So. I have neglected this blog.  A lot.  For a time it was lack of time, lack of initiative, lack of inspiration.  The last year has been from an over abundance of pain, sorrow, and soul breaking loss. In March of 2014 I was taking care of a dear friend in labor.  She delivered a beautiful baby girl, a baby she had tried for two years to conceive.  And then everything went sideways.  She started to bleed and nothing we did seemed to help.  All the experience I've had with high risk obstetrics, all the post partum hemorrhages I have been a part of, all of it meant nothing.  She fought a good fight, but it wasn't enough to tie her to this earth, to tie her to us.   She was my patient but she was also my coworker and my friend.  It's bad enough I couldn't save my patient, but to not be able to save my friend is devastating.  It has fundamentally changed me, not only as a nurse, but as a person.  Everything I knew to be true, is no longer true.  I feel as if I failed her.  Afterwards, her mother came to me and said "She told me she trusted you with her life." I know she meant that I did all I could, she wasn't blaming me, but I blame myself.  What didn't I know?  What should I have done differently?  Could advancing my education with an advance degree have helped?  There are no answers for me.  The hospital did a Risk Cause Analysis, and allowed us to review it.  After it had gone to Big Navy and the Joint Commission.  I read the review and was astounded at how the timeline was wrong, how events were out of order, how events were even completely missing.  So, not only do I have my own guilt, now it looks like I don't know my ass from a hole in the ground. Rage is also  something I am well acquainted with.

But, I keep going to work.  I keep doing my job, and fighting to be me.  I tell myself and others it's my way of honoring her.  Continuing to do the job she always wanted to do.  And it is. I don't think badly of those who could not continuing working where we all experienced such a horrifying tragedy; far from it.  We all have our trials, and we all have to do wheat's best for ourselves in any situation.  I feel like my life is a giant Jenga game; let's pull this piece from your foundation and see if you can remain standing! It's not my first rodeo with grieving, and I know the second year is always the worst.  When the bad times hit, they are really bad. I swing from incredibly high to crawling into a hole low.  Sometimes all I want to do at work is stay in my room and not interact with anyone but my patient and her family.  Then again, sometimes the last thing I want is to be anywhere near a pregnant woman.  My logical, critical thinking brain takes a hike if I see any tinge of blood in a catheter.  I know that it's the position of that baby's head on mom's bladder, but I am instantly thrown back into that labor room.  Was that the moment she went into DIC? Could I have changed to outcome at that point?  The logical answer is no.  I know that.  I have spent the last 15 1/2 months reliving March 9th over and over again, just trying to see if I can spot a point when we could or should have done something different.  If we could have gotten a second line in, if the art lines hadn't have failed, if the IO hadn't failed, oh my God, we stuck her everywhere. To no avail.  I have no way to reconcile what happened and why it happened.  I've seen worse hemorrhages and my patient lived; why was this different?  Why couldn't she stay?  I have no answers.

She was a beautiful, caring, loving, funny wife, mother, friend, nurse, and Naval officer.  Her name is Moani.  So, in respect for Mo and in her honor, I'm posting the song her parents sang at her memorial before she went home to Hawaii.

I have a raging case of insomnia.  Which is a little upsetting, since it's been so long since I've had to deal with it.  But, it's now 0200, I've been up since midnight, and my alarm goes off in two hours.  Awesome.  I even tried sending myself back to sleep with my good, old standby, self1induced orgasm.  No dice.  Well, hell.  That was a waste of battery power.  To make matters worse, I woke up singing "The Sounds of Silence." Yeah, that helps.  And, because my brain works this way, I began singing this to the tune:

Hello, Insomnia my old friend,
I see you're keeping me up again.
Now is the time I should be sleeping,
Not around the house creeping,
And I'm so tired
I can't remember my name
I'm going insane
With you, Insomnia.

Okay, so it's not great, but I could have done worse at this time of day on three hours of sleep.  And I should apologize ahead of time for the raging bitch fest that's coming towards my co-workers.  *sigh*  Sorry about that.

Will this make it better?

You want to know the absolute, worst feeling in the world?  It's when the most important and needed thing you want say to someone is the least wanted thing to be heard.  And then knowing that's the case.  And still wanting to say it every day, in every way.  But not doing it, so that no one is "uncomfortable."  Oh, well; fuck 'em if they can't take a joke.  My new(ish) philosophy.  Like the Ministy of Magic, I remain....strong.  (And, apparently, a giant nerd.)

This calls for some Tina.  

So much for my determination to blog more often.  Eh, life happens.  And in response to my shame at not blogging, here ya go:

Part two

I do believe I found the problem with my Ensign.  Anyone who knows me knows I like unmedicated labors or I like patient's who are almost circling the drain; give me a patient on Mag, Insulin, and Pit with a side order of pressor drugs and I'm one happy camper. I love me some adrenaline!  Don't get me wrong; normal, uncomplicated labors with epidurals and c-sections have the effect on me to a degree.  Seeing a family made complete, a new mom and dad enjoying this little person they've been wanting to meet for so long is amazing and humbling no matter how the kiddo comes out, or the circumstances surrounding the birth.  But day after day of induction, epidural, induction, epidural has a Groundhog Day effect and can leave me wondering if I need to change jobs for a little while.  Add in to this stew of ennui, a clueless Ensign who can't seem to grasp what the hell is going on no matter how many times I tell her, and I'm about to pull her hair out, along with my own, and weave a raft to paddle my happy little ass away from this Island of Frustration.

The other day I had her running triage with the understanding that the first patient through the door, in labor, was ours for delivery.  She needs to get the hang of the rapid changes that can occur during delivery and the need to multi-task with, sometimes, three different people asking you for something at once.  She's a very concrete thinker, and in high stress situations, tends to get ye olde "deer in the headlights" look about her.  Anyway, this young lady comes in to triage, it's her second baby, she is found to be 5 centimeters and she is adamant about not having an epidural.  Fine.  She "caved" (her words) during her last delivery and wanedt to avoid the word even being mentioned in her presence this time.  I told Ens. Getaclue that the patient and her husband needed to come up with a code word, known only to them, that, if she changed her mind and said it, would allow us to get her whatever pain management she wanted,  Otherwise, we would comply with her wishes and not talk to her about epidural even if she requested one.  (Some mamas, in the throes of transition, have been know to promise to give out the launch codes if they can just have an epidural.  This is transition speaking, not the mother's desire.  Unless she throws out the code word, like, say "chimichanga" and then her support person lets us know the patient is indeed serious about her desire to make this madness stop,)  We had been busier than a one legged man in an ass kicking contest lately, so we only had one room available and it had recently been cleaned.  The corpsmen were in the process of putting it back together and stocking it, so the patient was going to ambulate in the halls for a little while, unil the room was ready and then we would finish the admission process.  Which in this hospital meas at least IV access and labs for all laboring patients. As I am very territorial and have a definite "see a need, fill a need" mentality, I have not allowed myself to be in the room with Ens. Getaclue, unless she specifically asks for me.  So, I'm in the nurse's station, pacing back and forth (I hate not having anything to do) when I see this patient ambulating in the halls.  Then stop.  Get a death grip on the railing, bend her knees and breathe through a contraction.  "Shit, oh dear, " I think to myself.  I go to the room designated for her use and ask one of the minions if the room was about ready.  They only had linen left to stock in the room, so I said, "That can be done while she's in the room."  I urged the patient into the room and asked if she was interested in the tub.  She said, definitely, and since it takes roughly a millenium to fill, I started the water then went to tell the corpsman to set up a table.  The Ensign went in to start her IV, missed and asked me to come try.  I go in the room and wait while the patient signs her consents.  As I'm putting on the tourniquet she asks when she can get in the tub, and I told her if she wanted she could go right now and I could start her IV in there.  She jumps up, speed walks to the bathroom, and starts disrobing faster than a sophmore on prom night.  As she gets in the tub, she visibly relaxes and I say, "Awesome, right?" to which she replies, "Ten times better."  She has a contraction that she deals well with, kneeling in the tub surrounded by lovely water.  I
 put on the tourniquet to finally get this IV in, and she says, "You might want to wait...." So I release the tourniquet and she starts moaning, her eyes get the size of hubcaps, and she moves to where she is now sitting in the tub. I ask, "What are you feeling? knowing damn well what the answer is going to be, and she wails, "Lots of pressure!" with "pressure" being said on a gutteral growl that pretty much means "tape the windows, baby here comes the hurricane."  I, being much experienced and knowing that if I have a baby in this tub, the psycho doctor that's on the deck will make damn sure it's a blazing day in the ol' PacNW before a laboring patient gets in the tub if she's more than 2 centimeters, so I did the only thing I could; I shoved my arm into the water and stuck my left (and only gloved) hand onto her vulva, told her to blow and not push as I feel her perineum, and therefore the baby 's head, bulging into my hand.
I asked the Ensign to drain the tub and go get the doctor.  Then, as I felt her standing there looking at me, I looked her dead in the eyes and clearly stated, "Drain.  This.  Tub.  Go.  Get.  The.  Doctor."  This made some impact on her psyche, as she left the bathroom and returned with a physician.  By this time, the patient had enough clarity to say, "I'm ready, " flung her arms around my neck, I pulled her from the tub and she sprinted, literally sprinted, to the bed.  She crawled on it, about four seconds later her water broke, she looked at me and said, "What do I do???"  I told her to push her baby out, and voila!  Undmedicated birth, just like she wanted.  I was so stoked, you could have powered a small country with the energy I was feeling!  I was dancing around saying, "Oh my god, I DO love my job!"  And after this beautiful, natural, wonderful delivery, my Ensign came up to me and said, "I did NOT like that.  That scared the shit out of me."  And therein lies our problem.  Perhaps this is not the specialty for you, sister.  

Argh!  Just went to buy tickets for me and the boys for Brian Regan, coming to Skedaddle on March 23rd.  Figured it would be a fine way to help celebrate what would have been my 15h anniversary (March 21st), and what better way than to spend it with the boys, seeing a comedian that we all enjoy, as did their dad.  Yep, perfect plan.  I was on the website, ready to click "buy" when I said to myself, "Self, you should just double check that that is your weekend off."  Alas, alackaday, it is not.  Poop!  I guess that just saved me $160 bucks, but I'd much rather have gone to see him.

We just got back from Hansel and Gretel well, FB and I did, SoS declined. So, we took him over to Grandma's house with his brand new copy of Hotel Transylvania. And about three seconds into the start of our movie, I turned to FB and said, "It's a good thing SoS didn't want to come." To which FB replied, "Yeah, he'd have nightmares until he was forty." Needless to say, there were some elements of the film not for those of tender years or faint of heart. Despite the rather young children I saw in the theater. It was a fun film, with some serious action and some equally serious gore. Mwahahahaha! Of course, I wouldn't have cared what was happening as soon as Jeremy Renner took off his shirt. *sigh* This isn't without his shirt, but it has a nice brooding quality:

Also not shirtless, but you can see the potential:

And here, it just seems like my kind of guy:

Okay, so I have been slacking a tad, but I have good reason.  First, I actually started writing the previous post the second week of January.  And then my laptop ate itself.  I took it in to get it resurrected and, after three weeks of silence, called to see what the dealio was.  Hard drive trashed.  Not sure why this keeps happening.  Perhaps it's the porn.  I kid.  Why question mark because I love exclamation point.  Anyway, just got my new laptop today, and because I am incapable of waiting for anything, I bought it yesterday and had it overnight shipped.  Hey!  It was an option and only cost 45 dollars.  Seemed ridiculous to not take advantage.I have many posts floating in my head.  One would hope that I can actually get them out and they will be half as funny here as they are when I'm thinking of them.  And if not, I'll just post lots of man candy. Like, say, this one:

It's a new year!  It feels the same.  It usually does.  But, since I'm rapidly approaching 46 (*gasp*), I'm getting to where I am cutting dead wood left and right.  I don't have time to waste with unimportant situations people; I may be dead any second.  (Sorry, my 12 year old self sometimes intervenes and regards my age like unto Methuselah.)

As a final "F you" before she got out of the Navy, one of my bosses scheduled me to work Christmas Eve, Christmas Day, and the day after Christmas.  Let's talk about how ecstatic my mother was to hear this news.  Yikes.  We all survived, but I'm not sure we've all forgiven. :)  And. in true holiday fashion, I got pulled over for speeding on Christmas. Just hear how this went down.  My neighborhood abuts a gated community.  Because we were here first, we get the right of way and the inhabitants of the enclave have to cool their heels for a bit at a stop sign while I go sailing blithely past.  So I did.  The car that had to wait followed me down the hill and around the first (yes, there is more than one) roundabout.  As we crossed the overpass on the way into the second roundabout, this car suddenly swerves around me and goes flying onto the freeway.  I noticed it was a sheriff's car. Hmmm... he must have received a call and is now in high speed pursuit.  I continued to ponder this until I came up on the same sheriff's vehicle on the highway.  Going maybe, 55.  I moved over to the passing lane, and, just as pulled even, the sheriff took off at about 80 or 90.  Ooookaaaaay. Perhaps they had cancelled the first high speed pursuit, and substituted this one in it's place.  I move back into the right hand lane.  And about five minutes later, come up on this same cop.  As I start to move to the passing lane, so as not to tailgate this officer, (s)he swerves onto the shoulder.  I now no longer believe that this is a cop, but rather a cop's child who has taken the vehicle without permission to do God knows what.  As I'm contemplating whether I should call in such erratic behavior, the sheriff comes up behind me, moves over to pass me, and rides my rear corner panel for about 15 minutes.  At which point, I have now dropped down to 40, because it's the speed limit, and he decides to pull me over.  When his lights went on, I've got to tell you, my first reaction wasn't "Damn, I'm getting pulled over."  It was, "Who is he getting?" Rapidly followed by, "Oh, I'm getting pulled over." I pull over, put on my flashers, roll down the passenger's side window, and have my documents ready to hand over when this dude comes sidling up to my car, peeks around the door frame like we're in downtown Detroit, or at least, T-town, shines his Bigfoot sized Maglite in my face, and asks, "Are you going somewhere this morning?"  No sir, I routinely drive around randomly at 0630 on Christmas Day.  I did not, in fact, say that.  But I thought it. I hand over the goods and he questions me as to if I knew how fast I was going.  I gave him a blank look and said, "Just now?"  He said, "No, when you came up behind me." Now, of course my first reaction was to ask, "Which time?", but as I have gained some maturity and caution in the years I've been on this earth, I said, "Ummm, 60?  I had the cruise control on,"  He proceeded to explain that my cruise control must be faulty because he clocked me going 67 (Really?  While you too were in motion? Interesting.) until I got down to 40 and he pulled me over.  (Yes, after the fact when I was going the speed limit.) Then, without ever looking at my documents, he handed them back and told me to slow it down.  So, I can only deduce that one should not drive anywhere around a county sheriff when he is resenting working on Christmas Day.

So, I had a date the other day.  This is an unusual event for me since I haven't had one since Super Hot Slice O' Cuteness left for all points Thailand, found the love of his life (whaddya mean it wasn't me??), and started to procreate.  This all started with a friend harassing her husband about what is wrong with men that don't see some bonus is being with a woman who has a freezer full of meat, no less than seven channels of ESPN, and counts Die Hard as one of her favorite movies, continued with a drunk doctor asking me at the Christmas party, "Why are you single?" (Because I asked for the thrill of being widowed?  What kind of a question is that?), and ended with a blind date.  Me, being me, became more anxious as time went on, let my imagination run wild and thoughts of a hundred horrors that could go wrong from me being 20 minutes late and him thinking I had stood him up (which happened on my first (blind) date with the man who became my hubster), to me suffering a tragic fondue accident that would lead this poor man to needing me to be incarcerated for severe nerdiness.

All this led me to ponder the gender differences in date preparation.  I'm sure his preparation began that morning with a close shave and taking a change of clothes in to work, with a possible freshening shower 15 minutes before he left to meet me.  Women, on the other hand, usually need a few days to prep.  For instance, about three days before, we look in our closet and realize we have absolutely NOTHING TO WEAR!!  Which requires a woman to do her best Darryl Waltrip impersonation on the way to buy at least one suitable article of clothing.  You know, dress to impress, but don't set the bar so high you have to reach that acme every single time you go out.  Then, two days before the date, you have to finalize the ensemble: coordinate the shirt, undershirt, pants, shoes, makeup, hairstyle, and jewelry.  Perfection.  The day before the date there is the microdermabrasion of the face, mud mask to draw out impurities and heavy duty, night time hydrating lotion to prepare the canvas of your face for the next night.  And let's not forget the pregame shaving of whatever needs it.  Whether it will be seen or not.  *ahem*  The day of said date is spent relaxing and finalizing your plan for cleansing, perfuming, primping and dressing. Voila!  Perfection personified!  Unless you're me. Then, in an effort to keep yourself from totally chickening out,  you spend the entire day cleaning like a meth addict on a three day binge, until you see your face in the granite counter tops and one could serve Christmas dinner off the baseboards.

I am a orienting a new nurse at work.  And when I say, new, I don't mean just to labor and delivery.  I mean new to nursing, fresh graduate, holy-cow-I-have-to-break-everything-down-to-it's-simplest-parts, new. I may be getting too old for this, because, much as I tell myself that I was new once, everyone learns at a different pace, she has a huge learning curve facing her, all I feel in my head is that I am Kevin Costner as Crash Davis in Bull Durham when he gets sent down to A ball and says, "Yeah, well, my triple A contract gets bought out so I can hold the flavor of the month's stick in the bus leagues. Well, fuck this fucking game!"  I wish I could find a clip for it, because it's just pure truth at this point.  I'm going to blame my attitude on lack of interest in my girly parts from anyone of the non battery persuasion and the stress of the holidays.  Yeah, that sounds good.

It is a fact universally acknowledged that, when it comes to my patients, I am a tad territorial.  Think nesting alligator territorial.  This is usually not a problem since everyone is aware of it, I do my job and do it competently, and I'm nice about my territorialism, until someone gives me a reason to not be nice about it.  I love my job and I know when I need help , which is why I decline offers of help until I need it.  I know how I like things done and I'm severely anal about how things are done.  Why that doesn't overflow into my home life I have no idea. In spite of all this, or in a vain effort to change the way I am, I get a lot of students, orientees, and preceptees.  Right now, I have a brand new grad that I am orienting.  Which means not only is she new to nursing and nursing process, she is new to labor and delivery.  So, I have to explain a pretty much everything and make sure she is understanding why I am doing something.  This is not a problem, other than the fact that I have to make sure I am telling her what she should do, instead of what I have found to be the most efficient way to do something.  Totally a case of "do as I say, not as I do."  Develop your own bad habits, because I don't want to be blamed for them! She's going to do fine, but has said a couple of times, "Do you think I could do more stuff?"  Yes!  I do!  But you have to tell me to back off, because if I see something that needs to be done, I'm going to do it! It will make me crazy not to.  So, that's our goal for next week, for me to back the hell up and actually let her do the patient care.  We've just got to work on time management a little more...

So, New Grad showed up on Wednesday wearing a mask.  She told me, "They said I should wear a mask in patient care, but I feel much better than I did yesterday and last week."  Awesome.  So, after close contact with her at the desk, (not to mention last week when she was completely INFECTIOUS) along about the end of the shift, I started feeling like caca-doody.  I had thought the constant tickle in my throat all day was from trying to kill myself drinking water on the way in.  But alas, it was not to be.  I went to bed, hacked my way through the night and woke up feeling as though I'd been dead three days.  I was working an 11-19 shift, so I went to buy some herbal wellness drops and some DayQuil.  I know it's a little odd to buy naturopathic remedies with mainstream meds, but I was desperate.  I'm sure the herbal stuff is more placebo effect than not, but whatever.  So, I down those, get to work where I, once again, have to park at the helipad.  The parking lot and the grass overflow were both full and I was thinking of ramming the fence to the softball fields when a gentleman, who had to be a retired chief, flagged me down for his spot.  And wouldn't let any of the other cars looking for parking as well, park there. :) I went in to work and immediately got a mask.  My orientee saw me and asked why I was wearing a mask at the desk.  I replied that I didn't want to infect anyone with the Black Plague, cuz I'm considerate like that.  Yeah, it was shitty.  What of it?  I spent the next 8 hours explaining that I was sick, I wasn't desiring to be an OR nurse, and no, it is not an effective muzzling tool.  I had a change of shift delivery which put me home in time to send the kids straight to bed.  I was coughing my lungs out, expecting to see my toenail polish at anytime, and wishing for some cough syrup with codeine.  It's great for uncontrolled coughs.  Hey! I thought.  I have Mucinex, which is guaifenesin (cough syrup) and I have Percocet.  That has to be nearly the same thing as guaifenesin and codeine, right?  Right! So, with my little nurse-y brain convincing me that it was totally okay, I hammered back the Mucinex and chased it with a Perky treat.  It wasn't until this morning as I popped more DayQuil, that I realized the Mucinex wasn't straight up Mucinex, but Mucinex Cold and Flu.  Which has acetaminophen in it.  As does Percocet.  And DayQuil.  A quick calculation brought to my attention that I was kind of pushing the lowered maximum daily dosage for ye olde acetaminophen.  So, then I did the standard medical professional thing and thought, "It's fine for me though."   I continued the cough fest throughout the day, which included taking tackling a cat on the kitchen floor so I could take him to get his rabies shot (how do they know it's time to go to the vet?? He's not literate, so I know he isn't reading it off the calendar!) and wrestling to freaks of nature to the groomer.  The DayQuil wasn't cutting it in that department, so then I started swilling Delsym straight out of the bottle like it was Jameson and I was at an Irish wake.  At this point, I now longer cared that it was a once a day dosing of two teaspoons and that gauging I hadn't exceeded that by "it didn't feel like two teaspoons in my mouth" probably wasn't the most accurate methodology.

Once in a while it's kind of fun to look at the stats and see what actually brings a person to the blog.  Here's one of the search terms: "booba bouncing while she rides cock."  Whiskey Tango Foxtrot?!?!?

I was inventorying the kids' Halloween candy (read: pilfering their hard begged candy to feed my nefarious, and ginormous, sugar jones), when I ran across a bag of fruit snacks.  Fruit snacks?!?  Who the hell gives out fruit snacks?  Don't they know that they are treading a dangerous line, preventing middle aged women from getting a chocolate fix?  Seriously, if you give out fruit snacks, good for you for not bowing to commercial pressure and trying to stem the tide of childhood obesity in your own small way.  But, you suck, and it doesn't make you better than I.  So there.

My career choice, and the fact that I practice it in a part of the country/state I live in that likes to "grow 'em big," has resulted in chronic back pain that has escalated in the last 6 months to DEFCON 1 on the old pain scale.  (Not to be bothered with the FACES or numeric pain scale, I prefer to gauge my personal pain based on the defense level light board from WarGames.) I don't know why 14 years of hauling 200+ lbs of healthy womanhood and feti (plural of "fetus" that I just made up), epiduralized up to the nipple line (or "tittehs" as I have a tendency to say), would cause a condition that affects my quality of life, but it does.  I actually made an appointment with my well loved, but seldom seen, PCM, PCP, FP, GP, or whatever the hell we are calling them this week, to get a referral for physical therapy and/or chiropractic care (so I can continue to work, keep a roof over our heads, put food on the table, edification in my children's expanding minds, and keep FBs orthodontia from making us destitute), and not, I repeat NOT, to seek drugs as I think pretty much anyone I work with partially believes I am wont to do.  Methinks,  I wax Percocet poetic far too often.  Well, I received my referral, but I got meds without even asking.  Of course, these meds put me in the drool locker, thereby making them inappropriate to take at work.  That's not the only reason I can't take them at work, but it's a pretty good one.  So, when I get home after a rough day of helping women through the joy of childbirth and get all the animals, both bipedal and quadrapedal settled for the night, I get to pop my little cocktail of joy.  And spend the next 4-6 hours blissfully trying to scratch my skin off, but not really caring.

So, the Lawn Boy is still maintaining my lawn, but is no longer maintaining my lawn, if you get the way I'm drifting.  Seems that his life is a little too complicated and chaotic to have anyone else in it.  And I respect that.  His life is no different now than it was a year ago when we started this whole, whatever it is, but, okay, he feels what he feels.  I'm letting it go because I was widowed at 38 and know  life is too short to want someone who doesn't want me.  Got it.  Loud and clear.  So, I'm back to being me and the boys, doing what we do, and luckily,  I'm okay with being alone.  If it doesn't drop in my lap, it's probably not going to happen.  I work 12 hour shifts, I have a teenager and a tweener, and I have no time or energy left over for high speed pursuits. Although, I do miss having somebody just want to spend time with me, laugh, kiss, and oh, goodness, do I miss sex. Y'know...with someone else involved.  I get plenty one on one time.  Good thing batteries are fairly inexpensive.

I had a patient the other day that made me feel like I was back working at Big City Hospital.  She had no prenatal care that we could discern, despite her claiming that she had.  So, on a closing note, I just wanted to reiterate a few truisms from the labor and delivery world.  Ahem....

1. We live in the 21st century, not the 19th.  Records are electronic and easily verified.  By the time you tell me you got some care "in California" I have already received confirmation that you have never been heard of by any of the facilities you told me had seen you.

2.  Claiming we lost your records instead of confessing to no prenatal care also doesn't work.  Especially when the doctors you claim to have seen are on the floor and have never heard of you.

3. Please don't insult our intelligence when your "38 week" baby  is delivered and is clearly 33 weeks by saying we're wrong because there is no way you could have had sex when your husband was out to sea.  We are well aware that you can.  And did.

4. If you are a military dependent you should realize that we will get in touch with your husband's command and inform them that you had no prenatal care.  And then his ass is in a sling.  As well as yours will be when he finds out the baby is presenting as 33 weeks gestation.  See above.

5.  Screaming and breathing like you are giving birth to a Blue whale, will not put you into labor.  It will also not change your cervix from 2 centimeters.  Only labor contractions will do that.

6.  Simulating contractions while on the monitor will also not change your cervix.

7. We are professionals who look at fetal monitors A LOT. We can tell the difference between a real contraction and your little ab workout you are practicing in the triage room.

8. Throwing yourself on the floor, or better yet, out of the car at the gate and scaring the shit out of security without a person coming out of your body, RIGHT FREAKING NOW, does not impress us.  We will scoff.
9. Please remember what happens to post coital semen when you were not pregnant.  The same thing happens when you are.  Don't think your water has broken EVERY SINGLE TIME. If you insist on doing this, we will insist you stop having the sex.  Fair warning.

10.  If your water has broken, please let us know so we can best advise you.  Please don't stay home for two days, "because I didn't have contractions."  You will possibly come in infected and with a baby who is most displeased with its habitat and then every body gets cranky.

11. Remember I actually do love my job and it's my job to help you have the best labor/delivery experience possible, following your birth plan as closely as possible while still having a happy, healthy mom and a happy, healthy baby.  That is the ultimate goal.  Hospitals and the medical team are not inherently evil and do not look for every way possible to thwart your wishes.  Be informed, be flexible, work with your care team and make sure you fully understand everything that is being presented to you so you can make informed decisions with your care team.  If you believe our goal is to deprive you of your birth plan and discount your wishes, perhaps this is not the best place for you to deliver.

The Percocet is kicking in and I have to buy donuts tomorrow.  Good night.

Just in case there were any questions. It's still me. :)

It's September once again.  Only this September makes it seven years since Steve died; the same amount of time we were actually married.  The grief is seven years old, the healing is seven years old, the boys are seven years older.  And yet the rage is bigger and newer than ever.  I am angrier than I've ever been, but it's a weird anger.  It's there all the time, fermenting until some event or thought acts as a catalyst and it erupts like a psychic Vesuvius, flowing brief and hot until I can wrestle it underground again.  Isn't that what Mark Ruffalo said as the Dr. Banner in The Avengers? My secret is I'm always angry?  Yeah, that's my secret. I've warned my coworkers and my poor corpsmen to watch out for Queen Bitch of the Universe; she may be in attendance more often than not. Not that I want to be bitchy, or even plan to be.  But, I've already caught myself snapping at the kids (which, frankly, may be attributed to them really, really, REALLY needing to go back to school.  2 days, baby!), which I apologize for, and everyone, absolutely everyone, drives me insane!  Just the thought of them converting oxygen to CO2 makes me want to stab them straight in the throat.  *sigh*  Probably doesn't help that fate tried to beat the shit out of me by letting the young man I had great hopes of being with on a permanent basis decide that his life was far too complicated to complicate further. Kind of like, "I need some space.  Without you in it." (totally stolen from Jeff Foxworthy)  Gee, that's information that would have been a little more useful to me 6-8 months ago, rather than being dropped like a hanta virus infected rat.  And right at this time of year.  Awesome.  I drank myself into a good mood last night but woke up this morning with both my laptop and my wallet open.  That can't be a good sign. There's not too much more that I can pierce, since I do have to maintain a professional appearance, and my face is off limits.  As is my tongue.  I need to be able clearly articulate when I think a doctor is being a complete jackass.  I could stick a few more holes in my ears.  I'm desperately trying to avoid a major purchase, since I can pay off the Tahoe (another September extravaganza) in about 6 months. I am a pragmatic person 11 months out of the year, and then September rolls around and I kind of lose my shit.  Deep down I know I should get a grip and stay in control, but, as I may have mentioned before, I am a tad irritated.  

Me (explaining to her husband why my patient is comatose in between her contractions during her long, unmedicated labor): "It's mother nature's way of conserving energy so she can deal with her contractions and then have the strength to push."

Husband (gazing at wife who has abruptly awakened and is now breathing through contraction): "So, it's like sleeping with a snooze alarm."

Me: "Yeah.  A snooze alarm from hell."

I had a massage today and I swear my massage therapist was channeling one of the more motivated of the Gestapo elite.  I'm not so sure a "relaxation" massage should have me wishing for bamboo shoots under the fingernails because it would be less painful.  I've been having a lot of low back pain which is due, I'm sure, to 13 years of lugging epiduralized women around in bed, using equipment that was designed by a random engineer and not by someone who would actually use it (i.e. hardly functional and not nearly ergonomically correct), and packing half my life in my Big Ass Bag everyday to work.  One might think the BAB could be lightened, but I've tried and I can't.  I NEED everything in that bag like I need air to breathe. Honest.  Anyway, little Miss Mengele today suggested next time we work on my psoas and deep abdominal muscles but she warned me "it will be painful.  I just had it done and I screamed."  Awesome.  I'm already breathing like I'm in transition, let's add the sensation of crowning a 12 pound baby into the equation.  That should be fun.  I did feel better afterward, but then I screwed it up by staining the big toy.  You know, those big wooden play structures seen in all the best playgrounds and yuppie housing developments? Mine has been well loved and well neglected for the past 8 years.  Why not stain it when there's. more than likely only two years left before I tear it down, use it for firewood, and set up a bitchin' outdoor living room in it's place?  Lots of climbing up and down ladders, figuring out the best logistics so as not to paint myself, literally, into a corner, and cussing the amount of Solid Color Weatherproofing Deck and Fence Stain in Russet it takes to cover wood that has seen 8 years of Pac NW winters.  Sucks it up like a sponge.  Not to mention the amount of lichen that had grown on the roof of this bad boy.  I did attempt to do the responsible, anal personality I try to hide, thing and clean all of it off, but it proved more stubborn than I.  And as it's about 15 feet in the air at the peak, I think I can be forgiven for saying, "Fuck it!" and painting over all of the little symbiotic vegetation. (Before you judge, please reference the above "2 years before I trash it" explanation above.)

It was also 88 degrees today, which, for we poor Pac NWsters, is akin to living on the surface of the sun. Despite the level of SPF I slather on on a daily basis, my face looks like half of Richard Dreyfuss' in Close Encounters of the Third Kind. As I turn into Queen Bitch of the Universe the hotter it is (see, there are reasons I no longer live in North Carolina or Utah), I'm trying to convince myself it's actually cooler by watching Slap Shot and Fargo.  So far it hasn't lulled me into thinking my brains are not boiling in my head, but I remain optimistic.

The Senior Chief retired. This is a video commemorating his 22 years of service in the Navy. It never fails to make me tear up. I am so proud of him and so honored to be considered his "second wife." Congratulations, fair winds and following seas, Senior, and thank you for so many years of your service. Love you! (P.S one of my amazing corpsmen can be seen at the end) \

I love Mike Rowe in every way, shape, and form. And he just solidified it.

Mother of a teenager.  That should almost be a cuss word.  In fact, I may start using it as one.  Some may remember, that in FB's 5th grade year, some of the little girlies on the bus were found to be engaging in oral gratification for some of the boys.  This "in fellatio delicto" activity spawned a conversational tsunami of sexual and pharmacological rhetoric that I subjected FB to while trapped in the car on the way to see Michael, The Incredibly Gay Hairdresser.  This door having been opened, I thought perhaps I was free from revisiting the subject ( I seriously scarred him, I swear.) until the summer before he enters high school.  Which is next summer.  I may faint.  Refocusing on what I meant to write about, last night I went into FB's room to tell him it was time to ready for bed.  He was sitting at his desk, something he never does during the school year, by the way, writing something.  Something he didn't want me to see as he covered it with his hand as I walked in. Our conversation was as follows:
Me: "Hey, have you brushed your teeth and washed your face?"
FB: "Not yet." (Now moving his arm to fully cover what he was doing.)
Me: "You should get on that."
FB: "Okay." (Not moving from where he sat)
Me: (pause) "Like, now."
FB: "Okay" (Still sitting)
Me: (Backing cautiously out of his room) "Alrighty then."

I faked like I was going to my own room, and as he walked into the bathroom, ran back to his desk to see what exactly needed to be hidden from the all knowing eyes of the mommy.  I saw this: "Athena is the smartest, coolest, most beautiful..." and it left off where I had so rudely interrupted.  Now, I hardly thought he was composing an ode to the Greek goddess of war, so I assumed it was some little hussy that caught his eye.  I kid. (No.  Really I don't.  Any girl that catches his eye is assumed to be a hussy until proven otherwise.  Demon women!) So, as I went in to say good night I subtly questioned him regarding Athena.  And by subtly, I mean I sat on his bed and asked, "So, who's Athena?"  I am smooth.  After I discovered she was his friend from school (and actually in his grade and not some 15 year old from the Boys and Girls Club...yes, that has happened) my hackles relaxed enough to ask if he liked her.  Once we established he did, I reiterated my whole sex/love/responsibility talk but I added a new sidebar: "Bitches Lie." (And yes, I used that phrasing.  Don't worry; he couldn't believe it either.)  I informed FB that there are good girls/women who won't lie and manipulate, but there are a lot of them, i.e. "bitches," who will.  Then we had a little association game.  "I have a condom for you, don't worry."  Absolutely NOT!  Use your own, make sure the package isn't damaged and it's not expired.  "I've never done this before." Lie.  "I'm on birth control; we don't need a condom."  Big lie.  "I'm clean; you're safe."  Liiiiiiaaaaaaaarrrrrrrr!  I informed him my job is to keep him safe, he, meanwhile, has three jobs.  Stay true to himself, be safe, not make me a grandmother.  That's it!  That's all it takes!  Our next topic for "how badly can I scar my kid before his 18th birthday" is "don't stick your dick in crazy."  Thanks to Shelley V for the topic!