It was 2012 when I last wrote a post about my job. Reading back, the world has changed so much! I'll give you a look, from time to time about what it's like to be a team member in my NICU.
So, here we are; I should be asleep and truly wish I was! But once again the nightmares felt it necessary to trot through my dreams, filling my head with whimsical images which culminated today in hearing from a great distance my land line ringing....and ringing...and ringing until wakefulness brought me around, and then my cell roused me completely with an email beeping in.
I have clients this afternoon and believe me, I would not be lying if I didn't say that a part of me was hoping the message was from my first appointment. You know..to cancel...and then I could sleep another hour! No such luck, but then my kidneys mentioned to me that I really *should* get up, so I obeyed! My glance at the clock threw me completely into an upright position because I misread and thought it was telling me I needed to be at the office in 20 minutes.
Damn fucking tired brain! LOL! A friend gently berated me about my lack of sleep. As I said, it's one of the necessary things when building a business. The client wishes to make an appointment and one does so. But yes, I do try to give myself at least a three hour nap before scheduling someone when I've worked overnight. So, I'm an overachiever in a stupid way! I'm not blaming Himself, but it would have been helpful had he not had his meltdown yesterday and I'd have gotten a few more hours of sleep.
And, as the saying goes, I can sleep when I'm dead, right?
Anyway, back to the NICU. My feet are tired. I logged over 3.5 miles working the NICU and Nursery floors last night. And that was simply due to babies already arrived, almost all of which were being redrawn due to critical values on labs, or the never ending glucose protocols.
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One little Warrior Baby kept us busy - not just me - most of the night. The story of this baby is somewhat out of the ordinary.
If you've ever been on a nursery visit, there's a quick identifier when one glances in the room. There are blue cards and pink cards, a immediate clue to what the gender of the child is.
But wait...isn't that a YELLOW card? Yes.
It's called ambiguous genitalia. It means that the child's plumbing is not arranged in the commonly accepted ways. We see about 20 cases a year at BHTS. The nurses know I'm interested, so they usually show me what's in the diaper.
In this case, the child had either a very large clitoris or a very small penis. And a urethra. And a vaginal opening. And no testicles, but a scrotum. Bits and pieces of both genders.
The child was a transport from another hospital. Grandma insisted it was a boy, while the rest of us were not so sure. So the process of sorting it all out began in the last couple of days. Genetic testing was sent out for determination, and on the local level, ultrasound was done. There was a cervix, but no uterus or ovaries. No sign of testicles, either.
This puts everyone into that stage of "what if". When the genetics come back, what if the physical points to one thing and the child's brain chooses the opposite? It frequently happens, and that my friends, is where the potential of transgender comes into play.
I'll leave it right there, but I've got to say that all the current bullshit about transgenders in bathrooms is just plain ridiculous, and the small-minded people who want to target a creation of the Divine Plan are just plain wrong. Better that we follow the path of the Native Americans who treated "different" as "special".
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In this case the genetics have come back indicating that the child is a male. But, that's only one issue in a whole score of health issues which have now manifested.
When I arrived for my shift last night, almost immediately I was sent to that bedside to draw labs. Baby was ill. The team was in place trying to draw venously for a blood culture, and the next half hour I waited to see if they could get the draw rather than me sticking the kid again. Long story short, we were working on that kid off and on throughout the night. The poor kid was sick, and it wouldn't be impossible for a non-medical person to see it.
Fast forward to the later part of the shift. I was called back for a draw and the room had become an "airborne precautions" room. In other words, everyone had to wear a mask. Not an isolation gown, just a mask for the time being. Of course, I wondered why there was such a change in the works, especially since the child is several days old.
Thanks to the nurse practitioner actually reading the back story to this child, the potential was spotted and point of care testing was done immediately, then repeated twice more to make sure. The diagnosis? Herpes. Mom has herpes and baby contracted it while coming though the birth canal.
Believe me when I tell you that I've seen things that even a Divine Plan would have to consider a fuck up, but for some reason a baby with herpes just makes me want to curl into a ball and weep. I don't know why. It can be treated with some major drugs. But I get so mad at the medical profession when they see these things and don't react in the best interests of the child. If they *knew* Mom had herpes, the situation warranted a ceasarian section to keep the baby from going through the birth canal.
But, the other side of the coin is that perhaps the mother didn't know either, and only found out herself too late. It's not necessarily a case of poverty and lack of health care. It's just a piece of life puzzle and you never know when you spread all the pieces out whether all are, in fact, there. This, unfortunately, has some pieces which are missing and we will try to help find them, or suitable substitutes.
Baby, though, has been transferred to Nic1, which is for the sickest little ones. I will try to keep tabs on this one and update when I can. I will say with some dread, though, that it seems like some of these things come in waves, and we lost both a mother and a baby a couple of weeks ago - more back story on that, but herpes was involved in that one as well. I hope this isn't the start of something like multiple diagnoses of herpes coming through our doors.
And now it's time for me to get dressed and head toward my office to see clients. Hopefully no complications there!
Until next time...
Kate
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