Stretch uterus stretch!

Neela says "Come on people...please...what does a dog have to do to get a decent meal around here?" Neela has learned how to open our cabinet door and get out Brynn's gerber meal plates. She then drags them around and looks at us like she wants another meal too.

Yesterday I got to work a few minutes early, signed out my narcotic box from the OR pharmacy and got ready to set up my anesthesia tabletop for my first case. When I entered OR #12 I noticed that there were already endotracheal tubes and some oral airways on top of the anesthesia cart. Clearly I had a CRNA student or a RNAS (registered nurse anesthesia student) as they call themselves. I also noticed the pediatric cart next to the standard blue anesthesia cart that is in every room. Gulp. I had my mock transfer scheduled in a few hours at my RE's clinic in the medical office building, and I was hoping for an easy day! Peds cases are always a little more challenging from just the stress of doing anesthesia on kids, and having to supervise a student to make sure that they learn safely is a bit stressful at times as well. So having a student and having peds cases just means you have to keep things on a tighter leash. I quickly phoned our lead CRNA who was running the OR board for the day, to see if I could have my lunch break at 11:30 since my mock transfer was around that same time. She said staffing was tight but that it shouldn't be a problem.

Luckily we were working with one of the world's nicest ENT (ears nose and throat) surgeons who was ever so patient with my student as well. Our youngest patient was a 13 month old we placed ear tubes in, and our oldest patient was 5 year old who was having micorlayngoscopy and biopsy. After doing our preop anesthesia assessment on the five year old and talking with her parents, my student and I walked away to discuss our anesthesia plan. I asked the student if he noticed how nervous the parents of the 5 year old patient were. The student just nodded his head, but didn't look like he had given it much thought. Before I could get to miffed at the student for overlooking a huge part of anesthesia care of peds patients, mainly reassuring the parents of the kids that we were going to take good care of their child I remembered what it was like to be an anesthesia student myself.

When you're a CRNA student it's easy to get so caught up with the stress of the actual surgical procedure and what you're going to do during the case - that you forget about the patient's concerns or in the case of peds - the concerns of the parents. I told my student that as important as it was to do a good job with the anesthesia after the patient went to sleep, it was also important to do a good job in preop. It was our job to make sure that the parents knew we were going to do everything in our power to take the best care of their child. I told him that those parents were trusting in us as their CRNA or anesthesiologist the care of their most precious cargo...their child.

Honestly, while I was in school I don't think I even thought about this aspect of the job much. I was trying not to let anything happen during the case - I certainly was not concentrating as heavily on the emotional aspect of the job as well. It's kind of nice now to be to the point where you can step back and see the whole picture a little more clearly. I know I still have a long way to go but it's nice to be able to point out things to students other than the technical points of our work. A monkey can learn a skill - but it's being able to take care of our patients as whole human beings that makes us do what we do - and not be monkeys of course :-)

Long story short, I ran down to the first floor of the medical office building to my RE's office and waited to be called for my mock transfer. Once in the exam room I changed out of my scrub bottoms and into my fashionable pink paper coverup, jumped back into the stirrups once again, and my RE did his measurements with the catheter in preparation for our embryo transfer. Without much thought I remembered back to our mock transfer for our IVF cycle that resulted in our daughter Brynn. I remembered our RE saying, "deviated to the left...8cm." Meaning 8cm in was the correct catheter placement and that my uterus was deviated to the left - which was to be expected since I have a left unicornuate uterus. This time my RE said, "deviated to the left...9cm." Yay! That meant the measurements were not the same as first time, and that hopefully it was a little glimpse into the fact that my uterus might have stretched a bit from our pregnancy. A stretched uterus hopefully means more room for a future pregnancy and less preterm labor and contractions. A girl can dream right? My RE gave me a little high five (after removing his gloves of course, LOL!) and wished me good luck for my appointment with my peri next week.

I left the office with a gleeful smile on my face. Even my student mentioned that I looked happy and must have had a good lunch. Although lunch consisted of me scarfing a peanut butter and jelly sandwich and some string cheese in the waiting room - I agreed. It was a great lunch. Great news and a good lunch. And even more good news? My student took the time to talk to our last pediatric patient's parents before the case - and I could see that they were visibly calmer after he explained things to them. He was learning...and that made me feel a sense of accomplishment. My student told the parents that we were going to do everything we could to make sure we took the best care of their child. We would do everything we could so that the child had the best outcome possible.

Now if only I can keep reminding myself that my doctors are doing everything they can so that our family will have the best outcome possible. We have good doctors..we just have to have a good outcome...at least that is the mantra I keep telling myself.