This month we have another podcast of 30 minutes with a tried and true NICU parent, Nicole Zimmerman. Nicole and her husband Ed, are the parents of micropreemie twins, now aged four years.

Curious about  the family impact of having  preemie twins? Then I invite you to come listen in to their world of  joy and challenges. This story is a bit different from the stories you have heard in prior interviews here, as I haven’t featured anyone before who had preemies with the help of artificial reproductive technology (ART).

Based on the SMART ART  conference I mentioned attending beginning of this month, the subject has been on my mind. We know that ART usage continues to grow as women postpone pregnancy past the usual childbearing years. The caveats are spoken by physicians, but hopeful would-be parents often think “it won’t happen to me.”  With ART, as in all ventures, we have no reassurance that our outcomes will be what we expected.

Special thanks to Nicole for sharing her story and her insights. The interview is 30 minutes, so is divided into three parts— a bit longer than usual here— but worth the listen for anyone interested in this HOT TOPIC.

These and other HOT  topics were covered in the sweltering heat at the SMART ART conference in Las Vegas on Artificial Reproductive Technology (ART). Candy the Nurse was pleased to be one of the Round Table Discussion presenters, hosting the topic (what else?) “Psychosocial aspects of parenting a very low birth weight baby.”

Merck Pharmaceuticals sponsored this three day assembly where some of the best and brightest researchers and clinicians from the US and Canada shared updates on the state of the ART of the science of infertility.

Some nurses were invited to attend thanks to a grant from Merck. We thank you!

Participants agreed  that an ethical continuum exists  on one side, helping families longing for a child, to the other, which   stretches waaaay over to where Eugenics lurks in the midst of murky decisions. Surely, the next ten years of medical technological breakthroughs promise many changes in this young science.

The Renaissance Hotel proved a lovely and quiet refuge to study and discuss. The hotel and SMART ART staff went above and beyond to make attenders feel welcome.

Keep an eye out for interviews with several of the speakers, to be posted soon as your nurse here can eke out a few minutes to edit the audio files.

Cheers!

After months of planning, and a premature launch, I’ve taken the advice of my business coach and re-branded my business name. Peripatetic Productions will remain the corporate name but the brand will be: Candy the Nurse [TM].  Thanks to all of you who volunteered to give your  opinion. I value your input,  that the name suggests the combo traits of kind, intelligent and trustworthy.

The logo  (below) is taken as an alter-ego representation. (I only wish I  had curly hair!) The character first presents in My Mom Is A Nurse and reappears as the mom in Good Things Come In Small Packages (I Was A Preemie). Both books are available on this website, www.CandytheNurse.com website, or on Amazon.com. (There you can also look inside and check out the adorable illustrations by talented artist, Michael Vincent Fusco.)

And if you aren’t aware, there are FREE downloadable stickers and coloring pages for kids on the other website ! (The images are due to be changed soon, so go there now before they are no longer available.)

Michael and I are putting brains together to come up with  an “Activity Book” featuring these same characters. I’m hoping they’ll be available for December, so stay tuned.

Also, another (hopefully by December) project is the first translation of My Mom Is A Nurse, into Spanish. Other languages are planned, but I would really like some input on your opinion of which should be next? Suggestions so far are: Farsi, Tagali and Chinese.

Please write a comment and LET ME KNOW YOUR THOUGHTS!!

Thanks so much for your continued support. Your purchases help fund research for babies through the March of Dimes.

Til later, just sign me:

Candy the Nurse

PS

Yes, I know she lost her stethoscope (she is forever putting in down and misplacing it), but she will have one soon, I promise!

We need more studies to continue to follow families of extremely preterm children born in more recent years,like the a certain docu featured on this website!

And here’s news,from the June issue of Health Watch, of a study that parallels some ad hoc research I’ve conducted informally for many years as a NICU nurse, singing softly to preemies:

“We took healthy premature infants, the ones that are in incubators… and let them hear music by Mozart and compare their energy expenditure, how much energy they spent just lying there while listening to music compared to a period without music at all,” said Dr. Ronit Lubetzky of the Tel Aviv Medical Centre.

The effect was not surprising. The babies’ vital signs reflected a more restful state within 10 minutes of listening. In general, more rest = more weight gain = less time in hospital. That’s another win-win !

Stay tuned to more news on the preemie baby front.

Your comments and questions welcomed.

Ciao,

Candy

The first, from the June issue of Pediatrics, mentions a study which found C-Sections may increase the risk of celiac disease, as opposed to  those infants born vaginally.

Celiac disease is an autoimmune disorder which leads to inflammation of the gut when the person consumes any foods containing gluten (a protein found in wheat, barley and rye). In terms of the western diet, that’s a toughie.

The researchers have no certain understanding of the process at this point, but hypothesize that  perhaps the phenomenon is linked to the fact that infants born via C-Section miss out on the squeeze down the vaginal tract. We know that action helps eliminate fluid in the respiratory tract, but now scientists think perhaps there are other important microbes an infant would ordinarily encounter which trigger some sort of digestive colonization. As in all closed systems,when one part malfunctions, the result has a domino effect.

&&&&&&&&

Another story, out of the journal, Obstetrics & Gynecology, mentions a study of over 20,000 pregnancies in Scotland spanning a period of 60 years. The results are glum: mothers who were themselves born early (defined as 24-37 weeks gestation) were 60% more likely to have a preterm baby. Although there is no cure at this time, just knowing it,  makes a case for early prenatal care.

Hang in there, mothers. The March of Dimes is working as fast as they can to find a solution.

]]> http://peripateticproductions.com/articles/maternal-risks-of-prematurity-update/feed/ 0 http://peripateticproductions.com/announcements/new-orleans-news-lovely-despite-circumstances/ http://peripateticproductions.com/announcements/new-orleans-news-lovely-despite-circumstances/#comments Tue, 08 Jun 2010 08:13:16 +0000 Candy http://peripateticproductions.com/?p=562 Greetings, y’all~ I meant to post this sooner!

Recently returned  from New Orleans to celebrate the Loyola University New Orleans School of Nursing graduation and commencement activities, including induction into Sigma Theta Tau, Nursing Honor Society. New Orleans is known for beauty (and fun),  but touring the environs after viewing the oil spill from the air makes visitors and locals alike shudder.

However, New Orleans did not disappoint, despite the frustration, the heat, and the mess on the shores. Before I left the Bay Area, a friend whose father used to live in N.O. recommended a few grrrreat places to eat. One was closed up for good, but the others continued to make the south a new fave destination stop. Notable were Cochon (great pulled pork and all things carnivore), GW Finn’s (sea food magnifique), and the Gumbo Shop.

Three showers a day notwithstanding, New Orleans deserves to be on your “to do” list.  Tame the humidity by strolling down to the ol’ Mississippi, which flows through the south curve of the area, and take a slushy  drink with you.

Another Adventure used to be the Swamp Tour. Now it’s no fun.

God bless those who are working so hard to clean up the mess, and please, somebody…put the cap back on.

Dear Senate Appropriations Committee Member,
I urge your NO vote on SB 1051 re: Diastat rectal gel administration by unlicensed personnel in our schools,grades K-12. Please consider the “elephant in the room” before you vote on this bill:
Who does this bill really benefit? Is it  really the epileptic patient? (Or is it the School Districts, who seek to relieve themselves of legal liability? And the pharmaceutical company which gets to market more and more of the drug, as it expires every few months?)
The Epilepsy Foundation website recommends doing NOTHING to treat a seizure, save turning the patient to the side and placing something under his head,  and perhaps calling 911, as needed,  as most last only a few minutes.
And where will Diastat  (a type 2 controlled drug which has value on the black market, of course), be secured in the meantime? In a pocket? A drawer? The office? Under lock and key? How long would it take to fetch it?
Diastat directions state it needs to be given within 2-5 minutes of the seizure onset.
After it is found, how long will it take to:
-unhinge the Diastat from it’s double-locks?
(-put on gloves?)
-run to the pt
-pull down the pants of that writhing person, and
-insert it properly
??
Monitoring the pt for up to four hours is also in the directive, on the Diastat website, which also mentions the side effects and dangers of giving it to a pt who is not having a breakthrough seizure. This drug will  rapidly cause the person to experience to sleep. Deep sleep.
If the student is having a life-threatening seizure, certainly medical assistance is needed; this drug might help, but someone will still have to carry the patient to a place to recover (and where would that be in the school?)
According to the Diastat website, the drug can also be abused. It is not to be used more than once every 4-5 days. In an emergency, who at the school is aware of the frequency of administration at home or other places?
What price, in terms of psychological harm, will the patient pay for having a thing rudely inserted up the derriere in the middle of the classroom or playground? Isn’t it bad enough that the patient will have soiled himself?
And what if the non-medical personnel, in a hurry and unused to such rectal administration, makes a mistake and inserts it in the female vagina? Read the circular about that result.
The two sides of this bill both argue they care very much about the children.
I realize there is a mighty powerful lobby in support, but I ask you to consider this quote from the American Academy of Pediatrics:
The presence in schools of a full-time licensed registered school nurse is strongly endorsed.13 Registered nurses (RNs) have the knowledge and skills required for the delivery of medication, the clinical knowledge of the student’s health, and the responsibility to protect the health and safety of all students. The use of untrained school staff to administer medications to children with special health care needs creates risks, not only of medical liability for the school and the licensed registered school nurse but also of medication error for the student.14–16 To ensure the health and safety of students, all schools should have a full-time licensed RN who has the knowledge and skills required for the delivery of medication and the assessment of student health.17,18

http://aappolicy.aappublications.org/cgi/content/full/pediatrics;124/4/1244

Thank you for your NO vote on SB 1051. There is a better solution: AB 2454.
Respectfully,
Candace Campbell,  MSN-HCSM, RN
Film maker, Author, Nurse educator
925.207.1376
Peripatetic Productions, LLC
Host of The Preemie Post blog & podcasts
www.candycampbell.com
www.CandytheNurse.com

Another review to share with you about the latest book, Good Things Come In Small Packages (I Was A Preemie) from the Oregonian reporter (and mom of former preemie), Amy Wang.

Book review: ‘Good Things Come in Small Packages: I Was a Preemie’

By Amy Wang, The Oregonian

April 08, 2010, 4:18PM

View full sizePeripatetic ProductionsHere’s a relative rarity: a book written specifically for children who were born prematurely. 

“Good Things Come in Small Packages” (Peripatetic Publishing, 28 pages, $14.95) was the idea ofCandy Campbell, a Portland native and registered nurse who’s also madea documentary film about “micropremature” babies. She wrote the book from the viewpoint of a little boy learning about his too-soon arrival from his parents, grandfather, uncle and other family members.  

The short story is told in simple and sweet language that is best suited to beginning readers (the book is recommended for up to age 8). Michael Vincent Fusco’s soft, bright and humorous illustrations complement the text nicely. In a nice touch, the boy wears thick glasses — “a nod to the fact that so many of our micropreemies have eye surgery and need to wear glasses at an early age,” says Campbell. I’m thinking the glasses also give parents an opening to discuss the fact that preemies sometimes have long-term health and/or developmental issues. 

It’s definitely a book I’ll be sharing with my own former preemie.  

The price may seem a little high, but $1 from each sale goes to March of Dimes, a national nonprofit whose mission includes preventing premature births.

Got another book about preemies to recommend? Share it below in the comments section. 

And for more children’s books about preemies, check outhttp://www.prematurity.org/premiebooks4children.html.

– Amy Wang

http://blog.oregonlive.com/themombeat/2010/04/book_review_good_things_come_i_1.html

Enjoy!

Candy

This month let me tell you about a movement in California that has generated great concern among many of us moms who are also nurses. You are aware that the decisions of one state often lead to the next legislation for the other forty-nine. Parents of preemies, listen up, as your child may be involved in one of these scenarios.

There are presently two bills pending before our legislature which intend to protect the school districts from lawsuits brought by parents who react to faulty administration of medications to their children. These bills, AB 1802 (re: Insulin) and SB 1051 (re:Diastat rectal gel) are both worrisome. Why? Each has the possibility of physical and/ or psychological  harm to  the student if—

• given the wrong dose,
• given wrong site,
  

  Insulin

• given incorrectly,
• or given at all.

But what’s a mother to do? If the type 1 diabetic child becomes hypo- or hyper-glycemic (Hmmm, now which is which?) and requires Insulin, as opposed to Glucagon, and a nurse isn’t around…?

And what’s a mother to do if her child, K-12, suffers a (what is commonly called)  grand mal seizure in class or on the field? Does it make sense for the first responder to pull down the pants of that linebacker, unlock the Valium Rectal gel from wherever they decide it must be sequestered, and jam the syringe inside the poor student’s you-know-where, within the first 5 minutes, otherwise it is not effective?

And why has the  Epilieptic Foundation joined with the drug manufacturer to nod to this practice,when on their own website they advise first responders to do nothing but turn the victim to the side, and make him comfortable by placing a pillow or something soft beneath the head ? There may be exceptions, they say, but circumstances requiring medical intervention should be planned. Instead of calling 911, this is the plan? (http://www.epilepsyfoundation.org/about/quickstart/parents/qsprmanaging.cfm)

Diastat rectal syringe

Valium is a controlled substance, BTW, and in demand by certain folks who, shall we say, would want to take it without purchasing?

Lucky for us, the school districts (and the American Diabetic Assoc., plus the AMA; the  Epileptic Foundation, and the drug manufacturer) have the answer. They propose a volunteer (i.e., an unlicensed medical person), and a parent make a contract, in which the parent gives up the right to sue in case of dire consequences,or negligence, based on the volunteer’s lack of knowledge. Clever!

This is tantamount to hiring a handyman instead of a licensed electrician to wire your house. It may be a “cheap” fix, but there will be hell to pay if something goes wrong. Not to mention… it’s illegal! Yes, the Nurse Practice Act, which mandates the education and licensing of nurses, was established for the public good, just like the Building and Safety Code. Both protect consumers. From what? From deadly mistakes.

Their solution is just (may I say it?) a bandaid on the problem.

We know each school district gets a budget allocation from the state. We know budgets have been cut for “nonessentials” like music, art, P.E., and school nurses. And what are the consequences ? Sicker students have more need for knowledgeable nursing intervention at school.

Hurray for California Assemblymember Tom Torlakson, who served many  years as a teacher in California public schools. He has offered AB 2454, which mandates a safe-staffing ratio for school nurses.  If you like, here’s a homework assignment for you parents. What is  the ratio of students per  licensed nurse in your school district? Each is different, but I guarantee the answer will frighten you.

I apologize for  tardy posts. The trail has taken me again to the halls of legislature to learn and participate in healthcare debates which influence families, babies, and of course, nurses. I am completing a residency with the nurse advocates who work with the American Nurses’ Association in Sacramento, CA.

Sacramento Capitol

It was sloppy-wet day, but always a thrill to walk the hallowed halls of the capitol. I will finish the week here and return often until my work is completed, at the end of April.

At the Assembly Health Committee forum, I watched the fascinating grilling of Big Business (insurance companies in the arena today) for over two hours. This is Theatre of the Real, people! I believe you would be proud of most of your elected representatives who spoke,some eloquently, some pointedly and some in a genteel manner. Others were not so nice. (Recall visions of “Inherit The Wind.”)

Those who represented (one of the largest of the large) insurance companies gave cogent summations of their responsibilities and offered “the softer side” of what many consumers consider  cut-throat profiteering practices. Try as they might to cast aside aspersions with melodious, well-chosen arguments, the gallery was wriggling in their seats. One legislator summed it up by saying that it’s not business, per se, which is the concern here, it is the monopoly-factor which with health insurance corporations stifle real competition in the marketplace, and cry “ouch” as they calmly explain why they need to raise costs up to 36% in a month from now?!

A few citizens put a face to the dilemma during the public forum. One, a retired MD, sees from both sides now. He characterizes the irony: insurance companies regularly  lower physician reimbursements, while complaining to customers that because of demanding healthcare practitioners, it is necessary to raise rates…all the while fat-cat execs take (“earn” would be a misnomer) as much as $24 million a year!

Stay tuned for more … the debate surrounding premature babies and healthcare benefits has only just begun.

Candy