30 Something Baby Doc

I was on 2nd call a week ago and one of my high anxiety patients came in for active labor. Since I was on 2nd call (ie.. sleeping all night...unlike the poor bastard on 1st call), I was trying to keep a low profile. The patient's mother caught me sneaking thru the labor and delivery unit trying to get to my call room. She was very excited and asked if I would be involved in her daughter's delivery and of course I said yes.

Unfortunately the patient had a long difficult labor, developed a high fever and stalled out after only dilating to 6cm. We made the decision to perform a cesarean section. The patient started crying hysterically. I did my best to calm the patient and assure her that everything would be OK.

We took the patient back to the operating room. The patient already had an epidural for anesthesia, therefore she was awake for the procedure. Her mother was also allowed to be in the OR. I scrubbed with the OB resident and we draped the patient in preparation for surgery. I made the incision and the surgery was progressing well.

Suddenly the patient became unresponsive started shaking uncontrollably. The anesthesiologist (who was a 2nd year resident) immediately shouted loudly, " Something's Wrong!!!!....I need help now!!!" I looked at the monitors and all the patients vital signs were normal. I asked the anesthesiologist if the episode was anxiety related and I continued with the surgery. The resident continued to call for help " Get my staff here, get anyone!!!). The patient's mother became very upset ,screaming" What's wrong!". The nurse had to escort her from the OR. The nurses then started running around the OR frantically making phones calls etc. Even the OB resident I was operating with was starting to shake and become nervous.

I asked the anesthesia resident to assess the patient's vital again but I think he just wasn't hearing me.

We quickly delivered the baby thru the incision and the baby started crying immediately. The patients episode quickly resolved and she again became responsive. By that time every anesthesiologist in the hospital showed up in the OR. It turned out to be just an anxiety attack.

I don't disagree with calling for help when you feel a situation is over your head, but panicking tends to be very counter productive especially when it distracts you from objectively evaluating the patient in a code situation.

Am I afraid in these situations?? Hell Yeah I am!!! (we had a patient go into cardiac arrest a few months ago under similar circumstances)

But as a team leader you have to stay calm, if not, everyone will panic....and that sucks.

Many nurses come to see me for their prenatal care. The latter is flattering to me because I assume they like my practice style and trust my decision making.

But many times I get the feeling they are more uncomfortable with me performing their pelvic exam that my average patient????

As an Ob-Gyn I often recommend patients in the 3rd trimester of pregnancy to undergo 24 hour urine collections if their blood pressures are elevated. This is a diagnostic test for pre-eclampsia (A potentially severe condition in pregnancy that could result in seizures and death). My patients usually complain when they have to save up their urine in jug for a whole day. They say things like...."That's inconvenient"......"That's nasty"......."I have to carry that jug with me everywhere". I'm thinking to myself ..."Stop you yappin and just freakin do it!"

The other day I went to my doctor for a check up and my blood pressure was high. He order me to complete a 24 hour urine (damn!). I went down to the lab and they handed me this big brown jug. The whole process of saving my urine for a day was a pain in the ass.

First, I was on call the day before I had to turn it back into the lab, so I had to collect some of it while I was working. I had to keep it cold, therefore I hid it in the staff refrigerator (I'm glad no one confused it with apple juice). The hard part was to keep reminding myself not to piss in the toilet and use the jug only. When I got home I had to tape notes on all the toilet in my house that read "USE THE JUG DUMMY" After 24 hours and over a liter of urine I was all done. I turned it back into the lab without incident.

I think I'll have more sympathy for my patients in the future:-)

You ever have one of those days when you're seriously late for work and you seem to catch every freakin red light along the way.

It's Saturday night, a beautiful day, and I'm here in the hospital on call for 24 hours....what fun. At least I'm on 2nd call so hopefully the nite will remain quiet.

Friday was a real crappy day. It was the kind of day where I continually say to myself....."I need to get my MBA, or a law degree, or take up gardening...anything to get out of clinical medicine!"

It was one of those days where I feel like I can get more patient compliance out of a brick. Example...I had another patient who underwent a termination (abortion) last week who came in to see me for follow up. She wanted birth control, but started having unprotected sex already dejavu??? I asked her if she was having sex and she replied "well we didn't really have sex". I then asked her if he ejaculated inside of her and she replied "Yes". I guess I've been confused all these years on what sex really entails.

One of the pharmacist at my office pulled me aside the other day for sex advice. I find a majority of individuals believe male gynecologist are experts in issues regarding sex because they are men that spend most of their time between women's legs.

She told me the condoms her boyfriend used were irritating her even after trying different brands (including lubricated and non-lubricated also w/ and w/o spermacide). I suggested she try non-latex polyurethane condoms because she may have a latex allergy.

She also told me her boyfriend was having problems with the condom slipping off during intercourse.

Now , I had a little difficulty finding a solution to that one??? I told her that they should practice properly placing the condom prior to intercourse. But all the while I'm thinking to myself.....you should find a boyfriend with a larger penis.

MEXICO CITY - After a scolding from north of the border, President
Vicente Fox said he regretted any hurt feelings over a comment he made about blacks in the United States. But many Mexicans insist Americans overreacted.

In a speech Friday, Fox praised the dedication of Mexicans working in the United States, saying they're willing to take jobs that "even blacks" won't do.

I feel you can take this comment either way (racist or realist). But the latter distracts us of from the more important question; why are so many of these dedicated individuals are seeking employment and citizenship outside of Fox's country in the first place?

25 patients scheduled into a 3 hour and 45 minute time block? Does that make any sense to you?

Someone found a link to my site by doing a yahoo search for "Huge Pendulous Breast" '

You so nasty!

The other day, I was seeing a patient for a new obstetric visit. This was one of my more colorful patients who is high in theatrics and low in dental count. I placed the patient in stirrups in order to perform the pelvic exam. My medical assistant handed me the speculum. I spread the patient's labia (vaginal lips) and inserted the speculum with ease.

The patient then started to wildly exclaim," That thing feels strange!" She continued, "I don't know what's wrong, but it feels weird!"

I asked her what it felt like (why did I do that?)

The patient exclaims, " It feels just like a DICK!"


unbelievable.

One of my colleagues pass away today after a long battle with metastatic cancer. This was a wonderful person, mentor, administrator and dedicated physician. My colleague made patient care their #1 priority . This person's commitment was so powerful that they would receive outpatient chemotherapy early in the AM and then rush to the labor and delivery unit to begin a 24 hour shift (most individuals are wiped out after chemo). This was a compassionate health care provider who also exemplified what it means to be a Christian.

Why would this bad thing happen to such a very good person?????

I have learned that we must always strive to be better than ourselves no matter what our profession and I am very fortunate to have known this person.

I was running on vapors today. I stopped at the gas station to feed my hungry SUV. I pumped
$49.99 worth of gas. I couldn't bring myself to exceed the $50.00 mark

I saw a patient the other day who came in for birth control. She had an unwanted pregnancy earlier this year and opted to have an abortion. She wanted ortho-evra (a transdermal (patch) form of birth control that provides contraception for up to 1 weeks with each patch). We routinely check a pregnancy test prior to giving contraception. She had not had a period in 2 months and didn't seem concerned.

Guess what the results of her pregnancy test was........Positive? You guessed right. Our dialogue is as follows:

Me: Did the abortion clinic give you birth control after your procedure?
Her: Yes.
Me: What type?
Her: The pill.
Me: Did you take them?
Her: Yes.
Me : Did you stop taking them?
Her: Yes.
Me : Why?
Her: I don't know.
Me: Did you have unprotected sex after you stopped taking your pills?
Her: Yes.
Me: Obviously you didn't want to be pregnant or you wouldn't have had the abortion. Why did you stop taking your birth control when you knew you would get pregnant again?

Her: I don't know.

me(thinking to myself) Thanks for clearing that up for me:-)

OBTW the patient is older than 30