Heads Up

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

Surprise

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

A day in the life a mother

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

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

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

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

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

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

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

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

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

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

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

32 week pictures

I'm not sure if there is a whole lot of different between last week and this week's pictures. Today I went to a co-workers house and had maternity pictures taken. Just seeing them on her camera file, they look pretty good. I'm not good at having to smilr for the camera. I end up feeling fake and silly. I'm better focusing on something else, or being caught in action, but even the one's where I'm looking at the camera aren't too bad. She got a couple really good one's with Clara hugging my belly. Jacob was too busy playing with her toy tractors to be interested, but she got one with him looking up at me laughing and all you see is him and my belly.

Everything was fine yesterday at my appointment. Little booger cooperated great for the NST, and I only had 2 contractions during the 20 minutes. Cervix exactly like it should be, long, thick and closed. The doc said that if they continue, they become painful, or don't go away with rest adn water, then she'll do a fetal fibronectin test (a cervical/vaginal swab to check for the presence of fetal fibronectin, a substance that acts like glue to hold the fetal membranes to the uterine lining. It is high in the first part of pregnancy, and in the last couple weeks before delivery. A positive test for it means you are at risk for delivering in the next couple weeks). She also said she would probably restrict me to 8 hour shifts if after this weekend my NST shows my uterus contracting every 2-3 minutes again. Things have been pretty quite yesterday and today, so I'm crossing my fingers my uterus cooperates this weekend.

JCAHO, competencies and bleeders, oh my!

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

Nurses are such bad, bad patients.

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

Belly pics and Halloween pics

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