So I am officially FINISHED with ALL homework and assignments! HALLELUJAH! I managed to complete everything with 4 days to spare for studying AND to play with the Bird...And lots of time to visit patients like baby Xaviar and Ivy. Here they are at their one week check, Ivy is healing great and little Xaviar, though jaundice and small, is getting stronger daily. He is sporting some baby clothes you all donated! She LOVED them!
And pictured far below is one of my dearest patients ever. I took Lenita as a continuity way back in December. This was her 6th pregnancy and with 3 girls and 2 boys at home, she was hoping for another boy. Alas, her ultrasound said it was a girl. Lenita and I became good friends. She lives over an hour outside of Davao, so getting to her prenatal visits was a challenge at times. But she came as much as she could and I was throughly looking forward to delivering her baby.
However, her due date, April 28th, came and went and she wasn't even having contractions....and her blood pressure was high. Too high. We monitored it carefully and gave her some advice on how to bring it down. She didn't seem too concerned...but the baby needed to come soon, otherwise her blood pressure could put her in the hospital for induction of labor. NOT FUN!
So we waited and then at 4 am, May 1, I got a text: "Ma'am panabigon sa gawas, pero wala sakit"...Her bag of waters had ruptured, but she was not in pain. So we agreed to meet at Mercy as soon as she was able. That would be about 1 1/2 hours.
Meanwhile, Tim was taking off to Butuan. Good timing....NOT! So Promise and I headed to the clinic for a very early birth shift for Lenita. Promise was pretty good the first couple of hours as I checked Lenita in. Lenita, unfortuantely, indeed had ruptured membranes with thick meconium and was only 2 cm dilated...and high blood pressure. Not good. She had 12 hours to deliver this baby or we'd have to transport to the hospital.
Lenita's hubby, Rex, came in and we talked about the potential risks to the baby and to her. But first, we needed to manage the high blood pressure. After left-side lying for an hour, 4 glasses of water, 2 glasses of MILO (energy drink), an egg and frequent bathroom visits, we got her BP down to 122/82. WAHOOOO! Praise the Lord! We had a time of thanking the Lord and began to pray for a fast labor.
She headed outside for some exercising and walking with her hubby - by the way, he is a wonderful man! I had stripped Lenita's membranes to get contractions coming more frequently and to build intensity, so I was hoping that her walking, my stripping, her hydration and 12 hours to labor would get this baby out.
Promise started getting fussy around 11 am. Now, she had been up and entertained by Filipinas and midwives since 4 am...that's a long time...and she was losing grace for the birth room. My supervisor, Heather, shared that she had three helpers at her house with nothing to do because her kids were gone for the day...so she called one of them up and Lisa came to watch Promise in the birth room while I tended to Lenita. What a blessing!! Promise thoroughly enjoyed her time with Ate Lisa! See below...she met every baby that came into the clinic!
Lunch time came around and two babies were born in the birth room...unfortunately, Lenita's was not one of them. Her contractions were picking up, but they were only lasting about 30 seconds. They were strong, but not strong enough. It had been over six hours since my last internal exam, so it was time to do another to check on the progress of her cervix and the position of the baby. She had only progressed to 4 cm dilation...baby was still high and the meconium stain seemed worse. With only 4 more hours to deliver at Mercy, I felt strongly like it was time to transport her to the hospital. Meconium can be dangerous if the baby sits in it too long and she was not progressing like the average multiparous women.
At 2 pm, a new supervisor came on and after sharing Lenita's history with her, decided to transport to DMC. Disappointed, but hopeful, Promise, me, Lenita and her hubby, Rex, headed in the ambulance to a very busy and hectic DMC. I thought for sure Lenita would have a very long wait in triage....but the Lord provided an out....because Promise was with me hanging in her sling around my shoulder, we attracted every nurse in the entire emergency room...no kidding...I felt awful for the patients that had to wait as the nurses stroked Promise's skin, cooed and giggled at her and asked copious amounts of questions like, "Is her daddy a Filipino?"...now seriously...does Promise look like she has ANY Filipino in her?? I wanted to laugh and say, "DUH...whatta do you think?", but instead I said, "My patient is in pain and needs to see a doctor as soon as possible"...with a smile, of course....that got three nurses speeding passed me to get the paperwork filled out faster than speeding bullets! It pays to have a white baby.
Lenita was bumped to first class and it was time for prayer, a hug and then for Promise and I to head home. It was 4 pm. Over 12 hours of laboring insanity...but Lenita would soon meet her baby.
I waited all night for a text stating that Lenita delivered....none came. The next morning, I sent a few texts to her number asking if she had delivered her baby yet. Rex finally replied saying she was still in labor. STILL IN LABOR!? The doctor, apparently, was just now deciding whether to do a cesarean section....JUST NOW! It had been over 36 hours since BOW rupture with thick meconium! I was concerned and asked Rex to text me when he knew more.
Two hours later I received a text..."Ma'am, cesarean done, baby BOY! Doctor stitching up Lenita. Praise God! Thanks for prayers!" I was overjoyed! I quickly asked if the baby was healthy...."Yes, ma'am, but in NICU for observation". Lenita got her boy despite the ultrasound saying she would be having a girl. :) I told them to text me when she was in the recovery room and I would come with food and presents. (clothes from you guys, of course).
Tim, Promise and I headed to DMC and found Rex, Lenita, and baby AJ all together. Lenita was breastfeeding a healthy 7 pound baby boy. Apparently, the docs had tried to induce her further, but Lenita's mattress was just too tired and the contractions had stopped, hence the cesarean. They decided she needed a ligation, as well. Rex shared the frustration of the enormous cost of the ligation, cesarean and hospital stay. I chatted with Ate An An from MMC and she gave me some advice for them. We chatted a bit more about the next couple of weeks healing from the cesarean and adjusting to a very full house. They are set to come for a baby check this coming Monday. I am soooo looking forward to seeing them. I am hoping to head out to their home in Calinan before furlough, too.
That leads me to my next exciting bit of news....We're headed west June 14-August 28th! God is soooo good. In the meantime, Tim is tying up stuff with the water project and working hard to make sure things are set for while we're away. I am studying for my final final final exam on June 4th and enjoying the new freedom of not cracking open textbooks. Many blessings to you all!