Sunday, February 11, 2007

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!


Amanda said...

Do we get to find out what you're having?

I hope your nausea disappears soon. Seems like around the 16 week mark was when mine did.

Anonymous said...

I have a whole new respect for obgyns. Can I say EWWWWWWWWWWWWWWWWW. Can't you terminate her for that kind of behavior. That is disgusting. I am guessing since she was getting a GBS swab she was 35-36 weeks. It must be nice to be able to still do that type of thing that far along. I never wanted to be touched with a 10 foot pole then. Course I have never gone past 36 weeks either. Hang in there. We will wait for ya.

Anonymous said...


I'm a med student from Australia who stumbled upon your blog and haven't been able to stop reading it! I've always thought of an internal medicine field such as oncology or infectious diseases but your words have inspired me to look further into Ob/Gyn. Hope you keep writing, best of luck with the little bean and a big thanks for inspiring a meddie to hit the books!

Anonymous said...

Great entry. I'm glad you're feeling better.

Ottoette said...

Glad to see you back! I am jealous you're feeling movement at 16 wks when I have only felt movement ONCE at 21 weeks. I guess it's all the extra "fluffiness" I have. If you figure out how to "catch-up" please let me know. I am close to taking some time off just to get the house caught up!

Anonymous said...

You have some crazy patients. :)

It's good to hear that the bean is progressing well. Isn't 16 weeks about time for you to start feeling better? Best wishes on that front.

Jawndoejah said...

My levels were higher than I've had testing because I believe I'm farther along than I have been before with these beta and progesterone tests. HCG 68,000 (not a typo, 68,000), and Progesterone 18.7. With my wacky cycles, I think I should have waited a week past my cycle day 52 hpt and maybe would have had an early positive. Bloodwork was taken on cycle day 99. I beleive I'm 7-9 weeks along. Sonogram tomorrow for dating.

Jacqui said...

Eewww! Can't believe what you have to put up with. Hope your week goes well.

Love your blog by the way.

Jawndoejah said...

I had my sonogram yesterday. It showed a healthy, moving little squiggly person with a heartbeat of 166 bpm. The baby is measuring 10 weeks along. Whew, I got through the most of morning sickness. I have been feeling ill, but chalked it up to residual problems from the stomache bug in January. I also eat poorly at times, and thought I might be having a reaction to sugar/lactose. It was just hormones. Eating better now, no choice (anything bad for me makes me feel icky).

Bo... said...

I know the feeling. I still have unpacking to do from when I moved into this apartment last October. And my roots....ugh...

Laura said...

ick, ick, ick on the teen patient and her boyfriend. we had a couple doing the nasty during an overnight stay with their baby where they are supposed to do all the care overnight:meds, feeds, etc.
congrats on 16 weeks. hope the ms goes away for you real soon.

S. said...

First, congrats!

Second, hope you get a hair appt. soon, mine is quite scarey now too!

Third...OMG--I cannot believe that girl was having sex in your office. THat is just disgusting! Ick!

But a good story none-the-less!

Shawnee said...

Wow, that teenager needs to be taught about where to have sex if she wants to continue doing that sort of thing! WOW, that really shows how moronic some people can be!

dr. whoo? said...

amanda~ Hi! Of course I'll blab about what I'm having, if the bean will cooperate, that is. I actually had one whole Zofran-free day this weekend, but I paid dearly for that this morning. Ah, well.

missgamecock~ Yes, ew is right! I suppose we could make a case for terminating her, but she is close to term, and that doesn't give her a whole lot of time to find a new doc and establish care. She's obviously just not thinking clearly right now. I saw this couple back this week, and they were sooooo mortified.

icania~ Hello and welcome! I am so glad that you are enjoying the blog and that it has inspired you to perhaps broaden your medical horizons. I thought that I wanted to do Derm when I first started med school (all about the lifestyle, ha!) but I found when I rotated through Derm, all I did was itch and be grossed out! (Ah, what I wouldn't give for that lifestyle, though, sigh.) Good luck with your studies :)

anon~ Hi and thank you! Most days, life is very good.

ottoette~ Ha! I'm plenty "fluffy" in the abdominal area, but I do think that my placenta is posterior and fundal this time around. The movements that I do feel are few and far between, and very subtle. With CindyLou, I had an anterior placenta, and I couldn't distinguish true movement consistently until about 22 weeks. If I took time off from work to clean house, I would do what I did all weekend long...absolutely nothing. Bleargh. Hope all is well with you!

alice~ My dear, you are correct. My patients *are* crazy! In theory, yes, you are supposed to be feeling better after the 12th, 14th, and even 16th week, but someone forgot to tell my body that. I am the world's worst pregnant person. Kind of funny, isn't it?

jawndoejah~ Thanks for the updates! Congratulations on the heartbeat and new little one! I hope you are feeling better soon. Have you gotten over the shock, yet?

jacqui~ Welcome, and thank you for reading. Luckily, patients like that are the exception rather than the rule, or I'd be certifiable! :)

bhr~ Hee, unpacking, I still haven't unpacked my closet. Ack, my roots and my eyebrows. I resolve to call the salon this week.

laura~ Well, that's probably what they'll be doing at home, too. I just don't know where these people get the energy! Maybe I'm just jealous? Nah. ;) Ah well, at least the morning sickness isn't all-day sickness... it was much worse with CindyLou, so I guess I can grin and bear it.

s.~ Hi! Thanks for the congrats :)
I. will. call. the. hairdresser. this. week. I think I have about an inch of growth. Shudder. And, yes, a good story, to be certain.

shawnee~ Hello! I'm telling you, people are flat out weird. It's like they got all turned on by the cervical checking or something (ick, ick, ick). I can't imagine what labor with these two is going to be like.

Anonymous said...

Well - I am glad that couple was mortified! Maybe their is hope that they will become civilized yet!
The 'can you top it' story is the one from my work - when a PP nurse went to do her initial rounds on nightshift and found the couple in the same little hospital bed having sex - 2 days after delivery!
Talk about EWWWWWWWW and top it with an OWWWWWWW!