Spiders

I think there are spiders in my lovely dark basement room. Well actually I've killed two tonight, I know there are spiders. Those were the only two though. There are some things that I am okay with lying to myself about. I have shallow taste in movies, but don't think I'm shallow at all. I shower once a day at the most, but generally consider myself cleaner than other people in the elevator. I never eat vegetables or do aerobic exercise and I think I'm very healthy. But it's ok.

And without a graceful transition I'll go right into saying that I found out yesterday that my Grandma is sick once again. Her ovarian cancer has returned and she had a round of chemotherapy last week. Mom says she stopped eating a few days later and Grandaddy took her to the hospital, where she was admitted. I'm thinking about the nurses who are taking care of her. I've imagined a nurse getting report about the patient just admitted in room 16, Mary (because they probably don't know to call her Betty, and I bet she wouldn't correct them) starting her IV, asking her to pee in a cup, finding out what medications are ordered. Before they actually start doing all that I bet they go through a long history like we do in labor and delivery, that includes asking people if they have electricity in their homes and if they have any spiritual needs. I'm not sure what "stopping eating" means is happening. I guess the goal of the hospitalization is just to get her eating again and restore her energy. Pray for her. I hope she's okay, Mom's driving up to see her today after she takes Christie to the airport.

Welp now it's 6:30 and I'm going to bed for the day. Today's picture is of an office prank. I think I read about it on Yahoo Odd News, which is usually great. Reminds me of a movie my Mom used to like, Real Genius, where they fill the house with popcorn. :)

Nights & Who's Line

So life is good, night shift is fine, and I've caught 2 more babies and done my first laceration repair. The repair was SO hard. I could hardly see what I was doing because of all the blood, and the suture kept sticking to my gloves (which I sure as heck was keeping on!), and I forgot to wear shoe covers and dropped a big clot on my shoes, and it took like half an hour. But the midwife helping me said it was a complicated repair anyways and said I did okay. I got to use a subcuticular stitch (sewing immediately under the surface of the skin) so it looked really pretty in the end, no visible stitches or knots. Well, relatively pretty.

This was all last night, it was a crazy night, we had 4 patients in labor at the same time. I only cried once, when I was wheeling a woman out for a section and I looked back at the Dad, who was shaking with sobs in the now empty, flourescent-lit labor room. Luckily everything turned out fine for them. She had been in a minor car accident and hit her belly, and we did a lab test that showed that she had fetal blood in her circulation, which means the placenta was starting to detach. But like I said, baby and Mom were totally healthy in the end. No one can tell you're crying if you're wearing a surgical mask anyway, as long as you don't let your eyes run over.

I really needed to debrief afterwards so I called Lydia, who was trying to sleep in preparation for her night shift tonight, and told her all about it. I felt a lot better afterwards. I'm so glad she's here and working at the same place as me.

So tonight I'm off, woohoo! I'm planning on watching my new favorite show, "Who's Line is it Anyway?" but only if the black guy Wayne is on it. I actually laugh out loud when I watch it. He's like a genius, especially when he has to make up songs. (Christie likes Colin best, the Canadian guy.) And I am comfortable with being totally sexist about it, because the women just aren't as funny. It's like when we used to have to do skits in college, guys are just better at it.
Yep.

Swing report

Swing dancing was medium fun. I ran into Jina and Laura there, two girls I sorta knew from Covenant who graduated from Vandy, and they introduced me to some people they were with. Then Jina and Laura left, and I went to ice cream and then a bar with their friends. The bar was one of those things where you can sit outside on the patio to hear the band play, not a gross smoky inside deal. They played U2 and Coldplay and I talked to (yelled at) a Chinese medical student who reminded me of Ken. He said his favorite book was The Brothers Karamazov, which I have never been able to slog through.
Okay now I gotta go get ready for night shift. Thanks for all the comments lately guys!

Addendum: when I was at the swing thing, this guy introduced himself to me by saying "I'm Joel. I'm a terrible dancer. Do you want to dance?" And I said "well uh, do you know how to swing?" and he said yes and then changed his mind when he saw me starting to walk out towards the floor. It was really annoying. Then he said he wanted to learn, but he didn't actually. Then he asked me some polite questions until I trailed off with my face and introduced him to Laura, and myself to the cute Chinese guy.

Alarm clock

Well, I bought an alarm clock. The alarm on my cell phone is woefully inconsistent all of the sudden; resulting in late wake-ups all 3 mornings I had to be at clinical this week. Luckily by the 3rd morning my ex-roommate Lydia was calling me to get me up. She's been on night shift all week.

I'm going to nights tomorrow, and I'm a little nervous about it. I'm sure I'll have trouble staying awake- one thing that probably wasn't communicated by my last post is that it's been REALLY BORING at clinicals other than that birth and an interesting preeclamptic yesterday. Lots of sitting around, hoping for a midwife patient to show up.

My fabulous sister Christie is leaving soon for her trip to Greece, Italy, and France, so I've been giving her my winning travel advice on the phone, like "don't take pictures of fields and buildings" and "throw your purse in the bottom of your sleeping bag at night."
Tonight there's a big band thing at the park, so I'm gonna go see if there's any swing dancing going on. I went to some swing thing last month that was so fun, I've been looking to duplicate the experience ever since. That's a pretty geeky way of saying it but I forgive myself because it is definitely what I mean. I wish I could have the same exact thing happen again.

Oh yeah, one other thing. My favorite Californian, Em Monty, has recommended the numbers game Sudoku. I downloaded it the other night, played it once, and got nervous about getting addicted--it's fun. I'm going to try to add it to my links list.

Christie 

Dad with cool Christie 

First catch

So I'm all over that whole back-dating, cheating-on-when-you-post thing I guess. Here's the story of my first catch:

At 6:20 am I jumped out of bed and took one of those showers where all your hair comes out. You know, the kind after you've skipped a day and worn a ponytail all day to disguise the grease. I am technically supposed to be at the hospital by 7, but most of the nurses have this nasty habit of showing up at 6:30, so whatever. Anyways I was 15 minutes late but it was okay because my preceptor had been on call all night and was still sleeping in the call room when I arrived. :)
I went to resident rounds, spoke up and felt really dorky in front of the docs, saw the single postpartum patient with the midwife, and started to sit around and talk to the care partners and get bored. Around 10 the charge nurse said, "good news! a midwife patient is coming in, she's in labor!"
So I jumped a lot in the hallway.
She didn't speak much English, was Muslim and only wanted female care providers. Mostly her husband talked for her, but when he went out to smoke we talked about her life before Tennessee and her family. This was her 4th baby, she'd had one previous section and the last two were vag deliveries, so she was cool to have another one. She was 40 weeks and a few days. She came in at 5 cm, contracting every 3-5.
She asked for an epidural at 6-7 cm, about an hour later, and everything just stopped.
She went to sleep for a couple of hours and I just sat there and talked with her husband. When I asked him, he said he wanted to do that thing where the first words the baby hears is her father's prayer in her ear. Later I went around and told the nurses that we should try to be quiet after the head was born so they could do that. That was probably sort of annoying of me but I was REALLY excited that I remembered that thing about Muslim births, and wanted to advertise my cultural competency probably. Whatever.

After 4 hours of sleeping with contractions getting farther and farther apart, like 15 minutes, we asked her if we could break her water. She said yes. She had a few contractions, and I sat her up in bed, and an hour later they were almost gone and she was sleeping again.
Then I thought, "I can't be a midwife. I'm too impatient. This is making me crazy." And I felt like I understood why people get in such a rush sometimes, when there's not really any indication. The baby looked great on the monitor, there was no mec in the amniotic fluid, things were fine. I didn't feel the urge to check her a lot, just to get things going again.

So I tried to read my textbooks about the dangers of using pit in a VBAC and chill out. Then the midwife was like, "yeah, let's pit her, she's totally stalled out." I was really excited, because our shift was over in like 2 hours and I really wanted to catch this baby. After a lot of discussion and an embarrassing faux pas with the nurses, we got in there with the pit, explained our recommendations, checked her, and discovered she was complete. So, no pit. :)

After a few minutes, she started pushing, and the midwife had me check to see if she was actually moving the head further out with each push, because she still couldn't feel anything. Then I was the one at the end of the bed, encouraging her to keep going and also to take a break and I felt a little awkward but psyched. When we could see the head, I gowned and started supporting the head like the midwife was showing me, one hand on top and one on bottom. And then I think a lot of nurses and people were in the room, and the midwife's hands were on the sides of the head, pushing back her labia gently. The head was born, and I did the bulb suction thing even though I wasn't planning on it, it didn't seem like the time to argue with the midwife, and then I started to push the head down, but the midwife wanted to do like a see-sawing thing with the head to get the ant. shoulder out. It came, and then I tried to squish the shoulders in towards each other so the baby wouldn't fling an arm out and make Mom tear, but I was trying to hold the head at the same time and I couldn't really squish with one hand. The top arm came flailing out but luckily she didn't tear.

Then it was all out and I put her up on her stomach and all these nurses started rubbing the baby all over, and I tried to help but the midwife was like, "ignore the baby, you need to focus. what do you want to do with this cord?" It was a pretty short cord, so I clamped it and the Dad said he didn't care about cutting it, so I did so the Mom could hold her close. Then I had my hand on her belly, and the midwife asked me to run through the signs of placental separation, and by some miracle I remembered all 4, but the only one I actually saw was cord lengthening. I guarded her uterus and had gentle traction on the cord (actually it was harder than I thought it would be) and after a few minutes, followed the cord up with my fingers to see if the placenta was waiting inside the introitus. It was, and so we see-sawed again, and asked her to push, and then it started to come so the midwife grabbed it and started to twist but I took it away from her because I knew what to do. :) It was really slippery and weird, like trying to hold together a cup of water in an unzipped baggie, except it was as big as a restaurant dinner plate. Then it came out, and I started massaging her fundus (which was also supposed to be harder than I had anticipated) and her uterus got nice and firm so I stopped to see if she would bleed. Then the nurse asked me for estimated blood loss, and I said 200 mL, and the midwife said "perfect. exactly what i would have said."

Then I looked for lacerations, and checked the placenta, membranes and cord, and then the Mom and Dad were like thank you so much, and THEN I started crying and the midwife made me go chart this long delivery summary thing while my nose was still running.

It was brilliant. I can't wait to do it again.

Tuesday in my cave

Hi there. Today I'm getting everything ready for clinicals tomorrow and finishing up a research paper on bone loss with Depo-Provera. It's not a terribly interesting topic, but it was really easy to research. Sometime soon I need to write about DC, since I already covered the wedding. I'm excited to go to work tomorrow, I miss being busy and around other people. Yesterday I grated some cheese using my roommate's fancy Olive Garden type cheese grater-you know the kind- and accidentally dropped the handle down the disposall and turned it on. It's not that scratched up but I'm embarrassed to tell her. Great story, huh?
I was making tacos because I want to try to eat out a lot less this week, since I ate out for every meal almost in DC and it was way expensive. It's hard to figure out what I'll want to eat every day for lunch and dinner for the next 3 days, though, because a recipe usually serves 4-6. I checked some "single gourmet" cookbooks out of the library, but the recipes are more exotic than I like: Sea scallops in chutney, apple, and pear sauce, Ginger steamed red snapper with lemon-sesame sauce. Maybe I just need to branch out and give it a try.
Okay back to Depo-Provera.

The wedding

I flew back from Zach's wedding yesterday. It was really fun to spend so much time with Jackie and Chris- I was hardly ever alone, and I loved it. I got to see Wim & Wes, Ian & Andrew & Kat, Alisha & Nathaniel, and the Bechtel and Pribyl families. The St. Louis crowd pressured me more to move there and now I want to, even more then move to Chattanooga after graduation. Pastor Rayburn even encouraged me to go...he had some quote from C.S. Lewis about a circle of friends or something. Jackie has 2 cats, one of them slobbers a lot.
The actual wedding was good. Their church is all brand new and fancy with wood. Deana walked down to the song from that Italian movie, A Wonderful Life or a Beautiful Life or something like that. Her brother played the guitar and Teri Hannula played the flute and it was very pretty. Courtney Rayburn sang about seals, Wim prayed, and I got to read Scripture. Darcee said she was disappointed because my face was totally appropriate the whole time. I guess I'm improving. :)
They made lasagna for 450 at the reception. It was good. Jackie and I sat with Peter Rowan who goes to Covenant Seminary and is single, as I am often reminded. It wasn't as awkward as I expected. Then Landon stood up and told a story about riding in the car with Zach and Zach saying, "Landon, I've asked the most stunning, gorgeous girl in school to the banquet." And Landon said, "Jackie?" and admitted that he thought she was pretty hot at the time. It was so funny! Jackie laughed and blushed.
Okay that's all.

Zach and I 

starbucks

Hey I just have to tell you something: the new Mint Mocha Chip frappuccino is a no. Save your $6 for an iced chai.

Happy Father's Day!

Productive Friday

Hi. Today I took a test and got a 70 on it. I can pass this class with a 70, so I was okay with that. (It's not saying much, I'm always okay with anything passable). The test was on the internet and had multiple keying and spelling errors, and I feel confident we'll get points back when it closes. Anyways, since I'm trying to act like I don't care about this nearly failing grade, I'll drop it now.
So I also got my phone turned on, after much sweaty sitting out in the driveway on my cell phone on hold with BellSouth. So now I have internet at my new apartment too and feel much less isolated in this windowless room. I've checked all my favorite blogs and answered a few emails.
I tried to do the Wall Street Journal's crossword puzzle today and failed miserably. I'm bad at crosswords, even though I feel like the sort of person who should be good at them. My Mom's good at them. I try to store away useless information in case it ever comes up in trivial pursuit or something. I really wanted to answer the question about what people on Easter Island call their home, two words, beginning with an R.
The search continues for Susan G. Kent.
More later.

Susan in the papa san

a trick

Did you ever know that ctrl-n opens a new browser window?