A Little Slice Of Hell ((( The Energies Of Partuition )))

It takes a storm to bring a child into the world.

Last night at four in the morning, while I was doing the fourth epidural in a row, the new mother was really in a lot of pain. The charge nurse, who is experienced and excellent and compassionate, all at the same time, explained to the mother, 'giving birth is a (gestures with thumb and first finger) little slice of hell--but it is so worth it!'

Did you know that same nurse has been bit by a patient giving birth?

It was back in the day when medi-cal patients were not given epidurals unless they paid for them with cash. Insurance didn't cover it. They threw things, hit, bit, cursed, scratched, and spit at the nurses in the delivery room.

The OB gyn on call last night shared to me, in a low whisper, that on her way in to the hospital after doing an emergency gyn case at another hospital, she hit a dog with her car. She was heartbroken. It just ran out in front of her, and there was nothing she could do. She saw it wobbling but upright when she looked in the rear view mirror. Just then another car hit it. It went down and didn't move. She brought the car back to take it to the vet if it was alive. It wasn't. She had to come in for her patient here, who was not ready to deliver. I invited her to go to the Doctor's Lounge in the Main O.R. to get a cup of coffee, and talk. She accepted.

Did you know OB-GYN is one of the most malignant training programs in all of medicine? She trained on the East Coast, where it is even worse than here on the West Coast, but even still, it was so horrible that four of her class left the program. There were 'five bitches', four chief residents and one attending, who 'picked on everybody, especially the men'. One male, was not 'able to keep up'. He couldn't understand, even when given her notes she took and kept organized, what admission orders were, what a daily note format was supposed to be, how to follow up on routine labs. There it was explained clearly once and then expected to be perfect after that. He was asked to go. The other was a male who genuinely WAS competent, but the Chiefs didn't like him. He left to go into Sports Medicine because of the bullying he experienced. Another woman left to go to a different training program in the South to be with family. And another stayed at the hospital but changed specialties due to the stress.

Being an OB-GYN resident sometimes is like being in the Lindsey Lohan movie, 'Mean Girls'.

Yet obstetricians brave all this, and sacrifice not just their time but their being in such a malignant environment, because they truly love what they do. Our hospital is exceptional in that the different private practice physicians from all of the different groups socialize together. It is very cohesive, which makes for a better program. We are also all Facebook Friends, the nurses, docs, postpartum, and neonatal teams.

I won't begin to describe the anesthesia end of things--think of it as trying to his a moving target--

What I will share with you, as a teaching point, is how to master suddenly changing scenarios, full of drama, and risk to life.

I was asked to see a mom who had just delivered who had questions, at around seven p.m. I had so many clinical responsibilities (patients) needs I couldn't get to her room until ten at night. I politely explained the situation, and that I had not eaten dinner yet. She said, 'Do you want half of my sandwich?' I declined, saying it had meat and I am vegetarian. She said, 'Pick the meat out and eat it anyway.' which I did. Half a croissant, with lettuce and tomato did wonders! We talked through the question and arrived at an answer and it was very pleasant.

The energies were non-stop throughout the day, one 'drama' after another, and one in which the fetus actually was at risk. I fixed it with my knowledge of drugs, and although I had to leave a c-section (while they were closing) for five minutes to manage it, I confessed to her when I got back, 'I just saved the life of the baby by adjusting the blood pressure. No one will know it but me, and now you.'

What was different this time was the lack of emotional undertow into the drama/rapidly changing clinical situations. By 'hanging on to source and being grounded' I quickly prioritized the work and carried it out. One chart I had to complete at eight o'clock the next morning, because there was NOTHING and no time to chart when everything happened all at one time on the unit.

If the energies of the changes on Gaia arrive as I have a hunch they will, it is going to feel for you like the last OB call did for me. Handle it as best as you can without getting 'sucked in' to the swirling storm of emotions. Remain clear-headed, prioritize, and act. You have what it takes to 'get the job done' and help others who are having trouble adapting to the new energies and changes that are about to come with it.

You are about to go where angels 'fear to tread'--you alone are totally equipped for it, whether you know it or not. You signed up for it. http://aquariusparadigm.com/2013/11/14/taryn-crimi-angelic-guides-first-responders/

I know you will be great at it! Just think of all we had to do on OB to bring a baby into the world--all the training, all the experience, and all the love we have for what we do.

You are like us helping Gaia 'give birth' to the New Society, the Golden Age where everything is fair, just, and highly pleasant!

That is why it is called Heaven On Earth!


Aloha and Mahalos,
Namaste,

Reiki Doc

Obstetric Anesthesia: How I Share Your Pain

This is a spinal anesthetic; the anesthesiologist has pulled the stylet and is looking for a drop of CSF at the hub of the needle. This confirms placement is correct and injection of local anesthetic can go in.

Hi.

I do anesthesia for women who are in labor and having cesarean sections.  I support women's medicine for the entire day I am 'on call', offering emotional and Reiki/spiritual support as well as the removal of pain of surgery and having a kid.

I hurt.

I feel your pain.

And after you are done and ecstatic over your newborn baby, I drive home somewhat in a fog, anxious to go to sleep. I experience sleep deprivation just like you with your crying baby--only for me it's the phone in the call room that wakes me up instead.

Sometimes I wonder if our Guides and Angels get as tired as I get,  after helping us to get from 'here' to 'there' in our own growth and development.

Here are some of the ways all of us on the Labor Deck, not just the anesthesia providers (CRNA and MD) support you in ways you might not realize:

• The ward clerk and doctors office sees that all of your important medical information is sent to where you are having your baby so everyone will know your needs precisely for this delivery.
• The nurses carefully assess you and gather information for your current state and document it for the team, things like drug allergies, medical history, and obstetric history.
• The lab checks your blood for me to see if it is safe to put in an epidural or spinal for labor (not enough platelets, you can get a blood clot in the back that can paralyze you)
• The pharmacists make sure I have plenty of drugs to use to control your pain in the supply area.
• Emotional support begins with the nurses and they explain to me your 'situation' so I can react accordingly.
• Each of us on the care team makes it a point to communicate with face-to-face contact that 1) I'm here    2) I care about you     and    3) I know what to do to make you feel better
• The above statement is from the work of Charles R. McKay, MD FACC FAHA, based on his work with Heart Failure Patients. This face-to-face is a direct factor in promoting good outcomes in patient care.

Sometimes when it is busy all of us feel like we are taking care of all these hungry chicks

In Spirit:

I offer myself to you in service with all of my gifts. With my intuition, combined with my experience and the teamwork/pooled intuition of the nurses, we have a pretty good idea if you are going to 'go' with vaginal delivery or need a c-section. We might try other things to 'help' it, but many times the 'data' point in that direction long before we ever mention it to you. We give you 'your chance' to go naturally.

I take in all this 'information' on your energy and emotional state, and adjust how I interact with you to make it more effective. For example, when Spirit guides me, 'give the Transition symbol' while I am with you, I give it. For example,  I give a lot of Reiki while I hold you leg while you push. I also pray throughout the labor and delivery for both of us, for things to go as smoothly as possible.

In Emotions:

As an empath this is where I take the damage the most. When you are panicking, I feel it just like you. I do my work, but I have to be careful to take only 'what is mine' home with me at the end of the day. 

This is why I take a bath or go to the ocean the day after--to clean all the residue of these emotions I have been in 'contact' with off.

I make it a point to smile and to be pleasant when I am with you, even at three a.m. It's not your fault or the baby's that we are working when both of us could be sleeping!

I also do not wear makeup so you will be the beautiful one and be comfortable while you are with us.

In Professional Capability:

Sometimes I 'dig deep' to deliver the care for you. The spine isn't always 'textbook'. I have to make minor adjustments in dose, approach, and equipment in everything I do. There is a ton of information I must enter into the computer about what I have selected for you and what I want the nurses to give, and what I have given and how. My job is to make it look easy, but between us right now, more often than not, I sweat a little, and sometimes my knees wobble over the difficulty of what I have been asked to do. 'An epidural' sounds simple, doesn't it? But to me, it is often like Luke Skywalker using The Force to get those shots into the Death Star at the end of the first Star Wars episode. (Most pain doctors do this procedure with fluoroscopy --x-ray movie--visualization).

I also communicate to the team effectively about what I have done and make sure that your clinical needs are met after I finish with my care.

In Physical Capacity:

I am hungry, often times. I am sleepy. I am sore. I have a sore back from reaching over the bed. My muscles get a workout trying to get the needle through the calcified ligaments in your back sometimes. I might have just sat down to eat lunch when I am asked to come 'fix the blood pressure' or 'give an epidural'. My feet and legs ache at the end of the day. I might, when it is late at night, want to brush my teeth, but I am in the middle of procedures and I can't do that. Many times we have to void and there is no time so we are 'holding it' until the next chance we can get to empty our bladder!

In Mental Fortitude:

Sometimes we have just had something challenge us and you are the next one. I have to tell myself to 'pull it together' and 'move on'. Sometimes I have to focus for the entire team, and be a leader when there is massive hemorrhage and I am giving lots of transfused blood. Sometimes the nurse you have has written me up in the past (they do this OFTEN! Even me! LOL), and I know it, and I don't want to be working with her but I am, and I have to 'buck up'. One of the hardest ones is when technically my work is 'a challenge' and I would like to quit but there is no back up. I have to keep trying until I get it in and get you comfortable. Sometimes I have to come back and take it out and do it over to make you comfortable. It is all in a day's work, but you wouldn't know this; having to explain this to you takes a lot of mental strength on my part because you and I simply weren't expecting any difficulty in the first place!

How Spirit Helps:

• The team invited me to buy dinner with them, but I declined.
• Five hours later, when I was hungry, a nurse offered me a slice of her leftover pizza and a ward clerk shared salsa and chips.
• I get woken up in the middle of the night with a message: God has JOY! 
• Enough time is 'cleared' for me to take the yoga class offered free at work--in my scrubs!
• A song kept playing in my mind, all day, all night, and then the same one came up on the radio 'out of the blue' to comfort me. Here it is--above--see Coldplay's Chris Martin?

How You Help:

• Your trust
• Your smile when 'everything works'
• The gratitude of you, your husband, and your family for my work
• Your being yourself so I can see the 'spark of God in you'--sometimes it can be your carefully put together hair, your pedicure you picked out to make you look your best, your laugh and joking personality, your curiosity about 'medical stuff' and wanting to learn....you give back a lot by just being 'who you are'. I find it refreshing how 'different' every mother, father and baby is.
• Your little gifts for me or the team (we appreciate it VERY much)
• The look of relief and joy when I check on you the next day.

It is an honor and a joy to be there with you at this special event in your life. 

Even if I am worked to the point of pain while it is happening. 

We share that pain, together, while new life is being welcomed into this world!

Namaste,

Reiki Doc

OMG! Obesity in Labor and Delivery

"I know", I said to the charge nurse at ten o'clock last night, as she looked at me and tried to explain what was up in Labor Room 4.

"How did you know??!!", she exclaimed.

"I looked it up on the computer system before I came upstairs. There was something in your voice that made me look." I replied. "What did you tell her?"

"That we are going to put in the epidural." she said.

I matter-of-factly said, "How can you promise that? It might not go in."

"What are you going to do?" she asked.

"I am going to stick her until it goes in or she tells me to stop trying."

The charge nurse left to see the patient, while I got my cart and bag of local anesthetic from the pyxis. she came back and said, "I told her we are going to give it the good old college try."

"Thank you."

I get in the room and there is an enormous woman, with full make-up. Why they try to make the face look so nice when the body is, well, enormous with rolls of fat, is a mystery. Fake eyelashes, everything applied like a cosmetologist, hair perfect. What I see is the red thigh-size cuff barely fitting on her arm, because the arm in obesity is shaped like a cone, and the cylinder of the blood pressure cuff poorly fits. I take a large cuff on the forearm over a thigh cuff on the arm in the O.R. any day. It reads more accurate.

As I take this in, I take the energy read of the room. It is survival. Is there dark entities in her? They are going to make it tough. Is she stable, mentally and emotionally? The critical thing is, where are the folds in her fat? Back pannuses are thinnest at the fold. She could barely spin in the bed to expose her back. She had concern because her internalized monitor 'was coming out'. The external monitors can't read fetal heart tones or uterine pressure due to the insulating nature of fat.

Open mind, open heart, and prayer to St. Michael to protect and aid me, I got ready.

Twenty cc's of saline, not ten. And the local with the 22 gauge needle, not the 25, to the hub, and no contact with bone. (I had prepped wide with the betadine and draped first).

One hundred percent of my attention was on that back, with the family member in the chair I could see out the corner of my eye. Tuohy needle, to the hub, contacting bone, the spinous process. The epidural space was going to be about three centimeters in past the hub. I took care to stay in the midline. The needle, as I pressed, swerved and popped, as if guided by unseen hand. The interspinous ligament. Almost there. I leaned with all my weight with the Tuohy needle hubbed to get the three centimeters and loss of resistance that indicates the epidural space. The husband put his head in his hands as I did this. It was gory. No blood, but a needle going more than all the way in is a trip. With firm grip, I held tension on the Tuohy, took out the stylet, and grabbed the extra long spinal needle. A pop through the dura and CSF would mean I was totally in the right spot. Sometimes extra fat people have a loss of resistance outside the ligament, and the catheter will thread. No pop. No CSF. I threaded the catheter to fifteen centimeters at the skin, a first, the deepest placement ever. And when I went to remove the Tuohy needle, with all my force, I couldn't. It was stuck.

I never had been in that predicament. I pulled, and I asked gently, "can you please bend forward?' She did. The bones loosened their grip on my needle, and it came out. Test dose felt good. And it was negative. Her blood pressure dropped and she had relief of her pain.

It is better to be lucky than good.

What I have learned through the years is not to judge.

To stay in the moment with a challenge.

And to know that in that moment, once handled, lies the opportunity to show your skill set.

In this woman, as a Reiki Master, I asked for Divine Intervention in my work. I got it.

"How did you ever get that epidural in?" Lorna, a seasoned RN, asked in amazement.

"It's easy," I answered. "I prayed."

Lorna laughed a big belly laugh at that one. She knows. Poor charge nurse needed me to hold the other leg so she could put in the foley. That was a sight I would like to forget having ever seen--it was not pretty.

I did not have time for a cho ku rei. But I did have a partnership with spirit, that worked. And I did have humbleness about being there sincerely to take away pain. I also took away my judgement of how she would have terrible insurance. I was wrong. Blue Cross PPO, one of the best.

'You take care of me, and I will take care of you." said the father-to-be, on talking about his job as a server at a swanky restaurant, and what celebrities tip better than others. For a while I had thought about my role in medicine, "I will take care of you and maybe you will pay me and maybe your insurance will and maybe they will not." But I plucked it out of my mind. It was not healthy. And look! Good insurance after all!

Do not see like everybody else sees. A challenge is a gift to let us manage it. We discover how much better we are at what we do. Others show us pieces of ourselves. Embrace differences. For what we do to them we also are doing to our own hearts. Love is the only thing that will protect us and save us from any challenge.

Choose love. Hold tight to it, no matter what the challenges. And love will find the way through the challenges that await you.

Namaste,

Reiki Doc

P.S. Labor epidurals are put in by sight and by feel. When you can see the interspaces between the spinous processes, you go there. When you can't see them, you go by feel. The times you can't feel the bony prominences with pressure, you have to guess. Sometimes you go in by bouncing off the bone. You have a mental picture in your head of the space, and recreate it by bumping into the edges around it.
The reason I have a gift for the morbidly obese moms on labor and delivery, is that I have 'the sight', intuition. I go by feel. And also by guidance. I get direction like, 'that won't work there' or a feeling of forboding at different sites. I go for the one that seems 'right'. And that is how I get it. I did a four foot nine inch four-hundred pounder that way. It is never easy. But take away what you see and feel and know, and go in blind...that's where I come ahead of the rest. : D