Saturday, December 01, 2007

Going It Alone

December the first. Wow. I know that you are all dying (dying! I say) of suspense with respect to how solo call with an infant worked out for me. Chaotic? Anxiety producing? Strangely manageable? The answer is: All of the above! Fortunately for me, OtherDoc had "brought the house," so to speak, the week prior to his departure, so the weekend was eerily quiet with respect to laboring patients. I had lots of phone calls to field and triage patients to work up and manage, but actual admissions and labors were scarce. Unfortunately this lulled me into a false sense of security, because at 2 am on Monday morning I got the call that one of OtherDoc's patients had shown up to L&D in labor. Oh, and by the way, she is 8 cm dilated. Ack! There was no time for me to call my backup plan for childcare, since she lives a good 20 minutes from us, and by the time she got here the baby would likely be making an appearance. So I bundled up a very confused Bean, put him in the car, and away we went. Luckily for me it was a relatively slow night, and the nurses were thrilled to see him and watch over him.

I arrived just as the patient was starting to push, and my stomach knotted as I saw the verrrry sllloooww emergence of the baby's head. It was a hallmark shoulder dystocia presentation, and I locked eyes with the nurse, who knew automatically my suspicion. She moved quickly to get the bed down and the patient into McRobert.s. She also called an additional nurse for help. Sure enough, the anterior shoulder was wedged tightly against the pubic bone. Supra pubic pressure didn't budge the stuck baby. I reached posteriorly to try to deliver the posterior arm...no dice. By now, time seemed to have completely stopped. I could hear the blood rushing in my ears as the adrenaline surged, threatening to overcome my systematic approach to the delivery. Next step, I began rotation of the infant 180 degrees. Mercifully the anterior shoulder rotated free and the baby was delivered...a little purple but screaming. All 9 pounds and 13 ounces of him! Later the nurses told me that it was only 2 minutes total from head to body, but it felt like an eternity. I have had a few worse dystocias, where I have had to break clavicles, etc. but it never ceases to be scary. Bean, however, oblivious to the drama happening just steps from his cozy perch, slept sweetly the entire time we were in the hospital. What a kid.

We went back home for a couple more hours of fitful sleep before Monday began properly. Monday, by far, was the worst day. Hectic rounding, two laboring patients, busy office, an admission for a post operative abscess on one of OtherDoc's patients, and an eventual vag delivery and C-section for failure to descend (The baby never moved past 0 station despite 1 hour of "laboring down" and 2+ hours of pushing, poor girl!) My nurse had to pick up Bean from the daycare, and I didn't get home until about 8pm. Tuesday was moderately better, since I never even made it to the office due to a surprise labor, a preterm patient of OtherDoc's with seriously whacked out liver enzymes (but no other signs of HELLP), and drain placement on the post op abscess.

Suffice it to say I was properly exhausted come Wednesday morning, but I was optimistic for a smooth travel day with the Bean. Ha. Since this entry has run on quite long enough. I'll save that story for the next post! For now, we need to start "Christmas-ing" the house, and CindyLou will not be deterred any longer. More later...

7 comments:

trb310 said...

whoooo hooo.... good job. I enjoy reading your posts. to think that several posts ago you worried about jungling a carreer and a family. It isn't always easy but it is doable. Good job on your weekend. Enjoy the holidays

Kristina said...

Woo hoo! Loved the shoulder dystocia story! Do you ever end up using the Gaskin Maneuver during stuck shoulder deliveries?

Dr.StudyChick said...

I just found your blog and I have spent the better part of the last hour perusing it joyfully! Thanks for sharing all that you have. I'm a 3rd year med student leaning toward OB/Gyn... I was afraid I was going to love it, and I did... your call schedule totally scares me though. It's EXACTLY why I didn't want to like Ob... but I do, I can't imagine doing anything else really. Ack! I hope things change for the better for you soon!

Not Afraid to Use It said...

With all the other chaos going on, I am so glad Bean took it in stride. It must have been a relief for you to know he was asleep and in such good hands. Good luck with your Christmasification of the house! LOL

Anonymous said...

I think it's time to consider a live in nanny or au pair. between the day care rigamarole and dashing to the hospital in the middle of the night with an infant in tow, I would have gone insane a long time ago.

Anonymous said...

Really enjoyed reading through your posts over the last couple of days. My already high regard for my ob just went up a few more notches. A question, is socializing with patients a huge faux pas? I mean, it seems that going to a new town and spending soooo much time on the job, that is who you're meeting - patients who may have common interests. I suppose that a patient could just start seeing otherdoc instead....
Or is it really just a matter of not talking shop when guzzling a couple of drinks and then making the appt. to see you formally?

PE Mommy said...

Guess what??? I'm pregnant. HOLY CRAP that happened fast! I took an early test yesterday and got a faint positive. I then took 4 more which are positive as well. OMG, I can't believe it. I already called my dr's office and have an appt for the 26th. As far as I can tell, I am due 8/24/08. Hah, probably be a July baby, lol.