Archive | September 2019

School as a “Returning Learner”

As I have mentioned before, I am returning to school in pursuit of a career as a NICU nurse. Currently, I am taking Anatomy & Physiology I, which consists of a lab and a lecture. Having already been to college once (for a Bachelor’s degree in English Education), and being slightly older than the average first-time college student, I am classified as a “returning learner” for student purposes. Among other things, my background means that I do not qualify for FAFSA (free student financial aid), but it does mean that I have already experienced college, which I am beginning to see is a huge advantage.

This semester has been an interesting ride so far. From new online programs for coursework that didn’t work, to only using an online version of the book (until I bought the paper version last weekend), to my professors not knowing how to use the online coursework site, it was a rough start. I am already a very Type A person, and I prefer my schedule to be organized and itemized as much as possible. Knowing that this is the first “make or break” class of any medical program, I began preparing before the semester even began. I took a one week prep course that covered what you should know going into Anatomy & Physiology. I took notes and printed them out as a reference, sticking them in the back of that binder I use for class. When the textbook listing came out for this class, it included some study aids. After determining that I would actually use them, I purchased them–a huge set of flashcards and a coloring book (more on this in another post). I have heard from several people, some of whom are now nurses, that Anatomy & Physiology is a divergence point in the coursework of becoming a nurse. I was taking no chances.

The first lecture class was similar to most of the others I have taken. The professor lectures off a PowerPoint and posts the slides for the students to print and take notes from. Neither of the two students on either side of me had printed them. Instead, they were frantically scribbling down every single word on each slide, unable to focus on what the lecture was covering because they were trying to transcribe slides that they already had access to. Every so often, they would glance at me with a “what are you DOING?” look in their eyes. I was taking occasional notes to clarify or expand on a topic, perhaps highlighting something. I actually sat in a different seat at the next class because they were making me feel anxious with their frantic scribbling.

The most recent class was similarly notable. The professor couldn’t go two slides without someone asking if this would be on the test, or if we had to know this for the quiz. I gave up trying to hide my irritation after about the fourth time someone asked the same question. During the break, a few students were complaining to the professor that this was too much to learn, that they couldn’t memorize the book, that they didn’t know where to start, that they needed a study guide. When she finally lost patience, her reply was that this is an upper-level class for people who want to go into the medical field. We need to know ALL OF IT.

My lab class has different students, but similar attitudes. When our professor said that spelling would count on the lab tests, there was an audible reaction from most of the class. Her reply was that, as nurses, spelling something wrong can have huge repercussions, even cause an error that costs someone their life.

 

I think my favorite quote related to the mindset of going to nursing school is that we should be trying to become the nurses we would want to have if we were patients. I can tell that some of the students have this mindset, and are determined to learn as much as they can. These tend to be the older students, maybe the “returning learners.” The rest seem to want the answers for the tests handed to them. If it isn’t going to be on the test, they don’t want to hear about it, don’t want to learn about it. I figure that this class is the basis of every other class I’m going to have in nursing school, and I want to be prepared.

 

 

 

 

 

 

 

 

 

 

 

 

 

NICU Awareness Month

As I mentioned in my last post, September is Hydrocephalus Awareness Month, but it is also NICU Awareness Month! Here is the short story of how Little Miss Minion ended up in the NICU.

Little Miss Minion was born at 28 weeks because I had developed something called preeclampsia. Basically, this is high blood pressure that has negative effects on blood vessels that carry nutrients to the baby and to the mother’s organs, particularly the kidneys. When my kidneys began releasing large amounts of protein (measured by weekly urinalysis), my doctor decided I needed to be on bedrest. Two days into bedrest, I had a follow-up appointment with more urinalysis and bloodwork to see how things were progressing. When everything was analyzed, they told me to go the hospital for confirmation and to expect to go back home for bedrest.

While doing more bloodwork in the hospital, it was determined that I had also developed something called HELLP Syndrome, a complication of preeclampsia. In addition to (or because of) the high blood pressure and kidney damage, my platelet count was lowering, my red blood cells were being broken down, and my liver was being damaged. All of these things together made for a very bad combination. Toxins were building up as my kidneys and liver were damaged and unable to filter them out. My red blood cells were damaged, and my platelets were being destroyed. Platelets are a very important component of your blood. When you have a cut or any bleeding, they flock to the area and cause a clot, which stops the bleeding. Low platelets means that the chances of hemorrhage increase. Not a good thing when the only way to stop your symptoms is an emergency C section.

The scariest part of this whole thing is that I FELT PHYSICALLY FINE. I had headaches, but I always got headaches. My feet were puffy, but I was pregnant and that is apparently common. I am still so incredibly thankful that my OB listened to me the first time around (we had a mini version of this in April, when I was 25 weeks) when I said something felt off, but I couldn’t put my finger on it. My blood pressure was higher than normal for me, but still within normal limits. My bloodwork came back off, but not off enough to conclusively prove anything. My feet were puffy, but only after I walked around at work.

I had my first visit to the NICU a few hours after LMM was born. I had been too sick from the magnesium (used to keep my skyrocketing blood pressure from causing a seizure) to go down and see it. I can’t remember at the moment if Mr Minion was able to go down and see it beforehand. I know they sent a couple of the neonatologists up to talk to us at some point before she was born. We had been aiming for 34 weeks, then 32 weeks, and then LMM stopped moving on the monitors I was strapped to 24 hours a day. An hour after she failed the non-stress test, she was here.

My first memories of the NICU are hazy because of the magnesium. I don’t remember getting to her room, but I remember being in the room and looking at the incubator and thinking, that is not a baby. That can’t be a baby. So many wires and tubes and nurses…so tiny. There is a picture of me in the hospital bed in her room looking absolutely trashed and I can see the state of shock I’m in.

As I began to physically heal, the NICU became less of the shadowy and terrifying place I had seen that first night, and became like home. We had a routine after I went back to work 2 weeks later: we would arrive at the NICU at 6am. I would pump and we would get the overnight report from the nurse. I would leave for work at 6:30 and Mr Minion would stay until around 8, maybe getting to help with her diaper change or even holding her. I would get off work at noon (my work allowed me to change my hours so I didn’t burn all my time off before she came home) and drive to the hospital, change my clothes, pump, and hopefully get to hold her for an hour or two. Then I would pump again and try to take a nap. Mr Minion would arrive and we would have dinner in the cafeteria, then go back to the room for her evening cares (diaper change, temp, heel stick for sugars). One of us would hold her for another hour, I would pump again, and then we would head out after the night shift switch.

Repeat for 84 days.

When she finally got out, I was sure I would never go back. Then, I wanted to go back to help with a fundraiser for the parent group. Then, I joined the parent group as a full volunteer and went back into the Unit itself to talk with parents about their NICU journeys. Now, I’m going back to school to earn a nursing degree so I can come back to the NICU as a nurse.

It’s funny how thing work out sometimes.

Hydrocephalus Awareness Month

September is Hydrocephalus Awareness Month.

For those who don’t know, my daughter Little Miss Minion was born at 28 weeks. While in the NICU, she developed an infection that led to meningitis and sepsis. As a result of the meningitis, she developed a condition called hydrocephalus.

Several weeks after she was out of the woods from her infection and complications, I remember getting a message from the charge nurse one day when I was at work that said they had done a scan (they did brain scans periodically to make sure she didn’t have a brain bleed, another complication of premature birth) and the scan had revealed enlarged ventricles. Of course, I immediately googled enlarged ventricles and found articles about kids dying in Africa with heads the size of watermelons. Needless to say, I hightailed it to the NICU to find out what was going on with my baby. They told us that a specialist was coming to talk to us about our options. I was convinced that there was a strong chance that LMM would end up like those kids in Africa.

The specialist they sent turned out to be an incredibly talented neurosurgeon from a nearby Children’s Hospital. There aren’t many pediatric neurosurgeons in the country, and there were none in the medical system we used. That’s a story for a different day.

The neurosurgeon explained that LMM had something called hydrocephalus. He told us that, because of the illnesses she had overcome, her brain had become damaged and was no longer draining itself the way it should. He told us about cerebrospinal fluid and how your brain creates this liquid inside areas called ventricles. How something happened inside LMM’s brain and the liquid wasn’t draining. Instead of flowing around her brain and being reabsorbed, it was pooling and building up, putting pressure on her brain.

As if this wasn’t bad enough, he went on to explain that the only way to fix this problem was to surgically implant a device called a shunt. There would be a small tube placed inside one of her ventricles that would drain the extra fluid into a pocket near her stomach, where it would be reabsorbed.

Her first shunt surgery took place when she was about eight weeks old and weighed around 4 pounds. Since then, she’s had four more surgeries.

The only experience I had with hydrocephalus was watching a Disney Channel movie starring Frankie Muniz called Miracle in Lane Two. It’s about a kid who wants to race these Build It Yourself race cars. The kid has spina bifida, and uses a wheelchair to get around. He also has hydrocephalus, and has a shunt malfunction during the plot of the movie. Having this as my baseline knowledge, combined with the terms “brain damage” and “brain surgery” plus the fact that no one could tell us what this diagnosis meant for LMM, we were incredibly worried for her.

Luckily, the brain damage was minimal (as seen on multiple MRIs) and it appears that her brain simply went around those areas to make new connections. We won’t know for sure, so we just have to wait and see if she starts having trouble later.

If you’ve stumbled on this blog by searching hydrocephalus, I want to tell you that you aren’t alone. Also, don’t google it. 🙂