Dinner with Friends

A long overdue post from Bryan. Some internet issues, so my last post didn't go through. It's amazing how accustomed you become to something strange. Ultra pasturized milk now tastes as if I've been drinking it all along (they keep it at room temp...weird). All our food cooked from scratch. Rinsing your toothbrush needs to come from water from a pitcher next to the sink instead of the facet (yes, I've messed this up a time or two). The blank stare I receive while asking why CSF studies on my septic baby weren't run 12 hours ago. Do I miss the things that are "normal" to me? Not really - the states seems more like an alternate reality than an actual way of life. Thus, without the distraction of TV and media, the families here are experts at self expression - they all have hobbies that they are gifted at ranging from pottery, coffee, music, photography, to hiking and mountain biking. The richness of one aspect of life is simply transferred to another. People have someone over for dinner or go to someone's house several times a week. Relationships and friendships are built in a very lasting and enduring way that I find quite refreshing. Two nights ago we had Moses, one of the interns over to dinner two nights ago. He shared with me how much he had appreciated what we had done for him and his fellow interns. It was really good to hear about some of the benefit that he had received through our trip. I can't take personal credit either. Many of the medical pearls of wisdom I learned from my days in NICU I have been able to pass on (I only learned them months ago!). I was able to give the interns a copy of all the review articles and educational materials our residents back home have worked so hard to compile (thanks Cady and others for your work on the dropbox!!). We've also run several "code strategy" scenarios thanks to some NRP cards. I was reading about Barnabas and S/Paul (that's my new term for him) in Acts - Barnabas took S/Paul under his wing because I think he believed the best about him - that S/Paul would go harder, longer and farther than Barnabas would. Jesus himself took the same attitude toward his apostles - "the things you have seen me do, you will these and greater." The only way one can teach in humility is to value the learner above him/herself. This was a really neat lesson. Baby Grace is doing much better! Bilirubin is now down to 6.8. As soon as we started meropenem and acyclovir, her bili started dropping. Now, 5 days later her color is more normal. Her exam is still abnormal, but much improved. The conscensus (thanks Drs. Walker, Clark, Kevan!!) was that her degree of direct hyperbili could not have been from Klebsiella sepsis alone. At one point it was total 43/ conjugated 31. We have dont just about every lab the hospital could run. I am still waiting for the resutls of a peripheral blood smear. We have had 3 babies with VACTRL (someone needs to do a study here...). One of them isn't doing so hot - difficult to extubate, bradycardia from acidemia (the Hs and Ts really do work - thanks Amanda O'Kelly!!), anastomosis leak. His prognosis is starting to look pretty grim. The other esophageal atresia baby is doing remarkably well. We are working up on his feeds and expect him to do pretty well. He will have a colostomy for several months until he's big enough to repair the imperforate anus issue. He's also missing a kidney. Thankfully, none of them have had any clinically significant cardiac defects. All my other babies are doing reasonably well. I was thankful to be able to give surfactant to one of my 30 weekers. I believe she will have a much better outcome. I'm also thankful to have bubble CPAP - has saved more than one baby here. Sarahbeth has had a couple of deaths on wards recently. One of the babies had a rapidly progressive neuroblastoma, another with a congenital skull deformity. She also has a very sad case of congenital neurosyphilis. She's becoming an expert at severe malnutrition, dehydration, TB meningitis, malaria, etc etc. You know, routine. I just got called about another delivery, so need to wrap up quickly. Thanks again so much for the love, prayers and support!!! -Bryan