Halfway

I am halfway done with my CNA certification! It’s really amazing how quickly this month has gone by and how fast a 4 hour lab goes. We are so busy in class learning all of our skills, making fools of ourselves, brushing each others’ teeth and learning how to clean bed pans. Not the greatest thing in the world, however SOMEONE has to do it and they are good skills to learn even though I will not be working in the geriatric field. I already spent 3 years working in a retirement home at a front desk. I love seniors (most, anyway) as I seem to really get a long well with them. I’m just not a fan of what growing older entails. There are other, more passionate people out there for those folks. 🙂

I’m not yet sure what next semester will look like, but I do know I will be taking a biology class and statistics. Two tough classes with a ton of material. I’m not really excited about either, but it does get me that much closer to nursing school.

Speaking of, the school I am attending just included a bachelor’s program in conjunction with the associates so I am SO glad they did that! Now I don’t have to worry about transferring and possibly moving my family just so I can attend nursing school. We’d cross that bridge if we needed to, but I just was not ready to think about it. Hopefully by the time I get there this time next year all the kinks in the program will be worked out and it will be a smooth ride. I’m really hoping that I can keep working in the hospital. Leaving and getting back in would be much harder than for me to just transfer departments.

All the birthy stuff here has grown to a slow lull and a lot of that has to do with my not actually being on the birthing center anymore. 😦 My position was moved, out of my control, and, well, I am not getting the same kind of experience I was before. Yesterday I saw a patient briefly who seemed to be having quite a long contraction. Her nurse was not in the room and she was really having a hard time. I just told her to breath and relax and then she complained of lower right side pain. I’m not sure what ended up happening with her. I know she did not deliver, but it got my wheels turning. Without even doing any online research I asked myself:

  • baby’s position?
  • gallbladder?
  • appendix?
  • kidneys?

Then I saw that she was moved and admitted. I would guess one of the above is what’s going on, though if baby’s positioning was that serious, I’d guess delivery would have already happened. I love that my brain already gets into clinical mode without a lick of experience. Just goes to show how into this I am! Call it nosy, but I really just want to be in the thick of it all right now. I want to know and absorb everything I can. So there was my little lesson for the day. If I head up there later, I will see if any of my guesses were correct.

Advertisements

Guest Post: Planning a VBAC

A fellow blogger recently posted her plans for a VBAC (vaginal birth after cesarean . Ashley’s post is beautiful and encouraging. She writes over at Our Happily Ever Afters and already has two beautiful children. Check her out and enjoy this lovely post.

***

fam1

Our Plans for a VBAC

As far as our birth plan goes, that’s also different from last time. To quickly recap, Kurt was in residency when Evy was born. We had to make the decision to induce labor or run the risk of Kurt not being present at her birth, were I to go into spontaneous labor. For us, this was not even a question. So I was induced at 39 (almost 40) weeks. When I went in for the induction, I was not even 1cm dilated, and my body had shown no signs of labor being imminent. After 9 hours of Pitocin, Stadol (otherwise known as the drug from you-know-where), and NO progression (I only got to a 3) at 4:00pm my doctor recommended a C-section. More background: my mom had 4 C-sections and so that was very familiar to me. I had no fear of them, and at that point it was the logical decision to make. At 4:12pm, in the operating room, Evy Kate made her beautiful appearance. Kurt and I were besides ourselves with joy and it was absolutely the most amazing moment of my life up to that point.

When I got pregnant this time around, a VBAC (v*g*nal birth after Caesarean) immediately came up for discussion. We decided that we would ask my doctor at the time what her policy was for this. She immediately said that she wouldn’t do that, and no doctor in town would. Baffled, I left the office and went home to talk with Kurt. He had also been doing more extensive research on this topic and had become insistent that I be given the opportunity to try a VBAC. He even went to his hospital of employment and after talking with MANY staff members, was appalled at the attitude of most physicians regarding this topic (it basically boils down to fear of malpractice suits, but mostly their general unwillingness to labor with their patients and do whatever it takes to see a VBAC through). Almost every nurse that Kurt talked with was so thankful he was bringing up the discussion because they all agreed it was ridiculous how hardly any doctors are willing to give that option. We felt like it was an uphill battle to even get the hospital to acknowledge that this was evidence-based medicine and if they keep denying this service to women, it will have very negative effects. We’re hoping that more physicians in our area get on board!

We both felt (and still feel) very strongly that medical evidence and research OBVIOUSLY support this option, as opposed to multiple C-sections. Thus the search began for an OB who would allow me to try. We found one in our whole city (praise the Lord!). I absolutely love her and her bedside manner is awesome (unlike my last OB in Mississippi). She definitely agreed that it’s worth a try, and she’s willing to monitor my labor for as long as it takes. I’ll pause here and give some facts/info about why I’m choosing to try a VBAC.

-If you allow yourself to go into spontaneous labor on your own and do not take labor-inducing drugs (like Pitocin), you have a 70%-75% chance of having a successful VBAC. It also helps if you hold off on getting your epidural until after you get to around 4cm or so.

-Most doctors refuse VBACs because they are afraid of malpractice suits. This stems from the fear of uterine rupture (your C-section scar rupturing because of the pressure of natural labor). However, this only happens in about 1% of VBAC situations. 1%!!!

-The more C-sections you have, the higher your risk grows for complications. Kurt and I do not want to have to limit our family size due to the fact that I’m looking at major surgery each time. Obviously, God is in control and He knows what’s best. We follow His leading at all times and this includes when we pray about the size of our family. But I would feel better knowing that I’m not significantly multiplying my risk if I get pregnant one more (or several more) times.

-There are so many more facts and research you can read that I’ve not included here. This is a great website if you want to learn more about a VBAC.

Now for my disclaimers and thoughts:

-I am NOT trying to “redeem” Evy’s birth or trying to “redo” my experience with her birth in any way. I am NOT anti-C-section, and I don’t view Evy’s birth as a failure IN ANY WAY. I was trying to think of the perfect way to say this, and this is what I came up with: Evy’s story is her story. I have NO REGRETS and I look back very fondly on the whole experience. There were certain elements that weren’t fun, but I know without a doubt that we made the best decisions for us at the time. I simply view this as Lynley’s story, which could potentially be different, or it could be similar to Evy’s, ending in a C-section. They both have unique birth stories (and Liam has his unique story). I view them all separately, and not like I have to redeem one because of another.

-I absolutely, 100% believe that there is no right or wrong way to give birth. I’ve never found an article that I feel articulates this exactly as I would, but I found this one! I’m very careful about articles I post or share, because personally, I want people to really understand my position on something. There are lots of good elements in the article, but I particularly like that it points out that “bullying” can come from both sides. Just like doctors can bully women into having unnecessary C-sections, people from the natural-birth camps can make women feel like complete failures who haven’t made it into their “club” if they choose to have an epidural or other interventions. Birth is a miracle. Period. Life is entering the world, and shame on anyone who tries to nullify that by demeaning any woman’s experience.

-I feel like I’m in the middle of things, in that our plan includes non-intervention (going into labor on my own, trying to labor at home at first, no epidural until regular contractions are established and I’ve progressed to at least 4cm), but it also includes intervention (I definitely plan to have an epidural, I don’t mind monitoring, I’m not opposed to an episiotomy if it’s necessary, etc.). IT IS OKAY to desire elements from both schools of thought! You’re not a sell-out if you don’t wholly subscribe to one philosophy.

Who knows how Lynley’s story will go? God does. I feel like we’re making the best choices for us this time around (just like we made the best choices for us last time around), but ultimately we trust the Lord with Lynley’s birth and we will ask Him for His wisdom in everything. Ultimately, “Many are the plans in a person’s heart, but it is the LORD’S purpose that prevails.” (Proverbs 19:21) I am so thankful for that promise!

Slacker

I know, this blog is seriously on the last of my “to-do” lists and I’m okay with that. Being nearly 8 months pregnant, going to school and working full time is so incredibly taxing. Seriously, who the hell let me do this?! Anyway, up until the last week or two, things had been going well. Now my Bio class is seriously kicking my butt, and so is the weight and growth of this baby. I am suffering from horrible pelvic pain. I’ve knocked a few things off my work schedule so I don’ have to be up and walking as much for as long. It’s only day two so no change yet. Sometimes I feel like just quitting this whole school thing and I know that is just silly. It’s like when you’re in transition (labor) and you start talking about how you can’t do it, give me drugs, yadayada. Yeah, that is how I am feeling right now. I just want this semester to be over. Now.  But really, I have like, 7 weeks to go and I can get through that. It just might not be with As and I have to be okay with that. These are pre-rec classes for crying out loud! All that to say, I am seriously stressed out. I’m trying to relax which means that I’m slacking in my school and work efforts, but I do have to put me and my baby first. Such a hard thing to do! I am hoping that once this little arrives and we have a nice summer off that I will be ready to rock and roll again in the fall. In fact, I know I will be.

Have a fun, safe St. Patty’s Day Weekend!

Guest Post: Pregnancy Oddities

What your Mother Never Told you: Pregnancy Oddities

Kristen Hurst is a stay at home mother of three who enjoys blogging.  She received her bachelor’s degree in fashion marketing, and writes often about <a href=”http://www.seraphinematernity.com/maternity-clothes/maternity-swimwear.html”>maternity swimwear</a>.  When she’s not trying to juggle the lives of Casey, Austin and Ben, she enjoys painting and catching up with a great Jane Austen novel.

When I was pregnant with my first child, I appeared to have every weird pregnancy trait known to womankind; I had developed an odd line down the middle of my belly, from the moment that the pregnancy test came back positive I developed ‘cloasma’ otherwise known as ‘pregnancy mask’ where my face was excessively splotchy.  I gained weight not just around my belly, but all over my entire body.  At night I couldn’t sleep due to the severe heartburn I got from the first month and never subsided until I actually gave birth, weird dreams and then there were the emotions that ranged from anxious to insane. Little did I know that all these physical and emotional changes were preparing me for the wild world of parenting, but if I‘d known a little more, it might have saved me some sanity or at least reduced my anxiety levels.

Thank goodness, none of my curious pregnancy symptoms were serious, and yes my belly line eventually disappeared, yet, it was odd that I knew nothing of these things.  Here are some additional pregnancy oddities:

  • Skin Tags: It seems that skin is a likely victim of our over-flooded hormones, these seems to be a relatively common occurrence and appear in areas that have a lot of friction.  They are annoying but completely harmless and can be safely removed by a dermatologist with a snip of scissors or by freezing or cauterizing it.
  • Red Palms: Again, blame those raging hormones.   “Palmar Erythema” is its official term and it is caused by the women’s increased blood volume.  It  seems that being pregnant can affect many parts of the body you wouldn’t necessarily expect to have an association with, this includes your hair, your vision and your fingernails.
  • Appetite cravings/aversions: Yes, we know all about the stereotypical image of the husband rushing out at three-o-clock in the morning to satisfy his starving wife with an emergency gallon of ice cream and a jar of pickles, but truly a woman’s appetite is absolutely affected by the many changes that are occurring.  For others, their appetites become nonexistent, avoiding food to the point of weight loss and vomiting.  This condition is known as “hyperemesis gravidarum” and the newly pregnant Duchess of York gained global headlines after being hospitalized for suffering from this condition.  Some women experience pica, which can range from eating odd combinations of food to actually consuming things like rocks and metal, which of course, can be extremely dangerous to mother and child.  Most doctors will determine that in the case of extreme pica symptoms it is generally attributed to anemia.
  • A heightened sense of smell: Some women swear that their abilities to detect odors (usually unpleasant ones) was heightened during their pregnancies, of course, I have a personal theory about this, that when the baby comes, she’ll be fine-tuned for knowing exactly when that diaper needs changing.
  • Unable to swallow: Another oddity is the taste or feeling of saliva in a woman’s mouth, some women have kept bags with them so that they can spit into it, again, it appears that once the baby is delivered this symptom also disappears.

It’s true, pregnancy is a life-altering process and of course the events leading up to your birth are even more incredible.  Every woman has a different experience and tolerance.  Mine were unique to me, I guess and so were friends of mine who shared their oddities.  At the end of the day, even though pregnancy can be difficult and at times, unpleasant, the rewards are too innumerable to mention.

Dehydration in Pregnancy

This weekend, I had the very unlucky privileged of having food poisoning. Since I’ve recovered, I wanted to share with my readers what one should do in the event you get a nasty tummy bug that has you loosing a lot more fluids than you’re able to keep down. I was miserable and at nearly 9 weeks pregnant, I was very concerned about what my quick dehydration could do to the fetus. My body type does not handle any amount of fluids lost. I am tall and thin and cannot afford to lose any weight, especially while pregnant. No matter what your stature, this information is for everyone, even if you’re not pregnant.

I am only referring to the first trimester here. If you become ill and dehydrated later in your pregnancy, there are other factors and risks involved. Always speak with your provider about proper care.

If you become ill with vomiting and/or diarrhea, follow these guidelines to determine if you need IV hydration (as prescribed by the nurse who works with my midwife):

  • Ensure that you urinate at least once in 12 hours, more in my opinion. If you do not urinate within 12 hours, seek medical attention.
  • If your vomiting lasts more than 12 hours without keeping anything down, seek medical attention.
  • If your diarrhea last more than 24 hours, seek medical attention.
  • Stomach cramping comes with severe diarrhea; take two Tylenol, rest on your left side and if the cramping does not subside, call your provider (call your provider before taking any medication).
  • If at any time you develop a fever, seek medical attention.
  • As always, call your provider for the best guidance.

As you are dealing with the above:

  • Sip on fluids throughout the day and night. Drinking copious amounts of water can cause rapid nausea so sip on it. Also sip on drinks with electorlites like Poweraid.
  • If you can stomach some food, eat bland items like saltines, rice, apple sauce, toast and bananas, all of which are gentle on your sensitive system.
  • Rest. Sleep as much as you are able, while still waking to sip on fluids.
  • Have someone else take care of you. I know that for most moms out there this seems impossible but sometimes, your partner must take charge of the kids, house and you. The more you rest, the quicker you will recover.

Being sick is hard enough and while pregnant is even more difficult, especially if you are taking care of a family and working. Remember, your body is working for two now and resting and hydration are essential to healing.

 

Article Review: Eat More Fish!

This is the article critique I submitted for my pregnancy nutrition class. This covers a very important subject of eating fish while pregnant. Did you eat fish while pregnant? If so, did you follow your doctors recommendation of only two servings a week? What kind of fish did you enjoy?

****

A common discussion among pregnant women, their providers and the birthing world in general is whether or not fish is healthy to eat while pregnant and breastfeeding. Consuming fish regularly provides docosahexaenoic, or DHA, plus omega-3 fatty acids which are needed in any healthy diet, especially that of an expecting mother. An article printed by The Telegraph, a British newspaper, titled “Pregnant Women Should Be Allowed to Eat More Fish”, reports that women should be consuming more than the recommended amount of fish during their pregnancy to encourage vital brain development in their unborn baby while also receiving the benefit of this necessary fatty acid.

“Docosahexaenoic acid, an essential fatty acid, [is] thought to be important to the development of infants, particularly [in] regards their eyes and brain” (MedicineNet, 2012). This is a brief definition of DHA and why it is important during pregnancy. Since 2004, the Food Standards Agency along with medical professionals have recommended that women consume no more than two servings of fish per week, or 12 total ounces, which the article acknowledges that recommendation is “ultraconservative” (Gray, 2010). This suggestion is also seen in our text on page 114 which was printed a year after this article was released.

The article goes on to say that women should actually be consuming three portions of fish a week to ensure proper DHA and omega-3 fatty acids intake (Gray, 2010). Our text, unlike the article, describes the types of fish which are higher in mercury content and should be consumed less, if not at all. Those fish include swordfish, king mackerel, tilefish and shark, as well as no more than six ounces of “white tuna” a week. There is a danger to the fetus if too much mercury is consumed, however there is a number of other fish with less mercury content and high in DHA.

DHA has been nicknamed a “brain food” of sorts. “Women who consume adequate amounts of EPA and DHA during pregnancy and lactation tend to deliver infants with somewhat higher levels of intelligence, better vision and otherwise more mature central nervous system function than do women who consume low amounts of these fatty acids” (Brown, 2011). The article touches on this topic briefly while also stating that some research has found no correlation with better academic abilities in children later in life (Gray, 2010). Regardless, it is important to emphasize the importance of DHA consumption and how eating fish while pregnant is not nearly as bad as others have made it seem. When I was pregnant with my son, I avoided fish. I was only basing my decision off of what had been recommended to me by my doctor. Also, my husband is highly allergic so avoiding it was not difficult. However, later in my pregnancy I did enjoy a number of salmon meals. I know that I was not receiving an adequate amount of DHA despite taking a daily prenatal vitamin. I have gained a much better perspective on fish and how important it is while pregnant. I will ensure I consume enough DHA next time by taking fish oil and eating more than one serving of fish per week. Our text states that taking fish oil daily is safe and beneficial (Brown, 2011).

The only reference the article makes to data proving that not taking in enough DHA, or the recommended 340 grams per week, showed children were born with a greater risk of having low verbal intelligence (Gray, 2010). How high was that risk? Were these children exposed to any other teratogens while in the womb? Was the mother taking a regular prenatal vitamin? These are all the questions, and more, I asked myself as I read that statement. Studies like this can be a great stepping stone in determining whether or not fish can or should be consumed while pregnant. However, it is not clear on any of the other circumstances surrounding those women and their babies with lower verbal intelligence. There are many other factors which could cause a child to be delayed verbally. This is the first I have read that a lack of DHA could be one of those factors.

This article brings up a great point, encouraging women to eat more fish and that it is less dangerous than previously thought. The information provided is true in that consuming an adequate amount of DHA is very important while pregnant. However, our text still only recommends two servings versus three servings listed in the article. I consider myself to be less conservative and agree with the article. I do not think the information in our text is as accurate, despite it having been published a year after this article. I am not sure if that is because doctors must still only be recommending two servings or if the author of our text is biased. Our text even states, “Fish and seafood are by far the richest food sources of EPA and DHA (Brown, 2011)”. If DHA is so important for the developing baby then why is our text still only recommending two servings per week? In this case, our text does not support the recommendation presented in this article.

I would recommend other pregnant women read this article so that they receive information on this subject from different perspectives. Only she can decide what is right for her and her baby. I already find myself wanting to share this information with the labor and delivery nurses I work with as a means to create healthy discussion about something that is really important. I would tell them that they should read the article and consider the fact that most fish do not have a high content of mercury and that adding that natural form of DHA to their diet would be very beneficial. I would also share the research given about how good DHA is for brain development, which I think supersedes any other discussion about it. For me, that is a done deal. I will be taking in more DHA either through fish or fish oil. I would add more information about the brain development and how DHA specifically affects a positive result, especially in pregnancy. This is the first I have heard, even after having a baby of my own, that DHA specifically targets brain and vision development which would have been nice to know ahead of time.

 

References:

MedicineNet, 2012. Definition of DHA. Retrieved on September 6, 2012 from:

http://www.medterms.com/script/main/art.asp?articlekey=23903

Brown, J. E. (2011). Nutrition Through the Life Cycle (4th Ed). Belmont, CA:Wadsworth.

Gray, R. (May 30, 2010). Pregnant Women Should Be Allowed to Eat More Fish. The Telegraph. Retrieved on September 6, 2012 from:

http://www.telegraph.co.uk/health/healthnews/7782834/Pregnant-women-should-be-allowed-to-eat-more-fish.html

an unknown pregnancy experience

Recently, I was called over to the birthing center to register a mama who had come in through the ER and already delivered her baby. This is not a common occurrence and usually this is due to a home birth gone bad. When I say bad, I mean something like a retained placenta or hemorrhaging or respiratory distress for the baby. If a home birth is transfered to the hospital, it’s usually not good and both mama and baby are admitted right away.

So I headed over to see the patient and get her and her new baby checked in. I knew that there would be quite the commotion going on, but I was a bit surprised by HOW chaotic it would be. Registration always takes longer when there are a million questions flying at the patient.

The nurses kept asking her if there was anyone with her, if they could call someone to come and be with her. She was shaking from the delivery and the last thing I wanted to ask her was questions. I actually wanted to drop everything I was doing and just hold her hand for comfort.

After the doctor got situated with her and began cleaning her up, I moved in and got what I needed to get her checked it.  My little passionate button for childbirth was through the roof! I was listening to everything the doctor and nurses were saying and asking.  Lots of reassuring, positive words that she had done a great job without any medication.

Her baby was taken to the nursery for observation. After the doctor left and I was still working on her file, we learned that she had not known she was pregnant. She had no idea what was happening to her, began to vomit and bleed at home and proceeded to drive herself to the hospital and deliver the baby in her car. Kind of unbelievable!

Physically, the patient was in good condition but emotionally, she was in shock. It was scary and exciting all at once (for me). The stories you hear about women not knowing they were pregnant are most likely true. However, I do believe that there is a certain level of denial involved as well. I am not implying that this patient was in denial, just that some women convince themselves that they are not in fact pregnant and live a normal life until they go into labor.

This experience only made my itch for midwifery stronger. I wanted to be the person taking care of her and reassuring her that everything was going to be okay. Though the baby was in the NICU, she will be okay. Not knowing her gestational age and if she was exposed to any toxins prompts the hospital to do extra monitoring.

***

This was not my first experience with someone who had no idea she was pregnant. When my son was born, there was a woman in our “NICU babies” lunch group who didn’t know. She thought she had kidney stones, which is a very common complaint from patients when they are in labor and unaware of it. I also worked in a high school where a student went home for Christmas break and had a baby! She was very young and unaware of her cycle, things that an older woman would be more aware of.

All this to say that having experiences like this only help gear me up for what my future holds. The ONLY complaint I have about the entire situation is that the doc did not spend very much time with her after getting her cleaned up, but I suppose most busy OBs are like that.