November 30, 2007

My wish list

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

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

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

November 28, 2007

Remembering Mirabel Ozara

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

I Thought Of You

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

November 27, 2007

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

November 25, 2007

Counting flowers on the wall...

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

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

November 23, 2007

And a happy birthday to me

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

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

November 21, 2007

The progression













34 week belly pics




Good times

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

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

November 19, 2007

Pubic hair inhabitants

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

November 16, 2007

Heads Up

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

November 13, 2007

Surprise

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

November 9, 2007

A day in the life a mother

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

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

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

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

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

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

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

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

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

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

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

November 8, 2007

32 week pictures


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





November 6, 2007

JCAHO, competencies and bleeders, oh my!

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

November 5, 2007

Nurses are such bad, bad patients.

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

November 1, 2007

Belly pics and Halloween pics

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