December 29, 2012

There's no denying the belly

Hope everyone had a good holiday.  My family left last night to return to the East Coast after two weeks out here, so this weekend is all about rest and recuperation.

And jump-starting this little-one-to-be as he's been quiet all morning.  I'm not concerned yet as mornings are not usually his most active time, but I will be monitoring him to see that he does get going; otherwise, it's off to L&D we go for a checkup.  So I whipped out the V8 Fusion and downed a large glass, then got back into bed to type and wait for some activity.

He's 32 weeks tomorrow.  I figure I have one more month of freedom before it's baby watch time.  Not as though I'll get much sleep in January...haven't sleep through a whole night since August.  Oh well.

Being a nurse this time around the pregnancy ride has definitely made this pregnancy go smoother, at least mentally and emotionally.  I was so anxious and nervous with the first one, panicking over any little thing...I ended up going to the hospital several times to make sure all was well with the little first one.  This time, even though the risk is higher (and the first pregnancy had its own risks to begin with), I'm much calmer about things.  Not ignorant or unconcerned, just calmer about how I handle them.

My weight is up 24 lb.  As I mentioned earlier, I kind of knew that keeping it under 20 wasn't really going to happen, but at the same time, there was no need for me to repeat the 50+ lb. gain of the first one.  Funny enough, I now weigh more than I did when I delivered the last time, but I actually look smaller and better.   Brassiere size still in the black hole know the minute I find and buy more 38DDs, the chest will expand overnight.

We hope he's in the head-down position, but I really can't tell as the blows are coming from all sides simultaneously.  I'm giving birth to either a future gymnast or Cthulhu.  I've already decided that if he's not head-down or if he's more than 9 lb, C-section.   

Ah, some movement.  Little-one-to-be is waking up.

In other news, my current facility posted a few positions that I would love to apply for a transfer to.  Of course, they do it now and not when I'm not pregnant.  Day ICU part-time and per-diem, day detox per-diem, day residential detox per-diem, psych/med day part-time, facility registry...alas, if weren't for this belly, I'd apply.  But I can't apply for them knowing full well that I wouldn't be able to start working until May at the earliest.  *sigh*  And they know I'm pregnant so it's not as though I'd be able to hide it.

Actually, most of the facility and patients know.  There's no denying the belly at this point, even if I wear dark colors.  Now staff I don't even know are leaving me chocolate and pretzels.

December 21, 2012

So we're still here

As I told someone else, I go by the calendar printed on the Oreo cookie, and there was nothing on there about an apocalypse.  So I wasn't too worried about today.  Still, it's nice that the appointed time has come and gone, just to be extra sure.

In other news, I'm being wooed by a major hospital for their behavioral health program.   Not an agency, but the hospital itself.  If it wasn't for the fact that I'm 8 months pregnant as well as fairly happy with where I am working now, I'd seriously consider it.   But I'm not planning to make any career changes for at least the next several months...once the new little one is a few months old, then I'll look around and contemplate other positions as well as possibly other organizations.  If they're still interested in me at that time, then we'll talk.

It's very flattering though:  I feel all warm and fuzzy...and gigantic.  Apparently the baby-to-be is on a growth spurt.

December 15, 2012

Christmas party at work this week.  We played parlor games...and it's rather entertaining to watch psych staff play "guess the celebrity."  Most were identified by their psych issues.   Don't ask any of us what their latest movie is or who they're married to, but tell us their personality disorder or CD issue, and we're all over it.

Interesting fact:  Anakin Skywalker/Darth Vader meets most criteria for a borderline personality disorder diagnosis.  Vader's my favorite Star Wars character, so I found this intriguing.  This meant nothing to the men in the family other than it made them want to watch the Star Wars movies...again...

Sometimes my family just doesn't appreciate psych.

Senioritis:  2, Meriwhen:  0.  For history class, I have a test and a last entry to finish up in the next 8 hours, and I'm waffling on both.

December 13, 2012

The results are in

It's not preeclampsia.  And while we're here, I passed the glucose screening.  What a relief on both counts.

Now I just have to shake this senioritis and work on the final paper and exam, both for History class.

December 9, 2012

In 6 hours, the first digit of my age will change.  In the U.K., it's already changed.  Here in California, not quite yet.

I may be awake for the actual moment, as I am so far behind on my history coursework it's ridiculous--I really need to catch up tonight.  It also will not help that the other half wants coffee right now, so a pot is percolating as I type.  And I can't resist fresh coffee.

That's all, really.

December 7, 2012

I dropped off the jug this morning--I drove it in nestled in a bag of ice, strapped into the front seat.  First I had to drop the little one off at school, so I'm sure more than a few people who walked by the truck were wondering what I was doing with a biohazard container on ice buckled into the passenger side.

I will never take peeing for granted again.

Off today as I wrap up some history homework.  I'm kind of glad I'm off today.  The hospital's new grad residency program has started notifying applicants, and quite a few of them who had worked for the hospital chain--some for years!--found themselves told, "sorry, but no..."  And for some, it wasn't their first go-around on the wheel.  If nothing else will convince you that working as an internal employee is no longer the guaranteed lock on a new grad job, this will.

The mood in the hallways is probably going to be somewhat dark for a while.

December 6, 2012

So here I am with a gallon biohazard jug and 16 pounds of ice...

24-hour urine collection day.  Thank God I'm off because don't see this really happening--successfully--while at work.  So today will be spent working on my group project for history class, working on the rest of my other homework, and collecting my own body fluids.

For those of you who aren't nurses or medical professionals, the goal of this collection is to determine how much protein, if any, that I am excreting via urine in a 24-hour period.  If I excrete 0.3g of protein or more, I may have preeclampsia.  They'll evaluate that plus my blood pressures before they give me an official diagnosis.

Hopefully, all of this is for nothing, that we'll find out that I only have gestational hypertension or--even better--the nursing student from yesterday was wrong about the high blood pressure reading in the first place, the weight gain is just the new little one's way of making up for lost time, and I really need to put the salt shaker down.  It still wouldn't explain the vision issues I've been having...but that could have a variety of other causes.

That being said, I did a little refresher reading up on preeclampsia because I believe in hoping for the best but preparing for the worst.

Mild preeclampsia can be managed at home...the literature says bed rest and possibly medications.  I read that as "stop working" but that I don't have to chain myself to the bed 24/7 because the old little one still has needs that need to be met.

Moderate to severe may require I check myself in for more hands-on management by medical professionals.  The good news is that I am within 2 miles of a hospital--I could even walk it if I had to.  The bad news...because we're military, it's not my hospital.  I can use the local hospital for an emergency, but should we talk extended stay, the military will want me at their place.  Should it come to that, maybe I could negotiate being farmed out to the local hospital...but I'm not going to think about that yet.

If I were to have preeclampsia, the only cure for it is delivery.  I'm currently at 28 weeks:  if I were to give birth today, it wouldn't be great.  The kid would have a fair shot at life, but there's way too many risks that he a.  wouldn't make it or b.  would have developmental issues from being born so early.  The goal according to the literature would be to get me and little one to at least 32 weeks.  Going longer that that would be far better--they would try to get me to go as far towards 40 weeks as we could.  But at least at 32 weeks, his odds of survival without issues are much better.  Also, they can prep him to mature his lungs.

Again, not really going to think about that yet either.

Ended up going in yesterday for half a day, for admissions and to orient a new nurse.  Patients are commenting that the baby belly has really popped out of nowhere.  Staff keep bring me pretzels and peanut butter cups.

Going to have some coffee, get to homework, and try not to think about sausage and egg sandwiches...because I've been craving them lately, and I'm trying to watch the sodium intake.

December 5, 2012

Student woes

Not me as a student, but me dealing with nursing students.  As a patient, no less.

I had two student nurses (one prelicensure, one nurse-midwife) at my most recent OB appointment.  Pre-RN student was a train wreck:  poor interpersonal skills, manner less than professional, kept calling me "hon" and was more excited that she was able to get a normal blood pressure reading on subsequent attempts than she was concerned about the high blood pressure on the first--and correctly done--attempt.  She was so nervous and hyper it wore me out.

She meant well, I'm sure...but if this is what the local BSN program is turning out for nurses, God help us who live in this area.  Hopefully she is not representative of the whole.

Nurse-midwife student was better and more professional for the most part, but her demeanor still screamed "student."  Went through the motions of feeling how the baby was positioned, and still missed the location of heartbeat by a lot.  Reviewed some history in too much detail--seriously, did she really need to hear again that resolved issues from 2003 were still resolved?  Meanwhile, she glossed over other history which was more pertinent to my condition, such as my history of hypertension, psych issues and fibroids.  After telling her that I spent the last six weeks with difficulty walking to due to sciatic pain, she still chided me for not exercising as much as I should have.  She was WAY too focused on giving me education to hear my concerns about my blood pressure, vision issues and sudden weight gain (6 lb in 2 weeks can't all be salt).  They were addressed with her remaking "well, it's the holidays, and if I stepped on the scale myself my weight would probably be up too."

I explained that a.  I started the pregnancy overweight,  b.  I have not increased my food intake, and c.  perhaps if they weighed me on the same scale they usually used instead of the one in the students' room, she may see my concern, especially if she's telling me that "there's such a big difference between the two scales."  Especially since this scale had a fully-clothed me weighing more than 5 pounds less than a naked me weighed on my scale at home.  And yes, my home scale is well-calibrated and pretty damn accurate.  

In the end, I did get a preeclampsia screening out of her.   She agreed that it was better that we get baseline data now.  And better I get it done and told, "no preeclampsia, nothing to worry about!" than for the alternative to happen.

I didn't have the heart to tell either one I was a nurse.  I think I may have freaked the Pre-RN student out and made her even more nervous if I told her that.  I think the nurse-midwife may have figured it out when I used medical terminology fluently.  Yes, I'm a psych nurse, but I can speak medical nurse pretty well.

Oh well.

Slow working for a while.  I called out sick on Monday, off yesterday, today is pending whether they need me.  Thursday is off, Friday and Monday were taken off as I have birthdays to celebrate.

December 3, 2012

There are days where I worry that my taking time off to have the baby, especially in this job market, will seriously impact my career.  Then I see the latest message from a recruiter or agency dangling a shiny psych job in front of me, and I feel better.

Just hormonal and under the weather today, don't mind me.

December 1, 2012

So I bombed my third history test

Well, I didn't fail:  I got a 76.  But I earned that 76 because I didn't really study for the test.  I tried to, but over the last few days, every single time I whipped out my notes to study, I fell asleep.  I swear, these notes were a better sleep aid than my old med-surg textbook.

It also didn't help that the last two weeks at work were hectic:  both resulted in OT.  Actually, the whole month was straight 5-day work weeks because I was covering in not one but two programs.  I did have pockets of downtime so I was able to do some schoolwork at work.  But I would get home from work exhausted, cook (or usually order) dinner, help the little one with his homework, pass out, and wake up at 0-dark-30 to do it all over again.  All while doing this with sciatic pain which--thank God--has eased over the last week, to be replaced by a new pain that at least lets me walk.  Lather, rinse, repeat.

All weekends were spent doing family stuff, trying to rest, and trying to stay abreast of schoolwork.  Last weekend, I was too busy catching up on rest to get a jump on any assignments or even the reading.  I was too tired to do anything except sleep...and that is even a challenge thanks to being nearly 7 months pregnant.  I can't recall the last time I slept through the night...I know, I know, it's preparation for when the baby does arrive.  So I'm not entirely worked up over not sleeping well.  But that plus work plus school makes life hard.

After this month, I am really grateful that I withdrew from the other class.  I think that REALLY would have done me in.

Anyhow, the history test was due today and I kept trying to study this morning without success (but with one nap), until I just accepted the fact that it's just not happening.  I figured that I better just go take this test, get it over with, and let the chips fall where they may.  And they fell on 76.   When I clicked "start test" I accepted there was a risk I'd muff this test and I was OK with that...but I am still a bit disappointed because you know 76s on tests is not how I roll.

The overall desired grade of B is in no danger at this time, as long as this is my only misstep.  I do worry a bit as there's a group project coming up that could do some major damage, especially since I don't seem to be part of a very enthusiastic group.  An A is still very much possible, but I'm trying not to stress over that.  I keep reminding myself that the world will not end if I get a B.

Fortunately for me, my health and my academia, work will be easing up:  starting this week I revert back to my three afternoons a week.  I also plan to take off a good portion of time around the holidays to enjoy them and the family coming to visit.