Moving on to OB

We have finished our pediatric anesthesia unit and have moved on to obstetrics. OB always scared me the most when I thought about anesthesia prior to starting school. Now it kind of excites me. Still scary, having 2 patients to think of instead of one. And of course, when things go wrong in OB, it gets bad fast.

Oddly, listening to our OB lectures makes me want to have a baby more. One would think it would be opposite, since we are talking about all the things that can go wrong. But it makes me think of what I would want.

I have baby anxiety. I'm getting older; I will be 36 years old this year. Yes, I know plenty of people get pregnant and have babies around this age. I hear it all the time. But until I get pregnant and deliver a healthy baby, all the reassurances in the world aren't going to take that anxiety away for me. With all the major revelations that have occured in my marriage this year, it would be best to wait at least another year before considering having a baby. But I am not getting any younger, so this fall is when I will consider whether I can start trying. Come about October, I may decide that it's better for our lives and our marriage to wait longer. But I have so much anxiety that I'm not going to get pregnant, I suspect that I will try anyway at that point. I graduate in May, so getting pregnant anytime after September would probably be okay for finishing school and taking boards and starting a job.

It would be perfect if I could revisit this whole thing a year from now and see what state my marriage is in at that point. And I could do that. But I will turn 37 next year...not when I want to START trying. The few people that I talk about this anxiety with (mostly my hubby, but a few other friends too, mostly ones my age) don't really like to hear about my anxiety. So I don't talk about it much anymore. But it is there, I really want to be a parent, so I will have to make some sacrifices in some areas to ensure that it happens.

Meanwhile, we start practicing epidurals next week (on lab dummies). We've already been doing spinals for several months; I have about 20 so far. Epidurals aren't drastically different; they are a little more difficult. But one nice thing that I never thought about before now is when we do spinals in the OR, say for a hip or knee replacement, the patient is not in pain to start with, so they are more sensitive to the pain of injecting local anesthetic and inserting the spinal needle. Versus a pregnant, laboring woman, who may be sensitized to needle pokes and all that, and may have a difficult time getting into the right position, but if you place a successful epidural, you've just become that woman's new BFF. They start out in pain and end up comfortable, as opposed to the surgical patient who wasn't in a particular amount of pain to start with when you started stabbing their back. (That's said tongue-in-cheek. If done properly, a spinal shouldn't hurt except for the initial local anesthetic injection. Only maybe 2 of my spinal patients have had any pain at all when getting their block. But sometimes it's very hard to do "properly", depending on the patient's anatomy.)

I never realized that there are quite a few options for anesthesia for labor before now. I guess I had the idea that you either get a full block, numb from the waist down, or no anesthesia at all. But in fact, depending on what the mom wants, there are a lot of variations and options, from just "taking the edge off" to complete anesthesia. I think that's pretty cool.