Oh The irony

Picture this:  My regular running route. 
Little yippy dog frequently out front with no supervision. 
Has chased me on occasion. No danger really but I don't want little teeth in my heels just the same.
Irony #1: FULL fence in the backyard.
The worst irony of all...
The Runner Girl decal on the car in the driveway!

PUT YOUR STUPID DOG UP BEFORE I MACE IT!!!!!!!!!!!!!!

Just a few mind games while running

So I haven't run in forever.  (Yes, look at my log to the right and that's a ten day lapse...)Have definitely been too tired, and just not motivated.  A bad case of the "But I don't WANNA run..."  So today I strapped on the running shoes and decided i must go!  But rather than pick a nicely mapped route and face the knowledge of exactly how FAR I have to go before I shower I decided to go with a time limit.I know that it usually takes me about an hour to run 5 miles. So I figured I'd run where ever I wanted but I'd just try and run for about an hour. So I ran in some new neighborhoods, got a little turned around trying to find my way out of the neighborhood, went to one of my familiar neighborhoods through a back entrance, focused on running a little faster than usual based on my breathing and effort level. Made it home in 56 minutes. Mapped my route and turns out I went 5.34 miles which is a pace of a ten and a half minute mile.  Normally five miles sees me doing about 11:03-11:20 minute mile.  That's a lot faster not knowing how far I was going and not having prior expectations of myself.  How bizarre!!!!!!  The mind is an amazing thing!!!!

Which is easier? A C-section or a vaginal birth?

I have gotten this question twice now from young first time moms who have had c-sections.  They are convinced that a csection is easier. With the c-section rate at 30% in this country, csections are so common they are the new normal way of giving birth. On Sunday night this week, we had 19 patients in postpartum, 13 were c-sections, that's almost 70% of our patients!  And let me assure you from seeing csection and vag patients in recovery, a vag birth is almost always easier. Just the nursing care alone for a c-section should be enough to make it clear which on is easier and safer.  So I've come up with a new analogy for the next person who really wants to know which one is easier.
Uncomplicated vag deliver, no stitches below the belt: Like recovering from your first marathon that you trained well for but never intended to run as a super-athlete. You will be very very sore and tired for a couple days but overall you will be none the worse for wear.
Vag delivery with 1-3rd degree tear: You ran the marathon and got in a car wreck on the way home. No broken bones but you had to have a couple stitches. Now you are sore and you hurt but in a week or so you will be feeling much better.
C-section after long labor: You ran the marathon then on the way home you got into a horrible car wreck and needed a major surgery to put you back together.  Oh and during your recovery you will potentially have full responsibility for a helpless baby. Man, that just sucks!
C-section no labor: I figure you still have a race you just finished because the last couple weeks of pregnancy aren't exactly restful so we'll call it a 10K (not quite as exhausting as the marathon) and you got in the same nasty car wreck on the way home. 

Which one sounds easier to you?

One exception: I think some really bad 4th degree tears after long labors could be harder recoveries long term than a scheduled c-sec. BUT the hospital portion of it, the actual nursing care required, the potential for complications, the risks involved, the csection is still harder.

I heard a short snippet on NPR this week that a big group of docs got together to review the data concerning VBACs and safety and issue some new guidelines. Go figure, they decided that VBACs really are pretty safe and a good way to reduce our ridiculous csec rate. We'll see. At my hospital there is currently ONE doc that will do VBACs on a regular basis.  ONE!

Placebo scmacebo

Didn't take my cal-mag this morning because I was warm and cozy in bed when I remembered and decided not to get up. Slept almost 5 hours but do not feel as rested as yesterday.  Could be because I'm on day two with only 10 hours sleep total. One more night, then one off then three on, then 6 off.  I will survive.  I will survive. 

Sleep glorious sleep!

Finished my first night of my stretch this morning. It was BUSY but not because of scary stuff just people needing a lot of attention!  I slept for 5 and a half hours.  Beautiful!  I think I could do nights and not go insane if I could sleep like that every day.  The only think different that I did was put in ear plugs and take a big dose of calcium magnesium before I went to bed.  Oldest daughter asked if I thought the Cal-MAg was really responsible for my sleep or if it was a placebo.  Guess what?  I don't care what it was!  I'm just soooooooo glad I slept!!!!

Cool stuff I've done at work.

As a new grad and new orientee I have to get checked off on a variety of skills during my orentation time. And certianly as a new nurse there are all sorts of new experiences to  be had so here are a few...
1. I've gotten checked off on venipuntures (blood draws).  Scares me a little bit because it still feels like I am going in blind.  When I've had blood draws most of the time the phlebotomist at least acts like they have xray vision and can see right through the skin to the vein. I'll keep practicing but I have a little more confidence that I'm going to get blood out.
2.  Helped with a tummy wash on a baby.  Sometimes babies get amniotic fluid, mucus or even meconium in their tummies during the delivery and it makes them spitty and fussy.  A tummy wash drops a tube from their mouth into the stomach. Then you squirt in a little sterile water. Literally roll the baby around and suck the water back out.  You do this until the water is clear.  Baby doesn't like it much but it makes their tummies feel better.
3. Practiced my Spanish. My Spanish is very limited but it is better than many on the floor. So scary enough I have had a couple SPanish only patients. We have an interpreter service we can call but for general Necesita ir a bano?(Do you need to go to the batheroom) or A que hora come el bebe? (What time did the baby eat?) my Spanish is enough.  I had a mom the other day who was having complications an dwas spanish only. Then my Spanish felt soooooooo inadequate. She was scared and there just weren't enough words to comfort her much.  She ended up being ok I just felt so bad for her.
4. Did a Foley under some amount of time pressure. I've done Foleys before but there is a specific order that you have to do them in because it is a sterile procedure and I haven't done one in a LONG time. The other nurses were really helpful and gave me guidance and I got it in on the first try!  Yeah for stretched out girl parts after a vag delivery!
5. Eaten dinner provided by a formula company.  Dearest readers, please understand that if your child ate formula I hold no judgment. Simply from a professional perspecitve and a marketing perspective the formula companies have used tactics that are questionable at best and unethical at worst. The presentation I went to was put on by a very nice grandfatherly looking guy who said breastmilk is the gold standard then said that his own children were formula fed and he really didn't see any difference.  Then he told us how their new formula rediced fussiness 20% within 24 hours. He had some nice graphics and charts but the scientist in me wanted to yell, "How exactly did you measure fussiness? And what does 20% less fussy mean anyway? And if it is so much like breastmilk how did you manage to introduce white blood cells and neutrophils that have had their inflammatory response turned off? And are formula fed babies still more likely to die in the first year or did you fix that too?"  But I didn't say a word, ate my Chickfila and felt a little dirty afterwards.
6.  Just to balance the previous rant, I had a baby who was still working on learning how to breath after birth.  He was a little grunty and hicoughy etc.  Bottlefeeding wasn't going great according to mom. He would eat 10 ccs or so then start letting it flow out of his mouth and then quit altogether.  So I got him a slow flow nipple to reduce his stress while he was eating and he did great! Very minor intervention but it made a difference to this little guy and helped his mom feel more confident.

That feeling in the pit of your stomach...

I found this cool blog by a new nurse called "Fundus Chop". You'll have to read it to figure out what that means but it made me howl with laughter. She talks here about being a new nurse and that feeling int he pit of your stomach that maybe something will go really wrong and it will be because you are new, inexperienced and don't know your stuff yet.  Ya, I'm getting to be friendly with that feeling. This week I had a patient who was bleeding just a little too much postpartum. Then it was a little more, then it was a big clot, then a call to the midwife for some methergine, then more bleeding, then a foley catheter to keep her bladder empty, then FINALLY the bleeding slowed down.  My preceptor said that it didn't turn into a hemorrhage because I stayed on top of it and we intervened but it still acquainted me with that fear knot all night long.  When i go check her will she be bleeding? Will I massage her uterus hard enough to get it to clamp down? Will I recognize if it is boggy? If it's boggy what do I do??????  Thankfully I am not alone. The rest of the nurses are very nice and very willing to help and answer questions but still so much to learn!