Well, after all the adventures of last month, I guess things had to slow down a bit. After turning in the first assignment, I came down with a bad cough and a high fever and really didn't get much work done on the second assignment for several days. I also wasn't able to work at the clinic for about a week, which was kind of disappointing, but I suppose it's better not to spread my germs to minute old babies. Sarah was a life saver and took all of my shifts along with her own as well as taking care of me and working on her assignment in between. I'm sure she was relieved when I was well enough to start working again.
This last week was filled mostly with school work and trying to make up for days lost while I was sick. And I finally made it back to the birth room on Wednesday. I was very happy to be back. There were three labors there, and two of them started to push as soon as it was time for me to leave and go to class. That was kind of a bummer, but I guess that's just how things turn out some times.
My latest "adventure" was actually this morning, right here in the house. I had just gotten back from the computer repair shop (pray for my poor computer please!) and went up stairs to go to the bathroom and something must have happened to the door knob because as I tried to leave the bathroom the knob jammed and I was stuck! So I started yelling and banging on the door, but no one seemed to be around. After several minutes some girls who were outside doing laundry heard me yelling through the window and came upstairs to see what was going on. Those girls tried everything to get me out of there. They tried to fix the door knob, but that didn't work. Then they tried to take the door knob off, but it would not come off! Finally, after about 30 minutes, Janelle kicked in the door and I was free at last. I was very grateful to be out, as I'm sure you all can imagine!
Well, that pretty much brings you up to date on what is going on in my life lately. Please be praying that my computer gets fixed soon. It's very needed for school and communication home! Thanks everyone!
Saturday, October 20, 2007
Wednesday, October 3, 2007
Content
Hello everyone! Sorry for the delay in writing. It's been quite a week... or month.... I can't believe how the time has flown by. Life has definitely been keeping me busy, I'm not even sure where to start!
Work at the clinic has been incredible so far. I've seen 8 births already and prenatals are so incredibly fun! I love talking with the women and getting to find the baby's heart beat and seeing their faces light up when they hear it for the first time. Amazing! And there has been no lack of adventure over here. If there isn't anything exciting enough for us midwives, then we tend to create excitement. One birth room shift when we had nothing going on, Tiffany ( a second year student) decided to practice IV's on the rest of us (well, I've got really hard veins to poke so I ended up being in charge of picture taking) and that ended up with Jordan (a classmate of mine) fainting and then while she was still out, she seized! Yikes! Thankfully, Carmen remembered something she had learned about how to break a faint, and Jordan was fine. 
And the adventures don't stop there! Here's an excerpt from Tiffany's blog about another crazy shift...
The day shift started out pretty quiet; there was one labor, and Carmen had offered to graciously take her, because I needed to study for a semester exam. Her girl, Argielyn, delivered a 5 pound 3 ounce baby boy at 8:05 am. He was super small, but healthy and so so cute! Mom did a great job, and Dad was very proud of both her and his new son.At 10 am, Lois brought down a girl from prenatals who apparently was in labor. We sent her to the washroom, and I pulled her chart and began to go over it. Mary Jane was 19 years old, and this was her third pregnancy, although her second ended in a second-month miscarriage.I proceeded to check her vitals and the baby. Her pulse was high, as well as her blood pressure, but it was her contractions and the baby’s heart rate that had me a little worried. I couldn’t even palpate the contractions through her abdomen, but by her reaction and communication to me, one contraction was four minutes long! There was either something very wrong with her labor, or we were having trouble communicating. I was stumped. And the baby’s heart rate was a consistent 120. Normal fetal heart rate is 120-160, and although her baby’s was low normal, there was no variation. Most babies heart rates goes something like this: 136, 144, 144, 140, 132, all with fifteen second counts. Mary Jane’s baby was more like this: 120, 120, 124, 120. That was a little of a red flag, but we figured we’d monitor it to see how it went. She was also sporting a very small fundal height: Lois measured 29, and me 31…but either way, the baby felt very small.
I decided to do an IE; one, to see if she was truly in labor and dilating, and two, to get a better idea of her contractions. You can often feel the contractions better with an IE, as the bag of waters (amniotic sac) bulges tensely through the cervix during contractions, and is loose without. However, her IE was a little disquieting too. She was 3 cm along, which was great, but there was no water in her amniotic sac. I could feel the membranes, but no water between the membranes and the head. So, there were three possibilities: one, she had a leaking bag of waters that she was unaware of, two, she had severe oligohydramnios (lacking amniotic fluid), or three, all the water was behind the head. She was insistent that no water had come out, but it was still a possibility.
After her blood pressure had stabilized somewhat to 130/90 (still borderline), we decided to go to her house to get her husband and her supplies. Since she had been here only for prenatals, she had neither. At first, Ate Steph (my supervisor) was going to have her go alone, but she was beginning to react a little more to her pain, so she decided to have the ambulance take her. I asked if I could go along, and first she said no, then changed her mind. I asked if Holly, one of the new students, could come with me. She said no again, probably having flashbacks of mine and Holly’s last ‘home visit’, but with a pout and the puppy eyes from me, she also let her go. Sweet. I love home visits. I told Carmen where I was going, and she joking shouted out, “No boys this time”. This came from a the Filipinas joking Holly and I that our last transport had taken so long, because we had spent time at the girls house, flirting with her younger brother. Definitely not the reason we stayed so long…but you know Filipinas…they love love!Anyways, we all piled into the ambulance, only to found out that Mary Jane lives in Sasa, which is about 20 minutes away. Yikes. Oh well. What do you do?
The excitement started about 10 minutes down the road. I was looking out the windows, paying more attention to the scenery, when all of a sudden Mary Jane grabbed my arm, and gave me the whole, ‘this-baby-is-coming’ panicked look. I looked at Holly, wide-eyed, and proceeded to tell Mary Jane to breathe and focus. She could do it. I figured she was just getting active, and needed a little reassurance. However, the further we got from Mercy, the more frantic she got. She started holding her crotch and arching off the seat. That’s when I started to inwardly freak out. Those are definite signs of a baby coming! Especially in an already-mom! I yelled at Buding, the guard driving the ambulance, to turn around. Mary Jane, already lying on the stretcher-cot, sat up and yelled at Buding to keep going – apparently her house was close. We quickly got to her house, with me thinking “we NEED to keep going”, and Buding outside somewhere trying to find her family. (Later we found out that Buding had met up with a girl selling banana cubes on a little grill, and grabbed her by the arm, telling her to find him ‘so and so’, Mary Jane’s mother. The girl was freaking out, point at her burning bananas, but Buding just yelled, “It’s an emergency!” This is especially funny, because Buding is known as a very quiet, gentle man!)
Meanwhile, I managed to take off her pants and panties, and told her to keep breathing. Buding finally came back, and we turned on the siren and went on our way back. We didn’t have time to actually pick up the bantay, but only to tell them to meet us at MMC; I was hoping we’d make it back to the clinic. This all could have been avoided with a simple cell-phone text, but alas, Mary Jane had no cellphone. So, with Holly at Mary Jane’s head encouraging her, and me at the opposite end, we prepared to catch her baby.
With her next contraction, out came a very tiny baby boy. He literally slid out, so small he was. As predicted, there was no amniotic fluid at all, and thick mec to boot. I quickly began wiping the baby with the one wash clothe the mother did have, then grabbed her sweat pants to wipe off the rest. I yelled at Holly to pray, then I did what came to mind: postural drainage with stimulation, and when he still wasn’t responding, I did what ever midwife knows she has to do, but cringes at the thought of it…I sucked out the mec/mucous with my own mouth. But don’t worry, I spit it out afterwards! I didn’t get a whole lot, so after I sucked, I blew a little air over his mouth, just to help him a little. At this point, Holly was praying up a storm at Mary Jane’s head. The baby eventually gave a couple whimpers, and I almost cried. When I was confident he was more stable, I wrapped him in his mother’s pants and put him on her abdomen. The rest of the ride to the hospital was a lot calmer, with us reassuring Mary Jane and encouraging her to hold and talk to her baby.
Buding must have thought we were still in a state of emergency, because he was careening through traffic and for a minute I though I was going to fly to the other side of the ambulance. We eventually made it to the ER of Davao Medical Center in one piece, and with our siren blaring, we quickly brought lots of attention. I hollered at the staff to bring a blanket (she needed SOME coverage), and a stretcher. We quickly got her and the baby situated, and made our way into the hospital. The staff kept asking where the placenta was and how I cut the cord, and I kept telling them the placenta was still inside, and I didn’t cut the cord! The rest of an hour was spent checking her in, then being on a wild goose chase taking in blood work for her, since she had no ‘bantay’ (watcher). I eventually went back to the ER and told them I had to return to Mercy, and someone else would have to do the running around. They were definitely not happy, but I knew if I was any longer, MY supervisor would not be happy! I promised the Ob/Gyn doctor I’d find her a bantay, fast.
When we returned to the clinic, the first thing I said was, “I promise she was only 3 cm!” This brought many hysterical laughs from the Filipinas, known for their boisterous laughing. Holly and I had to recount the story hundreds of times, and were very high strung for quite a while… I couldn’t stop talking really fast and loud! I’m sure you all know what I mean! At one point Ate Susan walked into the birthroom and asked if it was a boy or a girl…”a boy”, I yelled! Carmen turned to me and exclaimed, “I said no boys!” We all died laughing.It wasn’t until after shift that I crashed, and had to go take a nap. And don’t worry…I brushed my teeth, and washed with Listerine!
Tiff and I later went to the hospital to visit Mary Jane and her little boy. He was on oxygen, but was doing fine. He ended up being a mere 3.5 lbs at birth! He was having a little trouble breast feeding, but he was very alert and I think that he's going to make it.
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