The Australian Consulate in Chicago is closed today in observance of Presidents Day.
Australians really do love their public holidays.
Monday, February 15, 2010
Saturday, July 25, 2009
You'll always be too shiny to me
Sad news - charlotte (my car) died. It was rather inconveniently too. It happen while I was on the freeway in Connecticut. The air conditioner suddenly wasn't so cold, a winding/grinding noise started while I was in fourth gear, went away for a few seconds after I shifted to fifth, then the car was no longer on. I pulled over and she wouldn't start again. I had always wondered what happened when your car broke down on the side of the road.
I had no clue what to do so I did what most girls would do and I called my dad. This was a special treat for me because I usually don't get to call my dad in situations like this because that he doesn't live in the country. He didn't really know what to do either. We did both know that I needed to call a tow truck, but the problem was I didn't know where I was. He suggested I call 911, but I really didn't want to do that. While it was unpleasant and inconvenient - it was not an emergency and I really hate when people use emergency services in non-emergent situations. After speaking to my friend that was more familiar with the route and trying to figure out where I was by having dad look up the exit I was by, I realized I had the solution to my problem in my hand. My phone has a "locate me" function on it. I was able to "locate me" and then google towing companies nearby. It made me really heart my data plan. So I got towed to a local mechanic the tow truck guy knew of.
After describing the events and sounds that led up to the deadness, the car guys asked me if I thought it was the transmission or the engine. I shot them a "seriously?!?!" look. I mean, c'mon. While I do know a little more about cars than some, and normally I would have a google diagnosis (I'm sure mechanics love when people self-diagnose their car problems just as much as doctors/nurses/midwives). However, I was kind of having a little crisis and my internet searching was somewhat impeded by my 2 inch screen. I told them that my dad thought it was the engine, but added the disclaimer that it is difficult to diagnose a car over the phone, especially when your on the phone with your crying daughter.
Anyways, dad was right. It was the engine. A used engine was going to cost $3000 and a new engine would have been $6000. She was also going to need a new clutch, brakes and exhaust in the near future so we decided to call it. Towing her home was going to be a lot of money, so I left her. I feel bad I had to abandon her in Connecticut.
It was very sad, but I have to give her credit for upholding her end of the bargain. When I went back to school three years ago charlotte and I had a conversation about her holding in there until I finished. I should have been more specific about waiting until I finished school and found a job, but that's on me. It was a good 7 years/100,000 miles and she got 39 mpg on the highway all the way until the end.
I had no clue what to do so I did what most girls would do and I called my dad. This was a special treat for me because I usually don't get to call my dad in situations like this because that he doesn't live in the country. He didn't really know what to do either. We did both know that I needed to call a tow truck, but the problem was I didn't know where I was. He suggested I call 911, but I really didn't want to do that. While it was unpleasant and inconvenient - it was not an emergency and I really hate when people use emergency services in non-emergent situations. After speaking to my friend that was more familiar with the route and trying to figure out where I was by having dad look up the exit I was by, I realized I had the solution to my problem in my hand. My phone has a "locate me" function on it. I was able to "locate me" and then google towing companies nearby. It made me really heart my data plan. So I got towed to a local mechanic the tow truck guy knew of.
After describing the events and sounds that led up to the deadness, the car guys asked me if I thought it was the transmission or the engine. I shot them a "seriously?!?!" look. I mean, c'mon. While I do know a little more about cars than some, and normally I would have a google diagnosis (I'm sure mechanics love when people self-diagnose their car problems just as much as doctors/nurses/midwives). However, I was kind of having a little crisis and my internet searching was somewhat impeded by my 2 inch screen. I told them that my dad thought it was the engine, but added the disclaimer that it is difficult to diagnose a car over the phone, especially when your on the phone with your crying daughter.
Anyways, dad was right. It was the engine. A used engine was going to cost $3000 and a new engine would have been $6000. She was also going to need a new clutch, brakes and exhaust in the near future so we decided to call it. Towing her home was going to be a lot of money, so I left her. I feel bad I had to abandon her in Connecticut.
It was very sad, but I have to give her credit for upholding her end of the bargain. When I went back to school three years ago charlotte and I had a conversation about her holding in there until I finished. I should have been more specific about waiting until I finished school and found a job, but that's on me. It was a good 7 years/100,000 miles and she got 39 mpg on the highway all the way until the end.
Thursday, April 02, 2009
er-go bye bye
So I sit here waiting to watch the last episode of er. This is kind of a momentous moment in my life, and a day I thought would never come. And while I had given up on er for the last couple of years (seriously, who could blame me), I do still consider myself a long time follower. Back when it started, I was a sophomore in high school and it used to be on after seinfeld - must see tv. It didn't start until 10, so in order to watch it I had to stay up until 11. pm. on a school night. When it finished I had to run to get as fast as I could cause you know what bad things happen if you stay up last on a school night. Mind you, this wasn't coming from my parents. They weren't terribly concerned about a teenager staying up until 11pm one night a week to watch tv with their family. But being born the grandma that I am, I had made my own rules up and 11pm was way after my bedtime. Actually, it was only half an hour after my bed time, but that was half an hour on a school night. I really think my parents got off easy with me, I now realize when most teenagers make there own rules they do not include a 10:30pm bedtime, a 12am curfew on weekends and staying inside a 5 mile from home "driving boundary."
Monday, March 09, 2009
The epidural is my friend!?!?
Since starting the actual catching of babies, one of the things that has changed the most are my feelings about epidurals. A lot of my patients get epis and honestly, I don’t think I could have made it through some days (and nights) without them. I started school feeling like epidurals had their place but where way overused and often unnecessary. I then went to feeling that an epidural is a necessary evil and I just had to accept it. Next was that it's about patient choice and while I might not agree, it’s not my labor as a midwife my job is to support her choice.
While I still feel that it’s about supporting choice, I never thought I would be talking women into epidurals. A few of the women I have been with, especially the very young ones, just can’t relax and stop having cervical change. An epi and a nap later they are fully. One could argue that labor support could have the same effect, but in reality there isn’t always the ability or time to do that. At least in the practice I’m with. I do feel like sometimes the epidural has at least in part been for our benefit. Between multiple patients in labor, triage, rounds and discharges we often don’t have the time to stay with a patient. There is also the fact that sometimes I need to eat and sleep. I remember when we first started call, the preceptors were always talking about how we should eat and figuring out good times to get food. The whole experience was so intense, eating was the last thing on my mind and skipping a meal didn’t seem like that big of a deal – who cares about eating, someone is having a baby! While it is still intense, I’m now to the point where I’m planning labor management thinking about when I can grab some food. Missing lunch very now and then is okay, but I’m realizing I can’t not eat and expect to keep going for 12-24 hours. I’m learning that sometimes it’s the epidural that allows time for food. Epidurals are also great when a first-time mom who is 4cm dilated gets admitted at midnight. Getting her comfortable and tucking her in to get some sleep also allows me some time to look at the inside of my eyelids.
Maybe someday I’ll be in a practice where I can sit with and support a woman throughout her labor, or every woman will have a fantastic support system, or even a doula. And there will also be puppies and hugs for everyone. Even if that happens, I'm pretty sure epidurals will still be used. Heck, after a long call shift - I'm ready for one.
While I still feel that it’s about supporting choice, I never thought I would be talking women into epidurals. A few of the women I have been with, especially the very young ones, just can’t relax and stop having cervical change. An epi and a nap later they are fully. One could argue that labor support could have the same effect, but in reality there isn’t always the ability or time to do that. At least in the practice I’m with. I do feel like sometimes the epidural has at least in part been for our benefit. Between multiple patients in labor, triage, rounds and discharges we often don’t have the time to stay with a patient. There is also the fact that sometimes I need to eat and sleep. I remember when we first started call, the preceptors were always talking about how we should eat and figuring out good times to get food. The whole experience was so intense, eating was the last thing on my mind and skipping a meal didn’t seem like that big of a deal – who cares about eating, someone is having a baby! While it is still intense, I’m now to the point where I’m planning labor management thinking about when I can grab some food. Missing lunch very now and then is okay, but I’m realizing I can’t not eat and expect to keep going for 12-24 hours. I’m learning that sometimes it’s the epidural that allows time for food. Epidurals are also great when a first-time mom who is 4cm dilated gets admitted at midnight. Getting her comfortable and tucking her in to get some sleep also allows me some time to look at the inside of my eyelids.
Maybe someday I’ll be in a practice where I can sit with and support a woman throughout her labor, or every woman will have a fantastic support system, or even a doula. And there will also be puppies and hugs for everyone. Even if that happens, I'm pretty sure epidurals will still be used. Heck, after a long call shift - I'm ready for one.
Thursday, March 05, 2009
2/26/2009
So celebrating my 30th birthday was not nearly as bad as I was expecting. The last 2 birthdays haven't been the bestest due to having finals the day after so I have kind of gotten out of the habit of doing the whole birthday thing. I wasn't planning on doing anything, but my roommate talked me into it. She organized a little shindig and seeing as though I only have 1 friend in town, she invited all of her friends. I went out to dinner with dinner with 2 people I knew and 10 that I didn't. I think that was the most people I've had at my birthday in a long while. I had macaroni and cheese and a side of brussel sprouts with bacon. I also had some cheesecake, which wasn't that good, but I ate it anyway. My roommate also bought me the birthday flowers pictured above.
I did do clinic on my birthday and actually took the next day off. No baby catching, which I think would have been nice - sharing my birthday with someone new. I guess there is always next year, and the year after that, and the year after that, and so on.
Friday, February 27, 2009
Party like it's 2002
For my 30th birthday I partied like a 23 year old. Due to the fact that my life is not where I was expecting it to be at this age. (I always thought I would be married with kids by now). So due to the fact that I didn't have anyone I had to be responsible for or to, I went out and drank birthday shots amongst other things.
Sunday, February 22, 2009
Light urple?
While purple may be the new fashion color of the season, I am not a fan of a purple baby. I had my first “tight” shoulder, which was compounded by a double nuchal. He had also managed to wrap the cord pretty tightly around his foot (? a pedal cord).
We were anticipating some shoulder issues. It felt like a big baby, she was a small woman, it was an induction at 42 weeks and a slow labor. Actually it is debatable if it was a slow labor, it was more of a case that it took a while (and max pit) to get her into labor. Anyway, the head came very slowly, took a while to restitute and then began to turn purple. I couldn’t feel a cord at first but when I began to apply downward traction it popped out from underneath the pubic bone. I was able to reduce it as the head turned a darker shade of purple. I again applied traction, but it wasn’t coming easily. She had been half-side pushing so we lower the head and moved her to her back. My preceptor jumped in to deliver the anterior shoulder. Once we had the shoulder, there was the other nuchal cord. I reduced it, delivered the posterior shoulder, unwrapped the cord from the leg, clamped and cut and handed baby to peds.
Peds was present due to “light meconium” on rupture. She spontaneously ruptured when no one was in the room – one of the nurses thought she saw mec on the pad, but the rest of us were dubious. Peds gave a first apgar of 3 - 2 for pulse, 1 for tone. The rest of the room thought he got robbed. I am no expert on apgars so I wasn’t going to argue. However, if the baby comes out and immediately looks like it is trying to do the dance moves from Michael Jackson's thriller I call that good tone. Also, we thought he was trying to make respiratory efforts but he got a zero. His 2nd apgar was 9 and that’s the one that really matters.
What I learned…so I am always rehearsing what to do in the event of a shoulder dystocia so I was prepared (as prepared as one can be) and knew (in theory) what I needed to do. The problem was that I was 2 seconds behind everyone else in the room. I knew I wanted the head of the bed down and to have her moved to her back. When I went to say something, it was already being done. My preceptor jumped in because of the color of the head. It was not my regular preceptor and my first delivery with her, so I think that played a part. We talked about it after, because I was having a omg!-how-am-I-ever-going-to-be-on-my-own moment. She was reassuring that it was normal for being new. It’s hard to take in what is happening with baby, what is happening with mom, what needs to be done and communicating it with the room all at the same time. It’s also tricky to learn how much resistance is too much and how “firm” you can be with firm downward traction.
As far as the mental multitasking goes, I guess it is like driving a stick shift. I remember how difficult it was at first coordinate the clutch, accelerator and shifting while still concentrating on driving. Now it is just automatic (excuse the pun).
Anyways, purple baby turned pink. Only weighed 7lb 12oz. Mom and baby were both fine.
We were anticipating some shoulder issues. It felt like a big baby, she was a small woman, it was an induction at 42 weeks and a slow labor. Actually it is debatable if it was a slow labor, it was more of a case that it took a while (and max pit) to get her into labor. Anyway, the head came very slowly, took a while to restitute and then began to turn purple. I couldn’t feel a cord at first but when I began to apply downward traction it popped out from underneath the pubic bone. I was able to reduce it as the head turned a darker shade of purple. I again applied traction, but it wasn’t coming easily. She had been half-side pushing so we lower the head and moved her to her back. My preceptor jumped in to deliver the anterior shoulder. Once we had the shoulder, there was the other nuchal cord. I reduced it, delivered the posterior shoulder, unwrapped the cord from the leg, clamped and cut and handed baby to peds.
Peds was present due to “light meconium” on rupture. She spontaneously ruptured when no one was in the room – one of the nurses thought she saw mec on the pad, but the rest of us were dubious. Peds gave a first apgar of 3 - 2 for pulse, 1 for tone. The rest of the room thought he got robbed. I am no expert on apgars so I wasn’t going to argue. However, if the baby comes out and immediately looks like it is trying to do the dance moves from Michael Jackson's thriller I call that good tone. Also, we thought he was trying to make respiratory efforts but he got a zero. His 2nd apgar was 9 and that’s the one that really matters.
What I learned…so I am always rehearsing what to do in the event of a shoulder dystocia so I was prepared (as prepared as one can be) and knew (in theory) what I needed to do. The problem was that I was 2 seconds behind everyone else in the room. I knew I wanted the head of the bed down and to have her moved to her back. When I went to say something, it was already being done. My preceptor jumped in because of the color of the head. It was not my regular preceptor and my first delivery with her, so I think that played a part. We talked about it after, because I was having a omg!-how-am-I-ever-going-to-be-on-my-own moment. She was reassuring that it was normal for being new. It’s hard to take in what is happening with baby, what is happening with mom, what needs to be done and communicating it with the room all at the same time. It’s also tricky to learn how much resistance is too much and how “firm” you can be with firm downward traction.
As far as the mental multitasking goes, I guess it is like driving a stick shift. I remember how difficult it was at first coordinate the clutch, accelerator and shifting while still concentrating on driving. Now it is just automatic (excuse the pun).
Anyways, purple baby turned pink. Only weighed 7lb 12oz. Mom and baby were both fine.
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