Saturday, December 14, 2019

Contractions: The Buzz Word

In relation to labor a contraction is referred to the tightening of the uterine muscles. The uterus is a very strong muscle. So, just like when you’re working out or lifting that heavy Halloween candy basket, your muscles are contracting to do its work. When you get to the end of your pregnancy, the uterus has grown to a very large size to enclose your baby, placenta and amniotic fluid. Normally your uterus is about the size of your fist. So, in the end its main goal is to push your baby out and shrink back down from the size of large watermelon to the size of an orange. That’s a lot of work. The contractions first help the cervix to thin out, then to dilate and ultimately push the baby down into your pelvis.
Your cervix starts out very thick and completely closed and the contractions do a few things to help you get to where you need to be. We use a percentage to measure the thickness of the cervix. We call this effacement and the goal is to be 100% effaced or thinned out. Along with this the cervix needs to dilate enough for the baby to pass through. The goal of this is for it to become 10cm wide. The last thing we look at is how far down the babys’ head is into the pelvis. We look at this in relation to a specific bone in your pelvis and we call this the babys’ station. 
So, when we say the cervix is 10cm, 100% effaced, and +1 station this is a good time to start pushing but not in every situation. If you’re 10cm and 100% the baby may be still high in the pelvis and a lot of nurses and providers will do a practice called ‘laboring down’. This allows the contractions to do more of the work without you pushing. This can save you pushing time and energy for when it’s really time to push. Of course, if the mom feels a strong urge to push that’s ok to push. Again, this is not true in every situation. 
After the baby is born this doesn't mean the contractions are done. The uterus also has to push out the placenta and then, like I said before, the uterus has to get back to its original size. In order for this to happen, it has to contract. Yes this sucks but it's essential. And don't worry, you'll forget how it felt eventually in a delusion vortex somewhere, which is why women decide to have additional children.

Below I have attached a video that is good at showing how contractions work. 

Saturday, December 7, 2019

Why You Shouldn't Send Your Kids To School

Last week I wasn’t able to post because I was in the PICU (Pediatric Intensive Care Unit) all week with my 2-year-old son. He got a wonderful combination of an ear infection, pneumonia, bronchiolitis, and RSV. Most of the time these infections can be treated at home, however they have the potential to be deadly. Then when they are put together, it’s a perfect storm. During his hospitalization he was diagnosed with asthma. This didn’t surprise me too much since his dad as it as well. 
We took him to urgent care on Sunday, which they had given him the diagnosis of pneumonia and said they had caught it early. So, we started the antibiotics. Then, as the evening went on, he had struggles with breathing. I kept him at home Monday with me and he would have short intervals of fast breathing but then be jumping all over a half hour later. It wasn’t until that night that we decided he was getting worse and we should have him seen again. 
He went back to urgent care, which led to the ER at the Children’s hospital. He couldn’t keep his oxygen at an adequate level, so they decided to admit him. Very early on Tuesday morning, they decided he needed more respiratory support, which meant he would need to be admitted to the PICU. My husband called me at 6am that morning to tell me that his situation was getting worse, but he was stable and able to keep his oxygen up with extra support. 
I took our older son to daycare and rushed to the hospital. We live a bit far from the city, so it took me about an hour to get there. Normally seeing someone hooked up to an IV, oxygen, and multiple monitors doesn’t faze me. I’m a nurse after all. I know what each thing is for and why it’s there. Seeing this on my own child, laying there helpless and struggling is the worst sight I think I’ve ever seen. And I’ve seen some crazy shit. My brain was combating with itself between nurse mode and mom mode. I was also having an argument with God. How could you let this happen to a small child? Why my child? Is this really happening? 
During the next few days my husband and I switched sleeping at the hospital and the other caring for our other son. We were both physically and emotionally exhausted. Our oldest was feeling the effects of this as well. He was sad that he couldn’t be with both mom and dad. He was missing his best friend. Tuesday and Wednesday, our little one didn’t seem to be getting better but he wasn’t getting worse. The nurses and doctors assured us that this can take some time for the RSV to clear his lungs and for him to need less oxygen support. 
At this point, I was worried of when we would be able to take our baby home. I knew we’d be staying for more days instead of hours, but I didn’t know how many days. I didn’t know when he’d start to get better. I did know we’d be spending Thanksgiving in the hospital. I did know that we were in the best place possible to care for our little one.
Thursday was Thanksgiving and he finally started to have more of an appetite. He was eating and drinking enough that when his IV broke they didn’t put a new one in. We had a small victory. However, my husband called me saying he was feeling sick. Great another person sick. I demanded that I continue to stay with Finn, so he doesn’t give him more germs. 
On Friday they decided he was doing well enough to put him on a decreased oxygen support system, a simple nasal cannula with regular oxygen. They put him at a low oxygen rate to see how he’d do. He was doing great!  I was not doing so great, though. I was so tired that I couldn’t keep my eyes open. The nurse came in and put a blanket on me. She said, “I will watch him. He’s fine watching a movie. You sleep.” She just gave me a great gift. At that moment this nurse was my hero. He continued to do so well on little oxygen that they decided he could be moved to a regular medical floor. Another victory! He was also getting more of his spunk and energy back. I thought, "Okay maybe we can go home soon!"
On Friday evening they took him off of oxygen completely and he kept his oxygen level stable. The only hurtle we had to go over for him to come home was that he needed to be off of oxygen for one night without needing any support. After he went to sleep that night, I was watching the monitor like a hawk. The requirement was he needed to consistently stay above 90% (100% is the best). He kept jumping from 90-92%. I was getting anxious that at any moment it would go down and he’d need oxygen and he’d be here for another night. By 11 o’clock I couldn’t stay awake anymore and fell asleep. When I woke up, I learned that he didn’t need oxygen. I was going to bring my baby home! 
He has been home now for a week and he's doing much better with a daily inhaler. He's back to his old silly self and I'm so grateful he's ok. I can't imagine how other parents deal with their children with worse illnesses spending weeks or even months in the hospital wondering if they are going to come out of this. My thoughts and prayers are with you. 
Now as many other parents know, if your kid goes to daycare or school, germs are everywhere! Sickness happens often. So, if your kid is sick, keep them home! The best way to prevent the spread of disease is washing your hands. However, germs are still spread easily, especially with kids. The next best way to prevent the spread of germs is it contain them. This means staying home away from other people until the person is no longer contagious. 
According to the CDC, “Each year in the United Statesan estimated 57,000 children younger than 5 years old are hospitalized due to RSV infection.” Even more contract the infection without being hospitalized. All children and immune systems are different. Children don’t have too strong of an immune system. Those children who have underlying diseases and the elderly adult population are very susceptible to these infections. Since Finn now has asthma, it’s much more difficult to fight off any kind of lung infection. It scares me to think that he can easily come in contact again with something that could be easily avoided. 
There are many other infections that can be spread, but we can try to avoid it by keeping our kids home if they are sick and prevent other children and teachers from getting sick. I know how difficult it can be to take time off of work or find a babysitter, but nothing is more important than your child’s health. Do the best that you can. 


This is the face of RSV


To find out more about RSV and how to prevent it click on the link below. 

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