February 20, 2013

Another day, another morning in fetal assessment.  Whee!

February 16, 2013

Good news:  no cholestasis.  Bad news:  still itching horribly.

The jury is still out on the preeclampsia...not all of the test results are in yet (and my OB was also out of the office so they had to find a substitute to interpret them) but so far there's nothing alarming in what results are in.

I have now officially gone longer than I did during my last pregnancy.  I feel all right.  Some cramping but nothing horrible.  No gushing leaks of fluid, no bleeding, no headache, no abdominal pain (outside of the cramping) and no swelling of extremities...actually, if anything, the edema in my feet has improved considerably.   Little one-to-be is moving great...he's really at it right now, which is different since mornings are not his usual active time.  In fact, during fetal assessment the nurses had to do several things to wake him up and get some accelerations going.  It was a little concerning at first but when he finally woke up he performed beautifully.

Kick counts are done between 1900 and 2100 since that's when he likes to throw his dance parties.  Surprisingly, he sleeps through the night now--whenever I wake up during the middle of the night, I'll rarely feel him move.  Unfortunately, we know that won't last after he's born.

Everyone has explained the contractions that I will feel when true labor begins and have been reassuring me that I will know.  I've only had those "stop everything I'm doing and breathe" type of contractions intermittently.  Nothing consistent.

I'm half-hoping it'll be this weekend, since everyone is off from work/school.  The better half is starting to get more and more nervous...it's cute.  In so many ways this really is his first pregnancy (he missed most of the last one).  He was up at 0500 fretting over how we'll coordinate going to the hospital and getting my sister there.  I told him not to worry, that I'll get him to the hospital safely :)

February 14, 2013

In the course of my OB care, I've been running into a lot of nursing students as of late.  It seems like every nursing school in town is sending their students to my OB for clinicals.  So I chat with said students...I tell some that I'm a nurse, while with others I say nothing about my profession.  Though it usually becomes obvious in my interactions with them that I must know a little something about healthcare.  I don't really mind students caring for me as I was once one myself, though if one is about to give me medication they better be able to pass my questioning without flaw.  Especially since I have medication allergies.

With the exception of the hyperactive puppy and the less-than-professional midwife-in-training, both of which I encountered in December, the student experiences have been pretty positive.  In fact, the last student I had--nurse midwife student--was probably one of the best I ever encountered.  I never would have guessed she was a student had she not told me.

Anyhow, it's obvious what specialty the nurse midwife students want to go into.

For the other students...I can tell which ones are really interested in their OB clinical rotation--or at least open to the experience--and which ones are just there because they have to be.   But I ask all what they're interested in doing when they graduate nursing school.  To date, the response of all I asked has been the same:  ER/trauma.   Everyone wants to do ER/trauma.   Of course, I'll probe a bit and see if there's other areas they are interested in, such as med-surg, L&D, OB, etc. (I never push psych unless I feel the psych vibe coming from them).

Again, it's all the same.  ER/trauma or bust--nothing else exists, nothing else is a possibility.  I say that's great and wish them well on the job hunt.  Inside, I feel a touch of pity.  With the way this job market is, few if any of them are going to end up right in the ER after graduation.  Definitely not the ADN students I've encountered, not when every facility in town prefers BSNs.  And those BSNs have a lot of competition for those few spots.

Better for these students and their fledgling careers if they are willing to be open to various opportunities early on and transferring to critical care later, instead of immediately taking the "ER/trauma or bust!" mentality after graduation and setting themselves up for a world of disappointment.  By all means, they should pursue ER/trauma...but they also need to be realistic and remember they will be job hunting in a state where nearly 50% of new graduate nurses can't find any nursing job, let alone one in their dream specialty.

Oh well.  They will figure it out on their own soon enough.

In other news, at this point in my first pregnancy, my water broke.  So I go through today with somewhat baited breath and avoiding the television, lest the same movie I was watching during this point in my first pregnancy ("A View From The Top") be on.  It has been playing a lot on Encore as of late.  Given the plumbing issues we have to fix over the next week, it would be better if little one-to-be stayed on the inside for a bit longer.

February 13, 2013

Work called asking if I was officially on maternity leave yet and if I wasn't, could I come in to cover because a nurse in dual diagnosis called out sick.

"Sorry, but I'm dilated.  No more work for now."

Seriously, I was tempted since I knew it'd (probably) be an easy shift...then again, with my luck we'd have unexpected admissions and/or at least one patient go off the chain.  And at this point, I really need to take it easy.  It's nice to know that I'm still in demand, though.

I accidentally felted a pair of socks in the washer.  The yarn wasn't superwash, yet it still ended up in the washing machine.  The better half must have tossed them in...but he knows not to wash any of my socks.

February 12, 2013

You can't make a day like this up

First of all:  the little one-to be is fine, and things at the house could have been far worse.

So I went for my routine 38 week appointment which, thanks to both a sudden increase in itching and an elevated blood pressure, was no longer routine.  Thank goodness it was my actual midwife and not one of her students...I guess she felt it was better to see me herself, given my complaint about itching.

First I had my assessment:  2 cm dilated, not effaced.  No PUPPP rash was found and all of my pressures were elevated.  Midwife was concerned an made some calls.  So off I was sent to the hospital for stat blood work, a little fetal monitoring in L&D, a referral for fetal assessment, a ramped-up appointment schedule, plans to induce should the little one-to-be not come out by 40 weeks and...yes, another red biohazard jug.  Guess what I'm doing over the next 24 hours.  Yup: my midwife also wants to rule out a late-developing preeclampsia.

So off I go to the hospital lab to get the bloodwork drawn and the whole process started.

Now, before I went for my no-longer routine appointment, we had a plumbing issue in the house.  Sewer backup.  Usually the problem resolves itself in an hour or so, but yesterday it didn't, so I called the insurance company for a plumbing appointment.  Then I let the better half know that he needs to try to be home early in case the plumber arrives while I'm at my appointment.  Then I drop the little one off at my sister's and head to my appointment.

Better half is able to be home because, of course, that's when the plumbers show.  Apparently things were not pretty at Casa de Meriwhen.  The better half was instructed to flush one of the toilets.  He did.  Our bathroom flooded and my poor better half was up to his ankles in sewage.   So he spent all afternoon and evening cleaning it up.  The plumber did his thing, checked almost everything (it was getting late and he couldn't reach the insurance company for further instructions).  He said he couldn't find the issue with what he did and that it was likely a city issue.

Meanwhile, I'm in L&D, strapped to a baby monitor.  Thank God something told me to bring my Kindle with me to this appointment.  I finished half of a history book while waiting.  Little one-to-be is fine, my pressures started elevated but eventually went down.  I even got a little peek at him via quick ultrasound.  After an hour, I'm unhooked and told that the doctor is reviewing my bloodwork and monitoring results.  Twenty minutes later, I'm restrapped to the monitor.  Apparently the doctor wanted to see more of the little one-to-be on paper.  So here we go again.

Another hour later, I'm free to go.  They're pleased with the little one-to-be's performance.  No word on my stat bloodwork but I'm guessing that if things were truly horrible they would not have let me leave.  I was told that I definitely earned the 24 hour urine collection so that needed to be completed.  However, I forgot to get that lovely red biohazard jug when I went to the lab and they're now closed, so I have to track down the main lab office and get it from there.  

I got the jug.  THANK GOD she also gave me a hat this time around.  It'll make things much easier.

I'm on my way to get the little one when I hear from the better half.  We have NO plumbing whatsoever.  Zero.  Horrible things are going on at home with our drains.  He tells he he'll tough it out with the pets at the house but that little one and I should stay with my sister if possible.

Of course it's possible:  she's my sister and she better not turn me out...not when I have a set of her house keys and can let myself in at any time.

So I drive up to her place, explain what's up, drive back to my place, pack an overnight bag and get my laptop and the little one's school things, and check in with the better half to make sure he's taken care of.  His mood is understandably black but fine.  Casualties of the bathroom flood:  one bath carpet, one scale, one cloth hamper, two brassieres, and my Clarisonic face brush.  Not sure how it became a casualty but it did and my better half erred on the side of caution and tossed it.   Which makes sense because to be honest, I wouldn't have wanted to use it on my face after that.

I didn't have the heart to tell him what the Clarisonic brush cost...yes, three digits.  It was a nursing school graduation gift to myself a few years ago and when it comes to beating my rosacea down, it's been worth every single penny.  Thank goodness one of my birthday gifts was a gift card from Sephora that I haven't used yet.  

I drive back to my sister's.  We live about 20-25 minutes away from each other.  Fortunately, there is a lovely state highway through the mountains that makes going between the two easy, as well as keeps me off of the interstates for most of the trip.  So while all the driving isn't exactly my idea of fun, it is manageable.

I had In-and-Out Burger for dinner.  Yes, my pressure was up, but damn it, I wanted something decadent after everything so far.

Get little one settled and get on the computer to find out who I have to call in the morning to have the city come check the sewer.  And lo and behold...apparently for sewer backup, there is a 24-hour hotline because they want to know ASAP.  So I called.  I was told a technician would be out that night to assess the sewer line.  I let the better half know so he could be prepared.  This is around 2000.

Meanwhile, my sister and I are looking at the brighter side of things:  should I go into labor that night, not only is she right there to take me to the hospital and her husband there to watch the little one while we go, the hospital is a straight shot from her house.

Meanwhile, my bank keeps calling me.  My credit card info was stolen a couple of weeks ago.  We caught it immediately and closed the account so there was minimal damage...however, now the bank keeps making automated calls to ask me to verify activity on the closed account.  I'm told I can just ignore the calls since the account has been closed and no further damage is being done...however, me being of the paranoid type, I return each call.  I'd rather do that and be told it's on the closed account, than miss returning a call and learn that somehow my new credit card info has been stolen as well.

2300:  The better half calls me.  The city came out at 2100, did a thorough assessment, and declared that the issue is not with the city's line but the house.  In the morning I have to call the insurance company/plumbers back to get them to come back out.  I call it a night and go to bed.  At least I don't have to do a kick-count tonight, not when I spent most of my afternoon tethered to a baby monitor.  

Besides the stress of the day, two old cats and a two year old (all of which are not mine) keep me up all night, but that's OK.  

As soon as the insurance company's office opens at 0530, I call.  A different plumbing company is scheduled to come today, sometime before 1500.   So I drove back to my city, dropped the little one off at school and headed to the house to assess damages and the better half's condition.  His mood is much better.  The bathtubs have drained but nothing works still.  The bathroom floor is clean...well, except for under the washer/dryer.  I'm going to attempt to squirt some Lysol under there today.

I brought the red jug with me.  With everything that has been happening, I figured I'd wait until the plumbing issues were settled before I did the 24 hour collection...but since I can't use the plumbing anyway, having to pee into a collection jar makes perfect sense.  My sister isn't bothered by the thought of my having to do this in her home:  she is a PhD who does cancer research, so having to deal with a jug of urine on ice doesn't faze her, not when she chops ears off of mice on a regular basis.  She even volunteered the services of her icemaker.

At my local 7-11, I bought ice, Lysol and coffee.  The cashier remarked that I must have an interesting day planned.  I agreed.

So here I am hanging out at the house for a while.  I'll just bounce between here and my sister's as I need to.  The plumbers will call before they head out to the house, so wherever I am, I will have time to return home if necessary.  The better half is going to try to get out early today.  The little one is covered until the evening in his after school program so I don't have to worry about him.

Meanwhile, one utility company called...apparently they had the stolen credit card info down for the autopay so my payment was rejected.  However, based on my household notes, I had thought I had my bank info listed as the payment method so I didn't think I had to call them to update my info.  I was wrong.  But that was an easy fix and update, and my credit rating will remain flawless.

And the last meanwhile for a while...

Meanwhile, fetal assessment called.  They want me to come in tomorrow morning, which will work out well as I finish the 24-hour collection at 0630 and have a fasting lab test (bile salts, I believe) scheduled when I drop the urine off.  So I'll go straight from the lab to the fetal assessment unit.  

Despite everything, my mood is fairly good.  For all of the horrible timing and inconvenience, this could have really been worse..far worse.  At least I have my sister here so we have a place to stay.  Little one-to-be is fine.  I wasn't admitted to L&D yesterday.  Our insurance will cover a lot of the costs of the plumbing repairs, especially as it's not a city problem.   And having to tote my jug of urine around with me isn't the worst thing in the world.  If anything, it'll make for a great story when I tell the little one-to-be what happened in the weeks leading up to his birth.

I did tell the little one-to-be to scratch the "come out any time now" plan, and stay in until next week.  Of course, he may not listen.  But there's nothing I can do about that, right?  It's one of those things I can't change and I know the difference.

February 9, 2013

So I inadvertently scared my sister...

She texted me to see how I was feeling.  So I wrote back that I was OK, having some irregular contractions but nothing to worry about.

I've never seen the girl call me so fast.   Come to think of it...her calling me that fast scared me.

She thought it was showtime.  I told her that it was Braxton-Hicks.  I reassured her that if it was really showtime, the text would have included the instruction to start driving to my house now.

I guess she's just a little anxious to be there.  She also knows that I never went into labor on my own for the first little one (water broke) and I admitted to her that I'm nervous as to figuring out when I need to go into L&D.  Guess she is trying to help.

38 weeks tomorrow.  Feeling OK except for the itching and the irregular contractions.  I finished knitting a pair of socks that were a birthday gift to a friend.  I'm going to work on an abandoned sock from last year...it was a complicated pattern and my first foray into both cable knitting as well as pink socks.  I haven't decided if I'm going to make sock #2 of the pair, but at least I could finish the first one.

February 8, 2013

Heard back from the OB:  based on my description of symptoms, it's probably PUPPP.  I have a list of remedies to try over the weekend and she'll follow-up on Monday.

So it's off to CVS for hydrocortisone, diphenhydramine and oatmeal.  That's the nice thing about CVS:  I can buy all three of those things there and only need to make one stop.

New symptoms

So the intolerable thirst is gone...no, it wasn't gestational diabetes, but the side effects of the salt cravings.  As I ran out of salt and keep forgetting to get a refill at the store, the problem resolved itself.  It also resulted in the loss of 4 lbs...which I found surprising given that my appetite is still off the chain and my lower extremities are still edematous.  I'm trying to keep what I eat under control, but overall I'm still eating more in this last month.   The Dave's Killer Bread craving has left, to be replaced by the Jimmy Dean D-Lights Sausage, Egg White and Cheese craving.  With hot sauce.  Lots of hot sauce.

Hot sauce is the gift of the gods.  Ever try it on pizza?  Do.  You can thank me later.

Anyhow, the thirst has been replaced by widescale itching.  There are a few bumps on the stomach, so I'm led to believe that this may be a case of PUPPP (translation:  harmless annoying pregnancy rash).  Then again, it could also be cholelithiasis (translation:  gallstones, not as harmless to the little-one-to-be), as the itching is not confined to the abdomen but occurs all over.   I wake up at night to scratch.

So I'll check with my OB to be sure.  I have an appointment on Monday anyway if I forget to call.  Being a nurse while pregnant has made me aware of more of the problems out there, yet I am calmer about them.  I know that based on odds as well as my symptoms, it's more likely that it's PUPPP than gallstones, so I'm not freaking out.  That being said, it never hurts to double-check.

In other news...I made a library run and took out a large stack of books to keep me occupied during baby watch month.  Including one on addictions...between that the copy of the Journal of Addictions Nursing that has finally arrived in my mailbox, I'm going to get started on these addictions CEUs.  I also knit a pair of socks.

February 7, 2013

Everyone needs to have at least one baby shower at a psychiatric hospital.  I'm just saying.

February 2, 2013

The better half and little one think it's cute when I get stuck in various positions, such as on the couch, in bed, trying to get out of the car, trying to get off of the floor...I tell the little one that he better help his mommy up, and I tell the better half that it's his fault that I'm like this.

I've told the little-one-to-be that he's staying in tomorrow whether he wants to or not, and that he can come out anytime after Monday.  Hopefully he'll listen.

February 1, 2013

Baby watch officially begins

Low census + no admissions = called off of work today.  I'm not complaining:  at least I found out early, before I dug out my scrubs and started the warpaint.  Fortunately, we planned financially for my not working during the next few months, so while making some money today would have been nice, it wasn't critical.

Come hell or high water, this would have been my last day at work anyway.  They knew I wasn't going to work once February came, and that I won't be back until at least June.   So...four months of officially not working.  I don't know what I'm going to do with myself...oh yes, I do:  take care of the little-one-to-be.  But until he arrives, it's going to be a long February.

I should get cracking on the addictions CEUs while I'm off...and dig out the Spanish lesson CDs for the computer.