10 centimeters and beyond

Miracles

2012-01-20T10:30:00.006-06:00

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

Mom: This child is my miracle baby

Nurselochia: Yeah?

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

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

Who says God doesn't perform miracles?

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

2012-01-09T08:25:00.004-06:00

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

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

High risk or Homebirth?

2011-12-17T08:46:00.004-06:00

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

Work, running, life

2011-11-22T16:46:00.005-06:00

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

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

New Father

2011-10-25T19:06:00.003-05:00

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

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

Chapter closed

2011-10-24T08:16:00.005-05:00

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

Marathon!

2011-10-15T08:15:00.003-05:00

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

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

Marathon in 2 days!

2011-10-07T09:26:00.003-05:00

I've been pretty quiet lately, not for lack of things going on or things I want to talk about, but because it's been pretty busy around here. The marathon is on Sunday and I'm trying to get my last minute stuff done. I'm done running until Sunday. I'm still pretty nervous about my lack of training and preparation. I could have done a lot more, but I didn't. I think I'll be ok because I'm not going out there to run a fast race, or to even run the entire thing straight through. That I'm not ready for. I'm sure I've talked about this before, but I have a plan. Tonight I have to work (not a good move on my part) and then tomorrow morning I'll come home and go right to bed. Husband's parents will be down early and Husband will go do our mandatory volunteer work at the kids games from 9a -11a. Then he'll come home, and we're leaving at noon. We're heading straight for the expo to get my participant pack, bib and timing device and from there we'll check into our hotel. Depending on how things go, we may meet up with a cousin of mine, but his wife is expecting and due any day and pretty uncomfortable so we're going to just see how she feels. Plus, really, I need to rest as much as I can. At the expo, I'm signing up with a pace team of 5:45 that runs 4miles/walks 1 mile. I've read that for your first marathon that you should run/walk and just take in the experience that is the marathon...and then go all in for your second. So that's my plan. I hope it works out for me. I have my pre- and post- race bags ready to go with my clothes for the race, with my name written in big block letters on the front, my energy gel, running shoes and socks, ipod playlist is ready to go and charged. Post race I have a change of clothes, sandals, baby wipes and a bottle of water. I'm ready as I can be. One concern I have is the weather. The usual temp is about 66 degrees, but the forcast is calling for mid to upper 70's. Fine for the morning, but because I'll be running into the afternoon a bit, that could be a little warm. But I'm pushing fluids now, making sure I'm well hydrated ahead of time. Plus I guess I ran the half marathon in warmer temps than that, I just wanted 60 degree temps. We'll see how it goes!

Harvest

2011-09-24T16:34:00.003-05:00

Early this past summer, I was on my way home from work, and it was probably around 7:30am or so. I noticed a line of corn knocked over, like a car had veered off the road into the field. Sure enough, as I got further on, there were a couple emergency vehicles and an SUV in this little valley between cornfields. I figured someone lost control over their car, and went off the road. Since the SUV was upright and appeared undamaged, the lights weren't flasing on the emergency vehicles, and no one appeared to be moving too quickly, I assumed everyone was just fine. Turns out a mother and nurse was on her way to work that morning, had a heart attack and had died there in the field. That straight line where her SUV went through the corn is still very visible. Someone placed a cross at the place where she entered the field. Every day I drive home, I see that path and I wonder if her family drives that direction. How painful of a reminder that path through the corn must be. As harvest season is upon us, I wonder, when the farmer harvests that field, will it be a relief to see that sad reminder of her last few moments? Or will it be painful, to see that the scar left on the field is gone, even though the scar on their hearts left by her absence remains?

One Year Ago...

2011-09-21T14:41:00.002-05:00

At 3:47 am, I met my handsome little Caleb face to face! What a ride it was getting him here! I reread my birth story and I can see the anxiety and frustration in my "voice". I am much more at peace with how things went than I was a year ago. Happy Birthday little guy! It's been a wonderful first year!!

T-3 weeks!!!

2011-09-16T20:17:00.004-05:00

The marathon is coming up in 3 weeks!! AACK!!! I'm starting to freak out more and more as M-day gets closer. I gave up on the idea of a 20 mile run before the big day. Yesterday I did get in a 17.4 mile run and I did it in 3:25, so I feel better. And I'm not really too sore today, surprisingly. Yeah, my calves are a little tight and my hips are a little stiff, but not bad at all. After my half marathon, I was pretty sore for a few days, so I expected more ache after 17 miles. Guess that's a good sign! My average mile pace was 12.5 minutes, so it's much better than what I expected. The pace team I'll be running with runs a 13some minute mile, so seeing my average mile pace was just a tad faster felt good. I will say that the last mile or so of the run, I was hurting a bit. My quads were on fire and my feet were starting to protest. I wasn't out of breath or anything, in fact I could have had a conversation with someone, but my muscles were unhappy. That does concern me a bit because I will still have 9 more miles to go. I'm hoping that a slightly slower pace and the adrenaline of running my first marathon will help carry me through, although I know at probably mile 19-20, I'll hit the wall and it will be a battle to finish. Next week starts my tapering...part of me wants to try another long run of at least 16 miles, but I I know I need to be kind to my body and let it recover completely before running 26.2. I'm still waiting on my packet to come in the mail that I have to take with me to the health and wellness expo so I can get my number and chip. Once I have that, the only thing left to do will be to figure out what shirt to wear. Oh, yes, I've heard that the marathon shirt is important. I'm still tossing a few ideas around in my head, but haven't decided what to do yet. I still have a little bit of time left. When I run, I run alone...and the only things to see are corn and bean fields. Ok, so know that we're in harvest season, I see the occasional harvester, and I'll have you know I run faster than a combine harvesting corn! Anyway, so my runs are boring, lonely and lack scenery. Marathon day I'll be running the streets of downtown Chicago. How amazing will that be?! Plus there will be thousands of people there cheering me on. I think that will help the miles go by much quicker than they do when I run on my own. That's my hope anyway.

About a Month Left until M-Day

2011-09-07T07:55:00.003-05:00

It's been a busy few weeks around here. School is in full swing, big kids are busy with football and cheerleading, and I'm trying my darndest to get out and run. The marathon I am running is coming up in 1 month and 2 days. I am so not ready for it. I still can't believe I'm really going to run 26.2 miles, willingly. I've been reading up on training and other people's first marathon experiences. I don't know if the stories help or are making the fear worse! A common theme is people are sore for a week after running, can't walk down stairs, and are ready to throw in the towel and quit as they enter the devil's territory at mile 20. Most people train for months for a marathon, getting in a few 20 milers ahead of time. The longest I've run is 14 miles. I've gotten in several 10-14 mile runs, but no 20 milers. And I'm not sure I'll get one in. This really isn't how I wanted to train for my first marathon. I wanted to feel more ready. My goal is to run at least two 16 milers beforehand. The biggest problem I have is finding the time to do these long runs. I'm not fast at all, so I need a block of 4 hours or so if I want to get in a 16 mile run. I did 14 miles in 2:50. That's a lot of time to block out of a day when you work full time, have kids in activities and the sun starts setting earlier and earlier. I do have a plan. My main goal is just to finish it in under 6:30 because that is the cut-off time to be an "official" finisher. I'm not worried I can't do the distance, I know I can do the 26 miles, I'm just worried I can't do the miles fast enough. If I'm going to run the damn thing, I sure as hell want to be an official finisher! I'll be signing up with a pace team of 5:45...that way I'll start out slow, have someone to pace me, and if need be, I can slow down a bit and have some time to play with to come in under 6:30. Holy cow, I could be running for more than 6 hours! Most people who run marathons probably have a goal to come in under 4 hours. I can't even imagine being able to run that fast for that long at this point. There are times I think that I must have some kind of mental illness because I'm going to run it, despite the lack of adequate training in my mind, and after reading the stories of how miserable people feel during and after the race. But there is also something else common in marathon stories - that sense of accomplishment. The feeling that people get when they cross the finish line, that they did something most people never will. A marathon is a purely personal, solo victory. There isn't a team to help you if you start to slow down and run out of steam. No one can train your mind and body to run for hours. No one can run it for you. I can only imagine what it will feel like when I finally cross that finish line, knowing that I accomplished something I thought I never would. After 4 kids, with the youngest being only 12 months, I will have completed my first (and maybe last) marathon. Who knows, maybe this will be the first of several marathons. Guess we'll have to see.

2 years

2011-08-27T09:08:00.003-05:00

Just remembering...2 years ago, I miscarried baby #4. While the pain of that loss has been eased in a way with the birth of Caleb, it's still sad. There was a little life there with us, if for only a brief time. And that little child led us on the path to bringing Caleb into our lives. If that child had lived, we wouldn't have this precious little 11 month old. At the same time, I wanted that child here. One day, I'll meet that soul I believe. But for today, I'm remembering...

Half Marathon....check!

2011-08-21T16:15:00.002-05:00

I did it! I finally ran a half marathon! I've been training since, I think April and this past Saturday, I actually ran it! And it was awesome! My main goal was to finish, but because I have such a competitive nature, I had really hoped to come in under 2:45...my official time was 2:25:19! I beat my goal time by 20 minutes. I'll admit, it wasn't easy. I felt great for the first 7 miles. I have a tendency to start out way too fast. It's easy to do because there are so many people at the start and everyone sort of moves in a group...plus the adrenaline of running a race kicks in. At the 1 mile mark, I was at 8:58. It was a much faster pace than I should have been running for a half-marathon. I tried to slow down, but I hit 2 miles at 19min, 3 at 29min, 4 at 39 minutes on up to 6 miles...then I started slowing down. The toughest mile was 8-9. I did manage to run to mile marker 9, but then I had to walk a little past the water station. (I walked through all the water stations because I'm not coordinated enough to run and drink from a solo cup...but it was only a few steps). Miles 10-12 were pretty tough and I was ready to be done. Finally, I could see the flag and a hill to go over the interstate and get back to the track. A guy there said we were only half a mile away. Thank goodness! I knew my kids would be at the finish and I wanted them to see me finish running, so I walked up the hill and ran the rest of the way. Seeing my kids at the finish line was the boost I needed to finish strong! It's a sort of cruel joke that you get to the track and you can see the finish line...but you have to run a lap before you cross! When you are tired, even after running 13 miles, a lap can seem like forever! I gave Isaiah a high five as I got onto the track and as I came around to the side that the finish line was on, Isaiah ran along the fence as I crossed the line! It was an awesome feeling! I'm pretty sore this am. Stairs are not my friends, especially if I have to go down. But I accomplished a goal! I'm still celebrating but I've got some major, major training to do to be ready for a full marathon. At mile 12, I had serious doubts about whether or not I can be ready for 26 miles so soon. I still have doubts, but I've got to try. But for right now, I can say I've run a half marathon and I'm looking forward to doing it again!

Murphy's Law of Motherhood

2011-08-11T22:37:00.003-05:00

You have sports practice for 2 of your 4 kids at 5:30, and you managed to feed them a healthy yet satisfying light meal at 4pm, get them water for practice, they are dressed (which is something for a momma who know nothing about football gear), baby is fed AND bathed after a blow-out diaper, the 3-year is excited for the park, and you *think* you have everything you need for the baby in the to-go-baby-bag should he get hungry/need a diaper change/want a toy, but you thought wrong. As soon as the 2 kids take off for their respective fields, and the 3 year old is outside ready to go play on the swings, the baby will projectile vomit his entire supper as you open the van door to pull him out of his carseat. And while you have wipes and a diaper, you realize you forgot a change of clothes.

Murphy's Law of Motherhood #567

"From that day on, if I was ever going somewhere, I was running!"

2011-08-05T21:16:00.005-05:00

Love that movie, Forrest Gump. Anyway, since May, I've been training for my first half marathon, which is coming up on the 20th! My training has been going very well, I'm up to 12 miles, which is the farthest my training schedule has me run, until race day anyway. I'm ready, I will probably have to walk a little bit here and there, but my goal isn't a great time...I just want to finish the 13.1 miles and be able to say that I did it. It's been a huge stress reliever for me and in a way, giving me confidence. Each mile I add to my long run has been therapeutic and given me a renewed confidence in my determination and physical ability. I never thought I'd get to a point where I could say "Yeah, I can run 13.1 miles, I'm ready".

I haven't even run that half marathon, but I'm already looking forward to my next challenge: a full marathon. I entered a contest to win an entry to a marathon. They asked for people's stories as to what their motivation to run is. I still don't know why I did it because I'm sure not ready to run 26 miles, but something made me submit my story, my motivation. And guess what? I now have an entry into a marathon this October! I'm pretty nervous about it because I didn't really think I had a chance, so I was quite surprised when I saw I was among the winners. My initial thought was "Oh, crap! I can't do this! Not that soon!" but as I thought about it, there was a reason I submitted an entry. Something pushed me to do it. And I meant every word, that I want to be a role model for my children. I want them to see firsthand that even though the road to attaining a goal might be tough and take many miles, if you believe in yourself, work hard and give it all you've got, you can reach that goal. That's exactly what I'm going to do. It's going to take a lot of time, sweat, hard work and determination, but I will do this. I will complete a marathon this year. Eek!!!

Here's my story:
I've always considered myself a runner and thought that one day, I would run a marathon. After getting married and starting a family, I found it hard to make time to get out and run. I'd still get out when I could, ran a few 5K's, but I never really made the time to push myself and train for that marathon. It became just a pipe dream. Last year, after a difficult pregnancy, and preterm delivery of my 4th baby, I slipped into that dark world of post-partum depression. Determined to find myself again, I started running, setting a goal to run a 5K, 5 mile race, 10K and then a half marathon in August. I have successfully left post-partum depression behind me, ran that 5K, a 5 mile race, and I'm prepared to run a half marathon, looking ahead to running that first full marathon. Not only do I run for myself, but for my 4 children. I don't want them to think any dream, goal or aspiration is out of reach. I want them to know that if you set your mind to do something, work hard and believe in yourself, that you can do anything.

Telephone Triage

2011-08-01T16:27:00.004-05:00

One weekend, the scrub tech answered the phone and got this panicked look on her face. She had wide eyes with a look of panic and said to whoever was on the phone "You need to come in but I'm going to have you talk to a nurse". It was a grandmother to be and she said "My daughter is pregnant, (went through a whole health history), her water broke and the umbilical cord is hanging out. Do we need to come into the hospital?" Now this is not unheard of, it rarely happens, but I can remember someone who had come in because she had something hanging out of her vagina, and it was indeed the cord, and thankfully it hadn't been compressed too much....I think because the baby was transverse or breech, but baby was delivered and fine. But it is a true emergency. After a few quick questions, it was determined that it sounded like a cord, and since you can't assess over the phone what is going on, and because of the potential serious nature of a cord prolapse, she was told "Yes, you need to have her get into a knee-chest position, hang up and call 911". Thankfully, anesthesia was already in house, we had an OB doc there who had just finished a delivery who had overheard the phone call, OR was opened and we were all ready. We figured she'd already have a IV in from the ambulance ride, doc would do a quick sono to make sure we had a reason to deliver urgently and we'd were ready. So a bit later, she rolls in, smiling, sitting up on the cart and we quickly check to see if we in fact have a prolapsed cord. The patient states "Oh, I pulled it out". Everyone is dumbfounded, and she holds up an emesis basin....with her mucus plug in it.

Everyone breathed a sigh of relief, the tension lifted like a heavy blanket. There was never any doubt that we made the right decision to tell her to come in. We aren't allowed to give out info over the phone, all we can say is call your doc or come in, because you can't assess over the phone. This is a perfect example.

Wanted to share

2011-07-21T14:51:00.005-05:00

I came across this today on another blog, Birth without Fear, and although almost 2 years have passed since my miscarriage, I found this very comforting. Thought I'd share it with you. I believe it is an excerpt from the book Heaven is for Real by Todd Burpo.

Mommy, I have two sisters,” Colton said.

I put down my pen. Sonja didn’t. She kept on working.

Colton repeated himself. “Mommy, I have two sisters.”

Sonja looked up from her paperwork and shook her head slightly. “No, you have a sister, Cassie, and…do you mean your cousin, Traci?”

“No.” Colton clipped off the word adamantly. “I have two sisters. You had a baby die in your tummy, didn’t you?”

At that moment, time stopped in the Burpo household, and Sonja’s eyes grew wide. Just a few seconds before, Colton had been trying unsuccessfully to get his mom to listen to him. Now, even from the kitchen table, I could see that he had her undivided attention.

“Who told you I had a baby die in my tummy?” Sonja said, her tone serious.

“She did, Mommy. She said she died in your tummy.”

…

I knew what my wife had to be feeling. Losing that baby was the most painful event of her life. We had explained it to Cassie; she was older. But we hadn’t told Colton, judging the topic a bit beyond a four-year-old’s capacity to understand. From the table, I watched quietly as emotions rioted across Sonja’s face.

“It’s okay, Mommy,” he said. “She’s okay. God adopted her.”

Sonja slid off the couch and knelt down in front of Colton so that she could look him in the eyes. “Don’t you mean Jesus adopted her?” she said.

“No, Mommy. His Dad did!”

Sonja turned and looked at me. In that moment, she later told me, she was trying to stay calm, but she was overwhelmed. Our baby….was–is!–a girl, she thought.

Sonja focused on Colton, and I could hear the effort it took to steady her voice. “So what did she look like?”

“She looked a lot like Cassie,” Colton said. “She is just a little bit smaller, and she has dark hair.”

Sonja’s dark hair.

As I watched, a blend of pain and joy played across my wife’s face. Cassie and Colton have my blond hair. She had even jokingly complained to me before, “I carry these kids for nine months, and they both come out looking like you!” Now there was a child who looked like her. A daughter. I saw the first hint of a moisture glint in my wife’s eyes.

Now Colton went on without prompting. “In heaven, this little girl ran up to me, and she wouldn’t stop hugging me, ” he said in a tone that clearly indicated he didn’t enjoy all this hugging form a girl.

“Maybe she was just happy that someone from her family was there,” Sonja offered. “Girls hug. When we’re happy, we hug.”

Colton didn’t seem convinced.

Sonja’s eyes lit up and she asked, “What was her name? What was the little girl’s name?”

Colton seemed to forget about all the yucky girl hugs for a moment. “She doesn’t have a name. You guys didn’t name her.”

How did he know that?

“You’re right, Colton,” Sonja said. “We didn’t even know she was a she.”

Then Cotlon said something that still rings in my ears: “Yeah, she said she just can’t wait for you and Daddy to get to heaven.”

…

“Our baby is okay,” she whispered. “Our baby is okay.”

From that moment on, the wound from one of the most painful episodes in our lives, losing a child we had wanted very much, began to heal.

…

But now that we know our little girl doesn’t have a name yet, we constantly tell each other, “I’m going to beat you to heaven and name her first!”

One month

2011-07-20T07:17:00.002-05:00

One month from today, I'll be running my first half marathon! It's a little scary that I only have 1 more month to prepare myself physically and mentally for this challenge. I know I'll be able to finish it, I just want to be able to do it without being last or completely miserable. I've been slowly increasing my distance and I'm up to almost 11 miles, which takes me about 2 hours to run. After I finish those long runs of 10 miles, I am pretty sore and tired. The first time I ran 10 miles, my body just ached all day and all night. I couldn't sleep because of it. It wasn't pain. It's hard to explain exactly what it was, but my muscles were definitely screaming at me that first time. Since then, it's been easier each time with less aching afterward. I only do one long run a week, and the day after is a rest day, so my body can rest and recover. This next month, I will be really focusing on my endurance for about 2 weeks. Two weeks before the race, I will do the only 13 mile run of my training. One week before I'm running a 10K and the week leading up to the half marathon is an easy week of one 2 mile run, two 20 minute runs and then resting up for the big day. I'm excited and nervous already, but I can do this!

Random tidbits

2011-07-12T15:02:00.002-05:00

Tomorrow, my first "baby" is going to be 8 years old. I can still remember like it was yesterday watching him being born in the mirror, being in awe that Husband and I had created a life and that I was a mother. I can still remember looking into his little face just moments after he was born and knowing what it means to totally and instantly fall in love with someone. He's come a long way from that 7lb 7oz newborn! He's a typical skinny 8 year old boy who loves baseball and football, is able to assemble those massive lego kits (which I STILL can't figure out) and he can navigate the computer as well (if not better) than I can!

Caleb is almost 10 months! He's becoming a chunky little boy and I just love it. He is still nursing, although most of his calories come from formula and table foods. And I'm ok with that. Every once in awhile when a mom on post-partum comes up with multiple bottles of milk she pumped and I'm barely able to eke out 3 oz when I pump, I do get a little bit of milk envy, but then I remember that I was once a milk machine too, just not with Caleb. He's crawling everywhere, and he likes to pull himself up to stand. The other night, he started cruising the length of the coach. Before long, he'll be running! I'm not quite ready for that!

In less than 6 weeks, I run my first half-marathon! Eek!! It's been so hot and humid lately that I haven't been able to get out and run. The heat isn't so much the problem - it's the humidity. But I've gotten in a couple 10 mile runs and if I can get a few more of those in, like one once a week, I think I'll be ok. The week before the half, I'm doing a 10K, which I realized is less than half of a half marathon, but it's a sort of warm up to the "big" one. I did get new running shoes and they feel great on my feet...can't wait to be able to get out and run in them, hopefully tonight.

Behind the nurses station on the night shift

2011-07-08T09:06:00.006-05:00

What do L&D nurses do when the unit is (dare I even utter the word) slow? Well, we come up with ways to entertain ourselves, like fashioning stylish outfits from hospital supplies. For holding the monitors on pregnant bellies, we either use belts or these beige girdle things that come in a huge roll. It's elastic fabric that they step into and pull up over their stomach. The scrub techs measure them and cut out appropriate sized girdles from the massive roll. Most people actually like them better than the belts, as do the nurses because they tend to hold the monitors in place better for when a patient is shifting around in bed, they can be held at a tilt with a wash rag over it, and some moms just like the support. Others hate them. One night, I decided that these girdles would make a beautiful mini skirt and tube top. So I donned them over my scrubs. It was a good look. The next night I came in, I found a long "evening gown" in my mailbox. So, like any good model, I tried it on, and then we accessorized it. A pair of white mesh underwear became a lace belt around my waist. In order for me to walk, we had to cut a slit up the side, up to the mid-thigh, which was very sexy given the blue scrubs I was wearing underneath. We thought the orange peripads would look great around the bottom, but decided against wasting too much in the way of supplies. So we used a few of the gold hearts that hold the temp probes on the babies - it added a bit of bling. A necklace could be fashioned out of IV tubing with blood tubes taped to it. And for the perfect shoes? Why those brown hospital socks with the treads on the bottom, of course! If we were going to go all out, we thought we could stain some areas with betadine for a patterned dress. The perfect purse, no doubt, would be that high-style foley bag. Most of the "details" we didn't actually add...we didn't want to waste much in the way of hospital supplies, but 2 pairs of underwear and about 6 gold hearts were used. Our style show lasted all of 15 minutes before we had to get back to work. Here's a picture of just the "gown", before we put a slit in the side and added our flare to it. It's lovely. I'm sure you're all jealous.

Half Marathon

2011-07-06T14:30:00.002-05:00

Over the last several weeks, I've been training for a half marathon. It's a life goal of mine and I'm happy to say that I think I might actually just be able to run one! It's been hard though, I won't lie. I've had to work to make time to get out and run and to build up my endurance. The morning of the 4th, I ran a 5 mile race right after getting off of work. It was hot and my time wasn't the greatest, but I am telling myself I'm slower than I was 2 years ago because I'm training for a half marathon, not 5K's or 5 mile races. My pace is slower. The last 2 weeks, I've managed to do a 10mile long run once a week. It takes me about 2 hours, and I'm a bit sore when I'm done. The first time I ran, I ran right after working my 3rd night shift. It was the only time I could do a morning run and have the kids already at the sitter. It went pretty well, but my muscles were quivering when I got done. Seriously, I looked at my quads and they were twitching. I did stretch for quite awhile, and then went to bed for a few hours before getting the kids. I didn't actually sleep because my body wouldn't let me. I'm not sure how to describe it because I wasn't in pain or anything...I can't really describe it. I must have slept for a little bit because when I got up around 3pm, my legs hurt. Last night I did the 10mile course again and it was much better, but I still didn't sleep as great as I normally do. The half marathon I'm signed up for is August 20th. The weekend before I'm running a 10K in Husband's hometown, and I took the whole weekend off for the half marathon. I've got a lot of work to do to get myself physically prepared for running a 13.1 mile race in August. I'm also mentally trying to prepare myself, too. I know I can do it, and I WILL do it. And even though I'm sure in the middle of the race, I'll be wondering "WTH did I get myself into?", it will be worth it. It's something I'm doing purely for me, to know that even after 4 kids I can still run 13.1 miles. I also think it will be healing for me, too. I'm at peace (for the most part) with my pregnancy/delivery experience with Caleb, but there's still part of me that feels like my body failed me and him: by delivering early, and by not producing enough breastmilk for him, even though I made a ton with my other kids and I've done just about everything I can to increase the supply. But we have to supplement with formula, something I never did before. I'm pretty sure it was due to him not have as strong of a suck since he was 34 weeks. Anyway, I'm looking forward to it, which I realize sounds a bit crazy, kind of like a woman looking forward to labor. I'm up for the challenge and the reward after it's done will be worth it!

You know you've got work on the brain when...

2011-07-02T13:01:00.002-05:00

...when you are dreaming that a couple of your friends are pregnant and came over to your house because they think they are in labor. They didn't come because they want you to time their contractions, help them decide if they are in labor or anything like that...they came because they want you to help them have a out-of-hospital water birth. At your house, in your tub. Amazing the things the mind comes up with when you are sleeping!

Childbirth Education

2011-06-29T15:42:00.003-05:00

I mentioned that I've been pretty burned out lately, and I was thinking that I need something different to change things up. Either that or a long vacation. Not from patient care. That is what gets me through my shifts. It's the other B.S. that goes on. Anyway, one of the doctors is looking for a new office nurse and I thought "Hey, talk about timing. I'm getting frustrated to the point where I understand why nurses leave the bedside and go to offices and here's an opportunity". It's one I didn't make, though. I couldn't actually leave l&d, I'd miss it too much. I realized that I just need to do something different, maybe 1 day a week doing NST's and whatnot in an office, just to have one day of work where I'm not waking someone up, or arguing with someone to come in. Then one night this past weekend, the nurse who is in charge of all the childbirth education classes the hospital has asked if I would be willing to teach next year. My initial reactions was no, but the more I thought about it, the more I decided that I would do it. She was getting ready to work on next year's class schedule and a couple people who are currently teaching aren't going to next year. The timing is perfect. The commitment isn't too time consuming, just one night a week for 4 week classes. Plus it wouldn't be until next year that I would start teaching. Already, my attitude is a bit better. She said here in the next couple weeks, she'd chat with me about what I want to do. She needs someone to teach the typical childbirth education class and someone to teach the smaller c-section awareness class. I'm excited about this. This is just what I needed at just the right time.

Burn Out

2011-06-19T07:43:00.004-05:00

I'm getting burned out. I'm in desperate need of a vacation, or something. I used to wonder why nurses would leave L&D for offices or Monday-Friday dayshift jobs, but I think I've figured it out. Here's a quick list of things I'm tired of:

1. Working so short-staffed that we are all just running from the moment we clock in to the moment we leave. The worst part is feeling like you can't give good care because you have too many patients and not enough nurses.

2. Arguing with physicians to get them to come in. Don't get me wrong, most of the docs I work with are great. But some aren't. Yes, I want you on the way to the hospital when you have a multip present at 8-9 cm and wants to deliver in the tub. And yes, I would like you to come see my preterm patient who has quite a bit blood running down both of her legs.

3. Scolding by physicians. Really? Do you have to yell at me if a patient comes in ready to rock and she vomits and her baby delivers before you got there? I didn't do it on purpose. And on the flip side, please don't yell at me if you have to wait 15-20 minutes until the patient delivers. Or getting my arse chewed because I've called too many times...not for ignorant reasons, but because patients come in. I HAVE to call and tell you that you have a patient that is here and in labor. It's not an option to have one of your children tell me that you are occupied and without a phone (you are on-call for several other physicians) and unless it's an emergency, that you will call back in an hour (because you are taking a nap).

4. Lack of sleep. I'm so tired of being tired. Night shift is wearing me down right now. My body wants to go to sleep every night and not have to switch from sleeping during the day on some days and at night.

5. Unpleasant coworkers. Yes, I know they are everywhere, but the morale is so bad right now. I had someone flip out because another nurse got pulled from post-partum to labor and a stool softener got missed in the process. Really? It's a stool softener, not a big deal if it's an hour late.

I know that all comes with the territory, but sometimes, it just gets you down. I will say that it helped immensely to have an awesome delivery last night. She had a pretty horrible birth experience with her first, but after she was holding her new baby, she kept saying how thankful she was that her labor with this baby was so much better of an experience. So that's why I keep going back...for those patients who need someone to advocate for them, someone to help them have the birth and healthy baby that they want, someone to argue with their doc to come in to see them, someone to work in the middle of the night, someone to do what's right for the patient so they can have a healthy baby. I'll get out of this funk here soon.

Summer

2011-06-13T02:14:00.002-05:00

We are in to the full swing of summer, and let me tell you, it is crazy up in here! Not only are we busy here at home with baseball games, bible school and just the daily stuff, but it has been crazy at work, too! Last weekend was one of the busiest nights I've ever worked. Maybe not the busiest, but pretty dog-gone close. It was one of those nights where it started off quiet...then all chaos broke loose when multiple patients came up at a time...and all of them were active labor. It was just nuts! And of course, we work short-staffed on weekends and nights because, well, don't you know that everyone sleeps at night? And just try calling people in on a weekend night too, see how many people will answer their phones, let alone come in. I actually ended up working a double shift Sunday night into Monday. It was the first time I've worked that many hours and when I got into the van to drive home from work, I didn't feel too bad. I called my SIL to talk to someone to help keep me awake, just in case, but about a mile or two from home, she had to let me go. Then out of no where I was in my driveway. I have absolutely no memory of how I got home. I've spaced out driving before, when I'm going somewhere I go to on a regular basis, like work, but this was different. This wasn't just a spaced out. This is memory gone, like I was almost asleep, under anesthesia or just teleported from one spot to the other. It really freaked me out and still does. Thank goodness I got home ok.

Around here, it's just been the usual summer stuff, except this year we have 2 kids playing baseball, so twice as many games, twice as many assigned concession stand dates. This past Saturday, Clara had a game at noon and I had to work concession. Fine, except Husband was working. Thankfully, Clara's game was at a park just outside of town and I was able to watch Jacob and Isaiah play on the equipment while I worked. Caleb had a good time in one of my wraps up on my back. It was funny watching people's reactions when they realized he was there. For awhile, he was banging his toy keyring on my back making noise. He did fall asleep eventually. At 4:00, Jacob had a game so I carted all 4 kids out again. Clara and Isaiah ran around, played with some other kids and at one point, Caleb was being squirmy, trying to climb all over me. This one mom was there watching her nephew and she had one kid who looked to be about 3 years old. He was being a typical defiant 3 year old, and she was trying to get him to behave. I really wasn't paying much attention, because 3 year olds act up from time to time, but when she finally sent him to sit with his uncle, she looked at me with Caleb and said "See what you have to look forward to?". I just smiled. At 6:00pm, I usually head to work, but Husband had just gotten to the field to relieve me so I could run home, grab my lunch and breastpump and head out the door, barely making it on time. I know, I know, when all 4 are older and in stuff it will be even busier. I will say we are getting better at time management and figuring out how to get this kid here when the other one has to be somewhere else. We're learning, slowly, but we're learning!

Out of the mouths of babes

2011-05-30T18:15:00.003-05:00

I was talking with the kids about school, etc. and they asked me if I went to the grade school they go to. I said "No, I went to Hometown Elementary, in the town Grandma and Grandpa live". They then asked me if I had music class like they do, and I said "yes, I had music class and even sang in the chorus in H.S.". To which they replied "Wow, Mommy, how can you remember something that happened soooo long ago?!?!?

Husband overheard it and started cackling in the background, until I reminded him that he is the same age.

Baby Wearing

2011-05-27T21:48:00.003-05:00

When I was pregnant with Caleb, I knew I was going to have to do something to help keep my hands free so I could chase after the other kids. I had been interested in baby slings/carriers/wraps when I was pregnant with Isaiah, but they scared me. Plus they aren't exactly cheap and I was afraid to spend the money and either hate it or not be able to figure it out. So it wasn't until a coworker gave me her Moby wrap that I tried them out. I loved the Moby! It was a little overwhelming at first when I unfolded the thing and the fabric just kept coming. I'm not exactly sure what I thought it was going to be, but it surprised me. I used it on a pretty regular basis and a month or so ago, I decided I needed something that wasn't so stretchy and had a bit more support. I thought I knew what I wanted, but I hadn't ever tried out any other carriers. I found that a lady in town sells baby carriers that I decided to try them out. She holds these babywearing demos and has people try out all the different types of carriers to see what you are the most comfortable with, and which works with your baby. I ended up with a long fabric wrap, a bali breeze. That's the pattern I got, too. It's very pretty I think. It's a big long piece of fabric, like the Moby, but there's no stretch. You can do all sorts of carries with it - it even comes with a cd to show you the different types and how to do it. I even got Isaiah up in it comfortably! I'm still learning but I love it! I actually figured out how to carry him on my back and he just loves it. I have to have Husband "spot" me to make sure I have the fabric stretched out nicely and that it's up high enough, but I'm getting better at it on my own. Tonight I got him in it on my back and he fell asleep. I know these things have been out there for a very long time, but I wish I would have discovered them when Jacob was little. I get all sorts of looks from people in town when I "wear" Caleb, because you really don't see too many people out with their baby in a wrap, especially on their back. Most people have their baby in a stroller, like what I always did, but it's really hard to push a stroller in the grass. Well, it's just easier to carry him then to push the stroller, I guess. I told Husband that with the way people look at me, like I'm some big hippie or very, very pale tribal woman, I think I might get me some birkenstocks, a long tied dyed dress and grow my hair out long and then go wearing Caleb around. Hey, I have to entertain myself somehow!

On the road towards that half marathon

2011-05-24T15:23:00.005-05:00

I signed up for a half-marathon about a month or so ago, to be run in August. Now, when I signed up, I was (and I'm still not) any where near half-marathon ready. Not even 5K race ready. But it's been a goal of mine for a long time and I figured I better get on with actually doing it instead of just talking about it like I have been doing for years. I have been getting out to run when I can, but with just life in general, it's pretty tough some times to make the time...and to not make excuses as to why I can't get out and run. This past weekend, the town I live in had a 5K for the town festival. A couple friends of mine were planning on running and I agreed that if it wasn't raining, I would run. Even though I didn't think I was ready. I'll admit, I really, really hoped it would rain. And yes, I realized that not wanting to get out and run doesn't seem like the attitude a woman wanting to run 13 miles in August should have. But I just don't want to make an idiot of myself. Anyway, I wake up and the sun is shining. Rats. Have to run. Plus my mom was coming up to watch the kids so I could run, and since she has to drive an hour, I figured I better make it worth her trip. So I got dressed, my mom came and I took myself down to sign up. And I ran it. And most importantly, I finished it!! Not a great time, 31:55, but considering I wasn't quite ready to run 5K, I'm very happy with my time. Plus I finished and have gotten that addiction to road races back....which means I'm now actually excited (and a bit nervous still) about the half-marathon. The adrenaline that kicks in and the feel of competition really works wonders for my persistence to keep running when I want to stop. And as for my time, a cousin of mine who runs marathons and helps people train said that my 5K times would slow down when I started training for a half because the pace is different. So I feel good. I ran that first race post-baby #4. My plan is to run a 5K in June, this 5 mile race on July 4th, even though I work a 12 hour shift the night before, and a 10K the weekend before the half. My official training starts Monday. On the schedule, the weekend before the half I'm supposed to run 6 miles so a 10K is perfect. I'll maybe fit in a 5K race sometime in June, but I'm even more motivated now. It's time to hit the road!

Just Made Me Smile

2011-05-04T07:35:00.002-05:00

On a fairly regular basis in L&D, we get patients that hit the door in the transition phase of labor, ready to birth their baby. No time to do much, other than get her pants off, make sure the baby isn't hanging out and get the doctor/midwife there for delivery if possible. Sometimes, labor just moves so quickly at that point, and there's no way for the doctor to get to the hospital in time and it ends up being an RN attended delivery. This was the case with this one momma, 3rd baby, who hit the door sitting in that tell-all position in the wheelchair: sitting off to the side, gripping the siderail as her body pushed her baby toward the outside world. We managed to help her get her pants off, got her onto the bed and I was able to get a pair of gloves on right before as she pushed her baby into the world. It was that fast! Mom was glowing and very proud that she had given birth the way she had always wanted to: no IV access, no monitors, no pain meds, just good old fashioned, medication free labor and delivery. The best part for her? Her first two children were born by c-section. The first was for failure to progress after an elective induction, the other was a scheduled repeat c-section. Made us all smile.

What I've learned (so far) as a Mom O'Four

2011-05-03T10:46:00.005-05:00

I know I have just started up the mountain of learning that lies ahead of me as a Mom of 4 kids. I can't even fathom what the next years will bring: 4 teenagers, 4 kids in activities, 3 boys to eat me out of house and home, 1 daughter's hormones to drive us all crazy, etc. I'm sure some of you experience moms of 4 (or more) will laugh at my naivete. But so far, here is what I learned about being a Mom of 4 kids, 7 years old and younger:

The house will never be clean so long as the kids are living at home. Unless we win the lottery and I can afford to hire a nanny, a few maids, a cook, landscaper and even then, it probably still wont be clean.

The dirty laundry is like a rabbit - it reproduces all the time and produces too many offspring to control.

As soon as I fold the last load of laundry, everyone will go to bed and you are left with the towels and dirty clothes for 6 people...that alone makes up a load of laundry.

Until the kids are older, I will have either drool, spit-up, snot or dried boogers on my clothes (this WILL end when they're older, right? right??)

A baby carrier is a must, and I'm not talking a carseat or stroller, I mean a baby-wearing carrier, sling or wrap. You need your hands free to chase after the older kids, and hold onto the 3 year old who wants to climb the paper towel display at Wal-mart.

Hide the markers. Otherwise you'll find a mural on the wall...or when you leave the room to go to the bathroom, when you return, the baby will have a green mustache.

If 2 kids are playing baseball/softball, there will be a night when they each have a game...at the same time...in two different towns. And that will be the night that Husband works too late to make it home.

Don't leave shaving cream out. Or glue. Or baby powder.

No matter how stressful the day is, nothing can beat these things: a tickle match in the living room with the kids. Watching them sing at the school spring concert. Getting beautiful works of art made with crayons(on paper). A big hug from each kid. Snuggling with a sleeping baby with the 3 big kids up close to you. A big opened-mouth baby grin and giggle. Hearing "I missed you so much" after a long night at work or "I love you" as they run off to play.

On the road again

2011-04-27T16:28:00.003-05:00

I signed up to run my first half marathon this fall. I've got a TON of work to do to be ready for it. I had signed up to run one last May, but a week after registering, I saw that second line on the pregnancy test, so I didn't run. I briefly considered running, but I was, I think, 15 weeks pregnant and didn't want to chance it. So this is the year I will finally run 13.1 miles. As far as training goes, I'm starting from square one. I'll admit, I haven't been out running much. It was hard over the winter with the weather and it getting dark so early, I didn't get out. I've been out a couple times and I'll tell you, it's not good. Instead of looking like the seasoned runner, I look like a 30-something, out of shape mom of 4, with extra weight around her waist attempting to do something athletic to lose weight. Oh, that's right, I AM 30 something out-of-shape mom with 4 kids and weight to lose. Anyway, so far I can run 2 miles but have to walk a bit in the middle. I did come up with a 12 week training program that I will start the last week of May. Until then, I have to work on getting my distance up to 5K again. I plan on running the 5K they are having here in my hometown the second to last week of May, and then I start to train. The week before my half, I'm going to run a 10K in place of my "long run" that Saturday. Then on August 20th, it's race time! Husband is on board with my training and finally crossing this off my list of things I have to do. He's going to take that Saturday off so he can be there at the finish line when I run (or crawl) across the finish line. My main concern is the heat. I have run at this event before, the 5K, and I know the course goes out into the country, among the corn and bean fields, and even though the race starts at 7am, it will be hot. Very hot. Oh, and I'm not a morning person, so 7am is really early for me. Husband thinks its hysterical that I'm willing to go run a race at 7am, which to me, is an awful time to have to "do" anything, unless I've been up all night, then 7am isn't so bad. I did request to take that weekend off because I have a feeling I'm going to be wiped after the run. And I'm going to want to celebrate, or have a nice long soak in an epsom salt bath to ease my aching muscles. So, let the training begin!!

Easter Parenting (almost) Fail

2011-04-24T16:18:00.005-05:00

This year I was so proud of myself for buying the kids Easter basket stuff ahead of time. I am notorious for putting it off until the last minute, then scrambling trying to get stuff together. For 3 years when Jacob and Clara were little, I actually recycled these 2 stuffed bunnies for Easter. Yes, I'm horrible. I've always been good going over the real reason, but when it comes to the Easter Bunny, I tend to wait until the last minute. I do fine with Christmas, Valentines Day, birthdays. Anyway, this year I actually got stuff ahead of time and stashed it where they wouldn't be able to find it. I was very proud of myself. No re-gifted toys this year! Flash forward 3 weeks. I went into work the night before Easter, got busy with an awesome delivery and it gets to be about 2:00am before I make a realization: I didn't put the kids baskets together and Husband has no idea where stuff is at, and it's 2:00am, I can't call him to tell him. Well, I suppose I could have, but that really wouldn't have been very nice. My only hope was that I got off of work early enough to get home before the kids woke up, gather up their Easter baskets that are scattered throughout the house, put stuff in them and hide them. As I'm walking out, Husband calls and says "The kids are pretty upset with the Easter Bunny". Parenting Fail. I come up with a plan that I hoped would work. I told him to where the bags of goodies were hidden, and had him put them outside with the baskets. I got home from work, assembled said baskets and came inside and said to the kids "Hey, guess what I found outside!". The kids come to the conclusion that the Easter Bunny didn't leave stuff in their baskets earlier because they didn't set them out. Phew. Thanks to my stealth mommy skills, Crisis is averted.

Growth

2011-04-20T21:09:00.004-05:00

Tomorrow, little Bubs will be 7 months old. I can't believe it. It still seems like yesterday that I was pregnant with him. he is finally starting to put on some weight. Over the last month or so this has been going on, he's had multiple blood draws for various things, sweat testing, GI consult, etc. After the first consultation with GI, she gave us zantac for reflux, and I was told to give him about 3 oz of this special order formula called pregestimil. It is incredibly expensive and apparently tastes awful. I really tried to get him to take it, but as soon as he started sucking on the bottle, he'd gag and throw up all the bmilk he had just had. So, go figure, he hadn't gained in a week or so, and then I was told to quit nursing and mix the pregestimil so it has 24 cal/oz instead of the usual 20cal/oz because she didn't think he was getting enough from me. I was devastated. I also knew that wasn't going to work because he didn't like the formula mixed regularly, so he sure as hell wasn't going to take it concentrated. Plus you don't take a 6 month old breastfed baby and say "Ok, no more nursing" and have it go well. But I tried it, pumped to keep up my supply because I really didn't agree with no more breastfeeding, especially because it wasn't that they thought he had an allergy to something in it, it was that they thought he needed more. So why not just supplement with regular formula. It was awful. He cried all evening and all night, refused the bottle, and he kept looking at me with those big beautiful eyes, pleading with me to feed him. Finally, at about 11pm, I said to heck with this, nursed him and gave him a bottle of regular ol' enfamil, mixed to be 24 cal/oz, which he took. We also started adding a few drops of safflower oil to his baby food, for extra fat. So I called our pediatrician, told her what I was doing and she said to go with that because if he's refusing the other formula, then it isn't doing any good. And guess what? He started gaining. The zantac helps with all the spitting up he had been doing, and the extra calories from the formula has helped. He put on 1 pound in a week. He was only 11lbs 9 oz a month ago...hadn't even doubled his birth weight at 6 months. Last week he was 12lb 8 oz, Monday he was 12-15, and Tuesday he was already up to 13-5. Different scales, but still a gain. I had worried about my milk supply since I went back to work. Caleb was never as aggressive of a nurser like the other kids were, and add to him being early, I didn't pump before going back to work as much because I was busy, and I don't always get to pump at work and you get inadequate supply. I know I could work a bit harder to build it up, but honestly, I don't have time. I am taking fenugreek and blessed thistle to help amp up my supply and it helps a bit, I get about 1/2 - 1 oz more when I pump when I take the herbs. So that's where we are: Caleb still gets to breastfeed, he's putting on weight with the supplemental formula and spitting up a little less. I don't understand why we had to jump right to this special formula. It's so expensive and I now have 2 cans that won't be used. I'll donate the unopened can, but the other was a waste. For a 16oz can of the stuff, it was $44. A can of regular enfamil, same size? $13. Yeah. It's that expensive. Husband tried it (he's weird) and he said it's horrible. You can tell by looking at it when it's mixed up that it has more fat in it because it almost looks oily. But, the good news is that he's healthy, we can lose the Failure to Thrive diagnosis and everybody's happy.

And here's my little bubs:

Great night at work

2011-04-19T07:55:00.002-05:00

I love when I have such a great night at work. Let me count the ways that made it such an excellent night:

1. As I walked out of the house to go to work, it decides to start raining like crazy. A serious downpour, right on to my freshly styled "do". My hair looked awful by the time I got to the van, but I figured "Hey, I'm saving a patient a trip to the OR because I'm having a bad hair day". (a superstition among my coworkers that if your hair looks good, then you'll end up in the OR with a surgical cap on your head)

2. I tripped over the monitor cables in a patient room and looked like a complete ass as I stumbled - but I didn't fall, or trip on the IV tubing so I guess you could say that was a plus.

3. Spiked a bag of fluid and the dang "spike" went through the plastic on the IV bag and lactated ringers solution started spraying me in the face. That was great fun. And let me tell you, it isn't tasty.

4. I was sitting at the desk and noticed a wet spot on my scrub top pocket. I looked at it and said to the girls there with me "What the hell? Why is my shirt wet?". Looked a bit closer and realized my left breast had leaked breastmilk through my bra, and the pocket on my shirt and I hadn't realized it. Yes, I am a dumbass. Now the irony is that we had to start supplementing Caleb because I'm not making enough milk (story for another day), and I haven't needed nursing pads for a couple months, and the left breast always made less than the right. So NOW it decides to overachieve?!? WTF!?!?

5. And finally, the best part of all? Had a patient's mother ask me how far along I was. I told her my baby was almost 7 months...7 months OUTSIDE of the womb. I knew I was still carrying 10lbs of pregnancy weight, but really? TGIT (Thank goodness it's Tuesday...the start of my "weekend")!!

Phone Triage

2011-03-31T09:33:00.003-05:00

You just never know what kind of phone calls you are going to get in the middle of the night. I don't know what it is, but something about the time between midnight and 3:00 am brings out the most intelligent questions. My guess is that people go to bed and lie awake just thinking about something that has been bugging them all day, pregnancy related, and then decide to call L&D. Or they want to mess with us. Either way, I've gotten some strange ones, like the grandma to be who called because her daughter who was 13 weeks pregnant was trying to poop, but couldn't finish the job. Her question was how to get the turd that was half-way out, all the way out of her anus. This past weekend was full of odd phone calls and while not as bizarre as the poop call, here are some of the gems I fielded:

"Um, yeah, I just found out I'm pregnant and I have a question for you. I just had sex earlier tonight and I was wondering if I could get pregnant with another baby while I'm pregnant with this one? I would shoot myself if I got knocked up with twins!"

"Can a chick have anal sex if she's pregnant?" Call was made by a man

"I accidently put nipple cream on my hemorrhoids. Is that ok?"

labwork and sono and doc appointments, Oh My!

2011-03-22T08:30:00.004-05:00

Its been a busy couple weeks for us. As I mentioned, we have had some issues with Caleb and his weight. It started I guess about 3 weeks ago. He started spitting up after eating, more like projectile vomiting large amounts after most of his feedings. He never acted sick, always had a good appetite, kept having wet and dirty diapers, etc. Nothing seemed too off. I didn't think too much about it, figured he wasn't burping good, and this was something I did as a baby. It gets to be close to 2 weeks I guess, and over a weekend (our furnace was out at the time, but that's another story) Husband mentioned that Caleb had been pretty fussy, not wanting to sleep. Come Tuesday am, he mentions he was making odd noises when he was breathing, like he was sighing after each breath but it only lasted a couple minutes. I went to feed him at daycare after I got off work that morning, and he seemed to be his usual self, he did vomit all over me but seemed fairly happy. When I picked him up that afternoon, he seemed pretty sleepy. He usually gets very excited to see me but he went right back to sleep after I loaded him up in the car seat. My mommy-intuition kicked in and I decided that I would take him to the after hours clinic, just to make sure he didn't have something like RSV. I get there and the first thing they do is weigh him - only 11lbs 8 oz. I immediately start to panic because I swore that was what he weighed at 4 months. The NP saw him, said he had an ear infection, but lungs were good but the real issue became his weight. The next day, we went to Hospital for a pyloric sonogram to rule out pyloric stenosis. Caleb hated it, but it was fine. He also had some blood drawn and a urine sample done. All the labs were fine except his albumin was low. So that bought us a trip to the Children's Hospital in Bigger City for a sweat test to rule out cystic fibrosis. Now even though I knew it was impossible for him to have it since I am not a carrier, I still was a bit anxious about it. It of course came back negative. By now, it's Friday and he had stopped vomiting. We've started solids and try to supplement with a bottle of formula a day. But in true style of my children, he refuses the formula, will take bmilk out of a bottle just fine, and doesn't really like the solids. I would just supplement with bmilk, but I don't really have enough stored. I'm down to six 5 oz bottles in the freezer. I took him back for a weight check on Wednesday and in a week, he was up to 11lb 10 oz. I actually think he gained more because the initial weight of 11-8 was in a diaper, and this one was without. But the fact that he's 6 months and still hasn't doubled his birth weight and is gaining so slowly is concerning. We saw a pediatric GI doc yesterday and she was actually very encouraging. She said a 2oz weight gain in a week was great. She also thinks he may have reflux, which could explain why he hates solids like he does, so we now have zantac for the little guy. She also thinks that this whole thing stemmed from the ear infection/virus he had, and he dropped weight from the vomiting. The low albumin she said wasn't really a good indication for his current nutritional level, so she wanted to have a pre albumin done, along with repeat CMP and urinalysis. She was very pro-breastfeeding and wants me to try to get him to take 6 oz at a feeding (a no go so far) and if I don't have enough bmilk to supplement, she wants us to give a high fat formula (which I still need to pick up from the pharmacy) and try to get about 4 oz of that in him a day. We will have weight checks every week for 4 weeks and we'll follow up with her then. If he doesn't put on much weight, then she'll give us the high calorie version of this formula. But she was fairly confident he'd be fine. I did have my moment on my way to work last night because the diagnoses for him are GERD and Failure to Thrive. I remember learning about failure to thrive in nursing school and the way they presented it, it made it sound like the parents were doing something wrong. That isn't the case, but there's a sense of dread over that diagnosis. Plus it just makes me sad that once again my body is "failing" me and not providing for him like I want to, and should be able to. And even though I know that really isn't the case, all you mommies out there know what I mean - no matter what, there is still that part of all of us as moms that makes us feel guilty. So last night on my way to work, I let myself cry about the whole failure to thrive diagnosis. But, he is a happy boy, meeting his milestones like he should and hopefully we can plump him up.

And as a bonus, here's my cute little bubs:

Let's talk about Stress, baby

2011-03-14T08:24:00.002-05:00

I never plan on being so neglectful...it just happens.

But in my defense, it's been crazy. Almost 2 weeks ago, our furnace stopped working and it took 5 days to get it straightened out. It was fixed last Tuesday and let me tell you, 50 degrees is WAY too cold in the house! At the same time the furnace man came, I was at the doctor's office with Caleb, just to be sure he was fine because he'd been throwing up after eating. Still pooping and peeing no problem, eating regulary, happy and content, but not sleeping as well at night. And he wasn't spitting up, but projectile-almost-emptying-his-stomach throwing up. He hadn't been too fussy and was still happy, so it was about 2 weeks this went on. I decided last Tuesday to take him in because Husband said he had a short period of time where it seemed like he was struggling with breathing - sounded to me from Husbands description that he was grunting, like a newborn who's lungs aren't quite mature and they start to tire. Caleb seemed fine in the a.m. when I fed him before going home to bed, but he wasn't his usual self when I picked him up. Mother's intuition said to take him in, just in case he's got RSV since my Fabulous new insurance refused to pay for the Synagis vaccines he was getting to prevent it. I really thought it'd be a pat on the shoulder, and an "He's just fine Mommy, quit worrying" kind of appointment since he wasn't really acting too sick. Nope. At almost 6 months, he's only 11lb 8 oz - the same as he was at his 4 month appt. That made Mommy completely freak out and bought us a pyloric sonogram, blood work and a urine sample. I also now know how they do a sweat test. And we get to see a pediatric GI doctor in a week. Yep, it's been, shall we say, a wee bit stressful here. I'd update more, but my bed is calling me after a long stressful night at work that included one true emergency.

Mass Chaos

2011-03-04T08:23:00.003-06:00

Time is apparently getting away from me...I don't think I've ever been such a slacker about posting! Work has continued to be chaotic. We are short staffed, we have mandatory call, and even with the call schedule, we are still short staffed. One night a couple weeks ago, we had 3 labor nurses on...and started the night with just a couple laboring patients. Then the gates opened and everyone, and I mean everyone, came in in transition! I think we had 6 admissions, all wither 7 or 8 cm. About the time I was unplugging the bed to take one of my patients to the OR for a c-section for failure to progress, another mom came in, 33 weeks, complete and breech. So mine got bumped and we had to rush to get her prepped. By the end of the am, no one really had assigned patients - we just went to each room, doing what needed to be done. "Ok, she needs an IV, this woman is waiting for an epidural, this room needs an exam to check for dilation. It was unsafe, but the charge nurse on that night did everything she could to get us help. But no one answers their phone at night, except one day shift nurse who came to help, but we needed about 2 more nurses with what we had going on. I can't remember the total number of admissions/deliveries/patients that night, but it was unsafe patient loads. At one point, the anesthesiologist that was doing the c-sections/epidurals we had going on was just standing at the desk, waiting for them to get our second OR up for my c/s that was bumped for the breech 33 weeker, and it was getting crazy, with patients needing things right now. So I handed him the lidocaine I had pulled for an IV start in one room and said "Here, help me, start her IV in room 6". He said "You can't get it?", to which I said "Well, I have to go into room 3 because she is going to deliver right now, and that patient needs her IV and wants an epidural, plus my patient who was bumped needs to go to the OR once they get it ready. If I could clone myself to do it, I would, and I don't think you want to go be the labor nurse & nursery nurse for the patient who is delivering. Please help". So he did. Patient delivered, baby was skin to skin with mom (love it! we're trying to do that more and more), give quick report to a post-partum nurse who was back to help with the recoveries, and out the door I go to help with the epidural for the patient I sent anesthesia to see to start her IV on. Epidural in, charge nurse comes in to monitor patient for 20 minutes after the epiural and I head back to the OR with my patient. It was crazy. The house supervisor had come up and was trying to help, but unless you work in OB, there's not much you can do but start IV's, and answer call lights. If one more thing would have come in, I think we all would have crapped. But we survived the night, patients delivered healthy babies, they didn't have great nursing care, but we really did the best we could do and tried our best not to look too harried! All my charting from midnight on was done after passing off to the dayshift...I didn't get home and to bed until about 10am. We need more nurses, but no one seems to be able to pull any out of their arse. Hopefully management will figure something out, but unless we get some experienced labor nurses in and fast, I have a feeling this will continue. February is statistically a SLOW month for us, has been the slowest since I worked there, so who knows what the rest of the year will bring!

Quote of the day

2011-03-01T19:48:00.002-06:00

Said by a scrub tech when she explained why she decided to get a nursing degree instead of a business degree:

"I decided to go ahead and do nursing because I can make more money as a nurse than I can if I get a business degree and go work for Big Insurance Co. in town."

All us nurses who were in hearing range stopped, looked at her, and then laughed hysterically to ourselves. Money isn't the reason any of my coworkers or I went into nursing, it was for patient care. If we were looking for a big salary as an RN, we'd be sorely disappointed.

Dear Lovely Twin Ladies,

2011-02-14T21:14:00.007-06:00

I apologize for last night. Work was super busy and I didn't have time to empty your compartments of the liquid gold you so diligently make for my child. It is much appreciated and I didn't make time for you last night, and I know how much you look forward to the emptying with either the pump or baby, and I am truly sorry. And I do understand your confusion when you hear crying babies and you aren't being taken care of. But is it necessary to make yourselves so firm that everytime I turned the wrong way, it felt like a boulder, or a tight water balloon, ready to pop? Mrs. Bladder was also ignored, but perhaps she is used to the neglect because she didn't cause any leakage and really didn't bother me until the end of the night, when I realized I hadn't peed all night, but then again, I ignored Thirst and Hunger, so there really wasn't too much to irritate her to begin with. I understand you are a bit more hormonal than she is, but really? Did you need to leak that liquid gold clear through my scrub top? I know that first time dad, who's wife was laboring and planned to breastfeed, sure enjoyed the show you put on. I can still see the mortification on his face when he realized what had caused the headlight style design on my scrubs. I know my caring coworkers sure enjoyed seeing that display of your abilities (I can still hear them laughing...) Message was received, I will not ignore you again for a full 12 hours.

Humbly Yours,
Nurse Lochia

You know you're a mother when..

2011-02-10T16:59:00.004-06:00

When you go to a health screening and it's not until you get home that you realize that you have breastmilk spit-up on your shoulder and one side of your nursing bra is unsnapped.

Or when you start making lunch and your 3 year old comes down the stairs, sans pants, asking you to wipe his butt. You grab the wipes and realize he's covered in poo. A bath is necessary so you take him upstairs to the tub and you find his poopy underwear in his room, poop smears on the hardwood floor, on his freshly laundered comforter, on a towel and smeared all. over. the. toilet.

Or when you are rushed out of the shower because the baby is hungry and it's not until the next morning that you realize in your haste to get dressed, you put your underwear on inside-out.

Gimmee a Pee!

2011-02-06T08:02:00.000-06:00

Something wonderful has been happening in our house... Isaiah is potty trained!!! YAY!! We decided with Isaiah to do things a little different this time around. Part of it, I'll admit, is because I'm lazy. I just didn't want to spend hours upon hours sitting in the bathroom, or forcing fluids down him, or getting him to sit on a potty chair while watching tv. Jacob and Clara were both 3 before they were potty trained and I don't think anything we could have done would have made them use the toilet any sooner. Yeah, some kids are completely potty trained before they are two. A nurse I work with was one of those lucky mothers, both her boys were out of diapers before they were 2, and I hate her for it. Ok, so I don't really, I'm just insanely jealous. I just don't think my kids were willing to give up the diaper until they were 3. With Isaiah, we never bought pull-ups. Maybe they work for some kids, but I think they were a hindrance for mine. We used them with the older 2, but really, I think they are just glorified diapers that still allowed them to poop or pee in their pants with little consequence. I figured I'd just go straight to underwear, and that way he would be really wet/dirty, not like how it feels and be more motivated to use the toilet. I bought underwear for him about a month ago and we'd put the underwear on over his diaper, and encourage him to use the potty. About 2 weeks ago, after changing a monster, nasty poopy diaper one morning, I decided I'd had enough. He would go on the potty sometimes, and he knew when he needed to go - he just wouldn't always want to do it. So I put him in underwear. Said today was as good as any to jump right in. He fought me for a bit, but eventually he decided that it was pretty cool to not have diapers on, plus I told him how happy I was, how happy his teachers at school would be, etc. I loaded his backpack up with plenty of underwear and pants/socks, shirts, etc and sent him off to school after lunch. His teachers are more than willing to help with the whole potty training thing, and I had told them my plan a week or so earlier. He came back in the same clothes, and we've been good since. He did have a couple accidents. The first one, he completely emptied his bladder, the next was just a dribble, and we only had one poop in the underwear but other than that, he's done fabulous! Those accidents helped him to realize that it doesn't feel good to go in his pants. He hasn't had an accident for a week, and while we still do diapers at night, he is completely daytime potty trained! I did promise to buy him a toy once he was using the toilet so I took him to the store and let him pick out a toy...that was a 30 minute ordeal, but it was fun. Over this last month, we've really seen major changes in Isaiah - he's talking more, he no longer demands a drink for bed, he sleeps all night (HUGE!!!) and now he's out of diapers! It sure feels good!

Get into the groove...

2011-01-24T08:05:00.003-06:00

It's been awhile...guess I've been pretty busy lately. Work has been hectic, but I've had a string of wonderful births and I think I can finally say that Momma has her groove back! One weekend, I came on shift and took a laboring mom who had just gotten an epidural and the last she was checked she was 4cm. After report, I go in and introduce myself and check her cervix: 10cm and the baby's head was L-O-W. So called Doc, patient delivered and it was a nice, easy delivery. I get everything settled with the new family, baby is nursing like an old pro and I walk to the desk to give them some time alone. About that time, a patient came in after she fell on ice. She said she managed to keep from landing on her stomach, thankfully. She was in her late second trimester and needed some lab work, continuous monitoring, and a sono to make sure that everything was fine with the baby and placenta. Soon as I get her settled and gave a dose of terbutaline to stop the few contractions she was having, another patient comes in, preterm and contracting. I get her admitted and call the doc and got some needed terbulatine to stop her contractions. I'm running in between my two preterm patients, both contracting and needing terbutaline and labs. Thankfully, the pretermers settled and I was to keep the one who fell for 4 hours and then she could go if everything was stable, and the other I was given a discharge order. The charge nurse had been checking on my delivered mom while I got through these admissions, otherwise I would have never gotten in to check on her. Things start to settle for the moment, so I get my delivered mom moved to post-partum. As I'm heading in to discharge the now stable preterm patient, our OB/OR tech comes around the corner...and she's moving at a pretty good clip. I look at the patient and immediately understand why: the mom is sitting in that tell-all position that every OB nurse/tech/doc knows well. She's got sweat on her brow and upper lip, panting and sitting off to one side of the wheelchair, hands clenched around the wheelchair arms so tightly her knuckles are white. Me and my stellar critical thinking skills decide that I would have to discharge my patient later. We manage to get the patient in bed, pants off and I check her and she's 9cm. One of my fellow weekend-option coworkers came in to see if I needed help. We work together like a well-oiled machine. Within 15 minutes, we had her admitted, IV in (yes, I know an IV isn't always necessary but she wanted us to try to get her an epidural, but we all knew it wasn't going to happen), assessment and admission complete, delivery set-up done, and the infant warmer set and ready to go. I started to think that the doc wasn't going to make it in time, but the OB got there just in time to put on a pair of gloves and catch. Mom did fabulous. She had really wanted an epidural but her labor went too quickly and she was so in control that she really didn't need it. I think it was more the idea of not having one that was scary to her. Thankfully, the rest of the night seemed to be a bit calmer. I was able to finally discharge my preterm patient. It had been awhile since I had done a Leboyer bath (well, a modified Leboyer if you want to be technical) so I was able to help the parents give their new baby a bath. Since it was such a wham-bam-thank-you-ma'am birth, the mom said it was nice to be able to slow down, and just support her baby's head as he floated and kicked a bit in the warm water. Thankfully all the labwork and sono results came back normal on the momma who fell, so she was able to go home at the 4 hour mark. At the same time as all the action I was in on, there were a couple more births and other things going on, but by the time dayshift had come in, we had all but one of the delivered patients moved out to post-partum, and all the other outpatients were treated and discharged. It looked to them like we had a quiet night sitting at the nurses station, reading the paper and chatting while the patients sleep...that's all that happens at night, you know. ;)

Another example of my genius.

2011-01-11T17:21:00.005-06:00

I had hoped after my example of genius last summer that my mind wouldn't be mush, as I'm not pregnant. If you've been following my mind ramblings, you'll remember my trip to the grocery store with my daughter and as I came out of the store, I couldn't find my keys...I found them in the ignition...with the van still running. Yup, it was a great moment of brilliance in my life, but I chalked it up to pregnancy brain. Well, maybe I don't have pregnancy brain now, but I'm not sure my brain is functioning at full capacity. Last night I went to work for an 8 hour shift, 11pm to 7am, and to get into the hospital after hours, without going through the E.D., you have to swipe your badge to get in. So I always have it out before I get out of the car so I'm not fumbling through my purse looking for it at night just in case there's some weird psycho waiting in the parking deck, and I put it back in my purse after getting in the building. After getting to the unit and changing in the locker room into the required hospital scrubs, I get my pockets filled with pens, hemostats, scissors, etc....all the things that I've come to *need* for my shifts. I rifle through my purse and can't find my badge. And I knew I had it because I got in the building. I look through my locker, purse again, around the locker room and this goes on for about 5 minutes and I'm thinking I'm going to have to trace my steps all the way through the hospital to find it. That is until one of my coworkers looks at me and asks "Are you looking for your badge?" to which I reply "Yes. And I know I had it because I got in the building.". She looks at me like I'm a fool and says "Um, Nurse Lochia, it's on your scrub top". Yes, my friends, I am a genius!

Awesome

2011-01-09T08:41:00.003-06:00

So I realize I'm no spring chicken anymore. I used to always look young for my age, but after awhile, time takes his toll, plus I work nightshift, have 4 children (5 if you count Husband, which I do) and have a 3 month old, so, yeah, I look a bit older than I used to. Last night I was in charge and had a labor patient (go figure). My patient, 9 years younger than me, was in for preterm labor a few weeks ago and she was my first patient after my maternity leave was up and we bonded. So I was glad to be able to see her through her labor and delivery. Anyway, she was asking about my kids, where I live, etc. It just so happens that the H.S. girls volleyball team in the town I live in won State Championship this year and this came up when I told her where I live. She then asks me "Are any of your kids in high school?" *Sigh* I'll be going out to buy some awesome face cream later. Guess that happens to the best of us!

3 months

2010-12-31T08:47:00.003-06:00

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!

2010-12-20T11:36:00.007-06:00

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

2010-12-14T08:00:00.003-06:00

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

2010-12-07T20:43:00.008-06:00

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

2010-12-07T14:15:00.006-06:00

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

2010-12-01T07:47:00.004-06:00

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

2010-11-22T20:46:00.003-06:00

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

2010-11-15T18:28:00.004-06:00

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

2010-11-08T14:24:00.003-06:00

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..

2010-11-05T13:10:00.003-05:00

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

2010-11-01T18:39:00.002-05:00

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

2010-10-29T20:10:00.005-05:00

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

2010-10-28T08:37:00.003-05:00

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

2010-10-21T16:46:00.002-05:00

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

2010-10-20T07:18:00.002-05:00

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.

2010-10-19T09:22:00.002-05:00

"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

2010-10-15T07:02:00.004-05:00

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

2010-10-14T13:21:00.002-05:00

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

2010-10-13T08:12:00.003-05:00

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

2010-10-07T11:05:00.002-05:00

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

2010-09-28T08:02:00.004-05:00

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!

2010-09-25T14:30:00.008-05:00

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

Caleb Dean

2010-09-24T18:15:00.002-05:00

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..

2010-09-15T21:22:00.002-05:00

...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!

2010-09-08T08:16:00.003-05:00

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

2010-09-03T09:27:00.005-05:00

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

2010-08-28T12:46:00.002-05:00

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

2010-08-27T06:41:00.009-05:00

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

2010-08-26T08:57:00.004-05:00

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

2010-08-22T16:59:00.000-05:00

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!

2010-08-19T09:08:00.004-05:00

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

2010-08-18T10:29:00.003-05:00

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.

29 Weeks

2010-08-11T11:29:00.009-05:00

Total weight gain/loss: 18 lbs. *Sigh* So much for being on the lower end of the weight gain spectrum...especially since I started out so well.

Maternity clothes? oh, yeah!

Best moment this week: I guess it's just kinda funny, but I was helping a mom sit up for her epidural Monday a.m., and she was a mom who was really leaning on me to support her during her contractions and the epidural. After it was done, she sat up, looked at my belly and said "Oh, your baby just moved!" Yep, it's noticeable even through my scrubs!

Movement: All the time! Like I said, his bigger movements are quite obvious even to other people.

Food cravings: Still liking the cookies & cream ice cream with cool whip. But, I only have 1 scoop and I don't eat it every day, just because I don't want to get huge. Grapes have been sounding really good too. I really wanted a nice cold beer a couple days ago...oh well, soon enough, and I think it was just the idea of a cold beer on the deck that sounded nice and not the actually beer.

Labor Signs: again, no signs of labor. Still having lots of contractions, having more and more "episodes" of pretty uncomfortable contractions every 2-5 minutes lasting about 1-2 hours, but about the time I decide enough is enough and I need to maybe go have it stopped, they quit. So the ole' uterus is just cranky and letting me know she's unhappy. Oh, and the fun sciatic nerve pain has been fun. Nothing like getting up to pee at night and getting that shooting pain down your leg.

Stretchmarks? nope.

How are you feeling? Tired but not feeling too bad overall. My patience with my 3 kids is waning...I'm really trying to keep my cool. Oh, and it's in the 90's with a heat index in the 100's and has been for a couple days. Thank goodness for the a/c. My 12 hour shifts are really getting difficult. Again, I know pregnancy isn't a comfortable thing, but this pregnancy has been rough. At about 2a.m., my upper and lower back really start hurting, the cranky old girl Ms. Ute starts to get pretty irritable...but I'm managing...I will make it!

What I am looking forward to: hitting 30 weeks, school starts next week for Jacob and Clara so for about 2 months, I'll only have 1 kid at home during the week. We'll be working on potty training Isaiah during that time. I really hope it goes well, he seems to be ready and likes to go on the potty.

What I miss: Sleep, being able to do things I just can't physically do right now.

And now for your viewing pleasure, a couple belly shots:
And now for the comparison picture...here I am at 29 weeks pregnant with Isaiah. Yep, I'm gonna be HUGE!!!!!

Two More Beautiful Births

2010-08-03T16:55:00.004-05:00

A few weekends back, I took care of two first time moms with very similar birth plans. They both wanted a natural labor and birth, didn't want to be tied to bed, wanted to move around, etc., the usual requests we see with a birth plan. They both did fabulous! But there were a few differences. The first mom came in defensive and abrasive - she thought I was going to force her to do everything against her wishes, take her baby away from her right after birth and do horrible mean things and ruin her birth experience. Couldn't have been farther from the truth! She allowed me to monitor the baby while I ran through the ridiculous list of questions I have to go through, assessment and calling the doc. She told me NOT to coach her with contractions or direct/suggest anything in labor or when it was time to push - her body would tell her what to do - she'd let me know if she needed me. I'm perfectly fine with that. We agreed that she'd let me monitor the baby and I'd be there just in case she needed something, but she didn't really want any interference on my part. So we had a deal. I call the doc, he agrees to her requests. I place the saline lock, help her into the tub and go in and check on baby every so often to make sure he was doing well. After awhile, she started to get pretty active and she also started to see that I was there to do everything I could to help her have the birth she wanted. No longer did she see me as the enemy, but as her advocate. We were getting somewhere. Generally, at least where I work, that's the case. Us labor nurses really do want women to have the birth experience they want, whether it's natural in the tub or with an epidural or a c-section. We do have rules the hospital puts in to place and a refusal of some interventions requires that a refusal form be signed to waive the hospital of liability. Anyway, she starts to feel pushy and she decides she wants out of the tub. I'm allowed to check her: nine centimeters. She was in that transition phase where she wanted to be done with the whole thing, felt out of control and that she couldn't do it anymore. I felt she was open to some suggestions so I got her back out of bed, on the ball, standing at the bedside, labor dancing leaning on dad, etc. Soon enough, she was complete and ready to push. She started pushing but not effectively - I could tell she was holding back - the urge was there, but her mind was telling her not to push because it would hurt. After awhile of ineffective pushing and not making progress, she started to look to me for suggestions. I then was able to give her suggestions on how to push, got her to try a few different positions - she actually liked the lithotomy position the best (I'm still astounded by that one!) and she started making progress, pretty fast progress at that. All she needed was just a tiny bit of help and she had it. Finally, we were ready for Doc, he came in, and she delivered a healthy little baby, just as she wanted. She told me afterwards she was so afraid that I was going to be this devil of a woman who would make her lie in bed, have an IV, be tied to the monitor, etc. because of all the stories she's heard about how horrible hospitals are. And I'm sure there are true stories like that, unfortunately. But there are a lot of nurses that want moms to have a safe delivery, a healthy baby and have the birth they dream of. She started off defensive, and realized that she did need someone to help support her (she didn't have a doula and didn't take any classes) and when she realized she could trust me, she was able to ask for help and was able to achieve the birth she so wanted. It really was a beautiful birth. Skin to skin right after delivery, baby latched on to the breast shortly after the cord was cut, and a great delivery.

The other momma had taken Bradley classes and was as prepared as you can get for your first run at labor and delivery. She and her husband were very receptive to any and all suggestions I could offer, and seemed to be reassured by my presence. Most times, Bradley couples have this great connection that they don't want disturbed by the presence of a stranger coming in and interrupting mom's concentration on labor. They had great chemistry but they also wanted that reassurance I could give them by checking on the baby frequently. After laboring for awhile, she decided she needed to do something different than sitting on the ball, so I helped her into the shower while I started filling our labor tub. After awhile, she decided the shower was wonderful and didn't want the labor tub. She progressed quickly and was 8 cm when I had to report off at the end of the shift. She did go on to have a drug-free vaginal delivery, after being complete for 5 hours and pushing for 3-4. I think they were probably starting to wonder if the baby would fit, but no time constraints were enforced as mom and baby were doing fine and in the end, she had a healthy baby in her arms. Another beautiful birth!

27+ weeks

2010-07-30T11:04:00.003-05:00

Total weight gain/loss: 16 lbs

Maternity clothes? mostly, but I do have a skirt and a couple tank tops that aren't maternity but are stretchy and comfortable

Best moment this week: Washing the baby clothes and sheets, organizing some in the baby's room. And I love feeling him move around, it's the greatest feeling.

Movement: All the time! It's fun to watch my stomach move with his movements.

Food cravings: ice cream and cool whip

Labor Signs: mild contractions all the time, sometimes more frequently and more painful than others, but no true "labor" contractions.

Belly Button in or out? still in, it's never been an "outie" even at the very end of pregnancy (it's a pretty deep cavern apparently!), belly ring still in but starting to be more prominent through the shirts, so it looks like I have an outie.

Stretchmarks? nope. Got great genes that way!

How are you feeling? Today's not such a good day, pretty achy, tired, back hurts, fairly frequent contractions, well, probably more irritability than contractions, I'm crabby and I'm thinking maybe I have some adhesions as I've been having some pulling/pain off and on around c-section scar the last couple days.

What I am looking forward to: being able to sleep and being able to go more than 2-3 hours without peeing, hitting that third trimester mark in a few days!

What I miss: Sleep, being able to do things I just can't physically do right now.

What I Wouldn't Give...

2010-07-21T10:08:00.007-05:00

I see the slender, in-shape runner, in her early 20's or even early 30's and I think "Man, I used to have a body like that and I used to be able to go run whenever I want. No worries about how long I was gone, no worries about the chores that won't get done while I'm out". I look down at my gravid belly and wonder if my body will ever be slender again, I know it will never be the way it was before after 4 babies...I remember when my hips were lean(er) before they expanded to allow a child to be birthed, my feet were a half size smaller, my legs weren't covered in spider veins and were tone and muscular. I could easily run 7 miles. I remember when my body was my own, before the skin was stretched beyond belief, before my breasts had nursed 3 children, before a cesearean and episiotomy scar left their marks, when I never worried about whether or not my bladder control would be strong enough to withstand a good sneeze. That thin woman running probably never thinks about that. But then I think "She may be in shape, but maybe she won't return home to children waiting with excited faces, waiting to show her their race track they built. She may not have the scars of childbirth, but maybe she wants to more than anything in this world. She may see me outside with my belly full of baby and my 3 children running wild around the yard and think "Man, I wish I had that". My hips may be wider, but they hold a child well. My abdomen will never be quite the same, but it grew to allow a child to develop. I may not have run a marathon, but I have finished the marathon of labor to bring my first child into the world. I successfully completed 3 rounds of pregnancy from start to finish. My breasts may never stand at attention like in my pre-child days, but they nourished 3 children and will do the same for the 4th. I may have scars from childbirth, but I wear those scars with pride...the reminders of what a wonder the womans body is.

After a long night of up and down, little sleep and coaxing a 2 year old back to bed, I long to be able to sleep all night long until I wake up on my own...something I haven't done in years. I wish I could sit on my deck, enjoy my morning Diet Coke before jumping into the day instead of getting up and jumping right into starting breakfast and answering the endless questions that start as soon as my eyes flutter open. I am awakened each morning by little fingers on my face and a small voice saying "Mommy, mommy" and oh!, how I long to be able to sleep in like some of my childless friends and have a full night of blissful sleep without disturbances. But, they wake up to quiet all the time, and they don't know what it's like comfort a scared child in a storm as they snuggle up to you and fall asleep in your arms, or to have 3 little ones climb in bed with you on a cold morning to watch cartoons.

In my shower, what I wouldnt give to be able to stand in the hot water for a long time, take my time, and shower in peace. And to be able to style my hair just right, apply make-up and leave the bathroom ready to go out. Instead, I take the world's fastest shower and still I have to holler at the kids to stop jumping on the bed, to stop hitting each other. I'd love to be able to shower, with the bathroom door closed. Frequently, I am scalded with hot water as one of the kids will sneak into the bathroom and flush the toilet before it's too late for me to realize. But, then again, I could take a long shower without interruption...but then what would I do? No, my hair isn't styled perfectly and my make-up is pretty minimal, my wardrobe, well, lets just say I'm not exactly in style and I usually have stains from little fingers on them by the end of the day. But I have a almost 6 year old that watches me as I get ready and says "Ooo, Mommy, you look so pretty!" and then I realize I don't need all that to be beautiful in my children's eyes.

I also remember the days of shopping for myself, by myself. I could browse the racks, make trips to different stores looking for just the right outfit, or pair of shoes. My underwear and bras matched. My selection of shoes was awesome, and I could peruse at my leisure. These days, my best white bra is an odd shade of gray, thanks to being washed with dark colors. I can't remember the last time my undergarments matched, or when I last cared. I may not have an awesome wardrobe, but my children have a great one. My trips to the store are rushed with children begging for this and that, fighting and running down the aisles. I see that woman about my age, looking at purses and shoes and I think "Man, I wish I could just go shopping alone again, and buy stuff for myself". But then again, that woman may look at my brood and wish she had what I have, that she had other things, like diapers and small clothes to buy.

I haven't read a great book for quite awhile...but I have read the journal of a 6 year old boy, who wrote "Me and Mommy played catch in the yard and then went to the park and it was fun". I may not have great pieces of art or sculptures, but I have crayon colored pictures on my refridgerator that say "Mommy I luv U" and a popsicle tower. My house isn't spotless, in fact, the floors need to be mopped, there are dirty dishes in the sink, laundry to be done, toys everywhere, but what good is a clean house if it is an empty one? While I would LOVE to have a cleaner house, I'd rather play a game with my children than have a spotless house that could pass the white glove test if it was empty. I don't have a flower bed with all kinds of exotic flowers or a vegetable garden with a large variety of plump, juicy produce. But I have a flower pot with a bean plant that we grew from a seed and a pot with a geranium that has a small handprint on the outside, given to me for mother's day. I haven't been to a musical in the city or in a big opera house for a long time, but I have seen some great talent at the 1st grade dinosaur play and spring concert. I haven't been out on the town for drinks at a bar, or to a movie theater or even out to eat at a nice restaurant. But I have snuggled on the couch to watch the latest Disney movie with a bowl of popcorn after a fine meal of pizza with my family.

Every day, I may have moments when I think "Man, I used to be able to do this before I was a mother", but then I look around and you know what? I wouldn't trade this for the world.

Work and pregnancy update

2010-07-20T18:38:00.004-05:00

What a night! Busy, busy, busy! Thankfully, we are starting to pick up in the baby department after several months of s-l-o-w. Summer is usually pretty busy and business has been booming. Of course, it's never a even level of busy. It's either dead or we've filled every labor and post-partum room. No happy mediums for very long anyway. This weekend was no exception. Saturday was pretty slow, which ended up being a good thing for me, which I'll get into later. Sunday night we were pretty busy but nothing crazy. Last night, we were busy from the start: short-staffed for what we had and quite a few patients. I was in charge and if things went as they were "supposed" to, it would have been fine. But, we all know that's not how life is in healthcare. About 5am, when I need to start calling people to see if they would work dayshift (who was also short) a labor was very close to delivery, we were expecting 2 people at any moment for 5AM for scheduled procedures, and we had 2 pretermers down in the ER. No one from nursery was available to attend the baby at delivery so I planned on doing it...until I realized I would need to admit one of the new patients. Thankfully, both people we were expecting at 5am were late. Tthe laboring patient wasn't completely ready to deliver until the dayshift charge nurses had arrived at about 6am and she ended up getting quick trip to the OR, which bumped our scheduled 7am c/s and the to-follow c/s. It was just crazy! But, we managed and I got to bed about 8:30.

I saw Doc today and talked about some of the preterm contractions/irritability I've been having. In the last 3 weeks, I've had 3 episodes of contractions and irritability that were frequent, consistant, and painful. I won't go into too much detail, but the last episode was Saturday night and I ended up going home early...with the promise to come back as a patient if things picked up or didn't slow down. Thankfully they did eventually slow down. Now I will say that I was fairly certain they weren't doing anything to my cervix - they were just very uncomfortable and miserable, and I have no intention of letting things get out of hand. I have no intention on having a preterm baby if I can help it. So at my appt today I talked with Doc about these issues. I had mentioned what was going on 2 weeks ago when she came in for a delivery so she kinda knew things were happening. She did a fetal fibronectin swab and I should have the results of that tomorrow. My cervix is closed, but she thought it was thinning a bit, but wasn't too concerned at this point. The fetal fibronectin is a substance that is like a glue that holds the amniotic membranes to the uterine lining. It's normally not detectable between 24-34 weeks. If it is detected in the secretions, or positive, then it indicates that the glue is breaking down and that there is a high risk of preterm delivery in the next 2 weeks. If it's negative, or not detected, then there is (I think this is the correct percentage) a less than 5% chance of delivery within 2 weeks. It's just a way to keep from intervening with bedrest and such for preterm contractions if it isn't necessary. So if it's negative, then I can continue like I am, but if I have another bout of painful contractions, then I earn myself some brethine, procardia or hydroxy-progesterone injections to calm my angry uterus. If it's positive, well, that changes things, and we'll see what my future holds.

Fun Conversation

2010-07-13T07:00:00.001-05:00

Actual conversation I had with a patients mother Friday evening. My patient was changing in the bathroom and missed out on most of this lovely conversation I had with her mother. For reference, I was in the usual scrubs with a scrub jacket on...usually that covers the belly fairly well.

Rude mother of patient: Wow, so how much longer do you have? (referring to my ever expanding abdomen)

Nurse Lochia: "About 15 weeks...I'm not due until October"

RMofP: (makes face that suggests she thought I was due any day). "Wow, you got big, huh?"

NL: (trying to hide my annoyance, feeling like I should further explain) "It's my 4th baby, and yes, I got big pretty quick. It happens."

RMofP: "Oh, my daughter is having her 4th baby too, but she's not nearly as big as you and she's due in 6 weeks!"

NL: (speechless, contemplating giving her the finger or commenting on the size of her waistline, but realize that may be a bit unprofessional, so I just smile.)

*patient walks out of bathroom*

RMofP: (to patient) "Hey, guess what? Your nurse here is bigger than you and she's not due until October!"

patient looks apologetically at me , embarrassed by her mother's comments.

It's never the patient that says anything to me about being pregnant...no one so far has ever been bold enough to ask me how far along I am. They all go about it in a round-about way, asking if I have children, etc. But the patients' mothers? They don't hold back. It's actually pretty funny because the poor patient and her husband/boyfriend/FOB always look at each other, sometimes horrified that their mother had the nerve to go ahead and assume I'm pregnant. Now, it is fairly obvious in street clothes, but in scrubs, especially with a jacket on, the belly is covered pretty well at this point. The first time a patient's mother made a comment, I was only 18 weeks - she asked me how far along I was. A bold move. I think I may start answering "Oh, I'm not pregnant", feign indignation and offense, and say no more. Just to see what people do. I know, I know, mean, but you have to admit, it'd be pretty funny. Hey, I gotta have fun somehow!

I hate my uterus

2010-07-12T08:47:00.003-05:00

I'm really not a big whiny pregnant woman usually. OK, I think everyone deserves to complain about the peeing every 2 hours, the backache and general discomfort that goes along with pregnancy. So I did my share of that with my first 3 kids. It feels good and relieves stress. But man, the last couple weeks have been unpleasant. I have a long way to go to be this uncomfortable. And really, I understand that being pregnant isn't a comfortable state to be in. But my back aches all the time, I contract all the time, every time I walk my uterus contracts into a tight little ball, I pee constantly, I still vomit daily and I can't sleep. My 12 hour shifts are killing me. It's all I've been able to do the last two weekends to keep my composure until I'm in the van - then the tears from the severe discomfort just come and keep coming. Baby Cletus is doing just fine, practicing acrobatics in my uterus and gently nudging me pretty regularly, which I love. But the bad thing? I feel like I'm supposed to be "tough", after all, I'm a labor and delivery nurse and I should know that it's not easy being pregnant, and I'm having my 4th kid and all so I am going to feel like hell. But I've been pregnant before...I felt GREAT until 32-33 weeks with Isaiah, felt great the whole time with Clara and honestly, with Jacob, I had no idea what to expect but I worked up until delivery day so that doesn't count. This time I'm miserable after any amount activity. My cervix isn't changing and I'm pretty certain he's going to stay put until October, thankfully. But I've got a long way to go. Being off work won't do much good because I work just as hard at home as I do at work. And I don't do well being told I can't do something. Not being able to run OR go on walks is driving me nuts! Can you imagine me on bedrest? Ugh, I really hope he's just positioned in there funky and that's causing all of this because it did come on suddenly the night I ended up as a patient at work. I'm trying to stay positive and deal with it because I know how blessed I am to have this healthy little boy growing...I just am angry with my uterus right now. I hope it gets better, or I figure out a way to deal with this irritable uterus of mine for the next 15 weeks.

Viability!!

2010-07-07T08:22:00.002-05:00

WooHoo! Today I am 24 weeks - Viability! This is probably the biggest milestone, right up there with 38 weeks. That means, God forbid, should this little guy decide to be born he would have a chance at survival. Not a great one by any means, and the chance of long term health problems would be pretty high, but there is a chance. I think 24 weeks deserves a party of some sort. Things are going pretty well. I'm still contracting more than a 24 weeker should be, but they aren't increasing in frequency and they aren't painful like they were last week. The pelvic pressure is pretty intense, but part of it I'm sure is it is my 4th baby and my poor ligaments and pelvic floor have taken a beating and are giving up! I chatted with my doc the other night, told her that when I walk my uterus tightens up in a ball, and that I was still contracting, probably more like irritability than contractions, had pelvic pressure, etc. She said as long as nothing gets worse, and my cervix doesn't start changing, it may just be that I have an irritable uterus and I'll be fine, and that I need to take it easy when I can. But if they increase in intensity or frequency, then I need to be checked out. Fine by me. But 16 more weeks of contracting all day everyday is going to get old. Plus I'm *trying* to take it easy...I don't like not being able to do all the things I want to do. My initial plan was to run the majority of my pregnancy, to take longish walks at the end, keep up with my kids and their activities, paint the kids rooms, rearrange things, etc. It drives me crazy that I just can't do it. I can't even go for a walk without getting uncomfortable. But I'm going to be good and not push it...I would not do well on bedrest. But I will do whatever it takes to keep little man in there until October.

Not a good sign

2010-07-03T08:29:00.002-05:00

If anyone who has read my mind ramblings from the beginning may remember that I had preterm contractions at 34 weeks with Isaiah. They subsided, never did anything except for the one night that I started hurting with them and bleeding. I had hoped to avoid that this time around. Not going to happen I guess. I'll admit that I have contractions from very early on - nothing painful or too frequent, but they are there and have never led to a preterm delivery for me. With the first 3 kids I noticed them from about 22-25 weeks. This time I noticed them about 18 weeks. I figured "hey, it's my 4th pregnancy, I'm more tuned into things this time". Or at least that what I told myself. I had to stop running weeks ago because it wasn't pleasurable and the last time I tried, it hurt. I can't walk too far either, because my uterus tightens up - something that didn't happen until 30+ weeks in the past. But I can do small things, like being able to play kickball with Jacob, etc. I again tried to explain it away as being just part of what comes with a 4th baby/5th pregnancy. Wednesday night, I had picked up an extra shift. Husband was home, so I had an easy day. I napped with Isaiah in the afternoon, and laid down at 7pm like I do before a 11-7 shift. About 8pm, I woke up with pretty severe cramping, and it hurt to move. I figured it was round ligament pain, which I think was part of the problem and tried to go back to sleep. Didn't work. I got up, drank 1liter+ of water, went to the bathroom hoping that would help, but I found it didn't. I had a lot of pelvic pain/pressure, and my whole abdomen was really tight, and not relaxing. I kept trying different things, hoping it was gas, etc. but about 9:30 I realized that maybe something was wrong. I called the charge nurse and told her I needed someone else to be a labor nurse and me be the patient. I told her what was going on and she said I needed to come in. Damn. I checked my own cervix, because I knew they'd be doing it and I wanted to know myself, and it was long, closed and high. A good sign. I was just sure I would get to L&D, rip a great big fart, and be fine, or it had to be a UTI. I just couldn't be contracting at 23 weeks. Well, I was, every 2-3 minutes. After about 30 or so minutes, they started to really hurt, and I got really worried. I didn't have a UTI, baby looked fantastic for a 23 weeker, and I got several shots of terbutaline. That eventually knocked out the contractions, but the pelvic pressure didn't go away, and it still hurt to move. It's better now, but I still have some pressure. I'm able to work - for now. I know if it happens much more, that I will be done. I don't need to be off work this early, but I also don't need a micropreemie, and 23 weeks isn't viable. I have been taking it easy, and I've really limited my activity. It drives me crazy that my body won't allow me to do the things I want to do. What worries me is the day I had this, I hadn't done much of anything. I hadn't been running around, cleaning, or anything. I napped, cooked supper, gave the kids a bath, napped again, and Husband was home all day. And the pain started as I was sleeping and I was very well hydrated. So we'll see how it goes. Maybe it was just an isolated incident and not an indication of how the rest of this pregnancy is going to go. And maybe that's just how I'm going to feel and it won't make a difference in my cervix or timing of delivery. We're keeping our fingers crossed - this little guy needs to stay put until at the very least October, preferably the end of October.

Something oh, so fun and new

2010-06-29T17:34:00.002-05:00

Last night, Jacob had his last get together with the baseball team. They had a pizza party and a game of kickball: parents vs kids. I decided I was going to play. OK, so as a kid, I was HORRIBLE at kickball. I could do other sports fine, but I'm just not that coordinated kicking a ball with my feet. But I wanted to play and not sit out. It was fun, but you can only imagine my pregnant butt out there, trying to kick the ball, running the bases. I'm sure it was quite entertaining. One bad thing was my two pairs of black running shorts I planned on wearing were wet in the washer and I knew I need shorts. I haven't bought a pair of real shorts, like jean shorts for years. I pulled out a pair of shorts that I can barely get buttoned not pregnant and put them on, and the buttons were about 1-1.5 inches away from my hips...but that didn't stop me from wearing them. I put on a bella band and went. It actually was comfortable and didn't look bad. So after the game we had pizza, and my stomach just can't handle some foods right now, like pizza. As I was eating it, it was very good but I knew it would be making a reappearance within the hour. Sure enough, we get home, get the kids bathed, and I had to run Jacob out in his towel so I could vomit. Here's the fun part: I vomited...and peed my pants. Yep, my poor pelvic floor has taken a beating and couldn't withstand that much pressure. Sure, at full term if I vomited that would happen, but I'm only freaking 23 weeks. It wasn't good. I hope that isn't a sign of what's to come even after delivery. I told Husband that it's hard to feel sexy when you know you just pissed you pants! Oh well, I can still sneeze without peeing, for now! And I guess it's a small price to pay for another baby, but I'll just have to be a bit more vigilant with those kegels.

My Birth Plan for Delivery #4

2010-06-18T08:23:00.008-05:00

I'm not anti-birth plans. Quite the contrary, I think they are a wonderful way for someone to think about how they would like their birth to go. But, there are 2 key points to remember with any birth plan: 1. show your doctor/midwife. and 2. be flexible. In a perfect world, everyone would have the birth they dreamed of, down to every last detail. We all know that sometimes things happen that make that ideal birth unobtainable - prolapsed cord, abruption, too small pelvis, etc. I've seen some very detailed birth plans, some 4 and 5 pages long and invariably, something doesn't go as mom planned and they are unsatisfied with their birth.
It's also a running joke among nurses, at least in the area that I work, that we are more prone to disasters during our births - hemorrhage, prolapse cord, severe pre-eclampsia, etc. Obviously, there isn't probably any truth behind it, but it all goes back to us being superstitious. To ward off those evil vibes, I posted this when I was pregnant with Isaiah, and thought it was still appropriate with this pregnancy, plus I added a few things.

A Labor Nurse's birth plan:

1. I want lots and lots of Magnesium Sulfate.
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)
3. If I dont get a emergency c/s and can VBAC, I'd like an episiotomy with a 4th degree extension, please.
3. I also would like to be tethered to the bed for the duration of labor with internal monitoring.
4. I desire lots and lots of cervical checks
5. I also would like my baby taken from me straight away for at least an hour so it interrupts with breastfeeding and bonding.
6. Only internal monitoring for me, baby!

Ok, all kidding aside, I do have a plan for this delivery. Because I know this will be a scheduled c/s this time, I have a few things that I want that will help make the experience the best it can be. If I do go into labor on my own, I get to the hospital and I'm 8cm, I won't be going to the OR - that would be pointless because it is likely that by the time they get everything set up and ready for the c/s, I'll be complete and ready to push. Especially if my water breaks. I may have to argue a bit, and I've jokingly threatened to break my own water with the amniohook (again, just kidding) to prevent going back while in transition. (Really, it was just to get a rise out of one of our new nurses...you should have seen the look on her face because she took me seriously! Ha Ha! Yes, I am evil) But, anyway, that's not likely to happen. So here's what I have planned for my c/s delivery:

1. I will NOT be given any sedative (versed) after the baby is out. Sometimes moms want this, because they don't want to think about being stitched back up and just want to relax. I know what they are doing, and don't care - I don't want to be doped up.

2. I'm still debating in the whole duramorph(astromorph) thing. I probably won't want it and will take a PCA pump instead, even though the pain control isn't as good. A side effect of that wonderful duramorph (really, it works well) is itching. I itched myself into a rash after Clara's delivery and the itching was 10 times worse with Isaiah. I ended up getting 2 doses of Narcan to reverse the effects as I was about to go mad from itching. It's that deep itch all over that you can't get to no matter how much or how hard you scratch. It was horrible. The pain control was nice, and I did have more pain after the narcan, but I'm afraid of how bad it could be this time. I was itching before I even left the OR with Isaiah, and itched for 2 days.

3. Tubal ligation for me,please. Yes, this is indeed the last baby for us. It is a little sad that this will be my last time pregnant, but there comes a time when you know you are done. We are done. There are times I wonder how in the world I'll handle 4 kids...I can't even fathom 5! So while they are in there, they might as well take those tubes and be done with it. No chance for mistakes, no waiting on a sperm count, and no chance for birth control failure.

4. My baby will not leave the OR (unless need be for health reasons). It is completely possible to do the initial assessment in the OR. The scale is right outside the OR door so they can get the weight. I'm fine with letting him go to the nursery later - I just want to hold him. I bawled like a baby and couldn't figure out why after Isaiah was born. All I can come up with is he had been taken to the nursery per routine until I was settled into recovery and I was the last to hold him. I'm not sure if it was that or not, or just my hormones and tendency to cry anyway. But my plan is to be wheeled out of that OR, barring any complications, holding my baby, skin to skin. Skin to skin may wait until I'm in recovery, but it will happen at some point. I wish we did this more routinely for all c/s patients. Not everyone would want this, but we are working on being more baby friendly. Now watch me be wretching so violently that this can't happen. Oh well, if all goes well, that's my plan, if not, then I'll hold him as soon as I can.

5. Then, once I'm ready to be moved to my post-partum room, then I'll let nursery have him to do his bath. Depending on what's going on in the unit, I may want him to have a Leboyer bath - they like that much more than the standard wipe down under the warmer. We'll see.

Again, I know that things don't always go as planned. I could end up hemorrhaging, feeling like complete crap or the baby may need extra care. But, if it goes anything like my last uncomplicated delivery with Isaiah, it could be a great experience. We'll see how it goes. I plan on talking to the pediatrician to make sure she's comfortable with it - I doubt she'll care. I have a few months before we're really even close to D-day.

Patience

2010-06-17T19:28:00.002-05:00

In any line of nursing, you will have your good shifts, and bad shifts, awesome patients who you mesh well with, and then, well, there are those more challenging patients that really test your patience. I was once put through the ringer with probably the most frustrating, challenging patients I've even taken care of. She was pregnant, completely and totally wasted drunk, and in preterm labor. She kept begging me to help her because she was cold and thirsty. But she refused to wear clothes or a gown, kept throwing the blankets off of her and vomiting all over her bed. I can't tell you how many complete bed changes and bed baths I did the night she was in. I've never been threatened so many times with bodily harm (I was pregnant at the time, go figure, but I was never in any real danger, as she was VERY small), cursed at so many times, and just plain abused. Multiple times I had to convince her that she needed to keep her IV in, that she should vomit in the basin, and shouldn't get up and walk down the hall naked. I tried to get her to put a gown on to help keep her warm and she grabbed it, blew her nose on it and threw it at the tech helping me. She purposefully peed and defecated in her bed as I was getting ready to put in her foley catheter...all because I wouldn't give her water, not because she refused the catheter, that she was ok with. She was vomiting - we don't give people more stuff to put in their stomachs when they are vomiting. I developed a real respect for ER staff and psych nurses for having the patience to deal with drunks and people you can't reason with. There were several times I wanted to shake her shoulders and get her to listen...I could have reasoned better with my kids than her I think. It was very, very frustrating. The bad thing was is she was in preterm labor. She did agree to let me do things to stop her contractions. I wasn't ever able to pick up contractions because when she was awake, she never sat still, but oh, she would shriek when she had one. We gave terb, Mag Sulfate and eventually we had to transfer her out to a hospital for higher level of care in case she delivered. Because of inclement weather, she had to go by ambulance...which meant that I had to ride with her. I admitted her right at the start of my shift and arrived back from the transfer 5 minutes before my 12 hour shift ended. I have never been so exhausted mentally as I was that night. But I was able to maintain my cool, and somehow, she seemed to trust me. Well, trusted me more than anyone else. Other nurses came in multiple times during her tantrums and she threw things, hit a couple of them but she never hit me. Eventually, I told everyone else to leave and the patient and I came to an understanding. I'm not saying it ever went smoothly, but she did eventually cooperate with me, and she never actually hit, bit, vomited on me or kicked me like she threatened. I never found out whether or not she delivered preterm or not, but I never saw her again. I just hope she delivered a healthy baby and got the help she needed.

Why?

2010-06-16T09:52:00.004-05:00

Working in OB, I've learned that there is one thing that I will never understand. It doesn't make sense to me that someone who cares nothing about their baby, will come in to the hospital, 32 weeks pregnant, completely drunk and high, and they go on to deliver a healthy baby. But at the same time, a perfectly deserving, loving couple can try for a long time, finally become pregnant with that little miracle, only to get the devastating news that it has a condition that isn't compatible with life. One mother does everything she should NOT do: drinking, drugs, horrible diet, etc. The other does everything she can to make sure she is giving her baby the best start: folic acid before conception, prenatal vitamins, excellent diet, etc. And who is it that suffers the loss? I guess I'm not meant to understand and I'm sure God knows what He's doing, but it's really hard to see down here. I know I've talked about this before, but this is one of the most difficult aspects of working in OB.
I joined a group of women who are all due in October. It's been fun to watch others grow and progress along with me. As you maybe guessed, one of the women received devastating news yesterday. I just pray she and her family finds the strength and comfort they need in the many tough days, weeks and months to come.

20 Weeks!

2010-06-10T11:31:00.003-05:00

I've made it to the half-way point! I can't believe that in another 20 weeks, I'll be holding a new baby! I'm feeling pretty good. I'm feeling quite a bit of movement and Husband was able to feel the baby move for the first time last night. I swear this child likes to do acrobatics on my bladder. It is very reassuring to feel all the movement...although it's just light little kicks and punches now, in a few weeks they'll be much bigger. I had the anatomy US this a.m. and everything looked great! It's such a relief, especially for a paranoid pregnant mommy like me! Heart had four chambers, regular rhythm, 2 functioning kidneys, fluid levels good and the baby is measuring a few days ahead of my due date of 10-27, and more along the lines of the EDC my LMP would have given of 10-22. But there's no need to change the due date at this point. Plus it's a matter of a couple days, so I think it's better to keep it where it's at. Oh, and we were able to see what this little one is....

He was quite willing to show off his goods. The sono tech kept laughing, saying that it seemed he wanted to make sure we knew he was a boy! Even when she was getting profile shots, he was "presenting"! I hope that's not an indication of the future....a 2 year old running around after ripping a diaper off! We're pretty excited. Clara had hoped for a sister, but I think she'll see the benefit of not having a sister - no one taking her clothes, make-up, jewelry, etc. It would have been nice for her to have a sister, but Husband and I didn't care, we just want a healthy baby. We are going to have to sit down and try to come up with a name. We had a hard time coming up with Isaiah's name, so now we are really low on ideas. It has to go with the other kids names, so it's not like we can have some trendy, modern name either. I kind of like Samuel or Caleb, leaning toward Caleb, but Husband isn't sure yet. But he doesn't have any alternatives. The day I ran across Caleb, I called Dr. Sis and asked her to give me a suggestion, without telling her I thought Caleb would be alright, and her suggestion was Caleb. That's a sign to me! We have some time to think about it, and search through more names. Any suggestions would be great though!

8 Years

2010-06-08T14:54:00.004-05:00

I can't believe that it's has been 8 years since I walked down the aisle and married my first love! Who would have ever guessed that in 8 years, we'd be where we are today: 3 wonderful children, and 20 weeks to go until our 4th child is born. I'll admit it hasn't always been easy, but I wouldn't change anything and would gladly do it all over again!

Passing Judgement

2010-06-03T18:02:00.006-05:00

Being a mom is tough, even without other people looking at you, judging how good of a mother you are. We live in a small town, and our house is on a corner lot...we have a good sized yard, and one of the roads is a main drag in town. It's not a busy highway by any means, but it does get a fair amount of traffic. It does make me nervous...I still don't let Jacob play outside without supervision...call me paranoid. Anyway, there is a old widow 2 house down the road from us and she is one of those old women that always is giving her opinion on what you could do better, that you suck as a mother, that kind of thing. I really try to ignore her but it gets to me sometimes. I don't know if she looks at our yard, which needs a good trimming, we don't have nice landscaping, our house needs painted and we have a gravel parking lot that we are letting weeds take over part of in the hopes that eventually we can have grassm, and thinks we must not take care of our kids. To the contrary...our yard looks like crap because we spend time with our kids. Today I took the kids outside and I was actually trimming the bushes, (something I hope I don't have to do in a few years with 2 sons, possibly son #3 gestating) and Jacob was pulling Clara and Isaiah up and down the sidewalk in the wagon. They were actually behaving. I'm fine with them going down to this widow's driveway and then turning around. Which is what they were doing. I guess maybe she didn't see me and assumed that the horrible mother down the road wasn't watching her children, even though I was just in amongst the forest that lines our porch and could see them. I could run after them and they were within earshot should I need to get their attention. She felt it necessary to walk down the sidewalk with her hands on her hips to see where I was. I just smiled and waved once she realized I was indeed watching my children. It's not necessary for me to follow directly behind them at all times. She then turned around and walked back up to her porch. I swear, it drives me crazy. I know I'm not the only one she does that to, but damn, it's irritating. My kids aren't ever outside unsuperivsed, and like every other mother out there, I do the best I can. There will be times they get away from me, or do something I wish they wouldn't have, but ask any parent whose kids are grown and they'll tell you...it happens, there's not a whole lot you can do but do your best. Time must have clouded her memory of the days of many small children running around. I have half a mind to really give her something to talk about. I think next time she's outside, I'll put on a white tank top and let my belly hang out the bottom, cut off a pair of my jeans so my butt is hanging out the bottom and see if I have a thong I could put on and let the top poke out the waistband, yeah, and I'll leave the top unbuttoned, grab a wine glass, pour grape juice in it, and put an unlit cigarette in my mouth next time I take the kids outside. I'll go outside, holler at the kids, chug down the "wine" and see what she says. I bet she'd be speechless!

A Superstitious Bunch We Are

2010-05-28T16:04:00.004-05:00

I think that all L&D nurses are superstitious. Maybe in other aspects of our lives outside of the hospital we aren't, but when it comes to uttering the "Q" word, or some other blasphemy, the labor gods answer with a hearty "What, quiet, you say? We'll fix that for you right now!" Or have a good hair night and you'll end up in the OR. For example, lets say you have a patient or two, laboring, or a stable pre-term labor, resting, FHR is beautifully reactive and nice progress is being made with the labor patient. But just let someone say "Boy, that's a nice strip" or "Man, we aren't busy, are we?" and watch out! About 30 minutes later, ER will call with 5 laboring patients, one a grand multip needing a repeat c/s and tubal, one of your patients with a beautiful strip will suddenly have a nasty deceleration out of no where, your preterm patient starts contracting and everyone who is laboring delivers at once. That's why we never say the "Q" word. Anyway, this was why I knew I was in for it last night. I was having a good hair night. The 3-11 nurse gave me report on my staged induction patient. Typically, these patients will get a cervical ripening agent, like cytotec or cervidil, and rest most of the night. The evening RN said "She'll be an easy patient for you. Her baby looks fabulous, the couple is very sweet and excited. It'll be a quiet night for you". Uh oh. You just jinxed it. So I go in check on my patient and she is indeed very pleasant, resting, not needing a thing, said she wanted to sleep and would call if she needed anything. OK, so a couple hours later, her baby starts having decels - the late kind. They resolve with appropriate interventions, only to return shortly, her previously nice clear fluid is bloody and baby takes a dip to the 60's for a few minutes - not appropriate behavior for 2 cm. Doc was called, he decided that delivery needed to be now, by c/s. So it's on with the OR cap (thus bye-bye good hair!), and back for a c/s. Nice delivery as far as c-sections go. I did feel like I was moving in slow motion for some reason though. I almost forgot to do a "Time Out" (a patient safety thing where we verify right patient, right procedure, right equipment) and I NEVER forget to do that. But I did remember, no worries. Then we couldn't find a lap sponge for a minute but found it under a towel, one doc tossed a bloody lap sponge in the bucket, but missed and it landed on my shoe, then we couldn't get the darn recovery cart to raise the head of the bed high enough for breastfeeding, so we were creative with pillows. Just minor irritations that had nothing to do with the patient, but made me feel inept for a bit. Anyway, I get her recovered, moved to post-partum and sigh a sigh of relief for a good outcome, happy patient and I'm a happy nurse. While I was back in the OR, the unit filled every labor room! Then, ER calls, another patient, in labor, repeat c/s. It's getting close to end of shift, and I go in to help with the IV start. I'm pretty good with IV's: I'm typically the one who can get it if no one else can. What happens? I blow not 1, but 2 freaking great veins! And my blood work I drew off? Clotted. Quite frustrating, probably wouldn't have been quite as irritating to me (and I'm sure the patient was even more frustrated with me) if I wasn't a hormonal pregnant woman. But, the shift ended, I got my charting done by 8a.m. and went home with crazy hair and slept. So, like I was saying, we are a bit superstitious. Now don't go reading too much into this that I'm complaining, don't like my job, or read any negativity into this post. It's not there, but sometimes it's hard to get tone into a post. I like busy, I love deliveries, I love the unexpected and don't mind mussing my hair with an OR cap, but had that evening shift RN not said the "Q" word, who knows how the night might have gone! One dayshift nurse said I could help my patients out by not brushing my hair before coming in! :) Hope everyone has a great weekend!

18 weeks

2010-05-26T10:45:00.006-05:00

This week the wee one is about the size of a bell pepper, according to babycenter.com. Another 2 weeks down! I'm almost at the half-way point, and only 6 weeks from viability! I have a sono in about 2 weeks, so I'm looking forward to that, praying that all the measurements are good and that the baby looks healthy. Would also be nice to find out what sex this wee one is so I can buy some fun clothes. We have most everything else. We just need bottle nipples, diapers, and clothes.

Vital Signs: + 4 lbs from pre-pregnant weight. I'm quite surprised that's all I've gained so far. I figure I'll make up for it in the third trimester. BP 96/56. It seems to catch the tech off-guard every time she takes it. I just explain that I am pretty active and that I (until recently) am a runner. FHR of 156, nice and regular.

Cravings: Potato and cheddar pierogies with butter, Triscuits with cheese and Olive Garden salad

Movement: Yep. Feeling the wee one move everyday, still very sporadic at this point, but he/she is making his/her presence known!

S/S: I'm still up peeing all night. I do drink all the time because I get this taste in my mouth, almost like cotton-mouth, and I keep trying to get rid of it. Still get a few bouts of nausea, but it's not bad. I am also starting to have a few Braxton-Hicks (boy, I hate that term for some reason) contractions, nothing painful, very sporadic, but they are there. There was one night I noticed them coming about every 5 minutes or so, but by the time I realized they were that frequent, they stopped. With my other pregnancies, I started having these starting at about 22 weeks and they never caused any problem, but this is a bit early. I guess I did have some preterm labor with Isaiah, but I still delivered at term. I did mention it to Doc and they aren't causing any problem, other than worrying me. Part of it I'm sure is I am more focused on the goings on in my uterus this time, and it's my 5th pregnancy so maybe I'm just going to feel the growing/stretching more. I'm also having round ligament pain. I never had that with my other pregnancies until the very end, and I can tell you that I don't care for it at all. There's nothing more annoying (other than leg cramps) than to turn over in bed, half asleep and be assaulted by this sharp shooting pain.

Exercise: I'm no longer running. I had to give that up a little while ago. When I see people out running on a nice day, I'm jealous and wish I could be out there, too, but I'm doing more important things, like gestating. I've been walking, which is nice, too. Really, just chasing after the kids is pretty exhausting. The neighbor kids were all over playing outside yesterday, a total of 6 kids I was trying to keep track of. I was pretty exhausted by the end of the evening, but the kids had fun.

Here's the latest belly pic. Not the greatest shot, but oh well:

Little League Season Begins!

2010-05-22T11:43:00.003-05:00

Today Jacob had his first baseball scrimmage game. I haven't been to one of his practices yet, as Husband has taken him every time, so it was fun to get to watch him play. For kids that are 6 & 7, they all did really well! I was also very proud of Jacob. Last year in football, he liked to mess around, not pay attention and didn't seem to care too much. Yeah, there was still some messing around, heck, all of them do, but he seemed to really have fun! They don't keep score or anything, they just run through the line-up and let each kid bat and then change sides, and they just played for about an hour. They also get 6 tries at hitting the ball. Jacob hit the ball every time! He's one of the smaller ones, and I think baseball may be more up his alley than football. Clara was whiny because it was sunny and hot, and Isaiah was a mudball by the time we got home, but it was pretty fun. I always enjoyed the summer baseball feeling and it's even fun watching the kids play and not being a player! I will say that it is a good thing that we get to ease into this sports/activities thing...it's going to take some juggling of schedules once we get all of the kids into their various activities, but it will be fun! I just wish I would have taken my camera to get some pics. Next time!

Deje Vu

2010-05-19T09:24:00.004-05:00

Last two shifts that I worked, I had 2 very similar births. Both were multips, with a history of fast labors - very fast labors. They both came in, almost complete. I could tell they were ready to rock as they were wheeled into the room - both were sitting in that tell-all sitting-off-to-the-side position. But they both managed to smile in between contractions. The similarities were many: Same doc, same labor room, same labor nurse (myself), same scrub tech and same nursery nurse and approximately the same time in the morning. Doc managed to get in from home in time to catch the baby - and he is one that takes about 15 minutes to get in. He laughed after the second birth and asked if this was something he should expect from me. I told him "If it were up to me, of course!" All of us in the delivery room had a good laugh. Both moms were very well controlled and even tried not to push so that the doc could get there in time. I'm always amazed when mom's can/are willing to do that when every fiber of their body is telling them to push and their body is pushing against their will. Truly amazing. But they did it, both had beautiful births, quick, less than 2 hours start to finish! and both had beautiful healthy babes that took to breastfeeding like champs! After my dry spell of births, it was nice to have a couple of births just like these!

Control and Everyday Miracles

2010-05-14T14:58:00.009-05:00

I see miracles every time I go to work. From every pregnant woman that comes up in labor to every new mom holding her newborn. Sometimes we forget how miraculous pregnancy really is. One egg and one sperm meet under circumstances that have to have perfect timing. They combine, divide over and over and over, perfectly. Each mother's body knows how to nourish this new life, how to keep it safe, and it knows when it's time to start that amazing process called labor that we have yet to completely figure out. The body knows. Then after some time, a new life is here - a newborn baby, and with it's first cry makes it's transition from its amniotic fluid world to an a world where air fills it's lungs.

Sometimes things aren't always so "perfect". Sometimes the timing of the sperm and egg meeting is perfect, but fertilization doesn't happen. Or it occurs but it doesn't divide just the way it should. Or the woman's body starts labor a bit too soon, or there is a complication that threatens the life of the unborn baby. We have technology to fight it. We have IVF, IUI, progesterone, clomid and many other meds to try to help pregnancy be achieved. We have cerclages to help keep a shortening cervix from opening. We have terbutaline and Magnesium Sulfate to try and stop preterm labor. We also try to prevent seizure and lower blood pressure from pre-eclampsia with medications, including Mag Sulfate. We have vacuums, forceps and operating rooms for when something just isn't going like we want and we need to get the baby delivered. Sometimes we are successful in controlling mother nature/playing God. Sometimes we are not. Sometimes God/mother nature/whatever being you believe in, lets us know that WE are not in control at all. Sometimes it is revealed that the baby has birth defects that are incompatible with life. Sometimes we can perform surgery to correct this...sometimes there is nothing we can do. We can put a mom on bedrest, start her on blood pressure medicine, Magnesium Sulfate to prevent seizures...but she still seizes. We can do NST's and ultrasounds and biophysical profiles to assure ourselves that the baby is doing fine...and then mom notices no movement and the baby has died. Sometimes we can use all the medications we have to stop preterm labor, put mom on bedrest with her head below her heart to prevent the weight of the baby from putting pressure on her cervix, we can place a stitch in the cervix to try and stop it from opening...and she still delivers prematurely. We can fertilize an egg outside of the mother's body and implant it into her uterus, hoping it takes root in her uterus, and it does...then she miscarries. Or we can use every for of fertility treatment we have over and over but she never becomes pregnant. We can rush a mom back for an emergency c-section when her baby's heartrate plummets to dangerously low levels...and the baby doesn't survive. We have ventilators, machines, meds, surgery, etc. - all sorts of life saving measures that can help a 24 week baby survive outside it's mother's womb. Sometimes that baby grows into a healthy adult. Other times it has severe disabilities...or we are unable to sustain it's small body outside of it's mother's body. Again, another reminder: We are not in control. For all we try to do, we can't control everything. But we try.

But in these instances when we do all that we know how to do and still can't stop mother nature, we can still see the beauty and the wonder of something we have no control over. We see it through tears when a perfect 20 week baby is born into his parents arms much too prematurely to survive outside the womb. We see how perfectly that sperm and egg combined and divided to make such tiny fingers, toes, hair, fingernails, a beating heart. We are astounded it when fights, and lives for a couple minutes, sometimes hours. We can see it in the infant born with anomalies that will prevent it from living outside of the womb, and notice how perfect her eyes and nose are formed, how her skin is flawless and see that baby grasp it's parents fingers in it's few moments it has on this earth. At 12 weeks and even earlier, we can see on ultrasound the baby moving and taking in it's amniotic environment.

But thankfully, the majority of the time, a full term, mature baby is born healthy into the arms of his parents, not needing any intervention from us. We aren't in control. The baby develops, labor will ensue and a baby is born. Regardless of us. He cries, he nurses, he grows into an adult that someday may have a child of his own. From one egg and one sperm, a human is formed. Just an everyday miracle.

16 weeks

2010-05-11T15:30:00.009-05:00

16 weeks. According to babycenter.com, the baby is about the size of an avocado. Some days it feels like this pregnancy is crawling, but most of the time, it seems like it's going so quickly. I know that doesn't make a whole lot of sense, but in my head it does. It's been fun so far keeping track of what's been going on - I didn't do any of this with my first two kids, and I did some with Isaiah, but just not to this extent and I didn't' take belly pics this early. It'll be a nice record since this will be my last. I'm feeling more and more certain that I am in fact feeling a little bit of movement. It's only happened a couple of times and it's very light. I would have probably missed it if I hadn't been sitting still. We finally told the kids the other night. We figured they would probably figure it out before too long, or someone would say something to them. We wanted to make sure they heard it from us. They were pretty excited for awhile, then they got off on another topic pretty quickly. Jacob and Isaiah will share a room, and right now, Jacob is pretty excited and started talking about how he wants it decorated, etc. Kids. Seems like my belly has started to pop out more in the last few days. I'm not huge (yet) but it's definitely growing. Isaiah came up to me last night, reached up, rubbed my belly and said "baby". It was pretty cure. So even he sort of gets it, although when this baby does come, it's going to rock his world. He'll be the one we really have jealousy issues with. Lately I've noticed that it's not all that comfortable sleeping on my back anymore because I can just feel the weight of my uterus in my abdomen. Oh well, I'm a side sleeper anyway. I'm still up several times a night to pee - and I have a feeling that won't ever let up. We've decided we are in fact going to want to know what this little one is. I thought a few times that we might wait, but we really aren't very patient when it comes to these things.

We'll here's the belly, at 16 weeks: