Jul. 21st, 2006

osodecanela: (Default)
I started to post this Tuesday, but got interrupted (Postus Interruptus!). Amen for Autosave.

A dear friend was supposed to make a rather long journey to visit her husband's family. She's the typical 'tween', stuck between aging parents, and young children, trying to make everyone happy. Satisfy her parents' needs, her husband's, her children's, her in-law's, as well as the demands of her job, which she's very, very invested in. Sometimes I wonder where she figures in, where her needs rank in all this. Organizing all the things needed to make this journey was far from simple, what with all the costs and variables to take care of, and once it was put in motion, it was hard to stop.

"What should I do?" she asked, when her father's surgery was rescheduled, so it was going to fall right in the middle of their trip, instead of prior. It's important surgery, but not impossible, nor particularly dangerous to delay a few weeks further. Allegiance first to parents here, or to in-laws at a distance and the children wanting to make the trip? Watching her agonize was not fun.

They were supposed to leave this morning, but aren't. Her husband got sick on Sunday and on my advice they're staying put until he's finished with his care. Could he travel? Perhaps, but I couldn't tell them it was safe. Not yet.

Last night I said to her, "Do you get the feeling someone is trying to send you the message that you're not supposed to take this trip? right now?" Why all the road blocks, if it's intended? I recounted the tale of the religious man in a flood, who waved away the row boat, the speed boat, and the helicopter that came to save him from his flooded home, as the water continued to rise. He kept saying, "God will save me." Ultimately he drowned. When he got to heaven he asked why God had allowed him to die. The Almighty responded incredulously, "I sent you 2 boats and a helicopter for crying out loud! What more did you want?"
osodecanela: (Default)
I feel like I'm waiting for yet another shoe to drop.

After almost 4 weeks without a delivery, there have been 3 since Monday, none of them simple. Monday's was the most run of the mill. Second baby, lovely mother. Just took longer than expected. A bit of chemical help with Pitocin helped.

Tuesday's delivery I never want experience, ever again. Also a second baby, and the mom pushed twice to get the kid out. Everything went fine, until it came to delivering the placenta, at which time this girl pushed like hell, and proceeded to turn her uterus inside out. This is one of those life threatening complications in OB that most providers read about, and pray they will never ever see. Most providers will have that prayer answered. For me, this is the second one I've experienced, the last being almost 10 years ago. The mother's alright now, as I got her uterus turned back inside the way it's supposed to be, but not before she lost about a litre of blood. I went home after that, in search of clean underwear.

While I was in the midst of Tuesday's near disaster, my 3rd lady arrived, 2 weeks early, and having broken her bag of waters. Her cervix was unfortunately closed. Not a good scenario. She got meds to 'ripen' her cervix to help it open, followed by pitocin to make her go into labor. By Wed. evening she had stopped dilating at only 5 cm. Off we went to c-section, only to have her rather tired and 'less-than-cooperative' womb, refuse to contract adequately, and so she also bled rather heavily. She's doing alright now, although I'm way grateful she isn't a Jehovah's Witness. In the past 12 hours I've looked at all three of these infants, all of whom are healthy, and were sleeping peacefully unaware of the trouble they've inadvertently caused for their mothers.

The OB stuff has been the icing on the cake; there's been so much more going on. I am SO ready for the weekend and a couple of days off.
osodecanela: (Default)
Here I was pissing and moaning about how horrid the week has been. I got up from the computer to go see a patient, a lady who's due in just over 4 weeks, to have her first child.

I couldn't find a heartbeat, she's not feeling any movement, and she's sizing a couple of weeks small. I think we likely have a fetal demise. I'll know for certain in a few minutes.

I sent her directly to L&D to get a sono, then went into my office to have myself a little cry. I'm praying I'm wrong, though I doubt it.

I'm absolutely heartsick. I've been taking care of this girl since she was 16.
osodecanela: (Default)
Sadly, I was not wrong. No heartbeat. Sono says the fetus sizes out to about 33 weeks, which suggests the infant may have died about 2 weeks ago. I leave in a few moments for the hospital to give this woman the bad news, grieve with her, and get her labor started. Im hoping to graduate from tearful to numb by the time I get there.

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