I haven't blogged in almost a year.  I've been busy.  Every few days, an idea for a blog post will pop into my head, but....I've been busy. 

I'm going to attempt to summarize the last year, probably in a series of posts.  Mostly for myself, so I can look back and know what the heck I've been up to.  Then when the mild cognitive impairment gives way to full blown dementia, I'll be able to reference important life events. 

My last blog post was in March 2012, in which I blasted my esophagus for causing me such misery.  Well, I'm happy to report that after having a 9lb 4oz baby boy cut out of my uterus, the esophageal issues have ceased. 

Luke Larson Bartlett (Larson is my mother-in-law's maiden name) was born on July 24th via a very convenient planned c-section.  Louisa was a very inconvenient, non-planned c-section which occurred after 5000 hours of labor and 400 hours of pushing.  I'm exaggerating a little. 

In the OR, an anesthesia resident placed my spinal and almost immediately I started feeling light headed.  I thought it was because I was laying supine, which I hadn't done in several months, and the baby was laying on my IVC.  Then I heard my heart rate on the monitor start to tank and I heard the number 70....referring to my systolic blood pressure.  I would have panicked, but I wasn't perfusing my brain adequately to do so.  The resident gave me some epi and my SBP came up to 150.  Hypertension feels GOOD!  A few minutes later, Luke was born.  Unlike his sister, he came out screaming!  This was a relief because Louisa really wasn't breathing when she came out and she was a slight purple hue.  I could hear my OB yelling at the nurses to get oxygen on her.  I did panic then, but soon she started crying and turned a lovely bright pink color. 

They took Luke to the nursery to get him cleaned up, but then they didn't bring him back to me.  They were concerned because his belly seemed to be getting more and more distended.  The nurse who relayed this information to me told me that they got an x-ray which only showed 11 pairs of ribs.  And because his belly was getting bigger and he had a skin tag on his ear, they were going to take him to the NICU. 

Um....what?  11 ribs? Skin tag?  Abdominal distension?  All of this information being told to a freshly post partum crazy lady who had a SBP of 70 withing the past 30 minutes and who still has fentanyl infusing. 

So they took him to the NICU and placed and NG tube (small tube that goes from his nose into his stomach to suck out any excess air) and placed an IV.  His abdominal x-ray was unremarkable and he never acted like he was uncomfortable.  He was having normal poops and passing gas too.  They wouldn't let me feed him, but instead gave him fluids through his IV.  He pulled out approximately 4 NG tubes.  I got to visit him in the NICU.  It was nice to be able to hold my boy, but it is quite disturbing to see an hours-old baby with IVs and tubes coming out of him.  The next day he seemed to be doing okay, but his belly was still big.  He was still pooping and seemed to be quite comfortable.  We got to visit with him more and I even dragged my edematous, post op self out of bed and walked down to the NICU.  Thanks fentanyl/percocet/ultram/toradol/ibuprofen.  I also have a fear of blood clots....that will get you moving! 

That night a nurse practitioner from the NICU came into our room to let us know that he'd lost peripheral IV access.  They had poked him everywhere (including his feet and scalp) to try to place an IV, but they couldn't get one.  So she gave us 2 options....either we try to feed him by mouth and see how he does, or they would have to put a central line in him. (A central line is a large catheter that you place in a deep vein, usually an internal jugular or subclavian. This allows for administration of fluids and medications when a patient can't take things by mouth. This is a procedure that I do when I'm in the ICU and it's not without risk - bleeding, infection, pneumothorax).  So you can understand why my initial reaction to hearing "central line" was something along the lines of, "What the *&^#^@%#$^$#!?!?!  Over my dead body!"  That was more of an internal monologue.  So, clearly we opted to feed him by mouth....and would you believe that he did just fine? 

They never did find anything wrong with him and eventually decided we could take him home.  His belly continues to be "protuberant" to this day.  So he got to hang out in the NICU for a few days because he has a Buddha belly.  Sorry Blue Cross. 

Oh, and it's totally normal to see 11 sets of ribs on a newborn chest x-ray.  The 12th pair often hasn't ossified yet.  Thanks Allison Zupon, radiologist extraordinaire!

An open letter to my esophagus

Dear Lower Esophageal Sphincter,

"Hormones" are not an excuse.  I have heartburn from drinking WATER!  You really need to step up your game, you lazy piece of crap.  My esophagus is freaking killing me.  And my sad little H2 blocker...?  It's like Charlie trying to piss out a bonfire. 

Consider this your warning.  Do NOT make me go to the ER and demand an IV PPI and a GI cocktail....and dilaudid....and IV benadryl.   

Sincerely,
CBart

Self Actualization

I grew up an insane KU basketball fan.  I knew all of the players (full names, hometowns, interests), had the press guides memorized each year and would often stalk players for autographs after the games.  Along with this love for KU came the inevitable and required intense disdain for Missouri. This lifestyle continued until medical school/residency/parenthood when there was simply no extraneous time for the luxury of watching college basketball.  During the last few years, I've grown in maturity and have actually decided that, alas, I don't hate Missouri.  What did they ever do to me?  Why should I dislike someone just because they live across State Line from me?  Just because someone went to an institution of higher learning in Colombia does not make them a bad person.  In fact, I have several wonderful friends who went to MU. 

So I was quite frustrated when I watched the pre-game coverage of Thursday's NCAA Tournament games.  Multiple KU and MU fans were interviewed and all of them expressed their hatred for each other.  How sad, I thought to myself....that grown adults act in such a childish way.  Why can't we all just love each other and appreciate and respect each other in spite of our differences?

A few hours later, I turned the radio on in my car, just in time for the end of the MU/Norfolk State game.  As the clock ran out and the commentator announced that MU had dropped to the number 15 seed....








YESSSSSS!  YESSSSSS!  

(Fist pump - fist pump - fist pump!) 

SUCK IT YOU DIRTY TIGERS!!! 

WHAT'S UP NOW?  HUH?  HUH? 

(More fist pumping!  And my face probably looked like this guy's....)

I guess my journey to self actualization and ultimate maturity hit a little speed bump.  But good-golly, there's a part of my soul that rejoices when those punks go down!

Rock Chalk!



Wisdom

A wise and learned woman once said:

'Tis best for thou to empty thy bladder frequently,

for thou never knowest when thou may laugh unexpectedly.

Actually the woman wasn't wise or learned, rather she finally put two and two together after nearly wetting her pants on a daily basis.....with a growing fetus smashing her bladder. 

A flaw in marketing judgement

I appreciate fashion as much as the next girl....well, if said next girl also prefers to live in sweats and t-shirts.  I became a doctor purely so I could wear scrubs to work....just kidding.  Kind of. 

Anyhow.  I received this flier in the mail yesterday for the "designer denim event" at a pea in the pod.  They graciously included coupons for $20.00 off of selected designer jeans.  Fantastic!  Too bad the jeans are all uber-trendy and originally priced at over $200.00.  A few reasons why this is ridiculous:
1) There are starving children in Africa
2) I just bought a cute pair of maternity jeans at Target for $30.00
3) These are jeans that I could only wear for 5 months....or more depending on how many babies I have.  Okay, and maybe at Thanksgiving. 
4) Lets say I have one day off per week for 5 months.  That's 20 days.  That's at least $10.00 per wear.  Compare that to the Target jeans....just a little math test for you.  I'm all about preventing Alzheimer's. 
5) I don't care how fancy the jeans are, they don't make me look any thinner or less pregnant.


Which leads me to the picture on the flier:

(My apologies....I couldn't figure out how to change the orientation.  

Just cock your head.  Then call my dad to fix your neck.)

Where the frick did they find this emaciated pregnant chick?  She's probably not even pregnant.  They probably found some random model with a BMI of 12 and stuck a pillow under her shirt.  Um....does this make me A) Want to buy your stupid, overpriced skinny jeans?  Or B) Want to throw on my favorite granny-panties (thanks mom), Danny's sweat pants, an XL t-shirt with stains in the pits and climb into bed with a tub of ice cream and cry?  Yes...choice B.  And the shoes?  My pregnant ankles would swell up like sausages within 5 minutes of trying to wear those. 

So....pea in the pod....you need to fire your stupid marketing department, which is likely run by men and start the frick over.  Frick frick frick!  

And if you were wondering how to thoroughly infuriate a pregnant chick....well, now you know. 

Back to the VA - a blog for S. Rod....

To ensure my good standing as I return to the VA tomorrow, let me take a minute to give a big shout out to one of my favorite peeps, Stephanie Rodriguez. 

If you've stepped foot inside the KCVA as a medical student, internal medicine resident or fellow, you know Stephanie well.  She makes sure that we are all licensed, oriented, qualified, identified (with multiple sets of fingerprints), certified, familiarized and petrified.  She keeps us on our toes, threatens life and limb when discharge summaries are late and warns us about "special" medical students she's detected during the orientation process.  She also tells tales of a certain staff doctor that she dated in high school. Apparently he was kind of immature....shocker!

Hands down, her most important function is organizing snacks in the conference room.  For whatever reason, snack time occurs on a daily basis when I'm away from the VA ( I know this because I still get the notification on my pager), but as soon as I return, snack time essentially ceases to exist....why is this?  What does it all mean?  Stephanie?

So....my friend, expect to see me bright and early in the morning.  I have forgotten my password and I will need to get my computer access re-established.  Then I will need you to remind me how to forward the ID consults to my account.  And I have like, a million notifications I need you to help me delete.  I will also need some chocolate. Aren't you excited to see me????

CBart

A Happy Reunion

(To the tune of Amazing Grace.....)

Oh coffee mug
I love you so
At work, you comfort me
I lost you in the ICU
Today, reunited with glee!

Ah....so much to be thankful for!