Ninety-six

So tired.

These were the hours I worked last week-- M-F 5a - 7p and then Sat 5a-Sunday call, which was 28 hours of never-ending busyness ending earlier this am. Is this a good enough excuse for not blogging earlier? Usually I am all about socializing (and communiating) despite utter exhaustion, and was able to go to that baseball game earlier this week as well as hang out with my OB and FP/OB classmates at a double-booked Thursday evening outing (first, Three Sisters Mexican with Lucy and Charmian; then yummy Thai food with Kyla, Aline, and Antoinette). However, some of my FP classmates went out on Fri. night to celebrate Phi's 30th b'day on Thursday, and I had every intention of going; however, I just had to take a nap b/c I was too dang tired, and that just turned into a night of not getting out of bed in preparation to return to work early the next a.m..LAME.

Last night was scary busy. I think there were upwards of 10 admissions; about 6 people actively laboring at the same time, 3 pairs of twins in (one with vertex-vertex presentation, which is amenable to vaginal delivery and which I'd hoped to deliver on my shift but they weren't quite ready to start pushing!); a VBAC (vaginal birth after cesarean; comes with risk of uterine rupture), several no-prenatal care patients (makes the job, and gathering information, much more difficult!!), a code C-section as well as one other due to transverse presentation and failure to descend, and the scariest shoulder dystocia (when the baby's head comes out but the shoulders get stuck behind the pubic bone) I have ever seen. The baby had a long decel and had to be pushed out STAT; but it was a big one (9#14 oz) and it just got stuck. The clock was ticking... They (it should have been "my" delivery, but I just backed away I was too stunned) tried flexing the mom's thighs, suprapubic pressure, rotation-- none of it was working. They cut a generous episiotomy and, close to four minutes after starting to try, Dr. B was eventually able to reach in, grab the posterior shoulder and arm and pull the baby out, but holy cow. I stood there shocked and so, so frightened. The mom was in near-hysteria with fear. I had never seen a face that purple. Baby had an apgar of about1 at first- floppy, no breathing, and peds took over and took him to the NICU. The mom then had a pretty significant post-partum hemorrhage requiring methergine and rectal misoprostal. I hope baby does okay-- mom is stable. OB can be terrifying at times with the acuteness of the problems (sorry, Laura!).

We were seriously running the entire call. No one even really had time to sit down and eat. My pager memory filled up twice with pages. It was absolutely ridiculous. As far as clouds go, I am definitely a BLACK one (see Wendi's post from today :)).

I came home and slept the day away, but have to gear up again-- the week starts again tomorrow around 5 a.m.! Although it's generally not a good idea to do math post-call, I was interested in figuring out the hours I'm doing because it just seems like too much. These are the hours for the last three and the following week I'll do (five days plus terminal Friday night call): 75- 75- 96- 85.5. If you average this out over the "month," it is not 80. It is not under 80. It is 82.7 (VIOLATION!), but feels more like a million. And I certainly don't have a 24-hour period off this week. Rough stuff!

Good news? I think the hours at the VA (where I start my medicine month on Monday) may be a bit better..., although I hear you have to deal with sexual harrassment from the vets and nasty food (I'm sure it [meaning the food!] can't be that bad... at least it's free!)... You gotta just keep on truckin'... Residency is hard!!!!!