Spring Conception & Prematurity

Although I love every moment in the NICU, in an ideal world neonatal nurses would be out of a job.  Congenital defects, genetic disorders, prematurity, etc. would never come to pass.  However, this is not the case.  All we can do is try to give our patients the best care possible and use new research to continually better our practice.    In my opinion, knowledge of good prenatal care and the will to educate pregnant mothers may prevent the occupation of some of our cribs.  That is why my ears perked up when I saw the article, “Really? Babies Conceived in the Spring Are More Likely to Be Premature” on The New York Times website (1).

According to the author, there is a large amount of medical literature discussing seasonal patterns and the risk of chronic conditions.  Despite the quantity of such research, the method of approach is often flawed.  Nevertheless, a study published in Proceedings of the National Academy of Sciences may be the largest and most persuasive connection between seasonal gestation and conditions, specifically conception in the spring and preterm birth (2).

The article, “Within-mother analysis of seasonal patterns in health at birth,” discusses the seasonality of gestation of about 1.4 million children.  The same mothers were followed over time to eliminate differences in maternal characteristics.  This accounts for socioeconomic differences of mothers who are likely to conceive in different months according to individual status.  The researchers claim that women who conceive in May are 10% more likely to experience preterm birth.  They attribute this pattern to the spike in influenza cases in January and February when the mothers are nearing full term.  Influenza has been studied and shown to cause adverse birth outcomes, possibly due to the inflammatory response which can cascade into labor.  In addition, studies have shown that vaccinated mothers are less likely to deliver prematurely than unvaccinated mothers.

The Take-Aways:

–  Women who are nonwhite, less educated, less likely to be married, and more likely to smoke during pregnancy, conceive in the first half of the year.

–  When controlled for maternal and birth characteristics, gestational length decreases about 0.8 week when conception occurs from January to May.

–  There is a strong correlation between influenza infection and shortened gestation.

–  Newborns conceived in the first 5 months of the year are of significantly lower birth weight than those conceived in the second half of the year.

–  Average maternal weight gain increases by 0.8 pounds in the first half of the year, plateaus in June and August, then returns to the January level (may account for pattern in birth weights).

References:

1) http://well.blogs.nytimes.com/2013/07/15/really-babies-conceived-in-the-spring-are-more-likely-to-be-premature/?ref=health

2) http://www.ncbi.nlm.nih.gov/pubmed/23836632 (If you would like access to the full text, please let me know.)

The Controversy of Mother Teresa

Whenever I am trying to introduce myself to someone in a loud environment, either myself or my new acquaintance will use the phrase “like mother teresa (?).”  For the rest of the evening, I find myself being referred to as “Mother Teresa.”  I have always felt undeserving of such a nickname, however, my friend brought it to my attention that this character may not be as all-around kind-hearted as proclaimed.  I brought my curiosity home to my parents.  My mother told me about this novel she read written by a former Order of the Missionaries of Charity (OMC) sister.  This nun discussed the disparities between the care Mother Teresa allowed the poor versus her own congregation.  She also reminded me that one of our family friends was a former sister of this congregation.  She left because she did not agree with their particularities and wanted to continue to help people in a different way; she is now a chaplain nurse.  I couldn’t let myself continue to hold this woman in such high esteem until I completed my own research.

Canadian researchers published an article called “The Dark Side of Mother Teresa” in the journal Studies in Religion.  They suggest that the Vatican should have studied her views and ability to handle money a little closer before her beatification.  It is believed that her beatification was a well-organized media stunt.  During her lifetime, Mother Teresa opened 500 missions, but doctors describe them as “homes for the dying.”  The conditions of these missions were unhygienic and the people were given inadequate care.  Despite the millions of dollars the OMC raised, Mother Teresa was more generous with her prayers than monetary aid.  At one point, she even said, “There is something beautiful in seeing the poor accept their lot, to suffer it like Christ’s Passion. The world gains much from their suffering.”  During various disasters, she was more likely to provide prayer and medallions.  The researchers claim her beatification was a stunt to revive the Catholic church, but also agree that such media coverage did inspire humanitarianism.

“I know God won’t give me anything I can’t handle. I just wish he didn’t trust me so much.” – Mother Teresa

Her belief that the poor and sick were given their hardships in God’s plan is one that I partially share.  I believe that everything happens in life for a reason.  If you have the will to overcome the trials you are dealt, you can experience a great deal of individual growth.  However, where Mother Teresa loses me is that she claimed to want to help people, but she did not use all the resources she could. If she believed that God created every circumstance, she should have believed in medicine more and provided proper healthcare to the sick.   I believe in prayer, but we all have the ability to change our course and I believe that is why we have been graced with our intelligence and the right to choose for ourselves.  The power of prayer can be strong, but just because I pray doesn’t mean I can sit back and wait to have things handed to me.  I need to know that I did everything I could to get what I deserve, to show that I am worthy.

There is no doubt that Mother Teresa could have learned something from Florence Nightingale.  A little more hygiene could have done wonders for the people she “served.”  Despite the debate of her work, thanks to the media and the Catholic church, Mother Teresa will always represent altruism and humanitarian work.  Her work and quotes have inspired a lot of people to better themselves and to help others, and for this, I am thankful.  As for the nickname, if it helps them remember my name it can’t hurt right?

Teresa Thomas Vellaringattu, RN, BSN

At 6:58 AM, I decided to check the CA BRN website for the third time this morning.  When I clicked “Find” I was expecting the same message, but this time I was greeted by my name and license number.  I cannot describe the feeling of relief that came over me.

On July 16th, I took my NCLEX-RN examination.  I walked in feeling confident after scoring 80s and 90s on my Kaplan review practice tests for a week.  However, when my test kept going after question 75 I started to get nervous (I blame the Select All That Apply’s).  After each question, I prayed that it would be the last and that I passed, but I kept clicking through until question 251.  At 251 my computer directed me to the exit survey.  I finished the survey, grabbed my personal items, and left the testing center.  I immediately called my mom and began to sob.  I was so scared that I had sat in that testing center for 4 hours, studied for weeks, and received a job offer for my dream job just to have it all taken away.

The last couple of days have been extremely bittersweet.  I didn’t know whether I should be celebrating or studying for the retake. The Pearson Vue NCLEX trick helped keep the hope alive.  I was definitely skeptical at first, even though I looked through five pages worth of Google search results that claimed its 100% accuracy.  Despite my success with the trick, I continued to do practice questions on my iPhone app, just in case.  Everyone kept telling me to enjoy myself, but I couldn’t until I knew for sure.  But now that I know, I can enjoy a couple of weeks at home!

I can’t wait to get started as a neonatal nurse.  These next couple of weeks will be filled with daydreams of what it will all be like to work in an amazing children’s hospital.  I’m really thankful for all the triumphs I have been given these past couple of months: I have a loving family, friends, boyfriend, and kitty, I graduated from college with a BSN, I passed the hardest test I have ever taken, I am a licensed RN, and I have my dream job.

It’s good to be me, Teresa Thomas Vellaringattu RN, BSN. 🙂

It’s a Girl, a Boy, and… Another Girl!

The Wedding Ring Test

For as long as I was old enough to sit with the aunties at family parties, I can remember my mother being revered for her skill at predicting the number and gender of children women would have.  I would watch as my mother tied a strand of hair on each woman’s wedding band, stabilized it on the side of their palm, and then watched it sway side to side (boy) or in a strong circle (girl).  She would always reject my own inquiry into my future progeny, claiming I was too young or shouldn’t be thinking about children just yet.  Finally, today, during a dinner party at a family friend’s home, my wait was over.  I cannot remember how the topic was started, but the second she offered, I had pulled a hair from my head and tied it onto her diamond ring.  They all asked what my ideal number and genders would be.  I answered with at least two and the first was to be a son.  Seconds later we were watching the ring dance above my left palm in large circles and my mom proclaimed the first would be a girl.  During the second round, the prediction was a boy.  When we checked for a third, it wasn’t looking so promising.  The ring hung limp over my palm, but after a bit it started swinging in circles again and she announced another girl.

For fun, my mom called Robert/Justin over.  She laughed and said she had to make sure our predictions matched or else we’d have some trouble.  Luckily, his prediction was the same: girl, boy, LONG PAUSE, girl.  I already knew my parents liked Robert/Justin, but this discussion of our future together was even more validation that they have accepted him as family. 🙂 Sigh, my parents are the coolest…

Now, I will have you all know that this prediction thing may seem like a bunch of bologna, but my mother has yet to be wrong.  You are all my witness.  As of July 5th, 2013 I am predicted to have a girl, a boy, and another girl, in that order.  Ten to fifteen years from now, this blog may not be active, but we shall see if she was right.

Coo Coo for Coconuts

I am a coconut-aholic.  I have been consuming coconut meat from a very young age, either spiced in my parents’ dry beef curry or stolen from the cutting board and dipped in sugar.  The Samoa or Caramel Delight Girl Scout cookies have always been a favorite.  Since my delve into paleo dieting, coconuts have made their way into every meal: oil, milk, water, flour, butter, shredded, grated… we do it all!  Despite these delicious ways to consume this wonderful fruit (nut, seed?!), my favorite product will always be the crisp and refreshing liquid from within.

Robert/Justin and I began our intake of coconut water after our sweet neighbor introduced us to her own consumption.  She adds the coconut water to jugs of filtered alkaline water and adds pieces of coconut.  She carries around this meal in a bottle everywhere she goes.  Since then, we have treated ourselves to young coconuts bi-weekly.  Robert/Justin likes to show off his amazing coconut cracking skills and I like to watch 😉  Afterwards we share both the meat and the water.

More recently, I began purchasing ZICO Coconut Water from Trader Joe’s.  It is 100% coconut water with no added sugar or water and I think it tastes pretty good.  Of course, there is nothing like the fresh-out-of-the-coconut taste, but it shall suffice.  I didn’t realize how in love I was with coconut water until my early morning spin class.  With every sip, I felt this tingling of refreshment and hydration.  Halfway through the class I had to tell Robert/Justin how good it felt.  I couldn’t keep the sensation a secret, it somehow felt greedy to do so.

Despite the expense, I plan to continue hydrating myself with this amazing drink.  I love the energy I feel and the fact that I am less hungry.  As I study for the NCLEX, I am comforted by the idea that I can enjoy this “drug” while improving my fluid and electrolyte balance!