Sep 21, 2010

Queuing Theory

The longer I live here, the more convinced I become that Quebec has a massive shortage of operations management professors, or just operations management professionals perhaps. Today was yet another failed example of Queuing Theory, or the mathematical study of queues or lines which "has applications in diverse fields, including telecommunications, traffic engineering, computing and the design of factories, shops, offices and HOSPITALS" (capital emphasis added by author).

Yes, as you can guess, we spent an entire morning in the hospital. We were first advised to arrive half an hour early for our 9:30 appointment, which, as good citizens, we did. Within five minutes my chart was created so I was in the doctor's waiting room by about 9:10. Then there is a process of tickets, lines and waiting. As we already experienced in other parts of the hospital. We took a ticket to "register" with the doctor (don't know why, since I had a set appointment). Then with a bare nod in our direction we were told to sit and wait. About 9:55pm, some 25 minutes late, I was called by my doctor.

There, things were well. The baby's heart is still beating at about 140bpm, and my uterus is about 20cm long, both in line with the number of weeks I'm pregnant (19 weeks and 2 days). I weigh 62.5 kg including my jeans, sweater, and shoes. Probably about the same as the most I've weighed naked. The doctor was her chirpy self and gave me a nice blue sheet to make a series of follow up appointments: one in four weeks time, the next another four weeks later and after that, every two weeks until about a month before the birth, then every week.

"Just go back and take a ticket," she smiled confidently, "and book all the appointments now."


But I think she didn't count on the fact that when I pulled a ticket back in the waiting room, there were some 13 people ahead of me in line. Mass confusion ensued. Some people had been waiting so long to "register" that their doctors called them before they got a chance to do so. Others, heavily pregnant or with babies, were being pulled in for weighing, measurements and vaccinations, and thus missed their number when it was buzzed. Still others, entirely confused about the system, kept going up to the window to be told that there were people waiting in front of them and they should take a ticket. And don't even get me started on the fact that the receptionists were (a) taking phone calls and (b) taking their breaks while there were some 20 people waiting in line.

I waited patiently for my number to be called, knowing that if I tried to phone them to make hundreds of appointments, I'd never get through nor would they ever phone me back.

Of course, by the time my number was buzzed, a flustered looking nasty woman was in no mood to book hundreds of appointments.

"Well, I can't do this now," she shouted at me, "I've got 23 people waiting in line."

"Yes, I know," I shot back, not about to be put off by a 5 foot dwarf pretending to be a Nazi. "I too, have waited for some 45 minutes so that I could make these appointments. Everyone is waiting. It's my turn now."

I don't think anyone has ever dared talk back to this woman. She seemed kind of shocked by my ire, and then actually apologized. She was very sorry, but could only book me for the next appointment, and someone would call me to make the rest. Only, once she'd booked me for four weeks hence, she claimed that I would have to make all the other appointments NEXT time I came in.

As if the queuing system will have improved by then.

I let it be, the Beatles song lyrics running through my head to calm me down. But next time, oh, next time, the dwarf will have my mother's blood that runs through my veins to contend with.

Sep 14, 2010


It was my mission this weekend and week to relax. On doctor's orders. So I cancelled all my meetings and a gym session and instead went on a walk on Saturday (a beautiful sunny day) with a friend and my dog. We ended up spending about 2 hours outdoors, at a slow walk, interrupted by occasional stops and of course, an ice cream, since this is probably one of the last summer days to enjoy something that cold in Montreal.

I declined my friend's offer to go shopping in the latter part of the afternoon, begging tiredness, and instead we hung out on my sofa and later went to a movie. 

Sunday followed a similar pattern of late morning naps, and a trip back to the Bay so I could switch the newly purchased Betsey Johnson bras. Turned out when I tried them on at home, they were suddenly too tight around the back, leaving a sizable dent in my rib cage. With my newfound enthusiasm to be a responsible preggers woman, I decided to go up a size so instead of a very scary size of 32DD, I'm now a slightly more reasonable 34D. And still able to fit in the very pretty and comfie BJ bras. 

The sales lady in the store roped me into getting a store credit card. So far I've resisted because at about 30% APR who really needs that kind of credit card. But she attacked me with it in French and I was so proud of my fluency that I obliged, realizing only to late it wasn't a POINTS card she was signing me up for, but a CREDIT card. Oh well, at least this one has about 4 times the limit of our other one and we can pay for something other than a tank full of gas with it. I'll just have to make sure to pay it off each month. Meanwhile, I'll happily be collecting points from the Bay, whatever those are good for.

My Monday routine followed the new resolution. I cancelled another gym session and my physiotherapist. Unfortunately, though, I couldn't get out of any more meetings, since I rescheduled all of the Friday ones to Monday. So Monday turned out to be only semi-relaxed. Instead of being able to stretch my body during the day, I ended up in my office, fielding phone calls, holding meetings, thinking about research, preparing for teaching (analyzing a case study and writing up my notes), trying to reach my own doctor, reaching my doc's assistant only to find out the only time she can see me is when I teach(!), finding a substitute professor for that class, and who knows what else. Hubby met me for lunch. I called my bro to say Happy Birthday. And came home Monday evening, completely exhausted.

Only to realize that hubby would be out all of Tuesday, the dog needed walking, and we had bought the wrong dog food. Hence, a very farty and smelly dog. As a diarrhea preventative (we have LOTS of that experience with our dog), we gave her some pills and they seem to have done the trick. I fed her some other food this morning, so that my day spent working from home wasn't going to be surrounded by sulphur-like gas.

Topping these days and the weekend, of course, was a series of student questions about wanting to get into my course (go see the registration people), having missed the first class because they "were on holiday" (too bad for you), and all else. Not putting me in the best teaching mood for Week 2 of classes. When will they learn that if you don't show up, you have no right to ask for anything?

So two days spent sitting doing work. Although today was less hectic than yesterday, I'm starting to feel an exercise withdrawal. But I'm sticking to my promise to the doc. Tomorrow, I'll field a set of questions to my own doctor, to find out what exactly I'm allowed to do, or not. I'm fairly certain that shouting at students would go into the "not" category.

Sep 10, 2010

Follow up

After yesterday's mini-panic, we went for a follow up at the hospital today for an ultrasound, as suggested by the emergency room doc. We got there in plenty of time (half an hour early, in fact), and I hadn't peed for about 2 hours. Of course, they told me to come with a full bladder, so added to our early-ness and waiting time, it was a good 3.5 hours since the last bathroom visit by the time I got in to see a technician. 

She showed us all sides of the baby, and all looked well. The heartbeat is normal, and the baby has two legs and two arms, ribs, a stomach, you name it. She checked its age by sizing the head and other body parts, and we're still exactly on track for a February 14th due date -- currently at 17 weeks and 4 days old. And ... she asked use if we wanted to know the baby's gender.

"Oh, sure!" I replied enthusiastically. In yesterday's preoccupation, I'd nearly forgotten that by now this would be possible.

She pointed to some little squiggle on the ultrasound picture -- looks like a boy. She did it again and confirmed her opinion. But warned: "We'll know for sure when you come back at 20 weeks." 

So probably a boy. Really cool. I had a feeling this morning that they would tell us that.

Of course, we thought we were done now and ready to head out of the hospital. Not so fast, keen one. Nope. We were sent back to the emergency room to follow up with a doctor there. The information was to be faxed down.

So back we went. Yet another series of tickets, and registration, etc. It seems that wherever you go in the hospital, it requires a ticket-wait-register-wait-wait some more-see someone-wait-see someone else-wait, etc routine. Not that I truly minded. By this time my mind was at ease from hearing the heartbeat and seeing the ultrasound.

The wait was not impossibly long and it turned out that this doc (unlike yesterday) was a bit more thorough. He did an internal exam and also asked my blood type -- a critical factor that I'd forgotten about. I'm Rhesus negative meaning that if you have any bleeding you should get a shot of RhoGAM to prevent any difficulties for subsequent pregnancies.

You guessed it: more waiting while they ordered the drugs. Then, administered it, and asked me to wait another 15 minutes before leaving to make sure I didn't have some kind of adverse reaction.

Well, at least they were thorough and like yesterday, everyone was tremendously kind. I'm glad that my 50% tax rate goes to some decent things.

I've been giving some restrictions: no bouncing exercise, no lifting, no gym therefore. For now, it will be walks with the dog and skipping the personal trainers. I'm to follow up with my own doctor as soon as I can, which I will do. 

All of this is fine by me. Mostly, we're both just extremely happy with the news today.

Sep 9, 2010

A bit scary

Today was a bit scary. I experienced some discharge, which is nothing unusual in any pregnancy, but in the past week, it has looked different. By noon, I also noticed some clotted blood. Alarm bells immediately started ringing in my head. Having gone through one miscarriage is enough to trigger panic based on tiny bits of evidence. And I don't know if it was my panic or a real symptom, but I started to feel some cramping in my lower belly.

So off to the doctor's walk-in clinic I went, around mid-afternoon. Luckily, I'm able to go to the university health centre, which has a relatively short waiting time compared to your average Quebec clinic. I took a ticket to registering for the walk-in appointment. Once called, I promptly burst into tears explaining what the matter was. The administrative person was a complete doll. She gave me tissues and said she'd rush me in to see a nurse. As promised, I didn't have to wait very long. The nurse, likewise, was a sweetheart. She tried to contact the hospital where my family doctor works and when that proved difficult, she ran to the nearest doctor in the clinic when she heard a door open in the hall. The doc prioritized my case and I followed her straight into her office.

The doc didn't seem too worried, but said it would be better if I went to the emergency room right away and try to get an ultrasound to confirm everything was ok. She even offered me a taxi receipt to get there, but by this time hubby had made it to the clinic and we drove ourselves to the hospital. Of course, by now it was about 3.15 in the afternoon and, as usual, traffic in Montreal was horrendous. We stupidly decided to follow the GPS's advice which routed us to the highway; it quickly became apparent that was going to get us nowhere fast. Some clever map reading and we made it to the hospital by 3.50 or so. 

At which point, of course, I had to take another ticket to wait in line for triage. The lovely triage nurse, like the one in the clinic, was super sweet, although she did laugh at my doctor's note mumbling something like "the way she wrote this is ..." (my doc had underlined the word URGENT and ULTRASOUND TODAY about three times). 

"I doubt you'll get an ultrasound today," the nurse said honestly. "They close at four." She glanced at the huge clock in the emergency room which indicated it was now 3.55pm. 

But she promised that I'd get seen by a doctor and when hubby inquired about waiting times, she said I was coded as a level 3 priority, which I guess means that you'll be rushed through. Because a few minutes later, another lovely nurse was taking my blood and then took me to a more isolated spot to wait for my next call because I was crying again. The next call came almost right away - this one to put a hospital wristband on my arm. Only then did I notice that most other people in the waiting room had similar wristbands. 

Then, I had to wait. For about 45 minutes. It was at this point that many different thoughts went through my head. Everything from recalling the last time I was in an emergency room, just after my miscarriage. And how I had just told almost everyone I know - even my students - about my pregnancy, and how sad it would be if something went wrong and I had to tell them. And numerous other things: like how I was better off than the poor sods being carried in on stretchers, or they guy in the wheel chair who looked about as sick as my dad had when he was dying of cancer. A hospital emergency wait room is an odd, odd place.

Eventually, I was called into one of the treatment rooms and asked to change into a gown. I kept my shoes on and put my sweatshirt back on too, as it was so darn cold. Hubby found me there with some food and magazines to pass the time. 

Some 15-20 minutes later a doctor came in. He asked a few questions, basically didn't look too worried but asked if anyone had checked the baby's heartbeat.

"No. Not yet."

So he went and got the doppler. Within two seconds he found the heartbeat. And I can tell you that there was never a better sound in the world.

Up till this point, I had been stressing out that everything might have gone wrong. But hearing the heartbeat was solid evidence that things were probably ok. The doc asked me if I was due for an ultrasound soon.

"Not till October 1st," I replied. That would be my 20th week or so.

He began to say that it was probably fine to wait till then; that there was probably little difference. But something, I don't know what, stopped him mid-sentence and he said:

"It's probably better if you get one done tomorrow."

So, about 10 minutes later, having gotten fully dressed again, he came back with an ultrasound form and appointment time, and a new blue hospital card (not sure why I need a second one, but I guess I'll find out tomorrow).

The entire experience today left me exhausted. Once in the car, I felt all my muscles getting sore - perhaps I'd been holding a lot of tension in them. At home, I fell asleep for a little while.

This whole week has been way too stressful. Five hours of standing/talking/teaching yesterday on top of a successful party on Monday and the preparations several days before. Well, perhaps I just need to do less, eat more and rest. That's what I'll be doing for the foreseeable future.