An experiment
So, here I sit writing this on my satnav! Jack is sleeping upstairs and we are waiting for a phone call from his Mummy to tell us what damage his Daddy did to himself when he came off his motorcycle during a race today. We are hoping that it's nothing more than a sprained wrist and nasty bruising but the amount of swelling involved makes me think that a couple of fractures might be the trophy he's won today. Casualty will be dedicating a cubicle to him at this rate since today is his second visit this week. On Tuesday he stepped backwards off the decking, lost his footing and caught his head on the wrought iron gate. The resulting gash to his scalp required sticking together with super glue.
Amy's house move is in a state of flux at present and it is really getting daughter down. The whole thing seems to be unbelievably disorganised. Everyone was gearing up to exchange of contracts on Tuesday and moving on Friday but then they heard that their buyer is still waiting for his mortgage to be approved, so now they are quite down. Daughter is starting to feel one of the effects of a twin pregnancy, super tiredness. yesterday we went 'buggy trialling' and we were really covering all possibilities when daughter just suddenly flagged in quite a dramatic way. All her energy deserted her and it was as much as she could manage just to make it back to the car.
Crickey. Just found this, web-site below. No wonder Americans are always confused by our antenatal care system. Seems more laid back than this. Health Tip: Prenatal Checkups
(HealthDay News) -- If you've just learned you're pregnant, don't hesitate to schedule a doctor's appointment.
Regular doctor visits during pregnancy are important to ensure that you and your baby stay healthy, according to the University of Arkansas for Medical Sciences.
At some point, you can expect to undergo:
A physical exam, including a pelvic and breast exam, checking your heart, lungs, eyes, ears, nose and throat, and measuring your height and weight.
Blood, urine and blood pressure tests, and a Pap smear to check for disease that could affect your health during pregnancy.
Checks for several harmful conditions, including anemia, bladder infections, syphilis, gonorrhea, HIV, cervical cancer, hepatitis B, vaginal infections and other problems.
Questioning about the state of your health and that of the baby's father.
-- Felicity Stone
http://www.medicinenet.com/script/main/art.asp?articlekey=81210
We never do the first bullet point. I suppose it's a general health check really, and in the US I believe they have obs/gyn for their pregnancy care whereas over here the first point of contact is generally the G.P who knows, or should know, your general health status and history. Pelvic exam?????
Reincarnation?
Daughter has just relayed to me a conversation she and Jack, aged 3, had when she was explaining to him why Scruff, their kitten, was no longer with them - Scruff isn't living with us any more because he had an accident. The other day he wanted to cross the road, but he didn't look first to see if anything was coming and he ran across the road when a van was coming really fast. The van couldn't stop quickly enough and so it banged into Scruff. Scruff died but he has gone to heaven to live with Granny. He's going to keep her company now and she is going to look after him. Yes Mummy. When I was a dog I was run over and I stayed with Granny. Then Granny said I was going to be a boy and come and live with you and Daddy and be your Jack. Scruff will be happy with Granny. Out of the mouths of babes?
Calling all Midwives and Health Professionals
Any Midwives, or even Doctors out there, who are reading this and have comments to register about the maternity services might like to go to this link to the Kings Fund who are currently collecting evidence for their independent review into the safety of maternity services. The closing date is 30th May. If it weren't for a Google alert I have set up I wouldn't know about this survey/review and I suspect that I am not alone in this.
Now for a 'God help us', hands up in the air, laughing at the extra demands being placed upon us, moment. Whilst midwives, and particularly community midwives are, on a daily basis, having to alter their practice, take on new responsibilities, fight their way through an ever increasing mountain of paperwork and try to provide women with the type of care they are being promised without the resources being in place, this message was relayed to us at a recent team meeting, 'Stop swearing in YOUR cars'. Apparently the university has said that student midwives have complained about the bad language used, whilst driving, by some of the community midwives. It has taken me two days to assimilate this latest edict, at first I thought it was a hoax, but now I realise that Big Brother really is trying to gain more and more of a foothold in my life. Now I've stopped laughing at the picture it paints, a middle-aged woman raging obscenely behind the wheel, I'm full of indignation. If the student objects to the fact that, on occasion, a midwife may comment on another road-users driving skills by the use of an expletive perhaps she/he is too precious to enter the profession. During her working life she is going to encounter many different cultures with very varying opinions on what is acceptable behaviour. Is she going to object whenever a woman a labour uses a word she finds offensive, particularly since most of these words can be heard on any TV channel, any pavement every day. How is she going to deal with the partner who is worried about his partner, finding it difficult to deal with seeing his loved one in pain and, in an effort to express his frustration with not being able to help, aims a swear word at the midwife? I'm not trying to excuse anyone who swears in an ordinary situation, but who hasn't released their frustration at another car driver by the use of some purple prose? During her training the student is in a rarefied position, she has a mountain of studying to complete, but clinically, and responsibly whichever midwife she is working with carries the can for any mistakes she makes, in other words, having a student out with you adds to the stress you are already under. All the students I have had out with me seem to have the most tortured personal lives which they share liberally during our time travelling from one visit to another. I accept this as part of my role as mentor, but it can really 'do your head in' when you are trying to find some obscure address and your passenger is bemoaning their life, answering mobile phone calls from an estranged partner and then bursting into tears. Can, or should, I be blamed for releasing my desire to throw her, and her mobile phone out of MY car, by transferring my irritation verbally to another road user? I am also guilty of uttering the odd expletive between patient appointments at my clinic, it is my way of releasing tension and prevents me from being terse with women who are causing my clinic to run late for no good reason other than their ability to read everything on the web, but apply none of the advice given there to themselves. I shall calm down now and just hope that I don't have a student allocated to me, as I can't promise that I won't let my refined vocabulary slip away and allow myself to shout 'donkey b*******' at the next chelsea tractor that cuts me up.
All creatures
I'm all itchy and I keep thinking that I can feel things crawling all over me. Why? An animal lover I had to visit today. On Monday one of my colleagues asked, really nicely, if I would pick-up one of her visits for her and, being the lovely person (!) that I am, I gladly agreed. When I went into the woman's house I had a rueful little chuckle to myself and I knew very quickly why the other midwife had passed the visit over, the house was filthy, smelly and filthy, and noisy. Yes, noisy, smelly and filthy. lovely couple but horrid environment. After I had manoeuvered around the staffordshire bull terrier which was overjoyed to see me, and closed my eyes and prayed when the pit bull stood in front of me, I promise this is the absolute truth, I sat down next to two large tanks, one on top of the other. Out of the corner of my eye I registered movement, bloody whatever's, the top tank had a huge snake in it, heaven knows how long as most of it was curled up and it was only the first three feet that had slid up the front of the glass fronted tank. I tried to act nonchalant but obviously didn't succeed as the husband started reassuring me about how friendly they are. They? Then I saw the second snake in the bottom tank, still large but not quite as impressive as it's tongue flicking friend in the top tank and with bright yellow markings. The guy told me that they are Burmese pythons and the young one is bright yellow and white because it is an albino, apparently it does have pink eyes. I left and promised myself that I would not be returning. Wrong. Today the sly midwife was off as she had been up all night at 2 homebirths and guess who I had to visit, that's it, the threatening creatures people. It was a pleasant reunion with the fearsome dogs and the large reptiles, although one of the snakes had just dirtied it's tank, apparently it smelled, I really couldn't tell as the house has so many noxious odours anyway that one snake poo obviously doesn't make a difference. So, I'm sitting there, dropping blood from the baby's foot onto the card for the Guthrie test when something flits from baby onto my leg. I continued with my blood-letting task whilst trying to ignore the fact that a super-sized flea was sitting on my trouser leg. I looked again, it had gone, gone onto my forearm whilst on the shoulder of the babygro I could see one of its relatives. I finished as quickly as I could, stood outside and shook myself and then started to feel super itchy, and I still do. When I got home I had to explain myself to Hubby as I was stripping off my clothes whilst I entered the house and by the time I had crossed the kitchen I was in a position to put all my clothes into the washing machine. I'm not sure if I should believe him but he thinks that the little bugs I had on me were baby locusts, nymphs, I think I would feel happier if they were, I don't think they bite, do they?
Growing up
Amy was 2 years old yesterday and reached a real milestone, she went the whole day without having one episode of wet knickers. This is great news as she has been using here potty all the time, as long as she hasn't got any knickers on, put a pair of draws on her, even her Dora the Explorer ones, and they are wet within half an hour. Yesterday though Nanny decided that cover-up was the order of the day, and it worked, hurrah, chocolate stars all round! All the praising that goes on when she uses the potty is having a knock-on effect, today Amy told me that I was a good girl for using the toilet before we went out shopping, she didn't reward me with any chocolate though.
Her Mummy saw the Consultant again today, and had another scan, all is well. Each twin weighs just under a pound, average for their gestation, and there is no sign of TTTS. Another appointment in two weeks and then, if all is still going so well, no more scans for 4 weeks. We will miss seeing Van and Lorry on such a regular basis but since they are still undecided about if scans are detrimental to unborn babies it will be good to cut down on the frequency of the voyeuristic invasions of their domain.
SIL raced at Brands Hatch on Sunday, in all that rain, and what a scary experience that was. I don't know how he felt, other than he was acting as if he had been wired up to the mains, but I found it frightening watching him zoom round the wet track at breakneck speed, especially when he approached the standing water where 5 riders came off and ended up being blue-lighted to hospital. Anyway, he got 2 thirds so he was a happy bunny, next race in 2 weeks. I shall not be a spectator, the nerves won't take it.
Unfulfilling
Have just returned from the Primary Care conference in Birmingham and rather than filling me with renewed vigour to face the challenge of midwifery in a rapidly changing environment it has succeeded in making me even more demoralised. Midwife after midwife voiced how they felt unable to carry out their role as they believed it should be and the exultation's of speakers as to how the profession could improve if we pushed for it often fell on such dampened spirits that any fire in them was soon extinguished. I'm not sure how life can be breathed back now, so many changes, too much paperwork, women's high expectations, litigation and frequent attacks from lay people, I allude here to a couple of NCT 'midwife bashers', have left too many of us wondering why we are battling to be midwives. As the midwife in the Panorama documentary said, as she packed to emigrate, 'it's not the job I trained to do.'
I did enjoy the interaction, the exhibition was profitable for me, not just due to the number of pens I obtained, but also because I was given two leads regarding jobs, one in the pharmaceutical industry and the other with an educational facility. Later I shall update my CV, send it off and wait and see.
Tomorrow the family are descending, en-masse, on Brands Hatch to watch SIL race, probably his last one as his funds are running out. The weather looks as if it will be horrid but we have been offered a corporate box so us softy girls can at least keep warm whilst the men patrol the track and pits.
Amy and her Mummy came round this morning and we had a good talk about tentative plans for when Van and Lorry put in an appearance. On Wednesday she has a consultant appointment and another scan, I'm hoping that she will be given a date for her section, weeks away yet but it will give me time to request the fortnight off work. She also questioned me about what to do if something happens whilst she is at work, difficult to answer really as there as so many scenarios, so the best advice I could offer was if it seems non-urgent get someone to drive you to the hospital you are booked at but if it seems urgent then call an ambulance and they will take you to the nearest, most appropriate one. That is the nub of the question really, what 'something' is she thinking of? For the first time today she voiced her fear of the twins arriving really early. I think this is possibly due to the rate at which her bump is growing, day by day it is increasing, and so she is now sure that she will have them before the 36weeks planned by the consultant. Already she is experiencing breathlessness, it is uncomfortable for her to bend forward as it feels tender at the top of her bump, and getting to sleep is difficult as, which ever side she lies on, one of the babies objects and starts to kick madly. Whilst we were on the subject of prem birth I broached the shortage of NICU cots and the chance that the babies could end up in different units, luckily she had already appreciated that because of her sister's threatened prem birth with Izzy and the treat of a journey to Bristol. Once she gets to 28 weeks I will begin to feel much more positive and every day past that milestone will be a blessing.
I see whilst I was away in Brum that NHS blog doctor has been scribing about free-birthers and independant midwives, interesting entry causing much debate about the right of the unborn baby. If only I had a laptop then I would have picked up on it earlier and commented.
If anyone is interested in the Independant Midwives lack of insurance debate then please look here my favourite G.P has given this blog a mention in his BritMed weekly awards, I love a good mud-slinging fest.