Sunday, May 31, 2009

The Life of an OB on Call

What a day I had yesterday! I have been following a pregnant patient (who we will refer to as "C" ) her entire pregnancy. She was due May 25th and I have anxiously been waiting for THAT call. Yesterday morning at 6:45 I got it. Labor and Delivery called to say she was 4 cm, 100% effaced, membranes were still intact, and had an epidural. Man did I fly out of bed. I was so excited! I drove the 20 minutes to the hospital to find out that floor is busy! There were 4 babies in the nursery (two being discharged soon) and 2 moms in labor. Dr. V found me, updated me on C, and we went and saw her. I got the summary from C, examined her, and began the waiting game. I spent a lot of my day glued to the monitor at the desk which shows a graph of the fetal heart rate, mom's heart rate, and contractions.

Another patient (who I will call A) got an epidural and went to sleep for awhile. Before the epidural, we checked her and she was about 4-5 cm. She slept for awhile, so again back to the monitors I went. Around 15:00 we went to check A out, and she was complete so we told her it was time to push. I was on "hold a leg and foot, push it back and tell the patient to push duty." I realized how awkward it is to tell a woman who is in a very bad mood and in a lot of pain to "push push push push push. Push like you have to poop. C'mon PUSHHHHHHH." Anyways, at 16:21, baby girl A was born :)

So, we clean up, get ourselves together, go check C who is sllloowwwly progressing, and see that she's about 9.5 cm at around 17:30-18:00. Dr. V told her she would come back in about 20 min to see if she was complete. So we're at the desk, discussing the rest of the day when we hear from one of the nurses "Dr. V would you like to join me for a delivery?" While A was delivering, another patient (B) had come in about 3 cm, wanting an epidural. Well, she went to 10 cm in less than 20 min and it was time to push. Again, I was on hold a leg and yell push duty. Baby boy B was born after about 5 pushes.

We literally changed gloves, and walked over to C who was ready to push. This time I went to "hold a leg and yell push, hold the fetal monitor, and help stretch around the baby's head duty." After about 15-20 min, Dr. V decided to let her rest because the baby was not tolerating pushing. The heart rate was bouncing between too low during contractions or too high between. In addition, we were pretty sure her pelvic bones were too narrow and his head wasn't going to make it. So the OR team was paged, we got everything ready to go and Dr. V and I rolled C down to OR where we got her prepped and ready to go. Once she was set, we scrubbed in and began surgery. Baby Boy C was born at 20:25. I'll admit, I got pretty scared as he didn't cry for about 3-4 minutes. There were a lot of people in the corner working on him, and they finally got him to. Phew. So baby C and dad left, C was knocked out and we finished up surgery. Dr. V allowed me to suture up the fascia, only two days after practicing on a chicken! I was scared, but I did fine.

Alright, surgery is over, we walk C to recovery, Dr. V goes to dictate and I go to find the baby and his family. I found the baby in the nursery with the nurse but no family. Where are they you ask? Oh in the basement. Why? Because there's a tornado warning. Yup Baby C was born in the midst of a tornado warning. No one even told us in the OR! LOL. So I found the family, told them C was great, baby C's weight and length and there were hugs all around. I waited until C came out of recovery to see the two of them together. One of the nurses snapped a picture of C, her husband and baby C with me. They will be emailing it to me later.

So, I got home at 22:50. It was a very long day with little food. My feet hurt like never before; I was exhausted. BUT it was the BEST day of medical school yet! 3 babies! Woohoo.

Thursday, May 28, 2009

I sutured a chicken leg today.

Practicing my suturing. This was very strange to do by the way. I think I heard my prof tell Paul today, "Ooh that's a great flesh wound."

Looking like I know what I'm doing :)

Ok so today I did something I've never done before. I sutured a chicken leg. I have not sewn before. I grew up with my mom refusing to sew, so my grandma did all the mending and I never learned. This made suturing a bit awkward for me. Oh well, I got the hang of it. Basically we cut the chicken and then sutured it back up. There are different types of sutures, different types of knots, different sizes of sutures, and different size needles. Each of these changes makes for a change in technique. I need to practice before I go to Brazil. The trip is a surgery trip so I better get much better than I currently am. Dr. Pedigo said I could come over and practice before I go. I believe I'll be taking her up on that offer. The hardest part was changing hand positions every fricken second, but again, it will come with practice. We also learned how to write hospital admission notes. Not as fun as chicken legs, but a major necessity for this next year.

Ok, I think that's it.

Wednesday, May 27, 2009

An update, plus Jake's visit

First off, a boards update. I changed them to July 13. I'm going to take them in CO instead of OH. I'm heading out to CO on June 12th and will study there for the remainder of the summer. I realized that my emotional well being will be much better if I'm with Jake for the most stressful period of my life to date. We've already got the whole schedule figured out. We wake up early, he drops me off at the library, comes and gets me for dinner and then possibly head back after dinner depending on the day. So yes my summer break gets cut down to less than one week, but my break was never about being off but being with Jake. I would rather get less than a week of break, but do well on boards then have three weeks off and have done terribly.

Jakester was here this last weekend. We had a great weekend. Friday we went to see Angels and Demons. I was very happy with it but it was good that I hadn't read the book in about three years. Mr. Photographic Memory remembered all the little (or big) details that were different. On Saturday, we just stayed around the house and I studied. Sunday we went to Taste of Cincinnati! Wow was that fun and yummy! There were so many good things to eat and I definitely had a food baby by the end of the evening. There was live music so we just chilled out on the Fountain Square and enjoyed each other's company. On Monday we went and saw the new Night at the Museum movie. It was so much fun! I love those movies and will definitely be purchasing once it comes out on DVD.

Tomorrow we will be suturing chicken breasts and doing Foleys. I'll take pictures!

Tuesday, May 19, 2009

Spring pictures

This first one is of Jake cutting a sugar cane stalk. He was pretty excited about it.

This is up in Rocky Mountain National Park. We did a small hike and realized how out of shape I am at altitude. It was super pretty though.

This is us over date night a few weekends ago. We stayed at the Westin, went out to eat at a great restaurant Palomino and then Avenue Q.

Fake patients= fun...I don't think so

Today we were subjected to the Mini-CEX. What does this stand for you might ask? I have no clue. What it means though, is that we wear our white coats, go see a "patient" who is pretending to have an ailment, go through a complete history and physical, write a SOAP (it's a certain way to write a medical note, nothing to do with Ivory or Dial) note on it and get graded. Sound confusing? It kind of is.

Normally, our patients are that's what I assumed today. My patient complained of a skin lesion on his nose. I didn't even examine his nose assuming that there wasn't even a real spot. He gave me this really complete history and everything. It's not until we were discussing the patient afterwards as a group that I realized it was all real. Oops. Yeah I'm going to make an amazing doctor. So yes, I gave this poor man a complete neuro exam yet I didn't even check his nose.

I did realize today that my SOAP note writing skills aren't too amazing. In the clinic, we never write things up. We just present to our preceptor. I need to work on this as who the heck knows what next year brings.

What's up for next week? Foley catheters and IV's. Thank goodness we aren't starting these on each other. There are medical dummies to practice on. I promise to get pictures of this and post them.