Week one is over, ten to go. It was hard, its going to be hard, but as I get into it–it will be easier.
Today (Saturday) and yesterday I woke up at 530 to get to 7am clinical. Yesterday was maternity.
On the maternity floor we didn’t really see or talk to expectant or in labor mothers. We had about 4 hours of INTENSE clinical lecture. We did tour the whole locked (people like to steal babies so most maternity wings are locked and all babies wear electronic security tags like nice shirts at department stores–cute) floor. We hung out in the nursery with the healthy babies. We changed a diaper on a freshly circumcised baby. It looked painful but he didn’t seem to mind. The one who was circumcised while we were there did seem to mind. We also hung out in the NICU. That was amazing and sad. One baby had been there for over 70 days and it isn’t even near the original due date yet. Another was only a few days old and born at 27 weeks. That’s 6months 3weeks. That’s crazy. The nurses were pretty positive but only fate knows if that one or the other little ones will make it. If any baby born that young does make they will probably face a life of (at least) breathing and heart problems.
Why is it that preemies struggle so much? Why was he breathing with his WHOLE body? Why was it only maybe 5 or ten years ago that preemies around 6months gained the chance of living?
What the crap is surfactant? Its a liquid in your lungs that cuts surface tension allowing the alveoli to stay open. Your bronchi (major tubes) divide into smaller and smaller tubes called bronchioles at the end of the tiniest bronchioles are single-cell-thick-sacs called Alveoli–they look like a cluster of grapes (except when you smoke the tissue breaks down and they look like one large sac and then you get emphasema and die but that is another-much-angrier-post). This is where gas exchange happens–each grape is surrounded by tiny capillaries that exchange CO2 for O2.
Surfactant doesn’t develop in fetus lungs until the 8month of gestation because they don’t need it as fetuses. They exchange all that crap with the umbilical cord. So if a baby is born at 7 months with little or no surfactant it has a very VERY hard time breathing. This equals death.
Think of blowing up a balloon (this is a prof’s example) –that first breath to get it just a tinsy bit inflated is always super hard. The following breaths are much easier. That is the same for an Alveloi when they flatten and have to be blown up again. Now imagine a tinsy tiny baby trying to do that with EVERY breath, with millions and millions of alveoli, with a body that is not even ready to be born yet.
On top of this, those flattened sacs are great places to grow bacteria and babies don’t really have ANY immune system. This is why preemies die (also why it is important to breast feed if you can). Today, NICU health care workers can give preemies a fighting chance with artificial (or pig-derived) surfactant. However–as my prof said–who knows what their quality of life will be should they make it. I am glad I do not have to make that decision.
Here is a video (there are some vajajas in here fyi):