March 29, 2010

More like this, please?

I witnessed the most beautiful, serene birth of my career last night. Wonderful couple, Bradley trained. Can I just say I love, love, love the Bradley method? She wanted a serene, quiet birth without unnecessary interventions, wanted to be free to move, and to deliver in the position that felt right to her...and that's what she got. She wasn't in-your-face, anti-hospital, or defensive like some people can be. She knew situations could arise that interventions could become necessary. She worked with us, not against us. Her view was that birth doesn't have to be the most painful thing a woman goes through. She said to me "I learned in Bradley classes that you have to train. If someone told you that you would be running a marathon in 9 months, you wouldn't sit around, you would train. So that's what I did. I trained for labor". She walked, moved around, squatted to deliver. Her doc had no problems with her birth plan, and gently helped her deliver her baby without tearing. Soft lighting, soft music, very supportive husband. I mean, this guy was awesome. He helped her stay relaxed, kissed her forehead, fed her oranges and gave her water. And mom, she decided as she was pushing to lay back after squatting for awhile, to give her legs a break. She then said "I'm too relaxed this way" and moved back to the squatting position and with one push her baby was crowning. After the contraction was done, the baby's head still crowning, she was talking to us, laughing...all while her baby's head was half way out of her vagina. Then with the next contraction, she delivered the head, and the rest of the baby came after. It was amazing. No need for IV fluids, a SL in place should it become necessary (but never needed), no IV pitocin after placenta was delivered. Skin to skin contact, baby moved herself to her mother's breast to nurse, all interventions/medications for the baby were deferred during this time, with a Leboyer bath that followed 1 1/2 hour later. Daddy supported his baby's head while she kicked and looked around at her new world, relaxing in a warm bath of water. After the bath, the baby was fully assessed, meds given while with the will probably never spend anytime in the nursery. Really, there should be more births like this one.

March 24, 2010

Pregnancy update

S/S: Oh, man, am I TIRED! Being a mother means that you are tired, and then throw nightshift on top of that and I have my baseline level of tired, but seriously, this pregnancy is kicking my butt. I could sleep all day and all night if I didn't have 3 other kids, a job and things to do. I've been falling asleep with Isaiah around 8:30, and when I wake up with a crick in my neck and my right arm tingling, I crawl into my bed and sleep until the kids wake up. There are many half-awake visits to the bathroom. I'm nauseated pretty much all day and all night, vomiting after almost every meal. I do have Zofran and it's helping, some. I can keep down oatmeal, a bowl of chicken noodle soup, toast, saltines, scrambled eggs (most the time) and 4 chicken nuggets. That's about it. I did eat half a Sub.way sandwich and kept that down yesterday. I'm staying plenty hydrated, because I'm thirsty all the time, but the whole eating thing is annoying. I'm nauseated if I don't eat, but its worse and I vomit when I do. Ugh, gotta love first trimester pregnancy. With this being my 5th pregnancy, I'm pouching out pretty quickly, although the extra padding around my waist doesn't help. I bought a Bell.aband and I've used that a couple times so I could wear my jeans comfortably. I'll start with some belly shots after I see a heartbeating on my sono next Friday. I have acne like a teenager, a short fuse, and cry at nothing. Ok, ok, I guess I cry for nothing anyway, but it is worse! I'm still a little anxious that something is going to go wrong and I won't see that little heart beating away next Friday, but I'm not as neurotic as I was a week ago.

Cravings: not craving anything at this point. I guess I would just like to eat food with more flavor than oatmeal and toast. The strange thing is that I'm hungry, even when I'm nauseated. It just doesn't make sense in my mind, but that's the nature of the beast of pregnancy sickness. The nausea is just a bit different than stomach flu nausea.

Aversions: Diet cola, anything with artificial sweetener leaves a nasty aftertaste in my mouth. Husband was cooking a ham slice the other night and I actually started retching at the smell. That was a new one for me.

Running: I really haven't been running too much because I've been so tired, and given the choice between running and sleep, I've chosen sleep most of the time. Plus, I feel the worst in the evenings, and that's when I'm able to run. I did run the last 2 days out of sheer stubbornness, and it felt good. They were nice, easy relaxing runs as the sun was setting. But, my left quad muscle feels tight and sore today, so I may not run again for a bit. Last thing I need is a pulled muscle right now.

My cat: Audrey, my female cat, has always been more affectionate and would sleep next to me during my other pregnancies. It would promptly end after I delivered. This time, I think she was thinking "Man, I thought you learned! Didn't I teach you anything, you silly human?!" and she had been avoiding me. But this past week, she's been laying on the floor in a sun spot in the bedroom while I sleep. So she's coming around.

March 22, 2010

Babies, Babies. Babies!

It was one of those nights - every time we turned around, we had another baby! Four vaginal deliveries and 1 c-section in 4 hours! I know that doesn't sound so crazy for a big, busy hospital, but when you have 3 labor nurses, including me and I was in charge, it gets a bit busy! We had a delivery right as we came on shift, which was nice. I admitted another primip for labor, and she had a cervix that just had that quick labor feel - you other labor nurses know what I mean. It was paper thin, super stretchy, baby was low and she was ruptured. She wouldn't labor long. I knew we would most likely have 3 deliveries all about the same time because the other 3 labor patients were all primips and all 5-6 cm, and same doc, which made things easy. One of the 3 was ready to deliver at the same time as one of the others - the doc, scrub tech and baby care nurse went in while she delivered, then scrubbed and went to the second delivery. Deliveries 2 and 3 of the night - only 13 minutes apart! After delivery #3, one patient was taken back to the OR - she had been laboring, ruptured, on pitocin for 40 hours and was only dilated 5 cm, and had been for several hours. So finally, she was able to hold her baby in her arms after a long, long try at labor. While that patient was being wheeled into the recovery room, my patient was complete and started pushing. She only pushed for about 20 minutes, which is awesome for a first time mom, and we had a beautiful delivery about 4 hours after we came on at 7pm! Of course, we had outpatients coming in all during the night for hydration, labor checks, decreased fetal movement, plus we had a couple inductions. Even though we were hopping from the time we clocked in to the time we clocked out, it was fun. It was a nice change from the painfully boring, slow weekend shifts we've had recently. Somehow, not sure how I managed it, but I was able to keep tabs on what was going on with every labor patient, with post-partum, nursery and pediatrics. I guess I'm getting used to being in charge AND being a labor nurse. I shouldn't say that too loud, or they'll keep scheduling me in charge!

March 19, 2010

March 19, 2010

Today would have been my due date for the baby we lost last August. While I am thrilled to be pregnant again with this new life, today is bittersweet for me. Just remembering today, and thankful to have known that life, if even for such a brief time. Remembering...

March 18, 2010

And We Have a Heartbeat, Folks!

Yes, that's right, we have a real live embryo growing away! On the way to the appointment, I was a nervous wreck. My legs were shaking as I walked into the office and I thought I'd puke from nerves. Then while my OB was doing the sono, I was watching the screen and I saw the baby, but I wasn't seeing a beating heart...I had to close my eyes for a minute to get myself together. But it was there, it just took a second to see because of the gestation. And it probably wasn't really that long, but it was an eternity for me. Nice heartbeat of 170. Today was just to check the viability and in 2 weeks, I see the nurse practitioner to do the whole work-up, pap, cultures, assessment, etc. They normally don't check hearttones at that appointment, but my OB said that she'll make a note on my chart to have a quick ultrasound, just to help put my mind at ease. I also got a nice script for more Zof.ran, which I was needed because I only had 2 pills left from my last pregnancy. I am more relaxed, but I'll be able to breathe easy in two weeks if there is a heartbeat. We did change my EDC from 10-22-10 to 10-27-10, based on the fact that I don't have a "normal" 28 day cycles, which the pregnancy wheels are based on. Mine are usually 32-33 days. The baby measured at 8w1d, which is consistent with a 33 day cycle. I'm happy about that, I want to make sure that the baby is ready when it's born, and not early because we were off by 5 days. Five days can make a big difference. I know there is always a risk, but today, I feel much better and more secure that we will in fact have this baby in the fall.

March 17, 2010

First appointment tomorrow with ultrasound

Tomorrow at 2pm, I'll finally be able to see if this pregnancy is developing like it should. I don't have the horrible feeling that something is wrong this time, which I'm taking as a good sign. Last time, from the very beginning, I had an uneasiness about the pregnancy - it just never felt "right", if that makes any sense. We had seen a heartbeat at 7w2d, but it stopped developing at approx 8w3d. When my hcg levels were undetectable by a urine pregnancy test, that was when I started bleeding at 11 weeks, and the whole process of the miscarriage started. About 18 hours before I started bleeding, I told Husband I didn't feel pregnant anymore. I'm past that gestation and hoping it's alive and well in there. I definitely feel pregnant - nauseated 24 hours a day, with bouts of more severe n&v, peeing all the time, exhaustion, ever so slightly moody :), and my pants are getting a wee bit tight. I actually had to run out of a patient room Monday night because I thought I was going to vomit - and did in the trash can in our locker room. That was oh, so pleasant. I will be buying a tomorrow after my sono if it turns out fine - I resorted to a rubber band to hold my button together yesterday. It's time for a band or bigger pants. I've been running through every scenario that could happen tomorrow and how I would react - non-viable pregnancy, viable pregnancy, twins (a coworker has been trying to bless me with twins, although two babies is the last thing I need. Can you imagine how crazy I would be with worry!?!?) , heart beating but too slow, etc. And Friday will be the due date for the baby I lost - isn't the timing great? Yesterday I thinking about the fact that I would be delivered by now, that I could be holding my newborn...but instead I'm carrying new hope for a new life, one that will hopefully be ready for our arms in October. I'll keep you posted...

March 11, 2010

A few more...

Here's 10 more signs you might have small children, courtesy of Melaniek at A Volunteer Firefighter's Wife!

March 10, 2010

Top Ten Signs You Might Have Small Children

10. You have a tub full of bath toys, a step stool, and a potty seat in your bathroom, complete with a basket of kids books for bathroom reading pleasure.

9. A whole playlist on your iPod is dedicated to kids Bible songs, songs from Elmo, Sesame Street and Dora.

8. You look forward to naptime, not only because it's quiet and maybe a time when you could get housework done, but also because you could take a nap!

7. Your work locker is loaded with your kids pictures and priceless pictures of Mommy in her "nurse clothes".

6. You don't think twice about stepping over gates and opening cabinet locks everyday.

5. You could recite the entire movie Cars because you have seen it, oh, a million times.

4. You sing the Hot Dog Dance song in the Shower.

3. You look forward to the Imagination Movers because they are the closest thing you see to adult men during daylight hours.

2. You tuck your patients in bed. I had a laboring momma who was returning to bed after going to the bathroom. I didn't think much about it, but I pulled the sheet and blanket up to her shoulders and made sure it wasn't wrinkled. She looked at me, smiled and said "You're a mom, aren't you?"

1. When giving report, you tell the oncoming nurse that your patient "Just got up to go potty".

March 9, 2010

Progress Report - Pregnancy #5

I'm finally starting to actually feel pregnant. I remember feeling that way from the very early beginning with my last two pregnancies and I've been waiting to feel that way this time around. "Morning Sickness" has started in, although it isn't horrible.With Isaiah and the m/c, I was nauseated all day, everyday, with lots of vomiting. I really only feel a bit nauseated at times, more of a sour stomach feeling than anything, and it's mainly in the evenings, which works well since I go into work at 7pm. I'm still a bit crampy on and off and for a day or two I had convinced the crazy part of my brain I had symptoms of an ectopic pregnancy...that is until the nurse part of me realized it's just round ligament pain. Man, I'm annoying like that! My pants are getting snug(er) and I can't suck my stomach in as much. It's amazing how much faster you start to get puffy your 5th time around.

I'm starting to enjoy the fact that my co-workers (except for 2) don't have any idea I'm pregnant. It's almost like a little game. Because I work OB, everything has to do with pregnancy. Feeling a little sick? You must be pregnant. Feeling tired? Gassy? Heartburn? Irritable? Hot? Well, you must be pregnant. Friday night, a few people asked if we were going to have anymore, if we were trying. "Oh, someday we might have another(in October)" "Well, we aren't trying per se (the deeds already done)" Then I just laugh to myself. It's been fun. Husband thinks I should deny all the way to delivery. "No, I'm not pregnant, I'm not sure whose prenatal record that is or why my abdomen is huge". And then after the baby is born, I can say "See, I told you I wasn't pregnant!". Really, I am easily amused.
Sunday night, one nurse did call me out. She is notorious for this. I'm not sure how she does it, but she always seems to know when someone is pregnant, usually before they tell anyone. We were sitting at the desk as it was S-L-O-W and she looks at me and says "You look different, you're glowing, are you pregnant? When was your LMP?" Yep, only an OB nurse would ask "when's your LMP?" I told her, "No, I"m not pregnant" but I guess my face gave me away because she was relentless until I couldn't lie anymore. And there was another nurse and a secretary at the desk. I told them under no circumstances could they tell ANYONE because I didn't' want to tell anyone until at least my sono on the 18th, but probably not until later than that. Well see. She's not good at keeping secrets, but she understands so maybe my secret is safe for now.

March 5, 2010

A Couple Videos for your Viewing Pleasure

I've never posted videos before, but I stumbled across these while playing around on the internet today and I thought they were pretty funny

And since I did work in critical care for awhile, I found this entertaining and educational:

March 4, 2010

Advanced Directives

Do you have a Living Will? Do you have a Power of Attorney for Healthcare? Well, you should. Anytime someone is admitted to the hospital, we ask them if they have an Advanced Directive. Most women of childbearing age don't have this, and feel they are too young to think about end of life decisions, and who will make them if they are unable. By default, those decisions would fall onto the spouse and they think that said spouse will know what they would and wouldn't want done. In a situation like that, your family members are hurting, may be in denial, and may not know what you would want. Make it easy on them, put it in writing. I urge everyone, especially the young and healthy to think about what they would want done, to what extent they want their life extended if they are in a situation that they can't make that decision themselves. Think about it. No one plans on the unthinkable, but the unthinkable can and does happen. Here is a very poignant post as to why you should think about this.

March 3, 2010

Something I love about midnight inductions..

...Is that sometimes they are already in labor when they come in! My midnight induction the other night was a multip, and just 3 cm when she came in, but her cervix was thin and very stretchy. Hmmm, maybe I'll just take my time admitting her, and recheck her in an hour before starting pitocin. Wouldn't you know it? 6cm. WooHoo! Thirty minutes later, her water breaks, she asks for the epidural and she delivers before the end of my shift. Gotta love that! It's great to be able to admit someone and see them through to delivery. Especially someone who thought she was in for a long induction of labor. She had said she was induced last time, that it took 18+ hours and she pushed for 2. Not this time. She had less than 6 hours of labor and only pushed a couple times! She was thrilled, I was thrilled, and her doc was quite surprised when I called her for delivery but was happy she delivered so quickly and easily. Isn't spontaneous labor awesome?!?!

March 2, 2010

First Status update for pregnancy #5

In an attempt to be more positive, I'm going to go ahead and start keeping a record of how things are going during this pregnancy, like I started to last time. I'm actually feeling pretty good, which of course adds to my worries...ahh, the neurotic-ness of nurselochia.

Aversions: no food aversions, but after a diet cola, it does make me just the slightest bit queasy.

Cravings: I was craving oranges, radishes and salad a few days ago...strange, I know! But it's better than craving, oh, cheeseburgers or Blizzards from Dairy Queen.

S/S: Really, I'm not having all that many symptoms, but I try to remind myself that I didn't have ANY with Jacob, outside of being tired. I am pretty tired and I've been going to bed about 2-3 hours earlier than normal, and feeling more tired at work. My energy level is definitely the major s/s. Every now and then, I feel a bit nauseated, but nothing too horrible. I am peeing all the time, but I do drink a lot in general. I was up 3 times today while I was trying to sleep, which was annoying. I noticed today that for the first time the ladies were sore, which they hadn't been. After having mastitis a few times while breastfeeding Isaiah, and having nursed for a total of 5 years, it's hard for me to really know sore breasts because really, I've had much worse. I'm pretty moody and as with my other pregnancies, smells stand out more. I've been again trying to rid my house of the "odors" that no one else seems to notice. I am also a little crampy on and off, and while I know cramping is normal in early pregnancy, it freaks the hell out of me. I don't remember being crampy with the kids, just felt "more aware of my uterus". I was crampy with the m/c, so any little cramp worries me. They are never really painful and I'm not bleeding so that's good. When I was pregnant with Clara, they asked me at my first appt if I was crampy, and I guess I did say yes, which led them to check my progesterone and put me on a supplement for the first 12 weeks. I don't know much about progesterone levels in early pregnancy, but I also thought I was 9 weeks, and was only five weeks when I went in (thanks to breastfeeding and irregular periods). So maybe that was a factor. Who knows.

Running: I'm obviously not training for a half-marathon anymore, but I am trying to keep up my exercise. I haven't been running since last week since I worked all weekend, but I plan on going tonight and doing 3-4 miles on the treadmill. But we'll see if I can drag myself out to the gym tonight.