3 months

Little Caleb is 3 months old already! He is still a very happy, easy going baby that hates to be naked and taking baths. I do hope that he will eventually love his bath time, but for now, he screams every time. We've tried different things, using his baby bathtub, the sink, and I've even gotten in the bathtub myself and brought him with me, hoping that would help, but no. He still hates it. Caleb is sleeping through the night from time to time. Most nights, he falls asleep around 8:30 or 9:00 and will sleep until 3:30-4:30. He'll eat and go back to sleep. It's has been wonderful. He got his 3rd Synagis vaccine a couple days ago and he's up to 10lbs 11oz. It seems so small to me for a 3 month old, but he's growing and I have to remind myself that he started off much smaller than my other kids. He is so close to a full out belly laugh. He smiles that big toothless grin, coos and almost laughs. I can't wait until he finally lets it out! The older kids will get down and talk to him he is just fascinated with them.

As for me, I'm trying to get myself motivated (again) to start running. I had been doing ok for a few weeks, but then I got out of it again. It's just so hard to get out after Husband gets home, drive to the gym and run. I'm 8 lbs from my pre-pregnancy weight but I'm hoping to lose about 20 lbs. I can get into 2 pairs of my jeans, and I should really buy another pair, but in my mind that would be surrendering to those last 8 lbs. They'll come off eventually. I did finally break down a few weeks ago and made an appointment to see the Doc for post-partum depression. It was a very hard phone call/appointment to make. It all started right after delivery. I figured by 6 weeks, my hormones would even out and I'd be fine, but that's when I started feeling even worse. I was irritable. I would lose my temper over little things that I wouldn't have even noticed before. I'd hear myself screeching at the kids and wonder "Who is this woman?" Sleeping was difficult even though I was exhausted and all I wanted to do was lie in bed. That just isn't me. And the crying, oh, the crying all day everyday. I kept thinking "Why can't I handle this? I should be able to handle this". I kept blaming myself for things that went wrong and for Caleb's preterm delivery, even though the rational part of me knew I had no control over that...and then that made me just feel crazier that I could still feel guilty yet know I shouldn't. Then the anxiety started. That tightness in my chest and racing heartbeat and worrying that something was going to happen to Caleb was miserable. At night if he didn't wake up, I was constantly checking to make sure he was breathing. It was a very dark and lonely few weeks. Husband had been on me to call for several weeks and finally I decided that something was wrong and that I needed to be seen. So I go into the appointment and when Doc asked me what was going on, all I did was burst into tears. I realized afterwards that I didn't even tell her everything that was going on, but I think between the tears and the post-partum depression test I took (and failed) was enough. She gave me an antidepressant and I am starting to feel better. She wants me to take it for at least 6 months and then depending on how I feel, I can start to wean myself off of it. I never thought in a million years I would be taking a med for ppd, but it has made a difference: I'm able to sleep at night again, the anxiety is gone and even though I still have days I'm not feeling great, I know in a few more weeks I'll see more improvement (hopefully) because it takes several weeks to get the full benefit. I don't know why I waited as long as I did to go in because its not something you have control over and should never feel ashamed of. We'll see how the next few months go. Hopefully after 6 months my hormones/body will have regulated itself and I can stop taking this medication and still feel like Me.

Happy 3rd Birthday Isaiah!

Three years ago today, Isaiah Edward came into this world, ticked off as all heck, wailing for over an hour after birth (most babies are in a quiet alert stage the first hour, not my darling Isaiah, he cried constantly until I was able to get him on the breast). My only child born at term. He is still our little spit-fire, all boy, rough and tumble. He loves to tackle his big brother and sister and he can't wait until he's big enough to play football. But with as ornery as he is, he can be also be the sweetest little boy, giving his little brother his paci, or giving me a back rub or one of his great big bear hugs. He is starting to be better about sleeping at night. Most nights now he sleeps until 5am, but we do still have nights when he's up once or twice. He just isn't a good sleeper, but thats alright. Most mornings he'll crawl into bed with me and snuggle until we have to get up. Fine by Mommy! Happy Birthday Isaiah!

Isaiah and Caleb

Isaiah lifting weights. Don't worry, they were very light weights!

Love his expressions!

Empowering

There's nothing quite like an awesome birth to make you smile. Mom, Dad and Baby all doing well, mom labored like she wanted, got the delivery she so desired. It was very empowering, not only for the patient, but also for the nurse. I love being able to help a mom as she labors and delivers just as she wanted to, even if it was outside the "norm" for a hospital birth. It was just what this labor nurse needed. :)

Still

Yes, I'm still dwelling on Caleb's birth. I don't want to, but the feelings of guilt, anger, sadness, etc are still there. Surprises me a bit, I'll be honest. That whole day leading up to his birth, I knew deep down I needed to be there, as a patient, and that I wouldn't be leaving the hospital pregnant. Another part of me felt silly, since my cervix hadn't changed all day. Then I started feeling ignorant, that I didn't need to be there after I was told "You are just someone who's going to contract. I'm not rushing you back for a c/s unless you make significant change". It was said as if I wanted to be delivered. Which I did not. Not at 34 weeks anyway. Then there are feelings of guilt that I did too much. Since nothing had changed over the 10 weeks I contracted, I kept on going. Maybe pushing with a patient for 3 hours was too much that night. It may not have made any difference, and I know that. Obviously up until then, it didn't cause any problem. I know I didn't cause it. I also feel guilty that I felt vindicated when I kept right on contracting on Mag and especially when my water broke. It was like saying "See? I TOLD you there was something wrong". I know rationally it was probably just going to happen. But the emotional side still creeps up. Caleb is almost 12 weeks and I still cry everyday for no reason. I'm irritable, I'm tired but I don't sleep well. I'm finding it hard to get out and do things, like run, which we all know I really enjoy. I still run the kids all over God's Creation and I do go run when I can, etc because I know I need to. Whenever Caleb goes to the pediatrician for a check-up or his Synagis vaccine, I feel that I let him down because I couldn't stay pregnant. And I know it's all irrational. I think the return to work stirred it up again as I started to hear details of things that were said. I had tried to tell myself that I was just exhausted and not in a right state of mind and that my perception of how I was being perceived was skewed. But each night I've been back, I've heard more and more about it, about things that were said, the eye rolling and attitude. Apparently I had some nerve going and letting my water break in the middle of the night and it was incredulous that I would want Husband there for delivery...Caleb was never in any distress. Ever. I looked at the strip. Never did I think I was being unreasonable. I didn't want to be a pain in the butt. I did look over my record, something I've done with each birth, just because, I guess. I noticed the number of phone calls made to Doc. None of them were at my request. Ok, so I did make one request right after the Mag was started in the morning that I not have to have a catheter and be able to at least drink. But that was it. I hope she didn't think I requested the phone calls be made. I'm not like that. All I wanted to do that night was sleep. I try not to complain (although here I do...it's my outlet) and I try to not be a wimp. When I had my D&C and was in the process of actively miscarrying and in significant pain, when asked, I rated my pain at a 6 and tried to "buck up" and take it. My sister stepped in and made sure they knew I was in a lot of pain and that I try not to complain too much, as she knows me better that anyone, other than Husband. I also laugh when I'm nervous, to keep from crying. Most people know that about me. I hope my nervous laugh that morning wasn't seen as me taking things lightly. I wish my coworkers would stop telling me more about the provider side that night. I might tell them as much this weekend. I was much happier not knowing the details, as the patient. I do have to work with Doc every weekend. I've always worried about what people think about me. I hate that Doc saw me that way - another pain in the ass patient who got her up out of bed in the middle of the night and wanted to wait just a bit to be delivered by c-section until her husband was there. I honestly would have been fine that night waiting until 6 or 7am to be delivered as I hadn't started contracting anymore than I had been all day. I did talk to her at my 6 week appointment. Felt a bit better afterwards, especially about the lack of interventions up until that point. I wouldn't have wanted to be on bedrest, on brethine and off work from 24 weeks on. For 10 weeks, my cervix didn't change. Had I received steroids after the positive fFN, it wouldn't have made much difference because it was about 5 weeks later when he was born. And he was fine anyway. When things picked up and didn't stop with terbutaline or procardia, that's when she ordered the big guns. Had the Mag worked, I would have been on bedrest at the point on. So that part I'm feeling better about and I hope I was able to convey that I never meant to be difficult, that I didn't do anything to purposefully make myself contract and that I never hoped to be delivered at 34 weeks.

I wish I could have a do-over. I'd have Husband stay with me overnight at the hospital and have my mom at the house with the kids, just in case. Heck, I'd go back and stay home from work that night, and maybe, just maybe that would have made a difference. Or maybe not.

Never, ever underestimate how important a woman's labor/birth is and how much that will affect her days, weeks, months, even years down the road.

Chart Review

Documentation on labor flowsheet (nurse documentation):
SROM @2:10 am, clear fluid, nitrazine positive . FHR 155,
reactive. Contractions every 5-10 minutes, (no change from prior entries). Mag Sulfate rate 2.5mg/hr.
3:25 am entry: EFM discontinued, patient taken to OR suite #1. FHR 150, reactive, contractions every 5-10 minutes, no vaginal bleeding. Mag Sulfate dc/d.


History & Physical:
IUP (intrauterine pregnancy) at 34 5/7 weeks, preterm labor. Gravida 5, Para 3, Prior c/s X 2. No response to terbutaline or procardia. Magnesium Sulfate protocol initiated.
PROM @ 34.5 weeks.

Progress note entry @ 3:30 am
Patient refused to go to OR until spouse present.


Hmm, sounds kind of silly to me to document on the patients chart that refusal. The patient is stable, baby is stable, doesn't appear anything changed after the patient water broke, and it is documented as such. Doesn't sound like such an unreasonable request of a patient in L&D to have her spouse present when she is delivered, since the baby was fine and there were no signs of uterine rupture. Especially since the time of SROM was only 1.5 hours prior to the time the patient was taken back for a c-section. I'm sure the patient would have consented to immediate surgery without her spouse should it have been necessary. I understand the need to document our backsides, but really? I've not seen this documented unless there was an issue that the baby wasn't tolerating labor or there were signs of a problem. Doesn't seem too necessary in this case.

This patient was very tearful, worried about a preterm delivery, hadn't wanted to deliver preterm. Not a case of tired of being pregnant. Not a patient who refused care just to refuse care. This was just a mom who wanted her husband there when their last child was delivered and really thought that her request to wait until her husband was present before going back for delivery wouldn't be a big deal. Her husband had been home, taking care of their other children and he was there in her room within about 1 hour. She would have consented to a c-section with no anesthesia, in the labor room, without her spouse, if it had been necessary.

I'm perfectly fine with that documentation on my chart. ;)

Hi-Ho, Hi-Ho, It's Back to Work I Go

I went back to work this past Sunday night, something I was dreading. I got used to being home with the kids and although I was going stir crazy being at home, I didn't want to go back to work. I'm not sure why but going back to work after maternity leave got harder with each kid. But, anyway, I went back to work Sunday night, only did an 8 hour shift, and had just a few tears as I left. Thank goodness it was a slow night. We actually had plenty of labor nurses (which is surprising) so I was only going to have 1 patient, the midnight induction. So I had about an hour to get ready, try to remember my passwords to everything. Thankfully, I was able to log into the 2 charting systems we use, one for the fetal monitor and the one for meds. But I couldn't log into my email or into the Omnicell, the machine that dispenses medications. And it wasn't because I forgot my password. Apparently they had disabled my user id and of course, being a Sunday night, no one was there to fix it. It was fabulous. The charge nurse was able to give me a temporary id and password so I could function, but it was a pain in the arse. It becomes almost mindless when you log into different things so when you have to change a password or, in my case, have some funky user id, it slows you down. As for my work email, the guy in IS who can usually fix anything with the computer couldn't figure out what the problem was with my email. So who knows when that will be fixed. Beyond the technical difficulties, the night wasn't too bad. The midnight induction was a no show, but I did admit one patient. Like I said, it was a slow night. I felt just "off" going through the millions of questions we ask when someone comes in. I had no problems with the assessment/hands on stuff, like the IV, cervical exam, reading the monitor, but it was more in my organization, my routine. It's a bit hard to explain, but I just felt like I had been gone for 10 weeks. Monday night was much better. I felt like I was back to my old self, well, maybe 95% back to normal. I think this weekend I'll feel "back".

Caleb did just fine with my return to work, sleeping through the night for the first time Sunday night and again on Monday. Lucky Husband. Of course last night, since Mommy was home, Caleb was up quite a bit. Figures, right? A friend of mine, who has 5 kids, calls it survival mode. They know Mom isn't there so they figure they might as well sleep.





On a completely different note, I want to take just a minute to remember my stillborn niece Mirabel. She would have been 7 years old today. My SIL and BIL have been actively trying to conceive for the past year without success. I finally talked her into making an appointment to see her physician. Today I pray they are able to conceive again soon. My thoughts are with them today as they remember...she may be gone, but not forgotten.

Spirited Child

One of the many good things about maternity leave is that I've been able to go to church. When I work Sat. nights, I just can't stay awake to go to the service at 11am. I'm just too exhausted and I figure God understands. But I do miss it. Last Sunday, a family had their baby baptized and their almost 3 year old son was running all over the sanctuary and the poor mother was stressed trying to keep him under control since Dad was holding the baby, trying to keep him from knocking over the candles on the altar, etc. It was quite distracting as the Pastor went through the Baptismal Covenant. He had a pencil and one of the envelopes meant for the offering with him. He would lay on the floor, in front of the congregation, color a bit, then get up and run to the other end, run by the altar, jump up and down to make noise, try to get his dad to pick him up even though daddy was holding the baby, and he just was nuts. The poor mom, she picked him up a couple times to try and control him, he resisted, fought her the whole time but she managed to stay focused on the son being baptized. Finally, she gave up, let her elder son lay on the floor and color while they finished the baptism. Every mother in the congregation was silently glad that it wasn't their child that was acting up. Seriously, how could that mother let the kids get away with that? Why didn't she have more control? How embarrassing!! Oh, wait, that mother was me and the child was my own sweet "spirited Isaiah that was running amok while Caleb was being baptised!!

8 Weeks

I just can not believe that my baby boy is 8 weeks. It just doesn't seem like it has been that long. I also can't believe I go back to work in 2 weeks. I like my job, but I'm not looking forward to going back. The first night back is always the hardest, and it seems like with each kid, I'm more and more emotional about leaving them to go back to work. You'd think by now I realize it's no big deal...I work 3 nights a week. One thing that will be hard is going back to switching my sleep schedule all the time. Sleeping at night 4 nights a week, working all night the other 3 then sleeping during the day. You don't realize how much that messes with you until you are going to bed every night. I've talked with a few of the girls from work and apparently morale is at an all time low - people who no one ever thought would leave the department are looking for other jobs and are even willing to leave to go to another area of nursing, like ER or med-surg and these are die-hard labor nurses! It's busy, short-staffed and everyone is taking on patient loads that make it hard to give good-enough care, let alone give good care. So I'm really excited about going back to work. Maybe something dramatic will happen and it will be all sunshine and roses, we'll get to do one-on-one nursing care and be able to give the attention we want to give to our patients. I won't be holding my breath.
But, back to Caleb. He's starting to be much more attentive to the world around him. He's been spending a lot more time awake, just looking around. He's starting to smile purposefully now, too. I just love baby smiles! They are addictive and I can tell you I've spent so much time trying to get him to smile again. The other kids look at me like "Mommy, what is wrong with you?". They think I'm crazy, I'm sure. But Caleb will sit in his bouncy/vibrating chair and just wait for someone to come talk to him. Then he just lights up, his eyes get really big and he will try to imitate what we do with mouths. It's so cute. He's still a pretty decent sleeper. He has a good stretch at the beginning of the night for about 5 hours, then he's up every 2-3. He ends up in bed next to me about every night. I prefer to not co-sleep, but he sleeps so much better next to me, and I usually just fall asleep nursing him. But, so far, sleeping isn't too bad. I just hope when I do go back to work, he does okay with me gone.

First 5K is around the bend

I have decided I am officially crazy. I've probably been this way, since, oh, the first time I saw 2 lines on a home pregnancy test back in 2002, but I'm finally admitting that I am in fact nuts. I just got the ok to start exercising last week and I've decided to run a 5K December 4th. That's right, in a month. Its a memorial race back home, so I can hit up my parents for some good food while I'm there, if I survive the run, in the cold of December. My luck it will be sleeting that day. But that's not the real issue. I have a 7 week old baby that was born by c/s. And I am severely out of shape due to lack of exercise for months. The last time I ran, 3 days ago, I did manage to run an entire mile,...but then I had to stop and walk. It was only 1 mile, not 3.1 miles. Plus I was running on a flat treadmill. No wind, no hills, constant slow pace. I don't know what I'm thinking, running a race so soon. But, if I have to stop and walk some, so be it. I'm not too proud to walk. I figured I gotta get back out there sometime, why not sooner rather than later? Talk to me after the race, and see if I still feel the same way!

I'm Too Sexy..

I told Husband last night "I just don't feel sexy anymore, ya know?"
He just stared at me for a second and then laughed. For a brief moment, I was irritated until I realized what I was doing. I was wearing a pair of his gray sweat pants and a tshirt I got in H.S. My hair was pulled back in a messy ponytail and I had minimal make-up on. But the best part? I was sitting on the floor, my old tshirt hiked up, exposing my jowls-of-a-dog post-partum belly, with the breast pump milking me like a cow, with enough suction to pull my nipples to a very unnatural length as milk filled the bottles. Yup, motherhood is sexy!

Reunion with my Running Shoes

Today I decided to go for my first run in months. Tomorrow I see Doc for my post-partum check-up so I figured 1 day ahead of time would be ok. Plus I knew I wouldn't be running very far. I tried to remind myself that I had a baby 6 weeks ago, added to the fact that I haven't exercised since May. Rationally, I knew it wouldn't be that nice easy run around the neighborhood, but in my head was the memory of those nice, easy runs. Let's just say it wasn't pretty! I can only imagine what I looked like. I have a long way to go to get back into shape. That said, it wasn't as bad as I expected, I alternated running and walking, and ran most of the way. I ran slow, but that's ok. I didn't push it, as I haven't gotten the "official" ok to exercise, but I don't imagine there's any reason why Doc won't give me to ok tomorrow. So I did it, I got that first run under my belt. It will only get better from here.

A Labor Nurse's Birth Plan - revisited

Ah, my "birth plan". I was laughing to myself (yes, I'm easily entertained) about the birth plan I had come up with when compared it to what actually happened with Caleb's birth. It is a good idea to have an idea of what you want and don't want, but once again it shows that even with the best laid plans, things may not go your way, even if you write a kind of "anti" birth plan, to ward of any unfavorable vibes for the labor/birth. Guess the labor gods decided to take me seriously and grant me some of the items on my birth plan. Figures, right?


Just for fun, let's look at my "birth" plan:


1. I want lots and lots of Magnesium Sulfate. Gee, I guess I got that, didn't I?!? My whole sense of time the day leading up to Caleb's birth is a bit of a blur, but I got a nice hefty 6g bolus and was on Mag, I believe, about 18 hours, and a nice big maintenance rate of 3g an hour the majority of that time. Good times, good times.



2. I'd like to have an emergency c-section without anesthesia due to a uterine rupture at my old incision site. (yes, unfortunately, we have done c/s sans anesthesia, luckily not often) - Thankfully, I did not have to have this. No emergency, no uterine rupture. And Doc told me after the c/s that my uterus did not look like a uterus that had 2 prior c/s. Nice to know the ole' girl healed well after c/s 1 & 2.



3. If I don't get a emergency c/s and can VBAC, I'd like an episiotomy with a 4th degree extension, please. Wasn't given a chance at a VBAC, heck, it seemed like it was a huge deal that I wanted to wait until Husband was there before I was taken back to the OR. When one of the other docs I work with heard I delivered, (according to a coworker/friend) by c/s, and had a vaginal delivery with my first baby (perhaps a breech in HIPAA, but I don't mind) he said he would have let me VBAC. Go figure. But, in reality, I would have been too nervous to VBAC after 2 c-sections.


4. I also would like to be tethered to the bed for the duration of labor with internal monitoring. No internal monitoring, but I was, in fact, in bed from the time I changed out of my scrubs and into a hospital gown right before they started Mag. However, I wasn't in any shape to stand after a certain amount of time, remembering how weak my muscles were just trying to move in bed and when I tried to get to the wheelchair for my ride to the OR.


5. I desire lots and lots of cervical checks - I did have several exams, but I realize they were all necessary to make sure I wasn't changing my cervix.


6. I also would like my baby taken from me straight away for at least an hour so it interrupts with breastfeeding and bonding. I had wanted Caleb to stay in the OR with me...but that was on the condition he was term and healthy. My coworkers tried their best to keep him in the OR, but I told them to take him to the nursery, make sure he's just fine. I did get to see and touch him before they took him to the nursery, so that was nice. Thankfully he was fine and it had no effect on bonding or breastfeeding. That boy latched easily while I was on the recovery room cart.


So, like I said in the original post, be flexible with your birth plans. You just never know what labor and delivery will bring.

A little daily ritual

Someday, I will not have to change the sheets on my bed everyday. Why, you may ask, do I change the sheets everyday? Is it because I am a clean freak? Clearly not if you saw my house. Do I just like to do laundry? No, not really, and even if I did really like laundry, I have plenty without my bed sheets to satisfy my craving. And no, Husband does not wet the bed, neither do I for that matter, and believe it or not, the baby isn't the reason for the daily bed change. My friends, let me tell you why I do this daily ritual. Husband gets up out of bed to go to work around 4:30am. I fall back to sleep after feeding Caleb about that time and when I wake up, Isaiah has crawled in bed with me. When we get up for the day, Isaiah is soaked. Not just full diaper soaked, but wet pants and shirt. He leaves a huge wet pee soaked spot on Husband's side of the bed, wet pj's, saturated diaper. You may think "Well, get him potty trained". If only it were that easy!! Or "Why doesn't Husband change his diaper when he gets up for work?" Well, that's because Isaiah is still sleeping when Husband leaves...and I don't wake up when he crawls up in bed because, well, I'm tired from the nighttime feedings. I suppose we could wake him up in the middle of the night and change him, I have considered that, but with as horrible of a sleeper that Isaiah is, I changed my mind. You wouldn't wake him up in the middle of the night to change him either, trust me. Bedtime is a huge battle we've been fighting with him for a long, long time so once he finally goes to sleep, we don't want to wake him up. We've tried limiting drinks, and he goes to bed with a fresh clean diaper every night. Sometimes he will sit and use the potty before bed...other times he just plain refuses to sit and try. We've tried so many things (that have failed), every old wives tale, every trick others have used, all have failed. I've decided Isaiah has a bladder the size of the water tower, and can store fluid like a camel. I've even gone so far to do a little dance around a fire and gave a sacrifice of a pack of diapers, hoping to appeal to the dry diaper gods, or at least to the not-saturated-and-overflowing, diaper gods. They haven't heard me. I may need to go buy a few more sets of sheets, maybe a set for each day of the week. I guess I could look at the bright side - if Husband irritates me, I could always NOT change the sheets!

Soon to be reunited

Dear running shoes,

Oh, how I have missed you so these last several months. I can tell you I longed for our long outings together...cruising the streets of town, running through the countryside. Oh, the times we had! We made quite the pair, you and I! What a great fit and the comfort I felt when we were together was better than any other running shoe I had ever been with. We were on a roll, spending more and more time together when suddenly we had to stop these rendezvous. I remember our last run together. I missed you, but it was more important that I grew this baby and kept him safe and sound until he was ready to live in this world. Our parting was sorrowful, but for great cause and I knew in good time we'd be together again. Our time is near! I anticipated our reunion in December, but as fate would have it, in November, we will be able to once again start our relationship anew. When we slipped out last night on a walk, those same feelings came back and my anticipation is growing. In a few weeks, we will once again become inseparable.

All my love,
Nurse Lochia

4 Weeks

I saw this on a few other blogs, and I thought I'd do the same.

How far along were you when you had your baby? 34 5/7

How long was labor? Hmm, true labor, probably only 2 hours until the c/s. My cervix hadn't changed during the day and I wasn't checked after my water broke around 2 a.m. But I was on Magnesium Sulfate for about 15 hours to slow the contractions and I doubt there was much change.

Total weight gain: 26 pounds

Total weight loss since: 13 lbs. 13 more lbs to go until my pre-pregnant weight, but I had put on a few pounds after the miscarriage last year while we were trying to conceive.

Back into your own clothes yet? Mostly...still wearing the black stretch pants I always wore and the one pair of jeans that are my "post-c/s" pants. I doubt my other jeans would fit and if they did they wouldn't be comfortable thanks to the incision.

Did you get stretch marks? Nope, I'm very thankful for the good genes! But I do have that darn skin flap that a lot of c/s moms complain about and my extra "padding" on my stomach appears to be misshapen. There is more on one side right above my scar than on the other. Looks a bit strange.

Did you deliver vaginally or by c-section? C-section

Best moment this week: 5 hours of sleep between two feedings one night

What I miss about being pregnant: The movement, the big belly and the fact that I was growing a life, but I DON'T miss being uncomfortable!.

How big is baby: I'm guessing he's about 7lbs now. He was 6lb4oz at his 2 week appointment, up from birth weight of 6lb1oz and from his lowest of 5lb9oz.

Breastfeeding? Still going great. He nurses about 1.5-3 hours during the day and will go about 4 hours between feedings at nights. I'm working on building up a nice freezer full of bmilk for when I go back to work.

Baby's temperament? He's still pretty laid back. We've not had any crying fits where we have done everything and he's still crying. He'll fuss with a diaper change and make some noise when he's hungry but he's so easy going. He loves to snuggle, too!

What I am looking forward to: Hmm, ready to exercise again and lose the baby weight, but I'm just trying to enjoy each day as they come.

"The drama of birth is over. The cord is cut, the first cry heard: A new life begun....The mother - seeing, hearing, perhaps touching her baby - scarcely notices the world around her, let alone how much her body aches. She just participated in a miracle."

Carrol Dunham


I found this quote in a book I was reading last night while enjoying a quiet bath. It brought tears to my eyes (although that's not hard, especially these days!) and it is now in the ranks of my favorite quotes ever. When Jacob was born, all I remember is seeing him - not other people around me, and when I was holding him in my arms, he was all I was seeing. Clara I didn't hold right away but I was no longer aware that I was on the OR table after seeing her face and when I held her for the first time in the nursery, again, she was the only thing I noticed. Likewise with Isaiah and Caleb. Holding, seeing my children, and hearing their first cries, I noticed only their sweet faces and delicate features and marveled at these perfect little creatures that Husband and I brought into this world. All I felt was love and awe of them, I didn't notice the staff, the exhaustion, the line of fire across my lower abdomen , or anything else other than the fact that I had indeed just participated in a miracle.

Pregnancy and Infant Loss Day

Today I'll be remembering all the babies that left this earth too soon. I'll think about those babies who's parents never got to hold them, those who were born sleeping and those who left after a short time. Personally, I will be holding my niece Mirabel in my thoughts...gone at 39weeks. Also I will remembering my own little angel, gone but not forgotten. I am forever changed with a life that was only here for such a short time. Because that life existed, I now hold my sleeping newborn son Caleb in my arms, but I will always wonder who that little life was that occupied my womb for such a short time. May God hold all these angels in His hands, and give peace to those left here with just memories.

Diapers

Just when I thought I had it all together...this am, after getting the big kids off to school, I get the two little guys home and Isaiah promptly needs a diaper change. I go to our usual downstairs spot for diapers and no diapers. I knew we were out of diapers upstairs because I had put him in the last one that morning when I got him dressed, but I assumed we had some downstairs. But no diapers there. I wasn't too worried at that point because there is usually a diaper in my purse, in my van and in his daycare backpack. Wouldn't you know it but not a diaper in any of those places? I curse a bit under my breath because I realized I had to go to the store...and I didn't have a diaper to put on him to even go to the store. Great. And he's been refusing to sit on the potty for the last month, even though he was doing great for awhile. So I put him in underwear, tell him he has to use the potty if he has to go. Now what do you suppose happens? As I'm feeding Caleb because he, of course, decided that now is the time to eat, Isaiah looks at me and tells me he's wet. He emptied his bladder while sitting on my living room rug and is saturated. Fabulous. So once again, I clean him up and I do finally get to the store to get diapers and thankfully he didn't have an accident while we were in the store or van. He did promptly poop in his underwear as we walked in the house, but at least we were home. I can not wait until he's potty trained. I actually thought a couple months ago that maybe he would be out of diapers by now because he was doing so well. But he was just messing with my mind, giving me false hope! Someday though, someday he'll be out of diapers and I won't have pee soaked pants to wash. Ah, the joys of motherhood!

Randomness that is my mind

Today Husband went back to work. It was really nice having him around as we adjust from being a family of 5 to a family of 6. "We are a 6-pack now" he says. But as nice as it was to have an extra set of hands, it was time for him to go back. Don't get me wrong, I love the guy, but I have my routine, my way of doing things and, well, we were getting in each other's way. Plus eventually we'll both have to go back to work and we'll have to see how our routine will be. So today, it was just me and the 4 kids and really, it went pretty well. We'll see how it is when Caleb is a bit older and not so laid back, but for now it wasn't too bad.
Yesterday we had newborn pictures taken with Caleb. We go to this friend/coworker of mine who does photography and has always done a great job. So I'm excited to see the pictures because he cooperated pretty well. We had been working on a pregnancy progression project and while we anticipated taking one about this time, right before I delivered at term, we took the final picture with me in the nude wrap and a newborn. It promises to be pretty cool, so that was fun.
I also had a quick doctor appointment to check on my incision. It's healing pretty well. I had managed to not get that flap of skin moms with c-sections always talk about having...until this delivery. It was inevitable I guess, but the scar itself looks pretty good I will say. A nice thin line that I imagine will fade quite a bit just like it did after my last 2 c-sections. I have to go back in another 3 weeks for the whole 6 week post-partum exam and to be released to go back to work. My plan is to talk to doc about some of my frustration at that point, just so I can see her perspective. I don't blame her for what happened, even though it may sound like it from Caleb's birth story, but I do have a few questions I would like answered. Plus I want to make sure that she knows I wasn't hoping for a preterm delivery to get out of the misery of pregnancy. I've been feeling a bit better with the "blues" lately. I think just getting out of the house and going for a quick walk, or even just sitting outside helps. So fewer sessions of tears for no reason has been nice.
I realized today that while I am enjoying being home, and I don't miss all the politics that swirl around a hospital, I miss working a little. Weird, huh? I miss laboring with the patients, circulating deliveries, and helping moms with their newborns. I know soon enough I'll be returning to the land of labor and delivery so I'm trying to savor my time away.

2 Weeks Already

It's hard to believe that just over 2 weeks ago, I was still pregnant. And strange that I expected to be pregnant right now...and for the next couple weeks. Caleb is doing great. He continues to sleep most of the time, eats about every 2-3 hours and generally is an easy baby for now. He has been awake a bit more the last few days so that's been fun to watch him taking in the world. Yesterday he had an appointment and he is up to 6lbs 4oz. So he's eating well and has surpassed his birth weight! I'm healing well. My incision appears to be healing nicely but my abdominal muscles are pretty tender still, tender well up to almost my belly button. But I figure that was the extra manipulation for the tubal ligation. These crazy post-partum hormones though are the devil. With my 2nd and 3rd babies, I didn't have post-partum blues, but I did with Jacob. And again this time. Nothing serious enough to warrant concern of post-partum depression, but I am pretty irritable, teary, sad at times, emotional, etc. I think part of it is because it is an end - an end of my childbearing years. And while I have no desire for more children, it is an end to that part of my life, and being a labor and delivery nurse, I love the whole pregnancy/childbirth/newborn stuff. This is the time in recovery that I remember why it is so much easier to deliver vaginally. I want to be doing more and my body just isn't ready, and that drives me crazy! I'm also still trying to reconcile the delivery I had to what I wanted, and I'm trying to quit looking back over the last weeks of my pregnancy and wondering "What if I had done this differently, would I have still delivered preterm?" I understand 34w5d isn't so bad, but at the same time, I wanted more time. I had plans, man! I had more maternity pics to have taken and I was going to let the kids finger paint my belly like a pumpkin closer to Halloween! Oh well, now we get to dress up little Caleb for Halloween, won't be taking him out anywhere, but we can still dress him up. That's also an issue - not going anywhere with the baby. Our pediatrician recommended we not take him out in public places for 6-8 weeks...hard to do with 3 older kids, and with errands to run, etc. It's just not realistic but at the same time, I don't want to take him out in a germy store and run the risk of him getting sick. But, other than that, we're doing well. I'm still getting about as much sleep now with a newborn as I did while pregnant, breastfeeding is going great, my breast aren't even all that tender, the kids are doing well and Caleb is such a sweet little baby who loves to cuddle but will also actually sleep in his bed!

Caleb's Birth Story

Ok, I did try to keep this to a short story, but it kinda turned into a novel...

The weekend before Caleb was born was a busy weekend. Clara's birthday was Friday. I had scheduled myself to work Friday night and Sunday night so I'd be off and available for Saturday. It was busy as all heck Friday night - I was in charge and had a full patient load! Then I went home and slept for a few hours before family came to town and we went to a huge apple orchard/pumpkin patch for the day for Clara's bday. They have a TON of stuff for kids there. But I didn't get a lot of sleep. Sunday 9/19 I went to work as usual. I had been a bit uncomfortable all day...had what I called butt cramps and I was just plain uncomfortable. I'd never had that discomfort before, but I figured it was probably just the baby's position, sitting on a nerve or something. And, really, I'd been uncomfortable all pregnancy and so far nothing changed my cervix. So I go on about work and at one point a couple of the other nurses and I thought we'd mess with the nursery nurse that was working. One of them went to the nursery and told her "Mary, get ready for a c/s. Nurse Lochia's water broke and she's only 34 weeks!" Yeah, yeah, we nurses have a sick sense of humor, but it was all in good fun! We all had a good laugh. Little did I know what was in store 24 hours later. Anyway, I push with this patient for 3 hours and she finally delivers. I had started getting really uncomfortable, not with clear cut contractions, but my back was killing me, I felt like I could faint and vomit, and my uterus was just sooo tight, it actually felt like it could pop. I told the charge nurse after the baby delivered, that I was not feeling well at all and needed to rest for a bit after it was all said and done. So delivery done, patient taken care of, and I run to the bathroom to vomit. I also took a brethine, hoping that would help with the tightness in my uterus. I felt a bit better after vomiting, but I notice I'm passing pink mucus. I sat down with a huge glass of water, ate my sandwich and finished my charting, but still wasn't feeling good at all. Finally, after much debate, we decided I needed to clock out and become a patient around 4am. I was contracting pretty frequently, cervix was 2cm, soft, but thick, but it was easy to reach. I really thought a few shots of terbutaline would do the trick. So I called Husband, told him I was a patient, that I'd gt a couple doses of terb and probably go home and probably wouldn't be working that night. Two shots in, I'm still contracting, and my pulse is 130 so they have to hold the 3rd dose. By now, it's 7am and my doc comes to see me. She said that when my pulse slows, I'd get that 3rd dose. If that didn't work, then she'd give me a dose of procardia to see if that helped. If that didn't work, then she'd have to start me on Magnesium Sulfate since I was only 34 weeks. I know some hospitals go ahead and let you deliver at 34 weeks, but in this area, we stop labor at that point. I knew from experience as a L&D nurse that if 2 doses of terb didn't slow the contractions, then the 3rd wouldn't and the procardia probably wouldn't either. Got the third dose and no change in contractions. I get the procardia and you guessed it, no change. By now my pulse was 150 and I felt like complete crap. At this point, I know what's coming: Mag. My IV is started and they draw labs, do a GBS culture and I get a 6g bolus of Magnesium sulfate and then the maintenance rate is 2g an hour. Can I just say Mag sucks. I tell patients that all the time when I start Mag but until you experience it, you just can't understand. It feels like fire in your veins, in makes you nauseated, and hot. I did ok with the bolus, though. Finally, the contractions start spacing out. I begged to not have the foley catheter...doc said fine but I had to use the bedpan and was not allowed anything to eat or drink...just in case. After about an hour on 2mg of mag, the contractions pick up again so I had to have the catheter put in to keep my bladder empty. I'm a baby and I hate catheters. They ended up bumping the mag to 2.5g/hour then to 3 g/hour. At 3g and hour, I felt like crap...again. Double vision, felt weak, and out of it. Finally, they slowed again, cervix still unchanged, thankfully. When they increased the Mag to 3 g, I started to have a bit of a melt down. I started worrying about the baby - I see 34 weekers born all the time and they almost always have problems. yeah, in the long run, they do fine, but initially, they have problems breathing, sometimes need to be ventilated and given surfactant, which my hospital doesn't do, they get transferred to another hospital with a big NICU. They also have problems with their blood sugar, keeping their temp up, weight, etc. Plus my daughter was 36 weeks and had respiratory issues, so I started freaking out. I called DH and he came to the hospital...I texted my sister, my due date buddy in my due date club I'm in, and talked with my coworkers, trying to calm my nerves. The kids pediatrician even came by when she saw my name on the board and that was nice...she could make a dead person feel better she's so soothing and reassuring. They were all reassuring, but I don't remember the babies that do well...I remember the ones who don't do well. Finally, after my "moment" I got myself together and I knew really needed to turn the labor nurse part of me off. Doc ordered a cocktail of meds that will help with pain/nausea/and will make people sleepy, Nubaine and Phenergan, since I had been up since Sunday a.m and it is now Monday at 3pm she wanted me to sleep. I didn't want this cocktail because I didn't' want to be anymore out of it than I already was on the Mag. I was seeing double and couldn't think straight. That combo of Nubain and Phenergan did not help at all with my mental clarity. From about 2:30pm on, I was out of it. It was like I was in a daze...not able to really sleep, but I couldn't keep my eyes open, couldn't focus to even form questions that made sense, couldn't hit the numbers on my phone. Around I think 4pm, my doc came to see me again...this time I felt like she really didn't think I needed to be there, kept saying "It's your 4th baby, your cervix hasn't changed, you were contracting every 2 minutes at your last appointment and you're probably just someone who contracts. When they hurt, then we are concerned. I'm not going to rush you back for a c/s unless your cervix changes". This pissed me off. Ok, first I was uncomfortable, and that was why I was admitted. Second, I know I contract all the time and when they didn't hurt, I didn't worry about it. Third, the very LAST thing I wanted to be was delivered. I'd been just fine with carrying until the end of October, I don't care how uncomfortable I was. I don't know if it was because I wasn't quite with it, but my coworker taking care of me told me she was just trying to reassure me that she didn't think I would have to be delivered. So I tried to relax. I sent Husband home to take care of the kids and said I'd call if anything happened. The rest of the evening was uneventful. I was in and out of poor sleep, and around 1am, my coworker came to give me another round of the Nubain/Phenergan and the ampicillin I had been getting every 4 hours. My WBC count was 15 - we see an increase in WBC when women come in in labor, or if there is an infection of course. Fifteen minutes later, I notice my underwear was wet. "Ok", I thought "maybe it was the KY Jelly oozing out from the cervical checks, or maybe the catheter was leaking". I took my underwear off, it was covered in mucus, but I had been losing mucus all day. Over the next hour, I finally realized that it was probably amniotic fluid I kept feeling and the pad under me was wet. I considered not saying anything right away...I had just been doped up with drugs, I wanted to sleep and the last thing I wanted was to be drugged out when my baby was born. Plus, I worried about how he would come out b/c of the drugs, but reason won over and I called my nurse. Sure enough, it was amniotic fluid, not that either one of us had any doubts. So I called my DH...and he didn't answer. "Ok", I figured maybe he was in the bathroom. I called 7 times and he didn't answer and I was furious! How could he not have his phone next to him! I had called my mom and she was on her way, but she is 1 hour drive away. My charge nurse actually called another coworker of ours who lives a block from me...she was still awake and she walked to my house to wake DH. About the time she knocked on the door, I got a hold of him- he had been trying to get Isaiah back to sleep. In the mean time, my RN called my doc, told her my water broke and that I wouldn't be going back to the OR until DH was there. My doc, (this ticks me off), wanted to make sure it was documented that I was "refusing" to go to the OR until my husband was there. Baby was fine, I was fine, so I don't know what her problem was. I think it was just the middle of the night thing - she had said half-jokingly earlier that she didn't want to see me at 2-3 in the a.m., and this phone call was at 2:30. It still irritates me, but whatever. Husband gets there very quickly, they also called in my pediatrician (who wasn't on call) and the favorite anesthesiologist (also wasn't on call) and they came in for me. It was really, really nice that they came in for me! I had no idea how weak I was from the mag, but I couldn't even stand up to get myself into the wheelchair. That was an odd feeling, not being able to hold my own weight up. So they help me into the chair, and off we went to the OR. I've been through a c/s before and I've seen hundreds, but when it's me, I'm still scared to death when it's me. I get prepped, draped and again, they ask if I want to go through with the tubal ligation or wait until later. I wanted it done then. At 3:47 a.m little Caleb Dean was born with a hearty cry before his body was even delivered! He did great, as I have bragged already! His apgars were 9 and 9, and he was 6lbs 1 oz, 18 1/4 in long. He was beautiful and looked just like my firstborn - full head of dark hair too! I got to cuddle him a bit before they took him to the nursery for a complete evaluation. He checked out great in the nursery, never needed oxygen. He just didn't seem to realize he was preterm! I finally got to hold him in recovery and he looked like he might nurse so I figured we'd try. I didn't have much hope he would because 1. it's hard to breastfeed on the recovery cart and 2. he was early and they don't always know how to suck. I laid him on my chest and he latched right on. I was amazed! I was laying down, and here is my little 34 weeker nursing better than my other kids did! The rest of our stay was uneventful - he still nurses like a champ, his temps were always good, his weight was fairly stable and although he was a bit jaundiced, he is fine now. He came home on time! with a biliblanket to help bring his bilirubin down, but the next day it was down enough we didn't need it anymore!

I recovered well. The duramorph they put in the spinal for pain control (a form of morphine) always made me itch like a madwoman, so they only gave me half a dose. I still ended up itching myself into a rash. I ended up with a narcan drip to reverse the effect of the duramorph - that also took away the pain control and I then was in quite a bit of pain, but some toradol and fentanyl did the trick. The pain was good and the itching was gone. I don't think the anesthesiologist believed my itching was as bad as they had said until he saw me in the hall - then he went to town trying to figure out what to do for me and we tried to decide if it was the duramorph that I had an allergy to. He suggested I list morphine as an allergy and also that I might have a latex allergy. Gloves don't bother me, but he thought maybe with exposure internally, it would cause the systemic reaction I had. But anyway, life was good. Caleb got to stay with me, never had to be in the nursery - I did let him go at night between a couple feedings b/c some of the girls wanted to get their hands on him...we love to cuddle with babies, especially babies of "one of our own". When I saw my coworkers I worked with Sunday night...you know, the one's who were in on the little joke about my water breaking...we had a little laugh. They said when they heard they felt guilty. We nurses are superstitious...but we also know it was just irony at work, but we all agreed - no more jokes like that on the nursery nurses!

Part of me is a little frustrated with my physician...looking back over the last several weeks, I had contractions that weren't painful, but were there. And I realize that hindsite is 20/20 and at the time, things seemed to be under control. She did multiple fFN tests and when one came back positive, she took the approach that b/c my cervix was still thick, I wasn't at too great a risk. She never changed anything. Never gave me steroids, no bedrest, etc. She did give me brethine to take as needed, but several of my coworkers expressed concern that she wasn't taking me seriously. Even when I was admitted and started on Magnesium, I felt she didn't think I really needed to be there. I didn't want to be off work if it wasn't necessary...I didn't want meds if it wasn't necessary, etc., but I also wanted to be smart about the whole thing and if she felt I needed intervention and medication, then I wanted to do whatever needed to be done to keep him in until term. I trusted that because my cervix wasn't changing, and that my doc didn't think it would change, that it was safe if I kept on going, I was just one of those women who "just contract and their cervix never changes". I was ok with that. I looked to her for guidance as my doctor - I trusted her judgement out of all the docs I work with and maybe in the end it wouldn't have mattered regardless of what we did...Caleb was tired of being stressed and I think he took his little finger and just went "pop" and broke the membranes. I perhaps should have listened closer to what my body and my "mother's intuition" was telling me. I told a few of my coworkers when I was about 20 weeks that I had a bad feeling I wouldn't make it to term. A mother always knows. He did fine, but most don't do that well. I brag how well he did after delivery, but the reality is that my uterus wasn't a calm happy place for him - the stress of being in utero probably made him mature faster. It's easy now to look back and wonder if maybe something should have been done differently - I'm not really a big complainer and I don't advocate for myself very well, so maybe I should have been more vocal about how I was feeling, or maybe my doc and myself shouldn't have been so laid back about the whole thing, but oh well, it worked out in the end. There were several prayers said for this little boy and I believe that is partly why he did so well...I am a firm believer in that.

I had my whole delivery planned: I had hoped for 10/22 to have a scheduled 7:15 c/s. My nurse friend S would circulate, the baby wouldn't leave the OR and I would get to hold him as I'm wheeled out of the OR. I wanted to avoid working most of a shift and then being admitted b/c I would go into delivery with lack of sleep. S was off after carpal tunnel surgery but had planned on being back in 2 weeks. I was admitted after a weekend I worked Friday night/Sunday night - and those weekends wear me out because I get very little sleep, plus we had a busy weekend with my daughters bday. I never wanted to experience mag or another preterm delivery. It just goes to show you just can't control delivery - and even though it was full of things I didn't want, all I really wanted in the end was a healthy baby, and that's what I got. I have a beautiful, healthy new son that we are thrilled to have, and his older siblings adore! I couldn't ask for more! Plus, now I can empathize even more with my patients: I've had a nice normal vaginal delivery, an emergency c/s with a preterm 36 week baby who spent a day in the special care nursery, a nice scheduled term c/s, an incomplete miscarriage and D&C, and now a preterm 34 week delivery after trying to stop labor with terb, procardia and Magnesium Sulfate...so I'll be a better nurse for it!

More pics for your viewing pleasure!

I'm pretty tired, but I wanted to show off some more pics!

Caleb Dean

Sorry for the long time between posts but we've been pretty busy! Last Sunday night/Monday a.m., I had to clock out at work and be admitted for preterm labor. They tried to stop contractions first with terbutaline, then with procardia and then I was finally on Magnesium Sulfate. After being on strict bedrest, npo and Magnesium contractions slowed to where I only had 4-8 in an hour...on 3grams of magnesium. But my cervix stayed the same. Around 1:15 am Tuesday a.m., I noticed fluid leaking and hoped it was just the KY jelly from cervical checks...but at 2:00 am. I knew that my water had broke. At 3:47 am Tuesday September 21, 2010, Caleb Dean entered the world by c/s. He was 34 5/7 weeks gestation, weighed 6lbs 1oz and was 18 1/4 inches long. He has done Fabulous! Never had any respiratory issues, breastfed better than most full term babies, has kept his temperature up and his weight. He is a bit jaundiced but we are at home with home phototherapy for a couple days. He didn't even have to stay any extra days! So I'll update with a full birth story soon...right now I'm going to go cuddle with my four children!

You know you're going to have a great day when..

...your toilet basically explodes all over the bathroom. Yep, that's how my day started out. It all started when I went upstairs to vomit. Yes, I still average a vomit episode about once a day. It really comes up out of no where. I'll feel just fine, eat a meal and then 1-2 hours later, I'm running (i.e. waddling) to the toilet. That's what happened this a.m. I figured after I emptied my stomach of my entire breakfast that I'd turn on cartoons for Isaiah and I'd take my shower. He'll sit and watch tv for 20 minutes and I can get ready for the day. Since we live in an old house and have old house plumbing, I didn't flush the toilet right away because I didn't want scalding hot water for my shower, and it takes forever for the temperature to go back to normal. I jump in the shower, it felt great and then I get out feeling refreshed after a long night of tossing and turning. I then flush the toilet. Here's where it got really ugly. I guess I hadn't noticed the water level wasn't where it normally is because, well, I was in a hurry to just get there in time. It started rising and I realized it was clogged. Usually the water level will fill just to the brim or maybe go over just a little. But that wasn't what happened. It just kept coming and coming. Not only did it cover my entire bathroom floor with water and vomit, it was apparently clogged with feces and toilet paper, so that was all over the floor. So there I am, standing stark naked, 34 weeks pregnant, on the verge of panic because the nasty water just keeps coming. I didn't know what else to do so I piled my bath towels on the floor to soak up the water. Then I ran out of the bathroom, trying not to cry. Didn't work. The smell was awful. I then had to figure out how I was going to clean it up. Ok, so I've had every bodily fluid on me: blood, urine, feces, vomit, sputum, amniotic fluid, breast milk, you name it, I've worn it. But this was more than I could handle. After a few hours I finally got up the stomach to clean it up. I wanted to wait until Husband got home, but it would have been hours before he got home and this wasn't just a case of a messy bathroom, it was unsanitary. I also considered calling a maid service, but I quickly realized I couldn't do that and they probably wouldn't clean up a mess like that anyway. So it was up to me. I had to throw some of my towels away because they had chunks of stuff on them and I just couldn't deal with that. Then I used bleach cleaner and went to town. My bathroom is now nice and clean and sanitary. I had planned on cleaning my bathroom today, but I hadn't planned on a mess like that. Hopefully tomorrow will be better, with no exploding toilets.

Charge!

A few months ago, at the beginning of this pregnancy, work was pretty darn slow, but wouldn't you know it, now that I'm getting large and having a hard time getting through my shifts, it has been pretty darn busy. Add to that I've been charge nurse the last several shifts I've worked, which I just absolutely love. Sense any sarcasm there? I've done it long enough I'm comfortable with the pain in the arse-ness that comes along with being charge nurse - I just would rather take care of patients and not deal with all the BS that comes along with it. One pain is figuring out staffing for the next shift. With the skill mix, a "flex list" and flex dates, it gets more complicated than it is for other floors. We have to have the right skill mix: nursery nurses, labor nurses, techs, secs, etc. and throw in there trying to see into the future as to what is going to come in during the day. I have to look at the number of patients we have currently, their acuity, and what is scheduled to come in, and then either try to find more nurses to work if they are short, or put nurses "on call" if it isn't busy. The hospital is really pushing keeping our staff ratios within budget so there is a lot of pressure to decide staffing based on what you have right then, not what could come in. But that can bite you in the butt if you aren't careful. So any "extra" nurses I always put "on call" instead of flexing completely off. That way they are available should a bunch of patient come in. Decisions and phone calls have to be made at 5:00am. But that leaves 2 hours where anything can and will happen. Like the other night. I made staffing decisions at 5:00. We had one momma who would be delivering - her doc was in the room, she was pushing and was very close - or so I was told. Well, about 6a.m. she's still not delivered - and ends up with an emergency c/s when baby decided he'd had enough of this labor business and wasn't going to come out vaginally. Then another patient comes through the door at 6:30, repeat c/s X 4 in labor and as she's being wheeled up, another pregnant momma had followed, with ruptured membranes. Plus we had 2 c/s already scheduled that would obviously be bumped. The first c/s didn't screw with the staffing for days much, or the patient with ruptured membranes, but a repeat c/s is a one-on-one nurse load for awhile and would require another nurse. No biggie in my head - pull one of the labor nurses off of postpartum, and call in one of the people on-call. But no, the day shift charge nurse threw a fit because I had put a labor nurse on call. With what we had at 5am, if I had left that other nurse on, she'd have been upset that I left them so overstaffed. It's a lose-lose situation sometimes and right now, honestly, I don't have the patience for it. I'm tired, uncomfortable, moral is very low on the unit right now and I'm burned out. I need a vacation and being charge isn't helping with the burn out. I know that is a a bunch of garbly-goo and maybe doesn't' make any sense, but trust me, it's irritating. Especially when I'd rather be the nurse taking care of the patient in labor or going back for the c/s, instead of being in charge and making the phone calls to get everyone there. And I'm scheduled to be charge on several more shifts over the next few weeks. Ugh. Oh well. Seven more weeks, well, more like 6 more weeks until I deliver then I'll have a nice break from work.

32 Weeks

It's been pretty busy around here lately. We're trying to get everything set and ready for baby boy's arrival. Yeah, yeah, I'm only 32 weeks, but these last weeks are going to just fly by and before I know it, I'll be holding this sweet little baby that is kicking me in the bladder at the moment! This past weekend I realized that perhaps I need to slow down even a bit more. I worked 3 twelve hour shifts in a row. It seemed like a good idea at the time. I always work 2 12's on Sat and Sun, and then an 8 hour on Monday. Work called Monday and asked if I would take call from 7p-11p. Sure, I said. I figured "hey, I work anyway, what's 4 more hours". Of course, they called me in at 6:30 so I worked a full 12 hours...and boy was I hurting Tuesday morning. My ankles looked like someone wrapped them in marshmallows, my back hurt, my uterus was pissed as all hell, I was tired and looked like someone beat me. Looking back, that extra 4 hours wasn't a smart decision. So no more of that for me! What made it worse was Tuesday am, Jacob had a doc appointment, so I couldn't go home and go right to bed. I got home at about 9:30, in bed at 9:45 but had to get up at 1:30 for my Doc appointment at 2:45. So not much sleep. BP was up 30 points, 6lb weight gain in 2 weeks (ouch) ankles were still swollen, but everything looks pretty good now. I've been taking it as easy as I can with 3 kids and I can now see my ankle bones a little. Other than that, I'm feeling ok. Baby boy is moving all over, measuring right on track and my cervix is still nice and thick.

Other than that, we're keeping busy at home and work. Seems like there are pregnant women due this fall everywhere! Good for business and job security. Jacob is in the middle of flag football so we have practices and games to go to. We also had Isaiah evaluated for his speech. He understands everything we say, he just doesn't talk much. After his evaluation, they said he's fine developmentally, except in expressive speech. With that, he's at an 18 month level and he's 2.5 yrs. So we will be starting speech therapy once a week here soon. One good thing is those sessions will be here at our house, but they also recommend that any kid in speech therapy go to group speech once a week. That will be on Monday a.m. and we have to take him to that. So we're going to be running constantly...right about the time we bring a newborn home. Oh well, that's what happens with kids. I wouldn't have the luxury of just staying home anyway, with all the kids activities. I plan on getting a wrap or sling to carry baby boy around in, so I can at least have my hands free, plus I figure that will be easier than pushing a stroller. We're busy, but we're hanging in there. It will most definitely make these last 8 weeks fly by!

31 Weeks

Ah, I'm in that final 10 week countdown to D-day! Nine more weeks until my EDC but likely only 8 more until I'm delivered! Seems crazy! I'll be holding my new son in less than 9 weeks!! Eight weeks isn't really too long! I know from my last 3 pregnancies that these last weeks drag on and on it seems...until it's over, I've delivered and then I wonder how the hell the pregnancy is over already. So far things are going pretty good. Baby boy is still pretty active and I think because this ol' uterus has been stretched that he's able to twist and turn and roll much more than the other 3 kids could. It's fun watching my belly move and change shape...Jacob and Clara think it's hilarious and amazing watching him move. I did have to be monitored and get some terbutaline shots last weekend to stop contractions, and I'm now on oral brethine on an as needed basis. No bedrest, and they didn't check my cervix but I assume it probably didn't change. I see Doc Tuesday and we'll go from there. The brethine seems to help. Night is my worst time and the other night I had a round of contractions that hurt bad enough all I could do was contract, had to breathe with them and they were coming every 3-5 minutes. I did take 5mg of brethine, drank a ton of water and they eventually eased up after a couple hours. So obviously, they really weren't too horrible or the brethine wouldn't have helped, but it freaked me out for awhile. Makes me wonder if I'm just a wimp, but I have labored before, and these hurt, and hurt a lot more than any of the other rounds of contractions I've had. The nursery is set up, I'm starting to get all the stuff I need/want for my hospital bag and maybe one of these days I'll get around to packing it...just to ward off any preterm labor. (You know how superstitious us nurses are! If you're prepared, it won't happen.) But for now, I'm still hanging in there, things are looking pretty good, and most of the time, I'm fairly certain I'll be one of those pretermers who contract and contract and then end up carrying to 42 weeks! And full term is just fine with me!

One Year

One year ago today, I miscarried my little angel. You know, it seems strange that it has already been a year. In one way, it seems like just yesterday, but in other ways, it seems like a lifetime ago. A lot has changed in that year and today I have all sorts of emotions/feelings/thoughts that I just can't put into words. If you've ever had a loss, I'm sure you understand. I wish that I hadn't lost that baby...but if I hadn't, I wouldn't be carrying this little boy that is due in 9 weeks. While I'm glad I will get to hold and love this little boy, I'm not glad that I miscarried. See what I mean? It's a bit confusing. Although I only knew that little life for about 11 weeks, it touched me and changed my life in more ways than I ever thought possible. I am grateful I was able to carry it for it's short stay here. I have an understanding now that I didn't have before. And I'm grateful that I am 31 weeks pregnant with this child. I remember the day I woke up bleeding being so angry with God, and not understanding why or what his plan was. But now, I think I do. I won't retype the whole experience but to remember, I have read my old entries...the emotions were so raw. Should you want to walk down memory lane, the entries begin in July 2009 and August 2009. It's amazing how much a miscarriage affects you. Tonight, I will light a candle, to remember.

Awesome, and a Bit Unusual Birth

This past weekend, I took care of a mom who said she hoped to deliver without an epidural. With her other kids, she had been induced, water broken early and she said she ended up screaming for her epidural around 6 cm. This time, she came it for some bleeding and an exam revealed she was in fact in active labor...very close to transition. She was surprised. She said she was only a little crampy, but never would have guessed she was in labor. Her bleeding was just bloody show. So I got her admitted, called the midwife and she decided to get up and walk for a bit. Her midwife wanted me to recheck her in an hour - she was now 7-8 cm, still looked more comfortable than any of us nurses! The dad actually asked me if they were going to get sent home because she wasn't feeling contractions! So her midwife comes in, sees how comfortable the patient appeared and I start to wonder about the accuracy of my exam. The patient decides to lay down for awhile. After a bit, the midwife decides to check her. We go in, she's on her side, in the middle of a contraction according to the monitor and she's breathing slowly with her eyes closed. Aw, that looks like she's getting ready. Nope. She was sound asleep. And she was 9.5 cm dilated! I've seen women seemingly labor effortlessly, but I've never seen anyone sleep at almost 10cm! Her midwife had never seen that and a couple of other nurses working who have 30+ years of experience had never seen that! Unless of course they have an epidural and she hadn't had anything, no pain meds, nothing! And no, she wasn't on any drugs or anything like that. Once her water broke, she did get uncomfortable as she delivered her baby. She did fabulous, although since she labored so easily, she was stunned after it was over because she went from sleeping to pushing her baby out without medication in 15 minutes. She didn't really have time to prepare is what she said afterward, but she was glad she finally was able to do it. I'm sure that happens more often than I have seen, but it was a first for me. Amazing!

Dr. Seuss for Nursing Moms

Would you nurse him in the park?
Would you nurse him in the dark?
Would you nurse him with a Boppy?
And when your boobs are feeling floppy?

I would nurse him in the park,
I would nurse him in the dark.
I’d nurse with or without a Boppy.
Floppy boobs will never stop me.

Can you nurse with your seat belt on?
Can you nurse from dusk till dawn?
Though he may pinch me, bite me, pull,
I will nurse him `till he’s full!

Can you nurse and make some soup?
Can you nurse and feed the group?
It makes him healthy strong and smart,
Mommy’s milk is the best start!

Would you nurse him at the game?
Would you nurse him in the rain?
In front of those who dare complain?
I would nurse him at the game.
I would nurse him in the rain.

As for those who protest lactation,
I have the perfect explanation.
Mommy’s milk is tailor made
It’s the perfect food, you need no aid.

Some may scoff and some may wriggle,
Avert their eyes or even giggle.
To those who can be cruel and rude,
Remind them breast’s the perfect food!

I would never scoff or giggle,
Roll my eyes or even wiggle!
I would not be so crass or crude,
I KNOW that this milk’s the perfect food!

We make the amount we need
The perfect temp for every feed.
There’s no compare to milk from breast-
The perfect food, above the rest.

Those sweet nursing smiles are oh so sweet,
Mommy’s milk is such a treat.
Human milk just can’t be beat.

I will nurse, in any case,
On the street or in your face.
I will not let my baby cry,
I’ll meet his needs, I’ll always try.
It’s not about what’s good for you,
It’s best for babies, through and through.

I will nurse him in my home,
I will nurse him when I roam.
Leave me be lads and ma’am.
I will nurse him, MOM I AM.

Author unknown

Genius!

Yesterday, Clara and I went to get my weekly/sometimes biweekly van-load of groceries. I always end up with a full cart - so full I have to actually strategically place items in the cart to make sure I have room for everything. We get to the check-out and the lady took one look at my ever-expanding waistline and was almost overly concerned about me lifting my groceries out of my cart. I assured her I would have no problems. They always have someone bagging your groceries for you, which is nice, and most times, they offer to help you out with your groceries. I figured I'd take them up on this offer this time because I had more than normal. Anyway, I pay the un-godly total, turn to grab my cart, notice that bagging lady had disappeared AND that she had filled 2 carts with my groceries. Really? Two carts? How the hell am I supposed to push TWO carts out? And you all know what carts are like - they never steer and pull to one side. I look around, dumbfounded, mutter some profanities to myself and start unloading one cart into the other. Of course, it took me a bit because I had to move all the soft items from the top of cart 1 so I could put the heavy stuff from cart 2 in without smashing things. And the overly concerned check-out lady? Never even turned my direction again. Finally, we head out. I hadn't been able to find my keys to swipe my preferred customer card and I figured I must have left them in the van. I don't usually do that, but the few times I've lost my keys, that's where they are. Clara and I get to the van, I look in the ignition, yep, there they are and I try to pull them out - and I realize I left the van running the entire time. Oh yeah. I'm brilliant. Of course, there is a lady putting groceries in her car right next to my van so it is now obvious that the waddling pregnant lady left her van running for a very long time while she got a cart-load of groceries. I felt like a genius. Thankfully, no one decided to take off with my van. So, pregnancy hormones are making me crazy - October can't get here soon enough!!

First day of school / 30 weeks

Today I sent Jacob AND Clara off to school. Clara has been pretty darn excited about finally getting to go to kindergarten. I'm still having a hard time believing that I have a kid in 2nd grade and in kindergarten. It's unreal. I didn't even cry. But you should have seen poor Isaiah. We saw them off on the bus then I drove down to the school to get a couple pics to make sure she got where she needed to be. As they walked into the school and we turned to leave, Isaiah started sniffling and crying these huge tears - it was one of the saddest things I've seen for awhile! He was just so sad leaving without them. I was pretty close to tears as you can imagine. So Isaiah and I went and had breakfast and played at the park. He's just fine now, playing with toys without someone trying to take them away. But he keeps asking if they are home and looking out the window. So it's pretty sweet.

As far as preggo me goes, I'm hanging in there. 30 weeks today! WooHoo! I will admit this weekend was rough. I was more crampy/tight than normal, my lower back hurt, had more pelvic pressure than normal and I started passing bits of mucus plug. All of my complaints were all pretty vague - they could mean nothing or it could be a sign something was happening. So I went in Monday to make sure everything was ok. They checked me for a UTI and I do have one. Never had any symptoms, but sometimes that happens. I will say that it wasn't a clean catch urine. They always have those wipes you're supposed to wipe off with first so you give a clean sample...well, they were out. And like I said, I'd been passing pieces of mucus, although by then they weren't bloody, so I'm not sure how accurate the sample was, but sometimes the WBC count is still high even if it wasn't a good catch. So I'm taking antibiotics, hoping it helps clear up the infection and I'll not be so crampy. Doc did another fFN swab, said my cervix still looked closed and fairly thick but it was pretty irritated. I assume just from being pregnant and working all weekend because I can assure you the last time anything was messing with my cervix was the last time she did the fFN. They called yesterday with the results: positive. Not what I was expecting at all. She didn't change anything so I'm not on bedrest, off work or getting meds at this point. She said only 16% of people with a positive fFN will go on and deliver preterm, but that I needed to be pretty tuned in to what was going on with my body and if I start contracting regular that I need to go in to L&D. Fan-freakin-tastic. The only time I want to be in L&D is as a labor nurse or when I'm having my full-term baby. Part of me keeps telling myself "oh, you'll be fine, it doesn't mean anything, you'll make it to term, no worries". If I was dilating or my cervix was pretty thin, I'd be more concerned. But there's also that part of me that is freaking out. So I'm still working as we figured work is pretty is a pretty safe place to be - my coworkers are like mother hens already, so they'll be keeping an eye on me. I may have to cut down to 8 hour shifts soon like I did with Isaiah, and I might have to not work labor from here on *sniff*. Not that I don't like post-partum, but my love is labor. But I don't need to be doing anything that could stir things up and put me into real preterm labor. Working labor and delivery is a pretty physically challenging job. But for now, we'll see how it goes. I'm hoping that the UTI is the culprit - that the antibiotics will clear the infection that's making me contract and maybe that's what irritated my cervix, got my mucus plug to start to dislodge and give a positive fFN result. Until then, I'm taking it easy, trying to stay sane and relaxed.