Sunday, October 13, 2013
A Christmas Letter -- because, let's be honest, it's awkward to talk about your family so much in a Christmas Card
Tuesday, August 28, 2012
I was at the beginning of my ED shift taking care of a man who I spent 30 minutes with taking a thorough history and performing a complete physical exam including a real, full, neuro exam (which any good medical student will tell you takes 15 minutes to properly perform start to finish) for his complaint of new-onset headaches...when I simultaneously get chewed out by the attending for taking too long because "we're just going to scan his head anyways" and paged by our clinic administrator frantically wondering where I've wandered off to this morning because I have a list of patients waiting for me in clinic. (note to self: evidently there are two clinic schedules and one is not correct).
--Whereas in any normal job telling your supervisor that you are in the Emergency Room will surely get you some sympathy--
I go to clinic.
First patient is an extremely complicated morbidly obese woman with a sad history and recurrent infections in her pannus (look it up--urban dictionary). And...not really my patient. She sees another resident who is on vacation (note to self: thank the residents seeing my patients when I am on vacation). But she is nice enough.
Second patient is the mother of a 3 year old with recurrent scabies. Because we all know that the real patients in peds are often the moms, let's be honest. And she was kind of mean about it when I told her the whole family needed to be treated again and for crying out loud wash the stuffed animals! Only after I told her my diagnosis did she offer up information about how, oh yeah, their cousin has scabies and hasn't been treated. Also their house has a cockroach infestation and could that possibly be causing the rash? Do cockroaches bite? Let's just say I wore gloves in there. And for the record, only Philippine cockroaches bite. That is purely anecdotal, but I believe it to be true. Please leave a comment if you know otherwise.
Have I mentioned I haven't pumped all day? At least my poor nipples got a break from all that biting this morning. Ahhh motherhood.
Back to the ER and some guy who's not very sick and not very emergent is going berserk because he was told at urgent care that he needs a surgery to pin his wrist in place and he wants it NOW. Can I call the head of ortho? Oh and by the way, no pain meds work on him EVER for ANYTHING and he's in 10/10 pain. He proceeds to laugh at some joke he makes that I do not find funny. I'm pretty sure that when I was in 10/10 childbirth pain I was not laughing. Just for the record.
I spend the next 1.5 hours trying to find someone--anyone--in radiology (where are those doctors anyways? Have they all moved to Hawaii?) who will be willing to load his x-ray from urgent care. Evidently there is a protocol for that and paperwork yada yada. So can I get the patient to sign the financial consent form that he might be charged for a re-read? Oh he's going to love that.
I am just now realizing while typing this that my patient had narcissistic personality disorder.
All's well that ends well though. I got to come home to Boyd and Edie and plenty of smiles and babbles. She is scooting around pretty successfully these days which proves to be quite amusing as she discovers all sorts of treasures on the floor. She loved eating the little cubes of beet I roasted for her for dinner. And I got to snuggle her and put her to bed in her pink fish jammies.
Sunday, July 8, 2012
Residency I mean.
Can I stop the post right there? Naw. That would be too dramatic. It probably doesn't deserve that much drama. Well, the nurses might think so, but I digress.
What are the stats you ask? Since July 1st I've...
-Delivered 4 babies
-Stitched up 2 moms all by myself
-Broken one woman's water
-Been first assist surgeon on 3 c-sections
-Helped one woman get started breastfeeding
-Pumped milk 22 times
-Done about 20 cervical exams
-Managed 8 women in labor
-Been in clinic 8 hours
-Written 4 prescriptions
-Missed bedtime twice
-Woken Edie up 3 times to feed her before I leave
-Unintentionally skipped 4 meals
-Been chewed out by 1 attending in front of the entire nursing staff
-Been reprimanded by 2 senior residents
-Been late 0 times
-Made cookies twice
-Cried 3 times
-Been called "honey," "sugar," and "sweetie" by 3 separate nurses in front of my patients
-Been asked by 2 separate clinic support staff, "how could you leave such a precious baby girl at home and come to work?" when my nanny brought Edie in one afternoon for me to feed her. That may or may not have been one of the times I cried.
And I've also made a pan of brownies. What can I say? I feel deprived missing meals so I clearly deserve extra dessert. Thankfully, while breastfeeding this doesn't seem to matter to my waistline. I do not, however, want to ask my pancreas how it feels about the sugar overload.
I love being on OB because childbirth is truly such a miracle. It is so painful and so awesome all at the same time and it is so incredible to be a part of that in someone else's life. I get to be the first person to hold their baby! I also hate being on OB. There is a lot more sadness and burnout there than a lot of people realize. It's hard. Being an intern is really hard.
I miss Edie. I miss Boyd. Only 155 weeks to go!
Friday, March 16, 2012
Wednesday, February 29, 2012
Let's start with this: I live and breathe baby. School? What is that? The dean of students actually had to call me the day my rank list was due for my residency choices to ask me if I was going to do it before the 6pm deadline. Three months ago I would have had obsessed over and finished that list weeks before the deadline. I did think about it, but let's just say it was more of an afterthought to my recent obsessions with breastfeeding, cloth diapers, and sleep, just to name a few.
Thursday, January 26, 2012
For pictures of the birth (everything PG) visit my friend Elizabeth Ashdown's amazing photography blog: http://elizabethashdownphotography.blogspot.com/
Ok, deep breath. Here goes:
A couple things happened the week I went into labor. One was that the blue and black cohosh didn’t work. I tried diligently for about 4 hours, alternating the tiny sugar-tasting pills, which I wouldn’t even blame the manufacturer if they truly were placebo. I was making enchilada sauce that day and taking the stupid little pills every 15 minutes instead of tasting my creation was truly maddening. Another was that I started up running again. At least if I wasn’t jump-starting labor I could lose myself in my ipod and work on getting fit for labor. Lastly, was finding two things online that really helped—the UK babycenter January birth club and a friend’s birth story. Both included women who were well over their due date and into their 41st week and still hanging in there. And with that I cancelled our original induction date/time at TMC for Saturday morning.
On Wednesday I called the birth center to see if I could get my membranes stripped. Somehow I knew I was close. Wednesday had been different; I just felt more somber. My 5 miles turned into 2 ½. The midwife did the strip which I laugh now thinking that I even though it was uncomfortable at the time. After the excruciating pain of labor it was like eating ice cream. Then I promptly went home and like anyone about to give birth, I made a lasagna from scratch. Best lasagna ever. Also hardest to make ever. I was contracting during cooking and they weren’t exactly painless. I was getting hopeful, but as the night wore on and Boyd and I enjoyed out last night together as a twosome the contractions died out. I went to bed at 11pm thinking I would wake up to enjoy yet another day baby-less. Wrong. And I was in for the roller coaster ride of my life.
At 5am on 01/12/12 I woke up to a pretty painful contraction. I had never felt anything like THAT before. Excited I laid in bed with my heart pounding. But nothing. Then 5:30—wham. Like being hit in the abdomen by a baseball. From the inside. Then nothing again until 6:00am. Then 6:20, 6:40, 7:00am. I wondered how long it was going to go on like this and if it would die off again like it had so many times before. But somehow I also knew this was it. I remember not wanting Boyd to see me during a contraction because I didn’t know how to hide my pain and I thought it might just be false labor. I didn’t want to be silly. But he came in the room to say he was leaving for work at 6:40am and saw me crouched over the bed. We didn’t talk about it. He went to work anyways, letting me save face like he knew I wanted to. I know that might seem strange, but it was what I needed. Come 7am, though, I was screaming it from the rooftops. He needed to come home and come home NOW!
My contractions were so intense I suddenly had this overwhelming panic about natural labor—if I was still only dilated to a 3 like I was during my visit the day before how was I going to do this? In the moment I did everything I could just to rinse the shampoo out of my hair. In a matter of minutes every class we had on relaxation, every technique we had learned was out the window and the only way I was dealing with the pain was by throwing up when the contractions hit a new level of intensity which they seemed to do every 20 minutes or so. Boyd came home by 8am (he had run to work, !?*&%!). At this point I didn’t know how I was going to sit in the car for the excruciating 20 minutes to the birth center. I also realized in that moment that waiting for real labor to start to pack my bags was a bad idea in general. I kept remembering things in between contractions and Boyd was frantically trying to stuff it all into a too-small suitcase. I truly regretted later not packing anything but a bar of dove soap for my shower afterward. A nice-smelling shower gel or at least shampoo and conditioner would have been a real bonus. Ah well, there’s always next time!
Boyd started out driving fast to the birth center, and I have to imagine that he was probably excited to use the “my wife’s in labor” excuse just in case. Because truly, there was no mistaking my state. But we hit that first speed bump on the way out of our complex and I think I squealed in hysterics. So much for a Hollywood entrance into the birth center. We did manage to make it there, albeit with a little more throwing up, and the first thing I hear when the nurse met us outside in the parking lot was, “ah a true sign of labor” at the sight of my bile-stained bowl.
I hobbled into the birth center and for the first time all day things started to feel under control. The midwife met me and instructed me to tone down my hysterical soprano notes a few octaves and to relax my pelvis during a contraction. She showed Boyd how to squeeze my hips during the worst of it, and before we knew it we were whisked into the pink room, bath running and ice chips waiting. Ice chips. Can I just have a moment of silence for this amazing invention? It was the one thing I specifically requested on my birth plan because I have an irrational love affair with ice chips. Since the birth center didn’t have the crave-worthy hospital ice (you know the airy kind), the nurse put the cubes through the blender for me! Ahhh such spa treatment! But I digress. At that point it took every ounce of effort I had just to hoist myself onto the bed so the midwife could check me. The whole time I just kept thinking, if I’m only 4cm we’re going to TMC and getting an epidural because this pain is ridiculous. Thank goodness I was a solid 7cm. That gave me a lot of motivation—transitional labor already! I could do this!
The next 3 hours were a blur of contraction upon contraction upon contraction spent in the bath tub. I only really remember Boyd staying by my side the whole time and feeding me ice chips. It’s ironic, because one of the reasons I thought I wanted to deliver at a birth center was because I wouldn’t be hooked up to anything, and so could walk around and eat etc…HA! To even imagine that someone in that kind of pain could walk is ridiculous to me. And eating? Well, we already heard about my propensity to toss my cookies, so that was out of the question. After 3 hours there was a still a small lip of cervix that was keeping me from the elusive 10cm and pushing. But the midwife said I was making sounds like I was starting to push (this was all news to me) and she was worried about me tearing my cervix so she gave me the option of either manually pressing my cervix back through a contraction and having me continue to gently push or having me stop any type of pushing while I finished dilating. At this point I felt like I was going to die with every contraction. I remember thinking—this is why women get epidurals.
They say that pushing is a relief, but I think that the contractions are just so painful when you reach 9-10cm that pushing is just enough of a distraction to keep you from going crazy. All I can say about the pain is 1) it felt like someone punching me in the abdomen every 2 minutes except that the punch was sustained for about a minute; it took all the energy I had just to remember to breathe and 2) it was so intense and such an out-of-body experience that I’ve already forgotten the sheer terror of it. So naturally, not pushing was NOT an option. But having her fingers hold back my cervix during a contraction was torture too. Needless to say my first hour of “gentle” pushing on the bed felt like the longest hour of my whole labor. Once I was fully dilated I still didn’t feel the intense urge to push and evidently this was because the head still wasn’t full engaged. My midwife had me get up on hands and knees and push as hard as humanely possible to try to break my water, which shortly afterward exploded on the bed.
The final hour of my labor was spent on a birthing stool on the floor. I gripped that thing so hard I’m surprised I didn’t bend the metal frame. After my water broke it was amazing how much pressure I felt. Her head felt like it was tearing and burning me from the inside, but once the head was delivered it was so strange how the rest of her body was perfectly smooth. I know now why I have been able to deliver so many babies as a medical student—because frankly, I could have cared less who was down there catching her. My first thought when they handed her to me was just how loud she was and how I hoped she wasn’t as traumatized by it all as I was. But I also felt such an amazing relief that the contractions were gone. I kept bracing myself for a few minutes afterward but then felt these amazing gushes of relief that the pain didn’t come.
I thought I would cry, but I didn’t. I also thought I would have some sweet image burned in my head of Boyd holding her for the first time but when they handed her to him while they sewed me up I couldn’t see his face. I wish I wouldn’t have missed that.
I also remember how beautiful I thought she was when she was born. And how perfect her little body was. Later that night after taking a shower and looking into the mirror at the hundreds of tiny popped blood vessels on my face and in my eyes, I remember how unbeautiful I looked. And how haggard, swollen, worn-out, and almost destroyed my body felt.
It was an amazing experience. One that I don’t think can be adequately described. One that already the snows of memory have softened. But one thing I can say, even when I felt so kicked to the curb that night, was the amazing sense of accomplishment I had. And when, at 3am, everyone was sleeping and I was overcome with the greatness and gravity of it all, I finally understood the scripture, “Mary kept all these things, and pondered them in her heart.” Truly, that says it all.
Sunday, January 15, 2012
She's here and she's wonderful!
Edith Lucy Gunnell was born at 3:09 PM on Thursday the 12th. She weighed 6 pounds, 11 ounces, and was 20 inches long. She has long fingers, toes, and fingernails, and lots of hair. She likes riding in the car and being wrapped up nice and tight. She does not like cold hands.