all of that, I bought insulation, and when I got home, I made a call to the store manager to complain. Hey, don't mess with a cranky pregnant woman whose attic is being torn up. I also got the baby's room painted, put up shelving in 3 closests in the bedrooms and moved the fouton out of the baby's room down into our computer room (with help, of course). And finished 6 loads of laundry! I feel accomplished. Tonight, while the guys are having fun in the attic, I plan on setting up the nursery, but we'll see if the kids let me do that.

Within the last week, I've definately grown in girth. My co-workers kept telling me, up until this past weekend, that I don't look that big. I felt they were lying, but whatever. This weekend though, people were saying the opposite. One girl asked how much longer I had. I said "I'm 28 weeks". That's when she smiled and said "I thought you were about 34 weeks". Another said "You're going to be HUGE!" when I told her I was only 28 weeks. Gee, thanks. Really, I dont care. Everyone remembers the size I was when I delivered Clara. I really didn't get big with her, but I got HUGE with Jacob. And I think that's how this one is going to be. Plus, I don't really have much control over how big my belly gets, my weight I do have control over, but if Isaiah wants a big uterus, that's what he'll get. Just as long as flips out of being sideways sometime soon!

October 9, 2007

The power of denial

One of the things that really gets me wondering about how strong the mind can be is the woman who comes into the hospital, complaining of abdominal pain and vag bleeding and finds out then that she's pregnant and in the 3rd trimester. We had someone this past week deliver a 33 week baby and claimed she didn't know she was pregnant. Come on now. Ok, ok, I know there probably are some cases where the woman really didn't know, but I think most times its denial. Usually, the women who don't know are larger to begin with so don't notice the growing waistline so much, have babies that just don't move that much, or have a tilted uterus which I heard makes it hard to feel fetal movement. Having been pregnant 3 times, I can assure you that I knew and everyone who sees me knew I was pregnant. The girl's roomie brought her to the ER because she was cramping and bleeding. She swears "No I'm not pregnant". A blood and urine test comes back positive for pregnacy and the ultrasound shows a 33 week live fetus. She is taken to L&D where she is found to be 6 cm dilated. She maintains she didn't know she was pregnant. Her roommate didn't know. Her boyfriend didn't know. Her parents, family, friends didn't know. They are all speechless and feel ignorant, and you can tell none of them knew. The patient, I think, knew. She went out and partied, shopped and went about life like normal. The patient was obviously pregnant. She was 120lbs pregnant and you could see a mass moving in her abdomen. If she really didn't know, I want to know what she thought was moving around down there. If I didn't know I was pregnant and felt movement like that and saw little edges poking out my abdomen, I would be flipping out wondering what kind alien was growing in there. Maybe I have very active babies, but there's no mistaking the movement for gas. Anyway, the story has a good ending. Her aunt and uncle tried for years to have a baby but couldn't and were looking to adopt, but had been waiting for 2 years. They are going to adopt the baby, the birth mom plans on returning to college classes this week and the baby appears to be healthy. I wonder if this little baby will ever know the circumstances, and all the lives that were affected by this birth.

On a different note, I had a nice delivery this weekend. When the MD arrived, the dad looked around at the staff attending the birth and noticed that the delivering MD was very pregnant, the labor nurse (yours truly) was pregnant, and the nurse attending the baby was pregnant. He said to his wife "Honey, I'll bring you in bottled water because I don't want you drinking the water around here. Everyone who works here is pregnant. And I think we should be careful." It was pretty funny.

October 5, 2007

The dreams of nurses

This week we had a staff meeting and I was a good employee and actually went. As usual, it was a waste of my time. We spent the majority of the time talking about what we wanted for our new unit. Plan is that we will be in a new building by 2011. Some things have already be decided. We are going to be a unit with LDRP's, and will have some "plain" rooms for antepartum, post-op, etc. We will still have 2 OR's for an estimated 43% c-section rate (which is the current rate for the month of Sept.) We'll have a level 2 plus nursery with 6 beds, and we'll be able to care for babies that are on vents for short term. Right now we cant care for any babe on a vent. There will be room for only 12 babies in the healthy nursery. In this community, the moms in general expect they'll be able to send their babies to the nursery to sleep between feedings, or be fed all night my us. They estimate we'll be doing 2400 deliveries a year from our current 1600 or so this past year. Major problems I see: The nursery is too small. We are a level 2 now and at times we have 5 sick babies. If we can care for babies on vents and more premature babes, where are we going to put them? What about the healthy babes? Some moms are too sick to have their baby in the room, and although it goes against the whole dyad nursing thing, a lot of them will want their baby in the nursery to sleep. Where will we put the babies until the expectation of putting babies in the nursery for the night ceases. The layout worries me, too. They plan on doing a triangle shaped unit with the OR's at the back. Ok, say we have a cord prolapse in the room by the entrance. We'll have to go down the hallway, around a corner and down a long hallway to get to the OR. All while keeping our hand pushing up on the baby's head to keep it off the cord, maintaining privacy and trying not to run over anyone int eh hall. These are the things I worry about. A lot of people were more concerned about ammenities. They basically want the patient rooms to be like a 5-star hotel. I admit, it would be nice, but will we have the staff to take care of the patients? We do need bigger, better looking rooms, internet connections, etc. , because the rooms now are small, ugly, don't have internet connections and the hallways have carpet (which is nasty). All I want is up-to-date equipment that works, and competant staff. All the foo-foo stuff doesn't matter. And I'm talking from not only a nurses point of view, but a patient point of view. I dont' need a fridge, fancy sheets, or a wide screen tv. Just give me a decent bed with clean linen, a clean working bathroom and diapers, wipes and a bed for my baby, and nurses, techs who can help me. Is this what other units are like? I've been shelter and have only seen 2 L&D units, ever, so maybe this is how things are, which isn't bad, but just not necessary. We'll see what we get in 2011.

October 4, 2007

More Belly Pics

27.4 weeks


After looking back at the belly pics I took 6 weeks ago, I am really regretting that I didn't do this with my other two kids. I've put on a lot more weight this time than I did with Clara, but less so far than with Jacob. I think I figured out why. With Jacob, he was my first and I ate what I wanted, when I wanted. So I gained almost 50 pounds. Clara came so soon after Jacob that really I was still adjusting to being a mom, and I didn't snack much at all. This time, I'm cooking more for the kids and instead of eating the fruit and veggies I give them, I eat just the chicken nuggets, mac & cheese, etc. I did start our 6 lbs heavier this time, but I'm only 2 lbs away from the weight I was when I delivered Clara. Oh well, you're supposed to gain weight while pregnant.
Today I took the kids to a small pond that has a mile track around it to look at the geese. After we were leaving, some guy looked at me with my kids and pregnant stomach and said "Man, you're having them close, you're going to have it tough!" Usually I have a retort, but he caught me off guard so I just looked at him. Why is it people say stupid crap like that? Do people really think they are being helpful? I got that ALL the time when I was pregnant with Clara when people found out there would only be 15 months between them if I delivered at 40 weeks. I dont think people always realize that perhaps this is how my husband and I want it. We wanted all three of our kids close, and expecially since the first two are so close in age, we didn't want the third to be so far behind in age and get left out, although that will probably happen anyway. So far though, no stranger has reached out and touched my stomach. That's another one of those annoying things people do. I don't mind so much if it's someone I know. It's the perfect strangers who feel that a large abdomen is an invitation to touch. I reach out and rub their stomach every time it happened to me. I actually saw a shirt somewhere on-line that said "Don't touch, I kick". But I don't think I'd get the same reaction as reaching out and rubbing their stomach.

October 1, 2007

Bradley and Leboyer

This morning I had a beautiful delivery with a great story to go along with it. Had a first time om come in in labor. She didn't look too uncomfortable, so we didnt figure she was too incredibly active. Doing the admission assessment, they told me they had been trying to get pregnant for more years and were told that they were infertile and wouldn't be able to get pregnant. They went through everything under the sun trying to get pregnant. So they were quite surprised when she got pregnant on her own after they had given up. They decided to use the Bradley method of birthing, which I honestly don't know that much about, but I love when patients use it. Its a technique where the mothers and her partner work together and the mom trusts her body, relaxes and tunes into her body, instead of using medication or distraction for the pain. The people who use it do extremely well and are in great control. And the dads play an active role in labor instead of being a bystander. We get so few here. The majority of people get epidurals (84%). She was in such good control. She turned out to be 8 cm. When she had a contraction, she would just completely relax and close her eyes. We did intermittant monitoring, only placed a saline lock, and she and her husband moved around and "danced" while she contracted. Baby came when he decided, which was before the doc could get there (and I actually thought I had called her in too early). But it was nice. We deferred all the stuff some people find necessary after a baby is born, mom did skin to skin and put her much wanted son to the breast right away. Then we did a Leboyer bath after they were ready. This is where instead of doing a sponge bath that the baby screams through, it involves submerging the baby into warm water and letting dad/mom support the baby's head and neck while the body floats free in the water. You can then wash them while the baby moves his/her legs and arms around. They stay warm and seem to really enjoy the water. The parents love it too. If I had to describe the perfect delivery, this would have been this birth. Wonderfully nice parents, healthy baby, fairly short labor and delivery without all the interventions. Maybe this will make up for the first elective primary c-section I have.

September 30, 2007

Time for a vacation

I had the strangest dream and I just have to share it. My husband thinks I'm losing it. I dreamed today that I was working a busy shift and that one of my patients I was taking care of was a fellow co-worker. In real life, she's not pregnant, but in my dream she was and she was in early labor. She told me to go tend to my other patients and she'd call me if she needed me. After a time, I go back in there to find she was delievering alone. But, the baby was coming out from in between her shoulders, breech. I hollered for another nurse to come in and said "the baby is breech and coming now". The baby delievered but was in an IV bag, which I suppose was supposed to be the membranes? It was weird. I think I need a vacation.

Monitoring

My appointment and sono Friday was pretty good. Baby's heart checked out fine, nice regular rhythm. I decided to ask my doc if there is anything I should try to avoid this time, since at 32 weeks Clara's heart was fine and in 4 weeks is wasn't and I got to be on the receiving end of a crash section. I was pretty sure that is was just something that happened, but I had to be sure. She said it was and that nothing can prevent it. She then asked me to describe in more detail what happened and guess what that won me? Biweekly NST's starting at 32 weeks to make sure everything looks ok. I'm just thrilled (sense the sarcasm) I'm sure she's doing it for my stress level, but really, I don't need to be monitored. I just dont see what monitoring is going to do, and it wasn't what I was hoping for by asking. Oh well. And this little guy is transverse. There's plenty of time for him to move, but I wish he'd just make up his mind one way or the other, preferably vertex. I knew he was in there funny because I swear he tries to kick my hip bones.

September 28, 2007

Cornered

Funny story. Ok, for background, I switched OB/GYN last year. It started when my health insurance dropped the practice I went to. I could have changed my insurance and stayed with my MD (Dr. T), but I would have had to switch my kids doctor and I didn't want to do that. So, I asked myself "who would I chose if I had to do it all over again, knowing what I know". Plus I wanted someone who would let me VBAC, and Dr. W and Dr. T both probably wouldn't let me, or rather, would discourage me strongly. So I changed to Dr. D, who has no problem letting me VBAC. The MD who actually delivered Clara is Dr. W, who has I swear a photographic memory. I've been wondering if she remembers that she delivered me last time or not. This a.m., I was in street clothes, waiting to have my yearly evaluation. She came over and asked me "So am I going to get to deliver this baby too?" I wasn't quite prepared, but I said "Well, I have this insurance and had to switch doctors, which sucks for my last baby", yada yada. I could feel my face flush, knowing I was sorta lying. She said "that's too bad, Dr. T won't get to deliver either". I feel a little guilty, I shouldn't, but I do. Dr. W is a good physician, but she's wants way too much control over delivery times. Dr. T, after seeing her in action, I'm thankful she didn't deliver either of my kids. It was a bit of an uncomfortable conversation. Oh well. I said to Dr. W "Well, maybe I'll go into labor on a weekend or at night and you'll be on call". She just loves weekends and nighttime deliveries. I was anticipating some type of conversation about my pregnancy and delivery, but I never thought she would ask me outright.

My evaluation wsa just great. The director said she doesnt hear much about me, but what she does hear is all glowing reports of what a great nurse I am, etc. I started thinking "Maybe I'll get more than the lousy percentage that everyone gets". Nope. Standard percentage slap in the face. At least its a raise. And this morning we got our "success sharing "check from the hospital, and I was quite surprised to see how large it was. I'll be able to put that to good use.

September 27, 2007

Chef Lochia

Ok, so the title doesnt work so well, but that's ok. Lately I've been working on expanding my cooking menu. Let me start by saying that I'm not a cook. At all. Ok, so I can work wonders with my crockpot, make great cold salads (that I actually will not eat) and I make a mean lasagna and italian beef, but beyond that, I'm not so good. I think most of it is because I don't really enjoy cooking, or rather, I don't enjoy cleaning up the mess. So I do as little as I can get away with. But, I've been tired of eating the same stuff over and over, and I get tired of waiting on the crockpot, so today I made beef stroganoff. I even used real sirloin and made the sauce from scratch. And it was actually good. And this last Friday, I put a chicken in the oven (I usually use my crockpot) and it turned out really juicy and good. So my confidence is growing and I think I might continue trying new things. I found several recipes on-line for different meals, so we'll see where that takes me. Who knows? Maybe I'll turn into a decent cook after all.

September 26, 2007

Monday madness

I was reading over some of my old posts, and man, do I need to start proofreading! Anyway, this week is going to be a long week. I work my usual weekend 12 hour shifts plus my 8 hour shift this past Monday. I had also signed up for mandatory call (which I loathe) for 4 hours before my shfit Monday night and was of course called in. And they called and asked if I could come earlier than 7p, so I got there at 6p for a fun 13 hour shift. I worked until 11pm as laobr nurse, doing clean-up (discharging patients, finishing jobs the evening girls couldn't get done, NSTs, etc). Then I worked post-partum from 11p-3a and had pretty busy patients. Then I had to be charge nurse from 3a-7p. Oh, and the 3-11 charge nurse called the night charge nurse in at 7pm and said she'd could leave at 3am, but didn't bother to find me anyone else to come in. So, at 3a.m, I was charge nurse, had a full load of busy patients and at 5a.m, had to go back to labor and admit the morning c/s patient, all while doing staffing for day shift, and doing the computer crap they make us do when we are charge. At 6:30, we had 3 patients come up from ER, one was a 28 week triplet mom contracting every 2-3 minutes. Thank goodness dayshift was there, but I imagine they had one hell of a day with everything that was scheduled and was going on. I didn't clock out until 7:45a.m. Towards the end of the night, after I had been running around, extremely busy all night, some people I work with started giving me crap for working too much since I delivered my first two kids at 36 and 37 weeks. (Which, isn't that early and I didn't labor with my 36 week delivery.) It ticked me off because they were the one's who asked me to do it, and where were they when I was busy? I asked for help with getting some things done, to which the answer was "I'm too busy". Plus, if I thought that I was starting to contract, etc., I would obviously stop. And what makes this even better is that I agreed last week to work for another girl on Thursday, forgetting about my extra call I took Monday. So, I'll be in overtime and hospitals love that. When I woke up this a.m., there was a message from work, asking me to come in because it was going to hell again. They only had 2 labor nurses working and had all 7 labor rooms full. I wondered why they didn't call earlier in the evening and try to get someone on call. Who knows. Friday a.m. I have my yearly evaluation with the director. When she first came a little over a year ago, she said that she would never know the night shift staff because she doesnt do well overnight. Nice. I feel it's the director's job to know at least the names of her staff. And I've heard that if she doesn't know you at your eval, she actually says "I don't know you, so all I have to go by is your peer evals". So I'm sure this evaluation will be even more of a waste of time than every other eval I've ever had. Oh well, I'll at least get my yearly raise, such as it is.