osodecanela: (cam capture)
This is been an interesting day.

I dropped off the new car for a scheduled maintenance at the dealership. The service manager promised me that when it was ready I would be called. Then he tried to sell me a brand-new set of tires, to the tune of $1600! Thank you, no.

I had their courtesy car service drop me at the hospital so I can have a light breakfast, and to update my registration with the latest version of the electronic medical record that they use, now which will be cloud-based. I had to get this done by tomorrow when it goes live. Then it was off to the office to get paperwork done followed by a very busy afternoon seeing patients.

At 7 o'clock I sent both the last of my staff and the last of the patients out the door, only to realize once everyone pulled away that the dealership had never called and I had no vehicle. To add insult to injury, while I was trying to get the dealership on the phone, labor and delivery called. I had someone in labor & no way to get there. Fortunately for me it was her first child and I had hours to get there. (She delivered at 1 am, which is why I'm still awake). Mama, whom I delivered once upon a time and her little one are doing just fine.

I called the dealership to find the service department was closed, so I called sales and got ugly. They sent someone over with a loaner car.

I'm going to try to get some shut eye now. Will continue this in the morning.
osodecanela: (cam capture)
Childbirth takes a lot out of me.

No, nothing like the mom, but really, either the child is born in the middle of the night, or the mother is in labor during the middle of the night. Either way, I'm up in the middle of the night.

The lady I delivered on Friday, I thought would likely deliver right after I finished work on Thursday. Mother nature however had other plans. Now for most women, 3 previous deliveries will post a sign on the inside of the cervix that reads, "This way out." Such was not the case for this lovely lady. She required antibiotics, an epidural and pitocin to complete the blessed event. The birth was at 2:15 am, and by the time the sewing, the baby exam and all the paperwork was done, it was already 4. Add a half hour drive to get home, plus a quick shower, and it was 10 minutes of five before I slid between the sheets.

My eyes rolled open at 9:18. I was dressed and walking out the door 12 minutes later. Keep in mind, my first morning patient was at 9:30, and there is that sticky issue of a 30 minute drive.

I called my office manager from the road and said I was likely not going to last the day. I thought I was clear in asking her to lighten up my afternoon, so I could head home early. At 2:35, seeing my 3rd person of the afternoon, it dawned on me that the afternoon had NOT been truncated.

By 4, I was fading faster than a bad dye job.

I was home at 7, in bed at 7:30 and out cold at 7:35. In that order, at least I think.
osodecanela: (Default)
I'm in the car in the driveway at the house. It's been way too long a night.

Patient went into labor early this yesterday morning and finally delivered after midnight, assisted by an OB consultant and a pair of forceps. Mother and son are doing alright, though I'm still cringing. This was the first forceps delivery I've attended in 18 years. It was needed, though many MD's would have reached for a vacuum instead. Either method has it's pros and cons, though in very experienced hands (please read that as not mine), forceps may actually be the safer option.

Mom was pushing very well, but she's small (bordering on tiny), this was her first child and baby was showing signs of not being terribly happy with the whole birthing process. She would have been pushing for another hour at the minimum, and this kid was simply not going to tolerate that.

I've finally driven home, and now that I'm here, must get the day's dictation sent off to my transcriptionist. My husband's asleep, so I'm doing that from the laptop, in the car, in the driveway, leaving him in the tender arms of Morpheus, at least for the time being. I'm way too awake right this moment to sleep, having been through the whole birthing experience, chased by a strong cuppa Joe to safely make the trip half hour drive home.

'Night all. Outlook just chirruped, letting me know all 26 Megs of data has uploaded and is awaiting said transcriptionist. Time to try and slip into the house and the bed, unnoticed.
osodecanela: (Default)
By the end of yesterday afternoon I had a headache the size of Cleveland. Two Tylenol did absolutely bupkis. So I went home and pulled the covers over my head.

Actually, I made LJ and I a light dinner (can we say Lean Pockets?), and then I got into bed. Just before I arrived at the house one of my staff called to let me know that Claudia thought she was in early labor. After three previous deliveries, she ought to know. I sent her to labor and delivery.

Claudia was right. She had broken her back of water, and was just beginning to contract. I got into bed, figuring I would be called and sometime during the night. I was right.

Labor and delivery called me at midnight to give me report, 3:30 a.m. to tell me she wanted an epidural, and then again an hour later to say it was time for me to come in. So, at 4:30 AM I was up, at 4:35 AM, I was out the door, at 4:59 AM I was at the hospital, and at 5:19 AM Arianna Michele made her entry into the world.

Claudia pushed once, but then again, this was number four. All very calm and very civilized. Our labor nurse was rather amused by everything. Claudia and I spent the 20 min. between my arrival & Arianna's arrival trading wise cracks.

"You know each other rather well, I take it?" She asked.
"Well, I've been taking care of her since she was 13." I responded.
"13? Since I was nine! Get a grip Doc, you're getting old. What's the matter with your memory?"

Claudia's now 34. As I said, we've got some history.

So it's 10 min. of eight in the morning, and I'm now seated at my desk at my office. I had a almost 7 hours of sleep last night, not counting interruptions. I will try and juggle things about, like trying to move some of the afternoon into the lunch hour, in order to get out of here by three. I really could use getting horizontal and unconscious.

The state audit went all right yesterday. Hopefully it will be a very long time before they come back. It was a lot to prepare for, and frankly I would be happy never experiencing another one ever again.

So that's the news from Lake Wobegon, my hometown, where all the women are strong, the men are good-looking, and all the children are above average.
osodecanela: (Default)
Little Mr. Ricardo arrived yesterday morning at 9:13.

He and I have something in common. Both of us were supposed to make our initial entry into this world on March 19. Both of us were late. He is a bit more punctual and I arrive in just three days after his scheduled arrival. I didn't emerge until 1 April. (Always a dramatic entry. Makes them remember you. The day I was born was also Good Friday.)

I've known this little man's mother for a long time. I've taken care of her since she was, umm, a fetus. His delivery with so much less traumatic than hers, but then she tried backing into this world, and I was faced with "cutting along the dotted line".

All silliness aside, this was a superlative experience to have been a part of. Ricardo's mother went to a very spiritual place, turning deep inside to find a peaceful strength to usher him into this world. I was honored to have been there, twice so to have had her confidence to attend to her at this vulnerable moment, thrice so to have the privilege of seeing life coming full circle into another life. These second-generation deliveries are milestones for me. This one felt truly sacred.

I was home by 12:30 and set about getting dinner ready. I had already done much of the prep work on Saturday. Sunday was more about assembly, with dessert being the major exception. As I had mentioned previously Mark ([livejournal.com profile] mark_monroe)and his partner Gene ([livejournal.com profile] velcrorodeo) are vacationing this week in San Francisco from their home in Denver. They were coming last night for dinner with their friends Peter and Ernesto. Gene and Peter grew up together back in Colorado. Patrick ([livejournal.com profile] healerpatrick) who lives here locally and assumed to be renting our granny unit was also coming over. He in fact joining me to help get things ready.

Mark has more than once commented on some of my previous food posts, and frankly I want a meal for him, as well of us our other guests that would impress. The final menu went as follows.

  • Hors d'oeuvres - Zacusca (Romania) on crackers (there were no plantains at the market) & phyllo pockets stuffed with suasage and zacusca

  • 1st course - Insalata Caprese (Italy) tomato, basil, and mozzarella drizzled with lemon balsamic and lemon olive oil

  • 2nd course - Melon e Prosciutto (Italy) found a lovely tuscan canteloupe and paired it with strips of black forrest ham garnished with blood orange

  • 3rd course - Avgolemono (Greece) egg, lemon & chicken soup

  • 4th course - Spanikopita (Greece) with Mamaliga (Romania). My mamliga had fresh ground rosemary, white pepper, and Pecorino Romano, and was browned in rosemary olive oil.

  • 5th course - Dessert! I made two. Apple Strudel with fuji apples, giant raisins, and plum wine, & bread pudding made from apple croissants.


The meal was wonderful, not so much because of the food, but the company! The conversation over food and wine went on for hours. It makes me sad that these four men are so far away. It was just so much fun just to hang out.
osodecanela: (Default)
Her name is Daisy.

Two weeks ago tomorrow, I handed her off to the neonatologist to resuscitate and prayed harder than I can remember for her welfare. She was shipped to SF and was released from the NICU less than 48 hours ago.

I just held her in my arms for the second time in my life (the first was when I carried her near-lifeless form to the resuscitation table in the OR) and had her gaze up into my face and actually track my movements. She gave a sniffle and then cried, after which her father popped a pacifier into her mouth. With that, she began to suck, and I began to weep.

I cannot remember the last time I felt either this grateful, this happy and this relieved.

I had not expected to feel quite so emotional, and certainly didn't expect to have tears running down my face (certainly not in front of the parents, but if they had any question about how much I was invested in their child, they certainly had that answered today. Dad's hand on my shoulder, as I sat and held his daughter, told me all I needed to hear.

I need to get myself back into study mode. Ironically enough, my neonatal recert. class is this afternoon.
osodecanela: (Default)
T'was a bit of an exciting evening.

My husband and I had been invited to dinner by my office manager. She'd made sarmale - stuffed cabbage the way they do it in Romania, something she knows I adore. That with some mamaliga on the side & I'm one happy puppy. This is stick-to-your-ribs, Eastern European cookery, very reminiscent of my bubbie's. It feeds not just my belly, but my soul.

We arrived in separate cars as I was afraid someone would go into labor. Someone did.

Maria was a week early. Generally no big deal. However, this was baby #2 which is often faster than #1 and being a bit early, he was a pound lighter than his older sister was. 30 minutes prior to his birth this little boy was face up. Not a good position to enter this world.

Well mom dilated fairly quickly, & then pushed mightily, spinning our young friend around suddenly & in rather short order he arrived, umbilical cord around his neck. Poor little man was dazed, and a bit bruised & having made a sudden transition to the outside world, appeared to have no idea that breathing was not an optional activity.

I'm not particularly enamored of neonatal resuscitations but this one went well. The little guy went to the ICN for an hour and came back right as rain. Unfortunately his parents, particularly his father were beside themselves until he did.

Neither of the parents speak any English, & while I finished up with the mom, dad had gone off to the ICN with the RN. Ten minutes later, I arrived on the ICN to find a flurry of RN activity around the baby and not one Spanish speaker there to explain anything to the dad. He's a laborer with a grade school education and he was in short, terrified.

I told hm not to panic, that everything likely would be OK. At that moment the baby needed oxygen and was gradually perking up. Infection was a possibility, though not a likelyhood. I sent dad out, promising I'd be out in a couple minutes. In the hallway, I found dad struggling to hold back the tears. I did my best to reassure him, while at the same time explain what was wrong, what we were doing and why. That helped and he was able to compose himself, before going back to his wite. Amen. The last thing we needed was another terrified parent.

By the time I walked back into the ICN, our infant was off of O2, pink and a helluva lot more alert. Time to pry my own shoulders down from around my ears and go reassure his parents completely.

And time for me to head for home.

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