Oh the joys of parenthood

The plan today - my only free day this week with the family - was to go to the semi-local lake that has a man-made beach, so we could go swimming and have some nice R&R time. Notice I said, "plan".

However, my child has decided to have hissy fits galore today. She has problems with wasting food, and her dad and I are just fed up with it. She made two waffles for breakfast. Not a problem, right? The problem starts when I tell her, "if you're taking two waffles, make sure you eat them all. Otherwise, just take one." Does she eat both of them? No. She eats about half of what she took.

Ok. Fine. Now it's lunch time. My dearest child, you will not waste more food today, so I've saved the rest of the waffles for you to eat at lunch. I reheat them. She eats about 2 bites. "I'm full" she says. Ugh, here we go again. She barely ate ANYTHING today. I told her, she must finish the 4 remaining bites, then we can go out to the lake to go swimming. Does she eat them? No. She decides to continue her hissy fit, and has now been grounded for the day.

Thanks for ruining what would have been a rather nice day out swimming today, oh child of mine!

Sigh.

Just got an email...........

........to schedule my interview for admission to Frontier!! WOOHOOOOOO!!!!!!!!!!!!!!

Do you think it's too premature to celebrate?

My interview will be on Aug 20th via phone.

Not a whole lot......

.....to blog about from the weekend. It was a relatively slow weekend on L&D. I had one birth on Saturday, a nice primip birth that when I walked into things, was very medicalized, albeit with a wonderful midwife. Medicalized, but not the midwife's fault by any means. Once mom pushed her baby out (pretty quickly, I might add), I helped change that medicalized birth into a very peaceful birth. Baby had skin-to-skin time for about 40 minutes with momma, while I stood back and kept pretty much hands off. Momma was loving her baby so much! It was rather beautiful. I hope this helped get her parenting experience off to a good start. It is going to be a rocky thing for this momma, considering that she was only 14 years old.

Sunday....not much at all to write about, really. Had a first time mom come in, ruptured membranes, and barely a fingertip dilated. Did a lot of education with her on early/active labor, comfort measures, pain management options, and breastfeeding. She seemed very receptive to education, as she was asking me tons of questions. She's another young momma-to-be, and I hope things went well for her for the rest of her labor and birth.

Sharing links

The Midwife Site

This is a website by a midwife that I know, and showcases her multiple talents, besides catching babies!

Photography, artwork, midwifery promotion, feral horses, nature, books and lots more!

Please, go visit her site. You will find numerous links to other sites that she shares about her life.

I am just amazed at how much we have in common with each other :-)

Hats off to you Bonnie!

Food post ahead!

Yep! You read it right! Another food post. Cause you know us post gastric bypass people still like to eat food!

No pictures of tonight's dinner concoction, so you'll just have to settle for words and descriptions :-)

Tonight's dinner extrordinaire was.....Sheppard's Pie!!

Ground beef as the bottom layer, followed by sauteed leftover mushrooms and onions from last night's steak dinner. (Yum!) Next layer: homemade beef gravy. Yes, yours truly can actually make homemade gravy. Over that was corn with lima beans and some green beans. Lastly, the mashed potatoes. Top with a sprinkling of salt and fresh cracked black pepper, bake at 350 for 30 minutes. And...ENJOY!

My teenage son actually was bugging me for when dinner was going to be ready so he could eat. He's huuuuuungry! Oh, and he also mentioned that this is one of his FAVORITE meals. Hmmm, really? Scratching head on that one. This is one of the pickiest eaters, next to my almost 5 year old daughter, who is even more picky than her brother.

My son promptly ate 2 whole bowls of dinner! WOW! Of course, my daughter stuck her nose up at the whole thing. When she heard I was making "pie" for dinner, she thought it was the "good kind" of pie. Not the "yucky kind." Too bad for you kiddo - this is dinner. Eat it, or nighty night to you. (Boo, hiss! Yes, I'm a mean mom like that!)

Anyhow......back to making that gravy.

I used:
3 beef bullion cubes
2 cups water
leftover grease from the ground beef
flour

Boil it all up, keep stirring, work at getting the lumps out (I wasn't too successful in getting rid of a lot of the lumps). But it tasted good!

Birth of a Surgeon: Mozambique Midwives

Birth of a Surgeon: Mozambique Midwives

I just finished watching this entire episode -- AMAZING!!!!

Go. Watch it. I guarantee you will come away with the same feelings I'm having right now. I'm speechless, truly. I just cannot put it into words.

A string of nice births

I've had a run of really nice births lately. Multip mommas mostly, where they are admitted shortly before (or after) I come on shift at 3pm, and have their babies before 6pm. I had a very nice one yesterday, where she was admitted by me, after I got her an epidural. Yeah, amazing concept, right? Get the mom comfortable - you know, actually doing NURSING care - then doing the paperwork afterwards. Damn regulations make us document out our asses about every little thing nowadays. It just pisses me off, because what laboring women want and need are put on the back burner to complete the paperwork and computer documentation first (in several different programs, no less). I've gotten pretty good at multitasking. While mom was positioned for her epidural, and while I'm doing my teaching and support during the epidural placement, I'm sneaking in my admission questions. Pretty savvy, eh? Consents? Bah! She verbalizes consent, so that's good enough for me. Get the consents signed after she's comfy from her epidural.

I also like multips for this reason: they don't take 2+ hrs to push. It's wham-bam-baby when they push - usually. Mom doesn't get exhausted from prolonged pushing. She's ecstatic and wide awake to enjoy her newborn afterwards. She breastfeeds sooner. Things just go smoother. Not that I don't love working with primips (first time moms) - really, I do! I love the education of first time moms, and the building excitement of them changing from expectant parents to new parents. Calling them "mom" or "dad" for the first time. Seeing their faces light up when you say "you have a girl!" or "it's a boy!".

Yeah, all is right in the world. ::smiles::

Stuffed zucchini

I whipped up this yummy concoction last night for dinner. I also made a side dish of whole grain pasta and meat sauce to go with it.


First, cut a large zucchini in half, lengthwise, and cut out the meat, leaving 2 "boats". I also lined the pan with a thin layer of olive oil to prevent the zucchini from sticking.

Saute the zucchini innards, a chopped onion, minced garlic, salt, pepper, and oregano in high quality extra virgin fresh pressed olive oil. Set aside in bowl when done.

Brown up a pound of ground beef. Add garlic and oregano.

Fill boats with zucchini and onion mixture.

Top with about 1/3 of the beef. Use the remaining beef to make meat sauce for the pasta (side dish).

Top with some tomato sauce. Mix remaining ground beef with remaining sauce and simmer for pasta side dish.

Top zucchini boats with 8 oz low fat shredded mozzarella cheese.

Cover in foil. Back for 40 minutes at 350 degrees. Uncover and bake 10-15 more minutes to brown the cheese.

ENJOY!!!

The Big Push Rally

Because it cannot be stated enough..........this is from the capital of my state, Harrisburg PA.

An ode to PMS sufferers everywhere

Click on images for original sources. You know, so I'm not accused of STEALING or something. Whatever.

Realization

I didn't realize it was happening, until later that day. My mind was in an oblivious state while shopping at the store. I had stopped there just for a gallon of milk.

I walked out with a bag full of junk food. Primarily chocolate.

I justified what I was buying as being for my teenage son. He's a junk food-aholic. He's a growing boy, so I don't see a problem with it, within reason. He's good about reasonable quantities of junk food.

I bring home the junk, and he promptly turned his nose up at most of it. What the heck?

It wasn't until hours later that I realized - I bought what *I* wanted to eat. Knowing that I couldn't eat much, if any of it.

Then I counted my menstrual cycle days.

I'm due for my period on the 20th.

Good grief! It's my PMS chocolate cravings time! I get like this EVERY SINGLE MONTH, without fail. I load up on chocolate items at the grocery store, not even realizing consciously what I'm doing.

I also had my usual PMS "I can't stand anyone" bitchiness yesterday at work, when I realized that my laboring patient was annoying the shit out of me. I really hope I didn't come across in a negative fashion to her. It honestly took all of my self control to be nice, when in the back of my head, I wanted to run fast out of the room because just her voice was grating on my last nerve!!

I really have to watch my mouth for the next few days. I'm liable to have something nasty slip from my lips.

I really hate PMS.

No news is good news?

Still no word on my application to Frontier.

I did email one of the contacts at Frontier 2 days ago, about whether my transcripts were received yet. No response back.

I imagine they are pretty busy processing applications!

I've applied for Bridge Class #64 -- December start. Anyone else out there apply for the same class? And if so, were you accepted yet?

Yes, I'm getting very antsy for a response - ANY response!!!

It's funny (almost) what people will say....

....when you reveal to them that you are a L&D nurse.

I was chatting with a fellow mom at the swimming area/beach at the lake yesterday. We were chatting off and on for an hour or so, and the subject of birthing came up. When I mentioned that I work on L&D as a nurse, let me just say, the floodgates opened.

She talked to me about how she was cut, and had 4th degrees twice.


Her third pregnancy, she was told to either consent to a c-section, or they would get a court order to do a c-section. She ended up consenting to the c-section. I cannot imagine that a doctor would threaten legal enforcement of a "recommended" primary elective c-section because of prior 4th degree lacs! Oh wait, yes I can imagine it. Wanna know why? I've had other woman with a 4th degree who were told after the delivery, to have a c-section with their next baby.

I told this woman - maybe, instead of having a doctor who is so cut happy, she could have seen a midwife instead? Anyway, it was too late now, since she had then revealed to me that she did end up having a primary elective c-section for her third baby. She actually didn't even realize that a midwife was an option.

How do we get the word out to women that obstetricians are trained in complications of pregnancy, and are taught to intervene...........and midwives are taught about normal childbirth, and low/no intervention? Obviously, we're missing a chunk of the population, who have no clue about what midwives can do for them. How big of a chunk of the population? I have no clue. But, obviously, there are plenty of women out there that equate having a baby with seeing a doctor/obstetrician.

I was sad for this woman, who had to have a c-section forced on her, when she wanted a vaginal birth for her 3rd baby.

She also did mention to me about some rectal issues she still has from her 4th degrees. I advised her to see a surgeon about possible surgery to correct the poorly healed tissues.

Grazing

Like a freaking cow. I couldn't stop from grazing all the yummy food brought in yesterday for a co-worker's baby shower at work. I ate three - yes THREE!! - helpings of an oh so delicious spinach lasagne. Oh my goodness. HEAVEN! Must get that recipe! I ate a bit of salad, some lemon fluff, ice cream cake (and didn't get that awful belly pain... WOOT!!), a few BBQ chips, and several cups of coffee. It was non-stop grazing, I tell you!

I made up for it today. I did 20 minutes on the treadmill (about 1.2 miles) and 20 minutes on the bike (4 miles), and my legs are aching.

I've also eaten so far today:

Breakfast:
1/2 cup coffee
2 - scratch that - 3 mini chocolate donuts

Lunch:
2 small slices pizza (frozen)
honey almonds

Snack:
1 mini chocolate donut
goldfish crackers (didn't measure them, probably about 2 servings)
1/2 cup coffee

Dinner:
I'm going to be making italian sausage, a veggie/pasta/cheese blend, and corn on the cob.

Weight today: 148 lbs

Catching babies

I caught baby #14 (for me) today. Another precipitous delivery, where her uterus was literally doing ALL of the work. Mom had a good epidural, and wasn't even pushing.....when POP! Out comes baby!

Of course, this was the first time that I caught a baby one-gloved. Yes, my second hand was bare. Amazing how you just do what you need to do to help catch a baby when he/she is coming out so quickly. I honestly didn't really stop to think....I just acted, with what I had at hand. One glove. No delivery table. No bulb syringe. Just a baby. No time to grab a second glove.

Oh yeah - and a nuchal cord x 1 that I delivered the baby through.

Still though, it was weird, catching a baby with one gloved hand, and one BARE HAND! I admit, for a fleeting second, I thought to myself, "my hand is full of birth goo!! Ewwwww!"

A photo session

My youngest child......I cropped and did some slight editing to these. I do believe I'm getting better with my photography!

And yes, she's wearing green nail polish.

Calling Dr N

Dude! I was *SO* looking forward to another wonderful, wacky Wednesday with you on call. Are you on vacation? Job hunting? I MISSED YOU!!! You know I'm going to miss you something crazy when you leave us.

I love how you teach the new residents and med students, and yes, even us nurses!

Dude.......don't leave us!

How to kill a cold in 7 days

Yeah, I'm still here, plodding away with this not-so-lovely upper respiratory infection AKA a cold. In the middle of flippin' summer, no less!

I've been working on keeping up with my fluids, and losing the battle. I've lost 5 lbs in the past few days. I'm now down to 144 lbs as of this morning. Who knew that a cold could be such a boost to dropping my weight - WHEN I DON'T WANT TO DROP ANYMORE WEIGHT!

Where was I? Oh yes, trying to keep up with drinking fluids. Sipping water throughout the day, even though I'm not thirsty. Drinking mint tea 2-3x per day - and finding that I love that oh so cool feeling of minty, but hot, tea. Yum! I admit, I do add a dab of honey to the tea. Yet another soother for the throat.

Not drinking much else, except my normal 1/2 cup of coffee in the morning. Yes, I know, before you yell at me, I'm not drinking my required fluids post op. I know! I'm supposed to drink about 64 oz of fluids a day - ain't happening folks! Too gorked in la-la land from the pseudoephedrine.

YES! I bought a 48 count at the pharmacy yesterday, after showing 4 proofs of ID, and submitting to a blood test to check for meth in my system, to make sure I wasn't going to use it for "illegal" purposes .... just joking. Just had to show my driver's license. And sign here _____________ and here _____________ and initial here _______.

Oh yeah, back to fluids. Fluids, schmuids. I know I need to drink more. I'm on that fine balance of hydration vs dehydration, as always. I think dehydration is winning. I've peed maybe 3-4 times total today. Not so good.

Food? Yeah, not so much. Barely any appetite. I force myself to eat something 3x a day. Usually soup or some canned pasta with meatballs (protein, ya know!). I did have a slice and a half of pizza for dinner tonight. So, I must be on the road to recovery, if I'm eating pizza, for goodness sakes!

Boy oh boy, do I ever nap a lot during the day now. My energy? Gone.

Called in sick today and yesterday, but if I call in sick tomorrow, it's a big no-no according to human resources. I have to file for FMLA and short term disability if I'm off 3 days or more in a row. Nice way to treat your sick employees huh? Make them have to haul their sick asses in to work and spread the love of the germs to their co-workers, who then spread it to their families. Just by me calling in sick 2 days in a row is an "occurrence" that is put on my permanent record. After so many occurrences, you get a verbal warning, then a written warning, then you're fired. Real nice, huh? Great way to retain nurses, right? An occurrence is also if you clock in ONE LOUSY MINUTE LATE. So, you can imagine that it doesn't take much to add up those occurrences. But that's another rant for another post, another day.

Back to work tomorrow, ready or not..........here I come.

Armed with tissues, pseudoephedrine, nasal spray (non medicated, of course), a brand spanking new albuteral inhaler, and cough drops. I may just need my own med cart, just for my meds.

Ha! I knew I wasn't imagining it!

Phenylephrine versus Pseudoephedrine:

***********************************************

Phenylephrine is used as a decongestant, available as an oral medicine or as a nasal spray. Phenylephrine is now the most common over-the-counter (OTC) decongestant; oxymetazoline is a more common nasal spray.^{[citation needed]} Pseudoephedrine was historically more common, although its notoriety as a methamphetamine precursor has led some governments to restrict its sale.

Oral phenylephrine is extensively metabolised by monoamine oxidase [1], an enzyme which is present in the gastrointestinal tract and the liver. Therefore, compared to orally-taken pseudoephedrine, it has a reduced and variable bioavailability of only up to 38 percent,^[2][3] and is therefore less effective as a nasal decongestant than pseudoephedrine. (It's not all in my head folks!! Wikipedia says so!!!) Because phenylephrine is a direct selective α-adrenergic receptor agonist, it does not cause the release of endogenous noradrenaline like pseudoephedrine does. Therefore, phenylephrine is less likely to cause side-effects like central nervous system stimulation, insomnia, anxiety, irritability and restlessness.

Damn meth head labs have to ruin it for congested people EVERYWHERE!!!

Can you tell that I'm still heavily congested?? I bought some of the placebo/phenylephrine yesterday, and IT'S NOT WORKING. I'm heading to the pharmacy today to buy the illegal-to-sell-over-the-counter good stuff.

**side note** Phenylephrine is also known as NeoSynephrine, and is given to combat hypotension in the PACU/intensive care settings. I had to give this drug via an IV to a hypotensive patient in the PACU last week. Works great to bring up blood pressure, without making the patient tachycardic, or if they are already tachycardic.

I'm sick

I hate getting sick. I have a head/chest cold. It started on Friday with just a tickle in my throat, and has gotten progressively worse.

Today - nasal congestion, throat so sore that I gag, ears hurting, head full of pressure, shortness of breath, you name it. Ugh. I took some pseudoephedrine (the only thing that works for my congestion), and now my head feels all floating, and my heart is racing a bit. Normal side effects for me. Which is worse? The sickness feelings, or the side effect from the cold meds?

I need to get more of the decongestants, and the pharmacies are all closed today, with it being Sunday. The only way you can buy pseudoephedrine anymore is with photo ID and at a pharmacy. Thank you meth heads and your meth labs. You've ruined it for the every day Joe to buy decongestants that actually WORK. The kind you can buy over the counter now, with the different main ingredient, well, it just doesn't work on congestion. You might as well spend your money elsewhere.

Like on Vick's imbedded tissues......oh baby...heaven for your nose!

Kind thoughts please

One of our (former) babies passed away recently, unexpectedly. This little one was just a few months old, was healthy, and suddenly went into cardiac and respiratory arrest while in the presence of her caregiver. CPR was started immediately, but the baby was pronounced dead on arrival at the hospital. Autopsy results are still pending.

I feel so bad for the parents, to have lost their baby so suddenly and for no apparent reason.

I found out about this from the mother's physician at work recently, and we're all saddened for the parents of this baby.

Please keep them in your thoughts and prayers.

Crazy

It was Crazy - with a capital "C" - last night at work. Oh holy Hannah! The floodgates were open, and we were body slamming against those gates to try to shut them, but the pregnant women burst forth 2x2!

We started out with a full unit, and it stayed that way through the entire shift.

I started out with a multip with an epidural, 7cm at last check. When I went to straight cath her around 4pm, she started crowning. Flipped on the call light for assistance -- need a delivery table, peds for meconium, and oh yeah, could I have a doctor or midwife please? Her doctor was catching a baby in another room, so a midwife came in to catch the babe.

Whew! One down, a thousand more to go..........

Next up, I admitted a woman for an urgent c/s for preeclampsia, and had to also start magnesium sulfate for her. Admit - check. IV site with labs - check. Mag started - check. Go back for c/s - check. Recover her in PACU - check. Get her back to L&D on mag - check.

Then the clean up - charting up the wazoo, and going through my list of things to do for all of the paperwork/charges/documentation/etc.

Sign off to the night shift - oh holy heck yes!! NIGHT SHIFT IS HERE!!!

I went home exhausted.

Waiting...patiently

I'm still waiting for word from Frontier about my application. Trying to be patient. Patience is a virtue that I do not always have.

:::sigh:::

I mailed the application out on June 10th, and received an email from them a few days later, letting me know that they are waiting on my college transcripts, and that I'll still need a phone interview.

Since then, I've heard nothing. Nada. Zip.

They did cash my application fee check on June 30th. So, perhaps my application is being reviewed still? Perhaps they finally got my college transcripts? (Which I mailed the fee and form to my college the same day I mailed out my Frontier application.....you wouldn't think it would take too long to get transcripts mailed directly to Frontier, do you??)

Waiting.

Waiting.

Waiting.

Patience.

Patience.

Deep, calm, soothing, cleansing breaths.

It's almost like labor, wouldn't you say?