tag:blogger.com,1999:blog-31146535.post117362180295770877..comments2023-09-19T11:02:50.976-04:00Comments on Ob/Gyn Kenobi: I'm Still Heredr. whoo?http://www.blogger.com/profile/10315615480530297472noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-31146535.post-12031666970956983392010-12-05T18:27:49.944-05:002010-12-05T18:27:49.944-05:00Great post, I am almost 100% in agreement with you...Great post, I am almost 100% in agreement with youAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-31146535.post-36578546239948505472007-04-13T19:00:00.000-04:002007-04-13T19:00:00.000-04:003carnations~ Well, I don't know about amazing, but...3carnations~ Well, I don't know about amazing, but the original post was a bit more fleshed-out and longer. <BR/><BR/>It can be very difficult when a patient is so panicked, but the key is to stay calm and focused and make eye contact with them. Shouting does no good, even when you just want to shake them!<BR/><BR/>anon~ Ha, I know that it took a good hour to get over the adrenaline surge. Thank goodness all turned out well. Yikes on the central line patient! Surely the hyperemesis had resolved after delivery? I hope she had good follow up and social service involvement.<BR/><BR/>liana~ Thanks! Yes, as hard as I try to banish it, I still am human every now and again ;) The more you see, the more you realize can go wrong. I think it is great that you want to include OB care. I think you are in Canada, is malpractice as bad there as it is here for FPs doing OB?<BR/><BR/>hi anon~ Yes, actually, in the original post I made the comment that she was behaving as though she had a history of sexual abuse. She had relayed no such history to me, and I do specifically ask, but there is no way to know for certain. As soon as the delivery was complete and the pain gone, the patient was remarkably calm. As for the baby, it is certainly within the realm of possibility, though the triple nuchal cord probably had a lot to do with the acute asphyxia.<BR/><BR/>labor nurse~ The reason for the section was the patient refusing to push and demanding the section and refusing an attempt at an operative delivery, trust me, cutting her was the last thing that I wanted to do. Luckily, mother nature took over and she pushed in spite of her fear. <BR/><BR/>As I stated in the comment above, I agree that she exhibited classic signs of an abuse history, yet she has denied this. Always a possibility.<BR/><BR/>michelle~ Hi and thank you! Congratulations on your successful VBAC! That is such a satisfying thing. I know of quite a few OB docs that are in favor of VBAC, for the right candidate, of course. We in the medical community are not always the pariahs that the anti-med community would have one believe.<BR/><BR/>I have another VBAC due the end of this month and I am really hoping for another success.<BR/><BR/>brn~ Thank you so much. Sometimes when you get on a roll, you just don't think about saving...it just pours from fingers to screen. I am trying to be better about this.<BR/><BR/>moof~ Aw, thanks! Each branch of medicine has its very own pitfalls. The stressful thing about OB is balancing the care of two patients in one! I am hanging in there. I hate not being able to update as much these days. Hope you are well.<BR/><BR/>msilf~ The genetic variant in surfactant is an interesting postulate! As for the placenta, once it is delivered, you can inspect the cotyledons. An abruption is usually evident as a disruption with clot. There is no way to tell when, per se, just whether or not it happened.<BR/><BR/>hi anon~ I am so glad that you have enjoyed the blog and that it has given you a small glimpse into the chaos that is my life. Thanks for the congrats on the bean, too! Ob is awesome if you love it, not so much if you don't. Good luck with the rest of your training and as for sanity? It's way overrated. ;)<BR/><BR/>jawndoejah~ How is everything going? Are you planning on having an amniocentesis? I wish I had some concrete data on false negatives/positives for each trisomy, but I don't. I *can* offer prayers and good thoughts for you and your small one. Please do keep us posted and hang in there!<BR/><BR/>anon~ Aw, it is kinda nice to be missed. I miss writing, too. I'm just trying to keep above water here. Nothing serious, just life and work! Thanks for checking on me! :)dr. whoo?https://www.blogger.com/profile/10315615480530297472noreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1173716681725581012007-03-12T13:24:00.000-04:002007-03-12T13:24:00.000-04:00If this was the abbreviated version, then the orig...If this was the abbreviated version, then the original post must have been amazing. :)<BR/><BR/>What a scary situation for everyone. I'm glad everything turned out OK. To see a laboring mother SO out of control must be terrifying, since there are very limited options of how to calm her down...Yikes. I'm just glad the baby is OK.3carnationshttps://www.blogger.com/profile/15942247215569463561noreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1173741944067852382007-03-12T20:25:00.000-04:002007-03-12T20:25:00.000-04:00Yeah - and you didnt mention at what point YOUR he...Yeah - and you didnt mention at what point YOUR heart started beating again and when you were able to start breathing! Am glad I was not at that one!<BR/><BR/>We recently delivered the patient who had to have a central line in place because at 3 weeks of pregnancy (yes, you did read that right) she started with hyperemesis which turned into being unable to take anything PO including medications...even the OB (who is rarely concerned about his patients at all) has stated that he is afraid what will happen to the baby after they are d/c from hospital...Yes she is under psych treatment and apparently the whole family needs to be also.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1173757336339571492007-03-13T00:42:00.000-04:002007-03-13T00:42:00.000-04:00Still a punchy post, methinks!I just finished my o...Still a punchy post, methinks!<BR/><BR/>I just finished my obstetrical rotation and am pretty sure that I would like to include low-risk obstetrics in my practice. So it's humbling to see that even the obstetrician gets scared silly sometimes.Lianahttps://www.blogger.com/profile/13354145408658237195noreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1173800026974356632007-03-13T12:33:00.000-04:002007-03-13T12:33:00.000-04:00I'm curious whether you considered the possibility...I'm curious whether you considered the possibility of prior sexual abuse in this woman, and if so, what you and the rest of the staff did to help this woman through her ordeal. For it truly was an ordeal, way beyond what could be expected in a primip unmedicated birth.<BR/><BR/>And as for the baby, have you considered that the she may have been reacting to her mother's fear and that was why she was "not present" at birth? I think I might have reacted the same way if I were that baby, knowing what my mother was going through at the moment of my birth. Maybe a bit of a reach for you (?) but I thought I'd put that out there...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1173884526738075172007-03-14T12:02:00.000-04:002007-03-14T12:02:00.000-04:00I guess I am confused with the reason for c-sectio...I guess I am confused with the reason for c-section. Was it because the FHR baseline was increasing or because this woman was totally freaking out and refusing to push?<BR/><BR/>I also wonder, is this woman a victim of sexual abuse or assault? Her fear around exams and pain of the pelvic region seems classic.Labor Nurse, CNMhttps://www.blogger.com/profile/15238921141380296441noreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1173926246920469722007-03-14T23:37:00.000-04:002007-03-14T23:37:00.000-04:00I came across your blog in a VBAC search and wante...I came across your blog in a VBAC search and wanted to say that I find your posts refreshing and interesting. I am sick and tired of hearing moms piss and moan about the medical community and insisting that all of them are anti-VBAC. I had my VBAC last August, and I completely credit my OB for making that happen. I just wanted to tell you THANK YOU for being open-minded to the subject and for letting those patients choose.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1174251276147682572007-03-18T17:54:00.000-04:002007-03-18T17:54:00.000-04:00It's a great post! I've also lost a blog posting ...It's a great post! I've also lost a blog posting once or twice and then had to re-write it. (And whenever it happened, I could still hear my dad in my head harping "always save your work often"---but when I get on a roll I forget to do that...)Bo...https://www.blogger.com/profile/02136803397641401011noreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1174692073995936872007-03-23T20:21:00.000-04:002007-03-23T20:21:00.000-04:00Thank you for sharing that with us. OB has got to ...Thank you for sharing that with us. OB has got to be one of the most difficult branches of medicine ... so much can go wrong.<BR/><BR/>Hope that you are well ...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1174775813783967152007-03-24T19:36:00.000-04:002007-03-24T19:36:00.000-04:00Hmm, genetic variation in surfectant? Not enough t...Hmm, genetic variation in surfectant? Not enough to do the really serious disease, but something less serious?<BR/><BR/>Ok, medical question for future non-OB. How do you see the placenta and tell what separated when?Sarahttps://www.blogger.com/profile/15606922510495018342noreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1174855828920004022007-03-25T17:50:00.000-04:002007-03-25T17:50:00.000-04:00Hi! I'm a 3rd year med student in Ca, and stumbled...Hi! I'm a 3rd year med student in Ca, and stumbled over your blog a few months ago when hunting out residency info. Thank you for writing out these snapshots of your life! It has encouraged me so much to see that there are people out there who love medicine, Ob in particular! I want to specialize in Ob/Gyn, and have learned to brace myself for the inevitable questioning of my sanity that follows disclosure of this fact!<BR/><BR/>Congratualations on your little boy-bean. It will be different, but no worries. You will all adapt, even CindyLou!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1174923536680661182007-03-26T12:38:00.000-04:002007-03-26T12:38:00.000-04:00I know you don't diagnose, so ignore this if you w...I know you don't diagnose, so ignore this if you want. I'm not wanting a diagnosis online anyway, it's quite impossible. After a quad screen I was told I have a 1/53 chance of having a baby with trisomy 18. I try not to worry, but this is scary. I go for a sonogram on Wednesday (this week). Have you ever had false positives in this disorder? I read a lot about false positives with down's, but it appears the false positives are less with t-18.Jawndoejahhttps://www.blogger.com/profile/12335811975587549394noreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1174984734364379142007-03-27T05:38:00.000-04:002007-03-27T05:38:00.000-04:00Hope everything is ok since you haven't updated fo...Hope everything is ok since you haven't updated for awhile. Hope it is just the stresses of the Ob/Gyn world and nothing too serious that is preventing you from blogging. You are sorely missed in the internet world!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-31146535.post-1175176542848611302007-03-29T10:55:00.000-04:002007-03-29T10:55:00.000-04:00Since I sent you such a scary message I wanted to ...Since I sent you such a scary message I wanted to update that my sonogram showed no markers, but we are a 8 days behind in size from the first sonogram. I'll know in three weeks at a third total sonogram if baby has grown appropriately. They will look again for markers of trisomy 18 or another disorder related to my low numbers. The perinatologist thought my dates could be wrong, but I wonder how often a 9-10 week sonogram is off by 8 days? Of course, baby was moving a lot and that sonogram was so very fast. If my date on the first sonogram was off, that means my quad was taken at 14 weeks instead of 15.1 and then it is invalid. Ugh. A lot of worry for errors...but it's better to catch the trisomy 18's than to leave it to the birth day in my opinion. No one can be blamed if it was mistake, in my opinion, and I appreciate all that has been done to make sure my baby is healthy.Jawndoejahhttps://www.blogger.com/profile/12335811975587549394noreply@blogger.com