Sunday, March 30, 2008

Sweet Spring is your

There was a certain something in the air when I walked out of the house this morning.  A certain crispness.  The snow is almost all melted.  It was actually comfortable with just a light fleece and no heavy coat.  Maybe Spring is actually coming!

I attended the end of the Geohazards' Conference this morning.  At least the lectures were more relevant to what I will be doing in the future.  And, on my way home I took this photo on the University at Buffalo North Campus:

The pond is still frozen over, but there is a promise of Spring in the yellowing branches that will soon sprout out with leaves.  Since I really don't have a lot to write about, I thought I would share one of my favourite poems by e.e. cummings: "Sweet spring is your"

"sweet spring is your
time is my time is our
time for springtime is lovetime
and viva sweet love"

(all the merry little birds are
flying in the floating in the
very spirits singing in
are winging in the blossoming)

lovers go and lovers come
awandering awondering
but any two are perfectly
alone there's nobody else alive

(such a sky and such a sun
i never knew and neither did you
and everybody never breathed
quite so many kinds of yes)

not a tree can count his leaves
each herself by opening
but shining who by thousands mean
only one amazing thing

(secretly adoring shyly
tiny winging darting floating
merry in the blossoming
always joyful selves are singing)

"sweet spring is your
time is my time is our
time for springtime is lovetime
and viva sweet love"

Tomorrow there isn't a lot to do other than my meeting for EMS in the morning.  We'll see if anything else develops during the day... until then!


12,368 seals killed so far


Saturday, March 22, 2008

Like Moths to a Flame



As I drove in to work yesterday morning, I saw the moon hanging over the horizon.  The full moon.  As it guided and directed the tides of the sea, it guided and directed the tides of women coming in to give birth throughout the next 24 hours... and they gave birth in waves.

After rounds, etc, we went to the L&D ward to find a quickly filling board.  Many women had come in overnight either in labor or to be induced for delivery.  So, in the morning, we had about 6 or 7 women who would be delivering at any time.  No sooner had we started getting settled in than one woman began to deliver.  The seniors covered that delivery because she delivered so fast that the rest of us never even got a chance to get in the room.

I admitted two patients early on who were progressing rapidly.  Given the other women we already had in labor, the concern was that they would all give birth at the same time.  Which mine almost did.  I went in to check on my second admission who'd given birth before. 

She said she was feeling uncomfortable and felt like pushing.  I told her to go ahead and see how it felt.  She did, and I could see the head working its way down the birth canal.  I told the RN to call my senior to come in the room as my patient was ready for delivery.  However, my patient decided that she wanted the baby out and started to push harder.

We told her to stop and wait!  She said, "NO!  It hurts too bad, and I want it over with!"  I barely had time to grab some gloves and run back to the bed as the head popped out.  We told her to stop pushing as I guided the umbilical cord over the baby's head.  She barely stopped to inhale as I did and then pushed again and the rest of the baby was out! 

My senior walked into the room to find me holding onto the baby and trying not to drop him.  I had birth slime and blood on my uncovered arms, and I was trying to keep my shoes somewhat clean since she'd delivered on the bed and everything was dripping everywhere.  I was barely able to get her placenta delivered and the paperwork and orders filled out before my second patient decided she was going to start pushing too.

I walked, luckily, into the next door room, and within about 20 minutes, my second patient delivered.  This time a lot more controlled, and at least I had a gown and shoe protection on.  After getting her settled, I went to change scrubs while I had a chance.  During that time, the baby tunes sounded over the hospital system.  Another one delivered.

I didn't have any more deliveries for a while, but that doesn't mean my colleagues weren't busy.  Soon we were "log jammed" and wondering how we were going to coordinate patients between those in labor, those delivering and those who had delivered.  I was told they'd had to put patients in the hallway, but we had so many coming in with labor that it wouldn't be practical.  Part of the problem was getting patients discharged from the Mother - Infant ward upstairs and rooms cleaned so our delivered mothers could move upstairs.  So there was a bit of stress until things started moving forward again and rooms were cleared on our unit.

Around 1900 I picked up a patient from the intern who was going home for the day.  I wandered in with the senior to introduce myself as he checked her progress.  He decided she was ready to start pushing and working toward delivery.  She did.  We breathed, she pushed and over about 10 minutes she was able to get the baby into position.  My senior walked out of the room to get the chief resident, and I turned around to grab my gloves and gown to get ready.

I heard the nurse say, "Stop pushing" while at the same time saying "Get those gloves on quick!" And barely turned while the nurse pushed the staff button to call in the delivery team.  I quickly grabbed my gloves and rushed back to the bed in time to get a hand on the baby's head to guide him in a more controlled fashion into the world.  The chief walked in the door as I was guiding the shoulders and quickly pulled on gloves to help me with the rest of the delivery.   Another bed delivery.  And, off I was again to change scrubs.

And the women kept coming.

Around midnight, I was in the middle of admitting two patients that I had rechecked after 2 hours and found to be in labor when another 3 patients showed up.  So the other intern and I scrambled to try to get everyone checked and admitted.  I was doing the paperwork for my second admission when the RN for the first admission called that the patient was uncomfortable.  The senior and I went to check her and broke her bag of waters since she was close to being completely dilated (10cm).

We stayed with her for a while while she learned to breath and push.  She was first time delivery, so I walked out of the room to finish my other admission's paperwork, but had to rush back in when the nurse called to say the patient was actively pushing.  Again, my senior checked her and said that it would be soon since the baby had moved down well, and he said the now ill-fated words that he was "leaving to get the chief."

I had my gloves and gown ready, and the nurse was getting things in order to break down the bed (take out the center cushion and put up the foot rests for delivery) when suddenly the patient said, "I really have to push" and did.  Again, barely got gloves on in time to catch yet another baby on the bed.  My fourth of the shift.  Afterward I was teased that I was supposed to be getting some experience since I was an Emergency Medicine resident but that didn't mean more than the OB interns!  It was all in good fun.

I finally was able to sneak in a nap between 4 in the morning and rounds at 0630.  My second admission of the night delivered with the other resident around 0700, which I missed, but somehow didn't really care.  I'd seen more than enough during the shift. 

On my way off the Mother - Infant unit, I stopped to look in the "Baby Aquarium" (my own special name for the large picture window where you can look into the nursery.)  I counted 15 babies.  That didn't include the ones still downstairs, or the ones in their mother's rooms. 

I wonder if the waning moon will lead to waning deliveries as I take my final 24 hour shift tomorrow.  We'll soon see.  
Baby Counter:
Births witnessed:  9
Babies delivered:  13
C-sections witnessed:  3

Sunday, March 2, 2008

The Bloom is Off the Rose

It's been a busy two weeks!
I know you're all wondering... yes, the wedding went beautifully.  It rained every day except for the day of the wedding, and we had the most amazing sunset that timed in with the start of the ceremony.  It all passed in a blur, and I had planned to blog during the week, but I had the worst internet reception;  even our cell phones were spotty in a lot of places.  C'est la vie, but I promise to share links and pics as they come around.

 I didn't write this last week as my hubby (isn't that weird to say, still not used to it) and I spent some time together alone here in Buffalo.  Not quite a honeymoon as I had to work this week, but a nice recovery period from last week's craziness and emotional pressures.  We will have our "real honeymoon" in about 6 weeks when we travel down to Riviera Maya just south of Playa del Carmen in Mexico.

As for the wedding which was on the 22nd of February, it was an amazing night.  Luckily, I didn't cry during the ceremony;  just two big tears while Jerry read his vows which he ACTUALLY memorized.  You have no idea how big an accomplishment that was for him, and I was so proud of him.  My Matron of Honor told me she wanted to reach around and just wipe the tears but couldn't do it without being totally obvious, or in the way.  They were the only ones, so I think I fared pretty well.

The next day we went to one of my favorite beaches near Goat Rock for our "casual pictures" and had planned to jump into the waters.  Didn't quite happen as there was a storm brewing, and we got soaked.  But, my wedding party stuck with it like troopers, and we managed to get some shots on the beach before totally freezing our butts off and all coming down with pneumonia.

As I said.  I don't have many pics now.  The photographer promises to have them up on Tuesday, and I will post them as I get them.  For now, these will do.  Also, I have started a second blog so if you're into scrapbooking or wish to critique my attempts at putting together my wedding scrapbook, feel free to stop by and do so...
http://journals.aol.com/vbonalesmd/MyPaperCuts



Oh, and I am starting my new rotation tomorrow, OB/Gyn.  Yep, a whole month of bringing new life into the world, or at least attempting to depending on what I am allowed to do....