Tuesday, March 6, 2018

Thoughts on Labor & Delivery #5: Flatulence

Given the effectiveness of my pain control (and my new “do whatever you want, I can’t feel it anyways” outlook on life) the doctor decided that this would be the ideal time to break my water, so she pulled out her handy crochet hook that likely costs more than 140,932 craft store crochet hooks – only the best for me and my water! and with one graceful motion it was suddenly high tide.

Having seen enough births in medical school, I did not feel compelled to watch this particular portion of the miracle of life, but I was promptly informed that the fluid was clear (a sign that baby is doing well and not in any distress) and did not smell (a sign that no one in the room would be needing nose plugs for delivery – and, more importantly, that there is no infection).   My ever-attentive nurse gathered up all evidence that my bed had previously been flooded, wiped me off (I think… she spent a lot of time down there but as I couldn’t feel anything, my interpretation of her actions was limited to context clues) and got me all tucked back in. 

The best part of the epidural?  I subsequently took a nap. In labor.  It’s worth it for that alone honestly, because once this adorable creature emerges and is given the option to scream whenever she likes, sleep is a long lost dream, just like your formerly flat stomach and once stable emotional state.

After the nap, it was time for some entertainment.  We reclined and watched the psychotic antics of Katherine Heigl.  We snacked on clear liquids and in our dimly lit hospital room it was just another relaxing evening.

 Our contented and calm environment was shattered with the loudest and longest fart I have ever heard.  It was at least 30 seconds long and was as loud as a whoopee cushion in a cartoon movie.  It could not have been real. PIC and I looked at each other wide-eyed and sniffed cautiously – the air was suspiciously odorless. “Was that in the hall?” I asked him.  He didn’t know. 

About 20 minutes later it happened again.  Equally alarming, but slightly less startling this time – we wouldn’t be taken completely by surprise twice! We were prepared to localize.  “Hon, I think that came from you...” PIC said (…with all of the vigor one would use to poke an unknown object that could quite easily turn out to be a bee hive full of deranged insects).  He might have suspected as much with the last offense but in sparing my feelings decided not to say so.  Smart guy.

I didn’t think I still had it in me to be embarrassed by my bodily functions after peeing myself publicly during a cross country race (or dealing with the consequences of consuming tarnished food in India).  It turns out that was not the case.  Did you know your digestive tract has its own separate nervous system?  It is known as the enteric plexus.  Generally, it just functions to do things that you don’t actually need to think about to do, such as push food from stomach to colon, colon to exit – and there, luckily, your real brain takes over.

My enteric plexus had gone rogue. 

I expressed my concerns to the labor nurse during one of her many visits to my room.  She was not at all alarmed and oddly enough, seemed pleased.  “That’s a great sign! It means the baby is moving lower and her head is pushing the gas in your bowels as she moves down.” 

Labor nurses are a rare breed… they likely encounter far more grossness than any other specialty, all with a smile on their faces.  No matter how many times I asked for popsicles, I was given them promptly. They asked about my pain almost every thirty minutes and never once doubted my rating on the scale.  They could even handle questions about phantom farts without flinching.  I wonder how they screen for that particular gift in the interview process?

At this point I had been largely paralyzed for several hours.  The epidural didn’t make it impossible to move, but my movements were limited to lateral shifting – lifting my hefty leg up in the air or repositioning it took far more effort than I had to give.  Unfortunately, laying motionless and straight-legged in bed is not ideal for preparing the pelvis to eject a fetus so according to my nurse it was time to try the peanut ball.

The peanut ball is a medicine ball that has been caught in the middle of mitosis.  Or, for a less nerdy explanation, it looks like two medicine balls that have been mushed together to form the shape of… a peanut. This contraption is used to “open my pelvis”; while laying on one side said ball is shoved between my thighs in order to prop one leg up.  I did my best to lift my leg with my own strength while PIC and my nurse positioned me but ultimately realized that was fruitless and refocused my attention on my sphincter to contain any phantom farts. It took a good 15 minutes, but finally I was propped on my right side, left leg rising to the ceiling at an acute angle, and covered with the blanket for the ultimate visual effect that I had been riding a pig, fallen over and decided to nap then and there. 

A downside to working in the medical field is that all of your coworkers are also medical.  Which means they see your name on the list of admitted patients and realize that it is only thirty steps farther from their usual coffee break to come say hello and offer well wishes for your labor – how convenient!  There I was, horizontally straddling a gargantuan purple plastic peanut, unable to feel even a breeze below the waist should my blanket happen to fall and leave me exposed, facing away from the door to the rest of the hospital, staring at a stupid framed picture of a starfish when I hear PIC say “Oh, hello Sir!”.

To reword a John Green quote, the Venn diagram of people he needs to address as Sir and people I don’t want to see my bare bottom is a circle.

It was lucky I was facing the wall so that our well-intentioned visitor could not see the daggers I was shooting with my eyes to accompany the expression that I was hoping said “Please stand up casually and readjust my blankets so that I know whoever is not politely avoiding the ‘full moon’ being presented to them as though I were a baboon in heat”.

The expression did nothing to convey my wishes, but good manners dictate that one should not stand fully behind someone while conversing so our visitor was obligated to circle around to a vantage point where my face was visible and my derriere was not.  Turns out, it was PIC’s boss, another anesthesiologist in the hospital.  We had met previously in a less compromising position and he was used to seeing patients in various states and maintaining some level of professionalism, so I felt slightly reassured and had a comfortable conversation. 

My sphincter had other plans for us all.

By this point, we had become quite the flatulence connoisseurs and this was the most noteworthy yet. It was loud and clear with variety of pitch as though my bottom were improvising a trombone solo in a jazz ensemble.  It would be something to brag about if I weren’t too busy looking for a way to inject air into my IV line and mercy kill myself. 

Amazingly, his professionalism held.  He didn’t even pause from what he was saying to look incredulously at the creature responsible for such a noise.  I breathed easier… until the true strength of my enteric nervous system revealed itself as putrid air wafted up my nostrils. I fought to maintain composure as the cloud of invisible death engulfed me.  I prayed he was out of range. 

“I am so sorry,” I squeaked out “I am no longer in control of my own body”.  He did not address my transgression to pardon nor condemn, but he did excuse himself fairly quickly thereafter. Dignity: 0, Baby girl: at least 16, but who’s counting?!

There was nothing to do but ponder exactly how many people would hear that story and how far away he had to walk before it was safe to breathe again until the nurse came in and informed me it was time to roll to the other side. 

“Full disclosure, I may have accidentally pooped myself.” Dignity: 0, Baby girl: 17. The scent was strong enough still that I was unconvinced that it was simply gas escaping.

Nurse: “Oh, it happens a lot at this point, you can’t control it, I’ll check”. Her eyes did not appear to be watering, which I took as a good sign.  “No, nothing down here – do you feel like you pooped?” 

Dignity: 0, Baby girl: 18.

“Sure smelled like it.”

We repositioned without any surprises escaping and now my imaginary rodeo horse was going the opposite direction and I was on my left side, facing the door and able to see any intruders (aka people wanting to be nice and say hello).

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