Friday, March 13, 2009

Stories From the Delivery Room

What a cute couple! Jill and Scott were in labor. Yep, they were totally in it together. You know, they were the kind who say “we’re pregnant.” They were so excited to welcome a second baby to their family.

It always makes me happy to see a team like Scott and Jill. Watching couples who are kind and respectful to each other is refreshing. I certainly do not take this for granted. Many fathers-to-be seem closer to the TV remote than to their wives. I was anticipating a fulfilling day at the office, caring for these two.

With each contraction, Scott looked into Jill’s eyes and helped her breathe. They had gone through Lamaze classes prior to the arrival of their first baby. “It helps a lot for early labor, but I’m no hero. Sign me up, I’m gonna want my epidural!” she said with a chuckle.

Within the hour, the joking and playfulness turned into concentration. The contractions were clearly getting harder. I gently pressed upon Jill’s abdomen, the contractions palpated strong. I knew it wouldn’t be before I would be calling the anesthesiologist.

When I admit my patients to labor and delivery, discussing pain management is a high priority. Breathing through the contractions, getting IV pain medication, or having an epidural are the three main options for dealing with the pain of labor. Some nurses strongly encourage their patients to get epidurals. They hate to see women in pain. I actually don’t have a preference. I truly believe pain management is a woman’s choice and that she should do what she feels is best for her. Supporting a woman’s decision is my job. Continuously questioning her or asking her if she has changed her mind only undermines her confidence.

Sure enough, before long Jill was ready for me to make the call. She was tired and ready for a break from the pain.

I walked out to the nurse’s station and paged the anesthesiologist. Within 15 minutes, I heard a cart rolling down the hall and a knock on the door. Dr Smith had arrived to place the epidural. Before he could start, he needed to take time to discuss the risks and benefits of the procedure. After Jill signed the epidural consent, Scott and I helped her dangle her legs over edge of bed and moved the tray table in place for her to lean on. Dr. Smith chatted with them as he readied his supplies. “Your position is really important in helping me place this catheter,” Dr. Smith instructed Jill. “I need you to drop your shoulders and place your chin to your chest. Good! Now push your lower back towards my fingers here, arching it just like a Halloween cat. Perfect.”

Dr. Smith’s attending physician, Dr. Wong, had arrived prior to the beginning of the procedure. By the time they begin their OB rotations, the anesthesia residents are skilled at epidural. However, supervision by an attending physician is required.

Dr. Smith’s skill was impressive, and within a few minutes the epidural catheter was in place. Scott held the over-bed table as Jill remained perfectly still, despite the strong contractions. Things were going smoothly. Dr. Smith performed a test dose to insure that the catheter was in the epidural space and not in the spinal fluid.

“Any ringing in your ears or metallic taste in your mouth, Jill?” Dr. Smith asked.

“No,” Jill replied.

“Can you move your toes?” Jill wiggled her toes in response.

“Do your feet feel numb?”

“Nope, they feel normal,” said Jill.

Those were the answers Dr. Smith was looking for. He then meticulously secured the epidural catheter to Jill’s back, using Tincture of Benzoin and 2 inch paper tape. Nobody wanted the catheter to pull out--especially Jill!

Scott hugged Jill and kissed her on the forehead. Clearly he was proud of the impressive job she had done, holding still through such incredible pain. I helped her to lay back down, flat on her back, just as Dr. Smith requested.

“Oh yeah, now I feel it. My legs are getting numb. Will my pain stop soon?” Jill asked.

“Not too long now,” Dr. Smith replied.

A few minutes later, Jill reported that she could feel her abdomen getting numb. Dr. Wong assured her that everything was going as expected.

Another minute went by and Jill started to become restless.

“My breast are getting really numb,” Jill said with anxiety in her voice, “and my hands are getting tingly too.”

The two doctors exchanged concerned looks. Scott was sitting tensely in the recliner by Jill’s side, holding her hand. Dr. Smith began to check the anesthesia level.

“Oh no, something is wrong, I don’t feel well. Oh, it’s getting hard to breathe. Something is wrong. Please, please, do something!”

To be continued…

31 comments:

Mighty M said...

Oh no! Why did you stop there!!! ;-)

April said...

Oh.My.Goodness...please don't leave us hanging! I have to know what happened! I pray that everything worked out fine and they all lived happily ever after!

Beth E. said...

Another cliffhanger! Aaaaaugh! You KNOW how to keep us coming back, don't you?! LOL

Looking forward to the rest of the story.

Teresa @ Grammy Girlfriend said...

Oh no.....you have to finish the story today....

blueviolet said...

You are killing me here!

He And Me + 3 said...

YOu can't stop there...seriously. What happened to that poor mommy to be.

tollesons4him said...

Are you serious, your going to leave us hanging like that....... Boy you are good!!!!

Jessica D. said...

so cruel!!

Rebekah said...

Ok, are you teasing us with the cliff hanger. Is this a test to the Labor and delivery nurse readers to pick up on your hints of the events to come? Hmmmm potential complications. Yes we are all anticipating the rest of the story.

Becca~TimeWellSpent said...

Oh no!!

Semi-Slacker Mom said...

Okay. You know I love you, your To Be Continueds are driving me crazy!!

Momma_Hug said...

Uhhhh, what? No, no, no. Keep going. What happened next?

Eyeglasses & Endzones said...

How can you do this every day!!! This is making me crazy~! I am anxiously awaiting the rest!!

Brooke said...

The suspense! It's like watching your favorite show on TV only to see those "To Be Continued" words.....hope we don't have to wait until next week (or even next season)!

Elaine at Matters of the Heart) said...

Darn you =)

Kameron said...

You're killing me! I need the rest of the story!

Belle (from Life of a...) said...

Hurry...HURRY

Lori said...

Don't do that! :)

Casey said...

I bet I know what happened next!

chickadee@afamiliarpath said...

great story. can't wait to hear the rest.

Tricia Nugen said...

Another cliff hanger? Cripes. This is like a soap opera for me and you leave me hanging. Can't wait to finish the rest!

Leandra said...

Julie-
My hands jsut got sweaty and my chest tight... this makes me glad I never tried the epidural!!! I knew I was scared of it for a good reason! I'm sure there's a good ending to the story...

Ms. Florida Transplant said...

OMG - You can't stop there!

Thanks for stopping by my blog. I'm looking forward to reading through yours.

Maggie said...

WHAT?! TO BE CONTINUED?! AHHHH!!! =S

I hope the ending is a good one; that sounds very, very scary!!!

And what the heck, I don't remember them asking me those warning sign questions when I got my epidurals w/ my boys. Geez, I think I was jipped. =)

Orah said...

I should not be reading this - but now I need to know what happens. I had 3 babies with epidural successfully placed and I plan this upcoming birth with the same pain management, I need to know what went wrong. (I never allow residents to do the epidural)

Helene said...

I was practically grabbing my computer screen as I was reading this...my heart sank at the end and now I'm wondering what happened...Oh, I really hope this has a happy ending!!

Cathy said...

To be continued??? What?? I guess that means I will have to come back....

Jen said...

why do you do this. I know where my mind took it, me being an ICU nurse and all and its not good, please tell me everything is all right.

Prisca said...

HEY! Where's ya go!!!! We want more...

Melissa said...

I don't like that game...seriously your a great wrtiter but come on now...stories like that can't be left hanging!

Teresa @ Grammy Girlfriend said...

Thanks for the end of the story.....that was a cliff-hanger.....

Love your blog...but don't do that again!

Teresa