Wednesday, December 22, 2010

Statistics - D.O.N.E.

I can't believe it....I really thought this class was going to be the death of me.  The final exam especially...13 questions? REALLY!?!? That's just not right!


Turns out,  I did okay.  I'm still not certain how I escaped with an A, but I've decided to simply accept it and not push the issue ;)


So onward to bigger and better things.  Graduate Pathophysiology and Role of Midwifery and Birthing Centers - here I come!

Friday, November 12, 2010

Birth Story

Spending these last few days in Nurse-Midwifery orientation really dragged up memories of Allie's birth, so I've decided to go ahead and post my birth story here.  Some of you already know a little about it, some of you don't, but I figured it would be an interesting read none-the-less.


This is copied from an online forum where I posted updates while in labor.  I've decided against formatting and editing any typos so as to keep the original feeling (since I was typing whilst in induced labor, cut me some slack on any grammatical errors ;)




Anyway, here it is:
~~~~~~~~~~~~~~~~~~~~~~~~~~~



Haven't started the cervadil yet. Danielle is getting farther and farther ahead of me. I'm trying to tell these nurses that there's a race going on but they won't listen. 




Other than that, nothing's happening yet. Hanging out in bed. I'll update when the excitement begins 




UPDATE @ 8:20am: So here's my update: nothing's happened yet lol. I've talked to my OB for about 30 min and signed all the paperwork. Still waiting on my nurse to come in and do her thing before I can get my nap 








UPDATE @ 10:15am: 
So the cervadil was placed at around 845. Got an IV and placed on the external monitor afterwards. I had originally said I just wanted a saline lock for the IV so I wouldn't have to deal with the fluids, but the OB resident said she has seen people progress better/quicker with one so I agreed 


I then fell asleep for about an hour and when I woke up the nurse said I could get breakfast! I decided I just wanted a huge bowl of cereal and OJ though. Didn't really feel like eating anything warm. Very happy about the surprise food though, can't turn that down 




Oh, I forgot to mention that when they did the cervical check before placing the cervadil....I'm still a fingertip dilated lol  








UPDATE @ 11:56am: I've started having contractions roughly 6-8 min apart. Not really painful at all yet, but they are definitely there. Here's hoping they progress! 






UPDATE @ 2:30pm: Did another cervix check at 1pm and I haven't dilated at all so they placed 50 micrograms of cervadil (twice last dosage). Still having contractions, but I haven't checked to see if they are getting any closer. I ate lunch and took another nap 






UPDATE @ 6pm: They checked my cervix again at 5 and I've dilated to 1cm and reached 50% effaced. The OB said they can't continue using the cervadil because my contractions are now 1-2 min apart, so they placed a foley bulb. It SUCKED. It took them 6 tries, with and without using a speculum. They gave me fentanyl prior to the first attempt which was fabulous until they started and then that flew right out the window 


So now I have really bad sciatic nerve pain and backache. Contractions have definitely kicked up, so hopefully I'll progress more. They will be starting the pitocin in about an hour, so we'll see how long I can go without an epidural.  


UPDATE @ 6:32pm: I am no longer having fun. This HURTS.  


UPDATE @ 6:37pm: Since my contractions are now 1.5 min apart they decided against starting the Pit. They may have to give me something to calm things down 


oh and: ow. that is all!






UPDATE @ 5am: Sorry for the lack of update ladies! The contractions went to 2 min apart so luckily I didn't have to start taking terbutaline to decrease them. The pain however became quite intense. We tried whirlpool therapy for about an hour which did help immensely at first, and when it no longer touched it they gave me some stadol and phenergen to help me sleep (it was about 11pm at this point) That stuff was awesome for the pain, but made me sooooo loopy. I have to get up and pee every half hour to an hour because I'm on IV fluids of course. It helps the pain too. When I was asleep the contractions started spacing out to every 4 to 6 min, so they started the Pitocin at 2am after another cervical check (I'm at 2cm and 70% effaced). They started at 1 and I'm awake now with pretty bad back labor again and it looks like they've gone to 12. I am waiting for some fentanyl IV to see if I can try and get more sleep. They offered stadol, but I don't know if I want to pass out again for that many hours. We will see what happens 




UPDATE @ 6am: Did another cervical check and I have gotten to 4cm dilated and 80% effaced. Yay! They broke my water, which didn't hurt at all. Fluid clear and baby is doing well. She's gotten to -1/-2 station too. Yay again! 


Contractions have gotten to 3 min apart prior to the rupture of membranes, so we'll see what happens now! 




UPDATE @ 11am: Forgot to mention that they removed the foley bulb at the last update, but they did. Feeling SO MUCH BETTER now that is gone. It was no fun at all. Anyway, after the ROM the contractions became much much more painful and by 830 I had decided to go ahead and ask for the epidural. The epidural procedure wasn't too bad, she got it in the first poke and it seems to be placed well. (I made sure to get a CRNA do to it and not the second year resident who wanted to...sorry mr. resident lol). The main discomfort was that I was contracting every 30 seconds so sitting up in that rounded back position was excruciating. Now I am happily numb and have pretty much spent the last several hours sleeping. Still pretty tired and I'll probably try to get as much rest as I can now that I'm stuck in bed. Oh, and I had no idea at the time, but I had been having some serious urinary retention issues yesterday and today before the epidural was placed. I kept having to pee every 30 seconds and would get out a little bit, but once the epidural was placed I swear I peed a bucket. Kind of ridiculous!!




UPDATE @ 12:30pm: Nothing really interesting to report, but I keep having blood pressure drops from the epidural. I keep trying to sit straight up to help LO drop down but then my BP drops and they make me lie down on my back. Lame!!! The next cervical check is around 4ish, so we'll see if I've made any progress. If not or if it's not enough, they will place an intrauterine catheter to see the strength of my contractions (I've dropped down to ever 3-4 min apart). Unfortunately I am on the max dose of pitocin and have been for awhile...so here's hoping I've made some changes and we don't have to start talking c-sections!!




UPDATE @ 4pm: Cervical check at 4 showed that I am still 4cm dilated and 80% effaced. They decided to take me off of the Pit for a couple of hours to let my body reset itself since I had been on the highest dosage all day. Just started it back up again..here's hoping something starts working! Next step is an intrauterine catheter and then...talk c-section if no progress by 6am tomorrow


UPDATE @ 5pm: I had been bugging the day nurse about my IV because I thought it was infiltrated. As soon as the night nurse came in I had her look at it and what do you know..it was.   It's kinda hard to get IV fluids and Pitocin when it's just going into my now giant arm, lol. 


UPDATE @ 6pm: New IV and Intrauterine cath placed. We'll see how strong these contractions are for real now! 


UPDATE @ 9pm: Contractions 2-3 min apart and nice and strong. Pit back up to max dosage at around 10. Having lots of pain now, so the anesthesiologist upped the basal rate on my epidural pump and gave me some buvipicaine to try and get some relief. Here's hoping it works...


UPDATE @ 920pm: Scratch that, contractions are now 1-2 min apart 


UPDATE @ 345am: Cervical check just done: 6cm dilated and 100% effaced! I've officially beaten my Mother in the dilation department. Still having lots of pain - seems the bolus of Bupivicaine likes to wear off at exactly 2 hours.


UPDATE @ 5am: Still waiting for the anesthesiologist...he eventually came in and really hooked me up with the pain meds. Thank god because I had been at an 8/10 for my pain scale the entire time  


UPDATE @ 630am: Just had cervical check: still at 7cm but Allie is now at 0 station. Allie is tachycardic and now my temp is 100.4. So I am 0.4 degrees away from being diagnosed with chorio. Not sure yet what the plan is for c-section vs waiting, the OB is coming in soon. The pitocin expired at 2am and the nurse just changed the bag too  I've been placed on oxygen to try and lower Allie's heartrate (just checked again at 646 and it seems to be working so far. I am also dehydrated because of water retention and a finicky IV (it was partially pulled out...luckily they were able to fix it), so they placed me on saline to boost things up. My contractions are 3-4 min apart instead of 1-2, so they are going to increase my pitocin over the max dose (from 20 to 24mg). I'm really hoping that it works and my uterus hasn't gotten exhausted. If I don't make any progress for 2 hours they will talk c-section. I will be so mad if I have to get one after all of this nonsense!!!




UPDATE @ 1pm: still no progress and have been in 8-9/10 pain since 10am. They are going to try a new drug, Propanolol and take me off of the Pitocin (been 28mg). I have water retention and now fluid in my lungs as a result, also can't pee. They will try the new drug twice and then they are done with their tricks, I'll have a c-section. My BP has gone to 165/90 as of the last check, most likely due to the pain. 


I've reached my breaking point and burst into tears a few minutes ago. They are going to try to give me IV fentanyl but if this doesn't work I don't know what I'm gonna do.






UPDATE @ 2pm: Just talked to the OB about the new drug and they will try it twice, 1 hour apart. If that doesn't work then I'll have a c-section. The anesthesiologist gave me IV fentanyl that worked very well and brought the pain down to 2/10. That's the ONLY reason I agreed to trying the Propanolol, which btw they are going to use WITH the Pitocin and not replace it like originally planned. Here's hoping it works...


Oh, and I tried getting in the trendelenburg position but with my severe water retention going on all it did was get fluid in my lungs. So now I'm one albuterol treatment and 2 rounds of lasix later :/








UPDATE @ 9am Friday morning: Oh my, Ladies! I have huge updates...sorry for the delay but I've been extremely busy.


So, since getting fluid in my lungs I have been on oxygen due to severe difficulty breathing and wheezing/coughing. I also had severe urinary retention (even though I had a foley catheter placed) and with fluids constantly being pumped through me, I only had 30mLs come back out. My kidneys were also shutting down.


Once getting onto the Pitocin and Proplanolol my pain once again shot through the roof with very strong contractions that did not ever allow my uterus relax. No pain meds were touching anything and I became very weak from all of that and the breathing difficulty.


My OB came in to see me at around 330/4 and was extremely concerned and basically pissed at how the other OB had put me in this condition.. (he hadn't been taking care of me that day, it was another doctor). The new drug that they wanted to try was very new on the market and not any real research had been done on it. Add that to the fact that I had been on pitocin for several days and he felt that I was going to be lucky if my uterus didn't either rupture prior to delivery or I would have such severe hemorrhaging afterwards that a hysterectomy would be necessary. I was severely weak at this point and could barely breathe. I had been on a face mask that poured oxygen into me since being put into the trendelenberg postition because nasal cannula didn't give me enough oxygen. My blood pressure was quickly nearing seizure level and my kidneys were shutting down. He said I was "very very sick" and said we needed to do an emergency c-section, which I completely agreed with at this point. I was actually ready much earlier in the day, but the OB taking care of me didn't give it was an option. I knew I was really sick and being in such severe pain for so many days had broken me. So my c-section began less than 30 minutes after my OB saw me. Everything went well in the surgery, but I did require several doses of pain medications. Because of the medications the other OB had given me, my Doctor wasn't able to give his normal meds he does to help limit the chance of a hysterectomy, so he tacked down part of the uterus and gave me a suppository form of misoprestal. Allie was stuck in my pelvis in such a way that there would have been absolutely no chance of her being born vaginally. She was actually stuck in such a way that it was difficult to get her out, but luckilly they were able to do so without resorting to a vacuum or forceps. I lost a little over liter of blood, which is more than normal, but a blood transfusion was thankfully not necessary. Allie started her little cries immediately after delivery and has done very very well since. She is such a calm and happy baby and already is able to lift her head and hold focus on both Andrew and I. Everyone has commented on how beautiful she is and they think she looks just like me, with Andrew's nose  


I myself am still on oxygen therapy and am constantly hooked up to 2 IVs, have several blood draws throughout the day, on a constant blood pressure cuff, pulse ox to monitor my oxygen saturation and heart rate monitor (still have a high heartrate - 140 - 180). They have weaned me down on the oxygen and I have tolerated it so far, so I may be able to stop that soon. 
I had a chest xray done last night which showed a lot of fluid in both lungs and luckily not a pulmonary embolism (blood clot in lungs), but the Docs feel that I should get over it without pneumonia. However they do think I am brewing an infection since my heart rate is so fast. So far, my bleeding has been within normal limits and my uterus is contracting down to normal size well and not filling up with blood. I am on special leg cuffs to help limit the chance of developing clots, but today another Doc is going to start me on a very low dose of heparin therapy to do instead. I am hoping to get off of the epidural today as well as the foley catheter. I don't like the fact that I've been tied down to a bed for 3 days and I know that if I am able to move around more I'll heal from the c-section faster. Plus I'm very independent and hate relying on Andrew to get me something from the other side of the room. 


So that's the scoop. I'm very lucky to have such a healthy baby after all of this nonsense and everyone that I've come across, both family/friends and those in the healthcare field cannot believe how much I went through. I do obviously think all of this torture was worth it for my little girl, but I know that I will never get another induction again. If in the future I have an overdue pregnancy that requires interventions, I will have a c-section. With how sick I became, I consider myself lucky to be doing this well afterwards. Family and friends that have visited and heard about everything have all cried about it and are still quite emotional.


To end this chapter on a positive note, it is so beautiful to see how Andrew (DH of course) has been acting with her. He started crying in the OR and has been so tender and loving towards her, much more so than I have ever seen anyone else be. And to think he was worried if he was going to be a good Dad.  


~~~~~~~~~~~~~~~~~~~~~~~~


Footnote:


     As I remember other points, I'll try to post them here.  One thing that comes to mind is that Allie had a 3 1/2 minute long decel the day prior to my cesarean, which is something nobody verbally told me about, but looking back I can see that was probably when a bunch of people had rushed into the room and started putting me into different positions.  It wasn't until months later that I found out what had happened, when I looked up my contraction history while working as a student nurse.



Creamy, creamy Vernix

Have you ever wondered what that creamy white stuff, otherwise known as vernix, was for?  Here is an excellent blog post talking about it :)


Vernix

Thursday, November 11, 2010

A reading from a friend

A friend of mine gave me a tarot reading today, and I wanted to share it.  Even if you don't necessarily believe in oracle readings, it's still a neat read :)

Here it is:

Is this the proper profession for Ginny?

The Eyes of Beauty
positive expectations, clarity

This card wants you to know that your path is right on track. You were supposed to be a nurse first to lead you here! If you have anxiety or had anxiety about making a switch, understand that this change is supposed to be 

How will this schooling/profession benefit Ginny?
The Ringmaster of Scrutiny
discernment, clear vision, details

You will learn much. You will become overwhelmed and may think you'll never get to the end but you will. Each thing you learn, take it as a blessing! You're more knowledgeable and one step closer to your goal, celebrate all those small victories and don't focus ONLY on the end result!

What struggles will Ginny encounter?
The Resting Tree
patience, stillness

This card is a repeat of card #2. Don't overwhelm yourself!!! Take it one step at a time, enjoy the schooling and the learning and the new experiences. You have to embrace this time in school and learn and love it to get to the end result 

Frontier Bound...and back

Whew! I am completely exhausted from the past few days!    Monday morning, I drove down to Hyden, Kentucky for Frontier Bound.   It took a little over 8 hours and was really a nice drive.  I went through a couple of states, saw pretty much only trees and mountains since C'ville and listened to an entire audio book.    I got there at about 3:30pm, checked in and rushed up to my cabin to find out that I was rooming with several girls I had already met through Facebook.  So exciting!!  Everything was so pretty and the weather was perfect.  Couldn't have asked for it to be any better.


After that, the next few days were pretty much in a blur!  We had several workshops, talked about registration and what to expect with school, and pretty much boohooed like a bunch of hormonal women the entire time. It really was ridiculous, and even I in all of my "tough girl" persona teared up several times.   When did I become such a sap???  I guess it just goes to show that we are truly in the right environment, and that was really the most amazing aspect of it all. Never before have I found such a large group of women that I had such similarities with.  Even though we were only together for a few short days, it truly feels like we are all one big family.  Frontier talked the talk, like most other schools I've visited, but it was so refreshing to see that they really lived up to the hype.  One of the students, Renee, told me that she was almost worried about coming because she didn't want to be disappointed if it didn't reach her expectations.   For me, Frontier has surpassed them. :)


Since the school is nestled in the Kentucky mountains, finding a cellphone signal was pretty much not going to happen.  They had an excellent wifi service though, so I fortunately was able to communicate through email and gmail chat.  I spoke with Andrew nightly that way, and we shared our days. That did help ease the pain of leaving my family so long.  The first night, after I excitedly told Andrew about that day's experiences, he asked me if I was in a cult.   I had to laugh, because if he had only seen all of us crying over stories of childbirth and our passion with midwifery he wouldn't have even asked. He would have been certain!!


Anyway, the drive back was interesting to say the least.  I left Wednesday night after Follies, although it wasn't without some stress.  Apparently my car battery decided that was the time to die, and I had to have the car jumped by a Staff member. (Michael, you rock!!!)   I decided to go ahead and go, and hoped beyond all hope that the half tank of gas I had in the car would buy enough drive time to sufficiently charge the battery so that I would be able to restart it when I refueled.   I made it about 2 1/2 hours, to Marion, Va, and stopped at a gas station after the gas light came on.   The moment of truth came when I had to restart the car, and after a hiccup or two, it started.  I'm sure I don't need to go into what a relief that was!!!   After that, I drove straight home. The entire trip took about 7 hours because I only stopped once to get the gas.  It was rough!!!! 


I made it home at 4:20am, and after taking a moment to notify my friends via facebook that I arrived safely, I took a quick peak at Allie and passed out in bed until 10am.  Now, after another nap at 2pm, I feel like I have a hangover and am seriously dreading going to work a  12 hour shift tomorrow.  Even so, I wouldn't trade the experience of these last few days for anything.  I am so excited to return to my nursing classes in January and simply can't wait until I can return to my Mommas and families :)


Friday, October 8, 2010

Phone Interview - Check

I finally had my phone interview for grad school on Wednesday, yay! It was pretty short, lasting a little less than 10 minutes, and she asked me the general questions such as any concerns I may have with undertaking an online program.  I told her that I was doing Statistics through them now and she said that will greatly help me when I start the Nursing courses.   

She said I need to make sure I bring my ipod, laptop and....a dress.  A dress?  I don't even know if I own a basic dress.  I guess that means I get to go shopping for one...unless they'd like me to wear my formal floor length silver one.  That'd be a sight LOL

Wednesday, September 29, 2010

Statistics!

Well my Statistics class began Monday and I'm already getting a headache over it.  I turned in my assignment last night, but I honestly have no idea if I even did it correctly. Boo!  Hopefully I did, or at least will get feedback about it quickly so I can fix any mistakes.

After reading my required chapters, I went over the powerpoint and was reminded about terms such as meta-analysis and quasi-experimental and psychometric evaluations.  Not only am I taking Statistics, but it seems like I am going through Evidence Based Practice all over again.   I was hoping I'd make it through another few classes before being immersed in it again.  Oh well. What really took a long time, though, was trying to figure out the program we are using. It's called SPSS and seems like a more complicated version of Excel. (which of course I've never really used before).  THAT truly is what gave me a headache.  Then after going over what I thought was homework for an hour, I realized I actually had done the graded portion first and pretty much wasted an hour of my time.  Well, I suppose it wasn't truly wasted since I did actually learn what to do with SPSS (at least the extreme basics).   Hopefully last night was the worst and I'll pick it up more quickly next time...

Assuming I actually figure out what's going on, I am hoping to get ahead and complete my coursework quickly.  As of Tuesday evening, I have turned in this entire week's homework.  I'm not sure if all the weeks are going to be similar it terms of amount, but if so I should be able to do at least 2 week's worth per week. Since this is a 12 week course (of which 10 weeks have actual homework), I should be able to get through this quickly.


So we'll see how well that plan works out....I'm sure I have absolutely no idea what I'm getting into.  I tried to complain about my poor, pitiful homework-ridden life to a friend (and old undergrad nursing classmate), but she cheerfully reminded me that this was why SHE was not going to graduate school. Which pretty much took all the wind out of my sails. After all, I did sign up for this.... :)

Thursday, September 23, 2010

Getting excited!

I am becoming ridiculously excited about Frontier Bound in November.   Seriously, can Nov 8th hurry up and get here already!?


This is what I've done for preparation:

* Banyan Tree 101 - DONE
* Register for Frontier Bound - DONE
* Pay registration fees - DONE
* Mail Health Forms - DONE
* Read Wide Neighborhoods- Need to finish this


Now all I need to do is get my Ipod Touch (which should be arriving today, yay!) and save up my pennies for the trip.  I'll be driving, so I will just need gas money and then of course funds for buying grad school swag.  I hope they have lots of things..I want to be a walking buildboard for Frontier, haha!!


I'm still looking for someone to ride with, but the few students that are in my class and from Virginia are flying. Boo.  I'm stocking up on audiobooks though, and quite honestly I think I'll enjoy the drive.  I drove a little over 7 straight hours overnight when we went down to Florida a few weeks ago and I really liked it. (as long as I have audiobooks, otherwise I may fall asleep)

Thursday, September 16, 2010

...and so it begins

Since I have many exciting adventures to look forward to in the next few months, I've decided that maybe now would be a good time to attempt working on a blog.  About once a year I get a crazy idea to start one, post maybe one or two entries, and decide my life is too boring to write out consistently. Maybe this time will be different ;)


So I (finally) graduated last May with my Bachelor's in Nursing.  It only took...oh....10 years since graduating high school.  Sad eh?  But this is what I get for taking a break and then changing majors. Oh well.  It's funny, during the last couple of months of school I thought of nothing else but finishing so that I could SLEEP and RELAX.   That was May and by the time the end of June rolled around I was so antsy and missing taking care of my Mommas that I decided to go ahead and enroll into grad school. So I did some research and applied to a highly rated distance education program. I'm extremely excited and proud to say that I got in and will be starting to work towards my Master's degree in January.  Part of me feels like I must be a glutton for punishment, but I truly do thrive on education.  I'm also crazy.

Another reason why I decided to go ahead and enroll now is because ever since my own negative birthing experience with Allie, I have felt a strong desire to go into obstetrics.  Working as a Labor and Delivery nurse was definitely a dream of mine, and I still would love to do so, but I knew I would face issues where I didn't agree with the physician regarding their chosen course of treatment.  That is when I knew I found my calling: nurse midwifery.   It still seems surreal to me when I think about returning to school and the possibility of really becoming a Nurse Midwife.  For now though, I am trying to be patient and focus on the present. I will be starting my Statistics class soon (yikes!). Of course I also have a crazy 13 month old Daughter who is the love of her parents' (and grandparents, aunts, uncles, etc, etc,etc.) lives. And speaking of Daddy, I also have a husband who is trying to focus on completing his own Bachelor's degree and needs my assistance with his homework as well.   

It's going to be a crazy time coming up. But really, when is it not in our household? :)