21st/22nd Catch in 4 Hours

Another night shift, and this shift was by far the craziest shift, possibly ever in the last 3 months. First of all, after working Night Shift last night (Sunday), I slept for a few hours, and then went to the clinic for baby checks, and spent most of Swing shift there (which Karissa was working), and read a midwifery book (very interesting!!), and slept...and had fun with the on-duty midwives.

Karissa was scheduled to work Night Shift as well (and she had worked Clinic before Swing, so talk about a crazy long day/night!!), and her midwife friend-Danielle from Manila was in town, and came to shadow the last couple hours of Swing shift as well as Night shift.

Danielle with one of Karissa's catches and one of mine. (Danielle is 17 y/o and about 6' tall)

I finally went home around 8pm, showered and brought back scrubs for me and Danielle, and quickly was caught up in the action, a baby being born at 9:28pm and Karissa receiving a labor, and another labor coming in at 9cm, ready to push. Ends up, I quickly got endorsed the latter labor, since I was first up...and an experience that was!!

Here this gal is, in active labor, semi-pushing, and she and her bana are arguing! She was constantly complaining about the pain (this was her 5th baby, at age 30), and blamed her bana for the pregnancy, while her bana blamed her for how long the labor was taking (which started at 1pm), and when she would reach out for his hand, he wouldn't take it, so when he finally did, she wouldn't take it in a sort-of retaliation...talk about marital issues!!

Thus, here the baby was in the canal, close to almost visible, and it really was all their own fault the baby wasn't born already... We let them try to work things out while we did endorsements.

Beautiful baby girl!!

She then informed me (still trying to push), that she wanted to get an IUD after the baby was born. (Inside I was like "Whoa lady! You haven't even had this baby yet, and you talking about what?!?") I informed her that that would be discussed at her 6 week baby check (which thankfully I won't be here for, since that is something I can't support or encourage..).

Anyway, we inserted D5LR because of maternal tiredness, and were I was doing new shift vitals (even though I'd been with her for the last hour of Swing Shift), when she and her bana informed me that they would like to be transported to the hospital to be induced. (Umm....lol..whatever!)

At this point, after talking to them, I decided to call my supervisor in to talk with them, and she informed them that first we would try to do labor stim/perineal pressure/hot compresses (catheterized twice), since the baby was right there. However, heart tones started going all over the place, and since she was still making no progress, I started filling out transport papers.

One tired but very happy midwife with her 2 catches (within 4 hours)

Everyone then left the cubicle except my assistant, and just then, my patient decided to push effectively. When asked why, she said she just 'felt like it now'...I guess she and her bana got things figured out??
5 minutes later, a beautiful 6lb 1oz, 52.5cm long baby girl was born, at 11:05pm. APGAR Scores of 7, 9 with O2. Placenta took a long time to come...but only 100 ebl and small 1st degree tear.

Funniest part was that as soon as the baby was born, the couple's attitude completely changed, and they became the sweetest couple and were so in love with eachother and their baby, and had no other issues..

Come to find out, their 4 other kids (11, 8, 5 and 1) were at home alone, they had no cellphone, and NO one (no neighbors or anything) knew where they were..and they had no way to communicate to anyone to get a bantay so the bana could go home...and they couldn't leave until at least 5 am. Well, the bana ended up slipping out to 'go get kwarta (money)"..

I had almost gotten all of her paperwork done, between charting 2 other births (there were 4 midwives catching and 2 assisting-only, plus Danielle-who was indispenable), when another labor (26 y/o, G4P3) walked in at 3:28am, and since it was my turn again, I checked her in.

Karissa and I with 4 of God's beautiful miracles!!

She was 9cm+ also with borderline hypertension, so we had her drink water, and left side lie...well, it was more painful for her to side-lie instead of sit, and she wouldn't cooperate, even when we did what we could. She then spontaneously went to hands and knees, and started pushing (3:40am), not listening to anything I said. Oh well! lol

Ate Jobs came in, and she finally consented to laying down with a wedge, and SROM happened. At 3:44am, a baby BOY born, after having sticky shoulders (not quite a shoulder dystocia). He had APGAR scores of 7, 8 and got O2 as well. This placenta also took a long time to come..but only had 200ebl with a slight 1st degree tear.

Baby boy at 1 wk. old

That wasn't the half of it....Karissa's delivered her first of the night at 1:29am and Eileen's (who came in fully and almost pushing) delivered at 1:42am. Then Ate´Jhobee caught her baby at 3:07 am (came in almost fully), and I delivered my 2nd baby at 3:44am (another fully). Then, Karissa's 2nd labor came in at 5:23am, and literally barely got to the cubicle, and had her baby. Karissa was in the postpartum with her patient, and so I called for her to come pus-pus, and she barely had time to put gloves on before catching...  Then, Eva's continuity patient who had been laboring all night finally gave birth at 6:01am.
So, that made 7 babies born on OUR shift (including the one born at 9:28pm).

One crazy shift!! (Notice all the "Came in Fully"s)

Praise God, Krys was on Day Shift--very good, since it would have overwhelmed some of the other supervisors... Endorsements finally happened around 6:30am, since we were all still scrambling around, and I still had over half my paperwork left to finish.

Leizel and her baby boy at 3 weeks old

Worse yet, we only have 10 beds total (5 birth beds and 5 postpartum), and so my last catch had her entire 'continued postpartum' in her birthing bed because there was 'no room in the inn' in the continued postpartum area!!

So a few of us were sitting around (finally relaxing), filling out reports and talking to Krys, when an ambulance drives up and 3 EMTs carried a pregnant women in on a stretcher--to MERCY! (not to the hospital!!). This is the 2nd time ever it has happened here..and one of the funniest feelings ever. She was in active labor.

I didn't end up finishing my paperwork until almost 8am, and had finally just gone to change my clothes and barely slipped into my dress when I hear Karissa yelling that I'm needed to chart a birth!! I thought "What in the world?? They have a bunch of midwives on shift..why would they need me?!?"

Well, our Ambulance girl's baby's heart tones were way too low, and different people were busy inserting an IV, giving O2, delivering the baby, etc. etc. (and other labors were going on too). So, I guess Eva said "We need a good charter, get Sarah!" So I charted. (what an honor!) Krys was there helping to deliver the baby, and after asking if I was really up to this after a crazy night shift (which I was), she gave me a whole ton of info to write down, and at 7:47am, a beautiful baby was born.

My 22nd Catch and I at 3 weeks old

Then, another baby was born at 8:02am. Making 10 babies in 10 hours!!! When I left, they had 2 labors waiting to be admitted--one was active and the other wasn't quite. If they were both admitted, that would leave ONLY 1 spot on the board left, and NO beds!!!!

Thankfully, it was 8am, and since the minimum stay is 6 hours, there were a bunch who could be discharged..however, to be discharged, you have to have midwives available to discharge..yeah, exactly. lol I don't know how they all did it...definitely triage, I'm just glad I was on Night shift instead of Day Shift!! A little intimidating.. Talk about a crazy shift!!!

As of now today, I feel confident enough to deliver in the Bukid as a solitary midwife, which as far as I know, is what it will be. Praise God! By His grace, I know I will be a help to these women. God has shown me, as in all other things, if I look to Him in all things, He gives wisdom, strength, grace..all we had to do is receive it.

Sylvette's Bridal Shower

So, the girls and midwives at Mercy put on a lovely Bridal Shower for Sylvette (partial surprise) on Saturday.

Jamie--our wanna-be-bride (and wedding coordinator assistant)

Brittany-our Bridal Shower Coordinator

Our beautiful bride-Sylvette

Of course, there are games at a bridal shower, and the first one was TP Bride. We had the perfect model-Rodelyn, and with Ate Jobs (Sylvette's wedding coordinator), Karissa and I? She was spectacular!!

All the beautiful brides-Rodelyn with her Victorian flare, Jamie, our East India Bride, Claire with her Native American flare, and Ate´Che Che with her unique flare. 

And....we won!!! :) What gorgeous brides..

Our beautiful gwapa..secret veil necessity?? Bobby pins!!

We also played a game (adapted to midwives), where an item was called out, and the team the produced that item first out of their purses (or not) won. For example, baby powder, mirror, doppler, measuring tape, sunglasses, lipstick, bp cuff, black pens, etc. Well, my team had the most purses...and so...we won. :)

Then, Brittany interviewed Jim Harris (or Toto), Sylvette's fiance, with different questions (like how many kids he wanted, when he first met her, why he was initially attracted to her, when their first kiss was, etc.), and Sylvette was supposed to answer what she though the answer was, and then Brittany read out Jim's real answer.

Sylvette hit them all on the head, except 2 (children and first kiss).

 Merienda Dessert: Filipinos love starchy textures and fried or boiled foods.

Some traditional foods: the big round circle is made of egg and corn, with coconut on top. then boiled banana, pineapple cake, etc. 

Some of us gwapas...Rodelyn, me, Claire, Sylvette, Jamie, Karissa, and Michelle

It was such a pleasure to participate in this beautiful, simple bridal shower, which lasted only 1 hour, but was perfect in every way!! Just goes to show that bridal showers really can be cost effective and simple, and still be so much fun and God-honoring too!!

Crocodile Park/Eye Exam

With Karissa leaving on Tuesday morning early, we had our last few days together packed with not only our busy shift schedules but doing some shopping, and going to the Crocodile Park. Saturday, we went to the Crocodile Park (via motorcycle), and I showed her around (being that I went there last year).  

Trust in meeeee...trust in meeeeee.... (From The Jungle Book)

I touched it...It woke up...I jumped...It jumped..It didn't eat me.

One of the largest crocs in the world (so I'm told)

Yeah..he may look hini-hini (slow), pero (but) he is pus-pus kaayo!! (very fast)

Who ever said turtles are slow need to reanalyze that statement--they may not be jaguars, pero, they keep plodding, and this one sure can move!! 

They had an incredible FireDance show...with maybe 16 dancers and many different forms of using fire. Thought of you Samuel and Alyssa!! <3..and I have a video!! ;D

We actually went to the Crocodile Park on both Saturday and Sunday (Sunday for the show), because Sylvette's bridal shower was Saturday afternoon...(next post.) ;)

Sunday night, besides shopping before Night Shift (last post), Karissa got new glasses, and the place we went to gave free eye exams, so I got one done for the first time in maybe 4 years! I used to wear glasses, because of a timing problem in my eyes (due to my brain being lodged forward), though I was also around 70-80/50-60 near-sighted.

Ever since my brain got moved back (correcting most all of my weird physical/endocrine problems, except my height ;P), I haven't worn my glasses, but always thought my eyes still weren't quite perfect, and knew my depth perception was sometimes way off.

Karissa's old glasses are similar to mine, except mine have dark frames and are a slightly different shape..kinda fun!!

Anyway, just as I suspected, my vision is 50/25 (R/L eye)-not perfect, but no need in my mind to wear glasses, as consistent use of glasses will only make my eyes lazy. However, I may go back to wearing my old exercise glasses again sometimes... :)... Overall though, it was so good to have an eye exam as an adult versus a child who has eye problems (and wants glasses).
Praise God for His healing!! At least I can drive!!

10/20th Birth!

Another Night Shift... This birth reminds me of the song "I am My Own Grampa"...even though it has nothing even closely tied to that song... I guess, in my mind, it was because I changed it to "I am My Own Assistant"...you see, I was!! Only Ate´Estef and I were there, and with 3 other labors going on, even she wasn't there except for the bare necessities, and charted the birth, and gave Pit. That was all!! I did the rest!!!

So....I charted a birth right after Shift started--another 1st year handled!! It is so neat to see these up and coming midwives deliver their first babies!!! What a joy! So reminds me of my first..

I was 4th up, and with 3 labors admitted, I was next up. I have only gotten maybe 12 hours of sleep since Wednesday (over 5 days), and so I actually broke down and of all things, got myself a Monster (FYI: I very much dislike Monsters--maybe even hate them..so for me to get one, is like to choose to drink Pepto Bismol.) I don't want to be slacking on a night shift because of lack of sleep, and so I figured if it came to that, I'd drink my Monster and get on with life. Praise God, I didn't need to drink it tonight..so it's waiting in the fridge for next time.  :)

Since there was nothing to do--everything was already stocked, and no one needed labor/delivery help, so I decided to take a quick nap (praying that I would wake up if a labor walked in). Praise God, I woke up-instantly and quite alert when my labor walked in at 2:23am. She was 28, G3P2, and her contractions were strong, every 2-3 minutes and lasting about 30 seconds.

I did an IE at 2:50am, showing she was FULLY dilated and effaced, and +3 station, IBOW!! She had no urge to push, which we found was because she lacked the money to pay for the supplies bill right now (her bana works for the PNP-Philippines National Police). Ate´Estef talked to her about it, and she got that off her chest, she all of a sudden felt like pushing!! :)

3:10am, she started pushing, and baby was out at 3:24am. A little girl--Althea Andrew--with APGAR Scores of 8,9 and a 200cc EBL. The mom had a minimal 1st degree tear, with no need to suture. Praise God!

Baby weighed 5lbs 15oz and was 20" long.

I learned so much from this birth--having to suction and stimulate baby, check APGARs, and watch for  any gushing of blood, etc. at the same time...lots of things to do!! However, it actually wasn't that difficult--just lots of multi-tasking.

The last 3-4 births have been like this too--me being my almost assistant (though this is the only one where it is actually charted officially--before it was a 1/2 to 1/2 job between me and my Ate´). I truly believe God is allowing me this experience, to help me get fully prepared for work in the mountains, where I may not have any official 'help'...

9/19th Catch

10/25: Night Shift... My patient (21 yo, first timer) came in 5-6cm dilation at 8pm with normal vitals. When she was endorsed to me, heart tones were tachycardic (160>), which was easily fixed by Left-side lying and drinking water. Since one of the 1st years needed a labor watch, she checked vitals for me throughout her labor. Interestingly, heart tones would plummet through a contraction, and bounce back to normal afterwards.

At 11:30pm, my patient went from laboring well to vomiting up water, which she proved not to be able to hold down. She kept feeling like she wanted to push, but we knew she wasn't ready yet, and so encouraged her to breathe through contractions and  do labor stimulation.

Around 1:15am, she was starting to get exhausted, from battling the contractions and not relaxing through them, so we gave her aD5LR IV, to give her more energy. I then did an IE, which showed she was 9cm, and almost ready to start pushing. However, upon next FHT, we found heart tones had dropped to 70/80bpm, and we almost gave her O2, except that they bounced right back up after the ctx was over.

Then, BOW became visible while doing hands and knees, so we put her on the antipolo and encouraged her to push. "Khent Ruberth" was born at 2:53am in the caul (the water bag), with a nuchal cord. Talk about an interesting birth!! Boy, was that amniotic membrane hearty!! Trying to rip through it with gloves and get the cord over the baby's shoulders (since it was loose enough), took a few seconds.

APGAR Scores were 7,8, and the EBL was only 200cc. She did have a 1st degree tear which one of my Ate´s sutured...but after talking to my supers, I guess they were expecting quite a bit worse, and that the caul aided things tremendously. (Though I have to add, that it was a little scary in some respects too, partially because it is so slippery, and you're expecting it to burst in your face in your face--even with careful guarding. ;)

Khent weighed 5lb 5oz. and was 20.5" long. Another successful birth, and another variation learned. Praise God!!

Shopping with Karissa

Karissa and I are like a hand and a glove...kinda like Rachel and I. We are so opposite in personalities, but really have become very close friends, and I am going to miss her desperately when she goes back home next week....I guess that means I'll just have to draw even closer to God, since soon, that is all I'll really have--which I know is God wants.

So, yesterday, Karissa and I needed to run errands, most of which had to do with going to the bank, Al Davinco, Chinatown, and Victoria Plaza. Window shopping, and not....and well, we spent all afternoon and evening just having girl fun....much better than the malls!! I bet we walked 2.5 miles by the time we were done... Lots of memories made!!!

The following are either on our way to Chinatown (we walked) or in the shops there:

I want one!!! I love pretty things! And THIS--IS PRETTY!!

This one is for you Papa!! Thought you'd get a kick out of seeing a Sun Financial here.

Chandelier Shop

Beauts, some of them

I love how the kitty cat is sleeping on the desk while the owner is tallying sums..  

Karissa and I in the shops...all we are missing are the forehead wraps...

Department Stores fascinate me....I have read about them in books--like all the ones in WWII, etc, and in that day and age, but I'm a small town, country girl and I've never really been in them before. 

The next sentence is my version of 'Department Stores for Dummies': Department Stores are huge--many floors with many different sections, and pretty much everything you need...and lots of employees trying to help you get what you need. Oh, no taking pictures either.... ;p

Wish I'd gotten the front of this..... Anyway, this is ingenious! a key holder that looks like a beautiful garden plaque.

So, today, we went to Rose Pharmacy to get medical supplies, and stopped by the amazing Boodels for lunch first. Karissa and I got to talking about glasses (since I used to wear them), and her glasses are a similar shape to mine...so we had to take pictures. :)

 Okay...last funny story for tonight, and then I'm hitting the sack....
I just moved into the intern room yesterday (with Karissa's help), which'll be nice to get my junk sorted and packed for Butuan.. Anyway, I decided to blog in there tonight and get some more stuff moved around, and got a lot of stuff done. Then, my computer was running out of power, so I went to get my cord, and when I came back, I started climbing onto the top bunk again, and it fell in!!!!

I guess the big metal bedframe is just standing there--no bolts attached--yikes!!!! Good thing there was no one sleeping underneath, otherwise, I'm afraid they'd be either be done in or in the hospital--literally!

So, ya know what they say: "If ya get bucked off, try it again", so I put it back together, and tried again (more carefully)...and boom! Same thing... Poor invisible person! They've died twice now...

Guess I'll trash that idea! :) Don't want the 3rd time to be the charm and the invisi-person to suddenly show up in ghost form!! ;D

8/18th Catch!

10/23 Swing Shift. I learned so much at this birth...another pus-pus kaayo daghang (very, very, much fast kaayo) birth...

My patient was Lani "Perfect" (the meaning of her last name) :). And perfectly sweet, she was! Experienced too...33yo and G4P3 with her youngest being 9yo.

Lani and I have a history together, which started last month, when I was endorsed her on Swing Shift on 9/25, when she was supposedly 41 6/7 (meaning if she didn't have her baby that night, she'd be 'post'term', and we wouldn't be able to deliver the baby). Her ctx were very spaced out, so I helped 2 doses of Castor Oil with OJ. She did labor stim constantly, but after an IE was done, showing a funneled cervix and only 1-2 cm, we sent her home with instructions to come back at 9am so we could transport her to the hospital for further evaluation if she hadn't already given birth.
She came back the next morning, and was transported.

So, imagine my surprise, when I see her walking into prenatals this morning (in early labor-2cm)! (I couldn't exactly place her, but knew I knew her). Then, when she came back later in labor, we both had to laugh...since we knew each other from the past. I guess, she had an ultrasound, showing her dates were off (which we knew something was off already, because her FH was off every time the past few prenatals)....

Anyway, when she came back on Swing shift at 2:59pm, she was 4cm, and had borderline hypertension, so we took necessary treatments and monitored it. At 3:50, she felt the need to push, and then all of a sudden, baby was out at 3:54pm... I called out for Ate´Erms to come pus-pus, and baby BOY! was out before you could blink almost--with tons of thick mec. stain.... Afterwards, we joked who was the assistant...because I was pretty much everything, and everything from the time she felt she needed to push until after baby was out was charted---after baby was out. ;)

Surprisingly (for the thick mec stain), baby only needed Bulb-syringed and had APGAR Scores of 9 and 9 (the last 9, I almost gave a 10, but had to find something off, because he couldn't be perfect...)
There was no tear, only a skin split, praise God!, and EBL was 250 cc. The placenta was greenish colored, from the thick mec stain...really--different.

The baby was transported shortly after birth (after a good nursing and the newborn exam--6lb 15oz, and 19" long), due to the thick mec stain, and tachypnea (fast respirations). Last I heard (today), he is still in the hospital...and I'm not exactly sure why...hopefully not sepsis!

It's kind of a miracle that I got to deliver this baby, because I was NOT first up...however, the girl who was first up was in class, and so I was first up until she got back---bb was born before she even got out of class. Though I feel sorry for her, because she really wanted to deliver one on shift (which didn't happen), I am so grateful God gave me Lani back....

7th/17th Catch!

10/22 Swing Shift. Seems like all these last few things I have had something especially something different....and learned something new (oh wait, isn't that why I'm here? To learn?? ;p)

My patient-Annie's labor started at 7am. (32 yo, and G5P3M1) She came at 6:03pm after working all day at the diesel pump (through her labor). SROM-Light Stain at 6:23pm. IE Done done immediately, showing 8-9cm dilation, very effaced and +2 station.

She was hypertensive (144/100), and so we took necessary treatment steps, including inserting an D5 IV in her cephalic vein, having her drink water, and left-side lie. At 6:40pm, she tried pushing, and at 6:45pm, baby BOY--pus-pus kaayo! (very, very fast)--with a body wrap. So fast in fact, that my supervisor was there with me for the birth, and Ate´Elsa came and charted, but since we had another gal pushing at the same time....I was partly my own assistant! (Though Ate´Else helped too.) :)

APGAR Scores of 8 and 8 and an EBL of 250cc (200cc of which was trapped inside the membranes). Had to use hemostats to remove her trailing membranes, and she had a 1st degree tear, which Ate´Elsa decided to suturd.

They named him Khalel. He weighed 6lbs 7 oz and was 20.75" long.