This week had lots of crazy moments amongst a lot of doing nothing and hanging out with newborns in the nursery. they are pretty fun to watch and test out reflexes on.

Monday started with me getting to the hospital at 6:45am and seeing a couple newborns and writing their progress notes. then rounds started at 9am. We saw a ton of baby humans, one of them had 12 fingers! its called polydactyly and we refereed him to an orthopedic surgery to eventually get them amputated. during rounds the intern got called to a CS [every CS has a pediatric team in the room just in case] and i got to join him. Being in there really made me miss the OR. I watched em yank out another baby [breech=butt first] and then the doctor walked her over and set her in the warmer. We immediately wrapped her in blankets and suctioned her noes and throat. she was having a hard time breathing so the respiratory therapist put a little NG tube down her nose into her stomach and pumped out all the amniotic fluid in her belly and airway. after that she was breathing fine. we walked her over to the other side of the curtain and showed her to mom and dad. its funny to see a mom with her organs out of her and then walk past the blue drape and just see her face smiling at you awake. anesthesia is a great invention!

after rounds we ate lunch and then hung around waiting for new babies to be born so we could do their initial physicals. we got home around 5pm.

Tuesday we came in a little later since we had more of an idea of what we needed to do. I walked in and the intern that was on overnight said she had a special patient for me that she needed to fill me in on. she said she decided to give her to me because i was easy to talk to and that i could probably handle the situation well. i felt really flattered until i heard about the case...

the baby was a newborn girl born to a women from Nigerian that was here visiting her family. she wanted to have the baby in the US and was here for about 7 weeks getting prenatal care. at this time she found out she was HIV positive, a sickle cell carrier, HSV positive and had immunoglobulins against toxoplasmosis. They tested the baby and found HIV antibodies and though this test is not very sensitive,it is still very worrisome. The worst part about this whole situation was the mother did not want to tell her family about her HIV status because she was scared they would kick her out. She was a very sweet woman and was unfortunately caught in a very hard position. SHe was so concerned about her baby and family and whenever i would ask about how she was doing she would dismiss the question and just say she was fine. I dont think she had slept for 24 hours.

I tried to do my best for her and the baby and we eventually transfered the baby to the NICU to get a more extensive workup and for infectious disease specialists to see her. I tried to counsel and inform the mother and grandmother as much as i could and of course, had to be very careful with what i said because the grandmother was always around and did not know the HIV status. it was both an emotionally challenging and intellectually challenging case and though i appreciated the experience, it was still a very hard day.

another case i had on tuesday that made the day pretty rough was a pt i had born to a 25yo girl who was in jail. i had to talk to the patient and get all her details about why she was in jail and who was going to take the baby and of course, it was because of drugs. she wasnt on drugs and to be honest, she wasnt messed up at all, but unfortunately she put herself in the wrong place at the wrong time and got caught with drugs in her car. for this mistake she will probably be in jail for 6-8 months and she was hoping to get house arrest so she could live with her parents and still have the baby. since she was still being sentenced at the time of the birth, the baby was going home with her boyfriend's parents.

there was another pt who's mother was in jail and had a baby and today it went home with her grandmother. sad thing is, the grandmother had custody of her previous kid also.

Wednesday and today have been a lot quieter with no other special patients. ive gotten more study time in and am looking forward to relaxing this weekend for my birthday.