Warning! Whiny post ahead! I'm in a terrible funk, and I just can't seem to shake it loose. It is my favorite time of year. The colors are bright, and the air is cool. It is beautiful here in the mountains. Hormonally, I'm still waiting for the PMS monster to go away (no, alas, I'm not pregnant). My football team is in the cellar of a mediocre conference, and I've been working really hard, but feeling like I'm getting nowhere. I was also sad to hear of a fellow OB/GYN blogger and her unexpected death. I really loved her blogging voice, and could relate so closely to the things she was enduring as an intern. She had a brilliant light, and it saddens me that it has been extinguished, I feel, too soon. It's funny, because we really don't know one another out here in the blogging world, but I find myself emotionally invested in the blogs that I read. I asked my husband to update my blog, should anything ever happen to me. I feel as though our whole lives are working toward something...the next weekend, the next vacation, the next pregnancy. We so often forget to appreciate the now. I have been trying to stop my forward thinking, just to sit back and enjoy all with which my life has been blessed.
I'm taking call this weekend for the hospital, for myself, and for OtherDoc, but tomorrow night my husband and I are going to a concert. I miss getting out amongst the living in a social setting (sans pager!) Next weekend will be the first weekend that I am not on call and not on vacation. I can't wait. I think we are going to visit some of the surrounding parks/recreation areas. The fall colors should be at their peak, and we will get to enjoy some beautiful scenery with our nature-loving daughter.
It has been a very busy week, and I've been at the hospital late a couple of nights. I've had good deliveries and not so great deliveries. One of the best deliveries was one of my post-dates patients (one I had to talk out of an elective induction) that came in naturally laboring. She walked until she was 7 centimeters, rested a bit, and then asked for an epidural. At that point it was too late because she was anterior lip and nearly ready to deliver! She delivered an 8-and-a-half pound baby without any meds. She was so thrilled. I love labors like these! My second labor patient of the day (the one that caused me to miss the live Lost premiere ) was also post-dates with oligohydramnios. She had a very large (and quite overbearing) family, and she had rotating groups of people migrating between her room and the waiting room throughout the day. She and her husband are quite pleasant, but you would not believe the way she was coddled by her family. It was if she were some kind of fragile doll. I chalked my snarkiness up to PMS, and tried to hold my tongue when person after person pressed me for a time of delivery. Her mother sidelined me and asked weather or not I thought she would be able to have a vaginal delivery, since she was "so small." I explained that she at least deserved a chance, and encouraged her mother to continue supporting her. The patient did have the rather unreasonable expectation of having no discomfort whatsoever in labor. That was unfortunate, and after she had been pushing for just a little under an hour, she begged me to "just pull it out!" I reassured her, and encouraged her to rest a while and resume pushing. The baby's presentation was right occiput posterior, but still a little too high for a vacuum or forceps. She pushed for yet another hour, and was able to bring the head down to +2 station. I applied a vacuum and rotated the baby to OA and delivered in one push. That was the good news. The bad news was that, upon delivery, the posterior shoulder tore into the perineum, and she sustained a partial fourth degree laceration. (No, she did not have an episiotomy.) Even more exciting, the spotlight chose that moment to expire, necessitating an impromptu call to maintenance. My patient rested, her legs up in the stirrups, draped strategically with blue towels, while the poor maintenance man did the fastest light bulb change on record. Talk about awkward! The repair itself actually went very well, but I feel for the discomfort she will endure in the coming weeks. Ouch!
Today I did a c-section on a woman with severe pre-eclampsia. She had been laboring for 2 days, and despite adequate contractions and every trick in the book, she never dilated past 2 centimeters. Stranger still, neither her mother nor her grandmother ever progressed in labor further than 2 centimeters! We jokingly dubbed the phenomenon the "2 centimeter curse." Luckily, she had a man-child, so he shall dodge the hereditary misfortune. Tonight I am praying for good company, some good sleep, and the return of a good mood. Perhaps I will awake tomorrow with the remnants of my funk evaporating like the mist over the mountains. I certainly hope so.