First Snow

Posted on October 29, 2011 by

And on the heels of that last post, the first snow!

First Snow

 I left the house without gloves (it wasn’t snowing when I left), my car still doesn’t have anti-freeze in it and my winter jacket hasn’t arrived yet.

I think the snow makes it look even more like Hogwarts

Thankfully I had the good sense to throw on rubber boots and a hat before I left, and, even though it required some digging, was able to lift my windshield wipers off my car when I came back.

Fall into Winter

Even though my little Californian heart thought (hoped?) we had at least another month before this stuff started falling from the sky, I became enchanted with this place when I visited last winter and the spell still holds me now.

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Autumn

Posted on October 25, 2011 by

I know I just told my parents that, according to people who live here and know these things, we weren’t going to have much of a fall this year, but here it is, in East Rock Park.

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Primary Series

Posted on September 30, 2011 by

I went to my first Ashtanga Primary Series class the other day – it was tough, although my friend told me there were a lot of deviations and I got off easy =P  I don’t know what it is about Ashtanga – I don’t love the style and I’m not that interested in half the poses – but for some reason, I’m completely fascinated by it.  So I decided to look up the official series and give it a go.  Here’s how it went:

1.  Like I said, I don’t love the poses, but the sequence really works for me.  There’s some serious vinyasa krama going on in Ashtanga.

2.  Somewhere in the last three months, parivritta trikonasana became easy.  I used to struggle through it with blocks and sweat and tears, and then one day I could just do it.  I’m going to go ahead and credit my teacher, Jean, with this miracle – she gave me a tip about freeing up my hips in the pose and it’s been totally different ever since.

3.  Cheats:  I picked up my back heel in parivritta parsvakonasana.  I know it’s supposed to be down, but if you’ve ever tried it, it’s incredibly awkward.  If some Ashtangi out there can convince me that there’s some benefit, maybe I’ll work on it.  Similarly, I do not bring my hands together in utkatasana.  Utkatasana is another one that’s already uncomfortable enough on its own and you don’t need to go and make it more uncomfortable by forcing your shoulders do things they don’t want to do.

4.  Skips:  I thought for sure I could do every pose up through kurmasana (which is why I initially planned to stop there), but it turns out that pretty much every joint in my leg is incapable of twisting itself into janu sirsasana C and marichyasana b and d.  I spent a few minutes looking at the picture, trying to persuade my knees and ankles to cooperate, wondering if the pose was even humanly possible and then finally giving up.

5.  Vinyasa:  Speaking of skips.  I think my dear friend and Ashtangi, Laurie, told me that you’re supposed to do a vinyasa between every seated pose on every side (so, side A, vinyasa, side B, vinyasa).  There was none of that today.  I did both sides and then a vinyasa.  This is one area of the sequence that I’m not on board with.  I’m not saying eliminate vinyasa from the entire rest of the series – some of them are very well placed – but it’s hard on the wrists and I feel like all those jump throughs/backs (and let’s face it, these are more like ass-plants and crumble backs for me) are fluffing my rajas and I’m not getting into the juiciness of the poses.  Although, it’s probably fair to point out that while I’m winding down during these seated poses, real Ashtangis are only halfway through the Primary Series and technically have like four or five other series after that (not really sure anyone actually does all six series), so they’re not as concerned with preparing for savasana at this point.

6.  Ass-plants and crumble backs:  Am I ever going to be able to do these?  Ever?  Today I was able to drop myself (literally, drop) into a cross-legged seated position on the jump through (slightly concerned about my tailbone) and the jump back was more of a press back to my knees, followed by a face plant, followed by me extricating my limbs out from under me and into plank, much in the way a cat does when it falls (“Me?  Ungraceful?  I have no idea what you’re talking about.”)

End verdict:  Still fascinated, but I’m not sure I’ll stick with it in its purest form.  If any ashtangis out there have some tips or stories to share, I’d love to hear them!

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A Strange Kind of Birth

Posted on September 29, 2011 by

It was a strange kind of birth.  Up until the time I started to smell burning tissue – kind of like the smell at the dentist when they’re drilling on a tooth – it was mostly like something on the Discovery Channel.  My friend, M, got to see a whole surgical team splattered by blood when the resident cut through an aorta (on purpose), but I was watching a laparoscopic hysterectomy on a video screen above the surgeon.  The surgeon, himself, wasn’t even touching the patient; he was operating the controls of the Da Vinci – this multi-armed robot that was doing the actual dirty work.  The patient, 46, had been unresponsive to various treatments for her fibroids and was now having her uterus removed.

For two hours, I had been watching the surgeon methodically sever the uterus from the fallopian tubes and surrounding tissues (moderately fascinating).  They had also spent about two hours prepping, so I had spent at least four hours feeling very uncomfortable – not knowing where to stand, whether or not I was in the way or if it was okay for me to ask questions and if I could ask questions, then to whom.  I had become so acutely aware of these feelings that it came as a bit of a surprise when the surgeon announced that he was done.  All that was left was to pull the uterus and cervix through the vagina.  He explained that he would do this by slicing the uterus into smaller pieces so that it would be easier to extract.  As he said this, I found my attention sharpening, my uterus cramping, the way it does at a birth when the mother begins to push.  After several hours of watching, waiting, holding space, it was finally time:  I held my breath as the surgeon made two or three longitudinal cuts, turning the uterus into some sort of soft-bodied sea creature.  Then, he instructed the resident to pull.

“Slowly,” he said, “You don’t want it to tear.”

I watched on the video as the uterus made its exit, the cut pieces folding over one another the way a baby’s skull bones fold over one another to ease its passage down the birth canal.  At some point, the resident had to start over and the uterus tried to reclaim its former home, the way a baby slides back into its mother between pushes.  Pull, pull.  Hand over hand.  Keep pulling.  And then it was out.

“Did you get it?” the surgeon asked
“I did!” the resident exclaimed.

The focus then shifted to the uterus, the prize in all of this.  Reflexively, I turned my attention to the patient.  I never noticed that I did this in birth – there was so much going on and it was clear that the mother needed me.  But, as I opened myself up to the patient, I remembered that she was asleep – bundled in pads and sterile sheets, cords hanging off and out of her.  I thought about how she would feel when she woke up – tired, sore, happy to be done and glad it went well.  My eyes shifted from the patient to the video, the video of the empty space that once contained her womb – the space that was once so full, now empty.

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Seen & Heard In Connecticut

Posted on September 28, 2011 by

Me:  So Connecticutians…is that what they call them?  What do you call people who live in Connecticut?

E:  Yankees.

Me:  What? No.  Why do they get a monopoly on Yankee?  There are other states that can lay claim to Yankee.

E:  No, come on, “A Connecticut Yankee in King Arthur’s Court…?”

Me:  Well what do you call people from Massachusetts, then?

E (deadpan):  Massholes.

Me: (dies laughing)

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Initiation

Posted on September 19, 2011 by

Today I attended a YSN midwifery potlock.  I’m not sure what I was expecting in terms of numbers, but I was surprised by how many of us there are.  We spent the first hour or so eating and mingling and then the faculty asked us all to gather in a circle.

They welcomed us to YSN, to midwifery and to the group of women (and man!) who would become our family during our time at school and beyond.  The faculty members then presented roses to the second year midwives, who in turn presented a rose to their little sib (first year midwives), who in turn presented one to each of us (GEPNs, their little sibs).  Midwifery is an ancient profession, one that has existed without doctors or nurses for as long as women have been giving birth.  The craft was passed down from one midwife to her apprentice, and so midwives learned not just from their mentor, but from all the women who came before them.  Just as a Mother becomes a vessel for the child she carries, Midwives become vessels for the wisdom of women, for the ancient art of being “with women” and the mystery of birth.

In The Red Tent, the narrator begins by saying that in order to understand a woman, one must first understand that woman’s mother.  As if to that end, our big sibs presented us with binders containing the stories of YSN midwives dating back to 1994.  Since then, each class has written a letter offering words of wisdom to the incoming class and then short bios about who they were, where they came from and what brought them to YSN.  There are also poems and art and quotes about midwives, birth and women.  We were also given mixed CDs with songs to get us through the year.  Then the second year midwives performed a dance number for all of us, parodying Beyonce’s Single Ladies, “If you didn’t want it, you should’ve put a ring in it.”  To close, they sang the midwives’ song – I don’t remember the words now, but I am sure I will learn them in my time here at YSN.

None of this stuff about the history of midwives was explained to us, but then it didn’t have to be.  Even before I arrived, I heard stories about nurse-midwives:  We are the only(?) advanced practitioners who are not nurse practitioners (according to rumor, CNMs have actually lobbied against the APRN designation on the basis that midwifery has a long history of existing independently of medical institutions and therefore CNMs do not have to be APRNs in order to be midwives).  Unlike other specialties, we are not interested in dabbling in other disciplines; we just want to catch babies.  We tend to think of ourselves as midwives first, nurses second.  Not one to be labeled or pinned down, I bristled at these generalizations at first, but like all generalizations, there is some truth in them.  I have spoken to a few classmates in other specialties who have some ambivalence regarding their chosen path, but those in midwifery are not among them.  I don’t think I have been asked by anyone in my group, in any year, “Why Midwifery?”

In The Circle of Life Elizabeth Davis and Carol Leonard say of midwives, “Just as Mothers are fascinated with their offspring and rejoice in their unfolding, Midwives are drawn to assisting others in the creative process, celebrating triumphs of the human spirit.”  Midwives are present to help initiate women into Motherhood, and I was grateful and honored to be initiated tonight into such a warm and caring community, into the great tradition of Midwives.

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Stand Down

Posted on September 13, 2011 by

Last Friday several us had the opportunity to attend Stand Down – an event where veterans can go to receive all kinds of services and resources.  This article has more information about the other stuff, but my classmates and I were there to provide some basic health care services.  Decked out in our scrubs for the first time, stethoscopes hanging around our necks (Linda keeps saying it’s “sexy,” but I am always surprised by how heavy it is.  Oh, the metaphor), we gave foot soaks, tetanus shots, PPDs, took blood pressures and glucose levels, tested peak flow and helped out in the dental and optometry tents.

My first assignment was in the foot bath tent – we were basically supposed to help the veterans soak their feet and bring any abnormalities to the attention of the podiatrist.  Ideally, these soaks were supposed to last about 10 minutes, but I sat at the feet of my last “patient” for a little over 20.  He showed me his toenails, which were long and curling inward, and explained that they were starting to become ingrown, but that he was afraid to cut them because he wasn’t sure what would happen if he did.  Privately, I thought that he should just cut them and his problems would be solved, but I found myself saying that I knew what he meant and asking about what it was like when he cut them last.  We talked for a while longer and I learned that he was a ballroom dancer and that he had some pain in his big toe.  I knew exactly where he was talking about because I have my own big toe pain, which I, too, think is from over-working it a bit.  I pressed on the area gently and he said it was sore to the touch.  For a moment, I wished that I had my mother’s sensitivity – she would be able to sense any subtle traces of injury (in the form of calcifications, I think?  I’ve been told that she can feel them in my toe and also my shoulder and ankle) and perhaps even release them a bit – but the conversation shifted back to his nails and then to the importance of good foot care.

After the foot soaks, I went back to the main tent to take some blood pressures.  Even though I had just learned how to do blood pressure and pulse rate, I felt fairly confident in my abilities, so I was surprised at the sudden anxiety I felt when it came time to place my fingers on the radial pulse of my first patient.  Thankfully, the steady beating of the heart has a soothing quality and I was soon comfortable again.  One of my patients told me that he was on medication for hypertension and that the last time he had his bp taken, he thought it was 170 over something, but couldn’t remember for sure.  So we were both pleased when we found that his bp was 120/72.  One of our preceptors came around and asked if we were happy with that number:

Patient:  Yeah, I’m happy with that number.
Preceptor:  Great, but I’m asking her.  (To me) Are *you* happy with that number?
Me (nervous):  Yeah, I’m happy.
Preceptor:  Is that normal?
Me (still nervous):  Yeah, it’s normal.
Preceptor:  Are you asking me or telling me?
Me:  Telling you?!?
Preceptor:  laughs

After blood pressure, I went to the glucose station, where I performed my first finger sticks.  Those were pretty easy – although I still don’t think I’d want to do it to myself.  The tetanus shots and PPDs were harder – I did two of each and still wouldn’t feel comfortable doing one without someone hovering over my shoulder.  I found that it wasn’t so much the needle stick and injection – it was everything else.  I would never have considered that syringes tend to stick when you first take them out of the package and I’m still not convinced that I’m properly drawing up a drug out of a vial.  I also cleaned my first arm incorrectly (Preceptor:  Okay, but first, when you swab an area, you make little circles to big circles.  None of this up and down stuff; try again.) and forgot to retract the needle on my first PPD syringe (unlike the syringes for the tetanus shot, you have to keep pushing down on the plunger once you’ve removed the needle from the skin).  And all of this while trying to put the patient at ease!  Although, as Linda pointed out, these people have been to war and been shot at and were probably injured in battle, so they’re not really afraid of a bunch of baby nurses with needles.  Her point was later proven when one young vet told me that I couldn’t possibly hurt him and that I should “just go for it” with the PPD injection.  I laughed and agreed that he was probably right and then scampered off to find a preceptor.

After lunch, my final station was at the demonstration table.  I was glad to be outside instead of in the hot tent and even though I had very little idea as to what I was supposed to be showing people, I found myself suddenly flooded with memories from OMSI and MSI and wanting to engage with people and share what little I knew.  At some point, Linda came over and told us everything about everything (which is something she can be infuriatingly good at) and then it was time to go.

I think I may still be digesting this experience, but one of the things that stands out to me is how safe I felt.  I knew I would enjoy talking to patients and hearing their stories and getting to practice clinical skills, but I didn’t expect to feel safe.  I expected to be anxious and awkward and uncomfortable and I was all those things at certain points, but in general it felt normal and “natural” (in the sense that it was natural to have no f-ing idea what I was doing 90% of the time).  The preceptors were all very approachable – I wasn’t afraid to ask when I didn’t know how to do something and they all taught with patience and care.  I’m sure that clinical will be much different, but it was a nice insight into what the process could be like.

Speaking of clinical – they start this week =)

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