Wednesday, September 30, 2009

One Pound.

One pound, fourteen ounces.

The weight of the jumbo can of pumpkin I used last night to make muffins. The weight of my cosmetic bag. The weight of my running shoes, my coin purse, my water bottle.

The weight of baby Ella at 26 weeks young.

I donned a mask, grabbing the blue face shield before I walked through the locked door of the NICU. The neonatologist stood watch, clipboard in hand, next to a small plastic incubator. The incubator with tubes & tape & cotton & wires keeping this young, fragile life alive.

Her raw skin peeled already—just four hours after birth. Her chest rose & fell in sync with the sound of “whooshing” air, gentle positive pressure airways held her trachea open to allow adequate oxygen exchange. Like a covered birdcage, the yellow elephant blanket draped over the top of the incubator darkened the fluorescent lights above.

And we joined the watch.

She is doing well,” the neonatologist told us, “But the next 24 hours will determine everything.”

And “everything” wasn’t an exaggeration. Vitals scribbled on the clipboard, the plan of care carefully dictated.

Just two hours earlier, we’d make rounds with a perinatologist—a specialized Obstetrician whose training in advanced fetal care gave him knowledge to recognize, diagnose, & potentially treat fetal diseases. With years of specialized training & over 30 years of practice in high-risk obstetrics under his belt, he knew. He knew that babies born at less than 27 weeks have a significantly decreased IQ. He knew that babies born at less than 27 weeks have increased risk of chronic disease, increased chance of incompetent bowel, and decreased neuronal connections in the brain. He knew that babies this premature, this underdeveloped showed smoother brains & severe neurological deficits. That these babies had a risk seven times greater than a full-term infants for Cerebral Palsy & that their chance of social competence & marriage was less than 25%.

And he knew that he had to tell the parents.

So while we stood watch over this one pound baby now growing & developing outside the womb, this one pound baby with red peeling skin in a bed of cotton & tubes, he made his way to the ICU…the ICU where Mama lay in a medically-induced coma.

Young & vivacious, mom’s body was suddenly a mirror of little One Pound—limp & red in a bed of cotton, tubes, & wires.

She lost so much blood,” he said, “and the next 24 hours will determine everything.”

And “everything” wasn’t an exaggeration. Orders written for more platelets, more medication, more bed rest.

Her six year old waited outside, hand firmly in the grasp of wet-eyed husband. Her two-month hospital stay with complete bed rest for placenta percreta had come to an end—the end everyone whispered about & no one hoped for.

The surgery was emergent. Four specialists waited on the sidelines of the main O.R. Blood bank was on alert. The NICU was ready. LifeFlight was warned. And we lingered by the phones for the updates.

And so on this day, we wait. We ALL wait.

We wait for little One Pound to grow. To develop. To breathe on her own.

We wait for Mom to recover. To heal. To grasp the news of that this was her last baby because her uterus had to be removed to save her life.

We wait for the tubes, the wires, the cotton; we wait for the compassionate nurses, the wise physicians.

We wait for the grim news. We wait for the miracle.

Sometimes I think we wait too much—for life, for death, for lab results, for transport. We wait for the bad news…& sometimes the good. We wait for the right time to deliver the diagnosis, to counsel the patient, to give the medication. And in the midst of that waiting, I too often forget to recognize the sensational people I’m surrounded by: Little One Pound. Brave Mama. Skilled physician. Well-versed nurse. I too often forget to notice the miracle of the present moment: A 26-week-fetus—ALIVE. A severely compromised Mama—SAVED. An incredibly skilled physician—MY TEACHER. Those amazing compassionate nurses—MY MENTORS.

The First & Final Physician—MY SAVIOR.

I think they look good,” I say, “and the next 24 hours will determine everything.”

And “everything” isn’t an exaggeration. A whispered prayer makes its way heavenward & The Physician whiddles the "everything" into a miracle.

Monday, September 28, 2009

fringes of hope.

She told me she felt fine. “Just tired,” she said.

So we transfused blood to bring her dangerously low hemoglobin up. Hoping that the fatigue would subside.

She told me she felt better. “Still tired,” she said.

So we stole a vial of the blood we’d given her & ordered more lab tests. Hoping that we could find some answers.

She told me she felt hungry. “Just no appetite,” she said.

And so we took a picture of her belly. Hoping that the “tired” & the “hungry” would all make sense.

She told me she felt anxious. “I’m just not feeling well,” she said.


I looked over those lab results. And so did the residents. And so did the attendings.

And we made the appropriate phone calls.





And we told her that she had cancer. “Everywhere,” we said.

So she started crying, because she’d ignored her body. She’d lied about her vaginal bleeding. She’d forgotten to tell us about her anemia over the last 4 years. She’d skipped her doctors appointments & forgone annual check-ups. She’d deceived herself into thinking that she was fine. When she knew better. She said she knew better!

And we smiled. And tried to console her. And tried to pass along hope on the fringes of anger & resentment & acceptance.

She wiped her tears. And asked if she could “Please go home.”

So we signed her discharge orders. And there was nothing left to say.

Saturday, September 26, 2009

snuggle time.

They sent her up to the 4th floor. To the people who specialize in ultrasounds. They sent her up to the 4th floor because they thought something wasn’t right.

And something wasn’t right.

That baby inside. That cute, precious baby inside. The one that jumped around on the ultrasound last week. The one she’d told her friends about. The one she’d announced with anticipation. The one she’d bought white onesies for as Target yesterday. The one she’d invested her thoughts in, her dreams in…the one she’d share blood with for the next 9 months & life into the next World.

She would have plenty of time to gather her thoughts. A whole lifetime, actually. And the gathering would start now.

Because from the 4th floor, they sent her down to the third floor.

Where we gave her anxiety medication. And oxygen. And a bed to lay on for the next 28 hours while she birthed that baby.

That baby inside. That cute, precious baby inside. The one whose ultrasound showed anencephaly. The one whose white onsies would still wait at home, package gathering dust. The one who would be buried in its first home just two days later. The one who would be cried over, mourned, & terribly missed.

The one whose 17-week-life was written by the fingertips of God.

The one who makes us ask the hard questions about life & death & reason & God’s love. The one who challenges our faith to accept what the World deems unacceptable.

The one who reminds us that sometimes God writes in snuggle time with us through the most unfortunate of circumstances.

Wednesday, September 23, 2009

project 365: 09.14-20.09

because i am SO BEHIND on posting my Project 365 photos, i uploaded all of them into an album on Flickr can catch up on your own if you really care about my day-to-day that much :)

{monday: 09.14.09} in a last hurrah of studying, i spent all day at work & came back to Rusty & Gay's house to 'enjoy' a quiet evening of review. i managed to fit in a bit of photo editing & rotation-planning...& in the process seemed to get a small glimpse of life-around-the-corner from my test.
[no photo]

{tuesday: 09.15.09} the "BIG TEST!!" began at 9am. i showed up 30 minutes early & was allowed to start early. i promised myself before the test that i would not change my answers, as most of those changed during practice tests were changed to incorrect options. without using the extra time to review my questions, i was finished a whole TWO HOURS!!! earlier than expected! the new bethany dillon CD was first on my list to find, but none of the stores in town had it in yet. and so i settled for a new magazine instead (something i rarely, if ever, buy for myself). Gay & i ran a couple of errands together, stopped for dinner at Didier's (a local "diner"), & headed to see "Julie & Julia" (which will soon be added to my "feel good" movie collection when it comes out!). i returned to the house after my test to find that jon sent me flowers & chocolate--what more could i have asked for?!


{wednesday: 09.16.09} the first day back to work, our patient load was light! what a blessing! this cart is one frequently found in the hallways of the hospital--we gown-up, glove-up, & mask-up for the patients with current infections or a history of MRSA. ...and we wonder why our landfills are filling up so fast, stop getting sick, people!


{thursday: 09.17.09} my family (minus sisters) drove into town to take myself, my cousin, & a friend out to dinner. my mom was hilarious...& her jokes were even more funny because ALL of us were exhausted. it wasn't the first time we've caused a scene in a restaurant because of our laughter...


{friday: 09.18.09} one of the pretty "contact precautions" gowns that comes from the carts {09.16.09}. aside from working on saturday, it was my last day of internal medicine for this sub-internship...i don't think i'm meant to work in the hospital....


{saturday: 09.19.09} After finishing work earlier than expected, I hooked up with Korryn & friends & hit some of the local thrift stores for photography props. We had a great time...& God gave us an incredible sunset on Saturday...& the location of Rusty & Gay's house makes the colors all-the-more amazing!


{sunday: 09.20.09} With church in the morning, errands, & then breakfast with Korryn & Kyle, I spent a bit of time driving on Sunday. and since my recent purchase of the Colbie Callait CD, my car CD player has been playing the same 5-favorite-songs for the past 2 weeks. ...haven't gotten tired of them yet!


Related Posts Widget for Blogs by LinkWithin