Reasons Why I Suck and Clinic Gems

So yes, I suck. I suck at keeping my blog updated, I suck at keeping in touch with my friends, I suck at keeping on top of paperwork, and I suck at keeping my house clean. I feel like I have been trying to play "catch-up" for the whole month of February, and the month is nearly half-over! I just feel like I am sprinting to stay in place. Over the last week I have updated my delinquent dictations, caught up the majority of my clinic charts, did a few surgeries, delivered a handful of babies, sat on my couch, and slept (I mean, I even fell asleep during LOST this week). What I have *not* done is talk on the phone to friends with whom I haven't spoken in ages (these people don't even know I am pregnant yet!), clean my house, do laundry, blog, get my hair cut and highlighted (it is getting ugly, people), given Mr. Whoo his wedding anniversary present (our anniversary was at the end of January), put CindyLou's baby pictures in albums, bought valentines for CindyLou's class party, and a half a million other things on my ever-growing to-do list. Mr. Whoo has been picking up the slack as best he can, but I know he must be growing weary of his slovenly wife.

I was hoping to really kick into high gear this weekend, but I have been on call, so I was at the hospital until almost 2 am on Saturday morning doing a delivery. I slept in until 10, went in for rounds, and then my whole Saturday from noon until midnight was spent at the hospital watching over one of OtherDoc's VBACs. It is hospital policy that the physician be on site the entire time a VBAC is laboring (with good reason, of course). I am always up for a good VBAC, and the patient seemed like a good candidate with a few vaginal deliveries, then one emergency section for fetal distress. The frustrating part is that the patient got to completely dilated, pushed twice, and then simply refused to push anymore and demanded another section (a mere 8 hours after she had been offered an elective repeat C-section in the first place!) The baby was low, but not quite low enough to put on forceps or a vacuum, so off to the OR we went. Since the baby was so low in the pelvis at the time of C-section and the lower uterine segment was paper thin, the uterine incision extended into the broad ligament on both sides, causing lots of bleeding and venous oozing, and the bladder was pretty traumatized as well. To add fun to the surgery, the patient seemed to be feeling everything we did to the uterus, despite anesthesia's best efforts, refused to be put to sleep, and instead kept a running commentary throughout the entire surgery about her discomfort (despite a truckload of fenta.nyl and verse.d). Her urine was blood-tinged prior to and immediately after the surgery, and I checked the bladder integrity prior to finishing, but I'm still fretting over an occult injury this morning. Sigh. I'm keeping her Foley in until her urine starts to clear and keeping my fingers crossed.

I also had a few notable moments in clinic this week. The grossest of which involved one of my young, teenaged OB patients. We had done her GBS swab and checked her (closed) cervix because she was complaining of irregular contractions. Her blood pressure had been slightly elevated on our automatic cuff, so, as per routine, we had her relax on her left side, and planned to return to take a manual blood pressure. When my nurse returned to re-check her pressure, she and her boyfriend were *having sex* in the exam room on one of the chairs! Squick! My nurse kicked the boyfriend out, pulling up his pants as he went. Needless to say, the patient's blood pressure was even *higher* on re-check. The real kicker is that we sent her with orders for labs and a 24 hour urine to check for protein, and her mother (a nurse) called, concerned about whether we should pull her daughter from school since her blood pressure was climbing. I couldn't tell her mother that I expected the elevated pressure was more due to the girl being all hot and bothered in my office than to pre-ecclampsia! At any rate, the last thing she needs is to be out of school so that she can fool around more. SuperNurse swabbed the whole room down (including the chair) with alcohol, and closed that room to patients for the rest of the afternoon. What is wrong with people?!

Honorable mention clinic moments include the school teacher that complained that she had to work on Thursday and Friday (essentially a two day week) after the schools had been closed due to weather issues on Monday, Tuesday, and Wednesday. "They should have just given us the whole week off!" she whined. I teased her and told her we should switch jobs. She then said, "Oh I would much rather do what *you* do!" Hm, so you are complaining about *having* to work a two day week, and you want to trade time off for bad weather (not to mention summers, holidays, and weekends off) for being on-call 24 hours a day, up to 14 days in a row? Call me crazy, but I think not. The other came from a patient on whom I am planning a tubal ligation. She wanted to be certain that her fiance was not told that she was having her tubes tied. Of course, it is none of his business what she does with her body, or how she chooses to practice contraception, but it seems like a suspect way to enter into a marriage. It is a sticky ethical situation, and while I know the proper thing to do with respect to the patient's right to privacy, I still can't help but feel odd about the situation.

So anyway, there is your latest installment of whining and moaning. Don't you feel better? I know I do. On the bean front, I am 16 weeks and 2 days, and I just had my Quad screen drawn this week. I'm still puking most mornings, and still taking Z.ofran every day. I think I may have felt movement this week a few times, but I am not certain. We find out in a couple of weeks what we are having. I'm still not sure what I think. I can't imagine not having another girl, but everyone else around me seems to be getting the "boy vibe." We shall see. Thank you guys for coming back to check on me, I will try to be better about updating the blog. I really do enjoy it when I get the chance. Have a great week!