Sunday, November 27, 2005

happiness is....

- new, freshly laundered flannel sheets and a new pillow
- homemade pepper and chicken quiche, with plenty of leftovers for breakfast/dinner this week
- my immediate family all together this week (all of our feet under the table, as my mom puts it)
- a year of this blogging thing down (another one to go?)

- a garage and a driveway that I do not have to shovel or plow (both things are a step up from my parkingban'ish place (with on street parking) last year)

- 8 finished hats to be sent off to warm little (and big) one's heads. (all are at least double thick or are made with two strands tightly knit yarn due to Norma's friendly request from the last time snow flew)

(tonight the ends will be secured)
- being on call this weekend and getting a call to be present at two births this weekend
- my youngest brother asking me to knit him a scarf to match his jacket

I knocked a few potential knitted gifts off of my "to do" list after evaluating who was going to receive what this year; my lists aren't long, and 98% of my holiday season shopping was done before Thanksgiving. Our family discussions have concluded that no one needs any more "stuff" and because it's as much of a birthday season as it is other holidays season we've vowed to enjoy our time together as much as anything tangible.

Two years ago I knit everyone a scarf and my youngest brother got one made out of a yarn with as much plastic as wool because his ski trips mean that whatever he wears needs to be washable and it seemed like a good idea to make it in his loud school colors. This year he surprised me by requesting one in more mature colors, similar to the one I made our other brother. I've got my eye out for some navy and burgandy cascade 220 and then the "what stripe pattern is best for him?" debate can begin.

My leftover/barginbin/why did I buy this again? yarn pile is sloooowly shrinking as I finish the donation hats. I've aways to go before it's finally gone but it is nice to the yarn finally being used up! It's also helped me to justify a few online purchases that may or may not be used for some birthday gifts...

This rotation is really squishing my knitting time and I've been trading it for sleep. I am looking forward to being able to think about complicated cables and fair-isle projects again....

What I learned this week:

I wasn't scheduled to be at the hospital Thursday through today but I left several well-placed notes with my pager number urging them to please call me if someone in labor came in. It was a very quiet (QUIET QUIET QUIET (if me chanting it doens't work then perhaps "shouting" it across the internet will work)) week and I knew as soon as I wasn't in there'd be some action. I was called in on Friday and two new little ones entered the world! The docs I'm working with let me in on the "schedule" of due dates in the next three weeks and at some point there will be A LOT of action. My fingers are crossed I'll be there.

Those with a birthplan will have everything they planned for happen opposite to the way they want(ed) it to. (for instance, several nurses shared that their experiences have shown that a birthplan = c-section, for a variety of reasons.) I'm still figuring out my own reasons but I've seen it happen.

Some women, even first time laborers, will smile until they are 5-7cms dialated. Their sense of humor is is an important guage in the scheme of things (the smiles do, in general, decrease as time passes) but it is not an absolute measurement of progress.

It is also important to note that most women are exceptionally polite throughout their entire labor, even with lots of encouragement to drop the niceties. (it's hilarious to me that someone who has been pushing a baby through the birth canal for 45 minutes (that's normal - nothing to be alarmed by dear pregnant readers) and is using lots of colorful language, will still stop and appologize if/when she hears she could push another way. Then she'll say "thank you" when I get ice chips and a cool cloth and in the next sentence spew half-formed words to everyone else in the room.)

I love obstetrics, but I do not really want to be an obstetrican. The family doctors that I'm working with get to follow the moms and the babies, whereas the OBs just follow the moms. One doctor told me that she thinks I'm a closet pediatrican and I had to agree with her - but even if I went that route I wouldn't get to help directly welcome a babe to the world. Another reason for me to stick with family practice....


Blogger Maria said...

Happy Thanksgiving to you! I have a new pillow too, and I have to agree that it is happiness. I love your rainbow of blue-hued hats.

I'd love to know the theories about why a birth plan=c-section, if you ever have the time and inclination to share them. My grandfather was an anesthesiologist, and I believe he decided against obstetrics because at some point in his training he realized that the happy births that go well all blurred together in his mind and the ones with problems and bad outcomes were the ones he remembered. I don't know if other docs have this experience, but it made some sense to me.

As a mom who pushed for several hours before finally giving birth (without drugs or medical intervention other than an episiotomy), I'm not an accurate reporter about how polite I was during labor, but I do remember feeling immensely grateful throughout the process to the people who were there, helping me, giving me sips of melted sherbet and help and encouragement. Between the hormones and the intensity of the experience, I was awash with gratitude towards everyone.

11:10 PM  
Blogger Norma said...

Family practice does seem to be your "baby," and that is comforting to me. There should be more caring family practitioners out there. Actually, I do think that family practitioners generally ARE very caring, come to think of it.

What a wondeful pile of hats! Bravo you!

11:22 PM  
Blogger Kathy said...

The "birth plan = c-section" has me laughing a bit, if only because I bucked that particular stat. I had a natural birth planned, did Bradley classes, had a birth plan, practiced breathing and relaxation with my husband, the whole nine yards. Then had pre-ecclampsia and needed to be induced, throwing most of those plans out the window entirely. The induction took quite a long time and I found out later that the nurses were betting on when I'd have a c-section. I'll be forever thankful to the L&D nurse who read my birth plan and did all she could according to what I had wanted. No c-section, not even an episiotomy, and we all ended up just fine. Oh, and oddly enough I ended up chatting about Indian food in between pushes during those last three hours. Evidently I get very polite and talk about food when in labor ;-)

2:55 AM  
Anonymous Carole said...

It must be amazing to be present at all these births! What a great experience for you. But family practice will definitely be more varied, I'd say. I think you'll be a great doctor in whatever way you choose. Love all those hats!

7:29 AM  
Blogger Katy said...

I'm so impressed by all of those hats! I am definitely a slacker knitter this fall; I am going to have to make some extra monetary donations to make up for it, I guess.

I would love to be present at a few births. I had a birth plan for each of my girls, but they were very flexible (the plans, not the babies, lol) and I ended up choosing to have an epidural with each. I had very intense back labor with both (contractions very painful and only 2 or 3 minutes apart while I was still just a few cm dilated--ugh). I definitely screamed some, um, interesting things during labor, but I do remember joking a bit with the nurses between contractions at times. You feel so vulnerable and you worry that the staff is judging you, even though that is a silly thing to worry about while laboring!

I used hospital based midwives for my deliveries, and I loved that they were able to stay with me for much of my labor. I have heard that doctors often do not have this flexibility; do you have any concerns about that?

9:15 AM  
Blogger Kate said...

Mmmmm. Fresh flannel sheets!! Glad you got in on some action this week.

9:48 AM  
Blogger Liz said...

Oh man, your pile of hats is making me feel bad...I may only have two to show for myself.
Chicken and pepper quiche sounds excellent, but for breakfast? not so sure about that. ;)

10:30 AM  
Anonymous melanie said...

Note to self - birth plans with twins probably useless, don't waste time. Got it. :)

10:51 AM  
Anonymous mamacate said...

Melanie--birth plan with twins is not necessarily useless. See it as an opportunity to gather support, comfort opportunities, and resources around you. If I hadn't had a birth plan, they almost certainly would have pushed a c-section earlier. The first doc on call got yelled at for not doing an (unnecessary) c-section at the end of her shift, and "dumping" me on the next doc (total asshole).

Anyway, my theory on that is birth plan=more educated=older primapara. Not too complicated from a demographic perspective.

The only thing about sticking with family practice is that you'll probably spend a lot of your time with old folks. Around here few people go with FPs for primary care for kids, which means that FPs have little experience and poor resources (untrained staff, longer waits, less to amuse during waits, lack of ped vaxes sometimes, staff (physician extenders) who don't know how to help kids through procedures), etc.). We wanted to do an FP model and started out with that and then switched because of shockingly insensitive nurses vaxing infants, and then my FP wanting to go high-intervention on something that a more experienced ped saw, accurately, it turned out, as a false positive test). Of course, to the extent that you can design your own practice, and to the extent that you'll be in a rural place where there isn't a huge ped practice down the street, you may see a lot of kids and even low-risk moms. I know a twin mom who got most of her prenatal care from an FP (with ob support at birth).

11:55 AM  
Blogger Carina said...

My Ob/Gyn for my daughter's birth said the same thing! He said that every single patient who ever wrote a detailed birth plan got a C-section--every single one, and he was a very busy doc. I made sure to tell him that I wanted a natural labor and was rather loud about that at the hospital, so everything went well.

FPs are in high demand in more rural areas. You can have a good life and practice doing that. No matter what internists say, there are many good FPs out there doing great work with their lucky patients. ;-) Go for it!

5:31 PM  
Blogger Theresa said...

I'm loving hearing your Ob-Gyn stories - I was so surprised last summer to find that it was one of my favorite rotations. There's just something so great about taking care of women's health, and generally healthy women. . . Although I can definitely see the family practice thing for you.

I'm on a vacation month right now (because 4th year of med school IS the best year of your life - can you believe I'll be a doctor in 6 mos?), so I caved and started a blog. - it's only a few days old, but you're used to that right now, right?

Oh, and don't forget to sleep when you can, eat when you can.

10:27 AM  
Blogger Bookish Wendy said...

I'm catching up over here and loving your baby stories!!! Keep up the great work.

12:47 PM  
Anonymous Kim said...

LOL.....oh, does that description quickly bring back memories of having each of the six children I had. I was forever apologizing.

I was fortunate enough to be with my oldest daughter during all of her deliveries and amazingly she did the same thing.....haha! I guess that it is hard for us to not be the ladies that we were taught to be, even when we do cuss out the doctor and or the husband....LOL.

Great hats!!

1:10 PM  
Blogger KMK said...

As someone who has completed an OB/Gyn residency, I can support the birth plan=c-section thing. It is probably the same frequency as other people, it just hits the birth plan parents harder. It seems that a lot of people who have birth plans really really want to be in control of what is happening to them (more than the average patient), and labor is nothing if not unpredictable. I have also seen birth plans work fabulously, especially those that do not make an enemy of the health care system.
A couple of words of advice. First, do what you want to do, what gets you excited, what gets you out of bed in the morning. Residency is miserable no matter what field you are in, and you have to love what you are doing to make it worthwhile. Along the same lines, be careful how much you volunteer for. It is easy to do when you are excited about something, but you can't take care of people if you don't take care of yourself first. Good luck!

4:20 PM  
Blogger Ruth said...

mmmmm ... fresh flannel sheets. I can hear mine calling me now.

As far as the birth plan issue, I went into each of my (three) deliveries planning to go as natural as possible for as long as possible, but understood that, as KMKing said, labor is nothing if not unpredictable. Good thing, too, because my first two deliveries were very difficult, and if I'd been certain that all intervention = the devil they would have been even more nerve-wracking.

My cousin is in family practice, and loving it. I can completely see you in that specialty. I think you'd be great.

1:12 AM  
Anonymous Anonymous said...

Terrific hats! And I think you will be great in Family Practice. :)

well done on holiday organization! I am desperately jealous!!


1:21 PM  

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