Oh No She Didn't!

Oh but she totally just did! Did what????

I JUST DELIVERED A BABY PEOPLE!!!!!!!!!!

no, seriously. I did!

Whoooo hoooo! :D A-MA-ZING!!!!

That's all i can say :)

I mean, i really didnt have to do a whole lot,

the mamma did all the work.

But, I really did just deliver a baby about an hour ago

with help from the Doc that i've been working with over the past week and a half. (oops, i forgot to tell yall i moved on to private practice last week after two weeks with my awesome gyn/onc team)

Not only was this my very 1st delivery but it was also the first vaginal birth i've EVER watched in real life. AAAAAhahahahaaaa!!!!!!! Seriously. I'm so freakin excited right now. And now i'm supposed to try and sleep for a few hours before our next one is ready to go sometime around 1-2 am??? Yeah right.

(lol, hey mom----I'mmmm toooo exxxxcciiiitteeed to sleeeeeepp!!!)

Awww. Sweet little guy, "prince brayden" that's what i'll call him :) 7lbs 15oz!! Go mamma!

Did yall know when a baby's head comes out, if its in a certain position, the baby will do a complete 180 degree turn all on its own??? Whoa. Wasnt ready for that! Don't worry its supposed to do that. His head came out, then a little arm poked out like he was reaching for someone to help him out.....we gotcha little buddy!

Then one shoulder, and the other, and bam....slide right out onto my arm with me holding on tight!!!

Dr. G said to me...."You got him? Hang on tight, that's the most precious thing you've held all day!" ....so unbelievably true.

After we delivered our new friend I was talking to "momma" and asked if i could get a pic with her and the little guy and she said of course. The nurse in the room said "OH you have to get a picture its your very first one!" I thought momma was going to be freaked out a little by that but she looked at me and said...."oh its your first one? then you're excited too!!" Too sweet.

I hope they all feel like that.

One of the lucky ones

My last blog post was a little fiesty so this time i thought i'd switch it up a little. I was hatin' some what on nurses in general and I'd just like to say thanks to Mrs. Libby, a scrub nurse over at Jewish East Hospital, who was very nice to me and a pleasant person in general. Actually, the majority of the people there were very friendly and easy to work with. Thanks! :)

If you've been following my twitter account over there on the side then you know that I finally got to see some babies last thursday!!!! YEA!!! Finally, some baby action. I have to say it was by far one of the coolest things i have ever seen. Granted, I still haven't watched a vaginal delivery but still, ceserean sections have to be equally as interesting, if not more.

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I was one of about 15 or so people in the OR waiting for tiny little "emory" to enter the world. It was somewhat of a 3 ring circus if you ask me. I scrubbed in and watched as they (two OB/Gyn docs) entered the abdomen, and cut open the uterus and then the amniotic sac, which allowed a large amount of fluid to spill out and over the table. Luckily, they have these plastic drapes on the patient to catch the fluids/blood as it runs all over. Thank goodness for those cause otherwise my shoes would have been uh....damp. All of a sudden a tiny little head was poking out and the doc reached in and pulled out this little baby. They suctioned the baby's mouth and nose and I got to hear the very first breath and then cry that this little girl would take. I then got to cut the umbilical cord and the baby was passed off to the pediatricians who evaluate the baby and clean it off. It's a pretty emotional feeling when you realize how priviledged you are to hear the first breath and sounds of the little person that was hidden from the world for 9 months. Not going to lie, I got a little teary eyed but couldn't focus on that for too long with an open uterus, abdomen, and nasty placenta to be removed. ;) I saw her later after she was cleaned off and had a tiny little pink hat on and her daddy was holding her. She was wide awake with these big black eyes looking right at me.

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I wasn't really prepared for such excitement in one day, but little did I know we'd be participating in another c-section just minutes after my first experience! This time was even more exciting than the first....i know! Hard to imagine. These little kiddos were 27 weekers (2+ months early!!) ....and did i say kiddo "s" yes....TWINSIES!! I dubbed them my little "hannah montana" twins. They were incredible. First of all they were being delivered really early because they were a "twin-twin transfusion" which is very rare. To summarize the twins have two umbilical cords but they share blood supply, sort of like one big open circuit.

However, one twin generally has most of the blood shunted to it, and as a result grows bigger and as I like to put it "beauregards" the other one in the uterus, pushing it out of the way and stunting its growth. Most of the time, both twins do not survive and very often they both die. Scary. When we delivered these two little girls out of their mommy the first one was the big one and was over 6lbs--pretty impressive for a 2mo premie! She was so stinkin' cute. They laid her on the moms legs to cut her umbilical cord and suction her mouth. She reached up with her tiny hand and grabbed hold of the first thing she could which was a string on a lap rag (rag used to soak up blood). She was holdin' on for dear life just a screaming and crying, so i had to unfold her little fingers and pass her to the pediatrician. Too cute. Then on to baby number 2, literally the little sister in every sense of the word. She was so so so tiny, probably about 3-4 lbs. She had to be held for forty-five seconds with her legs higher than her head and blood squeezed from the cord into her little body. It was a little scary but she did great! I cut the cord and we passed that little thing over. Both twins had excellent APGAR scores (first evaluation of infant) and mommy did well too. Couldn't ask for anything better than that!

These aren't my "hannah montana" twins but their rolls and cuteness were too much to not put them on here :)

WHAT A DAY!!! :D

Makes me smile just thinkin' about it. I know i said i'd NEVER be an ob/gyn but you never know.....

Need some help!

I just got my spiffy new iphone! whoo hoo! (call me)

Totally didnt even have my eyes on this but my techy hubby ordered me one :) *THANKS!* But, its really tedious to put in every persons phone numbers and emails and what not. (call me) Soooo.....please please please call me some time today or tomorrow. (call me)

I'm not going to be answering my phone so if you actually need something please leave a message.(call me) But most importantly...

CALL ME PLEASE! or TEXT ME!!!

So i can save your number in my new phone :)

Thank you!

erin

OH! Actually please call and leave a message telling me who you are because i dont know anyone's numbers, or you can text that'd actually be better.... ♥

I ♥ nurses!

If we didn't laugh at ourselves, we'd die. *this is scarily accurate :)

No seriously i do. My mommy is a nurse, and a fabulous, incredibly intelligent one at that. Nurses are by far some of the hardest working people in a hospital. They spend more time with patients than physicians do, and they log a lot more hours with patient families as well. They have that nurse/mom/dad/spidey sense that tells them something just isn't right, and it usually isn't. So don't get me wrong--I ♥ nurses.

From day one, all we hear from every resident, every attending, is "Be nice to the nurses, they can make or break you. They are very valuable." So we as lowly little useless med students, spend countless hours, and lots of energy trying to please all the nurses around us. We try not to get in the way of them doing their job. We worry if we interrupt their patient duties, or charting, or prep, and we try to follow protocol to the T so we don't make them mad. So much energy goes into this every day. It sounds like an exaggeration but truly, I can't explain it's full effect.

Today's daily gripe....
For those of you who are not aware of what "scrubbing in" is, here's how it works.

1. Secure mask, and goggles and begin scrubbing your fingers and forearms. *Advice from residents...ALWAYS be the last to finish. If the attending is still scrubbing, then you keep scrubbing till your little hands are raw. Attending leaves, resident still scrubbing....guess what?..you are STILL scrubbing.

2. You finally finish, you butt the door to enter the OR, and keep your hands in a "strike zone", careful not to touch anything. You do NOT walk in front of any attending or resident who is getting their sterile gown and gloves put on.

3. You towel off your hands/arms starting at finger tips, moving down to the elbow, grab bottom of towel and switch sides. You drop the towel on the floor (or designated spot) and then the scrub nurse helps you put on your gown. A circulating nurse ties up the back of your gown and fastens the snaps while the scrub nurse helps you put on sterile gloves.

4. The dance: You grab ties in the front of your gown and yank off one side of a cardboard tag which you hand to a circulating nurse as you spin around to grab the other end....ie you have both ends of your gown to tie like a robe without touching anything not sterile like your backside.
5. Done. Wait for attending to tell you where he wants you to stand next to the operating table.

Now you're caught up to speed :) Maybe you should scrub in for me. I'm sure you'd do a much better job and receive a few less eye rolls, "humphs", or "well....she's already messed it up so just tie it".

GrrrrRRRrrr. *evil eye* bite your tongue. (thinks) ....it's ok. it's not your fault she's an unhappy person. Crazy. I'm sorry. I keep whining, but i can't do it at the hospital so you get to listen to it on here. Well, i guess you could stop reading if it bothered you that much. Wow. Great idea, i wish i had a magic button inside my face mask that i could push with my tongue to put people on mute every time they choose to have a power trip kind of day.

my favorite comment today......"*sigh* you can just use the avaguard* next time"
(avaguard*= equivalent to hand sanitizer, slightly stronger, but used to scrub in very quickly for emergency procedures, or not so sterile procedures. It's not nearly as adequate as using the proper scrub soap especially when diving into an open abdomen.)

Translation......"I'm to lazy to hand you a towel to dry off, or to stand here and gown 2 attendings and YOU."

This would be right before the comment......"here's the scissors, you're up, you're gonna have to do something besides stand there and look pretty." ......wow. awww she called me pretty.

NOTE: I DO NOT assume that i'll be cutting anything, in any open abdomen, until told to do so by an attending. Bottom line. (so shut it lady)

I realize they have WAY more experience in the OR than i do. But, come on, I'm working on year TWENTY of my education. My spelling skills may be lacking, but I ain't as dumb as I look. Don't talk at me, teach me. I promise i won't do it wrong again.

I know its going to keep happening and eventually i'll just tune it out. But, for now....i'll just continue to chuck hemostats and retractors at their heads.
In my mind.

*I promise the next post will be a happier, less whiny me :)

Ya wanna know why....

I decided today that there are a LOT of frustrated doctors wondering around the hospitals. Tired, hungary, irritated, frustrated doctors. Yes, there are some who are just plain hateful and its not necessary but, the next time you encounter a "mean doctor" consider this....

*as third and fourth year students, we're the only ones in the hospital NOT doing an important job, or atleast getting paid to do it. We do a lot of work, simply for the purpose of learning. And we recognize this. We realize that we are often in the way, that things take a little longer with us around, and it takes more effort to teach us than to not have us around at all. we get that. But you don't have to treat us like we are completely a nuisance. We're just trying to take care of our patients, and learn as much medicine as possible, before we are responsible for actual lives in 2 years. We work really hard to adjust to the fast pace of being in the hospital, while attempting to please our residents, get good shelf exam scores, study so we don't look like idiots in front of our attendings, scrub in properly and excessively worry if we are going to be that stupid 3rd year med student that breaks the sterile field and has to re-scrub/gown/glove, etc., we spend half our day attempting to not piss of the nurses, and the other half worrying weather or not we getting on the interns' nerves by following them everywhere. So have a little pity on that cranky doctor next time, because he/she prob suffered through years of everyone around them recognizing them as and treating them, like they are at the bottom of the food chain. I'm not saying you have to take crap from people, because really no one benefits from treating other people like poo. Just cut them a little slack.

Daily frustrations from the algae at the bottom of the food chain [that'd be me]

1. I get to the hospital about 1 hour before my intern so that I can get all my vital signs, and labs off the patients charts and evaluate my patients progress over the past 12 or so hours, and finish my report before the intern gets there. When i get there, I see my patients do physical exams (yes they love that i wake them up at 4am!) and then its around 430-445 and I write down all my patients' medicines, and then look for their vital signs on the charts and their lab results on the computer. HELLO! These are important, and they are supposed to be done throughout the night but how am i supposed to evaluate how patient is doing with out them???? And what gives someone the right to get mad at me for getting there early?? ARRRgghhHH. You don't have to roll your eyes, or snap at me when i POLITELY ask to borrow the chart, or ask for my vitals. So i guess this is how its supposed to play out:

Resident: so you saw Mrs. XYZ this morning how's she doing?
ERin: uh well i saw her, she was talking to me and she was breathing, heart was beating. But other than that I can't tell you her blood pressures overnight, i can't tell you how much pain medicine she used, i cant tell you if she had a fever ever, what her heart rate was, or her respiratory rate, if she's on oxygen, how much urine output she had, what any of her electrolytes were, if she needs to be transfused or not, if her coumadin is being controlled, if her sugar is too high......uh I really cant give you any of that. cause it wasn't done.

See how that could be frustrating??? Ok I'll step off that soap box. Next,...

2. I sit and study while everyone has dispersed to their respective surgeries, mine is not until noon. I study in the doctors office on our floor in the hospital (its where we keep our stuff all day, and write in patients charts, look things up, etc.) When another team comes in to do their rounds, we get booted out on a daily basis and have to find somewhere else to read. I'm ok with this, i'm flexible.

2. I relocate to the nurses station, to look up labs on the computer since its been about 3 hours since they've been drawn and i still dont have the results. A "disgruntled" employee tells me I can't have a drink without a lid on it. Ok. Fine. I go in search of a lid because i dont want to get in trouble. Cant find one, so I ask someone who works on the floor on a regular basis..."excuse me, where can i find a lid?" the response i get...."oh a lid? we dont have any lids up here."....what the crap?! Ok so i head back the computer where i was working, my drink and book have been relocated because...well because it apparently was in someone's way. Ok so clearly I'm in the way again even though there are 5 empty computers around the room.

3. So i get up and walk to the break room where there's no employees and i dont need a lid. I read for awhile, two classmates join bc they too are not sure where to be "out of the way". Then disgruntled employee #1 walks in and loudly states to her colleague "yeah well be rounding in here in about 10 minutes" my good friend responds (in a friendly manner) "is that our cue to leave?! :) " response "well yeah. we need to be in here in 10 min." ok we get the picture. relocate again to sit at the end of the hallway.

4. I'm over this so I head downstairs to check on the status of the surgery going on before mine. I'm in the elevator which stops about 3 floors above the one where I'll get off. I see medical equipment so I hold the door open to let whoever step on to the elevator. A lady walks in and goes "OH! I have a patient. you need to step on out." (um, ok since you asked so nicely)....booted again.

5. You know what? whatever. I ended my day with a 4+hour surgery where we removed an incredibly painful cervical mass the size of a grapefruit, and a uterus from a young woman who will be feeling much better in about a week, and who will leave the hospital knowing her tumor was NOT cancer!..... so nah nah naaa na naahh naahh! :P My day was cooler than theirs anyhow.

Hmmm....revenge of the nerd.

so here's how it went down today....

3:15am--rise and shine!

3:55am--i leave the house, head downtown on 64, hit as many green lights as possible and flooring it when any of them turn yellow so i dont have to stop on shady streets this early in the morning, in the dark. [like tuesday when a drunkin' homeless man--blue jeans, blondish hair, royal blue t-shirt, late 40's--made an attempt to approach my car for a ride before i stomped on the gas pedal!]

4:10am--finish my slice of cookie cake in my car for breakfast, while waiting in the parking garage for supra.

4:15am--start the day on the floor. look over charts and then wake up my gracious patients to exam them at the butt crack of day. [oh they lOvE me] still dark out.

6:00am--finish my physical exams and my progress notes. horrible.

7:00am--lecture on chemo with attending and residents.

8:00am--pathology conference for interesting abnormal pap smears/biopsies. [we head down to the path lab and all sit at a giant like 16 head microscope as a pathologist explains different cases from the past week.

8:30am--round on patients on the floor. tough day. it has its ups and downs like a roller coaster. From one room where the sweetest little bald headed lady apologized to us because her "teeth were soakin" to the next room where we had to talk to a beautiful spirited lady who realized she needed to talk to her family about end of life planning. Wow. Rough half hour.

9:30am--head to Colposcopy clinic. get to see one, then i have to leave to grab a bite to eat before i head downstairs for surgery.

12:00pm--preop patients, wait for doc to arrive to start procedures. Upon arrival a whirlwind ensues.....running with residents back to OR, tie my facemask as we walk in and doc has pretty much started procedure already....3rdyr resident realizes doc is rip roarin' ready to go, runs out to scrub in...doc ask for med student (that would be me) but neither myself or the 2ndyr resident whom i'm with, have scrubbed in yet! Doc turns to some other random person in the OR and says come here hold this....meanwhile i'm lookin' at my 3rd year like "crap! what do i do, he's almost finished???" her response back with her eyes peeking over a mask say "hell i don't know i guess just go scrub in" so i do. Quick scrub scrub scrub.....i come back in OR ready for gown and glove...got the gloves, no gowns left so i just stand behind the attending and watch. Then I attempt to get out of everyone else's way that's actually doing something important. Uh...now that about three people have either walked in front of me or touched me i've officially broken my sterile field, and doc is about finished with the procedure so i stand there, out of the way. He then request the 2ndyear resident by name--who also didnt have time to scrub in and tells her to scrub in and come participate in the procedure, she leaves to scrub...i run to get her gown and gloves....5 min later we're finished and trying to run to the next OR before doc can make it there.

3:00pm--last procedure of the day. we scrub in on time, doc in much better mood-oddly enough. I get to help out and in 30 min we're finished and headed back up stairs to the floor. I finally get a chance to grab some lunch. We go over our progress notes with our fourth year resident who was VErY helpful, then we split up surgeries, and patients for tomorrow.

4:45--we can leave? really? we are OUTTA here!!!

*I'm actually enjoying this service, despite how early i have to get there and the some what long days. Our patients are absolutely wonderful women. They are so so sweet and I really am thankful that they don't mind students being involved in their care. They probably teach us just about as much as our residents and attendings do:)

*Tomorrow morning I have to work in clinic so no surgery for me.....but right now its 8:34 and i'm already up past my bedtime so I better ZZZzzzzzzz....................

life on gyn/onc*

*that's gynecology/oncology

3:30 am: up out of bed, get ready for first day on gyn/onc service (eta: wonderful hubby gets up with me so i don't have to walk out in the dark by myself, well and because we both went to sleep last night at 8:30pm)
4:10 am: leave the house in time to arrive at parking garage by 4:30am
4:30 am: search 8th floor, then 3rd floor labor and delivery for locker room and scrubs
5:00 am: wait patiently on 8south for our intern to arrive. 5 students standing around with absolutely NO idea what to do.
5:30 am: we're told our intern wont be here until we round at 7:15am. So we familiarize ourselves with our new patients, reading charts, doing essentially nothing that is of importance to anyone else. Then we wait around, and we wait, and read, and wait......
...is that the sun coming up?.....and wait.....
9:23am: we go over the patients for today and then start our morning rounds.
10:15 am: rounds over, we're left alone to wait about 20-30 min, then we'll start visiting our patients to check on them and tcb.....surgeries scheduled to start at both 12:30 and another at 1pm.....is anyone else ready for lunch yet????

*dont worry mom, i'm not going to get in trouble we have 30 min of free time. no one trust us enough to give us any responsibilities yet!

eta: 5:00pm : no reason for us to stand around doing nothing, so residents tell us to head home and be back tomorrow and ready to go by 6:15. We get the heck outta there and head home for showers, food, reading to prep for tomorrow, and to bed by 9.

Catch ya on the flip side!