Sunday, July 29, 2007

Don't go breakin' my heart

So Billybob wasn't aware that my husband would need a heart transplant as we were 'talkin' about everyone should be an organ donor. So here's the deal. I told you about how my husband initially got sick (the whole bad luck thing with a virus making its way to his heart and damaging it - can't have much worse luck than that) - well, he basically walked around with this really crappy heart function on lots of meds. The docs all told us that he wasn't getting better and that at some point he would get worse and need a heart transplant. My thoughts on this were "aren't you a fuckin ray of sunshine". But then he stayed at this level of health for a long time. It's now been five years and he still is doing 'well'. We had what we thought was a miracle over a year ago - his echo showed his heart function had dramatically increased. So we thought wow, he's ok now. Welllll....

After we moved out here to Arizona, he was due for a cardiology check-up. They decided to order a echo and also a stress echo (he had never had one of these) since it had been a little more than a year since the last one.

Yep, you guessed it, bad news. His ejection fraction was now 10%, with an increase to 15% during exercise. The last echo was a mistake or something. So they tell us this lovely news and add that he needs an AICD (pacemaker/defibrillator)...like....in the next week or so preferably. You see, these people with really low heart function have a really high chance (50%) of sudden cardiac arrest. And statistically, when this happens, it only happens once...cuz you die. The debrillators apparently have really had good success with treating this and increasing survivability. Naturally, I spoke right up and said he'll take it. You can put it up his butt for all I care - as long as it works. He could pull a crash cart around behind him for all I care. Give that man a shocker! Fortunately he has never had an arrythmia (abnormal heart rate) problem.

So now we wait...it's amazing cuz you wouldn't even realize he's sick, other than he gets tired easily. He works full-time as a cook and goes to the gym. He's gonna give up his job and go to school for a culinary arts degree as soon as I can get a job and pay for it.

The hardest part for me - will he be around to see his youngest child graduate, give his duaghters away at their weddings some day, grandchildren. What a sucky thought. And I don't think about it much, just once in a while. You get to a point, where it's (his illness) just part of life. He's made it over five years since initial onset. That's pretty damn good and way better than most. I mean the five year survival rate is 50%. I thank god he's part of that good 50%. *knock on wood and kiss the voodoo doll and all that*

Inappropriate and disrespectful

Wow, I can't wait to have anesthesia again - maybe someone will do something totally inappropriate and disrespectful to me. Oh goody.

Bring on the lawsuits...

I saw this on Kevin MD's blog about an OB being sued for missing a delivery. What do you think????

I think what B.S. I have caught some babies as a L&D nurse because the doc didn't get there in time. Sometimes we can't always tell Mother Nature what to do. Sometimes women go really really fast. The way things are going, there will be no one left to catch babies anymore. They will all be scared out of the field due to the malpractice issues. Then women can deliver at home...on their own...what's that called? Autonomous birth or something?

Have fun.

Midwifery school

Midwifery school was interesting. I think Frontier is an awesome school. I would definitely recommend it. They have changed their format though - before it was very much do-it-at-your-own pace. Now they have terms and cohort classes which I don't really like. But the school otherwise is great.

School was hard. By the end of it my husband and I were in marriage counseling. It wasn't just the school thing. There were other issues that contributed to a breakdown in our communication. Never fear, we are back on track :) But I think it's really hard for anyone to understand what it is to be a nurse, a midwife, a doctor unless they have been in that role. I don't think my husband and I had any idea what kind of commitment it was gonna be. I mean, you know it's going to be hard - it's graduate school! But you can't get it until you are there. I just recently cleaned out all the articles and paperwork that accumulated over the two year program. I sorted out the stuff I wanted to hang on to and the rest went in the recycle bin. I am having a major guilt complex over the forest of trees I killed! I ended up keeping enough journal articles that I could wallpaper this 3000 sq. ft house I live in.

BTW, all you midwifery students...the AMCB exam is easier than the comprehensive exam I had to take to graduate. I left from taking comps, feeling really really dumb.

Saturday, July 28, 2007

My second child

My second child...she's something else. She's 7 going on 17. I have no doubt she will be a nightmare as a teenager. She'll have to be the one kept locked up in the basement - haha. My husband is black, I'm white. So if you do the math and have read the previous posts, you can figure out that our children are....half and half! Very Good. They are gorgeous babies - and I know every mom says this about her kids unless she has problems. But mine really are. We especially get it with the girls. Since they were babies, you take them anywhere....

"Oh your girls are so beautiful!"

"What gorgeous babies you have"

"Are you babysitting these pretty little girls?"

Wait...what???? Yes I have been asked that. Or variations of that. Now mind you, we lived in South Carolina until last year. SC is 20 years behind the rest of the country. People still have outhouses. And they use them.

So anyway, my older daughter is beautiful and somewhat tomboyish. She likes sports, plays with the boys (and usually wins), but says she is never having a boyfriend. I'll enjoy that one while it lasts. My husband says he is putting bars up on the windows. He says the first time some young thug shows up on our doorstep, he's buying a gun. I like to remind him that he used to be a young thug. He says that's why he'll buy the gun.

I was induced with my older daughter at 38 weeks. Low AFI (Amniotic fluid index) of 3.47. I was a green apple so was admitted the night before for cytotec then the plan was for pitocin (the hurtin' medicine) the next morning. Well, it was never needed as the cytotec put me into labor. After cramping all night and only being 1cm dilated, my water broke and I immediately started contracting pretty bad. I remember they came in threes. My husband was useless naturally. He watched a baseball game. Looking back I should've thrown the IV pole at him. I haven't let him live that down yet. Three hours later I was 10cm. I did get an epidural at 5 cm...but it didn't work. When they cam back 20 minutes later to do it again, I felt the need to push while sitting up. I told the doc, who was still in the room. This is kinda what the conversation was like...

Me "I need to push" (mumbling this into the pillow I was leaning over)

Doc "You can't be, I just checked you and you were 5cm"

Me "Then I need to shit, can I go to the bathroom?"

Doc " no-no, let me check you after they finish"

And I was then 9cm. Here's a lesson...when the pregnant laboring woman says the baby is coming...it usually is! Of course there are times when I have had women tell me I gotta push, then you check them and they are 1cm. uh, NO YOU CAN'T PUSH.

So, after three and a half hours of pushing, three attempts with the vacuum to help, and forceps my older dughter arrived in the world. The third degree tear, not being able to pee for 24 hours, and the bleeding nipples I would have later all paled in comparison to her. She was sweet, and beautiful, and a doll. I can't figure out when she changed into the devil spawn whe is now. Just kidding. Sorta.

So enough for now...next post I'll tell you about my third birth and my tattoos :) Can we say almost total back coverage????

Friday, July 27, 2007

Stop the cutting!

The top 5 surgeries you don't want to have from Women's Bioethics Blog . Look at those first two. I love that this is from the CNN website which is awesome. Can we convince and educate women that they don't need always need a hysterectomy. We don't go around removing men's testicles when they are done with childbearing, so why should we have our uterus' removed when it's medically unecessary (there are other alternatives such as ablation, embolization, etc).

And episiotomies....let's get with the times please - I have tons of research that shows little or no benefit to this practice. Let's stop cutting on women!!!!!!

Why I wanna be a Midwife when I grow up...

I wanted to be a midwife when I grew up cuz my own childbirth experiences weren't what I wanted them to be and because I fell in love with Woman's Health. I really want o make a difference for women - I want to help them take control of their healthcare. I love making that connection, especially during labor and birth. I love being a part of one of the most special moments in their life. It's a privilege and an honor.

Not only do I miss this, but the longer I go without a midwife job the more fearful I become that I will start forgetting what I learned. Probably not too realistic in light of the fact that I am reading Spiritual Midwifery . I'm also part of nursing faculty at a local college and am teaching OB/GU among other things this upcoming semester. That serves for good review for me at least.

So anyway...all my babies were born vaginally...I know...what a shocker huh! It's surprising in this day and age!

My first baby - born when I was 20...and yes he was actually planned. Oh and even better, all my kids are by the same father. Don't see that much anymore! He was premature, born at 34 weeks. I did a lot of reading about pregnancy to educate myself but was of a low socioeconomic status at that time. I had three strikes against me and was treated as such...poor, no higher education (not even a HS diploma - got a GED), and unmarried to a black man. I was 'cared' for by residents (baby doctors - and I don't mean neonatologists). It was time in and out of the hospital being 'treated' for preterm labor. Yucky medicines such as terbutaline (makes you feel like you just jumped out of an airplane - kind of jittery and nervous) and mag sulfate (which makes you feel like the Mack truck rolled over you...then backed up...then once more over you for good measure in case you didn't notice the first time). Not a pleasant experience. When I was finally allowed to labor (I was 6 cm) they broke my water and made me get an epidural. What a sucky experience. And was he ok? No, he had chronic subdural hematomas that caused brain damage due to going undetected. He's 'ok' but not 'ok' in the sense of my two other kids. But he's a great kid nonetheless...starting that teenage smart mouth crap though.

My second child was the worst experience...and I'm still waiting on it to get better! She was warm and cozy in there and didn't want to come out.

Thursday, July 26, 2007

And I thought I was frustrated yesterday...

I'm really fucking pissed off right now. As you can see I am not always touchy-feely. Sometimes I am. But not right now. It's that whole Gemini thing - litte touch of dual personalities.

I hate to even bitch about this after looking at Billybob's blog , but what the hell.

So since I am a new midwife naturally I am job-hunting. I initially was planning to re-locate elsewhere since all the jobs where I live ask for experience only - and there ain't a lot of jobs at that in this area. So I get job offers in other states but then decide we are too broke to re-locate at this time, nor do we really want to. After all we haven't even been here a year yet! Now I can't find a damn job...I started applying for Nurse Practitioner jobs in OB/GYN offices in the hopes of creating some opportunity. No such luck - had an interview at one place which sounded really really really promising...then after stringing me along for two weeks, emailed me today and said thanks but no thanks...but good luck! I'm so bummed cause I thought this would be a really good fit for me. Had another interview which didn't sound real promising - they just want another mid-level provider to do gyn work. The third option I have been holding on to is another practice who is looking for a midwife. But I applied for it a month ago - they have assured me that I am at the top of their list...so what the hell are we waiting on????

So I have a job - I teach nursing students. Fun but not what I want to do forever and forever. Unless they let me start catching their babies during clinicals. Humm...
Anyway, I'm wondering, did I waste my time becoming a midwife? I know I love it and its what I really want to do but crud - just can't do a move now to be one. So perhaps my next step will be to go back to school part-time to complete the FNP program (for which there are jobs) while continuing to teach my little nurslings.

On the lighter side of things - I got my state license to practice as a midwife and am sending off the application (and more money) to the board of nursing (black hole) for prescriptive authority. So when I get my non-existent job I can the write prescriptions on my non-existent practice scrip pad. Fun.

Wednesday, July 25, 2007

Frustration

Ooooohhh, I'm frustrated...ok, I left out all the pretty cuss words that I normally would spout when I am frustrated. I found some pretty cool blogs I like and plan to check in on. So I thought I would post them as links on my blog in the hope that someday, someone will read this blog and see them. But the damn link to add links isn't working....grrrr. I just seem to have that affect.



So back to my story...I had just finished nursing school (an ADN program), with 2 kids in tow, and a defective husband. A defective husband you ask? Yeah, two and a half weeks prior to graduation he goes into the hospital with congestive heart failure and a really piss-poor ejection fraction (this is the measurement of how much blood the heart can eject into the circulation in one beat - measured in a percentage) of 15-20%. This is a man who has never had a health problem before...no hypertension, no heart disease, nothing. Oh but wait! His mom died two weeks after he was born from heart failure (she was 20!!!!!). Her father died in his early fifties from heart failure. Anyone seeing a link here? My father-in-law was kind enough to never have shared this info with us. Proves up that knowledge is power I guess. Anyway, 8 days later and 20 punds lighter he emerges from the hospital in time for my graduation. Woohoo! So I occasionally tell him that I want to trade in for the newer, upgraded model. He thinks this is funny. Do you see me laughing?

I managed to get myself pregnant again...yes, he could still have sex. I had my third baby while getting prepared to start a BSN program. No really, I had the baby in the wee hours of a Wednesday morning - missed a five hour chemistry class that day (they excused it though - funny how pushing a baby out your cootchie is excused) and returned to my biology class on Saturday for lecture and lab. That was soooooo fun....*said sarcastically*

Getting the bachelor's degree was pretty uneventful - although it was during this time I discovered Frontier. I really fell for the heritage of this school. It seemed that even though it was a distance program they really fostered a sense of community unlike some of the distance programs at the big colleges I had looked into. So I decided to go for it and was accepted. Meanwhile my stepfather was telling me I should just go to medical school if I was gonna go to school that long (he was a psychiatrist). He didn't get the difference between being a midwife and being a MD.

Tuesday, July 24, 2007

Blog Virgin

Yes, I admit it. I'm a blog virgin. I have only recently started looking at blogs and frankly, I like the idea. What better than a website devoted to me and anything I chose to talk about! You can't beat that :) As I always say...it's all about me!



You're probably getting that I am a Gemini by now.



So anyway, I guess I shall start out with a little about me.



I just recently grew up...meaning I have finally achieved my dream of becoming a Certified Nurse Midwife. *break into the Snoopy dance*



I am an alumni of Frontier School of Midwifery and Family Nursing (FSMFN), which is located in the mountains of Kentucky. Frontier is a distance education program where classwork is online and the clinical component is done in your local community. I consider myself fortunate to be part of such a historical midwifery landmark. As time goes by I will share some of the trials and tribulations of surviving midwifery school!



I was living in South Carolina with my husband and children (ages 12, 7, 4) when I embarked on this crazy, and at times tearful, journey. School has had such a huge impact on my life...it has been detrimental to my physical and emotional health, placed huge strains on my family...ok, did someone bring the cheese to go with my whine? I started nursing school in 1999. I decided to quit screwing around and wasting my potential (like all those guidance counselors tell you). At this point I had one son, who is a great kid with special needs. When I started nursing school I had no idea about being a L&D nurse, let alone a midwife. I kinda suspected maybe I would like obstetrics but wasn't really sure.



When I finally got to my OB rotation in nursing school I was in love. The experience that stands out in my mind was a patient who was having her second baby naturally. She was about 4cms and breathing beautifully through her contractions. I didn't know what to do with her and the nurse I was assigned to apparently felt that ignoring the patient was the best option in providing care. The woman sat on the bed in a zen-like position, with her eyes closed, breathing. I remember thinking how amazing she looked. How graceful. My next thought was "is she f***kin nuts??!! Where's the epidural????".



Yeah, okay, I wasn't enlightened yet.



So the experience decided it for me...as a nursing student I didn't like the whole 'sick people' thing. I much rather preferred the 'happy' environment of OB. Everyone is always happy and nothing bad ever happens...cue the Sound of Music...uh, so it wasn't realistic. I learned that soon enough. So during nursing school I learned about doulas, midwives (of varying kinds), and started contemplating the possibilities. During this time I also had another baby (baby girl who is now 7 going on 17).

Well...I want to keep you in suspense for the next installment...stay right there until my next post...I know you will :)