Goodbye, Chiefdom
Last Friday marked the last day (and night) I would have to spend as "OB Chief" on Labor and Delivery. I still remember (and it seems that it was not that long ago) how I spent many a workday (/night) timid and overwhelmed in triage, and it is truly amazing that I have completed my months at UCD being partly "in charge" and hoping not to be involved in too many interpersonal conflicts. I am currently on the "MIC" (maternal infant care) rotation, taking care of FP moms and babies and so I am still on L and D quite a bit. However, I'm trying to lay low, and trying to avoid getting sucked in to see random triage patients or put in orders on random people.
Rather than watching others do deliveries which is sort of what you do as chief, I hope to get to do a few myself this month.....which may happen if there aren't any more precipitous deliveries onto the bed!!
Lesson duly learned: never leave the room when you have a multip in active labor without an epidural.
Last week, a continuity patient of mine/Randy's came in in labor towards the end of my day. She'd had a relatively fast 1st delivery (which I'd missed b/c I was out of town). This time, she'd labored at home with her doula for most of the day. She wouldn't allow me to break her water and progressed steadily from 5 --8 cm.... but it wasn't quite time to push yet. The nurse asked me to come to the room as the patient wasn't able to hold back from pushing.... and, in the 10 seconds or so it took to complete our conversation, the baby was definitely coming...
I didn't glove fast enough and didn't really feel like barehanding the baby... so, at 11:00 at night, the baby delivered itself (en caul [in the bag]), and I laughed at how useless I felt or how I just spent several hours "hanging out" to watch a baby deliver itself (and without lacerations). The patient didn't need me at all!!! But it was about the spirit of continuity, right? ( Wasted bed delivery #1).
Today, I admitted a patient with ruptured membranes who'd had precipitous labors in the past (her last baby delivered on the gurney between triage and her room). She at first wasn't contracting but then got really uncomfortable... and was progressing at a very normal rate. I joked that I should just stay at the bedside so as not to miss the delivery (and her continuity provider was also notified to stick around!), but I made the mistake of turning my back when she hadn't changed much from 6 --> 7 cm in 30 minutes... and walked around the corner only to hear the staff emergency alarm go off. Sure enough, 1 minute later than my exam, head was crowning, and I bare-handed my first baby head, although there were plenty of other people in the room to help (Wasted bed delivery #2). Again, this humbled me as a provider in that really, how often do people need you for their deliveries? Babies have delivered themselves without obstetricians for centuries!!! Natural labor really is the best. But I still felt a little cheated of a potential delivery and still very much want to catch some babies this month.
Social outings
... have been few and far between in the past month. I always feel so out of the loop on L and D.
This past weekend, I got to go to Davis to meet Shabu, Serena's new shih-tzu puppy. While he is not 100% housetrained yet (no accidents on me, though!), he is just the cutest little thing. I so so want a dog... and am thinking a doggie might make a great birthday present for me and the big 3-0 in November [hint for Kelvin]...
Sorry the picture is so miniscule--- blame the Mac which doesn't save things well
Allergy hell
I thought I had bad allergies in Richmond, when the yellow tree pollen coated our dorm windows. I thought I got a bit sniffly in Rochester, MN summers.
But NOTHING I have ever experienced compares to the misery of this past week in Sacramento. I am a heavy springtime antihistamine user-- it used to be Allegra, then Costco loratadine, and occasional ($$) Zyrtec (which works the best). Since moving to Sac, I have had to add on daily flonase nasal spray which, albeit weird feeling at first, works quite well. However, this past week, I have barely been able to open my crusted, swollen eyes, due to the severe ocular allergies I seem to have. For the first 3 days of this week, people at work asked me, "WHAT is wrong with you?! You look awful!" I tried to hide my red, itchy, swollen eyes/eyelids with some fake glasses I have. The eye itching seemed to be antihistamine-eye drop-resistant. It was Visine-resistant. I could function marginally at work (it was actually a relief to be indoors... the bike ride with blowing pollen really destroyed me). However, I would come home from work after a brief stint outdoors and lie on the couch, unable to see or do anything, holding ice cubes on my eyeballs until I fell asleep and the whole cycle repeated itself.
Here is a rather tame picture of what my eyes resemble.
I was considering getting some goggles to protect me from the deadly pollen. However, this has been my savior:
I think the regular (BID) use of these antihistamine eye drops has really calmed things down. By Wednesday night, I actually felt well enough to go to "Wine Wednesdays" for a post-work tasting. Thursday, I was able to put eye makeup on again and feel like a regular person. While I have been avoiding the outdoors like the plague, today I ventured out for a run. I may pay for it tomorrow, but I have decided that I can't live inside like a sickly hermit for the next 2 months. If Zaditor fails, I hear that Patanol eye drops may be life savers. And maybe I'll need some goggles.
2 months left!
It is now after May 2nd, which means that there is fewer than 2 months until the wedding! This is incredibly hard to believe. We are excited. I am especially excited to have the big day over with, just to have more free time not sucked up with the "planning." We are very disappointed that several out of town friends can't make it, but are excited to celebrate with those that are coming!
This week, we went to the Sac County Courthouse to get our marriage license... and so now, there's no going back on the name change unless I feel like forking over another $88 (which I'm too cheap to do)....
We have our hotels for our Bali-Malaysia-Singapore trip, as well as some more specific plans like hiking volcanic Mt. Batur. We are getting gifts galore which are filling my living room.
It's starting to feel real!
Here's to a work-free, allergy-free and stress-free weekend!
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