Rants from the Crib

An Ob/Gyn gone mad

Archive for the tag “miscarriage”

A Typical Call Day

My day started at six AM sharp as I jumped out of bed and into the shower. My husband got up too as he had been tossing and turning for the last couple hours anyway. He went downstairs and turned on the fire for me. I shoved my wet hair up under a cute surgical cap, grabbed a couple Atkins bars and a Coke Zero and ran out the door for my seven AM c-section. My daughter wasn’t even up for me to hug goodbye.

I got to the hospital and parked in the doctor’s parking lot. It was still raining, which it has been doing steadily for the last three days. Things are starting to flood. I had my call bag, my purse, my heavy coat and my portfolio of paperwork I’m working on for my new job in North Dakota. I scurried my way in through the rain and found my way upstairs to Labor and Delivery.

One of the across-town doctors, whom I have not really worked with before, but he and I found we have a lot of friends and contacts in common, was waiting there to help me with the c-section. He just thought it would be nice to operate together before I left. We gowned up and did our c-section, which went quite smoothly. Nice healthy little girl baby.

After the c-section, it was time for me to round on all the OB and delivered patients on Labor and Delivery. Between seven doctors that amounts to quite a lot. I had two inductions, which are patients who are having labor started for various reasons. One was past her due date and had elevated blood pressures, and the other was a diabetic with elevated blood pressures. I was pretty sure the first one was going to wind up with a c-section. I got their pitocin started and it was time to do circumcisions.

The first circumcision was a baby who had been born the day before. This was my first circumcision in the new hospital, and the equipment and the location were unfamiliar. I got his done well with some minor frustration. The second baby was not a newborn – he was a twin who had been born prematurely and had been too small to circumcise at the time he was born. By that time I was adjusting to the new equipment, which contained a nerve-wrackingly sharp pair of scissors – not exactly the sort of thing you want to be waving around a little penis. Everything went fine. One of the nursery nurses was from our old hospital, so it was good to see her there.

Then I had to answer a bunch of phone calls. One was from my husband, who was trying to arrange some things for my new job in North Dakota. I had some calls from patients to answer, and a call from my recruiter for the North Dakota job who was calling to tell me that the hospital had booked the wrong hotel for me and that I didn’t have any call days for my first ten days in North Dakota. Call days equal more money, so I was a bit perturbed about that.

I went to the call room to lie down and rest, since I always lie down and sleep if I can if I have the chance. That way if I’m kept up all night working, I’ve gotten some sleep. I was just on the phone with the computer people who were assigning me a new password for their computer system, since my old one wasn’t working, when I got a panic call from Labor and Delivery – a patient who had come in in labor that morning was about to deliver in the bed and hadn’t been able to get her epidural because there was no time. I ran into her room and she was screaming quite piercingly. The nurse was entreating her to stop screaming. The baby’s head was right there – I could see it peeking out. All we had to do was to convince the patient to stop screaming and flailing around in the bed. She finally got it together enough to push and she pushed the baby out, screaming like a banshee the whole time. Can’t blame her too much, since she didn’t get an epidural. She continued to freak out after the delivery, despite my reassuring her that she was done, the baby was out, and she didn’t need any stitches. I wasn’t sure why she was still so panicky. The baby was fine.

I got a panicked phone call from the husband of one of my patients. She was scheduled for a D&C the following day, but apparently had started miscarrying at home. Her husband sounded very very scared and very very grossed out as he described how heavily she was bleeding, and how he thought one of the clots in the toilet might be the baby. I told him if he could to scoop the specimen out of the commode and bring it with them when he brought her to the ER. The ER was going to assess her and determine if she needed her D&C to go ahead and be done that night, or if it could wait until morning. They never called me back. I called the husband later in the evening and he said they were told she had not passed the baby. They were still coming for the D&C in the morning. He still sounded panicked and upset.

I was notified that one of my induction’s water had broken, and she was going to need an epidural. I OK’d that and then got a very interesting phone call from the ER of my old hospital – they had a lady there who spoke no English and who had two tiny baby feet protruding from her vagina. There was no heartbeat. They put her in an ambulance and sent her across town, since my old hospital no longer has the facilities to deliver or recover a pregnant woman. The OB nurse from the ER had to ride over on the ambulance with her, in case she delivered on the way, because the ambulance drivers were freaking out. When she arrived, the little feet were still protruding from her vagina. They appeared as if they had been there for some time. There was little bleeding. With pushing, she delivered the fetus in the bed. Fortunately I speak enough Spanish to let her know what was going on. The little baby was stillborn. From its appearance, I felt it was between 16 and 20 weeks and had been deceased for at least several days. With a little more pushing, she delivered the placenta, so, thankfully, I did not need to do a D&C to get the placenta out.

At seven PM it was time for shift change. One of my inductions was six centimeters dilated. The other one wasn’t doing a darn thing. I left orders for the night shift and retreated to my cave with several blankets – it’s cold in there. I was waiting to see if the six centimeter one would need a c-section or not. I slept a little while and was woken up by the nurse: “The baby is coming now!” I jumped out of bed and ran down the hall. The baby was NOT ready to deliver. She had gotten me up about an hour early. I went and laid on the couch in the call room until they were ready to call me back.

The patient delivered her baby and did NOT need a c-section. She did not need any stitches either. I was very grateful because for some reason, I felt really dizzy and needed to sit down. That happens to me sometimes with early morning surgery or late night deliveries. I don’t know why it happens. We’ve checked my blood sugar and everything and it’s been fine. Anyhow, I did my paperwork and retreated to my bed. My alarm went off at 6:30 AM and my call day was over!


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