It's time for my husband's annual "man weekend" with his high school buddies. For almost a decade, he and his friends find a cabin in the woods somewhere and behave (I am assuming from the pictures) as 10 year olds...that drink. Junk food, video games, and staying up way too late are part and parcel of the festivities. They look forward to it every year, and I'm happy to have him go. (The wives have a "girl weekend" in the spring, just to be fair.) So when I found out that he would be out of town for a weeknight (when I am on call for my patients), I thought to my naive little self, what's the worst that could happen? Ha. Ha. HA!
So I went about my regular single parenting duties in the evening relatively unscathed. Picked up the kids, got dinner on the table while Bean protested loudly that it wasn't fast enough for him, wrestled two squirmy kids through bathtime, and got everyone tucked in by a reasonable time. Then I prayed really hard that I could make it through the next 12 hours without having to leave the house. The peace lasted roughly 3 hours. The first warning bell came as a page from triage. A 38 weeker, possible early labor, contractions 20 minutes apart. The triage nurse said she was pretty sure the patient was "not doing anything" but we decided to observe her and let her walk for an hour. My second warning came at 1 am. The patient had indeed changed her cervix from 1 to 3 cm. A definite keeper. "Ok," I pleaded with the nurse, "PLEASE keep her comfy and pregnant for the next 5 hours so I don't have to pack my kids up in the middle of the night to come to the hospital." The nurse was fairly confident that the patient was not contracting regularly, and could probably coast until morning. I settled into an uneasy rest...until 2:30 am. I returned the page, thinking that I was going to have to drag in to cover for the patient's epidural. Imagine my surprise and dismay when the nurse answered the phone with "She's 9!"
Shit. Shit. Shit. It was off to the races...throwing on scrubs, rousting the kids up in their PJs, and flying down the highway in the middle of the night. "At least it will be fast," I chanted to myself as I sped to the hospital. I deposited the kids with one of the nurses and stepped into the delivery room just before 3 am. The patient was completely dilated and ready to push. She hadn't even had a chance to get *any* pain medicine, epidural or otherwise, due to how quickly she had progressed. So, the patient started to push, and *then* all hell broke loose. The first push sent the fetal heart tones down to the 30s. Ummm, surely that wasn't right! I placed a scalp lead to get an accurate tracing...still in the 40s-50s. Scalp stim...up to the 60s. Oxygen, reposition, knee chest. Nothing would bring the rate back up. The baby was at zero station. Too far up for vacuum or forceps. We tried a few pushes, but the head wasn't descending fast enough and the heart beat was a slow tick, tick, tick of a baby running out of time. After a quick verbal consent, we called the OR to let them know we were coming down for a crash section. "We aren't ready!" they said. They had another case going and needed to call in a team. "No time for that," I said, "This baby needs to come out now."
We ran the patient to the OR. The staff assembled a rag-tag team of recovery room nurses, opened the crash section cart, and haphazardly prepped. There was no time for a foley or to count instruments. Every second felt like an hour, though only 5 minutes had passed from calling the section to draping the patient. The patient went to sleep, and we got the baby out in less than a minute from the skin incision. She looked like a *million bucks*! She squalled as soon as she left the womb. She was pink! and happy! and had Apgars of 8 and 9! and didn't look at all like her strip suggested. I had truly feared the worst, the last terminal decel that I had seen like that, the baby had anoxic seizures after delivery. Luckily, this baby was great. The collective sigh of relief was audible in the room as I placed her on the warmer. The rest of the surgery proceeded smoothly, and I was happy to let the family know how well she had done.
As for the kids? I ran back up to labor and delivery to find them happily snacking on graham crackers and juice. CindyLou was entertaining the whole floor, and she kept saying how she wanted to be a doctor "just like mommy." (Oy.) We got them gathered together, I thanked the nurses profusely, and drove back home. "I like to go to your work, Mommy" Cindy Lou chirped, "It's still *night time*!" Once at home, the kids went back to bed without a fuss, and I crashed into the best 2 hours of sleep of my life.
The moral of the story? I survived! It could have been the worst case scenario, but we all made it. The kids did fine, the patient did fine, the baby did fine. It could have been a disaster, but it wasn't. I am ever so grateful for that, and never have I been so convinced that I *never* want that to happen again! Scary things do happen in the middle of the night, and sometimes the outcomes are not as good. I'm thankful for the nurses and OR staff that did what they could to make the surgery happen quickly enough. I'm grateful for the compassion the nurses showed to me and my children by caring for them when I had to care for someone else. Most of all, I am so thankful that my kids were able to take it all in stride and go with the flow. They are pretty amazing. I hope you all have a wonderful weekend, and are not bothered by scary things in the middle of the night.