Saturday, December 23, 2006

'Tis the Season 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!


Anonymous said...

Missed YouWhoo! ;) When you speak of the first patient's pannus of "one foot" are you talking about skin depth or how far it "stands" if extended? I have only seen one cesarean (G3P2 persistent posterior!) and it was pretty straight forward on a very healthy and trim woman. I would love to hang out in an OR all day and observe the surgeries. I guess you have to be a med student for that!

Happy holidays right back at you. I sent Christmas cards today too.

Anonymous said...

Merry Christmas, Dr. Whoo! Your blog has brightened my days and night as I experience many of the same things you do. Best wishes for a healthy pregnancy and a great 2007! Keep blogging...

medstudentitis said...

Merry Christmas and good news on the bean! Congratulations!

Anonymous said...

Just a quick drop by to wish you and yours a Merry Christmas, Dr. Whoo!


Julie, RN said...

Merry Christmas to you, as well. And a VERY happy 2007!

Laura said...

i am grinning for two reasons.
one being since i am the one you (and colleagues) hand the babies off to, i k now y'all are BUSY this time of year.
the other reason is because 20 years ago, my first born came into this world on what i learned later is traditionally the busiest day at least at that particular hospital, that would be 6 days before Christmas. after working their i learned that they have more inductions and sections that day than any other day of the year. yes, i was induced 5 days late and delivered 6 hours later thanevening. now she is 20! OMG!
i hope your holidays, whether working or not, were happy restful.

Fat Doctor said...

You are hereby tagged. See my 12/26 post. XOXO.

Bo... said...

Merry Christmas and a Happy New Year!

Anonymous said...

O where o where has our ob-jin gone, o where o where can she beeeeeeee?

dr. whoo? said...

frectis~ Aw, I miss y'all too! Her pannus was 1 foot thick (skin and fat) while lying down. It probably would have been more had it been extended. C-sections can be pretty nice, straightforward surgeries, or they can be nightmarish. Funny.

rural ob/gyn~ Thank you so much for your kind words! It's nice to know that there are others out there that relate to this kind of life :) I hope you had a wonderful holiday season, and I will be back in the blogging saddle again very soon!

Medstudentitis~ Thank you! I hope you had a wonderful Christmas break!

Hi, John! I hope you had a wonderful holiday, and didn't work too hard :)

julie, rn ~ Thank you! Wow, 2007...I graduated college 10 years ago. Crap.

amy1970~ Thanks for the congrats. They were actually kind to me on Christmas, and we didn't have any Christmas Day babies on the whole unit. Crazy, huh?

laura~ Thank you so much for sharing your pre-Christmas baby story! I know it is just going to fly by and one day little CindyLou is going to be 20, too. Time is just speeding up! I hope you had a wonderful holiday, as well.

FD~ Oh the pressure! I know I owe Dr. Wes a very belated meme, too. I'll get on it soon, promise.

Bohemian RN~ Thank you! I hope your holidays were wonderful!

frectis~ Here I am! Are you originally from Texas? :)