Monday, August 25, 2008

Craziness and Happy Drugs

So I really am still here...just been so exhausted this is the first time I've taken time to sit down and think about everything that's happened. Last week we did more ante's...but after Wednesday...we're done with them! It all went crazy on Tuesday, when we walked in and ended up taking a 35.4 weeker over to the main OR to take out her appendix. She had this "excruciating" pain in her abdomen that wouldn't go away, and her WBC count was 21, so after a bunch of surgery consults we roller her, a big 'ole baby monitor cabinet and a c-section kit (just in case) over to the main hospital for an open appy. Usually they can just do it laproscopicaly, but since she was more than 20wks pregnant, they actually had to cut her open. So J and I had to sit over there for the entire hour case and watch the baby's heart rate. It was cool though, they didn't give her general anes because that wouldn't have been good for baby, so they just did a spinal epidural like they would do for an epidural. That same day I went up to 6th floor (psych) and did a NST up there. I was a little scared that they might make me stay...

So we worked again on Wednesday...and I swear, J and I gave so many narcotics I left feeling like a street corner drug dealer. We had appy girl who still was rating her pain a 10/10, even though she still had her epidural. She refused to move much, at least when anyone was watching her b/c it "hurt too bad." It was quite the drama show...she'd be sleeping until someone would walk in, then her pain was a 10/10. I'm sure it hurt, but a 10/ can't sleep when your pain's a 10/10. Se got her spinal weaned, then she was popping handfulls of percocet and we were giving her morphine every hour. Right before I left I finally convinced her to dangle at the edge of the bed and pulled her epidural. It's a circle, and people don't understand. It hurts, so you don't move, so then you get stiff and your "problem" doesn't heal, so it hurts, so you don't move...I know it hurts people, but bite the bullet and'll help in the long run, I PROMISE!

The same day we were handing out narcotics to appy girl, we had a girl down the hall who had gallstones. You can't take that out during pregnancy b/c of where it is, so she's in for the long haul. But she's rating her pain a 7/10...all day long. Even with a continuous morphine PCA and then a dilauded phenergan and benadryl and zofran. TOO MANY DRUGS!!! I ran around so much on Wednesday, and I heard so many people complain about pain, and had nothing work to make them feel better that I was almost crying when I left. Not crying because I was upset, but crying b/c I was just tired of dealing with people's problems and not having anything work that I was just fed up! But then after work I drove to Manhattan for 3 days, so everything was good. We did find out that right after we left, appy girl's doctor gave up on the pain source and delivered her anyway...

So then I worked the weekend. J and I decided we were way done with ante's so bring on the labor patients! Saturday we had a nice little Indian couple who had a nice delivery. Mom had about every complication except for PIH...GDB, IUGR, GBS+...oh brother! The worst thing about the whole day was that neither the mom or dad wore deodorant...oh dear! But baby was super cute, and my 1st girl :) It's about time! We did a couple triage's after moving the first couple over to Mom/Baby, so that was good. Triage teachs me a lot, and they really hone my assessment skills.

Sunday was just as busy as Saturday. It didn't help that when I woke up my clock said I rolled into work about half an hour late. Not bad considering it takes me a good 25minutes to get to the hospital. That's one sinking feeling in my stomach that I don't mind if I never feel again. J just laughed, but I felt horrible. I guess when she told the family that I was running late, they said "maybe she's just hung over." J thought that was pretty funny.

So the multip that we started with delivered by 0900, and we had her moved over about 1045, then had another patient waiting for us. Primeip who thought her water may have broken about 2000 the night before, but then thought she just peed, so stayed at home, and felt more leaking Sunday morning. Oh brother...she was ruptured, and now everyone's worried about her getting a temp for prolonged ROM. She wasn't really in labor, and even after 6 hours on 20mu of pitocin, she still hadn't changed, so when J and I left she was getting ready to head back to the OR for a primary C/S. That sucks for her. I guess some pelvis' just aren't made to push a baby through, or maybe hers just wasn't ready.

Two days on, now two days off. It's nice to get babies again!

Babies Today: 2F
Babies Total: 6M/2F = 8
Vag: 4M/2F = 6
C/S: 2M

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