Friday, July 31, 2009

Speaking of Babies, Did I Ever Tell You WHY Evan is a Miracle?

It was just a couple of weeks after we saw the two pink lines on the little stick when the beeding started. The OB referred to it as "threatened spontaneous abortion". Miscarriage. But maybe not, because there on the screen was a tiny beating heart. The shock of realization on John's face will never leave me. His baby, who he said looked like a bean, there in living color. So I started the visits to the oupatient lab every other day, where they would leave black bruises on my arms in order to siphon from me the blood that would tell them that our baby was thriving. And every other day, we would wait and cry and pray that he was. Or wait for the call that it was all over, that we would try again, that they needed to schedule a D&C. We just waited.
Then one day it was over. I was so happy on that day. I envisioned my body making the discovery that this angel was there to stay for 40 weeks. To stop trying to get rid of him, that he was no intruder, but rather a welcome passenger. The nausea and vomiting were signs of life within me, and they were welcome too. We picked names. Emily for a girl. But what for a boy? He should be named after his father, we decided. But we hated the idea of relatives in southern Kentucky calling him "Junior". So we perused the books for boy names. The control freak in me was beside heself. We needed a boy name. Brady? Tucker? No, too trendy. Then one day I saw it: Evan: Welsh version of John. Little Evan for a boy. Named after his father, but still his own person.
The happiness was short-lived. My body is stubborn. I felt the first contraction a few days later like a gentle tugging within me. But wait. Accoding to the calender, I still had 5 months to go. That gentle tugging turned to tearing, ripping, searing pain. Thoughts of all of the bleeding, John's excitement, Evan or Emily, pink or blue...they all swirled in my head as John rushed me to the hospital. And the first feeling I ever got of John-and Andrea-Against-the-World was when the young doctor told us that th medication did not work, that the contractions were continuing, that he was sorry, but I was having a miscarriage. I wonder what he thought of us, as we clung to each other, crying those big hot tears, grieving for the baby that wasn't to be. Married for about 6 months at the time, we were all each other had in that moment. I imagine it was pity he felt. Or determination. Whatever the reason, a second dose of mdication was given, and the contractions stopped. And we rejoiced. And I returned home a few days later. Only to return again. Same scenario, different day. Again and again we grieved for the loss of our baby, only to find out that it was another near-miss.
After 2 weeks of trips back and forth to the hospital, we met the doctor who would test our resolve. More pre-term labor. But this ime, the doctor and nurse came in to the room and pulled up chairs by my bed. They started speaking of babies with profound disabilities from prematurity. Of families wrecked with medical expenses. Of our youth. The doctor actually said the dreaded word next. Abortion. He told me to let God have our baby, that it wasn't in the cards, that we could have another. I didn't understand. Was the baby okay? Wasn't it just my body? Didn't they have medicine to stop the labor that had been working? Wasn't I at 20 weeks of pregnancy? The age of viability, as they had been telling me during previous visits? I didn't understand, but we knew we needed to find a docotr who wanted us to have our baby like we wanted to.
A couple of months went by, and we switched hospitals to one with a top-rated NICU in preparation for a birth of a very premature infant. We toured the NICU. The hospitalizations continued as we braced ourselves for heartbreak. I learned what the "Special OB Unit" was at Good Smamritan in Cincinnati. I spent over a month there, on magnesium sulfate drips. At such a high dose that I was not permitted to get up to go to the bathroom or even roll in bed by myself. I had chest x-rays every oher day because such high doses were associated with fluid on the lungs. They would cover my arms in hot packs to relieve some of the pain from the viscous fluid going into my veins. They said it was about the thickness of corn-syrup, and that is why it was so painful. Every third day, they would come in and stop the drip because it was not safe for me to be on it any longer than that. And every third day, the contractions would start back up. I got yet another course of steroid injections to prepare the baby for the early birth that could not be stopped. I met a maternal-fetal specialist who was the best in his field and began to get ultrasounds twice a week. We learned tht it was a boy in there. That there was no infection in the amniotic fluid, and no other reason for me to be having the preterm labor. "Sometims this just happens", they told me. But with each week, I got closer to the day that our baby could be born, that the rate of survival for him increased just a teensy bit.
I ws sent home. I was on a medication that would lower my blood pressure so much that when I would take a hot shower, I would pass out from the further dilation of my vessels. I was on another that caused such horrible acid reflux that I was essentially vomitting without wretching. Huge moutfuls of hot sour acid would wash up without any warning. But my baby was okay.
It got to the point where we thought Evan would survive, and we begged the doctors to deliver him. "You can help him", I woul plead. I just wanted them to make it stop.
A little past midnight, on September 1st, 2001, it finally did. I was havng hard contractions, and a nurse midwife who had never seen me before insisted that I was not dilating. And she said I wasn't due for anothr 5 weeks. We laughed at her like maniacs and begged for the on-call obstetrician. I blurted out words like fetal fibronectin,amniocentesis, ultrasounds, steroid courses in all 3 trimesters, hCg levels, magnesium sulfate, age of viability... She started telling me about "what is best for the baby", and a cried hot tears as I told her of the unspeakable hell I had endured for my body to continue to provide a home for this growing baby. I knew from my experiences that if you start labor at 36 weeks, they will let you go. I was 35 weeks. And I didn't care about a few more days. I couldn't do any more. My body was physically, emotionally, and mentally drained in every way imaginable.
The OB finally came in, and he ordered everyone to get off of me. He put his hands on my giant belly and felt as contraction after contraction ripped through me in waves. Contractions that felt like they were ripping me in two, but were not causing any results. And he told me to breathe through them. The monitors came off as he let me feel this last bit of pain unencumbered by the trappings of modern medicine. And he explained to me how they usully do c-sections after just a day of labor, citing failure to progress as the justification. And I had been in labor for literally 17 weeks. I had endured my hell, and he wanted to help it end for me with a c-section.
After that, I didn't feel another contraction. They never stopped, even as th doctor cut through the soft layers of my abdomen. And I was prepared for the silence that follows a cesarean birth. The birth canal doesn't squeeze the fluid from the baby, and often they need to be suctioned. Plus this was a baby who was early. The last to develop is the lungs. He may need help. But from the instant he was exposed to this world, my son let out the lustiest cry I have ever heard in a newborn. And tears choked my voice as I shouted out that his lungs were okay, long before I had ever laid eyes on his beauty.
There is not a day that goes by in my life wih Evan and John when I don't look at my little family and have waking nigtmares of what could have been. Where I do not thank God for the sloppy kisses and brown eyes that sparkle with laughter and amazement and wonder. Where I do not count my blessings. He truly is my Evan from Heaven. Our miracle. A tribute to God or Allah or the science of modern medicine. Or maybe a mother and father's determination.

Jordan Leon

Welcome to the world, Little Jordan. He is my sister-in-law's much-anticipated sequel to Joanna, who will be 2o years old in February. In other words: our new nephew. Over 9 pounds of bouncing baby boy makes her my new hero. 6-pound Evan was nuthin'!
We haven't seen him in person yet. I'm afraid. John and I toyed with he idea of another baby. We would have scares, where Mother Nature would be late. I would mention it to John, and he would sprint to the store to get a home test. And it woul be negative. And we would speak words of relief to each other that betrayed the hint of regret in both of our eyes. And we would remind ourselves of why we didn't need another. I worked hard to get to where I could earn a decent living and give Evan the life I always wanted to give him. I had these lofty ideas of higher-and-higher education. I had such a hard time having Evan, that he truly is a miracle, and one miracle is enough for any family.
It is sort of like the window of opportunity passed us by. I started school and my RT career, though not in that order. I traded visions of a new baby girl in pink for the vision of me in a white coat. And med school and a new baby is not a good combo. A baby that John would have to raise by himself. And by the time I am finished, I will be in my early 40's. And consiering the problems I had with Evan, each passng year makes me more of an obstetrical nightmare...
So we are finished. And it was a hard choice to make, and I can only hope it will be worth all of this in the end. But baby Jordan reminds me of what the other option was to be...

ICU Bed Vs. RT's Foot.

You can barely see it in this pic, but I ran into a little trouble at work Monday morning. Errrrr, more like it ran into me. I had the SICU, and I get a call that we are transporting one of my patients for a stat head CT. Oops, they forgot to call me, and transport is already there and ready to go. So instead of hooking up the transport vent, I decide I am just going to bag the patient fo a quick trip down and back. Off we go.

We ge down to CT without a hitch. Once there, I move to the other side to the bed to arrange IV lines and such for a safe transfer from the ICU bed to the CT scanner. That is when the very sweet patient transporter starts pushing the bed. Right over the top of my right foot. The ICU bed that weighs as much as a car, without the squishy air-filled tires.

But I am a trooper. I stay, balanced on one leg, bagging the patient until the ordeal is over, then hobble to the ER for x-rays. This is where I learn that the male RNs in the ER really are knights in shining armor. Poor Ben gets down on his knees and takes my shoe and sock off. My rubbery shoe. After working 11 out of 12 hours. And he says nothing, even tough I am crying and blubbering about smelly feet and stubbly ankles. Then Steve comes in to make sure I can walk on crutches. Don't even get me started on Norm, the security guard who wheeled me into my room and filled out the incident report for me. They are all angels. You just can't see their wings through the scrubs they wear.

As for me? Outlook not so good. I am on crutches. I am off of work, which I hate. The employee health nurse was teasing me about my control issues and workaholic tendencies. She asked me if I was taking my pain meds, and I told her no, that they drug me up, and she laughed and said that it is because they make me lose control of the situation and sleep. She's probably right. So for at least this week and next, I am just a student.

And I am bored.

Wednesday, July 22, 2009

Back in My Element

I love this commercial.

Okay so what's up in my world? The same. Work and school and homework and just a little sleep thrown in. And now working out again. Back to the grind in the gym. I started back last Thursday. I have already lost 10 more pounds and almost 4 inches of of my waist. Go me!

Though I love swimming, the pool hasn't bee my friend recently. Read about it here.

Wednesday, July 15, 2009

16 out of 18

The word of the day is tired. I work entirely too much. Out of the past 18 days, I have worked 12 hour shifts on 16 of them. Evan it is at his grandparents' house in Madisonville. Chemistry starts tomorrow. Watch a video.

Wednesday, July 8, 2009

My Animals Hang With the Animals

Today I took some time away with the fam for a trip to Cincinnati Zoo and Botanical Gardens. We had fun, aside from Evan complaining about his feet hurting after he insisted on wearing flip-flops. I'm glad I got this time with him, though. I have to work tonight at 23:00, and work twelves for the next 7 nights. By the time I am finished with this stretch, I will be back in class. He is going with his grandma this weekend to King's Island, along with John and his cousin Joanna, then making the trip back to Madisonville with her to spend the week at his grandpa's house. Summer is flying by. At least I got a little bit of time with him first.

By far my favorite pic of the entire trip. The goat kept trying to eat Evan's shirt, so Evan would giggle and step away, then try to pet it again. Each time, it would get a mouth full. It didn't tear the shirt, but it did give me a great photo op.
Too cute for words.
This damned thing. I was leaning over the glass, trying to get a good shot of the sea lion that was underwater playing with a ball. All of the sudden, this #$%^& popped it's head up at me, scaring me to death. Note that the camera was not zoomed for this pic!
Lucy wouldn't wake up for me and I was very disappointed. (See below.)
Awwww. Lucy the Baby Bearcat. Sponsored by the University of Cincinnati. Go figure.
The seductive ape. I kindly left the other one out of the pic, who was showing its hand in its mouth repeatedly. I had just said "What is it, bulimic?" when it purged its food into its hand to feed its baby. Disgusting.
This is "Francois". Some type of monkey that had Francois in it's name. It had a faux-hawk and white muttonchops, and was the coolest monkey ever.
I don't know what in the hell this thing was, but when we went to walk away, it made some weird crying sound until we came back.
The polar bear insisted on showing me nothing more than his browneye as he ate his lunch.
I think John was making funny faces behind me.
So peaceful here. I didn't want to leave this spot.
The big one and the little one take a break to eat popcorn.
I have this horrendous phobia of snakes. Just walking into the reptile house was a huge step in conquering my fear. And it was packed too. As I looked at the snakes through the glass, I was sizing people up to see how much effort it would take to knock them out of my way if I needed to make a break for it. Then I saw this S.O.B.....
Evan kept calling this rhinoceros "Clyde". I have no idea where he got that name.
Evan poses with the likeness of his father.
Is that the Fergie family? Mom, Dad, and Evan.....
The gorillas were pensive.
The bearcat would not be still for her photo shoot. I swear I stood there for about 15 minutes trying to get a good shot. No wonder UC thinks this is a good mascot....stubborn as hell!
I think I interrupted the sexy time of the "Giant Bait", as my hillbilly husband called them.
These lizards were looking at me.
The lemurs. This is when Evan screamed "Look, Mommy, it's Zoboomafoo!"

Monday, July 6, 2009

The Ball Tick and its Aftermath

When we were out in the country weeks ago, on John's Dad's property, we found ticks on us. Yes, as in multiple ticks. We got them off, even though I was grossed out entirely.

So fast forward a couple of days later. I think it was a McDonald's we were at for breakfast. For the umpteenth time that day, I caught little Evan scratching his nether regions. He never does that. Well, being that he is getting older and more aware that Mommy is girl, I sent John into the bathroom with him to inspect. Yep, you guessed it! He had a tick fully embedded.... there! So John tries to get it out, to no avail. I call the doctor, and she is going to get a male colleague to get it out if I will just stop by the office. At this news, Evan starts wailing. He doesn't want the doctor to do this. So I call the in-laws. They're country people and know more about this crap than I do. My father-in-law tells me to hold a match to it. Seriously? Did he even hear where I told him it was on Evan's body???? But the heat idea....hmmmm. So I get Evan in a hot shower, hoping it will back out enough to get the sucker out. Of course not.

I have no idea how I did it, but I managed to convince the kid to let me have a crack at it. I hope no neighbors were looking through the windows, because I had to have my son lay on the floor, and I had to get my face very close to see what I was doing. But armed with nothing but a pair of tweezers, I got the damned tick out. Ewww. The entire time, Evan was whimpering about the "ball surgery".

So here we are a month later. The spot where the tick was located looks awful. And Evan has developed this horrific rash all over the lower half of his body. We have tried every over-the-counter cream there is, from anti-inflammatories to anti-fungals. Nothing is fixing this rash. A week later, when it is actually worse, we take him to the doctor.

My child has lyme disease. So now we are on a one-month, three-times-a-day course of antibiotics. So much for summer!

Friday, July 3, 2009

Taking the Bait

I immersed myself in kid lit. I had to see what the fuss was over, and now I see. I finished Eclipse late last night and am now reading Breaking Dawn of Stephanie Meyer's Twilight series. This is the last book, then I can go back to big-girl books.

Wednesday, July 1, 2009

Sticky Situation I Found Myself In

A Patient is completely alert and oriented. She is intubated and has been on a ventilator for days, thought the initial problem had nothing to do with her lungs. Now she is awake and demanding to be extubated through hand gestures. Her vital signs look amazing. She has an order for a wean in the morning. But she insists on now. The family is called in to speak with her, and the family agrees with the idea of honoring her wishes. Her doctor, on the other hand, did not give the order, but did not tell us not to extubate, either, but simply made the statement that extubation would be at her wish and not his order. You put her on a t-piece and monitor her. There is absolutely no change in vital signs for 2 hours. You get a blood gas, and it is textbook-perfect. What do you do?

I'll tell you what I did. I pulled the damned tube, documenting heavily on her stability and the family and patient's wishes. Apparently, this has been the talk of the MICU. My director, critical care coordinator, and supervisor have commended my actions, saying I did exactly what I should have done in that situation. The director has even gone so far as to copy my charting to place in my personnel file along with a typed commendation from him. Only one pulmonologist has said anything. She wanted to know if it is "standard practice to extubate a patient in the middle of the night without a physician's order". Absolutely not. But to honor a patient's wishes while safely monitoring the patient's cardiopulmonary status...My intent throughout the whole ordeal was to watch for anything that would indicate that she would not be able to handle extubation. Had anything come up, I would have immediately had a discussion with the family regarding my concern. But nothing did. I could find no reason to leave her intubated against their wishes. And the outcome has been phenomenal. She hasn't needed so much as a breathing treatment since I did the deed.

So my Big Boss is recognizing me, stating that I have done a tremendous job for the hospital since I have been employed with them. Up until recently, I didn't even know if he knew that I work for him. But according to a phone conversation this morning, he has been getting a lot of positive feedback about me. Kind of makes my ears burn a little bit, wondering what has been said and when. But overall, it feels great to have your hard work recognized.