I've been considering writing this post for awhile. It's been quite an interesting few weeks, and my life has changed in many ways.
Prior to the start of match week for residency, I was under the impression that I would become an OB/GYN. I had fallen in love with the specialty during my third year, love everything about pregnancy, and have a special bond with women in general. However, come Monday afternoon I found out that not only did I not match into OB/GYN, but now I needed to scramble and find a residency program that would teach me. Because it's one thing to not end up in the specialty that you hoped to enter; it's another thing entirely to end up in no specialty at all. And that couldn't be an option for me.
Tim and I worked tirelessly together to come up with a list of 45 different hospitals that I could apply to, for OB/GYN, pediatrics, and family medicine. Out of those, I was really hopeful for at least one of the OB/GYN places to pan out. That evening, I got a phone call from Guthrie/Robert Packer Hospital, to discuss the possibility of me joining their family medicine program. I remembered working with them during my third year, really likely the attendings, and especially how the residents were treated and interacted with one another. I thought that this could be a doable fit, especially with the amount of electives that would allow me to tailor my training to be more OB/GYN and pediatrics based, as well as family medicine. I got a bunch more phone calls on Tuesday, which really made me feel good about myself for once. I'm the type of person who doesn't truly believe in herself, that my best isn't good enough. I'm the person who had to take the MCAT 3x, took a year off before medical school, and then really struggled and studied my butt off for just above passing scores on both of my boards. This has not been an easy process for me, but this is something that I truly love learning about and want to help others through this profession. The many phone calls and interviews helped boost my self-esteem and begin to realize that I am worth it.
Wednesday rolled around and my first offer for a job was through Guthrie/Robert Packer Hospital. I quickly took the job. I know that I will fit in well with the rest of the team.
I recently received my paperwork to fill out for employment, and seeing my name written as Dr. Harbison, really made me smile and feel happy. I can do this!
Another interesting turn of events happened this past week, the week after the match. I officially hit 33 weeks this past Tuesday, Tim decided when he would stop working and start being a full-time Dad for a year, and we had a good headway on the nursery for our little Preston. I was at the hospital, going around with the pediatrics team in the ER checking on a couple of sick kids. I remember feeling a bit of pain in my lower abdomen, like really intense menstrual cramps. I had pain there, and in my lower back as well. I sat down, and started working on concentrating on my breathing, figuring that the pain would subside on its own. Soon, the pediatrician came by to check on me and convinced me to be checked out by labor and delivery. I got checked in and hooked up to the fetal heart monitor and the contraction monitor. Sure enough, I was having contractions, about 10-15 minutes apart.
A midwife came in and examined my cervix. She had a hard time getting to it, because it was so far back (good for me and baby) and it was closed and not effaced (thinned) at all. She also did a test called the Fetal Fibronectin test (FFN) to check to see if I started preterm labor. It came back as negative. She also took a urine sample to check if I had a UTI. While she was gone, the pain of the contractions continued, and I started to get very uncomfortable in bed. I finally rang the call bell (something I hate to do, because I hate bothering people) and asked for an update and told her about my pain. She noticed that the pain was not going away, and consulted with an OB/GYN. They decided to give me a liter of IV normal saline fluid, give me a shot of terbutaline to stop the contractions, gave me Tylenol 3 with codeine for pain, and ordered an ultrasound to check on Preston and to check out my cervix. At this point, I decided that I didn't want to be alone anymore, and told Tim to come to the hospital to join me. (I had been giving him updates on the phone).
The shot hurt like none other, made me feel very dizzy, and drove Preston crazy. I've never felt so much moving/thrashing inside my belly before. The fluids made me pee like crazy, and I don't think the Tylenol 3 did anything at all. Tim arrived after I was hooked up to the IV. We both got to see Preston during the ultrasound. We found out that he's measuring 35 weeks (2 weeks larger than dates) and is about 5lbs. The measurement on my cervix was 2.4 cm. Apparently, a good cervix that won't go into labor is 2.5 cm or larger. Due to the closeness of my length to being worrisome, I had a follow-up ultrasound scheduled for the next day.
On Wednesday, my ultrasound showed that my cervix was measuring 2.9 cm. However, the discrepancy of measurements could be due to having two different ultrasound machines and two different users. I spoke with the OB/GYN for a lengthy period of time. He said that he's still concerned about my cervical length. He wants to get another ultrasound of it next Tuesday. Plus, there is already some fluid and mucus pooling into my cervix, suggesting that Preston is starting to push a bit more downward, suggesting that my water could break a bit earlier. However, he doesn't think that I need to be put on bed-rest or to abstain from any of my remaining rotations. I could go into pre-term labor, or I could go to term. If my cervical length is still questionable on next Tuesday, he wants to give me a shot of steroids to help speed up Preston's lung development just in case I go into labor early. From my discussion with the OB/GYN, I believe that I have a slightly higher than normal chance of pre-term labor at this point.
If Preston does go to term, the OB/GYN suggested that I get an ultrasound around 39 weeks to check his size, because Preston is measuring so big, and I may not be able to push him out on my own. If that is the case, I will easily accept the option for a C-section. I don't want to risk any unnecessary trauma to my little guy in the birthing process.
All of this has been a bit nerve-wracking. Going from a decently normal pregnancy, to now one that has become a bit more interesting. To say that I'm totally nonchalant about the whole thing would be a lie. I am a bit concerned. I really don't want to give birth early, and then have to have Preston in the NICU at the hospital where I currently rotate, and not being able to be with him while I'm on rotations. That would tear me apart. However, it has been helpful to talk to my Mom, Dad, Tim, and some close friends about the subject. I've also been trying to rely on God more throughout this process. I know that God has a plan for me, Tim, and little Preston. I know that God is leading and directing everything. I don't always understand His ways, like ending up at Guthrie instead of an OB/GYN program, but I know that it's for the best. I know that God especially watches over his little children, and that He holds them close to His heart. The only thing I can do is pray, wait, watch, and learn. I'll hold fast to the promises that God has made to me and my family in the Scriptures. I'll hold fast to the covenants that I've entered into with God. And I'll do my best not to worry.
