After the wedding, the daughter and I made a quick dash to Tennessee to welcome the new grandbaby. I have to admit he is a real cutie - but then what would you expect me to say? He seems to be quite content to sit and look around until it's either time to eat or sleep. It was hard, but we said goodbye today and started on the way back to Texas. When checking the weather and road situation for the trek back the word was snow and/or freezing rain so we stopped in Nashville and got a room at the Gaylord Opryland for a night or two. Not the trip or Christmas that we had planned but we'll see how the weather thingy works out and hopefully only be here for the night. If not, we're determined to have a great time here anyway.
Sending Merry Christmas wishes to one and all...be safe, happy, and hug those you hold dear - and even those you don't!
Tuesday, December 23, 2008
Sunday, December 21, 2008
Breach
From James:
I didn't realize it was urgent till I burst through the door into labor and delivery.
I knew the woman in labor had a fetus in the breech position with one foot wanting to come out first. I'd told the midwife to alert me when she was completely dilated so I could assist the delivery.
Sarah came and told me that the woman was about to deliver so I wandered back over to the hospital.
When I opened the door, I sized up the situation instantly and sprang into action.
I saw a woman lying on metal table with her legs spread apart and coming out of her was an abdomen with two legs attached, flopping down onto the bed. No arms or head was visible. My first thought was gloves but as I reached for the ones I'd washed and hung to dry earlier I realized they were still too moist to get on quickly so I dove in with my bare hands.
When the baby comes out feet first it's very important that she deliver quickly because if not the umbilical cord coming out of the abdomen will be compressed by the fetal head blocking off the blood circulation and its crucial supply of oxygen to the baby.
I had no time to lose since who knows how many minutes had flown by with the head stuck before I arrived.
I reached inside to try and free up the first arm. It wouldn't budge. I twisted the baby around so the other arm was on top. This time I was able to hook it with my index finger and drag it down and out. I turned the baby over again and freed up the other arm. Then I stuck my finger in the baby's mouth and pulled his chin down to his chest all the while pulling with my other hand firmly grasping the baby's feet between my fingers.
The head popped out and the baby flopped to the table. No tone. No cry. No breathing. Grayish blue color.
I quickly clamped and cut the cord and moved the limp mass over to the reanimation table. I started rapidly pressing the chest with one had while I quickly grabbed the bulb suction with the other and tried to clear his airway. He had a faint, slow heartbeat. For those of you who know, APGAR at one minute was one.
I kept doing chest compressions while the midwife dried, stimulated and sucked the gunk out of his nostrils.
After what seemed like hours, but was really minutes the heartbeat started to pick up. He grimaced a little and seemed like he wanted to cough.
We continued our efforts.
Slowly but surely he started to pink up and his heartrate became normal. Still pretty floppy and no breathing.
Don't stop now.
Finally, his legs and arms started to curl up. He was getting some muscle tone and his body was now pink.
At last, after I turned him over and gave him a good whack on the back he started screaming like a banshee.
Amazingly enough, APGAR at 5 minutes was nine! He was discharged home in good condition two days later.
I knew the woman in labor had a fetus in the breech position with one foot wanting to come out first. I'd told the midwife to alert me when she was completely dilated so I could assist the delivery.
Sarah came and told me that the woman was about to deliver so I wandered back over to the hospital.
When I opened the door, I sized up the situation instantly and sprang into action.
I saw a woman lying on metal table with her legs spread apart and coming out of her was an abdomen with two legs attached, flopping down onto the bed. No arms or head was visible. My first thought was gloves but as I reached for the ones I'd washed and hung to dry earlier I realized they were still too moist to get on quickly so I dove in with my bare hands.
When the baby comes out feet first it's very important that she deliver quickly because if not the umbilical cord coming out of the abdomen will be compressed by the fetal head blocking off the blood circulation and its crucial supply of oxygen to the baby.
I had no time to lose since who knows how many minutes had flown by with the head stuck before I arrived.
I reached inside to try and free up the first arm. It wouldn't budge. I twisted the baby around so the other arm was on top. This time I was able to hook it with my index finger and drag it down and out. I turned the baby over again and freed up the other arm. Then I stuck my finger in the baby's mouth and pulled his chin down to his chest all the while pulling with my other hand firmly grasping the baby's feet between my fingers.
The head popped out and the baby flopped to the table. No tone. No cry. No breathing. Grayish blue color.
I quickly clamped and cut the cord and moved the limp mass over to the reanimation table. I started rapidly pressing the chest with one had while I quickly grabbed the bulb suction with the other and tried to clear his airway. He had a faint, slow heartbeat. For those of you who know, APGAR at one minute was one.
I kept doing chest compressions while the midwife dried, stimulated and sucked the gunk out of his nostrils.
After what seemed like hours, but was really minutes the heartbeat started to pick up. He grimaced a little and seemed like he wanted to cough.
We continued our efforts.
Slowly but surely he started to pink up and his heartrate became normal. Still pretty floppy and no breathing.
Don't stop now.
Finally, his legs and arms started to curl up. He was getting some muscle tone and his body was now pink.
At last, after I turned him over and gave him a good whack on the back he started screaming like a banshee.
Amazingly enough, APGAR at 5 minutes was nine! He was discharged home in good condition two days later.
Tuesday, December 16, 2008
The Dress for the Wedding
What a whirlwind week it was last week. I drove from So Cal to just south of Ft. Worth arriving in 19 hours. I was surprised myself, but glad that I wasn't on the road for the 24 hours that I had planned on. There was hardly time to do anything but run here and there making sure that all of the decorations for the church would work, finding enough food to make sure that all of the out of town guests would have something to eat and just tying up all of the loose ends that are always there for special events like the wedding.
It was a wonderful 73 degrees the day of the wedding and I must admit that I was second guessing my choice of stretch velvet for my dress when I was fanning myself to stay cool during the wedding. The pattern, Butterick 5280, turned out to be a great pattern. I decided to do a FBA just to make sure that it would fit better and not so tight even though it was designed to fit snuggly and I was glad that I had. An adjustment for square shoulders and adding to the length were the only other adjustments that I had to make.
After making the FBA I remember reading on someone's blog about the two sides of a wrap top not matching after making that adjustment and then showing the solution. I finally found the information here: http://thesewingdivas.wordpress.com/2007/03/09/adjusting-for-a-full-bust-on-a-wrap-top/, followed the directions and it worked perfectly. All that being said, I will be making this pattern again as it fit great and was really comfortable.
This is my niece, Kristen and her new husband, Wil. The only reason I am in this picture is because I capitulated and agreed to be my sister's gofer for the wedding. It was fun and we had a great time.
We are now stuck in Texas as the weather it the big news here. Freezing rain, sleet and icy roads are all over the area until sometime this afternoon so we are sitting tight in front of the fire until things warm up a bit.
It was a wonderful 73 degrees the day of the wedding and I must admit that I was second guessing my choice of stretch velvet for my dress when I was fanning myself to stay cool during the wedding. The pattern, Butterick 5280, turned out to be a great pattern. I decided to do a FBA just to make sure that it would fit better and not so tight even though it was designed to fit snuggly and I was glad that I had. An adjustment for square shoulders and adding to the length were the only other adjustments that I had to make.
After making the FBA I remember reading on someone's blog about the two sides of a wrap top not matching after making that adjustment and then showing the solution. I finally found the information here: http://thesewingdivas.wordpress.com/2007/03/09/adjusting-for-a-full-bust-on-a-wrap-top/, followed the directions and it worked perfectly. All that being said, I will be making this pattern again as it fit great and was really comfortable.
This is my niece, Kristen and her new husband, Wil. The only reason I am in this picture is because I capitulated and agreed to be my sister's gofer for the wedding. It was fun and we had a great time.
We are now stuck in Texas as the weather it the big news here. Freezing rain, sleet and icy roads are all over the area until sometime this afternoon so we are sitting tight in front of the fire until things warm up a bit.
Friday, December 12, 2008
Blue Baby
I finished my dress for my niece's wedding and will post pictures next week - after the event. Even though I could only find black stretch velvet to make it out of, the dress went together quickly and actually is a fairly decent fit. What a crazy time it is around the holidays to be doing weddings! Oh, and I have a new grandbaby. Jonah Keith, 8lbs. 7 ozs. born Dec 5. No pictures of him yet. (No, he is not the blue baby this post is about!)
Now from James:
Dr. Jacques knocks on the door.
"I just assited an uncomplicated vaginal delivery, but the baby is having
respiratory distress. The nares are flaring, the intercostal muscles are
retracting and he's just having a hard time. I tried aspirating to see if
he had any mucus but it seems his nose is blocked...it's like there's just
no connection to the throat."
In my mind I'm thinking, "yeah, right, he must just not know how to stick a
tube down a baby's nose..." but my better judgement says I should just go
and look.
I enter the dimly lit corridor and push open the labor and delivery room
door into a brightly lit, but small chamber. A quick glance takes in a
young woman lying comfortably on the bed, not much blood around, and
breathing and glancing around normally. She's fine.
I turn to the baby reanimation table and see a chubby, bluish gray baby with
a disproportionately tiny head (normal newborns heads are huge compared to
their bodies) lying staring up and grunting but not really breathing.
I grab him around the chest, flip him over on my hand and slap him hard on
his back. He starts to cry vigourously. I think that must be it. They
just are afraid of these supposedly fragile little beings and don't
stimulate them enough.
I flip him back over on his back on the green, brightly patterned cloth
underneath him and reach for the aspirator. A tiny tube goes into a small
canister with a slightly larger tube coming out the same top. I slip the
bigger end in my mouth ready to suck and slide the smaller tube into the
baby's nose. It only goes in 1-2cm and is stuck. I wiggle it around and
then try the other nostril. Still no passage. I stick my finger into the
newborn's mouth straight back into his throat. He starts to gag as I feel
around and confirm, there's no opening between his nostrils and his airway.
Now, here's the problem. Instinctively, a newborn is an obligatory nose
breather. This allows him to nurse and breath at the same time, two very
important things God makes sure they now how to do instinctively because
there's just no spare time to have to learn it in. He only breaths through
his mouth if he cries.
We can't just make him cry all the time, he just won't do it. He cries a
little and starts to pink up and then goes back to sucking in impotently on
his blocked up nostrils.
What to do? I think quickly and go to the OR to find some probes and see if
there isn't some passage back there after all that's just blocked up.
The probes go nowhere. I've brought the hemorroidectomy kit as that's the
only one I know of with probes.
I call the father in and explain the situation.
"He can't breath through his mouth because it's against his instinct and he
can't live without breathing and we can try to poke a hole through but he
could bleed a lot and die or we could damage some important things, but the
bottom line is he won't live if we do nothing. What do you think?"
"Do what you have to, it's in God's hands."
I grab a Kelly clamp and probe downward in the right nostril to where the
palatte seems thinnest between the nose and mouth. I poke through. I then
do the same on the other side. However, he still can't breath because the
mucosa of the mouth just falls back in place. We need something to keep it
open. I grab the aspirator and cut off a piece of the bigger tubing. I
reach the clamp through into the mouth, grasp the tube and pull it out
through the nose. The first time it pops all the way out. I then attach
another clamp onto the mouth and and pull it through again, this time the
clamp prevents it from coming all the way out. I repeat it for the other
nostril.
I suck up some blood out of the nose and mouth and down the tubes using
what's left of the newborn aspirator. He's still struggling but I can hear
and feel air coming out the two tubes.
I then insert a feeding tube in the mouth and the mother starts squeezing
out breastmild which we feed the baby through the tube with a syringe.
He's already pinking up, only his hands and feet stay blueish gray.
Yep, he's in God's hands all right.
Now from James:
Dr. Jacques knocks on the door.
"I just assited an uncomplicated vaginal delivery, but the baby is having
respiratory distress. The nares are flaring, the intercostal muscles are
retracting and he's just having a hard time. I tried aspirating to see if
he had any mucus but it seems his nose is blocked...it's like there's just
no connection to the throat."
In my mind I'm thinking, "yeah, right, he must just not know how to stick a
tube down a baby's nose..." but my better judgement says I should just go
and look.
I enter the dimly lit corridor and push open the labor and delivery room
door into a brightly lit, but small chamber. A quick glance takes in a
young woman lying comfortably on the bed, not much blood around, and
breathing and glancing around normally. She's fine.
I turn to the baby reanimation table and see a chubby, bluish gray baby with
a disproportionately tiny head (normal newborns heads are huge compared to
their bodies) lying staring up and grunting but not really breathing.
I grab him around the chest, flip him over on my hand and slap him hard on
his back. He starts to cry vigourously. I think that must be it. They
just are afraid of these supposedly fragile little beings and don't
stimulate them enough.
I flip him back over on his back on the green, brightly patterned cloth
underneath him and reach for the aspirator. A tiny tube goes into a small
canister with a slightly larger tube coming out the same top. I slip the
bigger end in my mouth ready to suck and slide the smaller tube into the
baby's nose. It only goes in 1-2cm and is stuck. I wiggle it around and
then try the other nostril. Still no passage. I stick my finger into the
newborn's mouth straight back into his throat. He starts to gag as I feel
around and confirm, there's no opening between his nostrils and his airway.
Now, here's the problem. Instinctively, a newborn is an obligatory nose
breather. This allows him to nurse and breath at the same time, two very
important things God makes sure they now how to do instinctively because
there's just no spare time to have to learn it in. He only breaths through
his mouth if he cries.
We can't just make him cry all the time, he just won't do it. He cries a
little and starts to pink up and then goes back to sucking in impotently on
his blocked up nostrils.
What to do? I think quickly and go to the OR to find some probes and see if
there isn't some passage back there after all that's just blocked up.
The probes go nowhere. I've brought the hemorroidectomy kit as that's the
only one I know of with probes.
I call the father in and explain the situation.
"He can't breath through his mouth because it's against his instinct and he
can't live without breathing and we can try to poke a hole through but he
could bleed a lot and die or we could damage some important things, but the
bottom line is he won't live if we do nothing. What do you think?"
"Do what you have to, it's in God's hands."
I grab a Kelly clamp and probe downward in the right nostril to where the
palatte seems thinnest between the nose and mouth. I poke through. I then
do the same on the other side. However, he still can't breath because the
mucosa of the mouth just falls back in place. We need something to keep it
open. I grab the aspirator and cut off a piece of the bigger tubing. I
reach the clamp through into the mouth, grasp the tube and pull it out
through the nose. The first time it pops all the way out. I then attach
another clamp onto the mouth and and pull it through again, this time the
clamp prevents it from coming all the way out. I repeat it for the other
nostril.
I suck up some blood out of the nose and mouth and down the tubes using
what's left of the newborn aspirator. He's still struggling but I can hear
and feel air coming out the two tubes.
I then insert a feeding tube in the mouth and the mother starts squeezing
out breastmild which we feed the baby through the tube with a syringe.
He's already pinking up, only his hands and feet stay blueish gray.
Yep, he's in God's hands all right.
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