Monday, June 18, 2007

The Good News and The Bad News

Today I had my OB appointment and my (long awaited) second ultrasound. The reviews were mixed.

The good news:
We have a beautiful, healthy, perfectly angelic looking baby growing and thriving inside. (All bias aside, we got a glimpse of his face with the 3D scanner and he is gorgeous.)

The bad news:
He's breech and near the 90th percentile of size for dates.

The good news:
My 24 hour urine protein was below the range for mild pre-eclampsia.

The bad news:
(TMI alert) I produce so much urine in a 24 hour period that I filled the collection jug to capacity and was unable to capture my last two voids. (I knew I went a lot but this is ridiculous! That jug is frigging huge!)

The good news:
My OB thinks I may be a candidate for an external version.

The bad news:
But that is subject to change if this kiddo continues to grow to gargantuan proportions.

The good news:
I don't seem to have pre-eclampsia, yet.

The bad news:
I definitely have gestational hypertension (146/90 today) and may have to repeat the 24 hour urine study in the not so distant future.

The good news:
I may soon be able to tell my patients what it is like to have both a vaginal delivery and a C-section.

The bad news:I may soon be able to tell my patients what it is like to have both a vaginal delivery and a C-section (sob)!

All labels aside, I am trying not to flip out too much about the Bean's stubborn streak just yet. I am just shy of 35 weeks, I have great amniotic fluid (18 cm plus) and a little more time. I'm more than a bit discouraged that he is measuring so large, because that can be 1) an impetus to proper positioning and 2) even less pleasant to deliver vaginally, should he decide to turn around. The fact that I am outgrowing scrub sizes in a matter of days despite not gaining tons of weight on the scale (18 pounds total for the pregnancy thus far) should have been some sort of clue to his rapid expansion, I suppose. While a C-section isn't an ideal outcome for me, it won't be the end of the world if if is necessary. There is no guarantee that I would have a vaginal delivery, even if he were cephalic, and if he's ginormous, I'm not too sure that I would be all that keen on a dystocia or a 4th degree over a surgery. In fact, I *know* I would much prefer a C-section over a 4th degree (just repaired one at 2 am this morning, as a matter of fact) some orifices just shouldn't combine. Ah well, patience was never a strong suit of mine, but I will just have to wait to see how this all turns out. For now, I'm (mostly) healthy, he's healthy, and that is all that truly matters. (But if you have any sure fire remedies for flipping breech babies, please do clue me in!)

Sunday, June 10, 2007

8 Random Things

Let me begin the post with apologies for the delay in responding to the tag by Medstudentitis; she is a great blogger and I'd hate for her to think that I was ignoring the tag! I'm sure that I am probably repeating myself with some of these "random things," as I have an embarrassing tendency to allow all of my inner random-ness hang out all over the place on this blog.

1. I am an introvert. If you want to get really particular, my Keirsey temperament profile is INFJ. This seems strange, I know, being in a profession that requires so much social interaction. I am quite easily fatigued by socialization and feel like I have to be "on" in social situations at all times. I much prefer small group settings to big parties. I require a certain amount of time to recharge and regroup either alone or just with my family. I love to just read, veg out in PJs, and just *be*. Now, don't get me wrong, I can be sociable with the best of them, it just really drains me emotionally. Sometimes I think having my job and an extrovert for a husband keeps me from being a total internet hermit full time!

2. I met Mr. Whoo in an online college football chat room. We were email buddies for about 9 months before we met in person and our relationship took a more romantic turn. We met online back in 1997, a time when internet dating was more fodder for Jerry Springer than mainstream, so we kept it kind of quiet until it became more acceptable. The best thing about emailing and chatting during the initial stages of our relationship is the solid foundation of friendship that we built, even before all of the physical attraction got started. Our friendhip is the rock of our marriage, and after all this time, he is still my best friend in the whole world. Aw.

3. I stubbornly dated the wrong guy throughout high school and college (7-ish years), thus stunting my dating experience dramatically. Don't get me wrong, he was a good enough guy, he just wasn't the right guy for me, and never would be, try as I may. I hate to say that those years were wasted, because the lessons that I learned from that relationship were invaluable, but I never had to work so hard to keep a relationship going. The relationship ended when, after seven odd years of dating, he told me he didn't know if he *ever* wanted to marry me. Crushing. I was devastated, but then I finally "got it" and moved on. Ironically enough, the week after that conversation took place, I had my first internet conversation with Mr. Whoo. There is a line in a Sister Hazel song that always reminds me of my first relationship - "You were the one who taught me what I don't need, and I thank you, I thank you for that."

4. In another lifetime, I was a competitive cheerleader. Seriously. I started cheering in the South at the ripe old age of ten. We practiced 4 hours a day for competitions during the summer months. I cheered through Junior High and High School, co-captaining the Varsity and Competitive Squads. I choreographed routines and lifts and cheers in my spare time. I coached a mini-squad and took them to competition. I went to a college cheer camp at the University of Kentucky and seriously considered trying out for my college squad...until I discovered I could either be a cheerleader or a Biology major. (Cheerleaders couldn't have Friday classes due to travel obligations, and all science courses were M, W, F.) I guess it's obvious how that decision worked out. No regrets here, either.

5. People fascinate me. I love to get a peek into someone's inner psyche. It is a large reason that I became a physician. I like to know what makes someone tick, literally and figuratively. From an early age, I was always the "counselor" of all of my friends. I think this is why I am so addicted to reality shows, reading blogs and message boards, and just plain people watching. Undoubtedly I am not alone, as I believe that this is the case for most Bloggers and blogging fans. Some people rock, and some people suck, but all people are interesting in one way or another.

6. One day, I'd like to write a book. I'm not really certain what I would write about, and I'm really not certain that anyone but my family and friends would want to read it. I just love books, and I love to write, and if I ever win the lottery and/or become independently wealthy, I'd like to write a book. I'll probably end up like Chevy Chase in Funny Farm, but that would be fun too.

7. I'm not really a "kid person." In fact, for a long time in my younger days, I swore that I would never have children. Then I met Mr. Whoo, and I decided that there was someone in this world with whom it was worth procreating. Don't get me wrong, I love CindyLou and we have fun together, and obviously I'm having another one, but I still don't know what to *do* with kids, especially in a group setting. I have the patience of a 3 year old...I know this because I have one, and sometimes, she's more patient than I!

8. I really love the *idea* of being outdoors, but the reality? Not so much. I love the scenery, but not the nitty gritty realities. Some outdoor activities are fun, like white water rafting, even canoeing. It is fun to hike, but I don't really want to camp unless there is air conditioning and a toilet involved. Bugs squick me out. I hate to be hot. I sunburn in 8.2 minutes flat. I guess that you could say that I love the great outdoors from a distance.

If anyone is still reading, I hereby tag anyone that didn't do this a month ago, when it first started making the rounds. Happy Sunday!

Saturday, June 02, 2007

Still alive, still pregnant, still whiny

Is it really June already? I'm not ready for it to be summer! The last few weeks have been (SSDD, I know) a whirlwind of work, catching babies, visiting family, and minor freak outs about the status of the medical blogging community in general and about my blog in particular. It is difficult for me to even see hits from the same *state* on my stat counter without getting antsy about being "found out." I debated stopping altogether, but I miss blogging and talking to you all out in blogland. I guess that I was never organized enough about blogging to figure out what I wanted this blog to be, a mommy blog? A doctor blog? Educational? Entertainment? To tell the truth, more than anything I approached it like my own personal journal, an outlet for all of the jumbled thoughts in my brain that I need to spill and sort out in black and white. A journal that talks back ! (The coolest part of all.) So, I think that is what it will continue to be, with major alteration of details surrounding the particulars of my job. I think I can live with that. We shall see.

So let's catch up. On a personal note, I am 32 weeks and 2 days. The Bean has hiccups regularly, and I am convinced that he is still in transverse lie. I've been measuring almost 2 weeks ahead for the last few appointments, and I am dying to know how much this kid is going to weigh. (Did I mention that I don't have free access to an ultrasound machine, so I am at the mercy of the insurance/physician order just like every other pregnant woman? Shameful. I'm dying over here.) The "due any day now" comments are coming fast and furious, along with the shock and mock horror when I tell them that I still have at least 8 weeks to go. People can be so jerky to pregnant women, it's unreal. It continues to be a real test to patiently listen and empathize with my whiny pregnant patients, being a whiny pregnant person, myself. More than once, when asked when their maternity leave should start, I've stifled the urge to quip "You can't stop working until *I* stop working." Ha. I would never say this out loud, but it's fun to fantasize about. I had a very busy delivery month in May, and I am looking forward to having only half as many patients due in June. Pregnancy symptoms include lots of contractions (but a negative fetal fibronectin, so all is well), sciatic pain, mild pubic symphysis diastasis discomfort, cankles, borderline elevated BP (130-140s/80s), and killer heartburn. I am happy to report that I am no longer puking, even on a weekly basis.

Remember the less than stellar med student that I posted about a while back as an example of what not to do? Not too long ago, that very same student cornered me in the Doctor's Lounge and proceeded to tell me how "shocked" they were at the grade that I had given them. (For the record, it was in the ballpark of an 85 percent. I felt that I was more than generous for the work the student did!) I got treated to a talk of woe, that they had really, really wanted to do OB/GYN and my grade didn't place them at the top, where they believed they should be. I also heard about how the grade I gave them was the worst grade they had ever received. (Which shocked the hell out of me, leading me to believe that this student must have been allowed to slide by with being "cute" and "sassy" because their clinical knowledge and work ethic was sub par, as far as I could see.) I was as gracious as I could possibly be, and stated that it was possible that I was a stricter grader than the student's prior preceptors, and I encouraged them to pursue recommendations and work hard in their 4th year electives in OB/GYN. Then I politely excused myself before their audacity completely caused me to lose all composure and give them a real piece of my mind. Now I wonder if it would have been better to just lay it all out for them, because, really, I am not doing them any favors, allowing them to think that they were the best student around, and I am just a mean, hard-grading jerk of a preceptor. (No, it isn't me, it's *you.*) I just suck at unexpected confrontation. I need time to formulate coherent arguments, otherwise, I tend to just make off the cuff, not so nice, and certainly not constructive comments. Ah well, just thought it would amuse y'all to hear the update.

I am off this weekend, and Mr. Whoo and I are about to tackle the master closet. A project a long time coming, accelerated by the fact that an entire rack of clothes fell off the wall this past week, requiring immediate attention. Sigh. Home improvement sucks.