January 31, 2013

Turned work down for today, so tomorrow will be my last day of working before baby watch begins.

My dad got out of the hospital today...a couple of days ago, he had tripped and fallen on some drawers that he was working on.  No broken bones, no stitches needed...but lots of pain, blood and a the development of a 12-inch hematoma courtesy of 30+ years of being on warfarin (Coumadin).  So off he went for a two-day stay full of Vitamin K and painkillers.

While inpatient, he got a complete MRI.  My mother said she was worried about it and so read it to me over the phone.  Word for word.  All 6 pages.  Lots of interesting tidbits but nothing that struck me as being horribly abnormal...though I'm no MRI expert.

I was getting exhausted from listening and translating stuff, so by the time she got to the kidneys, I asked her if any of the physicians at the hospital told her that they found any problems.

"No," she said.

"Then don't stress.  If there was a serious problem, I'm sure they would have told you--they wouldn't court a lawsuit by not mentioning anything.  But take it to your regular doctor so he can review it too."


In other news...I noticed something.  Over the last couple of weeks, I have been incredibly thirsty.  Insanely thirsty.  Not the typical "I've had too much salt" thirst, but a painful thirsty feeling.  Thirsty enough that the word "polydypsia" came to mind today.  Then once that word entered, I realized that the appetite has increased considerably over the last couple of weeks too.  And the edema started around that time too.

For the record, polyuria never crossed my mind as the little-one-to-be is securely parked on my bladder...and has been for several months.  So constant urination is nothing new to me right now.  And no weight loss (ha!)...for the record, I'm now at a 39 lb gain.

Appetite increase, polyuria and edema:  I could put all of these down to the pregnancy.  But the insane thirst has me a little concerned.  I passed my glucose tolerance test in week 28, and have never had a problem with diabetes or blood sugar before then.  So while I'm not getting worked up into a "I've turned gestational diabetic!!!" frenzy, I'm going to call my OB and/or regular PCP tomorrow just to be safe.

Of course, I couldn't notice this before my last OB appointment so I could bring it up.

*sigh* x 2

January 29, 2013

So far so good.  Little-one-to-be is in the correct position, his heart rate is good, and he is estimated at 6 lbs.  I'm not dilated at all, my blood pressure is good, my weight up up but my feet are well and truly swollen and apparently I've got a lot of amniotic fluid in there...my abdomen was described as being "very squishy."  The midwife was able to bounce the little-one-to-be around in there.

I also got a DTaP shot.  The nurse was rather tickled to find out I'm a psych nurse, and we spent about 15 minutes comparing notes on IM techniques.

Next appointment in two weeks.

Work wants me to work Thursday as well as Friday.  Every time I try to get away they pull me back in :)  I'm thinking about it.

January 28, 2013

If it wasn't enough to hear it at work, my sister declared that I am huge.  The better half is predicting that the little-one-to-be is going to be gigantic.  The little one introduces me as "my mommy with the basketball in her belly."  Seriously, my abdomen has doubled in size overnight.

So have my feet and ankles.  I couldn't get on most of my compression stockings...I had to wear the lightest-strength ones that I owned (only 8 mmHg) and even then, my feet and legs looked like a claymation accident when I took them off last night.


Doctor's appointment tomorrow.  We'll see where things stand.

I am glad I am off work since last night I could not get comfortable to save my life, so I didn't sleep much.  Watching Lon Chaney silent films didn't help me get tired, but I figured that if I wasn't comfortable I may as well be enjoying myself with good cinema.  So I'm planning to go back to bed later this morning.

I did do my daily spot of nesting.  My bathroom is clean.  I also cleaned this past weekend since we had company (sister and her kids) over.  Half of the house, including the soon-to-be-nursery, still looks like Hiroshima after the bomb though.

Only one more day of work this week.  Given the sudden stomach expansion, I may have to go in wearing civilian clothing.  That's another benefit to working in psych:  in a lot of facilities, scrubs are optional attire.  While I prefer wearing scrubs due to a.  the comfort and b.  there's no mistaking that I'm a nurse (as though the ID badge with the big "RN" tag didn't help with that too)...I also need to be comfortable for this last day.

January 26, 2013

They're making bets...

The consensus of my coworkers is that the belly has gotten so large, that few think I will make it until the end of February.  Half predict I'll go into labor on Super Bowl Sunday, which is exactly at 37 weeks.

"No," I said.  "The Ravens made it, and I want to watch the game without having to stop and push!"

I thought this week was going to be my last week at work, but I got talked into doing one more day next week.  I told them that had to be it because once I was at term--which is either Super Bowl Sunday or the following week, I'm not good at the definition as OB's not my specialty--I wasn't working anymore...at least, not until the little-one-to-be is 3 months old.   Then I'll be back in some way, shape or form.

In the meanwhile, I'm finally having a bona-fide craving that is lasting more than a couple of days.  

It's whole wheat toast with real butter...specifically, very well-toasted Dave's Killer Bread and salted butter, though if desperate I'll use unsalted.  Seriously.  I'm putting down a few slices each day.  I even made some at 2200 last night and had it with a glass of chocolate milk.  I suppose this is a better craving than ice cream, sugar or cheese...the last in the list being a major craving last pregnancy and which resulted in 50+ lbs going on the body.

Speaking of weight gain, I'm up near 33.  So much for keeping it around 25...still, it's better than last time.  I'm aiming to keep it under 40 but at this point, any weight gained is mostly kid, breasts and peripheral edema, so I'm trying not to let the scale get me stressed out.

I did start getting the MyFitnessPal account ready though.  As much as this pregnancy has been good to me--seriously, it's been miles better than the first one--I'm ready to start having most of my body back.  The breasts, I'll have to continue to lease out to the little-one-to-be for at least a year, but the rest of me can start to be reclaimed after birth.

January 19, 2013

I started cleaning out the office, which will become the little one-to-be's nursery.  This is not meant to be a one-day process:  I figured I'd work on a it a bit each day.  Of course, little one-to-be won't be living in it for several months, but given that I'm a pack-rat by nature, I need to get an early start on the process.

I culled the nursing school textbook herd quite a bit and I still have almost bookshelf full.  Same with the knitting books.  Unfortunately, there's too many to combine into one bookshelf, so I'll have to think of something.

I also found a few unfinished knitting and crochet projects that I should tackle once I stop working and go on baby-watch.  I found a blanket for my bed, two wool shawls, two pairs of socks, a burp cloth and a charity blanket.  I also found a baby blanket in gender neutral colors that I have no idea who I was making it for, but it's almost finished.  So I'm going to finish it off and set it aside for the little one-to-be.

I also cleaned the stove.  That's today's adventure in nesting.

I was going to see my nephews tonight to let my sister have an evening off.  I made plans for the better half and little one to go to a monster truck show while I babysat.  I actually like monster trucks (and my Grave Digger is going to be there) but figured that being at a monster truck show at 35 weeks' pregnant is probably not the best idea.  The boys better bring me back lots of pictures and if possible, a Grave Digger souvenir.

But then I found out that my sister and one nephew have strep, and the other nephew has a cold.  So no babysitting for me.  I need to get strep while pregnant even less than I need to be at a monster truck show while pregnant.

I now have an evening to myself:  definitely a Chinese food night.  I wonder what sort of movie/television marathon I should have...and I should pull out that baby blanket in progress and work on it while I'm watching.

January 16, 2013

Reasons TO become a psych nurse

The stories you'll be able to tell.  You can't make up what you'll see when working in psych.  You will have the best stories to swap with other nurses, and except for those staff who work in ED (which is pretty much where half of the psych patients come from), no one will even be able to come close.

Professional development opportunities.  You will develop great therapeutic communication and interpersonal skills that translate over to many specialties.  You will keep up more of your medical skills than you think, since psych patients don't leave their medical problems at the door when they are admitted.  You will become a master at injections and secure-yet-quick-release knots.  You will know how to sedate a patient twenty ways to Sunday.

Worried about the technical skills getting rusty?  Anyone can relearn how to insert a Foley...same goes for most tubes and skills.  Nothing to lose sleep over.

Fewer blood and body fluids to deal with.  Granted, sometimes the ones you deal with may be encountered in new and creative ways.  But you're not going to have to deal with lines and IVs, and more than likely you will not be giving bed baths.  You'll see far less blood, poop and sputum in psych.   Vomit...well, if you work detox, you'll see more vomit.  But even in detox, there's still less blood, poop and sputum overall.

Less family members to deal with.  Most psych facilities limit visiting times, which means fewer demanding/entitled family members to deal with.  So you're not going to be fetching sodas, snacks and blankets for people other than your patient (actually, you won't even be fetching them for your patient, but that's another bullet).  And thanks to HIPAA, you may not even have to talk to them about the patient other than saying, "he's in the day room, I'll bring you there."

Opportunity to meet lots of people in law enforcement.  Without you being the one in handcuffs, that is.

You're not a glorified waitress/maid.  In psych, we encourage patients to do as much for themselves as they can.  So if a patient comes to us asking for a change of linens, instead of making the bed ourselves, it's actually more therapeutic for us to respond, "Sure, I'll get you a clean set so you can make up your own bed, and then show you where to toss the dirty sheets."  Patient wants a snack?  "Here, let me show you where the pantry is.   Help yourself."  Patient spill something or make a mess in that pantry?  "Hang on, I'll get you a towel so you can mop it up."

Try doing that on a med/surg floor and see what happens.

No call bells.  Need I say more?  OK, call bells may exist in gero-psych.  But in most of psych, there is no such thing as a call bell.

You really get to talk to patients.  It's part of our job!  We're expected to chew the fat with them--that's one of our therapeutic interventions.  No running around doing drive-by assessments and spending 15 minutes or less (out of 12 hours) with the patient because you're too busy juggling everything and anything.  So if you're the sociable type, you'll enjoy psych.  If you're not as sociable...work nights in psych where only half the floor is awake, so there's only half as many patients to talk to.

Dealing with your own difficult family members/people will become much easier.  Seriously.  After honing your interpersonal skills dealing with psychotic patients, patients who are acting out, patients with personality disorders, or patients who are hallucinating about an army of squirrels that are trying to to implant microchips in the entire human race...handling an overbearing parent, ornery child or a delusional boss is a piece of cake.

Job security.  Not many people want to work psych for whatever reason.  You'll have less problems getting a psych job than you will trying to get a job in one of the high-profile specialities that everyone else wants to work in.   You'll probably make a higher hourly rate too.  Also, psych nurses frequently get recruited...and you don't need to have 7+ years of experience to be targeted:  have just two years and recruiters will start making advances at you.  And this includes recruiters NOT in North Dakota.

January 15, 2013

Well, the dentist went well...a drastic improvement over the last two visits (which have been detailed in an earlier post)

It's times like this that psychiatric nursing skills come in handy.  Not only could I talk the little one out of his panic, I was able to manually restrain him myself.  Not as bad as it sounds...just keeping his arms from flailing and hitting the equipment.

34 weeks

6 weeks--likely less--to go.  I only made it to 38.5 weeks last time, but this time I am several years older.  Major discomfort has set in...I'm spending more time lying down than I am doing anything else.  Though funnily enough, sometimes standing is the most comfortable position for me.  Go fig.

Beat the cold.  Only working one day this week.  After that, my schedule is open.  One of the departments that I am covering for got their own per-diem back and if all goes well should have a new full-time person starting soon, so I won't be needed as much if at all.  My core unit doesn't need me much now either--she's taken care of all of her personal issues and unless she decides to take advantage of me to have a day off this month, I probably won't be going in to work for her either.

Need to take the little one to the dentist today...it was either pull him out of school for the day, or wait for the first free afternoon appointment in mid-February.  So here we go.

Pray for me...or if you don't pray, just think happy thoughts for me.  His last two dentist visits did not go well.  One resulted in him vomiting all over himself...which was fine by me, except that he stripped down to his underwear and ran out into the waiting room because he didn't want to wear vomit.  The other involved restraints:  he actually requested the papoose board.  So he was strapped in and screamed bloody murder the entire time, then as soon as he was released was all hearts and flowers and "that went well!"

So yes, pray for me.

January 11, 2013

So I ended up leaving work after just 2 hours on Wednesday.  They were all surprised I showed up--the general consensus was that I looked and sounded horrible.  Fair enough, I did try to push myself.

I spent most of Wednesday night and most of Thursday unconscious on various pieces of furniture around the house.  I'd move to one room, take a nap, wake up, move to another room, take a nap, wake up, lather, rinse, repeat.  The cat followed me around the house and parked herself on my leg at each spot.  The little one followed me around the house and would arrange his Star Wars Angry Birds figurines on my belly at each spot.  Good thing for both cat and Angry Birds that I don't move when napping.

Today...I am feeling somewhat better.  At least I can breathe--I have no energy, but I can breathe.  The sinuses seem to have cleared themselves out for the most part.  I still called out for today--actually, I called out yesterday at one point when I was conscious for a bit. Considering I tried on Wednesday to go in--and failed--I figured I really needed some solid rest.  So no more work until sometime next week.

In other news, my sister has volunteered to be in the delivery room with me.  She's very excited about it, actually.  I know she wants to be there for the birth of her nephew, but I think a small part of it has to do with the fact that she's never had a vaginal birth (she's just not structurally built for it--she has the wrong shape of pelvis) and this is probably the closest she'd ever get to the experience.

Truth be told, having had one vaginal birth...I don't think she has missed much.  Lots of frustrating contractions, waiting, and pushing--during which I kept falling asleep--then the lovely discomfort afterwards...I'm half-hoping that this time, I'll need a C-section and just get the whole process over with much faster.

Anyhow, considering that the other half almost passed out during labor and delivery class the first time around (they showed him a picture of a placenta and he went white), it may be safest if he's not there while I'm laboring and she is.  He'd probably pass out and then they'd have two patients to have to tend to.  Poor guy really doesn't do well with anything medical-related.  And for someone who likes horror movies and video games, he can be incredibly squeamish.

So I told him about her offer and he agreed she should go in, saying that someone would have to watch our other little one and it should be him...but there was no mistaking the look of relief on his face.   It's all good though.  I'd rather he not be passing out on me when there won't be much I could do about it.

January 9, 2013

Afrin: the scourge of evil

So after a very restless night where I woke up q1h to blow my nose, I decided to try the other half's advice and use some Afrin.  He's sworn by it for years, and considering he was spot on with his other holy grail cold medicine (Theraflu:  works and makes you feel warm and fuzzy at the same time), I figured it was worth trying.  I whipped out my drug guides and data to check if I could take it, and majority of the data showed that it's safe for pregnant women for the most part if used as prescribed.

So I tried it.  And right now, I want to claw my face out.

The pain immediately started off as a massive fire in my sinuses; now it's down to a moderately dull burn.  The nose is running like a faucet.  My throat hurts even more than it did before.  The eyes are tearing.

The other half was worried.  I reassured him that it wasn't his fault:  I'm glad Afrin has always worked for him but I am apparently one of the few who can't tolerate it.  Almost any medication has the 1-5% of people who can't tolerate it or have a paradoxical reaction.  Take Benadryl and my little one:  there is no better way to guarantee that he'll stay up all night than to give him a dose of diphenhydramine.  Works better than soda and candy.

I'd rather wake up q1h to blow the nose than to ever experience this again.

Unfortunately, it's a 12-hour spray, so there's little hope of things wearing off quickly.  I'm just hoping the discomfort will get tolerable enough for when I go into work later.   Fortunately, that's not until later this afternoon, so I have time to gnash my teeth and wail in pain as I run though Kleenex like there's no tomorrow.


As far as this cold goes, I'm really not feeling outstandingly better, but I figured I should go in and work whatever I can this month, before I go on maternity leave.  One, the extra money--even a little--will be nice to have.  Two, I still feel edgy about taking a few months off of working.  I know I'm in little danger of losing my main job:  I'm per-diem so it's not as though anything is guaranteed to me, and the higher-ups in the food chain have been pleased with my performance as well as supportive of my pregnancy, so I think the chance of me being let go for not working for a while is minimal.

And there's always the agency:  they're still calling to ask if I can go work, and I'm still telling them not while I'm 8 months pregnant.  Which is a shame because I really miss the place...I definitely want to go back there if they'll have me this summer.

But still, you know I can be insecure at times.

Going to try to nap for a while and see if that will help with the face discomfort.

January 8, 2013


Too sick to go to work:  called out for the last two days, and tomorrow is looking iffy.  No fever, thank God.  Sore throat, nasal drainage, sinus pressure, fatigue, headache instead.  But there's no fever.  I've been resting a lot, and catching up on reading A Game of Thrones.  I know, I'm behind the times...I've actually had the book on my Kindle for a couple of years; I just haven't gotten around to reading it until now.

I've also finished packing the hospital bag.  It's all ready to go should labor strike or--given my prior track record--the water breaks.  Clothing for me, for the little one-to-be, toiletries, book (decided I'm not bringing the Kindle so I won't have to keep track of it) and knitting to entertain myself with.  I know I've got at least a month, so I hope.  But it'll put the other half's mind at ease.

January 6, 2013

Last month of work, two months of pregnancy to go

This is it.  One more month until I take my leave of absence to spawn.  I'm scaling the hours back already...going back to 2-3 days a week for most of the month.  Plus, one of the nurses that was out on their own medical leave is returning, so I won't be needed as much.   Mind you, whatever hours I do work this month will be fun because acuity in psych hospitals skyrockets after the holidays.  I had an admission last week that on the surface seemed fine but during the assessment I realized they really needed to be 5150-ed.  Fortunately, they were receptive to the voice of reason and came in voluntarily.

Anyhow, by February 3rd, I'll be at term, so no more work lest I go into labor at work.  Plus I need the time to rest and get things ready around here.

The better half is starting to get nervous.  He wasn't around for the first little one's birth--he was stationed several hundred miles away, and the first little one broke the water bag three days before he was supposed to return home--so this is all new to him.  He's nesting...which is good--at least one of us is.  I never really nested the first time either.  So I'm watching him clean and cook.

He also asked me if I have started packing my hospital bag.  And to be honest...I hadn't thought of it yet.  So I started getting one together even though I still have a few weeks.  I also have to remember to program the hospital into the GPS because even though he knows very well where it is, he will forget on the big day.  That is, if he's not too much of a nervous wreck to drive.  It may be better if I drive even if I am in labor.
I really hope I don't go into labor during the Super Bowl.  The other half's team didn't make the playoffs this year, but mine's still in contention.

In other news, I'm coming down with a cold, I think.  Bah.

Colds and strep throat have been making their rounds among the patients and the staff.  All this past week, I've been as careful as I could be about hand hygiene, but yesterday I started feeling run down.  At 3am, I woke up with a sore throat.  Today, I have nasal congestion and feel run down.  No fever, thank God--I'm hoping I only caught the cold bug and not the strep.

Of course, being pregnant means my medication options are limited.  If I wasn't pregnant, I could Theraflu/Nyquil myself into oblivion and get rest.  But since I am spawning, I have to stick with drugs in the Pregnancy Category B family.  With some OB-recommended Category Cs in moderation.

So yeah, it's Tylenol, Chloraseptic and a gigantic bag of Halls Cough Drops.  I could do Benadryl if the nose runneth too much, but I'm trying not to.