Thursday, November 17, 2011

The fears of a doctor

I have recently flown on several flights.  I feel like I get more nervous each time I fly.  Yesterday, I had two flights on relatively small planes.  And small planes really bounce in turbulence - which I am not a fan of.  As I was death gripping the armrest and praying that we wouldn't drop out of the sky, I realized that if I knew what made the pilots nervous then maybe I wouldn't be so anxious.  I pictured them up front joking about the bumpy ride and realized that this is probably not the things that make them nervous.  But I am just a lay person - I have no idea what gets the blood pumping in the pilots.

But I do know what makes my heart race in the Neonatal ICU.  And it came to me that maybe parents of preemies would be a bit more at ease if we let them know what really got us nervous.  If I didn't know anything about the alarms and disease processes in the NICU, I would be a wreck if I saw my own kid going through it all.

So here is a list of the things that really get me on edge in the NICU:
1. Grade 4 head bleeds - in the short term babies can have a really hard time with bleeding issues but I am much more worried about long term issues.  If babies survive the short term issues, they still may need a VP shunt for "water on the brain" or hydrocephalus.  But the neuro outcomes after this are quite poor.  Sure a few babies can be normal after a grade 4, but the majority have severe disabilities and delays.  And it is so hard to make life changing decisions at the time when your baby looks like a baby, but when a 2 year old or 5 year old still looks like a baby-I think families realize the severity of the situation.
2. Babies that are still on the vent after a month or so.  I get worried that the baby may never come off.  Or they will need a trach.  Which in and of itself isn't bad, but the quality of life may be quite different (nurses living in you home, etc).
3. Necrotizing enterocolitis requiring surgery.  This can become such a mess.  Sometimes it is a quick surgery and things get better.  But sometimes a baby loses a lot of bowel and then they develop lots and lots of complications over time.  And some get NEC again.  And usually then other organs get damaged.
4. Seizures.  Babies that keep seizing have poor outcomes.  If it takes more than 1 drug to stop them, the outcomes are usually quite severe.  When it takes continuous infusions of meds to stop them, I start to question what the quality of life is going to be and are we doing the right thing.
5. Term infants that come out and have something wrong that was found on prenatal screening.  Probably makes me more nervous of being a mom that this happens to versus what the actual outcomes are.
6. Codes.  Not so much the code itself, but if I have to do chest compressions for more than a few seconds and I start pushing drugs, I really worry about what I am doing to the brain.

And for now that is all I can think of.  Sure some other things might get me worried, but really this is the list that makes my heart pound.  And I know some of you have experienced a few of these things.  Or a lot of these things.  My goal in life would be to have parents tell me they really knew what decisions they were or were not making.  Maybe by reading this, others will have a little less anxiety too over all the dinging and beeping that goes on.

Wednesday, November 9, 2011

The dreams, the reality, and the life.

Where did I just come up with such a title?  So you remember how I wrote about the life of a doctor way back here?  Well I am finally interviewing for a job.  You know - my very first real job.  Ever.  So maybe my life isn't quite so on hold anymore.  And it is exciting and scary.  But I know that something good will happen.
But at the same time, I have dreams.  And dreams that have nothing to do with medicine.  I have lived such a dichotomous life.   The artful, designer side and the studious, medical side.  There are times where I wished the former had won out over the latter.  Don't get me wrong, neonatology is great and I love being with families and helping them through some of the hardest moments.  But darn Pinterest - it pulls at my little heartstrings.  I see a picture of something so beautifully created, like these amazing tables from this amazing person over here.  

And I just get a bit of knife feeling in the gut.  I just start thinking of all the things I could be creating - especially like the table lady does with all recovered materials.
How do I merge those dreams with the reality that I am a physician?  There is not enough time to create these pieces just as a hobby.  If I tried- it would probably take me months.  I am not patient enough for those results (that is why I am in intensive care after all).
So the husband and I have agreed that we can leave medicine once the loans are paid off.  Not saying that I will leave medicine sooner than retirement.  But I might.  And he might.  And maybe we will become this well known couple that designs and creates amazing furniture.
And it is times that I am thinking like this that I wish my dad was still on this earth.  He was an architect.   He had visions and was able to create.  And when he died, he was just finishing one of his greatest projects.  The irony is that he died of a heart attack.  
John Nasseff Heart Hospital
It has been nearly 12 years since he passed away.  I was in college at the time and too young and naive to have conversations about what his dreams really were.  But I hope he was living them.  
And maybe someday I will get to merge my reality, life, and dreams all into one.

Wednesday, November 2, 2011

A little Re-nest shout out

So I got a little blog recognition today from  Have you ever seen their site?  It is a part of the apartment therapy group of blogs.  Re-nest is the green design blog.  Well if you happen over there, you may just see my recent headboard project featured:)  It is king of funny how this all came to be, and the husband may have had something to do with it.  But if you are coming over here from re-nest- welcome!  I don't have a ton of time to blog- but I usually blog about DIY projects, food, or home life.  I usually blog once a week or so.

And in honor of Halloween and my DIY stuff, I thought I would tell you about the Halloween costume I made for the Tank.  I usually make the kids' Halloween costumes.  This year the Munchkin wanted to be a princess at school.  And we had a nice warm ladybug costume for nighttime.  And the Tank had a horse costume that was given to us.  But I just couldn't not make a costume.  So I decided last minute to make the Tank a costume.  I pondered some pictures on the web, but just didn't like any.  Then I remembered I had some insulation/foam panels in the garage (from trying to make this headboard- which was a total disaster).  So what can a girl make from foam panels- but of course a Lego.  So I cut out some circles from the foam, glued them to another rectangle piece (front of the costume/Lego).  Then shaved out some circles from another rectangle piece (the back piece).  Wrote "LEGO" on the circles in glue so it was a bit raised.  Spray painted everything red.  Stapled some yarn to the inside top of the two rectangles and the sides.  Then hung it on the Tank. (like a sandwich board)  And he promptly ripped it apart.  I tried to duct tape the pieces together- yep ripped that apart too.  And it went in the trash before I could get pictures.  So sad.  It was so cute.  Maybe next year I will make it again.  So instead he wore the Munchkin's penguin costume (that I made) from last year.  He was cute.  And the Munchkin was cute in her (store bought) ladybug costume.