D.O.N.E.

I've done it! I've successfully completed my first term in graduate school, and I didn't even end up in the mental asylum! (I did find a couple gray hairs, but we'll address that on another day... ;)

These last few days have been a complete blur with me scrambling to get things finished.  Today I spent several hours camped out in the bedroom churning out a 9 page paper for my History of Nurse-Midwifery class. At this point I don't even care if I get a bad great on it, I'm just so happy to be finished.

Now I get to enjoy 2 whole weeks before starting it up again.  The next term's classes are Decision Making in Health Assessment and Theories in Advanced Primary Care Nursing....and I just bought the required 5* books. Ugh.

* There are actually 6 required books, but the other one is an APA manual.  I'm not buying it because I already own 2 of them and have the PERRLA software...plus I really don't feel like cluttering up my bookcase with another book. I'd appreciate it if you didn't tell on me. 

I'm finished with Pathophys!

It seems so surreal that I have (successfully) completed my first graduate-level course...in pathophysiology no less! At this point I have taken 3 courses in this subject alone...and it is by far one of the most difficult ones for me.   Not only that, but I was 1 point away from an A too!  I refuse to be discouraged about my grade, because I am absolutely flabbergasted that I was able to get through it successfully without going completely insane!!!


Today alone I took 3 exams, listened to a 71 minute long lecture, wrote a paper and completed a homework assignment.  If only I was able to plow through like this all term I may have been able to finish it sooner!  Well, no not really because I still had to listen to her lectures as she put them up...oh well.


I AM SO RELIEVED TO BE DONE! (with pathophys...I still have to write 2 papers for my History of Nurse-Midwifery course...which shall be completed by this weekend)

Woo!

Go, Go, Go!

I completed a homework assignment and an exam during Allie's nap today! (oh and took a shower...it was definitely a necessity)


Now I only have 1 exam and 3 homework assignments (1 large and 2 small papers) to go. I can do this!

Go, Go, Go!!

A couple of thoughts...

I have two reflections to post about:

1) I am utterly sick and tired of typing out the etiology, pathophysiology and clinical manifestations of various disorders. Seriously.

2) I just realized that I have 2 weeks to complete 4 exams, 2 homework assignments and 3 papers.  Will I be successful??  Time will tell! (insert *goingcrazy* emoticon here)

Exams, Exams and more Exams!

I had a minor nervous breakdown the other day for multiple reasons, but one being because of school.  I'm finding it more difficult to set aside homework time than I was hoping it would be, which really shouldn't be any surprise when you think that our household has 2 adults working full-time with both in school part-time and a little monkey who's main goal in life seems to be to completely destroy this house ;)    Oh, and let's not forget the minor fact that we are also trying to get said house ready to put on the market!  (which brings in an additional set of complications)

Anyway, I started this week off being 2 weeks behind in patho since I had taken some time off of that to devote all my time to a paper due in the history course.  Thankfully I was able to take one exam on Sunday and have gotten prepared to take another exam tonight (Wednesday) and that will bring me up to speed. Then I can start working on this week's homework ;)

Phew.


I'll be so glad when I am finished with Pathophysiology.  It is by far the most difficult subject for me.  Next term I will be taking courses in Nursing Theory and Decision Making.  Not specifically midwifery related, but oh well.  Hopefully they won't be too difficult.  I think I get something like a week and a half off between these two terms, but I'll have to double-check.  Not much of a break....

Emotional upset surrounding milk letdown...

Navelgazing Midwife has a blog I follow and she posted a topic today that I find simple fascinating.  Apparently, there is a condition known as Dysphoric Milk Ejection Reflex (D-mer) that causes some women to have intensely negative feelings when their milk is letdown and all throughout the feeding process. Can you imagine a new Mother with her first child, who is already struggling to adjust to her new life and little one, only to have this extra situation piled on?  These poor women, and I am curious to see if this is corelated with PPD and a more difficult bonding between Mother and Child.


Her direct link is below:
Terrible Emotional Feelings Surrounding Letdown




and this is what it says:

Terrible Feelings Surrounding Letdown?

SATURDAY, FEBRUARY 12, 2011 AT 01:44PM

You might have something called Dysphoric Milk Ejection Reflex -D-Mer for short.

I stumbled across an article a couple of days ago and while I’m still reading about the condition, I didn’t want to wait until I was more knowledgeable before sharing it here. 

Just-Identified Breastfeeding Disorder Gives New Meaning to ‘Letdown’,” written in Babble’s Strollerderby, speaks D-Mer, a negative visceral reaction surrounding the let-down reflex while nursing. It seems to have been begun being studied in 2008… that’s the earliest studies I can find. (A list of the available studies is found on the D-Mer.orgwebsite.) 

While the causes are still being explored and studied, it seems there’s a glitch in the dopamine receptor and its regulation. This is the more scientific area I’ll look at later. 

It’s the information that women aren’t nuts if they feel these feelings during nursing that I want to get out right now. 

Alia Macrina Heise writes in “Opening the Door to Breastfeeding’s Best Kept Secret”: 

“The birth was a fairytale and my babymoon was like a dream. Then the babymoon came to an abrupt end as I started to find that just before my milk released, each and every time, I had an overwhelming sensation of guilt, dread and horror. I didn't have any pain, no physical problems, just a surge of negative emotions that hit me in the gut out of nowhere, only to fade away a few moments after my milk released from my breast. I felt great otherwise.” 

Michelle writes in “A Feeling of Dread – Michelle’s Story”: 

“I asked myself if maybe it was postnatal depression, but that didn’t sit right. I was actually elated to have birthed at home and to have had such a great experience. Maybe I was coming down from that high? I wasn’t sure. At first the bad feelings were like an intuition, that something really bad was about to happen. There was nothing I could put my finger on, but I had been trying so hard to tune into my intuition over the final weeks of pregnancy and during labour, I thought I was somehow now psychic and that bad things were about to happen to me, the kids, my husband, the house. Once I even hobbled out of bed to check my older son, not really sure why, but so sure that something was wrong.” 

This is fascinating. And is a testament that even someone like me who reads nearly everything she can find on birth and nursing, there are still black holes of knowledge that need filling. I wrote in Facebook: 

“It's when topics like this come up... a very, very important link in the birth process... that I've never heard of before that keeps me humble as all get out. You all see only a part of what I read on a daily basis and... for goodness sake,... I was a La Leche League leader for 10 years! I just cannot believe I've never heard of this. 

And yes! When I take this new color to the breastfeeding spectrum and hold it up against the misunderstood or confusing situations I've seen over the last almost 3 decades, some of them make perfect sense. As Erin said, ‘I never understood why some women said they hated breastfeeding... now I get it.’ 

And, beside the humbling aspects, this also serves as a GLARING reminder of the massive amounts of information still yet to be ‘discovered’ and named and studied... experiences women right next to us... or even ourselves... have no explanation for that, if we had the future knowledge, might change the entire relationship with our bodies/our breasts/our babies/our partners/our minds. 

Just wow.”

I hope this information resonates with any of you that might not have heard of D-Mer either.

Passed Exam 2

I passed Exam 2 after stressing out about it for two weeks. I am so glad that is over with!  I've also already taken the open book exam covering chapters 44 and 45, which luckily I did well in. Now to move forward and prepare for Exams 3a and 3b...only 6 more exams and a few homeworks to go and I'll be finished with this class.


At some point I really need to work on my Midwifery paper or my partner is going to beat me.  Perhaps I'll do that tonight or tomorrow after Andrew comes home.



Ugh. Remind me why I thought going to grad school was a good idea :S



Disclaimer: After having my brain melt over school, I have apparently lost the ability to form proper sentences and follow grammatical rules.  You're stuck with this because I am too tired to change it ;)

I am an idiot.

So as I am sitting here getting ready to listen to my most recent Elluminate session (online class lecture), I realize that I had completely forgotten to listen to the one covering my last exam. No wonder I did so poorly on it!

...I guess the only positive thought I could take from this is that now I have more insight as to what happened with that last exam and what else I can do for my future ones. What a harsh lesson though. :(

An email from a friend

I just received a great email that I'm posting here so I can remember it whenever I'm feeling discouraged :)

_________________________

Hey girl! I know you had been having a lot going on over the past couple of weeks. I hope that all is going better. It has been very overwhelming to work full time, school full time, and have a family....adding sickness for both yourself and your little doesn't help. Keep your head up and moving forward..you are so strong and your desire to succeed will help you get through it. I am keeping you in my prayers and just wanted you to know that I was thinking about you..
Love, J

Overwhelmed...

Ugh, these last couple of weeks have been a complete blur.   I came down with the norovirus and a bad URI/influenza/plague that knocked me off of my feet for a couple days. Then of course Allie came down with it and had a fever for several days, which one time resulted in us taking her to the hospital because it was 105.1 rectally. Then she continued to have the coughing/sneezing/wheezing nonsense and was just overall not a happy camper. Pretty stressful time for the Bowers fam.


Of course I tried to continue to keep up with my homework and so I took an exam in Pathophysiology (Exam 1b).  Which I failed. Hard.   That resulted in a couple conversations with my instructor and advisor, and then I had to fill out a student learning plan basically outlining what the problem was and my plan to fix it.   Fun times all around.

So now I've been working on the study guide for Exam 2 for two weeks now and I'm scared to take the exam for fear that I will fail again.  My self-esteem is pretty much shot with this class, even though I got a 96 on the first exam. (Seriously, who follows up a 96 with a failure?)


So that's where I am now. Oh and my midwifery class?  Haven't thought about that in almost 2 weeks because of Pathophysiology! ;)

First Exam...and I got an...

A!   


I took my first secured exam in Pathophysiology on Saturday after spending several days working through the study guide.  I was pretty nervous, especially since I was delayed somewhat by coming down with the norovirus (thanks work!)


Luckily, I only missed one, which gave me a 96 on the exam. Phew!  There may be some hope with me passing this class after all! ;)

Holy stress levels, Batman!

Well classes have officially begun as of January 10th. Of course the majority of our classmates on the Facebook group are nice and freaked out, but hopefully things will calm down once we all get into the swing of things. 

I took one of this week's exams in pathophysiology yesterday. It was in acid-base imbalances, and thankfully I aced it.  It did help that it was open book, but I'm pretty proud of myself anyway because I was able to pick the correct answers, Haha!

One thing I picked up on pretty quickly is the amount of reading we have to do each week. It is a TON.  I am so glad that I didn't try to register for 3 classes this term...I think the readings alone would have killed me!


As excited as I am about finally starting my courses again, I have a very much unwanted added stressor.  One benefit that my employer offers is tuition reimbursement, which is fantastic, however even though I had it all finalized...the HR rep sent me an email last week saying she needed a form for the school to fill out before they could remit payment.  Well that was accomplished quickly enough, but then fast forward a week of me calling and pretty much stalking the woman until I finally got ahold of her supervisor, and then she finally decided to return my phone call.  So now the payment won't be sent out for another week or so due to "processing."    Too bad the tuition is due the 15th and if my school doesn't receive payment by that time I will be suspended.  Reinstation isn't such a huge issue, but that means I can't turn in any assignments or complete any exams during that period...plus I get hit with a late fee.

Needless to say, I'm freaked out.  I've sent a few emails to my school's financial advisor trying to get an extension. We'll see what she has to say. :(

Posterior Tongue-Tie

This is a fascinating read for someone, such as myself, who after all her experience and education regarding breastfeeding, still couldn't get her daughter to properly breastfeed. Yes, I was able to still provide her with milk from pumping. But that was by far a second-best option for me.

Original article posted on: Stand and Deliver

 

Posterior tongue-tie

In last weeks' post A Proactive Approach to Breastfeeding, I briefly mentioned tongue tie as a possible culprit for breastfeeding problems. Cassandra of wrote in about her daughter's posterior tongue tie:

My 3 month old recently had a posterior tongue tie fixed after being told by three different IBCLC, my midwife and a pediatrician that nothing was wrong with her. She got clipped and like magic latched for the very first time. I'm doing what I can to spread the word about this rare but severely underdiagnosed problem since if I hadn't been extremely stubborn and kept at it, this problem would never have been taken care of. Here is a very in depth and fantastic resource for diagnosing tongue tie of every type: http://kiddsteeth.com/articles.html

I wanted so very badly to breastfed I seriously almost killed myself over not being able to (yay hormones) and it's incredibly frustrating that it was a problem that could have been fixed, but nobody caught what was actually a pretty obvious tongue tie. I don't want to see any other moms go through the same thing.

Yesterday, Shannon shared her story of posterior tongue tie at the Motherwear Breastfeeding Blog. Shannon was an IBCLC and still did not pick up on the tongue tie! It wasn't until she was in a room full of IBCLCs (most of whom misdiagnosed the problem as well) that she met one woman experienced with posterior tongue tie. Like Cassandra's story, as soon as Shannon took her baby in to have the tongue tie clipped, the baby latched on perfectly for the first time. Here are a few excerpts from her story:

After the birth of my first son Aidan, I was so excited to nurse. After spending so many years teaching breastfeeding, I was finally going to experience it myself. In the labor and delivery room when I nursed him for the first time, I was surprised at how painful it was. I knew I was latching him correctly; after all, I was the expert! When he came off, my nipple was misshaped, smashed into a slant, like a new tube of lipstick. I looked at his tongue and he could stick it out, so I thought it was not tongue tie. By the next day, my nipples were cracked and bleeding. The agony was too much, and I had to pump and bottle feed most of the time to give my nipples a break. I was devastated and thought I might have to change careers.

I was ashamed that as an IBCLC I couldn't get this right, and the only person I could be honest with was my husband. When friends and colleagues would ask how things were going, I was not fully honest about how terrible I was feeling. When Aidan nursed, it was more than just a pinching or biting feeling. It was irritating, like sand paper on my nipple. His sucking was choppy, and he was having a hard time maintaining latch. Feedings were 45-60 minutes long....

Then there was one IBCLC, Debra Page, who saw him stick out his tongue and said I think he is tongue tied. I asked her to explain because when I worked in the hospital, the babies I saw who were tongue tied could not stick out their tongue past their gums, and if they did, it was heart-shaped on the tip. She said there were different types of tongue tie, the obvious ones are type 1 or type 2, and it looked like Aidan had a type 3 posterior tongue tie. I had never heard of this. She explained that he couldn't elevate or lateralize his tongue, and when he did stick it out, it was duck bill shaped, not pointed.

The surgeon we went to, Dr. Elizabeth Coryllos, explained that she would do the frenotomy in the office and she would numb him under his tongue. I began to cry. She assured me it would not be painful to him and he would be able to nurse right away. I told her that was not why I was crying. I explained to her I was upset that I was not able to solve this on my own, that as a professional and as a mom I felt like a failure. Then she gave me the best advice I have ever heard as a mom. She said even if I was the best race car driver in the world and I had the best car ever built I could not win the race if a tree fell across the track. Someone would have to remove the barrier so my car and I could continue on our journey. It was not my fault that nursing was not going well. I had the best baby in the world and I was the best mom for him; we just needed to remove the barrier to continue on our journey.

In an AAP newsletter on breastfeeding, the article Congenital Tongue-Tie and its Impact on Breastfeeding (PDF) explains the four types of tongue tie and how they can affect breastfeeding.

Types 1 and 2, considered “classical” tongue-tie, are the most common and obvious tongue-ties, and probably account for 75% of incidence. Types 3 and 4 are less common, and since they are more difficult to visualize are the most likely to go untreated. Type 4 is most likely to cause difficulty with bolus handling and swallowing, resulting in more significant symptoms for mother and infant.

An infant can obtain milk from a bottle without the wide gape and consistent suction needed for a good breast latch. If the tongue-tied infant cannot maintain the tongue over the lower gum during sucking, the “phasic bite reflex” (chewing) is triggered. This chewing motion is ufficient to transfer milk from the bottle, but is clearly problematic at breast. Bottle feeding allows milk to drip into the mouth without effort, thus requiring less tongue muscle effort (such as tongue grooving, cupping and depression) than needed for breastfeeding. Breastfeeding requires well-defined peristalsis from the front to the back of the tongue as well as tongue–palate synchronization. Some tongue-tied infants cannot even manage a bottle.

Even more simple forms of tongue tie can be overlooked. In Totally Tongue-Tied, Sheila, an experienced breastfeeding mom, describes her difficulties nursing her third baby. She had expressed concern to her pediatrician about possible tongue-tie, and he told her that " there was nothing wrong with Kyle's tongue since he could extend it out past his lips." But it turns out her baby was tongue-tied. His latch improved somewhat after the frenotomy, but he still had to learn how to latch, to drink, and to extend his tongue properly. She writes:

I was frustrated that it was taking so much work to train him to suck, but the lactation consultant reminded me, "He hasn't been able to move his tongue out of his mouth for 9 months. It's going to take more than a few days to teach him to use it properly to nurse." The next day, I noticed Kyle was actually sucking and swallowing while at the breast, so I started massaging the breast while he was nursing to encourage the milk out and his swallowing per suck ratio increased dramatically. He was still requiring about an ounce of additional expressed human milk after nursing most of the time, but this was major progress. At three months, Kyle is now nursing totally independent of any supplements, and only occasionally requires adjustment of his sucking.

I never expected my third child to be the most difficult to breastfeed. I feel very fortunate to have an extensive network of support from friends and family. I am eternally grateful for a loving and supportive husband who feels as strongly about the importance of mother's milk as I do. I am also thankful for the support and encouragement I have received from my La Leche League friends. Without them, I feel I may not have been able to provide my son with the best nutrition available to him, his mommy's milk.

School is starting soon!

I feel like I just turned in my Final exam for Statistics...how in the world is the next term coming up so quickly!?!


At any rate, January 10th is quickly approaching whether I'm ready or not.  I told myself I wouldn't do any school work ahead of schedule, but I did go ahead and setup folders on my Google docs site so I can organize it.  I have OneNote at home, which I actually prefer (especially since I paid for it), but I need something that I can access at work. Unfortunately, I don't think they'd let me tote around my giant laptop....

I'll be taking a course covering the Role of Midwifery and Birthing Centers in America, as well as a course in Pathophysiology. Both, of course, are graduate level.   I'm so excited to finally be starting to work on my Masters, and yet I still can't believe I'm here. It seems so surreal and feels like just yesterday I was working on my first undergraduate degree in Biology. Where has the time gone!?!?!

I'm somewhat nervous about Pathophys...I find the subject fascinating, but so complicated! I hope my brain can handle all this information!

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!

How To Make a Baby

Too cute  :)

How To Make a Baby

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

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 :)