Antenatal Class - Signs that labour has begun!

So after another (one of the rather frequent) breaks to "make a brew" that our tutor Fiona was so fond of, the class then turned to the very late stages of pregnancy, and the signs one should look out for - clues that the little bun might be just about ready to pop out...first up was something that never occurred to me, the fact that as the baby runs out of room, so it won't be able to kick out quite as sharply, this coupled with occasional back ache is a sign to keep a closer eye on things...in preparation, snacks should be switched to high energy ones (again the glucose tablets were mentioned), but essentially it's important to stay active and keep on as normal (keep on with going to the shops, going out for lunch etc.), Mum deliberately spending as much time as possible on her feet, posture while sitting now should be comfortable, but always upright (or slightly leaning forward)...if the back pain gets a bit much, take two paracetamol...

The next most likely thing to happen is for the waters to break, although this is by no means a certainty, it was explained that sometimes just a little will emerge, sometimes a lot will emerge, and sometimes (although rarely) the sac will be born intact with the baby and the midwife will need to cut it open herself...so assuming any water discharges at all, the midwife should be called immediately and told what colour the fluid is and a rough estimate of how much there was...at this point you are anything up to 3 days from the start of labour (believe it or not)...!

Along with the waters (possibly) breaking, another thing that *may* happen is what is known as a "Show" (delivery of a mucus-like plug that resembles watered-down strawberry jam), this again doesn't mean labour has started, it's just another indication that things are moving along in the right direction...

Contractions should now follow (sooner or later)...to start with they will feel like alternating back pain and period pain and will be extremely irregular (perhaps hours apart), but gradually, gradually they will arrive more often...during this stage, it is also important to stay mobile (gravity is labours friend), when sitting stay upright (as before), or leaning gently forwards (to help the baby into the correct position for delivery)...good things to do now are take long, warm baths (which will massively reduce the pain of contractions while still allowing them to continue apace) and sitting on a birthing ball (if you have one) or astride a chair (facing the back) with the head resting (if you don't)...

When contractions are perfectly regular, lasting 1 minute, and are happening every 3-4 minutes (and mum can't talk during them), it's time for Dad to throw the bags in the back of the car while Mum calls the midwife...

Next stop is (almost certainly) the hospital... :0

NHS Antenatal Class, East Surrey Hospital

I have to say, I was completely confident that attending NCT classes was the best approach we could take (as prospective parents), I was pretty adamant that the NHS one-day class couldn't possibly offer us anything that we wouldn't already have covered (and covered in more depth)...but I was wrong...and I was very glad I did (in the end) decide to attend (despite resenting the lost weekend time)...

Those four hours on Saturday last (considering we have already spent over 6 hours in NCT classes) actually answered more of my nagging, half-formed questions than all of the NCT sessions put together - although in fairness, we do still have a number of NCT sessions left (during which they may well fully redeem themselves)...I think my point here is that this class (in a nutshell) fully covers the *essentials*...

I'll sum up here the very important things they went through, just as a personal aide-mémoire (if nothing else), but you never know, someone out there might find this useful too... ;)

Facts and figures first of all - East Surrey hospital is a teaching hospital with 100 midwives on their books, in the ordinary labour ward (they told us not to use the term "high risk", as it simply isn't the case) there are 9 beds, each in it's own room with en-suite facilities (bath, toilet etc.) plus a further 6 beds for those needing to be induced (which are just normal rooms)...this area is a normal hospital environment (i.e. 100% clinical, perhaps a bit scary for a first time mum and dad)...next there is the birthing centre where things are rather different - only three rooms this time, but each has a mattress on the floor, birthing mats, large bouncy balls (for sitting on), sofas and even a flat panel TV, lighting is subdued - the whole environment is about as far as you can remove yourself from "ER" or "Casualty"...they also have a birthing pool, calm music is encouraged and lights tend to have dimmer switches...if there are no complications at all (and the rooms are available) then anyone can use this area...the nice thing being, if anything does start to concern the midwives, within 2 minutes you are in a clinical environment with all the tools and staff at hand to deal with any emergencies...it really does have the best of both worlds...

The next thing they took us through was all the (critical) things to pack...

So here, the definitive list of "What to take to hospital" (from a senior Midwife's point of view) -

2 large towels

3 baby vests

3 baby grows

A pot of barrier cream (Sudacrem)

An infinite supply of muslin cloths (you can never have too many)

A selection of cool clothes for mum (suitable for long, refreshing constitionals around the golf course)

A large selection of high energy snacks (up to 6,500 calories (that's 1,500 more than NCT estimates!) can be burnt up during childbirth)

Glucose tablets (same reason, plus quick and easy to imbibe)

Lip balm (the gas, if taken, tends to dry out the mouth)

A baby blanket (not white, or the orderlies might take it down to the dungeons to be washed, never to be seen again)

A full pack of nappies

2 pillows (the hospital is low at the moment - again though , not white pillow cases!)

1 (must be brand new and boxed, or you won't be allowed to plug it in for health and safety reasons) electric desk fan (it is deliberately kept warm on the wards to reduce shock to the newborns, and it's going to be hot anyway)!

...and in a *separate* carrier bag (ready to hand to the midwife when requested) -

1 disposable nappy

1 basic vest

1 basic baby grow (don't bother with a posh one at this stage, by all accounts it will be covered in sick by visiting time, switch to the posh one 2 minutes before the door opens to admit relatives)

1 basic hat

1 basic cardigan

Next up, I'll cover the signs they told us to keep an eye on as the due date approaches, getting to hospital, and what happens during the first stage of pregnancy...but that is for another post (as this one is already quite long enough... ;)

Antenatal Day Unit, East Surrey Hospital

We had a hell of a day yesterday...got up as normal, I got washed/shaved/dressed and bumbled downstairs, put on BBC Breakfast (to blip in the headlines and absorb weather and travel reports in the background), wandered into the kitchen to put some milk into the microwave ready for Flyingpops breakfast, ran the tap for some cold water for me to pop my effervescent vitamin tablet into - and then heard a pitiful cry from the stairs, I called from where I was standing asking if everything was okay and got only a pained "Fink!" in response, by the time I had reached the living room door she was in the hall, bent double and holding her bump with an expression of pain wracking her face...

We had a quick discussion about how she felt, which concluded with her deciding to try eating her breakfast and see if the pain subsided, and actually, as soon as she sat down, the pain in her middle lessened considerably, the only problem was, as soon as she finished eating and stood up to go and brush her teeth, it came right back again...

I told her we should go straight over to the hospital to get it checked out, but she wanted to call and speak to her mum (some misguided idea that the hospital staff would tell her off for being silly), but Nanjan confirmed my decision, so we picked up all our commuting stuff and headed over to the Antenatal day unit at East Surrey Hospital (which is only minutes away, thankfully)...as soon as we walked in she was popped up onto a hospital bed and surrounded by Midwives who didn't hesitate but to run a series of tests, starting with urine (normal - no infections) and measurements (using an Ikea tape measure - the Midwife actually confessed "I was in the store and spotted them and thought, those would be good for work"!) which were all okay, and then they plugged in their expensive foetal doppler and found the heartbeat right away (phew!), they asked a battery of questions which culminated in a doctor being paged...

When the doctor appeared (about half an hour later - during which time I tried in vain to stop Flyingpops reading her work emails on her blackberry and worrying about her meeting in the afternoon she didn't want to miss), she poked and prodded, asked some more questions, then ordered a range of blood tests to be carried out, telling us that everything seemed normal with the baby, but just because Flyingpops was pregnant, didn't mean that other things couldn't go wrong, more specifically the place and nature of the pain did kind of match the symptoms of appendicitis...

I took this opportunity to run outside (while the nurses tried to find a vein) and rang Flyingpops mum, so she wouldn't worry and called both of our bosses to update them as to the situation...waiting for the result of the blood tests took just over an hour, the midwives told us to go for a walk (so we went and bought some snacks from the counter by the east entrance) and by the time we got back (Flyingpops being unable to manage anything other than a slow stagger) we only had to wait about ten minutes and the doctor reappeared, said all the blood tests were clear and the pain was likely to be just temporary, she told Flyingpops to take some weak pain killers, get some rest and come back if it persisted, or in fact for anything else (they were wonderfully kind and attentive, nothing was too much trouble)...

As we went to leave (I fully intended to get into work as soon as I could) we were only a few steps out of the front door when the heavens opened - and of course there was no chance of Flyingpops speeding up...we got absolutely *soaked*...Anyway, she rested up at home for the rest of the day, I made it into work for lunchtime and this morning she's feeling absolutely fine...so totally the right thing to do - go and get it checked out - and now we know exactly where to go for this sort of help and advice...thank you East Surrey Hospital...!

NHS Cheese givaway!

I think I might have *slightly* missed the connection here (and I'm sure there is some obvious link between the London Healthcare and French Edam), but anyway, it's promoting the "Have your Say" campaign being conducted by MORI Poll...it doesn't affect me (I don't suppose) as I live in Surrey, but thanks for the cheese anyway...went nicely with my morning apple...the debate, however, as to whether NHS funds should be spent on feeding hungry commuters, is another matter entirely... ;)

"It's not the years, honey, it's the mileage".

...well, crap...

Got the results of the MRI today, bit of bad news (but not too bad) looks like I have worn out some of the cartilage under the knee cap and on the right hand side below the calf on my right knee, this explains the bi-yearly problems with mobility...

Anyway, a consultant rheumatologist now must be consulted and then we shall see if nasty holes must be sliced into me to fix the issue...bah...

MRI Scan at Docklands Healthcare

So had to face the music today and go and visit "Docklands Healthcare" (it's very handily only five minutes from where I work, you gotta love Canary Wharf!) to have my very naughty knee scanned in their lovely new "Siemens 1.5 Tesla", managed to forget that there is an east entrance from the Jubilee line, so took a very pleasant (and rather suprising) walk through Jubliee Park -

- where I was slightly delayed, as it seems all sorts of detached frog eye installations have been arranged in various amusing places (did a double take when I spotted the first pair peering out from inside a bush) -

- most of them also appear to be illuminated, so I imagine the very best effect is to be seen during the hours of darkness (when it would seem that giant slimy creatures were lurking in the shadows all around the place)...very amusing stuff! Will have to go back one evening with a tripod... ;)

Anyway, a very short walk later I found myself at the entrance to Docklands Healthcare, had to fill out a couple of forms (nothing too stressful) you just have to confirm in no uncertain terms that no-where on (or in) your body is anything remotely foreign and metallic (as the huge magnet would have absolutely no difficulty in ripping any such object straight out of your body, so remove any piercings before going, eh?)...

The MRI Scanner itself resembles an old IBM mainframe with a *HUGE* tube of Polo mints stuck on the side, you place yourself on a remotely operated table (after stripping down to a surgical gown in a little changing room), and the appropriate area of your body is then wedged in place (to stop it moving) by plenty of chunks of tempurfoam...some headphones are placed on your head (big, old fashioned cans, but fed sound through thick hollow plastic tubes (no metal remember), so everything sounds rather muted and distant)...you are then asked if you are comfortable, offered your choice from a list of music (they had all sorts from Classical, through NOW Albums all the way to a selection of classic Arabic hits)...I chose a bit of classic Coldplay...sat back as the slightly underwater sounding warbling began and was then told by the (nice antipodean or possibly South African) radiologist to "Stay as still you can, relax or we will have to repeat each scan"...and then the racket began, I tensed up *immediately*, just couldn't help it - it sounds like someone is attacking the tube with a hammer (very quickly) - in the end I was stuck in that increasingly uncomfortable position for over an hour - "Ok, there was a bit of movement there, did you feel it?", (nodding, Yes, I'm sorry), "Okay, we'll have to go again, just another 4 mintues, try to relax and *don't* move"...*Groan*...

Suffice it to say, doing this is very, *very* difficult and doesn't get any easier as time marches on...

Anyway, it's all over now, I walked away with 2 CDs full of interesting shots like this one -

- that show slices of me as if I had been shredded on a giant mandoline...quite amazing!

Next step my consultant, as all that the pictures (although I glanced only briefly) seem to do for me is make me think of Sunday Roast...(which I am fully aware is, at the very *least*, a *little* strange, and potentially a very, *very* wrong reaction indeed)... ;) Just glad they weren't in colour...

Don't worry though, I'm not hungry...right now... ;)

Dislocated Patella - my last couple of days

A picture for you...in words rather than pixels...

We went down to the coast on the weekend on a mission to score an awning for the camper, being new at this kind of thing we enlisted the help of Flyingpops' mum, she even kindly volunteered to drive, but by the time we had got down there, bought the thing (£50 bargain) , stopped for a quick (rain-soaked) lunch at a garden centre, and got back to Surrey (for me to be dropped off at Vodqueen and Al's) I was seriously limping... :(

Having been cramped up in back of the car for a couple of hours, having really no idea I had put myself into such a terrible position (joints felt slightly stressed, but just thought I should put up with the pain), by the time I had struggled (slightly embarrassed at my lack of mobility) along the flooded path and then into the various painful prone positions required to change CD/DVD drives over configuring VQ/AL's new machine, my knee was swollen to a very nasty degree...
We came home, and gritting my teeth somehow managed to cook dinner and then collapsed onto the sofa in absolute agony...as I fell into my final state of rest, my knee made the most horrible popping/cracking sound (causing Flyingpops to say "Ew!")...

2am I awoke in a similar state, sleep quite impossible, tossing and turning until my thrashing finally awoke Flyingpops (with a groan from her, then a freaked out exclamation, followed by a sleepy elbow into my face, *ouch*) who's (zombie-like bumping-into-walls) rescue mission (once semi-awake) to find some anti-inflammatory drugs succeeded in getting me back into a state of unconsciousness after about 90 minutes...

She dropped me at East Surrey Hospital first thing in the morning (stressed to the hilt, late for her train)...not that she was to know, but it was going to be a long way to hobble from the bus stop where I was dropped to where I (finally) found rest...

I checked in, on my own, (just before 8am), knowing the routine by now, despite the pain - smiling, hopeful of attention (although of course smiling only as often as I felt appropriate) at the lady sat (also alone) behind the bullet proof glass who was both obviously ignoring me and my attempts at eye contact and also ignoring the grating, shrill ring tone of the handset immediately to her right (it must come with practice)...

Ten minutes later (now wincing with pain, eyes watering and smile fading fast) amazingly the receptionist's attention managed to slip from whatever was so interesting about the end of her fingers, to the person stood right in front of her, my details entered, then, into the machine, I was told to report to "the main department"...Hmmm, not been there before...

Two blagged security doors of hobbling along later I was stuck, leant up against a wall, unable to get any further...I stood, exhausted and direction-less next to a swipe card machine and unyielding portal, with a leering sign just beyond hinting that I had at least got near "Childrens A&E"...

The nurse (that eventually materialised from behind) let me though (only about 8 minutes later) giving me a very suspicious look, but directed me finally, to where I should have been ushered initially...it must be noted, at this stage, that none of this misdirection was my fault, there were simply no signs indicating which way I should have gone to get to "the main department"...when I weaved my way between patient after unconcious patient on hospital trolleys, plugged with drips parked along the corridor (making me feel like I really was in completely the wrong place, not being half as poorly as they obviously were) and finally found what looked like the bridge of the starship Enterprise (many monitors all showing vital signs or other intreging readouts) and handed over my form, I was shown to a chair (phew) and then was completely ignored for the next 30 minutes...at this stage I was joined by a man with a bandaged hand (called "Cook") who politely enquired how long I had been waiting. I told him. We wait for another 20 minutes (overhearing a nurse telling one of the patients with a drip "Well, I would go private personally") before being told that we should go back to the entrance and wait at the walk in centre...great...so back I hobble, having the same problem with the doors and lack of signage, sit back where I checked in after re-annoucing my presence to the receptionist and waited some more. Another 20 minutes go by and then "Mr Cook" was called for! >:(

So I wait, find and read a terminally dull magazine called "Kent Life" (from cover to cover) and 40 minutes later Mr Cook comes back out, smiles and waves (git) and I am called in...My examination takes 90 seconds (but hurts a lot), I am told that it's most likely soft tissue damage again caused by a dislocation of my patella, but it might be a fracture, so I need an X-Ray (oh no!), I get placed into a wheelchair and then dumped into the corridor to await a porter. Feeling rather like a parcel awaiting collection I twiddle my thumbs for 15 minutes or so, toy with the idea of using my good leg to propel myself backwards to the X-Ray department and actually have an experimental poke or two, but just manage to face myself into the wall, when a nurse comes round the corner and says "Lets just whisk you up there, if you wait for a porter you'll be here all day" (Yes!)...

So I get to the X-Ray department (she had to drag me backwards because one of the wheels was faulty) and being one of the wheeled wounded (rather than the walking wounded) has a distinct advantage, I skipped the queue, just joining the 6 other people in wheelchairs, a meer 1 hour's wait and I am irradiated, we collect the prints (not sure this was really the best use of the nurses time, but at least I had someone to talk to), and back to see the doctor, who pronounces me just to have soft tissue damage (hurrah!) and the nasty noise on Sunday was my patella popping back into place most likely, binds me up, orders me onto pain killers and 3 days total rest (which I have just concluded), and packs me out the door, ready to process the next case...

You have just got to love the NHS...anyway, all better now, swelling gone down and knee now bearing weight again...I'm going to go to my GP though, at some stage to get it checked out properly and take some advice as to how I can look after it, my mobility is rather important to me...

Soft Tissue Damage...

What on Earth is it with me at the moment...? Only a couple of months on from the broken finger and I'm back in hospital...!

Ironically, it was exactly the same doctor too, he didn't remember me, I thought about it for a second (as he had been a little judgemental last time) and then decided to remind him of our prior acquaintance...he apologised ("I do see rather a lot of patients, you know"), but then suddenly recalled "Oh yes, you were due to go on holiday just as it happened, did you make it?", so I had actually made something of an impression (not that it's important) but anyway... ;)

To cut another NHS story rather shorter than it probably should have been, I have been, poked, prodded, scanned (all as usual) and then sent home, bound with some wonderful experimental German latex tubigrip replacement (which is going to save the NHS millions, apparently) , am taking drugs whose only function seems to be to make me feel sick, been given a poorly photocopied sheet explaining how to put frozen peas on my leg and have been told to take "total rest" for four days - "don't make any journey further than the loo, Mr Angel, then we might get you back into London for next week"...

Pants...