Tuesday, July 31, 2007

Catching Up

Sorry to disappear from the blogosphere for such a long time. I've just been a wee bit busy here. When I posted last, my partner was off on vacation, I was on call, and my blood pressure was teetering on the borderline. I made it through the first week of OtherDoc's vacation relatively unscathed. I had lots of clinic patients, but the deliveries remained somewhat manageable. I, on the other hand, was feeling pretty drug out and worn down. (Wonder why?) At my 38 week appointment, my OB was on vacation as well, so I saw another physician in the practice. My pressure was 148/89, my cervix was closed (surprise) and my NST looked great. I got the lecture about taking it easy (yeah, right) and I had to repeat the dreaded labs and 24 hour urine protein. I saved that joy for the weekend. I collected on Saturday and turned it in on Sunday when I went in to round on patients.

I'm not sure if this is a coincidence or not, but on Sunday I admitted and delivered a severe HELLP patient of mine. She had no preeclampsia, only HELLP, and she got really sick really fast. She came in complaining of upper abdominal pain. Her labs were just mildly bumped at that time, but she was term with a favorable cervix, so we began Mag Sulfate and started the induction immediately. Luckily she delivered within a couple of hours. Then the fun with labs started, her liver enzymes soared as her platelets plummeted. The platelet count nadir was around 40,000, just shy of needing a platelet transfusion. Luckily, with the help of Dexamethasone, she turned the corner and recovered very quickly. She was able to go home on her 3rd day post-partum. Later that day I checked my own labs. No signs of HELLP, but my 24 hour urine protein was solidly in the mild preeclampsia range. Knowing that my time was limited, and in anticipation of having the smackdown at my Wednesday afternoon appointment, I attempted to stack my schedule for Monday, Tuesday, and Wednesday morning.

Monday was an absolute blur, lots of clinic patients, charts, and 3 inductions, not to mention my sick HELLP patient. I was waiting on a delivery (around 5:30) when I got a phone call from my physician at labor and delivery. Uh-oh. It turns out that he had been looking for my labs, and when he saw the 24 hour urine protein, he was compelled to find me and tell me to stop working...pronto, and to pick a day for induction. Eeek. I immediately flashed on how sick my patient had gotten in such a short time, and I knew that it was time to start taking care of me. He sounded like he meant business, so I immediately called the back up covering physician, who was wonderful and told me not to worry about him covering my patients, even though I had stacked inductions and sections for the next few days. I then made out an extensive check out list and did the final delivery ( a rather difficult vacuum, at that). Then I went to see my patients that I had scheduled for induction and explained that I had been pulled from work by my own physician and would not be attending their deliveries. Then I cried, in front of the patients, and felt like an idiot. Both women were very understanding. I finally got home around 11pm, cried some more, and felt like the weight of the world had finally been removed from my shoulders. Tuesday I did absolutely nothing but sit and catch up on my patients via computer. Wednesday I (finally) packed my hospital bag and prepared to go to my appointment. Little did I know how important that would be....

To be continued...

27 comments:

Christine said...

wow, it's a cliffhanger! Glad you're back, I hope the happy ending is in the next post!

Trope said...

WHAT?? Dr. Whoo, you must tell us! We're dying over here!

E.M. said...

Oh, don't leave us hanging too long! Hope everything went alright.

medstudentitis said...

Oh my god I'm so excited!!!! More!!!!

Kim said...

I don't remember how I found your blog. I have been checking in to see if you have had the baby. I hope everything is well and I cannot wait to read the rest of your story.

AtYourCervix said...

Ack! Don't leave me waiting! I want to know how things went! I've been very concerned about you, having seen NO UPDATES in 3 weeks.

geesh lady....scare the L&D nurse wouldya??

part 2 of your labor/birth por favor...............

Anonymous said...

Oh yay, you're back! I'm glad you are ok, and hope the bean is too! I'm waiting for the end of the story with bated breath, after a few of the ominous portents in your entry... I wish you and all of the Whoos the best!

Nine Texans and friends.... said...

I'm so glad you are posting. I've been getting worried. Anxious to hear the rest of your story. Sounds like it's shaping up to be a lot like my last with PIH really mucking everything up.
Just praying little man came through it all unscathed.

Amy said...

No fair, we don't like "to be continued" stories... :)
Hope all is well. I am an L&D nurse who enjoys your blog.

The MSILF said...

Glad you're back! I've been checking every day to see whether the Bean has been born yet. Sounds like things got complicated...hope it wasn't too bad...and waiting for the rest of the story.

LL said...

Welcome back to your blog. I've been checking in regularly. But now you've left me hanging!! I'm hoping you've had your beautiful baby and that everything is ok. Best of luck.

Cindy said...

To be continued! I hate waiting to find out the end on an interesting story. But since you ARE writing this I am assuming that all ends well for you. Looking forward to the next installment.

3carnations said...

Aaah! You can't leave us hanging like that! I hope everything is going well!

PE Mommy said...

AGGGGGGH and you leave us hanging.....

I have been checking to see if you had that babe of yours yet!

Anonymous said...

Why on earth would you jeopardized the health of your unborn baby and yourself by working so hard with BP's in that range, never mind your 24hr protein? Your patients can find another doctor in an instant, as I'm sure you have found. Your unborn baby, daughter, and son have only one YOU and you owe it to them to take better care of yourself. Please don't be a martyr for your patients, they don't appreciate it!

Anonymous said...

You're being mean, but I think it's because you're holding your baby all day and cannot get to the computer...

Hope so!
Blessings!
Dawn (jawndoejah)

Kim said...

Delurking to say that I hope everything is okay and that you and the rest of the Whoo's are home safe and sound and enjoying the newest Whooville resident.

Anonymous said...

What kind of selfish bastard goes on vacation when his partner is 38 weeks pregnant?

AlisonH said...

You do know, don't you, that the crying part was perfectly okay. The times I've felt closest to the medical personnel in my life is the times they've allowed themselves to be perfectly human.

So how's the baby?...

The Girl said...

Wow, can't wait for the next post! I hope it all went (and is still going) well!!

ReetzS said...

I've been checking every couple days for updates since you were getting so close to delivery. . .

Hope all is well with you and your family.

Anonymous said...

Ack! Please continue!! Or, are you busy tending a newborn? ;-)

A. said...

I hope you are doing well. Did you develop HELLP?

I want to say come on, come on, TELL, TELL!! But I also want you to be well & recovered first :)

Congrats, of course, if that's in order!

Can't wait for the conclusion :)

Anonymous said...

Aaaah! Come back and finish the story, we need to know what happens!

Jean said...

26 comments to the previous post and none to this one. I hope the abrupt end is only indicative of how incredibly busy you must be.
I've not had a baby in 43 years, but I remember. Sincerely.

Anonymous said...

You're leaving us dying of anticipation! Hope all is well with you and the little ones:)

Lizzie said...

Ahh!! I'm on the edge of my seat waiting for the sequel. You are a GOOD writer! Okay, how selfish am I? I'm sure you've got plenty on your hands right now without worrying about your blog. I hope and pray all is well.