News From the Nursery Lab - 2010-1

Welcome to the first edition of Nursery Lab 2010.

There are dozens of stories I wish I *could* tell you about, and one in particular, but at this time, it's just not to be. Perhaps, in time, I'll be able to share those things, but just not now.

There've been wonderful things happen in the NICU, and of course, and thankfully to a far smaller degree, there've been tragedies.

One of the joys came with a price we were sure would NOT bring happiness. Those of you who are older may remember the horrific births that occurred in the 50's when women were given a drug called thalidomide to combat morning sickness. The drug caused severe birth defects in babies. Many were born with limbs missing, for example. When the connection was made, the commonplace use of thalidomide was discontinued.

Before the little girl was brought to NICU, we heard whispers of problems in Labor and Delivery. When lab was notified to come draw, we were told to be prepared - for what, we weren't told. When I arrived, the nurse pulled me aside and told me that the little girl was born without one arm, and only had a partial arm on the other side. She didn't want me to gasp, or cry out or act shocked in front of the family who was in there.

I have to admit I was somewhat miffed at the assumption. I am, after all, a professional. I might cry, but I'll save it for later.

I went in, drew the baby. She was absolutely gorgeous. Her grandmother stood at the bedside, across from me, and simply beamed at the little beauty in the warmer bed. Auntie stood at the foot of the bed, beaming every bit as much.

I did my draws, congratulating them on this beautiful child, and listened to the conversation. These two women were absolutely fantastic in their forthrightness about the child's infirmities. By the time I left that room, I had no doubt whatsoever that this child would be loved and cherished, be given the ability to reach for the her own personal stars. This was reinforced on her second day of life when I went to the Mother-Baby unit to get the child's newborn screen.

There I saw something I'd not seen in my years on that unit. Upon entering the room, I saw the plastic "crib", which normally sits in a wooden frame, in the bed with the mother of the baby. Because Mom had had a c-section, she was still laying pretty flat. In order to reach her baby, she had the crib placed next to her so she could reach the child. She told me that it was easier to scoop the baby to her that way, since there was no way to pick the baby with her lack of arms. It was innovative on her part, and yet the child was safe from being crushed by a co-sleeping arrangement. Again, the love, the determination that this baby would be given the opportunity to live her life fully was more than evident. It was incredible to see, and I felt blessed to have witnessed it, even more so because many of the parents I see in our teaching hospital are of the type in which I weep for the child. Not so this one. She'll be amazing with female role models such as she has!

We lost a little guy just a few weeks ago, a death that was agonizing to me as it was so long in coming. The baby was a gastroschisis baby - in other words, he was born with his intestines outside his body. When this happens, depending on the severity, surgery to correct could happen almost immediately, or in some time after the baby has grown enough to allow the intestines to have space within the abdominal wall. Sometimes more than one surgery has to be done.

In this case, more than one surgery was needed. And, even more sadly, other things went completely wrong with the recovery. There were not enough drugs in the world to combat what was going on in this little guy's body. Yet, he hung on...we almost lost him once; the parents were in the room, the docs explained everything to them and what to expect and awaited their decision. He was so bloated that the in-dwelling lines were compromised for lab draws, and we had to do heelsticks and draw several waste tubes in order to get a draw to result normally. The parents made the decision to let the child pass away.

But, somehow, he did not. He rallied. Efforts to get him to survive were done with intensity. He'd have several good days, then some bad days and the cycle would repeat. But, he slowly began to fade again. Tensions ran high. And snapped.

We came to work one day and found that security had been called the previous shift. In bits and pieces we got the story. Dad and Mom were both quite young - around the age of 20 or so. Dad was, intellectually, quite smart, but the common sense gene was non-existent. Mom was a drama queen of the highest caliber. Her drama translated into neediness. His lack of common sense made him arrogant to the staff and he treated the nurses as his servants. When they were on the unit, it was not a particulary nice place to be.

And, as I said, the day came when security was called. The parents were staying at the hospital's in-house "inn". And Dad decided that enough of whatever was happening was enough. He took a swing at the mother. She called the NICU, who told her to haul ass up to the unit for safety. Security was called to keep the two of them separated.

There's no way I'd want to cross 8 or more nurses on a NICU unit who thought either a parent or one of their babies was in danger. Uh-uh...

Dad was banned from the complete hospital campus with the only caveat for his entry to be if the child was dying, and only then could he be there with security in tow.
About ten days later the boy left his place on earth. He did so without fanfare, just slipped quietly away. Another angel gets his wings...he fought the good fight.

And, to end this on a more happy note, I wrote about a baby in the NICU back in 2007. She was referred to as our "ice storm baby".

Over the Christmas holidays I saw a picture of her. She's around two years old, is perfectly normal and is as cute as can be. She's a beautiful girl and I'm proud to have been involved with her care while she was in NICU.

My next blog about the NICU will most likely be more on the critical care end of things. But that will be written another time.

All the best to you, dear readers!

Slainte!