26

So I just survived my last OB/GYN call and it was a doosie. Not quite Jack Bauer, end of the world stuff, but 5 C-Sections, 4 of them emergent, and lots of running around. No missing nuclear warheads, government conspiracies or biological warfare, but lots of fetal heart decelerations, arrested labor (not as entertaining as Arrested Development), and pre-eclampsia. But it was fun in a weird, med school kind of way.

A break down of my long day:

6:30 am: Rounding on postpartum patients, are they breast or bottle feeding? do they want contraception? how's their incision? nausea/vomiting? vaginal bleeding? ambulating? eating? flatus? fun stuff

7:45 am: Breakfast! My amazing resident buys me some fresh fruit from the cafeteria (not from the horrendously expensive Au Bon Pain which has taken over the hospital)

8:00 am: Changeover with the people from the night before. Gotta love running the list.

8:30 am: Cervical check on a HIV+ lady. She hasn't told her family her HIV status. Fortunately she has a low viral load. I'll cross my fingers for the baby.

8:45 am: Update records for some of the patients.

9:00 am: C-Section #1...this one was planned...it was the lady's 5th section! Crazy. Wisely, this time around she's also getting a bilateral tubal ligation...I get to cut the fallopian tube. Yay!

11:00 am: Watch the swearing in of Sonya Sotomayor...all goes smoothly, no jumbled lines. Try to study Case Files.

12:00 pm: Lunch! I eat the lunch I packed the day before and never ate since I went out to Clarian West to see the uterine septum removal. That day I ended up eating a chocolate pop-tart for lunch. Not the best.

12:15 pm: Check the Amniotic Fluid Index on a lady at term who may or may not have ruptured. It still looks good...she goes home...no baby today.

12:30 pm: Recheck the lady with HIV. Slowly progressing. I secretly hope she'll deliver vaginally and not tear. There's so much blood and blades and scissors flying around during a C-Section it'd make me a little paranoid to participate in that surgery. I trust universal precautions...but still...

1:30 pm: The lady in Room 5 isn't progressing...we're going to do a C-Section but then the nurse suggests we give her an epidural and see if things change. So we wait.

2:00 pm: Back in the break room watching Runaway Bride. I prefer Pretty Woman.

2:15 pm: Write a bunch of B9 discharge papers. Hopefully some women can go home soon.

3:00 pm: Watch Sex and the City! It's the one where Miranda moves and is afraid she'll die and the cat will eat her face, Carrie gets back together with Big and they go bowling, Charlotte dates the widowed guy, and Samantha becomes a social outcast only to be saved by Leonardo DiCaprio ex machina. Why do I so clearly remember all the episodes? Why can't medical knowledge stick so well? At this point I do the smartest thing I did all day and eat some of the pesto pasta I brought for dinner. Even though it's early I'm hungry and you never know what's going to happen...

3:30 pm: Go to check on the lady in Room 5 and discover that the baby in Room 9 is crashing and needs a C-Section first. I get to retract, sponge, sew up fat and staple. It's a boy! Hurray! Get reports that the baby in Room 3 is crashing. Great.

5:00 pm: Room 3 gets a C-Section...the little boy is all tangled in his umbilical cord but does fine.

6:00 pm: Now it's Room 5's turn for a C-Section. Haven't I done this before? She's quite large and has about 6 inches of fat over her uterus. Challenging surgery. Get reports that a 430 pound lady just came into triage and the baby does not look good.

7:30 pm: Call Monkey via Skype on my phone! So glad he'll be back in a week and I'll be done with this craziness.

7:40pm: The staff physician is ordering Jimmy Johns and gets a #5 Vito for me. Awesome. Write Op Note from the last surgery.

8:00 pm: The super size lady is brought back to the OR but the spinal anesthesia is taking a while because, well, her spine sure as hell can't be palpated or visualized and she can't bend forward at all. Also can't monitor the baby properly through all the extra tissue. Yet another reason not to get fat. But seriously...this lady is almost 4 times as big as I am!

8:30 pm: Spinal still not in...go eat Jimmy Johns. Everything looks better after eating.

9:00 pm: Back to OR. Help position patient which requires about 8 people, table extenders, tape, and lots of rolling and pushing. Definitely the largest person I've seen in an operation...of course I've been working on little babies in the past rotation which are challenging in their own way. Scary moment when we take out the baby and there's lots of meconium in the amniotic fluid and she's totally blue and not moving. Hand her over to peds and she eventually gets apgars of 3/8/8. So glad the baby survived!

10:30 pm: Out of surgery. The lady with HIV delivered while I was in one of the C-Sections. Yay!

11:00 pm: Amazingly the resident sends me to bed. Fabulous!

5:00 am: Wake up for morning rounds. See our three antepartum patients. Pre-eclampsia, IUGR, and an MVA with a pelvic fracture...very not cool during pregnancy.

6:30 am: Meet my friend who's just starting her rotation here and has to be on call and see all the postpartum patients we delivered yesterday. Plus her resident isn't there. Help her see patients, it's nice to check in on all the ladies we delivered yesterday not that I'm not delirious.

8:00 am: Change over

8:30 am: Stumble out into the sun and humidity. Good bye Methodist!