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...