'Tis the Season

...to be crazy. I've been laboring under some grand delusion that the "holidays" were supposed to be relaxing and carefree, as suggested by the title "holiday." Instead, they are more work and more stress and more pressure from patients to have their baby/surgery/consultation "right now" so as not to interfere with their holiday plans. There are times that I wish I were an OB that had no qualms about scheduling purely elective inductions. I would have stacked my remaining December patients for induction early in the week, clearing my holiday weekend from pending labor time bombs. Alas, more inductions = more sections. This isn't convenient for anybody.

Wednesday I had 4 scheduled surgeries and two inductions. The first surgery was a 400 pound repeat C-section. Her initial incision was, for some reason, made high on her abdomen, transverse, through the thickest part of her pannus. (We are talking about one foot of fat here, at least.) Due to the increased risk of infection making an incision in a low position under the pannus, we decided to use the same site. To add to the fun, the baby's presentation was transverse back down. We had to rotate kiddo to vertex, then I used a vacuum to gain the proper traction to deliver the baby. Fortunately, I had a seasoned OB as a first assist, and we both struggled with this case. Comparatively, the remaining surgeries progressed in a fairly straightforward manner.

One induction was for post-dates, one was for pre-ecclampsia. In true pre-ecclamptic style, my first induction zipped from 3 cm to pushing in about an hour, max. My second induction never made it past 4 cm and -2 station, as the baby decided it was against this whole labor business and decided to have huge, ugly late decelerations. To the OR we went, and thus I had my 5th surgery of the day.

My parents are in town, and CindyLou is just beside herself with all of the attention being lavished upon her. My mother baked (love you, mom!) and my dad fixed up the Grinch-y Christmas tree so that all of the lights are lit and the star is straight! I addressed all of the Christmas cards this morning (better late than never). Now I have to get myself together, get to the hospital to round and to tell my 39 weeker with gastroenteritis why this is *not* the ideal time for induction (what she wants), what with her puking her guts out and all. Then it's off to brave the last minute crowds to finish up the shopping! I will likely be incommunicado for a bit, with all of the family and holiday and work obligations, but I want to wish all of you a very Merry Christmas and the happiest of New Years!

No Champagne on NYE

We have a heartbeat! We also have a due date - July 23, 2007. The little bean looks really good, and is measuring about 9 weeks exactly. The heartrate was 171 bpm. We saw limb buds and even some movement today. I am beyond relieved.

I also got a really nice compliment today from the OB that I went to see in University City. I refer high-risk patients to this clinic, and the doc today said that they always welcomed my referrals as they were always appropriate. He said "If you call us after-hours about a patient, we know that she needs to be here." So very nice of him!

I am feeling all warm and fuzzy and happy now. We celebrated by taking CindyLou out for Mexican; she even ate salsa! I just wanted to give you a quick update and to thank all of you for all of your wonderful comments and support through all of my angst-ing. Your kindness has meant so much to me. Y'all are the best! More later, must. dictate. charts. :)

Jealousy

I hate to admit it, but I am an envious person these days. Instead of stressing about Christmas card lists, I will instead list people of whom I am jealous:

~people whose job resides within the confines of 8 to 5

~people that don't have to work at all

~one of my colleagues that is working in a large group and only has call one weekday each week and one weekend each month

~every person that has their holiday shopping/decorating/baking done

~anyone whose Christmas tree has not fallen over (twice) this season, thus destroying countless ornaments and hence appearing as though the Grinch has attempted to stuff said tree up the chimbley

~my patients that lounge upon my exam table (in their pajamas, no less) and proclaim how the hour of 10 am is "sooooooo early" to be at an appointment

~my patients with the unmitigated gall to start asking for medical maternity leave at 8 weeks gestation because they are just "way too tired" to work

~anyone whose job perks include having every single holiday off...Thanksgiving, Christmas, New Year's, etc. Not to mention everyone whose job guarantees every single weekend without work obligation

~organized people (like those crazy people from whom I received Christmas cards in freaking November!)

~clean people

~people with time in their life to sleep, to exercise, and to prepare healthy meals for their families

~Fat Doctor, who has spent the last few weeks making the conference rounds at fun locations (so jealous!)

~people that aren't so whiny and complain-y as I

~people that can brush their teeth without fear of yakking

~people that know how their pregnancy is progressing without fear or worry

All right, enough pity party for now. Lest the strident objections about how I "chose" this lifestyle and "knew what I was getting into" when I became a physician arise, let me say that there really is no way to anticipate how difficult this kind of life can truly be until you are actually living it and unable to turn around and choose again without serious repercussions. I would say that 90% of the time I love my life, and wouldn't change a thing. Sometimes, that 10% that I would like to change gets a little vocal. I have so many blessings in my life for which to be grateful, so maybe I should start listing them when I start feeling my green-eyed monster stirring about.

Now I must do some serious internet Christmas shopping. I don't think anyone in my life would be getting any presents at all if not for the wondrous internet. I heart shopping online. Happy weekend to all!

So Tired

I have never been much of an Ozzy Osbourne fan (past, chicken-head eating Ozzy, nor present, parkinsonian DTs dysfunctional-parent Ozzy), but I distinctly remember seeing a portion of the video for the song "So Tired" in my old house in Mississippi and hearing the refrain "I am sooooo tired, and I just can't wait around for you." That's all that I remember of the song, but whenever I get really exhausted, this refrain echoes around in my foggy little brain like some sort of anthem. Truly bizarre, what the mind can spit out under duress. I wish that I could remember other, more useful details in this manner. Sorry for the silence, but I, as per usual, have been quite busy, and when I am not being busy, I am being catatonic on the sofa, stewing over everything else that needs to be done. Nary a witticism nor quirky observation about the universe about which to blog has entered my brain. Thank goodness that I've been tagged with not one, but two memes!

First, from Dr. K at That Mirror belongs to Frank - My 5 favorite Christmas Songs.

1. God Rest Ye Merry Gentlemen - My current favorite is performed by the Barenaked Ladies and Sarah McLaughlin, and it is such a cool version, how can you not love it?

2. O Holy Night - This song never ceases to make me tear up, pregnant or not.

3. Carol of the Bells - I identify with the frenetic pacing of this Carol. Makes me feel right at home!

4. Tie! Simply Having a Wonderful Christmas Time - Paul McCartney This is a song that is really happy and cheery, and it reminds me of my parents. (P.S. Ew, while looking for a clip online I found out that Hilary Duff ruins, I mean, covers this song. My ears! Ick.)

Rudolph the Red-Nosed Reindeer - My childhood favorite, now CindyLou's very favorite, as well.

5. Adeste Fideles (O Come All Ye Faithful) - Only because I took Latin once upon a time, and I can actually sing this entire song in Latin. Yes, I am a dork.

Honorable Mention - Just about any song from John Denver and The Muppets - A Christmas Together. This just really takes me back to my childhood and Christmas with my parents. Also guaranteed to make me bawl like a little girl.

The second meme comes from At Your Cervix, and is titled "6 Weird Things." Only 6? Hmm.

1. I think that I have mentioned before that I have a real social phobia. I know this is weird because I interact with multiple people, strangers, in my every day work and life, and do quite well at it. However, in residency, I developed a true reluctance to answer the phone at home...ever. I think it stems from having such a demanding job, and I am wanting my time at home to have no other demands placed upon it. I am a real call screener. Sometimes I can make exceptions for my mother, but most of the time, I have to talk myself into answering the phone. Also, I hate to call in orders (like for pizza, etc.) or speak to people I don't know on the phone. Email can also go unanswered (and sometimes even unread) by me for weeks because I can't handle the pressure of a reply. Weird, right? I should be on medication for this.

2. I dig the paranormal. Ghosts, hauntings, astrology, tarot cards, divination, you name it, it is fascinating to me. I know my rising sign and where my moon is and have analyzed my and Mr. Whoo's astrological charts. I can also be very superstitious. This is weird because most of me is very rational/scientific, but I'm a sucker for anything extraordinary. Must be the Pisces in me. ;)

3. I eat spaghetti with ketchup on it. Yes, you read that correctly. Spaghetti with ketchup and parmesan cheese, and sometimes butter. This evolved from childhood, when my mother used to add a little ketchup to her spaghetti sauce on my serving, because it took the spice and bite out of the sauce for my young, delicate palate. It has since mutated. This habit really grosses Mr. Whoo out, but he eats tuna in mac and cheese, which I find equally disgusting. (How can you defile mac and cheese in this way?)

4. I am somewhat claustrophobic. While I don't dig small places, the true underlying fear is being unable to breathe. If I am in a small place, but can feel cool air blowing past my face, I am usually ok. I once had a total meltdown whilst "caving" in Tennessee on a youth group trip, because in one portion of the cave you had to get down and *roll* to pass through the cavern. Huge rocks on the top of you, mud and dirt beneath you. Freak out city. I also have to sleep on the right side of the bed, because I sleep on my right side, facing right, and have to have air in front of my face.

5. I was a Navy brat. I grew up moving about every 2 years, which sucked. My dad retired from the Navy when I was 12 or 13 and we moved to Florida where I completed high school, college, and med school before moving northward for residency. Mr. Whoo and I hope to stay put so that CindyLou can have the experience of growing up in one spot.

6. As a child, I was obsessed with Unicorns. Loved them to pieces. Think of Kate from Dodgeball, except that the obsession did not follow me into adulthood. I wanted to believe they were real, and I had a book extolling all of the possibilities of the existence of unicorns. I had a blue million "My Little Ponies." (Which, I am happy to report, CindyLou now adores.) I have an obscene collection of unicorns packed away in my basement, just waiting for CindyLou to be ripe for a passion of her own. Evil Mommy.

I know that I am now supposed to tag other people to do this, but I think that everyone I read has already done these memes weeks ago! If you haven't yet, consider yourself tagged. Lazy = me.

P. S. S. As for the bean, no news, thus far, is good news, right? So far everything is status quo, gagginess, fatigue, et. al. No bleeding or cramping, so I assume the bean is hanging in there. My appointment isn't until the 18th, so I am trying not to obsess too much until then.

Walking Barefoot Uphill in the Snow....Both Ways!

I'm going to turn in to one of those crotchety old physicians that thinks that the younger generation of physicians are a bunch of slack-asses. I can just feel it already. From time to time I have a medical student on rotation for OB/GYN with me. I usually only have 2 or 3 a year, but lately, more and more have been requesting to switch rotations from some other doc to me. I am flattered, really, that the students are having such a good time in my clinic, but sometimes I come across a student that just rubs me the wrong way. Here is a list of what not to do as a student (claiming to want to go into OB/GYN):

~ show up to round at least half an hour after the physician is already there, and a full hour after the time that s/he told you to be there

~ after being late to said rounds, ask "Well, you don't want me to write notes on the patients *now*, do you?"

~ when your precepting physician asks you to pull up a newish drug on your fancy new PDA to check for interactions, do not say "Don't *you* have one of these to look things up?"

~ wander over and play with the newborn kiddo while your precepting physician is repairing a second degree, and trying to show you how to do it.

~ make up a lie about an ailing, possibly dying, relative, in order to get the full week around Thanksgiving off, rather than just being upfront, honest and asking for the time outright.

~ ask your precepting physician for the dosages of medications when writing prescriptions (after s/he has told you several different times, nevermind that you have a fancy PDA to look them up) because "It's easier to ask you than to look it up."

~ near the end of the rotation, when you are well versed in discharge instructions and discharge meds, when the precepting physician asks you to get a patient's discharge ready, do not ignore her/his request, and instead, play with one of the newborn kiddos in the nursery because "She was crying."

~ decline to watch a circ because you've "seen enough of those, already."

This is just a sampling of the smorgasbord of med student miscues during a recent rotation. It really blows my mind (long winded tirade ahead) because when *I* was a student in a large teaching institution, my butt was rounding on patients at 4 in the morning, frantically getting notes written, vitals, and labs pulled before the intern came in to round between 5 and 5 :30 am. You wouldn't dream of getting to the hospital after the intern much less the attending! All discharge orders were skeletonized (along with prescriptions) and tucked in a pocket in the front of the chart in order for more efficient discharges. If (and I do mean if) the attending ever spoke to you directly outside of lecture and asked you to do something, you better have it done before the request was cold in the air! You certainly didn't smart back. Declining to watch *any* procedure? That just didn't happen. Because of the atmosphere in the hospital in which I trained, you functioned as a Sub-I when you were a third year, and really, as a fourth year, you functioned as an intern. I realize that a small community based hospital is going to be cushier, and definitely not as much work as a large inner city hospital. The respect and interest in learning should be the same across the board though. *Sigh*

Okay, you can start reading again. I'm done ranting for now.

In other news, Mr. Whoo is sitting out in the freezing cold woods looking to shoot some poor defenseless animal, CindyLou is watching her 3rd episode of Mickey Mouse Club-house, and I am getting really good at holding my breath when opening the fridge, lest the smell of the food in there make me gag. I really don't think there is anything rotten in the fridge. Mr. Whoo can't seem to smell anything offensive, but I'm gagging just the same. I'd like to know what is going on with this pregnancy, because I'm really not digging the gagginess, but I would gladly take it if it meant that the bean was going to be ok. I have made the decision not to order any further testing on myself, and I will wait until I see a physician in University City and let them diagnose me...hopefully sometime next week. Thank you all again for your kind thoughts, wishes and prayers. You are the best, and I will keep you updated. :)