Sunday, September 27, 2009

The Vasovagal Reflex.... Narrowly Averted! and more...

Friday I was at the hospital for most of the day. I walked into the hospital and heard a woman in the "theatre" pushing her babe out. There are several student nurses here who are also trying to get experience, so one of them was managing that birth. So I took the opportunity to just observe and give support as needed. Well the first thing I noticed was that it was particularly hot and stuffy in the theatre that morning..... this was the third birth that had happened since midnight, so there was the smell of birth in the room.

The AC wasn't working and I was standing next to the baby warmer. I felt just yucky.... wooozy..... and could feel the vasovagal reaction building. For those of you who have had the pleasure to be around me in the perfect circumstance when such a reaction has occurred, you can see it written all over my face, right? Pale as a sheet and a glazed look in my eyes. Yes, I've been a fainter my whole life, since the time when I was touring the hospital in my kindegarden "Brownies" troop (aka pre-Girl Scouts) and the smell and the warmth of the room was too much and down I went for the first time. As a 5 or 6 year old, that was a bit terrifying, especially when I awoke in a wheelchair thinking I might be dying. Well, I wasn't that time, nor was I the several other times that the lights have gone out and the sounds faded away.

So, you might be thinking, how is it that a fainter can be a doctor, yet alone a MIDWIFE, with all that blood and stuff? Well, I'll tell you I've never once felt faint at a home or birth center birth. It is something about the smell and environment of the hospital..... since I was a child, when I was in Costa Rica, now here in Vanuatu. It's undeniable and I am reminded how grateful I am that I won't be walking into the hospital every day of my working life as a naturopathic midwife. Yes, I prefer the hardwood floors, and cozy couches, and back porches, and sunny kitchens of home births. But I am here to work in the hospital, and I know that feeling was only temporary until I adjusted to this new environment, including the tropical heat. To shake it off, a cup of hot tea (per one of the Sista's recommendations) brough the blood and color back into my head, keeping me off the undesirable floor of the birth theatre, and I felt fine the rest of the day :)

On another note......
I got to give a sweet, 4060 gram baby boy a bath (a babe this size is a novelty of sorts here!) This is something that we don't generally do at home births since we test our moms for blood-borne pathogens and we value the coating that the babe is born with as protective to their delicate skin- so we don't routinely recommend bathing newborns immediately. But as the New Zealand midwife (who's here helping for a couple weeks while on holiday) said, this is the "hepatitis bath." It is given to wash any bodily fluids off since prenatal Hep. B testing is not done here. Ideally it is done before any injections are given, to prevent transmission from mom's bodily fluids that are on babe's skin, but it is generally done after the injections are given here. I am not sure why, perhaps just based on timing and to return the baby back to the mama to breastfeed after the injections are done as quickly as possible.

After finishing at the hospital, I headed down to the Vila harbor to do the "swimming course" in the ocean (that's the harbor above). This involves swimming out around a bouy, past a floating helicoptor landing dock, then if you're really feeling it, out to a large rock. Luckily I brought my swimming goggles, sexy as they are, because it was relatively shallow for most of the swim and there are a lot of fish and coral to see. Swimming in warm salt water is soooooooooooooooooo different from Lake Washington!!!!!! I'm really enjoying the added bouyancy.

Okay BEEF lovers! Apparently Vanuatu has some of the finest organic, grass-fed beef there is because that's just how all of the cattle are raised here. Some of my Australian Baby Doc friends were headed to the Raging Bull Steak House for dinner and live music. Yes, they convinced me to go to the steak house and yes, I ate a rump steak. And yes, enjoyed it. Sorry veg friends. Can't remember the last time I ate a steak..... tropical islands get you doing all kinds of out-of-the-ordinary things.....

Like SCUBA DIVING! I started my open water scuba certificate program on Saturday. After all, there is so much to do away from the hospital. This involves some classroom theory time, some pool time getting used to the equipment, and 4 ocean dives. Of the few people I encountered in the States who had acutally heard of Vanuatu (besides Bastyr and midwifery folks), 100% of them knew about this tropical island nation because of the incredible diving here.

well, good thing I bought that all-inclusive traveler's health insurance the day before I left, 'cause I really didn't think I would be diving. But I am, and I did my first ocean dive yesterday. What better souvenir to bring back from Vanuatu? We drove out on the boat to a beautiful cove, suited up, and walked off the boat into the ocean. The experience of breathing under the water is just incredible, and a bit intense! I felt I was dreaming, being down on the ocean floor, with the rhythmic sound of breathing in and out through my regulator. I love the feeling of putting my hands behind me and just giving the slightest kick of the flippers..... then sailing through the water amongst the fish and coral, supported by the water. Magical! Our first dive was 10m for 42 minutes. Not bad for a first time! Some of you know that I am actually part mermaid, so this experience was particularly fabulous. I need to learn more about identifying the tropical sea life, as it is all new to me..... sea anenomes, lots of colorful fish (neon blue to flourescent yellow), a huge clam, huge eels..... sorry i don't know the names yet. I have at least 3 more dives to work on it.

I postponed my other dives til later this week because my right ear had trouble clearing as I descended yesterday, and then was very clogged for the past 24 hours. It's feeling much better now, and one of the Baby Docs is gonna take a look in it tomorrow at the hospital.... I infused some garlic in olive oil and had a friend funnel it into my ear to help loosen any wax and prevent any organisms from multiplying in there (garlic is wonderfully antimicrobial). These other Baby Docs sure do think we naturopathic folks do some FUNNY things. Garlic ears? Clay packs on an infected foot? B vitamins to keep the mosquitos away...... I've forgotten just how "out there" this stuff is for most people. But this is what we're working with here, the basics, and what I always start with, tropics or not. I guess that's what traveling is good for..... to give you some perspective outside the normal bubble we create for ourselves. On that note, off to bed for an early start at the hospital in the morning.


1 comment:

Em said...

A lovely post! I'm really looking forward to hearing about more of your adventures. Have fun with the scuba diving ... sounds lovely.

I like your sentiments about home birth. The idea sounds absolutely wonderful to me, but I just can't get over the paranoia of "what if something went wrong ... " even though I have the good example of a friend who has had TWO HBACs.