Return to B ward

Recently, Bill mentioned that maybe I should go back to B (maternity) ward to help me gain more confidence in that area. My first reaction was no. I felt that I was okay because I had gained experience on call, and was actually feeling pretty comfortable with things on B ward. Being able to do CSections on my own has certainly helped. If I make a decision that a pt needs to go to CS, I no longer have to worry about what my colleague will think when they come in to help me, I just do it. So right or wrong I stick to what I have decided and do it, which has been good. But if I was going to go back to B ward, I would prefer to do it when Bill was here to field my questions. So after Bill talked to Andy this am and he agreed to swap wards with me, I found myself back on B ward.

Today was a reminder why doing more of B ward is a good thing. Over the weekend, we had a pt (Annah) who came in with a retained placenta. A volunteer attempted to manually remove it, but couldn't get a plane, so he started a D&C. After a while he stopped, but knew there was more to get, that she likely had a placenta accreta. So we stabilized mom with IVFs and blood, and reassessed today. She was still bleeding some today, but her BP was more stable and her Hgb was 9. So when she had more blood ready, Bill and I proceeded with a D&C this afternoon. I got out a lot of tissue, but still felt like there was more. After a while, we stopped and got her some more blood and went back to OPD. After OPD, I went to check on her and found her bleeding again with lots of clots in her vagina and uterus. So after giving her some more meds to help her uterus contract, I retalked with Bill. Although I hadn't really asked him to help initially, but he thought I had, I was sure glad he was there. He agreed there was too much bleeding. We had talked earlier that this pt may need a hysterectomy due to the placenta accreta, so he went to retalk to Jim about her. By this point her bleeding had slowed a bit, but her Hgb was 6 - a little lower than we would have liked. So she is currently getting more blood and we are stabilizing her for a possible hysterectomy or repeat D&C in the morning.

This was a good reminder for me of how precious life is and how quickly it can be taken away. Psalm 103:15-17 "As for man, his days are like grass, he flourishes like a flower of the field; the wind blows over it and it is gone, and its place remembers it no more. But from everlasting to everlasting the Lord's love is with those who fear him, and his righteousness with their children's children." Pregnancy is one of the happiest times as God brings new life into the world. However, caring for these pts isn't always that simple. I often have thought that OB was one of the scariest things because you have 2 lives that you are responsible for. Usually 2 healthy lives that no one expects something bad to happen to, but at times bad things do happen that aren't always expected. Keep praying for the patients (especially Annah above), and for God to give me wisdom as I care for these moms and babies.