Updating before the year ends - now with videos added

Well, unfortunately I've neglected this blog for the past several months. Since October - well actually more like July, life seems kind of like a blur. I'm going to try to update on a few things before this years comes to a close.

June was crazy as could be with work. Our chief residents have the last two weeks of June off to prep for boards and then to actually take boards. This means that we get really short-handed at work. I was the sole resident on the onc service and I've never been more exhausted in my life. The service was super busy and my patient's were spread out throughout the entire hospital - literally one patient per floor. I had really, really early mornings and late nights. Most nights I'd come home, head straight to bed just to get up at 4am the following morning to start all over again. With only one major melt down (at work I should clarify, I had several melt downs at home - just ask Ryan), I survived. *sigh* We had our first trimester screen at the end of June and everything turned out great. Here's a few pictures of our little peanut at that time {sorry for the poor quality - these are cellphone pictures of the actual pictures as I do not have digital copies}.

Body Profile - head on the right, back at the bottom, belly on the left.

Legs! Ultrasound is a little difficult to look at but you can see the whole body, the left arm and the head {which is extended} in this picture too.

In July, pregnancy was going well. I hadn't really had any morning sickness up until that point - it was more like evening nausea. This wasn't a problem until I started night float and was up at night :( But I managed and only had a few nights where I felt super nauseated and would sprint to the bathroom to throw up :) Oh the joys! Here's a little video that we took one night with my cellphone of our little one moving and grooving all around. Darn it - I'm having problems uploading video :( Once Ryan gets home from work, I'm going to have him help me.

I think that I figured out how to post videos now. Here's the first one:

One of the highlights of August was our family vacation that I did manage to already post about.  Just before vacation, we had our anatomy ultrasound to make sure our little peanut had all of it's parts - this is also the ultrasound that took a look at the gender :) Here are a few pictures from this ultrasound.

Looking straight at us.

five fingers :)

I was out at our private hospital on gynecology for the month of September. As a third year resident, this is the rotation that is the best. You get to spend a bunch of time in the operating room, the mornings are not as early and the nights are not as late. There was nothing super eventful during this month. I was enjoying pregnancy and I was still feeling good! I'm lucky to have had a pretty easy pregnancy :) Since my placenta was on the front of my uterus, I didn't feel a ton of fetal movement. I was 22-23 weeks pregnant before I started to feel movement. Because of this and doing what I do for a career, this can create a lot of anxiety. A co-worker borrowed me their doppler to use so that I could listen to our baby's heart beat if I wasn't feeling a lot of movement. We didn't listen a ton, but it was fun to listen at night to our little munckin with Ryan. We have a video of Westin's heart beat in utero. I'm not sure if it is going to work - if not, hopefully Ryan will be able to help when he gets home. Nope didn't work. Stay tuned.

Update: 
Here's the video where you can hear Westin's heartbeat and you can also hear him moving around. 

I didn't take many bump pictures. In fact I think is the only one that I took on 9/22/13.

Zoey hugging my baby bump :) 9/28/13

October was completely uneventful. I was on night float which means that Ryan and I barely saw each other. Usually we would see each other in passing as Ryan was getting home from work and I was heading out the door for work. I rarely ever made it home in the morning before Ryan left for work so we would usually wave to one another as we both drove passed each other. My last night float shift for the month ended the morning of Halloween which meant that I would be home to hand out candy to the trick-or-treaters. Handing out candy is one of my favorite things to do. We had a bunch of trick-or-treaters again this year, although we didn't keep track of the number like we did last year. I do have to say that the costumes this year were not as good as last year but for the most part all of the little kids were still really cute. Well - that was an easy October update! Ha!

3D picture of our little guy on 10/8/13. I had to go in for an ultrasound as my uterus was measuring larger than my gestation age. Everything at the ultrasound was normal - normal amniotic fluid level and normal sized kiddo in the 50th percentile :) {Pictures like these make me so appreciative of the advances in technology.}

The month of November was busy - actually very busy. I changed rotations and was on the high risk OB service. Being on this rotation means service obligations M-F but then also 3 to 4 nights of overnight home call per week. I was actually very lucky and had fairly uneventful home call nights which was nice since I was feeling more and more pregnant by the week. The first weekend in November, Ryan and I set up the crib for the babe and I caught up on sleep.

Ryan reading the instructions.

I guess here's another bump picture. I have to say I look pretty stellar - ha! (11/2/13)

The finished product!

Being visibly pregnant and working on the high risk OB service is kind of awkward at times. There are times when I wished I could have hid the fact that I was pregnant since I was working with patients who were having less than ideal pregnancy outcomes. I guess it comes with the territory though. I was delivering patients who were earlier in pregnancy than I was and on a few occasions I delivered some patient's preterm that had the same due date as me - it kind of made things a little surreal. It was always a little weird to be triaging patient's around the same gestational age as I was. Hard to really explain without going into more detail than I actually want to put on the internet. Actually one that I can share: I was triaging a patient that was due a few weeks after me. I was asking them about their nursery and they told me they had it all set up and ready for a baby and that it had been that way for over two months! I was thinking to myself - oh my gosh, we only have our crib set up and at that point we didn't even have a crib mattress yet - ha! I guess the logical part of me was thinking that if I went into labor and had our baby in November, the kiddo would have to be in the NICU and then we'd have time to buy additional baby stuff and finish the nursery before our baby would get discharged from the NICU. Good thing we didn't have to worry about that though.

On November 9th, my sisters threw me a family baby shower back in Minnesota. Ryan and I drove up to Minnesota separately {Ryan needed to do somethings at our place in Minnesota and at his parent's work and I wasn't able to take time off of work}. Anyways, in hindsight, that wasn't the best choice. Ryan left for Minnesota on Thursday. I left for Minnesota Friday after work which was 630-ish pm :/ So I drove almost the entire way home in the dark :( Also I had to stop to go to the bathroom all the time :( There was one point during the drive near Worthington that I was in literally the middle of nowhere and had to go to the bathroom so bad that I seriously considered pulling over on the side of the road. It was awful. Do not take bladder capacity for granted because when you're pregnant and have a bladder the size of a walnut, it's awful! Anyways I survived but was pretty tired by the time I got to my parents house that night!!

I slept in a little on Saturday which felt great! My sisters threw the shower in Henderson at the community center. The theme for the party was "Ready to Pop." Everything had some aspect of popping incorporated into it. It was really cute! The tables where decorated with pop-up books, toys that made popping sounds and books that also made popping sounds. For food we had pop-over sandwiches, fruit pops and a treat table with popcorn, cake pops, blow pops, tootsie pops, pop rocks and ring pops {I think I got them all}. My sisters also froze little baby figurines in ice cubes and used them for a game. Everyone got one of those ice cubes and the first one to have their water pop {aka, baby break free from the ice cube} won a prize :) It was good to see a bunch of family, especially since living so far away, I'm not able to make it back home for every family function. A nice surprise was that Anna, one of my high school girlfriends surprised me by coming! I haven't seen her in forever and it was so good to see her! I received a bunch of great gifts for our little baby too :) which was nice.

The tables all decorated.

How cute is this diaper tricycle!!

My mom and me :)

Me and two of my aunts :)

Anna and me :)

Lol - Hillary don't be mad at me, but this is the only picture that I currently have of the snack table.

I just realized that I have more pictures of the shower but I think they are on my sister's camera. When I get those pictures. I'll be sure to share.


While us girls were at the baby shower, Ryan and Hillary's Ryan were working at some stuff at our Minnesota house. Later that night, my uncle Curt came down and took my Ryan, Hillary's Ryan and my dad to the MSU hockey game in Mankato. I guess the game ended up being very, very slow but I believe MSU won with a score of 1-0. While the guys were at the hockey game, my mom, sisters and I went in to visit my grandma and grandpa. We brought some left over popcorn from the baby shower for my grandpa. He was all about the popcorn until the nursing home staff brought him in some ice cream :) It was good to see my grandparents and visit with them. I wish I lived closer to home! Sunday morning after eating breakfast, Ryan and I hit the road for the long, boring drive back to Nebraska.

The following Saturday, November 16, my resident-mate Morgan threw me a baby shower down here in Omaha. I was exhausted and slightly overwhelmed on that Saturday. I basically slept in a tiny bit, woke up, showered and got ready for the shower, went to the baby shower, came home, took a quick nap and then started working on Grand Rounds which I was giving on Wednesday, Nov 20 {more on this in a minute}. Anyways, the baby shower was pretty low key which was really nice. I again received a bunch of really nice gifts for our little kiddo and we ate some really yummy food. Morgan's aunt actually hosted the shower at her house {the same place we had Morgan's baby shower a while back}. Her home is very inviting and comfortable. Morgan's husband made a french toast bake for the main meal and it was delicious!

So onto my Grand Rounds ordeal. Every year, we sign up for a grand rounds date well in advance. I had signed up for December prior to becoming pregnant and having a December due date. Anyways, my initial grand rounds date was December 18 - five days before my due date. Seeing as nobody knows when you'll actually deliver, my grand rounds date got moved up to November 20. This kind of stressed my out, well, lets not lie - this really stressed me out. The date change happened in October, while I was on night float. Being on night float, you don't do a whole lot other than sleep and work so I didn't make any progress on my presentation during October. Then in November, I had already had the two baby showers scheduled on the 2nd and 3rd weekends and the first weekend of November was right when I was coming off of night float which really limited my free time to work on my presentation. Anyways, I had tried to work on it during the week while at work but that time was always interrupted which isn't optimal for working on a grand rounds presentation. Not to mention, I was one tired pregnant mama :( So by the time my second baby shower finished on Nov 16th, I still hadn't even started on my grand rounds :/ I had a hand full of articles but had only been able to read through two by this point. I literally worked on grand rounds all afternoon and until midnight on Saturday, then woke up early on Sunday and worked straight all the way through until 11pm on Sunday night - not to mention, I started home call at 10pm on Sunday :( Then I worked on it again Monday after I got home from work until I was deliriously tired and praying that I didn't get called into work {which I didn't - thank the Lord!} I wasn't on home call Tuesday night {thankfully} and finished up my presentation around 11pm and then went to bed having not even gone through an entire practice run of the presentation {I don't recommend this.} I then woke up at 3:30 am to shower, get ready for work, drive the 20 minutes out to work, rounded on all of my patients for the day and wrote all of my notes by 6am so I could round with my attending and be on the road to the med center by 7am since traffic between the two locations in the morning is awful, awful, awful! I got to the med center at 7:43, I looked through some of my slides quick and then set my cellphone alarm and took a ten minute nap in my vehicle {I was so incredibly tired at this point} and then made it to our grand rounds conference with two minutes to spare {just enough time to take my coat off and load my presentation onto the computer!}. Apparently I was cutting it too close for one of the residents who worried that I might have gone into labor while rounding that morning so he actually called the high risk desk to make sure I wasn't admitted as a patient - ha! My grand rounds presentation itself went great and it was just long enough to fill my allotted one hour time slot {thank goodness as I had no idea how long or short the presentation was going to be since I hadn't even done a practice run!}.

Update:
Here is a picture of Westin helping me work on Grand Rounds :)

Up until this point in my pregnancy I essentially had no lower extremity swelling and felt pretty good. Unfortunately since I sat in our office working on the computer for a couple straight days starting and finishing my presentation, I developed massive lower extremity swelling. By the end of that Sunday before my grand rounds, my swelling was so severe that I felt like the skin on my feet and lower legs was going to split open! Thank you very much grand rounds!! Ryan had never seen pitting edema before and was slightly grossed out/worried about the state of my legs - lol. Anyways, I survived - barely, but I did! Ryan went out and bought compression stockings for me that weekend. I wore those everyday there after and the swelling did go down but it never went away {until after I delivered}. Looking back at those first 20 days of November, I realize how crazy my schedule was - I would not recommend any 32+ week pregnant lady replicate my November - ever! Oh man, what was I thinking - I was crazy! Needless to say, I spent the weekend of Nov 23 and 24 sleeping since I was so run down - not good! The month of November went by so fast and was such a blur. I literally was going, going and going some more.

I was assigned to Thanksgiving call at our private hospital which consisted on 24/7 call starting Nov 27 and ending Dec 2. Luckily I didn't have to take call on Nov 26th and got a good nights sleep because the holiday call was crazy busy starting the morning of Nov 27th. I spent 3 of the first 4 nights at the hospital over that holiday call. It was crazy busy! The morning of Saturday Nov 30, my attending looked at me and joked how I couldn't go into labor for at least another 48 hours as it was too busy and he didn't know how to use the electronic medical record - ha! Well that Sunday, the craziness continued. Both my attending and I were called in Saturday night at 1030ish for a new transfer admission. Once I finished all of the admission orders and my attending finished ultrasounding the patient, we saw a consult and did an ultrasound on her and then ended up having to take one of our other patient's to the OR to be delivered. Literally as they were rolling out patient out of her room at like 1am to head to the OR, another patient arrives who was about to deliver, the front desk wheeled her into L&D and shouted "this patient is going to deliver!" Since there was no time for the on-call generalist to get there {they are just down the hall in the call rooms}, we ended up delivering. Once that delivery was over, they took our patient back to the OR. Since our patient was preterm, they increase the OR temp to 80 degrees {new policy since perterm infants were going to the NICU with hypothermia} which means that we surgeons over heat in our surgical cap, mask, gown, gloves and knee-high boots :/ So for me, this means that I start contracting :( Ugh, so uncomfortable. We finally left the OR after 2 am but I still had to dictate an admission, a consult, the vaginal delivery and the c-section before going to bed :/ Anyways, this holiday call was absolutely crazy. Fortunately after my attending and I finished rounding Sunday morning I was able to go home. I got home at around noon and I think and was able to take a three hour nap - I was exhausted! After getting up, Ryan and I cleaned out our garage and put together some shelving units so that we could reclaim some space in the garage {hello nesting!}. Then later that night my water broke and instead of being the provider, I became the OB patient :) more on that in the next post.

Anyways, I think this somewhat sums up what we've been up to for the past several months. More about my month of December to come :)

~Ashley