Best description of a TENS unit EVER

“It’s like white noise for my body.”

Posted in Cool midwife tricks, Labour pain relief options | Tagged , | Leave a comment

Home labour induction tips

See what I did up there? “Labour”? I’m getting this Canadian spelling thing DOWN!!!

A while back I was, at a woman’s request, going through non medical induction methods. Near the top of the list was, “Have you tried fooling around?”

It’s not an evidence based suggestion, but hey, it’s fun, and besides, the couple is cut off for six weeks after the baby comes. Theoretically, anyway.

She waved me off and said, “Oh, we’re on it. For the past few weeks, in fact. We call it ‘basting the turkey'”.

 

Basting

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Self interruptus

Me at a recent home visit:

“OK, now that your milk has come in, the baby will probably nurse for shorter periods of time and sleep for longer ones. You’ll probably notice more cramps when he’s nursing, so make sure you’re staying on top of your ibuprofen, but know that it’s a good sign that all of your hormonal pathways are working correctly. You’ll also notice OH MY GOD YOU HAVE  CARDS AGAINST HUMANITY.”

“Yep,” said the new dad. “That’s our litmus test for whether or not someone gets invited back to our house.”

I stopped myself from asking when their next party was. I really need to just get this game and have my own parties.

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Only funny to Gen Xers

Hi everyone! I’ll get back in the swing of blogging nice thoughtful posts, as well as some deets of my past year, but I figured I’d start with a quick and cute little story or two.

A few months back I was finishing up at a home birth. The adorable and energetic two year old ran into the kitchen where I was packing up my supplies.

“STOP!” he commanded

His dad asked in his best Mister Rogers voice, “OK, Brandon, now can you say, ‘collaborate and listen?'”

He obliged with a bashful smile, though it came out sounding more like, “Cab ate an issen!”

He looked very proud of himself as I giggled helplessly.

And of course I had an ear worm for the rest of the day.

Posted in Funny kid stories, Funny stories, Home birth | Tagged | 2 Comments

I looked up and….

…six months? Really?

Well, yes.

I got here in late August, hit a speed bump with getting started, and have been trucking along since mid-September. Getting settled has been emotionally more difficult than I thought it would be. I didn’t think it would be easy, mind you, I just didn’t think it would be hard. Such is the outlook of an optimist.

I’ve had a few Facebook requests to the effect of, “PLEASE! Tell us what’s different! We want to KNOW!”

So here are a few:

MORE POSTPARTUM VISITS.

To all of my former patients: I’m feeling guilty for the years of one home visit 24-48 hours postpartum and one at six weeks. A few years back I started offering a 2 week visit just because I missed you and not because I thought it was medically indicated.

Here? Visits at day 1, 3, 5, and 7, AND at week 2, 4, and 6.

A sad point is that I don’t get to “keep” my patients after that. Here, midwives don’t do family planning, though it’s something the profession may add in years to come.

A happy point is an echo of my old life: We get to end our discharge visit with, “See you at the annual reunion party!”

MORE PAIN RELIEF OPTIONS!

In the US, the pain relief menu is short: narcotics and epidurals. Some hospitals offer water labor, and a few offer water birth.

Here, we have TENS units, nitrous, and just last month I did my first sterile water papules! (Geek alert: I’m linking to journal articles.) To be fair, sterile water papules are available in the US, I was just didn’t want to do it with no training.

(Us birthy types, of course, know that the REAL list of pain relief options is much longer: touch, massage, position changes, presence.)

So far none of my clients have availed themselves of a TENS unit, and I’ve used nitrous a few times. Wait, that came out wrong. A few of my clients have used nitrous. I had a small hand in getting it to them. Another time or two and I may be able to do it without help.

On a mundane, everyday note-like, REALLY mundane-I’ve had to get For Real about recycling. Also, all three areas of Ontario I’ve lived in for the past year have had municipally supported composting. As in, compost gets taken out on trash day just like trash and recycling, in municipally provided green bins with snap locks. I also got a cute little snap lock container for under my sink.

I’ve learned that I produce half a bag of trash per week, and I produce more compost than trash, primarily in the form of coffee grounds.

A few language things:

I haven’t picked up the “eh?” yet, though I did when I was in my clerkship. Not sure what that’s about.

Here, you don’t “call” people, you “phone” them.

A work specific language thing requires some background information. When we assess babies after birth (and the rest of the time under our care, of course), we count their respiratory rate and assess their respiratory effort. Grunting, flaring, and retracting are Not Good Things, each signaling that the baby is having to work a bit too hard to breathe. This is what retractions look like. The pertinent part starts at 0:26. Notice how the lower ribs suck in with each breath.

Here, it’s called “indrawing”. Not a biggie, but I’ve corrected myself a few times in mid sentence.

Finally, I have to pay attention to my spelling. Labour, not labor; favourite, not favorite; paediatric, not pediatric. As teeth gritting as I can be about proper grammar and spelling, this is something I need to be careful about lest I find the shoe on the other foot.

More to come!

Posted in I'm HEERE!!!, Labour pain relief options, Newborn respiratory assessment, postpartum care, Research | 1 Comment

Ch…ch…ch…ch…changes

Greetings, friends and neighbors! It’s been a bit, and a LOT has been going on!

Remember this post? I got the job. Full time temporary, labor and delivery nursing, and I’ve never been happier to be working.

And this one? All kinds of happy.

My inner worry wart (not to be confused with the brain weasels), not content to leave me alone, fixated on whether or not my work visa would arrive in time. Based on the timetables listed on the Citizenship and Immigration Canada website, it was looking iffy.

It arrives in the mail a few weeks ago.

I’m running out of things to worry about.

Amidst my various frettings, I did a little confused self examination. Why wasn’t I turning cartwheels, shouting from the rooftops, and bursting with gratitude? All at the same time?

I identified that I’m still waiting for the other shoe to drop. Moving to Canada became a goal almost two years ago, and I’m having trouble believing it’s finally within reach. I berated myself for NOT turning cartwheels, shouting from rooftops, or bursting with gratitude.

Then I went all geeky. I started to think about emotions as biochemical reactions. The stress response, fear reactions, even joy and anticipation all have identifiable biochemical pathways. I’ve been living with some degree of fear and uncertainty for the better part of the past year. My nervous system has acclimated to it, and it’s not going to disappear overnight. It’s like when you switch from hot water to cold water and the remaining hot water needs to flush out before the water gets cold again.

I decided to let my body heal, let my emotions be what they’re going to be, and take the next step. Joy and anticipation are coming.

 
Next week I’ll be going to Cambridge to look for an apartment. I think joy and anticipation will hit me then.

Oh, yeah, that’s where I’m going. Guess I forgot to mention that.

 
Here they are!

Look, I’m even on their list already!

I wanted to work in Toronto, true, but not badly enough to beg for a job. Of the four Toronto practices with openings, I interviewed with two and both said no (they both did me a favor), one wasn’t willing to do a Skype interview (must be present to win, I guess), and one didn’t call me back despite my diligent follow up. In some worlds, the kind of diligence I demonstrated could be construed as harrassment. However, the only acknowledgement I received was after a phone call to the office manager who said yes, my resume has been received. Otherwise-crickets.

Meanwhile, the practice I’m joining was upfront about wanting someone with my kind of experience, clinical and otherwise. Ah, FINALLY, an acknowledgment that I have something to offer!

In both interviews-Skype and in person-I was struck by their clarity and directness, within the group and in their descriptions of their relationship with the hospital. I’ve been around enough to know how rare that is. A midwife is on the medical executive committee at their hospital. Given my experiences here with hospitals, I know how rare THAT is. Finally, I’m suitably impressed that the senior midwife is working on her PhD.

All in all, I’m pretty sure I’ve struck gold.

OK, this is working. Telling the world my good news. Teehee.

Next up: my full time temp job. Teaser: according to 2010 statistics, their c section rate is 21%.

Posted in Career moves, How did I get here? | Tagged , , | 1 Comment

Diversion

Sunday I went to Chicago’s Gay Pride Parade. While immersed in the sea of carnival style happiness, I did lots of people watching, and BOY, is there lots of that to be had!

Lots of people were topless in some fashion with stuff written on them in magic marker. My favorite: FUCK H8. Others were, of course, rainbows, interlocking male/male symbols and female/female symbols, happy faces, peace signs, hearts.

Some had words: Declarations of love, sentiments against intolerance, and “FREE HUGS!”

My singular point of angst was a few twenty-something year old men with this written across their chest:

“Free hugs and kisses. Women only, I’m here for the boobs.”

Really, guys? You’re at the Gay Pride Parade to exercise your straight male privilege?

I REALLY hope they met some people with “boobs”.

 

Posted in Feminism | 1 Comment