A study on Irish roots in childbirth

All good things have to come to an end, and I have sadly finished my rotation on the labor and delivery unit. It's always exciting to go some where new, but delivering babies was so enjoyable that leaving is difficult. Our last week there was jam packed with excitement and very busy. I helped a woman whose family, like mine, hailed from Ireland and was expecting a baby girl. I was assigned to help with the delivery. It was like right out of a tv show, with me holding one of her legs back in a very compromising position and yelling at her to push. I wiped her brow, made her sip liquids from a straw, and tried to ignore the overwhelming smell of birth products in the room. I changed linens, ran water,and gripped her hand when she needed me. As high tech as medicine has gotten, I was struck by the natural flow of the whole event. We inherently know how to give birth and helps others do so. I felt extremely in touch with my Irish dozen-of-children-bearing heritage that has gifted me with the intrinsic ability to yell push and, I can only assume, spit out like nine kids of my own some day. 

When the baby was finally out, she was purple. The cord had been wrapped around her neck twice. She didn't cry for the longest time, putting me into a slight state of panic. But she started to turn pink, and then did the most amazing thing: she latched on to her mother's breast and began to suck like a starving monkey. She was there ALL DAY. It was astounding, because most babies don't do that right after birth. Not to mention most mothers don't have milk in that early, but this mother made her equally Irish ancestors proud by being more fertile than most believe possible. 

With mom and baby happily engaged in their nutritional needs, dad went out for a Guinness and I had time to roam around the floor. I reflected on some of the odd, yet endearing, qualities of the maternity floor. There are many nice paintings hanging on the walls in a variety of pastel colors. All the paintings are of vaguely vaginal flowers or waves with many folds. I'm not sure what the subliminal message is suppose to be, but it is soothing to know exactly what the specialty of the floor is based on the decor. Some of the other paintings are of lighthouses. These are fake frames that swing forward off the wall like a James Bond style hiding place. Behind them is all the emergency equipment needed when things go downhill super fast. I'm glad this was revealed to me in orientation, because I would never have guessed to look behind the phallic painting.

 

I also visited the other students, like my friend Kim. Kim is the most in demand student nurse because she can speak many languages fluently. Currently, she was translating for a Spanish couple who had questions to ask about the pregnancy. Kim chatted away with them, her face looking increasingly uncomfortable. Later, she told me the husband began asking her questions like "Do we need a car seat?" then some how moved on to "How do we get a DNA test?" Kim didn't understand I thought maybe they were concerned about genetic diseases and began to counsel him on genetic disorders. He stopped her and said "No, I mean like paternity testing..... I had a little.... you know, problem with her a while back...." Thankfully, Kim is very fluent and knew exactly what this meant, while I would have probably needed further explaintion. 

I brought homemade girl scout cookies to the last day. They took me forever to make and were super time consuming, but people really loved them. I made Thin Mints, which I'm not crazy about, but others adore these fudgey treats!

Homemade Thin Mints
2 1/4 cups all purpose flour
1/4 cup cornstarch
6 tbsp unsweetened cocoa powder
1/2 tsp salt
1 cup white sugar
1/2 cup butter, room temperature
1/3 cup milk (any kind)
1/2 tsp vanilla extract
3/4 tsp peppermint extract

In a small bowl, whisk together flour, cornstarch, cocoa powder and salt.
In a large bowl, cream together butter and sugar. With the mixer on low speed, add in the milk and the extracts. Mixture will look curdled. Gradually, add in the flour mixture until fully incorporated.
Shape dough into two logs, about 1 1/2 inches (or about 4 cm) in diameter, wrap in plastic wrap and freeze for at least 1-2 hours, until dough is very firm.
Preheat oven to 375F.
Slice dough into rounds not more than 1/4 inch thick - if they are too thick, they will not be as crisp - and place on a parchment lined baking sheet. Cookies will not spread very much, so you can put them quite close together.  Warm dough in your hands if it crumbles.
Bake for 13-15 minutes, until cookies are firm at the edges. Pay attention, but its very easy to burn them! Cool cookies completely on a wire rack before dipping in chocolate.

Dark Chocolate Coating
10-oz dark or semisweet chocolate
1/2 cup butter, room temperature. I used a bit more, and it was okay, but more watery than I wanted.

In a microwave safe bowl, combine chocolate and butter. Melt on high power in the microwave, stirring every 45-60 seconds, until chocolate is smooth. Chocolate should have a consistency somewhere between chocolate syrup and fudge for a thin coating.
Dip each cookie in melted chocolate, turn with a fork to coat, then transfer to a piece of parchment paper or wax paper to set up for at least 30 minutes, or until chocolate is cool and firm.
Reheat chocolate as needed to keep it smooth and easy to dip into.

Makes 3 1/2-4 dozen cookies, if not more. You could make your own little cookie army with this recipe, which means you'll need more chocolate to coat if you make a ton. I ran out because I had more than 4 dozen cookies. I would make these again if someone requests them, because people loved them so much, but they did take forever to make!

Tropical Vacation

A lot of babies get jaundice. Some babies get jaundice so bad you think to yourself "omg she gave birth to a carrot!" and then you are confused. It's a pretty common complication and most babies are able to bounce back without having us to intervene. However, there are times when treatment is required. The best way to treat really bad jaundice is with phototherapy.

Phototherapy is basically exactly what it sounds like. We put the little new babies under tanning lights. Like a ton of them. Well, at least three. They wear little diaper speedos and we put sunglasses over their eyes and lay them down on the tanning bed. Yesterday morning, the hospital lost electrical power, so we plugged the tanning beds into the emergency outlets and let the babies laze around under the lights. In the dim nursing lighting, it looked like all the babies were on tropical vacations, and I mixed them all up a bottle of pina colada to sip on. Because nothing clears up a touch of jaundice quite like dark rum. Fuck yeah spring break!

In keeping with a tropical theme, I mixed up some banana cookies the other day for some fun and healthy flavor! 

Banana Oatmeal Cookies

1 cup all purpose flour

1/2 tsp baking powder

1/2 tsp baking soda

1/4 tsp salt

2 tbsp butter, very soft

1/2 cup sugar

1/2 cup brown sugar

1/4 cup mashed banana (1 small/medium)

1 egg

1 tsp vanilla extract

1 1/2 cups oats

Preheat oven to 350F and line a baking sheet with parchment paper.
In a small bowl, whisk together flour, baking powder, baking sodaand salt.
In a large bowl, cream together the butter and the sugars. Beat in egg and banana, followed by the vanilla extract. Gradually, on low speed or by hand, add in the flour mixture. Stir in the oats. It'll be thick, so I usually mush with my hands (then lick them later).
Drop dough by tablespoonfuls onto prepared baking sheet.
Bake for 11-14 minutes at 350F, until set and lightly browned.

You can add chocolate chip to these for some variety. I'd probably use mini chocolate chips so they don't overwhelm the banana flavor. What I really love about these cookies is that they bake up super high and airy, instead of being dense and heavy like you would expect. But this does make them super addictive! I hid them in my pockets, then passed them out to random patients who look they they needed a boost, because I might be early for spring break, but babies can't tell time anyways.

The Final Day of Pediatrics

My last day on the pediatric floor was the total opposite of the rest of time there.
It sucked.
I was on the verge of tears from most of the shift. I had to deal with a horde of medical students poking my poor nine year old medical mystery, while being totally annoyed with following percautions protocol. If I never see a blue plastic protection gown and mask again, I will die happy. I was nervous about the intense medications being given, including Ativan, Prozac, Depakote, and Risperdal, which I've never even seen used in kids. I watched over her for most the day, because it was possible for her to have a seziure at any moment, but no one taught me what I should do if it actually occured. So I just kept praying it wouldn't happen, figuring I'd just cross that bridge when I got to it (this probably isn't smart). As miserable as I was though, I was able to help out my patient and her mother by capitalizing on a unique gift God has bestowed upon me and I use to spread happiness throughout the world: sticky fingers.
I am very very good at stealing things. I think no one expects me to be stashing tons of things underneathe my white coat all day long, so I float by undetected with all my pilfered goods. I have weighted myself with and without my lab coat on, and there is a ten pound difference because of how much I have shoved in the multiple pockets. My patient's mother told me she was insanely bored, and suddenly Better Home magazines began disappearing from the waiting room. Cookies and coffee went missing from the break room. I totally just claimed a vital signs cart and blood pressure cuff and hid it in a closet, figuring my need of it was probably greater than others without unstable patients. Obviously, I didn't go rob a bank or anything, but I have begun a life of crime.
As it was the last day, I made something decedant for the peds nurses: cheesecake brownies. Brownies are really strange to make, but apparently I have mastered the art of creating them, because I get requests all the time.

Cheesecake Brownies
1/2 cup butter
2-oz chocolate, chopped. Dark is probably best, but I didn't have any so I used 1 oz milk and 1 oz unsweetened
1 cup sugar
2 large eggs
1 tsp vanilla extract I couldn't find my vanilla. Turns out it fell off the spice rack, and I found it later in the back of the pantry. Instead I used 2 tsps of rum. I know this sounds weird, but OI sometimes use it in place of vanilla. It has a much more grown up taste that makes things a little interesting.
2/3 cup flour
2 tbsp cocoa powder
1/4 tsp salt

Cream Cheese Layer:
8-oz cream cheese, room temperature
1/3 cup sugar
1 large egg
1/2 tsp vanilla extract

Preheat oven to 350F. Line an 8×8-inch square baking pan with aluminum foil and lightly grease.In a small, heatproof bowl, melt butter and chocolate together. Stir with a fork until very smooth. Set aside to cool for a few minutes.In a large bowl, whisk together sugar, eggs and vanilla extract. Whisking steadily, pour chocolate mixture into sugar mixture. Stir until smooth. Sift flour, cocoa powder and salt into the bowl and stir until just combined.Pour into prepared pan and prepare cheesecake mixture.In a medium bowl, beat cream cheese, sugar, egg and vanilla extract until smooth. Drop in dollops onto prepared brownie batter. Gently swirl two batters with a butter knife.Bake for 35-40 minutes, until brownies and cheesecake are set.

The brownie layer is thin and SUPER fudgey and the rum made it taste really dense. Overall, I think they came out good and it was a great way to bribe the nurses to let me come back to pedatrics.

Obstetrics Day #1

Today was the first day of my rotation on Labor and Delivery. I woke up in the slight panic and needed to take at least 10 deep relaxing breaths before heading out the door. I was so jazzed up, I was a little concern that I had accidently given myself seretonin syndrome, a bizarre fear I've been harboring for a few weeks now.
Anyways, I wasn't super excited about Delivery. I had loved pediatrics and wanted to stay there. Maternity freaked me out, because I had no previous experience to draw upon and didn't really feel fit to care for anyone's reproductive plumbing. Plus, the word fundus always make me giggle in class, and I didn't want to insult anyone if I burst out laughing when they gave report. Thankfully, my anxiety level started to fall after my third soothing cup of coffee and I found out I had been assigned duty in the nursery. My experience in caring for babies in much more advanced than caring for their mothers, so I felt comfortable swaddling infants for the next 12 hours. However, when I got to the nursery, I found out all the babies were off with their new moms, rendering me utterly useless. After 20 hopefully minutes where I prayed my clinical instructor would just ship me off to some place I could disappear, like the OR, I was assigned a nurse to follow and a patient. She was not postpartum, but had given birth to a little boy a weekend ago before developing preeclampsia. She was also an NP who worked in the ICU at my school.
Preeclampsia sucks. It is high blood pressure greater that 140/90, with protein in the urine, low platletes, terrible headaches and epigastric pain, visual distrubances, and the nasty habit of causing seziures. I have no idea why it happens, and it freaks me out that so much can go wrong so quickly. It is however, diagnostically interesting, at least to me, and the use of mganesium to treat is bizarre because normally levels of over 2 are not great and my patient's was 5.8, which in this case is considered theraputic. Also, preeclampsia was on an episode of House a few weeks ago, which really is the greatest learning tool available.
I had a great day with her. A few hours of chatting and two foot rubs later, I that she was awesome and gave her my email address when I left. Interestingly, I found out that she had been doing "natural family planning" where she monitored her cycles as a method to prevent birth control. She was married April 12. She was prgnant April 18. She told me "I think we need to re-evaluate our methods..."
After lunch, to my surprise, I found out I was still considered the nursery room nurse and there was a baby I needed to care for. I walked into a room and quickly realized that my new patient hadn't been born yet, but was apparently coming soon. The nurse, pedatrician, and I set up suction, tubes, and blankets while the mom pushed, and I whispered to the doctor, "Um... this is my first day..." and he was like "um.... really? Wow, intense first day huh?"
The birth was what you would logically expect. A watermelon sized head was attempting to fit through something much much smaller. I watched the fetal monitoring strip that reported the baby's heart rate, and thought "Oh this is total shit" as it declined to dangerous levels. The doctor was forced to quickly cut an episotomy and pull out a baby that we grabbed. About a billion things suddenly happened at once, and I started adding up the APGAR score in my brain, while I tried not to cry/puke/pass out. After, I took a "bathroom break" where I just sat in the stall clutching my cellphone, our generations comfort item.
I've decided I love labor and delivery.
I brought 10 grain muffins, because I had a bag of 10 grain cereal in the pantry, and I really hated it, so I figured I'd bake it up. They were a total hit with the nurses, who requested the recipe a million time. I was relieved, because I really thought they were crappy muffins, but they enjoyed them. Here is the recipe:

INGREDIENTS:
1 large Egg
1/2 cup Sugar
1/3 cup Margarine
1 cup whole wheat flour
1 tsp Salt
1 tsp Baking Powder
1 tsp Baking Soda
1 cup 10-Grain Cereal
1-1/4 cup sour Milk or Buttermilk
Mix 10 Grain Cereal and milk; allow to stand for 10 minutes while preheating oven and assembling other ingredients; cream sugar, margarine, and egg together. Add dry ingredients and milk mixture. Stir only until mixed. Spoon into greased muffin pan. Bake at 400°F for 15 minutes. Makes 12 muffins.

I added blueberries and almonds to mine, which gave it nice color and a good crunch. I also ended up with 13 instead of a dozen.