#23 weekers

[the-ninja-legacy-whip]

OC Musings #23

Today's Musing: Coffee shop or high school AU, your choice: tell me their role.

(well, they're all already in a high school au sorta, so coffee shop it is!)

Jesse: Is the poor overworked barista Olivia: The customer with the overly complicated drink order Miranda: The regular that buys out all the pastries Bridget: The once-a-weeker that only ever buys a single black coffee Sunni: Works at the rival boba shop across the street Harleigh: The new customer that just discovered coffee somehow and is now on their fifth cup–

. . .

Question Inspired from this Prompt List

[projectoffice5487]

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The failure to afford him a hearing therefore invalidated that decision. It was only in the path of the tip of March 1990 that he determined to accept a advice to terminate the appellant's services. Nor do they allege that they'd the authority to take action. S 12 in my opinion provides the clearest pointer to the legislature's intention. Nowhere in the Act is provision made for the discharge of an employee serving on probation.

With our child’s medical history as a 23 weeker untimely child who is now four year old, she wants common checks with dietitian and pediatrics. I need us to return to Australia where we get free medical support and assistance when wanted. Kids get free dental and we all get free GP visits when needed.

For example, the Office of the Family Advocate, a Social Worker or Psychologist. Obviously, their experts need to seek the advice of with both mother and father and the kid and have all the facts before them before they can provide suggestions to the Court. They might resolve Staff Relocation In Wynberg to seek the guidance of with the child’s school teachers, family member etc.

[thenextjesuschrist]

personal #oof

Being a stay at home mom and an introvert is incredibly difficult for my mental health.

I am so overwhelmed by being surrounded by these tiny humans who have no empathy, reasoning, or care for me and what I do. They don't listen to me or give a shit if I start crying. That's not their fault obviously, it's just hard when my life, personally and socially is literally just kids. I see the successful moms that continue their work or school while being a mom. It makes me feel like a failure. Even though I know our situations are different. Adult connections and conversations are so limited that I hardly notice until I do. Most conversations are between my child's therapists or doctors and it's always the same thing. Am I doing my job? Is she thriving? Or am I shit and not doing enough even with the 25 hours and 8 days a week I spend with her. Why do I bother complaining or feeling overwhelmed with all of her things if she is all I talk to others about anyway? She's the only and most exciting and busy part of my life. Which is fine! It's just, is that all I am now?

At the same I'll take hours or even days to reply to a friend on Facebook messenger. I'll ignore tags to relatable memes just because I don't feel like commenting and starting a thread. My fiance will message me something interesting and I'll look at it and replying just seems so exhausting that I put it off. My friends will reach out with interesting shit about their own lives or even to ask about me and I'll put it off. I have mom friends I could reach out to to hang, I think everytime I see them post on Facebook. Yet I rarely will reach out because more often than not the day will come and I will instantly regret having made plans to leave. My body will be extra exhausted and mentally it will drain me. I barely ever want to leave my home anymore, and at the same time I'm constantly begging my fiance that we go somewhere, do something on his day off. I don't make any suggestions or have any clue what we would do, probably because in reality I know I would regret it as I got dressed.

How do people do it? I want to be more, but I also want to bury myself in my bed for eternity. Maybe that's just being a mom and I'm just a dramatic bitch???

[izzymccoy]

1/6: Back to Work

New year, new schedule. Ensley went back to work today. This means changes in the house, as she began the new regimen of getting up early so she can spend some time with Izzy before going back to her office. This also means it’s up to Dad and Elliot not to burn the house down after Mom leaves every morning—no promises, but we survived Day 1.

This entire process will be made easier by two huge factors: 1) Ensley’s company has been almost impossibly generous and provided her with the schedule flexibility to make this happen. 2) Isabelle is doing great.

Our meetings with the doctors last week were almost entirely positive. Before they got into the specifics of the numbers and analysis, they went out of their way to tell us how proud we should be of her progress. On the scale of babies born at 23 weeks (affectionately dubbed “23-weekers”), they explained that Izzy is doing incredibly well. She’s getting big—almost 7 pounds!—and if you can see beyond the tubes, looks and acts very much like a normal newborn (she even spit up all over Mom the other day).

Slowly but surely, her little lungs are growing. The doctors expect that we’ll be in the NICU for several more months, but they said that when we do go home, she shouldn’t need intense care. It’s also likely she’ll have some kind of assisted oxygen for a little while, but in the realm of possibilities—which included things as severe as multiple daily nurse visits—this is a major victory for all of us.

So, for the first time since the madness of September 16, we have something close to a plan: Work and wait for the beauty of spring. And it’s hard to believe considering what we’ve been through, but in the meantime we have to start preparing the house for a new member!

[riaa-isabel]

After Scarlett’s grand escape from NICU, she and I didn’t immediately go home. Home for us is actually 2 hours away in Andrews, Tx.  So going “home” for Scarlett meant an extended stay at Grandma Sylvia’s and Popo’s house (my mom & her boyfriend). 

Both of whom we are so incredibly thankful for, for opening up their home to us following Scarlett’s hospital stay. I honestly can’t say enough how much their help meant to us during this transitional period. 

Our reasons for sticking around longer are not as crazy as you might think. BJ & I made decisions that were best for our family at the time. While we would have loved nothing more than to take our sweet, tiny warrior home; it was better if she and I stayed close to her doctors for a little while. Following her release from NICU she would have several specialists she would need to follow-up with (within the first month alone). Cutting out traveling time, not only helped us financially but also gave this mama a peace-of-mind staying close to doctors who were already familiar with her medical history.  Not to forget to mention that Scarlett came home on supplemental oxygen support! All of which was something I wanted to be completely comfortable using, before taking any extended road-trips.

The Oxygen tanks & Pulse Ox Machine

The answer to the million-dollar question: Why did we choose to follow up with doctors in Lubbock, rather than Midland/Odessa which are a lot closer to us?

For starters. Because we wanted to. Our kid, Our choice lol.

But for real, because I was scared. I was a first-time mom, with a fragile baby, who had already overcome SO many obstacles. Having a choice between going to doctors in an area I’m not 100% familiar with. Verses seeing doctors in the area where my daughter was born, and we already knew.. I mean… It wasn’t really a choice – at least not in my eyes. We also have most ALL of our family in Lubbock. It’s where BJ & I were born and raised. So having that familial support and being so close, allowed the opportunity for our family to enjoy time with Scarlett. That was something we really wanted for her, especially during that time.

Grandma Sylvia

Finding balance isn’t; easy and can be very taxing. I know it took us time to find ours (and we’re still working on it lol). We found that by following the NICU schedule the first few days at home made the transition a lot easier on Scarlett. The absence of machines beeping and people coming and going made home eerily quiet for her. Thankfully the sounds from her oxygen machine created white noise which helped her sleep. I eventually started changing the routine a little at a time in order to make it our own and what worked for us.

That first couple of days home were both a challenge and a blessing. While I no longer had the helping hands of 100 NICU nurses, I was able to take care of Scarlett all by myself. I had been looking forward to days like these. That’s not to say I didn’t have my worries. But thanks to the wonderful UMC NICU staff, I had been well “trained” on what to do in case things got a little hairy.

The days were fairly smooth and easy…when she slept, I slept – We slept. 😉 Jk. I had a “newborn” on my hands – I wasn’t getting any sleep! lol Like any other mom, I spent most of my time changing diapers, prepping bottles, feeding, and washing bottles. Change. Feed. Wash. Repeat. You get the idea. My mom and Luis (a.k.a Popo) were almost always at work, so most days we had the house to ourselves. Visitors were far and few between. We were still in Flu/RSV season and everyone respected our boundaries. Healthy = a visit & Scarlett snuggles.  Unhealthy = Love us from a distance.

When our families would visit I would get a “break” and was able to shower and feed myself lol. Which was AWESOME! You don’t realize how amazing those things are until you wind up skipping a few meals and start to smell like baby poop. They are such a godsend! They stepped up and learned Scarlett’s routine in order to alleviate some of the work Scarlett required lol. I’ve said it a thousand times and I’ll say it a million times more. OUR VILLAGE ROCKS! Seriously.

Laura stealing Scarlett cuddles so Mom could “nap” (aka clean lol)

Tia Stephanie & Tia Mo helping with the nighttime routine

Night times were a little more challenging. BJ would continue to travel back and forth from Andrews to Lubbock, which meant I was something like a single mom. (Kudos to ALL of you full-time single parents. Raising a small human on your own ain’t easy!)  On the weekends, we would take turns getting up with Scarlett during the night which worked out…for the most part. However, two grown adults sharing a twin bed wasn’t exactly comfortable…so neither one of us was getting much sleep. Yet, somehow, we managed. At the time, I think BJ & I were in “survival mode” and just did what we had to do to make things work. We didn’t take a single thing for granted. After all, we had already been blessed beyond measure. Scarlett slept in a pack’n’play that was given to us by our dear friend Shannon. Which made things SO much easier! With Scarlett on oxygen support, she would constantly need her pulse ox monitor on. The pack’n’play made it THAT much easier for us to pick her up/move her without having to thread or untangle all of her wirings. I highly recommend using one of these for your own little one in the beginning.

  Her first post NICU appointment would be with her pediatrician, two weeks after her release. That day was one of my most anxious days of all.

From our Facebook Group 1 1/2 years ago. 

I took Scarlett to her first appointment today; and I’ll be honest with you – I was really nervous about it. Just like any first time mom, I felt all of the anxiousness you feel when it’s time to take your new baby on their first outing. I had all of these questions and worries flooding my mind. What time should I leave? Will we be there on time? Am I going to the right place? Do I have enough diapers? Do I need to pack extra clothes? And the list goes on and on and on…

And then on top of all of THAT, I felt the nervousness new moms, of a preemie, feel and all of THOSE worries and questions that come to mind. How am I going to carry Scarlett AND all of her equipment? Will I need to take all of her medicines with me? Do I give her medicines now or wait until after the appointment? What if the battery goes out on her monitor? What if her tubing gets snagged somewhere and I don’t know how to fix it? And on and on and on…

Needless to say – I was one very anxious and overwhelmed mess of a momma this morning. (And don’t get my started on how my night went, especially, with our little rain storm)

I made a plan. I had a list. I tried my best to be prepared.

So I when woke Scarlett up this morning to start our morning routine, (change diaper, feed Scarlett, give Scarlett her breathing treatment…) God surprised me and put my worries at ease. I walked past my moms room, like I have every morning since we came home, and instead of it being empty, my mom was in her bed. She was waiting for me to wake her up so she could help and go with us today.

We went to her appointment and it was great! We got there okay, and after a little adventure (called being lost), with some help we found our way. I met with Scarlett’s pediatrician – she’s nice, I REALLY like her. But she gave me a lot of information and in the end I felt overwhelmed yet again. I forget that even though Scarlett is out of the hospital, she still has a ways to go before she is caught up with other babies her age. There are things that I as her mother have to do to help her get there. So when we came home I was kind of feeling down in dumps. I just felt worried all over again because I want to make sure Scarlett is taken care of and that I am doing the best that I can for her.

I don’t know about you, but to me that’s a lot of pressure to put on yourself – but I tend to do that sometimes. I have worried so much about Scarlett, her health and wanting to do what is best for her. That I sometimes forget to stop and ask God to help me. I forget to ask him to take these worries from me. When I opened my bible app today, I was searching for a new devotional to follow and I saw my favorite bible verse. Isaiah 40:31 And in that moment I felt an instant relief. I laughed at myself; because in all of my worrying, even though I forgot to ask for Gods help, he saw what I needed and he provided for me – like he always has. He never ceases to remind me of his constant love.

1st Doctors Appointment

I know this new season of life will challenge me again. Now that Scarlett is home there are new obstacles to face and overcome. But only by Gods grace and love will we be able to get through it. We just have to take things one day at a time and remember to pray.

So with all of that being said – Scarlett is 8lbs 9oz and 20.5in long! She’ll have a weight check appointment next week. We will see her pediatrician every 2 weeks (until we decide otherwise) and She has an eye appointment on Friday. Please pray that we get good results like we have been.

Thank you all for your love. And I hope this helped you in some way. If you are struggling with something or just needed a reminder of Gods love. Know that he is always ready and waiting.

“…the Lord must wait for you to come to him so he can show you his love and compassion. The Lord is a faithful God…” – Isaiah 30:18

 Looking back at this I can’t help but be PROUD of myself for being strong and BRAVE enough to talk about my feelings. It’s scary to open up and be 100% honest with not just yourself but the world! 

While life after NICU was ANYTHING but normal and easy, I am so grateful that God provided for us time and time again. It’s hard being a new parent and learning to take care of someone else. But it’s just a “tad” bit harder when your child requires a lot of special attention. Yes, we are blessed that SO MANY things went RIGHT for Scarlett. But that doesn’t mean our struggles weren’t real. I’m still dealing with my PTSD and taking things one day at a time. But if sharing our story will help any of you other NICU parents, I am so happy about that!

I hope that you can learn to find balance too and always know that no matter how hard the struggle is, you are NEVER alone.

  Epilogue: Balancing Act – Life after NICU After Scarlett's grand escape from NICU, she and I didn’t immediately go home. Home for us is actually 2 hours away in Andrews, Tx.

[whisky--tango--foxtrot]

Whoa what an exciting morning.

We had a pregnant woman (23 weeks) come to the ED after SROM s/p MVC. Because of concern for worsening abruption, she was taken to the OR for an urgent cesarean followed by ex-lap and the NICU team had to cart all of our shit down to the OR to receive the 23-weeker who we had to intubate.

Is it naptime yet?

[dax-micro]

A series of 9 screenshots from Reddit.

Image 1 ambidextrose5: They're dropping like flies in our ICU. 20- and 30- years-olds on vent ant 99% of them unvaccinated. Even had a patient's family member bring in a letter from a "lawyer" demanding that the doc give the patient ivermectin. Reply from QuittingSideways: I would make a complaint to your state bar association—they regulate the behavior of lawyers like out state boards of nursing do. COVID-19 is not going to be cured by our knowledgeable friends in the malpractice and general complaint making business which is the law. If they want to weigh in on what nurses and doctors do they should go to school and get the license required. They should also have to have extensive inpatient training. That would shut them up.

Image 2 Alwayssunnyinarizona: The anti-masker in Texas who's about to come off vent had been using ivermectin. And by "about to come off," I don't mean "on hisway home."

Image 3 DaiLo4Lyfe: I had a covid patient on Friday, I gowned up to go into his room to give his meds. He was laying there purposely trying to make my job harder. He was coughing in my face (I have N95, regular mask, and face shield) and I asked him to wear his mask and he asked me "why?". I said it is to protect you and myself, he said "no I don't want to, you are probably vaccinated so you will be fine". I tried to stay professional and not let my emotions show. Right when I was about to leave he asked to be unhooked from the IVs to use the bathroom, I had to stay in that room to wait for him to finish so I don't have to gown up again to go in. Not only that, I caught a family member try to sneak into his room without proper PPE to give him food. I had to stop her immediately to give her proper PPE, she got angry with me saying we are blowing this out of proportion. I sometimes question myself if I really need this job, cause it makes me hate people LOL

Image 4 jroocifer: I am in med surf we just had one who was intubated in January. He was tube feed and A+Ox0-1, bedrest, and dies in misery a week ago. But at least the family was able to was $1 million tax payer dollars on the process and never visit him. So yeah, that's the best case scenario.

Image 5 "I might just quit" [Rant] (no screenname): I get to my shift this morning for my Neuro step down. I have 7 patients, 2 restraints, a screamer and hardcore withdrawal and a Covie patient. I just can't with this shit anymore. If I survive today that will be a miracle. Wish me luck. It's just unsafe. And here's the kicker, the joint commission was here yesterday so they staffed us well but as soon as they are gone, they fuck us over. This is unsafe madness.

Image 6 "Covid from a NICU perspective" [Discussion] (no screenname): Tonight at 2000, we will admit our 6th baby born to an unvaccinated, Covid mom on ECMO. I'm currently caring for a 26wk premie who's mom passed away last night after the family removed life support. He never met his mom- she survived on ECMO for 23 days before suffering arrest and brain damage. They have 2 other kids at home. Tonigh's delivery will be a 28 weeker. Mom as heen on ECMO for 2 weeks and they haven't been able to get her stats above 70% for 2 days so it's time to take baby before we lose them both. They told Dad to expect Mom to survive for a day or so after delivery. This will be our 6th baby that will never meet their mom since Covid started. We always hear moms say they worry about what the shot will to do baby, but they never consider not getting the shot will to do baby. I'm not sure how much more I can handle.

Image 7 Relevant_Solution297: I'm an ICU doctor. If you're unvaccinated and end up on a VENT- I don't care if your 20 or 60, obese or not - you"re not leaving the ICU alive. Let that sink in. And then go get vaccinated.

jgalol: The only one I had who made it was actually vaccinated. They were intubated for only 3 days—unheard of for Covid—and was outta the hospital a few days after that. I didn't tell them how "lucky" they were to be vaccinated because I'd never seen a Covid come to pulm stepdown without a fresh as trach... no vaccine and they woulda died a bad bad death. I didn't think a freshly extubated person needed to hear that, lol.

Image 8 mellowella I'll let you know soon. I have two unvaxed, intubated patients for the last week. One is 82 and was a DNR until family convinced him otherwise. Tubed him last night. The other is 64, his whole family has covid, including his pregnant dauther. All unvaxed. [That next pair or sentences is highlighted] I'm tired of answering these phone calls from family looking for a glimmer of hope or a sign that they are getting better. They aren't.

Image 9 RankledCat: A year ago I truly believed that people would take the pandemic seriously when they saw their friends and family members personally suffering from it. I was naively optimistic and so very wrong.

Reddit’s nursing forum makes for some pretty grim reading.

[morganbelarus]

“World’s Smallest Surviving Baby” Leaves Hospital For The First Time

Baby Saybie was born at Sharp Mary Birch Hospital for Women & Newborns in San Diego, California, in December 2018. Weighing just 245 grams (8.6 ounces) and measuring a delicate 22.9 centimeters (9 inches), medics gave her just hours to live.

But five months later, she had grown into a healthy baby girl, weighing 2.5 kilograms (5.6 pounds) and able to leave the hospital for the first time. This makes her the smallest surviving baby in the world, as recorded in the official Tiniest Baby Registry maintained by the University of Iowa, officials at Sharp Mary Birch Hospital have said.

Baby Saybie shortly after birth. Sharp Health Care

Due to serious pregnancy complications (in this case, pre-eclampsia – a condition that can be fatal for woman and child), Saybie’s mother was admitted to the hospital for an emergency C-section at 23 weeks and 3 days gestation in the womb.

While a premature birth refers to any that takes place more than three weeks before the due date, Saybie was what is called a micro preemie. That is an infant born before 28 weeks’ gestation – i.e. 12 weeks earlier than a typical pregnancy, which ends after 40 weeks. 

Even for a preemie, Saybie was tiny, weighing half as much as a normal 23-weeker and about as much as a large apple. But unlike many infants born before the 28-week mark, she didn’t suffer from any of the typical complications. These can include brain bleeds and problems with the lung and heart, the hospital says.

Now, after a five-month stint in the hospital, baby Saybie weighs 2.5 kilograms and has been allowed home.

Sharp HealthCare

Preterm births make up 8 percent of babies born in the US and Canada, and thanks to improvements in healthcare, they have a better chance of survival than ever before. 

Evidence collated by the American Psychological Association (APA) suggests that a low birth weight includes certain health risks that extend into adolescence and adulthood, including an increased likelihood of developing certain mental health conditions such as attention deficit hyperactivity disorder, depression, and anxiety. Other research suggests premature infants tend to be less healthy and face a greater risk of heart health problems in adulthood – but loving and supportive parents as well as nurturing school environments can help mitigate the effects. The research, presented at the Eastern Nursing Research Society in 2011, also found that premature babies tend to be resilient with a strong drive to succeed.

Original Article : HERE ; This post was curated & posted using : RealSpecific

“World’s Smallest Surviving Baby” Leaves Hospital For The First Time was originally posted by MetNews

[lastsonlost]

In a major step aimed at improving the survival odds for extremely premature infants, Children’s Hospital of Philadelphia researchers have created an artificial womb — a fluid-filled “BioBag” that kept fetal lambs alive and healthy outside their mothers until they could survive on their own.

The animals received oxygen through their umbilical cords and continued to develop much as if they had remained in the uterus, leading the team to express hope that the procedure could be tried on the youngest human preemies within three to five years.

The authors of the research stressed that they were not trying to enable the delivery of babies earlier than the current limit of viability, generally 22 to 23 weeks of pregnancy.

Instead, their goal is to provide a safe transition to the outside world for those infants, most of whom die under the current standard of care. Those who survive usually suffer from grave disability, such as chronic lung problems or cognitive impairment.

“It is very clear that they simply are not ready to be here,” said Emily A. Partridge, one of the study's authors.

Physicians not involved with the research, published Tuesday in Nature Communications, hailed it as a big advance. Jay Greenspan, a neonatologist and chair of pediatrics at Thomas Jefferson University/Nemours, called the team's efforts “heroic and monumental.”

Still, he cautioned that performing the procedure on extremely early human preemies would be a challenge, in part because they are one-third to one-half the size of lambs at the same stage of development. Most of the lambs in the study were removed from their mothers at the equivalent of 23 to 24 weeks' gestation for human fetuses, which at that point are less than a foot long and weigh a little more than a pound.

“Surgeries become even more challenging because these babies are so small,” Greenspan said.

But George B. Mychaliska, who is developing a different type of artificial womb at the University of Michigan C.S. Mott Children’s Hospital, agreed that some form of device could be tried on human infants within several years.

CHILDREN'S HOSPITAL OF PHILADELPHIAAlan W. Flake, left, Emily A. Partridge, and Marcus G. Davey led the artificial womb research at Children's Hospital of Philadelphia.

Researchers have tried to create such a support system since the 1960s for premature lab animals — lambs are commonly used because they are developmentally similar to humans — but have struggled to accommodate their delicate, underdeveloped anatomy.

A primary problem is the lungs. In very premature lambs, as well as human infants, the tiny sacs that exchange air and carbon dioxide with the blood are not fully developed; the maturation process stops when the lung cells are exposed to air at birth. Currently, intensive-care teams use ventilators to force air into the lungs of the youngest preemies, often damaging the organs.

The Children's Hospital team, led by fetal surgeon Alan W. Flake, approached the problem in stages. First, team members tried immersing lambs in a fluid bath to allow continued lung development, but some became infected by contaminated fluid.

Years of tweaking led to the closed "BioBag" system, which recirculates sterile fluid and features watertight ports to accommodate medical instruments. The fluid contains electrolytes for nutrition; future versions may include growth factors and proteins to prevent infection.

The lead "tinkerer," as he refers to himself, was Marcus G. Davey, a fetal physiologist who talks like an engineer. Because he built the system from scratch, some of the parts came from unconventional sources.

"A lot of the equipment we have here in the lab is from Home Depot," Davey said.

Since the animals' lungs were immersed in fluid, much as with a fetus that remains inside the mother, the researchers needed to deliver oxygen.

Normally, fetuses get oxygen through the mother's blood, via the umbilical cord. After delivery, however, the cord tends to spasm and contract, making access difficult.  

The Children's Hospital team solved this problem by devising an adapter that could be quickly attached to the umbilical cord moments after birth, allowing the insertion of a thin tube known as a cannula so the lamb's blood could circulate through an external oxygenator, which serves the function of a lung. Surgeons administered medication to prevent cord spasms, and also kept the operating room at a toasty 90 degrees, as umbilical cords are more likely to shrink in cooler surroundings.

Other researchers have tried a variety of different methods for delivering oxygen, generally with an electric pump. But that approach can overtax a premature animal's circulatory system, leading to problems such as swelling and heart failure, Flake said.

Instead, the premature lambs at Children's Hospital pumped the blood with their own hearts,  directing it through an external oxygenator. The latest generation of these devices exchanges oxygen and carbon dioxide across sophisticated, low-resistance membranes, so the tiny hearts had enough strength to push blood across them.

The protocol called for keeping the lambs on the system for no more than a month, supporting them until they (and someday, it is hoped, their human counterparts) could be successfully switched to a ventilator.

The team reported successful results with eight lambs.  Seven were euthanized so that the researchers could ascertain that they had achieved normal development of the brain, lungs, and other internal organs. The other lamb grew into a sheep and appears normal.

The same is true for several additional lambs that received the treatment but were not part of the study published Tuesday, Flake said.

"We've bottle-fed them, we've grown them up, and they're reasonably normal in every respect that we can tell," the surgeon said.

In the United States, an estimated 30,000 births each year are defined as critically preterm, occurring at less than 26 weeks into the pregnancy. But the artificial womb would be an option only for those that are delivered by cesarean section, as the umbilical cord spasms quickly after a vaginal birth, Flake said.

Asked how much it would cost to sustain a baby in an artificial womb, hospital officials said it was too soon to speculate. But they said it would be more than offset by reducing the risk of long-term disability, which currently costs the health-care system billions of dollars each year.

Mychaliska, the Michigan physician who is working on an alternate technology, cautioned that with Children's Hospital's approach, parents would be asked to try the artificial womb without knowing whether their baby might be OK without it.

"Not every 24-weeker does poorly," Mychaliska said.

In Michigan's system, called an artificial placenta, physicians can first see if lambs will breathe on their own before hooking them up to the system. The animals' lungs are then filled with fluid to allow further lung development; they are not immersed like the animals in Philadelphia.

Flake countered that if anything goes amiss with the Children's Hospital approach, a premature animal can quickly be removed from the bag and placed on a ventilator as it normally would be.

The next steps for the Philadelphia team include one more study in animals, as well as creating a device with medical-grade plastics for eventual use on humans. The human system is designed to be as womblike as possible; the babies would be kept in the dark, and they would hear recorded maternal heart sounds. Their parents would be able to see them via a "darkfield" camera, Flake said.

Children's Hospital has funded the research itself; it declined to reveal the total amount.

The project began more than five years ago, when Partridge proposed it to Flake, convinced that there had to be a better way to treat extremely premature infants. Five years from now, they hope to know the answer.

[chriscoles96-blog]

Catching the flu from a labouring woman with flu

23/02/19

I spent the first half of the day recovering one lady from a section, and waiting for my second lady to come back from seeing her baby in NICU.

When my second lady came back I transferred her to the Antenatal ward and began to focus on my other lady who was on half hourly obs. She couldn’t be transferred until 12:30, however at 11am the lead midwife decided to shake up who was looking after to who, so I had to hand over my lady to take a labouring woman.

The woman I was to look after was a 36 weeker, who’d been on the sepsis pathway - the antibiotics had done the trick but the doctors had decided we needed to crack on and have the baby. She was screened for flu but the result had not yet come back and therefore the precautions were not quite up to scratch as no one had bothered to locate some masks.

I broke her waters and spent time with her, her mum and her partner. Unfortunately her contractions didn’t really get going and when reviewed she hadn’t progressed. Syntocinon infusion was commenced and her contractions began to kick in, at 20:00 just on hand over her contractions were perfect and I knew it wouldn’t be long until she delivered. I wished her luck and left her in the capable hands of another midwife.

Jokingly I mentioned the possibility of catching the flu which had been confirmed before I went home. Unfortunately I did catch the flu and spent my annual leave achey and feeling unwell, it’s hard to have flu but I couldn’t compare mine against hers, she’d had to deal with all the symptoms while having to labour, it didn’t seem fair but sometimes the unfair is sometimes the safest thing for both mum and baby.

[amigos-americas]

Mail Time in the Dominican Republic

Our first batch of mail from the USA arrived today! (Friday 6/23). The earliest postmark in this batch was from June 6th! Our suggestion to make sure all your letters arrive on time is to make sure they are in the mail by THIS MONDAY if your participant is a four-weeker, and by July 19th if your participant is staying eight weeks. As a reminder, no packages or money please because we cannot guarantee their delivery.

Happy letter writing!

[lucyjanexo]

@daniellerawrr

I’m 23 weeks 5 days, so next milestone is on Friday where I’m officially 24 weeks. I think so long as I’m stable then, I may be allowed home and it’ll just been taking things 2 days at a time with monitoring and growth scans.

They’re pretty much treating him as a 24 weeker anyway, the consultant said if he did come now they would do everything they can for him because what difference does 2 days make? Which was really reassuring.

Haha yeah the steroid injections were foul. The first one seemed to fade a lot kicker but it stings so bad and then it feels like your whole butt cheek cramps up really hard and doesn't let up for a few minutes. 😣

[preemiemomlife-blog]

The Rollercoaster Continues

So we were really hoping that as soon as we got home the rollercoaster would slow down a bit.

Ha.

We were really lucky. We have a 23 weeker that came home with minimal diagosises and no oxygen. Our biggest issue was not eating so we have a G Tube.

We were told that her stamina will increase once she’s home. Bottle feeding will become easier.

Our reflux has only gotten worse. Our Zantac, which our Pediatrician prescribed days after our discharge, has not helped any. She does not want to talk about switching formula from Alimentum to anything thicker or with cereal until she’s 9 months actual.

It’s so frustrating. She could do so well, but she’s in pain when she eats. While she’s still gaining weight and not throwing up a significant amount, I can hear her swallow her reflux, she’s hoarse after every feed, she arches her back and screams during feeds.

I’m at a loss of what to do. I just want my baby to feel better.

[janice0600]

Sleep disorders he invented

22/9/18.. technically.

Today was good. It started with me waking up to my alarm set to 7am but as usual, I would get up only after 2-3 snoozes. Got up from bed after the second snooze today afraid that I might wake my room mates up. Sister’s off today and ng jucel is on pm shift.

Transferred to the living room where i carried on sleeping in the sofa for a few more minutes then finally stood up surprised that the next snooze was already at 7.40!!

Late again..

Showered and wore my oversized sweater thinking that today will be cold and i dont ever want to catch flu again. Went out together with ng eena cause she was heading to simei. Hehe. Simei.. his place. Our place. Our hiding place. To her to take the Paya Lebar route for easy access and she did.

Arrived at work hungry so I got a pack of biscuit before diving into all the paperworks. Wasnt a busy day. It was friday so we’re trying to keep clinic as light as possible. There was nothing unusual in the rest of the days.. had my lunch out at Jollibee and spoke to him over the fon while i was eating. He was heading to work then. Well let me try to remember.. we were talking about how noob I was playing mobile legends. I had 0 kills with 7 deaths!! Such a loser. Anyway, we were just making fun of my innocence until the lunch was over and I had to go back to clinic. Then I was reminded that we were to go with Dr Nair for Sue’s son funeral. Shocks! I just wore shorts and sweaters today. Not prepared for the occassion at all!! Had to run off to velocity cotton on and got myself a dress.

We went to Mandai and there I saw for the first time how a 23 weeker looks like. It was so heart breaking looking at Sue talking to his son in the coffin. Whats more is the dad, Roger, crying heavily beside her. Max’s soul is in heaven now. May the good Lord look after his parents and make them strong in this time of their life.

James dropped us off Kranji afterwards and I took the train home. We were messaging cause he was on dinner break/ gym time but we didnt talk much. He just said he missed me. Thats sweet. Told him that Im on my way home to Bishan.. his old place. And he replied with I am his new home. Lol. Such a corny guy. And I love him for that. My honey. Sleeping so soundly now infront of me. He called from work while the funeral was ongoing so I din pick it up. He called again when I was having dinner so I din get the chance to talk to him. Only when my cousin left and he was heading home then I was able to chat with him a little. Poor thing. He is so hungry. Havent had dinner from work and no meal prepared for him at home. I wish to make you dinner someday my love.

I hope Im this smooth everyday.. waiting for his texts but not worried about the missed messages. I hope I can be this calm for all eternity not caring about what he might be doing or thinking but instead just doing what I have to do without any expectations in return.

After awhile he called. Hes done with dinner, shower and cleaning up dishes. He is in bed and getting ready to sleep. We spoke about why I wasnt able to pick up his call, how to better his jawline, how to diminish his face scars, and later on how he looks when he sleep. Hilarious how he said I sleep with mouth widely open and kind of gasping for air. Stupid shit I dont do that. I got back to him by saying he sleeps while blowing out air in pursed lips. Then he was like I sleep and spit at the same time?? Wtf. And sometimes sleeps and vomits altogether? Hahaha. Told him we had a gp before who sleeps and snores and raises his head while he does the other two. He tried to imitate it the worse way possible. He stood up while sleeping, he sat, he slept sat and opened eyes. Shit it was so funny I could die laughing. Today is a good day to remember. I dont want to forget it. I dont ever want to forget how he slept here. I love you, hon.

[fishermariawo]

What Can Heat Do For Your Health?

A few months ago, I explored the benefits and applications of cold therapy. Today, I’m going to talk about the benefits and applications of heat therapy—one of the most ubiquitous and ancestral therapies in the history of humankind. You name a culture and—as long as they didn’t live in perpetual tropical heat—they probably had some form of heat therapy. Native Americans had the sweat lodge, those of Central America the temazcal. The Romans had the thermae, which they picked up and refined from the Greeks. Other famous traditions include Finnish saunas, Russian banyas, Turkish hammams, Japanese sentó (or the natural spring-fed onsen), and the Korean jjimjilbang. People really like the heat.

Right off the bat, that’s one major benefit to heat therapy compared to cold: It’s an easy sell. “You can luxuriate in a sauna for half an hour or lower your naked body, genitals first, into a bathtub filled with ice water. Your choice.” People are far more likely to sit in the hot room for 20 minutes than they are to sit in an ice bath for 3 minutes or even take a cold shower. Short-term heat exposure is generally regarded as pleasant. Cold exposure is generally regarded as torture. If heat therapy offers legit health benefits, this is a major point in its favor. So, does it?

Oh, yes.

In a recent review of the available observational studies, controlled trials, and interventions, researchers found evidence that sauna usage has an impressive array of beneficial effects on health and wellness:

Increased lifespan and decreased early mortality.

Reduced cardiovascular disease.

Lowered blood pressure.

Improved cognitive function and reduced the risk of neurodegenerative disease.

Improved arthritis symptoms.

What’s going on here? How could sitting in a hot room do so many good things?

Stress, in a word. One of the coolest things about us is that encountering, facing down, and then growing resistance to one type of stress tends to make us better at dealing with stress from other sources. A 30-minute sauna session at 174 ºF/80 ºC raises body temperature by almost 1 degree C, spikes your flight-or-flight hormones, raises cortisol, and triggers a powerful hormetic response by the rest of your body. That’s a stressor. After such a session, subjects report feeling “calm” and “pleasant.” This isn’t a surprise. Intense exercise also raises cortisol in the short term. And like regular exercise, longer term sauna usage (daily for four weeks in one study) actually reduces stress hormones.  It’s a classic hormetic response, where acute doses of the stressor increase oxidative stress enough to provoke a compensatory adaptation by the organism.

What does this sauna-induced hormetic stress do for us?

Benefits of Heat Therapy

It reduces oxidative stress. Short term, it increases stress (that’s why we see the transient spike in cortisol and other stress hormones). Long term, it reduces oxidative stress. Long-term sauna use has an inverse association with levels of C-reactive protein (CRP), a “catch-all” biomarker for oxidative stress and inflammation. The more often you use the sauna, the lower your CRP.

It may reduce mortality. The more frequently a person visits the sauna, the lower his risk of premature death from heart attack and all causes. There is a dose-response relationship happening here, which has me leaning toward “causal.” Those using the sauna two to three times a week had a 23% lower risk of fatal heart attack compared to men who used it just once a week. Men who used the sauna four to seven times a week had a 48% reduced risk of fatal heart attack compared to once-a-weekers. The more frequently men used the sauna, the greater the protection (for other causes of mortality, too).

It improves vascular function. A single bout of sauna (or exercise, for that matter) reduces vascular resistance—the amount your blood vessels “resist” blood flow—in hypertensive patients for up to two hours.

It’s good against type 2 diabetes. Sauna use has been shown to improve almost every marker related to type 2 diabetes, including insulin sensitivity, fasting blood sugar, glycated hemoglobin, and body fat levels.

It can improve depression scores. Patients with depression who underwent heat therapy saw improvements in their Hamilton Depression Rating.

If you’re an athlete, or exercise at all, you should try the sauna. Training magnifies the benefits of the sauna.

Finally, pairing exercise and heat therapy together is a boon for cardiovascular health. For instance, people who frequent the sauna and the gym have a drastically lower risk of heart attack death than people who do either alone. That combo also reduces 24-hour blood pressure in hypertensive patients and confers special protection against all-cause mortality above and beyond either variable alone.

Post-Workout Benefits

Post-workout sauna sessions improve endurance performance in runners: For three weeks, endurance runners sat in 89° C (+/- 2° C) humid saunas for 31 minutes following training sessions. This amounted to an average of 12.7 sauna sessions per runner. Relative to control (no sauna), sauna use increased time to exhaustion by 32%, plasma cell volume by 7.1%, and red cell volume by 3.2% (both plasma cell and red cell volume are markers of increased endurance performance).

Post-workout sauna use increases plasma volume in male cyclists: Following training sessions, cyclists sat in 87° C, 11% humidity saunas for 30 minutes. Just four sessions were sufficient to expand plasma volume. This is important because increasing plasma volume improves heat dissipation, thermoregulation, heart rate, and cardiac stroke volume during exercise.

Post-workout sauna—either dry or steam—can also alleviate muscle fatigue.

How About Pre-Workout?

The effects are more mixed. In one study, pre-workout sauna reduced strength endurance and 1 rep max leg press, had no effect on 1 rep max bench press, and improved maximum power (vertical leap). Another study found that in female athletes but not in males, maximum power decreases after sauna use. It’s possible that these performance disturbances are caused by dehydration rather than the heat itself, so make sure you rehydrate if you’re planning on training after a sauna session.

If you want to apply heat pre-workout without overdoing it, I’ve always liked a nice hot bath to help limber up, mobilize my joints, and clear out any stiffness for the coming workout session.

Oh, and It Can Help You Detox

I was going to write the full word “detoxification,” but I figured I’d write “detox” just to trigger the hardcore skeptics reading this…. Heat exposure can augment your natural detoxification capacities by at least two mechanisms.

First, exposure to extreme heat increases something called heat shock proteins, or HSPs. HSPs are responsible for many of the benefits of heat therapy, including enacting beneficial hormetic effects on our detoxification capacity. They trigger compensatory adaptations and activate antioxidant defenses in the blood of healthy volunteers. They even increase regeneration of the body’s main detoxifying organ—the liver—after it’s been damaged.

Second, contrary to popular belief, sweating can aid detoxification. Sweat itself contains bioaccumulated toxins, including BPA—even when it doesn’t show up in the blood or urine. Sweat also contains certain phthalate compounds and their metabolites, none of which we want. Sweat also contains arsenic and lead in people exposed to high levels of the metals. Sweating may even improve the function of another important detoxification organ—the kidney—by restoring nitrogen excretion in people with kidney disease. In one study, police officers with chronic illnesses caused by exposure to high levels of meth lab chemicals experienced major improvements after sauna therapy.

What If You Don’t Have Access To a Sauna?

There are other options.

Steam rooms work. Only problem with them is it’s difficult to remain in one long enough to trigger the necessary stress response. Saunas, with their dry heat, are easier to stick with. Steam rooms feel different enough that I wonder if there’s something unique about them. Not enough evidence to go on, unfortunately. Perhaps I can revisit this later.

Jacuzzis and hot baths work. A recent paper found that taking regular hot baths at home improved insulin sensitivity and increased nitric oxide synthase activity about as much as working out. Another found that, compared to showering, bathing improved mood, perceived stress, blood flow, and accumulation of metabolic waste products.

You could probably sit in a black car on a hot day with the windows rolled up and get an effect.

Just get hot, as hot as you can stand. Then stay a little longer. (As always, be sure to talk to your doctor. Certain conditions and scenarios, like pregnancy, require extra caution with saunas or other forms of heat therapy.)

Have you used the sauna? Are you a regular attendee? Or do you use other means of heat therapy? I’m curious to hear your experiences, tips, and stories below.

References:

Laukkanen JA, Laukkanen T, Kunutsor SK. Cardiovascular and Other Health Benefits of Sauna Bathing: A Review of the Evidence. Mayo Clin Proc. 2018;93(8):1111-1121.

Leppäluoto J. Human thermoregulation in sauna. Ann Clin Res. 1988;20(4):240-3.

Sutkowy P, Wo?niak A, Rajewski P. Single whole-body cryostimulation procedure versus single dry sauna bath: comparison of oxidative impact on healthy male volunteers. Biomed Res Int. 2015;2015:406353.

Laukkanen JA, Laukkanen T. Sauna bathing and systemic inflammation. Eur J Epidemiol. 2018;33(3):351-353.

Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med. 2015;175(4):542-8.

Krause M, Ludwig MS, Heck TG, Takahashi HK. Heat shock proteins and heat therapy for type 2 diabetes: pros and cons. Curr Opin Clin Nutr Metab Care. 2015;18(4):374-80.

Laukkanen JA, Laukkanen T, Khan H, Babar M, Kunutsor SK. Combined Effect of Sauna Bathing and Cardiorespiratory Fitness on the Risk of Sudden Cardiac Deaths in Caucasian Men: A Long-term Prospective Cohort Study. Prog Cardiovasc Dis. 2018;60(6):635-641.

Kunutsor SK, Khan H, Laukkanen T, Laukkanen JA. Joint associations of sauna bathing and cardiorespiratory fitness on cardiovascular and all-cause mortality risk: a long-term prospective cohort study. Ann Med. 2018;50(2):139-146.

Gayda M, Paillard F, Sosner P, et al. Effects of sauna alone and postexercise sauna baths on blood pressure and hemodynamic variables in patients with untreated hypertension. J Clin Hypertens (Greenwich). 2012;14(8):553-60.

Hedley AM, Climstein M, Hansen R. The effects of acute heat exposure on muscular strength, muscular endurance, and muscular power in the euhydrated athlete. J Strength Cond Res. 2002;16(3):353-8.

Gutiérrez A, Mesa JL, Ruiz JR, Chirosa LJ, Castillo MJ. Sauna-induced rapid weight loss decreases explosive power in women but not in men. Int J Sports Med. 2003;24(7):518-22.

Genuis SJ, Birkholz D, Rodushkin I, Beesoon S. Blood, urine, and sweat (BUS) study: monitoring and elimination of bioaccumulated toxic elements. Arch Environ Contam Toxicol. 2011;61(2):344-57.

Genuis SJ, Beesoon S, Birkholz D, Lobo RA. Human excretion of bisphenol A: blood, urine, and sweat (BUS) study. J Environ Public Health. 2012;2012:185731.

Khodarev VN, Zhemchuzhnova NL, Olempieva EV, Kuz’menko NV. [The influence of general infrared sauna on the antioxidant systems in the blood of volunteers]. Vopr Kurortol Fizioter Lech Fiz Kult. 2013;(5):10-3.

Shi Q, Dong Z, Wei H. The involvement of heat shock proteins in murine liver regeneration. Cell Mol Immunol. 2007;4(1):53-7.

Mccarty MF, Barroso-aranda J, Contreras F. Regular thermal therapy may promote insulin sensitivity while boosting expression of endothelial nitric oxide synthase–effects comparable to those of exercise training. Med Hypotheses. 2009;73(1):103-5.

Goto Y, Hayasaka S, Kurihara S, Nakamura Y. Physical and Mental Effects of Bathing: A Randomized Intervention Study. Evid Based Complement Alternat Med. 2018;2018:9521086.

[akb48loveantena-blog]

【欅坂46】1/23放送『踊る！さんま御殿！！』長濱ねるに続いて、菅井友香が出演決定！お嬢様エピソードとか披露するのかな…

踊る！さんま御殿!! 2018年01月23日 19時56分～2018年01月23日 20時54分 あらすじ テーマに沿ったエピソードをゲストが次々と披露！▽思わず飛び出す裏話に大爆笑！ほか1997年10月に始まった、明石家さんま司会のトークバラエティー。毎回、スタジオに招かれた各界からの有名人たちが、テーマに沿ったユニークなエピソードを披露する。 出演者情報 明石家さんま(司会) アジアン(ゲスト) 定岡ゆう歩(ゲスト) 佐藤エリ(ゲスト) とろサーモン(ゲスト) 青山テルマ(ゲスト) 加藤貴子(ゲスト) バイきんぐ(ゲスト) 石原良純(ゲスト) 菅井友香(ゲスト) 岡田結実(ゲスト) 引用元（タレントWeeker）より引用しました。 9: 名無しのまとめラボ 2018/01/15(月) 07:05:19.41 ID:km4zfBre0 1/23���　さんま御殿　菅井友香   108:…