Archived entries for NICU

things overlap

So, one of my first blog entries here was about how Senyo Agawu ’13 is the son of Princeton-affiliated Kofi Agawu, a music scholar who Ani has previously cited (and, I found out today, is currently reading). Here is another, much larger coincidence.

I have been amassing loads of articles on about twenty different topics. Usually I exaggerate when estimating, but there are actually three binders, among which twenty topics are covered. They include fetal and neonatal responses to music, heart beat variability in neonates, circadian rhythms in neonatal cortisol, and long-term consequences of NICU stays and neonatal surgery. One of the articles is called “Long-term effects of neonatal surgery on adulthood pain behavior.” Published in Pain in 2005, the first author on this paper is Haverford’s very own Wendy Sternberg. (When typing “Wendy,” I almost typed “Wednesday.” I should go to sleep.) I found this out last month when I first came across the article. It was one of the first I found in my search because it addresses one of the more pressing issues relevant to the study: how does the process of getting surgery affect subsequent development, sensations, and life outcomes of these patients?

When reading the authors, I stopped at Sternberg. I e-mailed her about my little discovery, and when I returned to read the paper, I started with the abstract and skipped past the other four authors, all of whom were in the same thesis group several years ago. Two days ago, I zoned out for a few seconds when looking at the paper (not for lack of interest but for, quelle surprise, lack of sleep) and when I came to, I see “Lauren D. Smith.”

I am living with Smiths: Penny and Jay ’73. I found them because their daughter Lauren graduated from Haverford relatively recently in ’04. Penny’s mother went by Doe, and I remembered vaguely that Lauren’s middle name was Dorothy or Dorothea or something. Could it be? Could I be living with the parents of one of the co-authors on one of the most relevant papers for this study?

To find out, I called Penny. I feel like whenever I call Penny, she automatically thinks something is wrong because I call her so infrequently. As usual with phone conversations, I started it as awkwardly as possible.

Me: “What is Lauren’s middle name?
Penny: “…Dorothy” [I don't know how they spell it.]
Me: “Yadda yadda yadda wow she wrote this blah blah blah.”

The world can be pretty absurd sometimes.

tape that is red

We are just about ready to purchase salivary cortisol collection swabs from the company Salimetrics (yea…), and the total, including rush shipping, is probably going to be approximately $150 or so. If I needed to buy these swabs for my own personal use, I could probably just call the company and buy them. But since we are going to use them for the study I needed to call Dr. Knight’s assistant who e-mailed the study coordinator who asked the budget coordinator how to get money out of the account.

Dr. Knight has been able to expedite this process a little bit, but this is just one of many obstacles that has greatly slowed our progress. My experience with this project has been rewarding, indeed, but in ways other than what I expected. I thought all of the data was going to be collected by the time I left and that there was going to be a paper in the works. The world is not that fast, in fact it looks like this, especially when so many people have their hands on the wheel, and each of these individuals is trying to control a dozen or so wheels. I have learned so much from my literature accumulation/review that will help me in the future, but I also realized the great amount of work actually goes into developing a research study.

When I was discussing this was Dr. Knight today and she sensed the frustration in my voice, she looked at me with this look…this look that wanted to knock out my naiveté. Pretty sure it worked, as far as I know.

i made a poster

The NICU employs eight doctors, two fellows, a fluid (but moderately high) number of nurse practitioners (NNP), and over 150 nurses. The doctors, fellows, and NNPs all know why I’m always in the unit, but it is difficult to keep all of the nurses informed because there are so many. So, Dr. Knight had me make a poster with all of the information. I decided to make it super colorful and I had a lot of fun with it. Felt like art class.

reresearching (or, finally researching again)

My favorite part of an undergraduate education is doing research for papers. It is the thing I miss most in the summer, so I requested an off-campus VPN log-in so I can get my research fix whenever and wherever I want, as long as I have my laptop. That “Proud to Be a Nerd” moment aside, yesterday, my computer at NSI was set up with access to journal articles abound and I was able to dig for information about infant neural development, cortisol levels, stress in the NICU, infant perception of music, etc. etc. If only Rob Haley could see me now. He is Haverford’s Interlibrary Loan (ILL)  librarian who has definitely written a poem or two to cope with how often I request articles.

Yesterday at Children’s, Dr. Knight gave me the task of perusing through the data input program to familiarize myself with its format to speed up the process of entering data when the study actually gets underway. After this task, Abbie, Dr. Knight’s assistant, gave me a PowerPoint document that included a lot of info about the NICU to help me get a better grasp about how RCHSD’s NICU is set up.

Finally, I gave myself the assignment of looking through all of the various heart conditions that plague infants, neatly described on this website for parents and Wikipedia. I’ve been keeping notes while at the hospital of little snippets of doctorspeak to look up when I get to a computer again in hopes of picking up some of their language. I’m finally getting there with some of the acronyms, as observed in native speakers with sentences like, “This one is SGA* with PDA** and needs ECMO*** stat.” (This sentence does not refer to any baby in particular, and I’m not even sure if ECMO would be needed for a patient with PDA, but I’m learning the nouns and adjectives first, okay? I’m getting there.)

*SGA – small for gestational age

**PDA – patent ductus arteriosis, a heart problem that results from a failure of the ductus arteriosus (a blood vessel connecting the aorta and the pulmonary arteries in fetuses) to close, resulting in a mixing of oxygen-rich and oxygen-poor blood and strain on the lung arteries and the heart

***ECMO – extracorporeal membrane oxygenation, essentially a heart-lung machine

Stress 101

While I was waiting for my parents to pick me at Haverford, I started reading Why Zebras Don’t Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping by Robert Sapolsky, a book Ani assigned to me to introduce some of the concepts we would be dealing with this summer. I haven’t gotten far yet, but the entertaining and approachable writing makes me excited about progressing through the book.

The beginning of the book had already altered the way I think about stress. Sapolsky remarks that the stress-response is the set of bodily reactions that is intended to help the body return to homeostasis after experience of or in anticipation of a stressor. Most humans have very few of the acute and chronic physical stressors that plague animals like having to hunt their food, but all animals have adapted ways to effectively cope with these stressors. Much of human stress is chronic psychological and social turmoil that never manifests physically, and this tends to lead to physical illness. The energy that is expended on the stress response cannot contribute to development and maintenance of other vital bodily functions like the immune system.

The directly relates to the population of babies that I will be working with this summer because the stress of cardiac surgery and of constant NICU stimuli effects their growth and development. Music certainly has the potential to reduce stress, and stress reduction is particularly important for babies, especially those that are at risk. And now, a lullaby rendition of “Smells Like Teen Spirit” by Nirvana.

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