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Archive for August, 2007

Here at last

brothers.jpg

The twins were born today at 11.45 and 11.46. Little boys weighing 6lbs 2ozs and 5lbs 15ozs. No names yet. Twin 1 is fine and with Mummy, twin 2 is having a few problems with his breathing so is on SCBU getting some help. Daughter is well. I’m shattered, emotional day.

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Basics

I have just done a bit of last minute ‘hospital’ shopping for daughter. Nappies, she had bought some but I suspect that 1 packet for 2 babies is not going to go very far so I purchased some Boots newborn. According to both daughters Tesco disposables perform as well as Pampers and Huggies, but are half the price and this will be a chance to test out another make. I have got a box of real nappies upstairs, Kushies, first grandchild started out in them but after a few major leakages they were abandoned.

I have also put a small bottle of ‘hand sanitizer’ for her to take in. The hospital does have dispensers positioned strategically around but I reasoned that it wouldn’t hurt for her to have a a small one in her washbag for when she uses the loo. The literature on hand hygiene recommends that handwashing is the best way to ensure cleanliness but you still have to use the door handle to open the door and the person before you may not have been into the idea of washing their hands after using the facilities.

On daughters list was Arnica, to, hopefully, reduce any swelling and bruising she experiences after the op; tea tree oil, to use in the bath to act as a deterrent to wound infection; Bach rescue remedy, for all the family, well hers anyway. The only time I have taken it was years ago when I was nursing in the community and went to visit an elderly patient who lived in the middle of no-where. I went into the house to find the patient sitting in her chair in the sitting-room, with all the family sitting watching TV. Absolutely fine, except she was dead and, from how cold she was, had been for some time. The family had been blissfully unaware. This was pre-mobile phones, and there was not one in the house so I ended up, in the dark, walking up an unlit lane to the home of a local G.P. He came and certified her death and helped me move her onto her bed so that I could ‘lay her out’. He also phoned to where we knew my colleague would be to give her some of my workload. Next thing, colleague arrived and ordered me to allow her to drop some rescue remedy on my tongue. I’m still alive, so it obviously did no harm!

Mumof4 asked about how much larger you would expect a twin pregnancy to be in comparison to a singleton. I really don’t know if there is an accepted ratio but I did measure daughters bump today. She is now 36 weeks. Measuring from the top of the fundus (top of the womb) to the top of the bone at the pubis is 48 cms, with a singleton it should be between 34 and 38 cms, rough rule is that the measurement in centemetres should equal the number of weeks of pregnancy. Out of interest I also measured around her bump, 123cms, or 48”, her waist measurement is usually 25”. In other words she is 4 ft around her waist, I find that mind-boggling. Whilst I was conducting my investigations the twins became really active and at one point I could feel so many limbs that it seemed as if there was an extremely lively octopus under my hand, it must be so cramped in there now.

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Countdown

Tuesday, Wednesday, Twinday. I’ve got butterflies, so heaven knows how daughter feels about meeting them. I do know that she feels huge, tired, worried for Amy and frightened of the operation.

twins-35wks-bump.jpg Taken last week!

Good news that Dave Cameron has decided to make A&E and Maternity Services his pet election seducers. Even if it does nothing to boost the Tories ratings it might make them more high-profile.

BBA last night (born before arrival). Should have been a homebirth with 2 midwives present, instead it was a homebirth, in a birthing pool, with the midwives arriving 2 minutes after baby. Thankfully all was well, in fact Mum and Dad described it as ‘perfect’, I shan’t dwell too much on the ‘what ifs’ but rather the ‘what is’. Have we got an excuse, other than that we wern’t called until the last moment? The police had closed a road off which made the journey slightly longer.

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Doctor in training

At one of my clinics last week I was lucky enough to have a trainee Doctor in with me. During their time in the G.P surgery these mini medics have to orientate with all the disciplines, I suspect that they are not always happy with their roving lot but this new doc made the most of her short time with me and at the end of a long clinic thanked me and told me how much she had enjoyed it. I had enjoyed having her in the clinic with me as she was obviously really interested and wanted to learn what midwives get up to. Today I was pleased to see her happy face as I did my usual last minute dash into the surgery, and even more pleased when she asked if she could join me again in my clinic. This time I encouraged her to do the practical elements of the appointments, after all next week she will be seeing patients with no supervision , so better that she flexed her knowledge and practice whilst I was there to support her and answer any questions she was unsure of the answers to. I hope she enjoys the rest of her time at our surgery and that she continues to be the really human, grass roots practitioner that she is now and doesn’t lose her enthusiasm for her chosen profession and the people that she encounters.

My job-share of 6 years has now retired and, wonders of wonders, a new job-share has been appointed. Okay, so she won’t be starting for a couple of months but in Health Service terms that is amazingly fast, and it’s someone I know, very well in fact. Yes, it’s the midwife who helped my first Grandchild into the world. We have worked together in the same team before the birth of her first child so at least we won’t have to go through all the getting used to each other aspects of a job-share, and, if our 90 minute phone conversation this evening was anything to go by, communication should not be difficult.

Today I visited my couple who had suffered a stillbirth 3 weeks ago. They are still amazingly philosophical about baby dying but I do worry that they have shut themselves away from the world. Apart from their parents and me they have not spoken to any friends or relations since the trauma as they don’t want to keep telling the story of what happened. I can understand, but it does worry me. I am no bereavement expert so am not sure what my reaction should be, and how I can help them through the ‘re-socialising’ phase of their grief so, as usual I just went with gut-instinct and told them I could understand their reluctance to feed what they are seeing as a ghoulish fascination with the details regarding the loss of their baby. Physically all is well so I could have discharged her today but instead I’ve told them that I shall keep them as a case until after the post mortem results are received so, if they need to, they can call me round to have a chat. At least with me there are no explanations needed, I know why I’m there and we can talk about things as much as they need to. It’s so, so difficult though. I am naturally one of these really weepy people and in these scenarios I often find myself on the point of joining in with the tears, I have to swallow so hard to hold it back that I end up with a sore throat, and I’m not always successful entirely covering up the fact that my emotions are attempting to take over. It’s their grief, their tragedy and I should be there being strong, impossible.

One week today, the twins will be born. I’ve got butterflies. Heaven only knows how daughter and son-in-law feel.

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Customer Relations

In response to my previous rant about Haart Estate Agents, or perhaps more correctly one branch and one employee, the Customer Service Manager left a comment on the post ‘inviting’ me to contact her with my concerns. Two emotions immediately coursed through my system, the first was, for some unknown reason, embarrassment, which caused me to blush and the second was pleasure that Haarts appear to be concerned about the service provided, or not provided, to a customer. I phoned daughter who told me to e-mail back with the information that on Friday letters were sent to the Head Office, the Branch involved and to the person responsible, Simon. I’ve done this and hope that the response is positive and procedure is tightened up. What it is impossible to communicate is the utter frustration experienced throughout 6 months of the sale, exchange and completion. There have been many times when I have wanted to go into the branch and confront Simon publicly about his attitude, his seeming desire to, if not obstruct, at least not further the sale and his complete inability to empathise with a couple experiencing a complicated pregnancy where stress could only make things worse. As an example of how poor communication had become, Simon moved to another branch during this debacle but didn’t bother to inform daughter of this fact. The reason I didn’t blog before the move about which estate agents were involved was wholly due to a commonly held belief that Simon was already deliberately not doing all within his power to move things along. This was felt to be due to the fact that the house daughter was purchasing had been with him, but daughter was buying through another agent as it was their details she had received first and, therefore, he was peeved by this loss of commission. This is just supposition but it certainly prevented me from performing my ‘outraged Mother’ act!

Anyway, if there are any further developments about this I shall blog them. Here’s hoping something positive happens.

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could find themselves having an extremely difficult, protracted moving home experience. Yes, these are the estate agents that pregnant daughter was unfortunate enough to sell her house through. They advertise themselves as being the ‘total moving experience’, and they are not wrong. If you want to really experience every possible problem with your house move use Haarts. You can be sure that any time there is a hiccup they will sit on their hands and do absolutely nothing to help smooth the way. For their 1.5% they will market your house by mail, text, e-mail and on-line but verbal communication, information gathering and liaison are concepts that they have a real problem with. Perhaps I’m being a little unfair as we only have experience with one branch, and one employee, Simon but I can honestly say that if it were not for another local estate agent, who was handling the property daughter was purchasing, the whole chain would have collapsed on several occasions. Simon’s advice during one stressful episode was ‘put your house back on the market’, and when another problem happened he said ‘Well, now you’ve wasted a month so it’s your own fault if the twins come before you move ‘cos I told you to remarket.’ As the final nail in the coffin they ‘forgot’ to inform daughter that completion had happened. They only found out when their vendor and her estate agent came round with a bottle of champagne, some flowers and a card! So in my 2nd rant I nominate Haarts as the least helpful estate agents.

Yes, daughter has finally moved and we have spent the last 3 days helping them out and making sure that if Van and Lorry decide to arrive now there will be space between cardboard boxes for their cot and that Amy’s bedroom is clear of clutter so she can settle in.

Friday was moving day. I swapped my working with my job-share but was still on-call, so the inevitable happened, 5pm I was summoned to a homebirth, ‘Come quickly’, says job-share, wanting to go home, ‘she’s pushing’. I had a quick wash, I was filthy, changed and drove, at rush hour speed to the address 10 miles away. When I got there N was in a birthing pool, huffing and grunting with every contraction. Job-share told me that she had problems doing an examination as N wouldn’t leave the pool, which had wide, inflated sides so was assuming that the cervix was ‘fully’. As I was taking over I wanted to examine N myself. It was 4 hours since the last examination, when the cervix was 4cms dilated, N had been in the pool all that time and although some first time Mums do progress quickly N’s contractions didn’t seem beefy enough to have got her to that stage in 4 hours. I’m pleased that I did examine as there was still a thick rim of cervix at the front, that was as much as I could detect leaning over the side of the pool, and at an odd angle due to N’s reluctance to move. Another midwife arrived, job-share had summoned us both as she was leaving and had believed N was about to give birth. We sat and chatted for an hour, I had asked N’s partner to turn down the thermostat for the pool as baby had a slightly fast heartrate at 160bpm and the water temperature was slightly high at 38C. N’s contractions were reasonably regular, about one every 3-5 minutes, but they were quite short at 30 seconds. The pool can slow labour down, plus N had not been to the loo for over 3 hours so we encouraged her to get out, go to the loo and have a wander round the garden. She was still feeling the urge to push with every contraction, but there were still no signs of full dilatation of the cervix. I did another internal examination, no change from the last one apart from the rim of cervix feeling slightly thicker. This may have been due to the pushes that N was giving with every contraction causing the cervix to swell slightly, it would be helpful to reduce the amount of pressure. One of the best ways to achieve this is to encourage the woman to lay on her left side so this is what N spent the next hour doing, dozing between contractions. Gradually the contractions increased in frequency and duration, we were there and the pushing began in earnest. At 9.15 a 7lb little boy, Findlay, was born to an emotional Dad and a jubilant Mum, and at 11.30 a weary Midwifemuse went back to the hospital, replenished the on-call bag, returned the 5 entonox cylinders, completed the notes and got home for 12.15. I was really hungry, nothing to eat since breakfast, but decided that bed was the imperative, especially since I had to be at work for 8.30.

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Nominations

Nominations are invited for the most useless, guaranteed to never have have what you want in stock, poorly laid out baby store in the UK. I nominate Mothercare. So, the readers of Parenting Magazine have voted Mothercare their ‘favourite parenting retailer of the year’. In their catalogue Mothercare boast that ‘you will find a huge range of pushchairs….expert staff on hand to help you’. Well, here in the home counties, two different home counties in the last week, there was not a ‘huge range’ of anything, especially cot mattresses, fitted cot sheets, or stage 0 car seats, the only things we wanted to buy. I do have to admit that a helpful member of staff, she appears to be in the minority, phoned around to see if any other local Mothercare stores had them, they hadn’t. Daughter was plodding around the store muttering about how much she hates Mothercare and she wishes that people wouldn’t give her their ‘so**ing’ vouchers ‘cos it means she has to go there. I suggested that she write to customer services and express her irritation, she says that Edwina Currie bad-mouthed them on TV and in the papers and even that didn’t work so why should her grumbles make them sort their act out? I can sense people saying ‘why didn’t you phone ahead? Their catalogue suggests that as a good idea’. Don’t worry, I’ve tried that and, guess what, no one answers the phone. Mumsonline seem to think Mothercare is wanting in the customer service department, I just find them a really frustrating, overpriced, poorly stocked disappointment. Oh, nearly forgot. The store today had two large piles of returned goods, on the floor, shoved against the far wall behind the till and whilst waiting for daughter to be served two people returned deficient items. This was after Amy and I found that all the toys they had for customers children to amuse themselves with were broken, but still on the shop floor. Good advertising.

This is the first of two rants. The second rant I can’t publish until after midday on Friday.

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