Tuesday, January 30, 2007


It was one year ago today that I started blogging. Please indulge me on this occasion in a few random thoughts about blogging.

Blogging has been very interesting and a lot of fun. It has allowed me to have conversations with people I never would have otherwise, about subjects I probably wouldn't have discussed otherwise. But I wonder how long I can keep it up. I mean, let's face it, I covered most of what I wanted to say in the first six months of the blog: my combination of frustration and sympathy for poor, single mothers; my thoughts about resuscitation of extremely preterm children; thoughts about heroic measures for babies with devastating defects like holoprosencephaly and Trisomy13; thoughts about fathers in the delivery room; and so on. I worry my blog is getting repetitive. How many posts can I write about drug using mothers or outcomes of premies before my readers get tired of it? I don't know, but I guess I'll keep plugging away.

I don't read many other blogs very often, and I'd like to apologize to bloggers who faithfully read my blog when I don't read theirs. It's not that I don't find them interesting; it's just that there are only 24 hours in a day and by the time I'm done maintaining my blog, my time for the blogosphere is up. The blogosphere can be a seductive siren, and sometimes I have to force myself away from the computer to tend to other areas of my life.

I didn't realize when I started blogging how much fun and how interesting the comments section could be. I really don't mind when people disagree with me. It's a big world with room for lots of different opinions. At times, though, you have to have a bit of a thick skin, at least if you want to be candid, because now and then some of the cuts get a little personal. Until I read the comments, I didn't realize I was sexist, racist and adolescent. Well, maybe the adolescent part I did.

A few months after I started blogging, and after I was getting some comments from regular readers, I said to my teenaged daughter, "I've got more friends in the blogosphere thanI do in real life!" She shook her head and looked at me. "You are so pathetic," she said. We both laughed. It's good thing I'm not too insecure about my social life. Now, though, I might phrase it differently, because the blogosphere, I think, is part of real life, not distinct from it.

The blogosphere can also be a little unpredictable. Some posts I think will generate a lot of interest don't, and vice versa. Nobody has asked me what my favorite posts of the last year were, but if they did, it would be hard to decide. (Warning: Attempt at humor ahead.) Hmm....I don't know, but those posts entitled Moustache and Nudity keep coming to mind....


Anonymous Kath said...

Happy Blogiversary, Neonatal Doc!

Hope you don't shut down anytime soon as I love reading your blog. Here's a possible future topic for you. What is causing so many preemie births these days?

I work in healthcare placement for Respiratory Therapists and have seen a huge increase in the last 3-4 years for RRT's with NICU exp. My NICU RT's can't get over just how many preemies are being born these days as well.

One of my clients (who works in a major Children's Hospital on the East Coast) says the great majority of infants he helps these days are micro-preemies.

So there's a topic for ya...consider it a Blogiversary gift...with cake and ice cream on the side :-)

8:44 PM  
Blogger Nancy said...

Happy Blogiversary.

Here's another topic for you...thoughts on IVF and selective reduction? And as far as IVF is concerned, is it ethical for a doc to transfer more than 2 or 3 or 4? Are they really trying to give that couple the family they so desperately want or are they trying to become infamous.

These 2 topics sort of ride the coat tails of kath's suggestion for a topic. Are the number of IVF babies and multiples the cause for higher numbers of premature births?

I would add some cake and ice cream as well, but I don't like to share that once it is in m posession :P

9:24 PM  
Blogger The Preemie Experiment said...

Happy Blogiversary!

I want to take this time to thank you. Thanks for all of the posts. Although we don't always see eye to eye, I feel that I have learned a lot from you and your readers. Your thoughts are important as well as the conversations they generate.

A teenage daughter?? I guess I am still learning more about you!!

Kath... I think there are many reasons for the increase in premature births. IVF for starters. Also, I think the way premature births are recorded now has changed the stats. Also, earlier preemies are being saved so the NICU sees more of them. Before, the baby was born, allowed to die and it never made it to the NICU.

9:58 PM  
Anonymous Lori said...

LOVE your blog. Keep on going!!

9:59 PM  
Anonymous Anonymous said...

I started reading you last week. I like that your job is interesting. I like that you're a good writer. I like that you write frequently. Happy anniversary, and I look forward to many more years!

10:48 PM  
Blogger kate said...

I just found your blog today and i think it is just fascinating...so please keep it up! Happy Blogiversary!

11:01 PM  
Anonymous Chris and VIc said...

It is a fact of life for me that I have to keep repeating things that I believe. So, as far as I'm concerned, you, too, can repeat (topics) as much as you want. Maybe you'll get more/different feedback on a repetition (call it revisiting)---because you have gained a larger readership in a year's time, and more people with more varying perspectives will respond.

Ideas for future posts: MRSA; medical homes; co-sleeping with an infant; safe sleep guidelines by the AAP. And how about burn-out and cynicism? I, myself, like the philosophical discussions---about hopefulness in parents (or not); about ethics vs legalities; about informed consent. You could try again to engage us about talking with people who speak other languages and are from other cultures.

11:15 PM  
Blogger NeoNurseChic said...

Happy Blogiversary!!

I'm sure I can think of lots of topics for you, but I'll have to send them via email! Thanks for your support of my blog, especially right now. I don't know if you saw my reply to you or not, but I don't have your email addy, so if you could send it to me at lizzpiano (at) gmail (dot) com, then I can add you to my list of people to keep updated about my blogging status, especially if I end up making the site private!

At any rate - happy day! I think your blog is great, and I almost always agree with what you write...don't know what that says about me! haha *wink* *grin*

I think you're the type of doc who I would like to work with in the NICU! Keep on blogging!

Take care,
Carrie :)

11:17 PM  
Blogger the night owl said...

Happy Blogiversary-Neo Doc

I retired from nursing three years ago; I worked in a special care nursery and loved taking care of my babies.We were a level two nursery and had a Neo Doc on call to assist us in a crisis.We had great RRT's to help us stabalize the babies until the Neo came and placed UAC's.

I am excited to find your site and will be your fan.

A Neo Nurse from Savannah,Ga.

11:30 PM  
Blogger Kelly said...

Hope you keep blogging, ND. I'm sure you see a lot of the same things in your practice, but every now and then there's a twist or something out of the ordinary. Just blog about that stuff if you think you're being repetitive. But honestly, I don't think anyone cares.

I particularly like your one word titles, and the fact that you keep your posts short. I know that if I only have a few minutes to spare, I can get a good quick read out of your latest offering.

Here's to another great year!

11:41 PM  
Anonymous Anonymous said...

It's Liz from I Speak of Dreams.

Happy Blogiversary!


But I wonder how long I can keep it up. I mean, let's face it, I covered most of what I wanted to say in the first six months of the blog

My response: is blog repetition so bad? Your job, to a certain extent, is repetitive. Is that bad?

A broader question: is repetition so bad?

Sometimes you need to say or hear the same thing over and over again.

Anyway, I enjoy your (written) company, and wouldn't mind repetition.

11:57 PM  
Blogger Ex Utero said...

Congrats ND!

The blogosphere would not be the same if you went silent.

12:00 AM  
Blogger Dream Mom said...

Happy Anniversary. Now had we known in advance, we could have had a virtual party. This can actually be a lot of fun. Or, if you prefer, we could have a "real" party and then you could meet all of your on-line readers. Wouldn't that be special?

You are right, blogging can be interesting and a lot of fun. I agree the comments can be a little rough sometimes but it certainly makes it interesting. I think people tend to forget there's someone writing these things! It's always fascinating as well, in terms of the response. I enjoy the one word titles.

As for the repetition, it's to be expected. I doubt we can post with this amount of frequency and not cover some topics more than once.

Hopefully, you will keep writing since the blogosphere wouldn't be the same without you. Here's to a great second year.

12:40 AM  
Blogger Awesome Mom said...

Happy Blogiversary! I too hope that you do not go anywhere because I very much enjoy reading what you have to say.

1:00 AM  
Anonymous angrymama said...

Please, please, please don't stop!
Your blog is by far my all time favorite.
My first child is a NICU graduate, and my second threatened to be a micro-preemie (would have been DNR), I owe a great deal to NDs, and I have come to appreciate and respect their opinions a great deal.
You remind me of a couple of them.

Happy Blogiversary!

2:03 AM  
Anonymous Anonymous said...

As a mother of a premature infant currently in the NICU, I enjoy reading your blogs. Surprisingly, I agree with you on neonatal resucitation, as I witnessed from the sidelines a family's hopeless journey with their infant, and seeing them keep him on life support was a situation I empathized with...but did not agree with. As for the posts on single mothers addicted to drugs, you are quite right to be jaded. Obviously these women are prone to making poor choices across the board, not just in their reproductive lives, so to speak. It is impossible not to become jaded. Even civilian bystanders are jaded. It sheds prematurity in a bad light, as not all preemies are born due to addictions. But that is the first thing that comes to mind, along with older women who put their career first long past the point of prime gestating years. Sadly, this is my second preemie, and my last child. It does not seem meant to be for me to carry a child to term. Your blog puts a lot in perspective for me, and it helps in "humanizing" my son's neonatalogists.

3:59 AM  
Anonymous Chris and Vic (CAK) said...

Re: jaded views of substance-abusing moms.
My son's birth mom had just done a hit with crack cocaine about 5 hours before her baby was born into the toilet (and left there).
When I tell Vic's story, I add that his mom had no prenatal care, probably did not know how far pregnant she was or how old the baby was; and may have thought that she was having a miscarriage. And that her thinking was clouded if she was using cocaine. Oddly enough, I anticipated hating her guts, till I heard her voice on the phone. For some reason, I could not hate her, once she was a real person, calling with a tentative, then fearful voice, to ask about Vic and to say she was praying. She said things like "He has taught me something." When she fell back into drug use, during Vic's 3-month NICU stay, she went into rehab. I gave her credit for trying to correct her errors. Though I run the risk of being boringly repetitive, "There but for the grace of God go I." If any one of us got really desperate, what might we do? Desperate circumstances call for desperate solutions and drug-using women epitomize desperation.

So, Vic has cocaine (actually polydrug influences) in his prenatal history. Yes, he has the expected ADHD symptoms; but he is so neuro-atypical that ADHD symptoms are the least of it. We had a spate of methadone babies about 18 months ago, in one of the NICUs---THOSE babies were clearly withdrawing in a big way, were clearly suffering, and several stayed for 3 months in the NICU, as we went up and down the yo-yo withdrawing them from their morphine and phenobarbitol. I know how hard it was for me (known to be a very patient person) to take care of those kids for 8 hour blocks---what on earth would the parents do, I wondered?! Nurses indulge in black humor at times like these, and we say "That mom is going to throw this kid against the wall. This kid is going to be wall-art." (The methadone clinics tell these moms that their babies will not be much affected---that they may have a brief period of withdrawal, just a few days . . .)

So, neonatal doc, there is always more to talk about on this subject as well. Have you taken care of many methadone-withdrawal kiddos? At a perinatal assoc. meeting about a year ago, one of the neos asked the representative from other hospitals in our state if they had seen very much methadone withdrawal, and they had not. I have seldom seen cocaine withdrawal that is very remarkable in infants---but methadone withdrawal is a b****.
CAK (Chris and Vic)

7:41 AM  
Anonymous Anonymous said...

Happy anniversary from one of your faithful readers & first time commenter. Please know that I make reading your blog a priority each day, because you have excellent thoughts, great teaching skills, and a writing style that conveys what you want to say succinctly and clearly.

I am a NICU nurse in the Midwest, and many of my experiences have been similar to ones you report. You brighten my day with your thoughts and ideas. I hope you'll recover your enthusiasm, and keep posting as often as you feel moved.

Peggy, RN -- not a blogger, but a faithful reader

10:29 AM  
Anonymous Anonymous said...

Happy Blogiversary! Love your blog. As a mother of a micro-preemie I find your blog very insightful and love when there is dissent among comments as it makes me think a bit harder.
I'm a huge fan of repetition. In fact my husband calls me repeat. I strongly believe in repetition learning and taught my dog to speak and am hoping to do the same for my daughter...I know, odd grouping, but consider them both my kids.
You can't stop now as I've introduced your blog to our favorite NICU and have got everyone hooked. Keeping going, and keep repeating...it's the best way to learn.

Mom of 24 weeker

10:59 AM  
Anonymous Anonymous said...

Congratulations on making one year. I wouldn't worry about repeating yourself. You may find that your ideas have changed when you do revisit subjects. Few things are ever chiseled in stone. There is always going to be more information for you to assimilate, more ideas from others (who may see things totally differently) to nudge you in one direction or another, more and more varied experiences to shift whichever paradigm might be at stake. So just keep writing. I may not always agree with you, but I haven't been bored yet. --Melissa (http://linkology.diaryland.com)

11:00 AM  
Blogger Candy said...

Happy Anniversary! I, too, hope that you don't stop blogging any time soon. I only found you a few weeks ago and reading helps me pass my time while on bedrest. I've made it through about 1/2 of your old posts.

I am going to make time to put my thoughts down on recussitation of micro-preemies. Being a mom of a 25 weeker, I support it greatly even though my daughter did not make it. It's important to note that her lungs were not the issue.

On that subject, I'd love to hear your thoughts on NEC and if there's progress being made to stop it. That really doesn't fall into the category of ethics, but it's an important subject to me obviously.

Lastly, in response to the comments regarding IVF causing the increase in higher order multiples and preemies....yes, IVF does increase the risk of multiples, but the majority of these case are caused by IUI (intra-uterine insemination). IVF is a bit more controlled than IUIs. With IUIs you must determine how many follicles are mature and will release eggs. That seems to not always be easy. With IVF you know exactly what you are transferring. I personally support no more than 3.

Keep on keeping on!

1:07 PM  
Blogger Surgeon in my dreams said...

Hmm....I don't know, but those posts entitled Moustache and Nudity keep coming to mind....

Now how did I know you were gonna say that!?!

If you're keeping count Neo, I read you every day. Read, grumble (or smile) and come back again the next day!

Happy 1st birthday...and many, many more.

2:02 PM  
Blogger Momof2boys said...

Happy Blogsversary! I do not read many blogs, okay I admit, I only read 3. Yours is the only one though that I check everyday!! Please don't stop! You are on a roll!!!

2:16 PM  
Blogger stockingup99 said...

I go over the same stuff again and again in my blog, trying to understand.

Feel free to repeat.

I think our toxic lives are leading to more preemies. That and doctors' willingness to rescue the fetus from that unpredictable old uterus to get it under their control.

It could be the excessive level of testing causing the problems.

2:17 PM  
Anonymous Chris and Vic said...

About the causes of prematurity, have you read Baby ER by Hume(s?)? There is a chapter in that book about contributing factors and causes.

Interestingly enough, prenatal care does NOT seem to PREVENT prematurity . . . which is counter-intuitive for most people.


6:21 PM  
Blogger Kristina Seleshanko said...

I hope you continue blogging. Not everyone reads old posts...and there are just too few blogs like this one out there.


4:15 PM  
Anonymous Bryan said...

Great thoughts. Blogging has given me new meaning to social networks on the web.

10:01 PM  
Anonymous Anonymous said...

Happy Anniversary, and many more!


12:59 AM  
Blogger Dr Dork said...

Happy Blogiversary.

Believe it or not, you are an entertaining and perspicacious writer. Here's hoping you continue, whatever the topics.

Kind regards

1:02 AM  
Anonymous Anonymous said...

Hi Neontal Doc!
I enjoy your blog. As the mother of a 26 weeker (now 21 months and THRIVING - no problems whatsoever) I want to thank you for chosing a profession that is so valued. I am sure many parents don't tell you how special you are. That's a shame. We visit our daughter's NICU often, we actually live across the street from one of her primary nurses. The care and knowledge that NICU nurses and neonatologists provide are priceless. Thank you!!!

3:46 PM  
Blogger sexy said...







2:03 AM  

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