Sunday, May 27, 2007

Beard

When the bearded lady walked into the NICU, I knew it was time to start blogging again.

Her baby wasn't very sick, just premature enough to require an IV for a few days. I was speaking to her at the baby's bedside about two days after delivery, telling her that her baby was doing well and wouldn't need the IV for more than another day or two. The mother nodded and smiled, seemingly appreciatively. Then she said to me, "I'm going home today." She looked searchingly at me, until I figured out that she was really asking whether her baby could go home today, too. I told her that no, her baby still needed the IV and wasn't quite ready for discharge. She began crying.

I understand that women want to go home with their babies and that it's a hard thing to leave the hospital without your baby. I understand their disappointment and anticipate it, often saying to them "It's hard to go home without your baby, isn't it." But it's still a little puzzling when a baby is born several weeks prematurely, is in the NICU, and has an IV in place, why doesn't it even cross the mother's mind that her baby might not be ready to go home?

I don't think it had anything to do with her beard, which was pretty impressive. It wasn't so long, more like just a two or three day stubble, but it's distribution was so wide, on her cheeks and chin and neck and upper lip, as widely distributed as a man's beard. For some reason, I've seen a lot of facial hair on women the past few years, and it's usually just a moustache or some on the chin, often like sort of a bad goatee. Not so here; this woman was unfortunate enough to have a macho five o'clock shadow.

I don't say this to mock her. I know it can be a real problem, especially if a woman has polycystic ovary syndrome. But it can be pretty striking, and for better or for worse, was the most memorable thing about this mother.

62 Comments:

Blogger Eliza said...

YAAAAY! I'm so glad you're back!

8:37 PM  
Anonymous Anonymous said...

Welcome back! As a recent graduate from nursing school, I'd like to hear more about the nurses you work with. I am thinking about post-partum or labor and delivery.

8:40 PM  
Anonymous Jessica said...

Nice to have you back! I missed reading your posts.

8:48 PM  
Anonymous Anonymous said...

Way to make my night, ND! As a preemie parent, I've learned to hang on to tiny nuggets of hope, so I've been checking here every other day waiting for your return, sure that my OCD would pay off. I'm sure I'm not the only one who is dancing a lil' jig tonight.

As for the never ceasing stream of women who just don't seem to get it that probably a sick baby shouldn't leave the hospital with its mom: we simply have nothing to prepare us for a "less than optimal" birth. There is such a tremendous dearth of information about what will happen if your pregnancy doesn't follow the week by week Baby Center emails. I'm pretty sure the famous book series doesn't include a "what to expect if the totally unexpected lands your kid in the NICU".

I wasn't pg long enough to go through prenatal classes, but I did grate some enamel off my teeth listening to the ones in the room across from my son's NICU's waiting room (the instructor insisted on leaving the door open, while we were stuck there during shift change). If she covered the topic of preterm birth, it was only during the last 5 minutes of a class when, mercifully, I could escape back to my son's bedside.

NICUs and nd's are the ugly stepchild the baby industry would just as soon keep out of sight. With 1 in 8 pregnancies ending preterm, I don't think it's unreasonable for way more information about what your job entails to become part of mainstream baby "media".

Strikes me as odd that you see so many "hairy" women in your line of work. Wonder if there's some sort of connection? Probably wouldn't offer me any answers, though--I only get an odd chin hair and pluck those suckers as soon as I can get ahold of them. Even if I let them grow and did a little comb-around, I'm pretty sure I couldn't even qualify as a bad goatee.

Welcome back, doc. I missed ya.

Kassie

9:12 PM  
Blogger samylaine said...

I'm glad your back.. and she just might have PCOS... i do but I don't have a beard thank god! lol

Sammie
www.n8andnoah.com

9:20 PM  
Blogger Emily said...

Welcome back!

10:12 PM  
Anonymous Elisabeth said...

So glad you are back!!!

Elisabeth

10:27 PM  
Blogger Ex Utero said...

Whoa,

I just finished a post about you posting and now your whole blog is back. I thought you'd trashed past posts for a little bit there.

Glad your back.

10:44 PM  
Anonymous Eva said...

So glad you are posting again!

It's true, there is no preparation for when things don't go as expected. You of course see that all the time, but all most people know is that you have a baby, and then you take the baby home. Lay people have little sense of the relative import of the various problems you are treating.

11:00 PM  
Blogger Awesome Mom said...

Welcome back!!!

11:11 PM  
Anonymous Pen said...

Good to see you back.

When my son (not a baby) was in intensive care we hoped we would be able to take him home every day, even though it was bleeding obvious that he would be in hospital for weeks even after coming out of intensive care. We were completely irrational, and were disappointed every day, despite steeling ourselves to leave him there. And yes, it resulted in lots of disappointed tears.

No beard so far, but a slightly flourishing moustache today.

11:22 PM  
Blogger Kelly said...

It's about time!

Just joking! Missed ya as well!

Hey, can I make a suggestion? You seemed to shut down because of all the crazy commenting wars going on. You could always open a email account just for comments. That way, no one else sees what other people say to you. Because really? Aren't the comments supposed to be directed to you? And aren't you supposed to be able to say what you want on your blog? By all means! Just write, we'll read, and maybe we should only be allowed to comment if it pertains to YOU.

Or, you could moderate comments. But that might take a while.

Either way, it's a suggestion. I'd hate to see you go on hiatus again because of commenters!

Hope you're here to stay.....:)

11:53 PM  
Blogger angrymama said...

Welcome back, dock!
I missed you!

1:31 AM  
Anonymous Anonymous said...

Welcome back. Glad to see you have got going again.

mother leaving hospital without their baby is so sad, in the NICU we experience their distress everyday (to the point that we want to cry with them sometimes!). For some, leaving everyday is as bad as the first time.

RL

4:29 AM  
Blogger Reserved Stipulation said...

You're back! YAY!!!!!

9:13 AM  
Blogger Lisa - Mum to Mitch & Harry said...

Welcome back ND - like others I have checked back at least once a week to find out if you had returned from your hiatus. And I am so glad you did!

As for the bearded lady - I suffer from PCOS too - part of the reason for me being an "elderly primip", with an IVF twin pregnancy and a premature delivery.

I was astounded during the boys 5 months in hospital the number of parents who felt that in some way the doctors were keeping their babies longer than necessary! One mother begged the nursing staff to let her 34 weeker go home after a few days because she had a christening organised for the little girl. Another mother picked up her baby and walked out of special care with nursing chasing after her - she "just" wanted to take her daughter for a walk outside.

Leaving my boys in NICU was the hardest thing I ever did - and each time I left I thought my heart would break, BUT I understood why they were there and was grateful for their care. My major lapse of sanity came from walking past heavily pregnant mothers standing outside of the hospital smoking - it took every ounce of inner strength I had not to run them over with my car!

Welcome back,
Lisa
mum to Mitch & Harry
ex 24.6 weekers
now almost 3 years old

9:14 AM  
Anonymous Anonymous said...

Hooray! Welcome back!

11:36 AM  
Blogger Laura said...

once again you voice what we think as nicu professionals even though we understand.
welome back, doctor.
you have been so missed around this place.

12:18 PM  
Anonymous Anonymous said...

I have checked your site regularly hoping that you would be back. I now have a happy Monday.

1:45 PM  
Anonymous midlife mommy said...

Welcome back!!

3:39 PM  
Blogger frylime said...

yay!

6:05 PM  
Anonymous Anonymous said...

Welcome back!! I have been checking every few days to see if you were back.
JoDee

7:08 PM  
Blogger Nancy said...

Welcome back!

I have to say though, leaving my 25 weeker at the hospital 4 days after her birth wasn't the hardest thing in life I have ever had to do. Watching her for 106 days was. Don't get me wrong, it was a horrible thing to have to do. However, you're pregnant for 40 weeks for a reason. Not only so the fetus can mature and develop, but mentally and emotionally a woman needs to prepare for being a mother. Only 25 weeks into the pregnancy, I was in no way shape or form ready to be a mom. Over the course of her stay, it "grew" on me, if you will. By the time she reached around 35-36 weeks gestation, I couldn't have gotten that child out of there fast enough. And when you think about it, that's around the time that expectant moms start wanting to "get this kid out!"

So while it was most certainly difficult to leave the hospital without something that I came in there with, in my heart, I knew she was being well cared for, far better than I could care for her. And I wasn't ready to be a mom just yet.

Welcome back again...you have certainly been missed.

8:03 PM  
Blogger LMF said...

Welcome Back, Neonatal Doc! I posted a welcome back post on my blog in your honor. Glad you are back.

10:06 PM  
Blogger Amanda said...

I just found your blog at the beginning of this weekend and was sad to see you were on hiatus. That didn't stop me from reading the backposts, though! Excellent stuff, even the parts that made me a bit uneasy (I had a homebirth with my younger son... and you made me think and then inflict two terribly long posts about it on all four of my regular readers).

I'm very glad you're back, even if you do make me think and stuff, which is something I try to avoid outside of working hours ;)

10:44 PM  
Blogger Jen said...

Woohoo! Yay! Welcome back. We missed you very much.

11:20 PM  
Anonymous Anonymous said...

So good to see you back!

Often parents have little idea what we are doing for their babies (understandably). Sometimes I think this is a good thing.

11:40 PM  
Blogger Karen said...

Welcome back ND!
The disconnect between patients' expectations and reality is not just limited to neonatology - I think we see it in all areas of medicine.

11:59 PM  
Anonymous Anonymous said...

Welcome back! I bet she was in shock a little bit :)

(I am so glad I just waxed :) )

7:04 AM  
Blogger Evil HR Lady said...

I'm so happy you are back!

8:06 AM  
Blogger PE Mommy said...

WHOO HOO YOU ARE BACK! SO SO HAPPY. As far as leaving without your baby, even though you know they still need medical care. It's just so hard. I didn't have a baby in the NICU, but I did have to leave my baby at the hospital. It was THE hardest thing I ever had to do. It is terrible leaving the hospital with an EMPTY car seat carrier. You just can't know till you have been through it. There are so many insensitive comments, "well at least you'll be able to get your rest tonight or you'll be able to sleep". You don't want to sleep, you want YOUR baby.

So glad you are back.

8:12 AM  
Anonymous Carol said...

GLAD YOU ARE BACK!!!!!!!!

8:26 AM  
Blogger Nurse M said...

Welcome back!

8:32 AM  
Blogger ~Denise~ said...

Welcome back! We've missed you!

Thank you again for your great words. Yes, it sucks to leave your baby at the hospital, and I agree with the commentor who said each day after sucks worse when you leave. But we were so relieved to know that great docs & nurses were taking care of our baby. We were sad at the loss of the dream of bringing our baby home, and I think for most the loss of the dreams (perfect pregnancy, great labor & delivery, going home) are just so overwhelming for parents. We become a bit irrational as this is something new to us and cannot fathom having to go through.

Again, welcome back!!

9:16 AM  
Blogger amy said...

Welcome Back neodoc! The blogosphere hasn't be the same without you...

1:56 PM  
Blogger abby said...

Welcome back, ND! The blogosphere is a richer and happier place today!

2:15 PM  
Blogger JC Jones MA RN said...

I know some bearded ladies who go through a lot of trouble (bleaching, shaving, what have you) to disguise or hide their beards. Wouldn't you think they would just go get a good medical work-up. I never understand it but they never seem to want to talk about it...I am really interested in knowing what people think.

2:18 PM  
Blogger Maggie Rosethorn said...

Welcome back, ND. So glad you are back. Don't let the nuts north of Canada bring you down (hey, I grew up north of 8 Mile Rd, so I know about the area quite well...first job was there!)

funny thing...my word verification word is waxge!!

5:54 PM  
Blogger Aidan's mom said...

I check back about once a week to see if you've decided to come back to us! YAY! The blogosphere seems normal again!

6:09 PM  
Blogger Agatha said...

HURRAH!

6:24 PM  
Anonymous Anonymous said...

This is for JC Jones MA RN and all the rest who don't seem to 'get it'. The "bearded ladies" as you call us, are well aware that we are being talked about and gawked at. We might as well be sideshow freaks. A woman who has facial hair, especially a full beard situation, is viewed to be less feminine, less of a woman. It's depressing and there is no way to get rid of it, unless you can afford several hundred dollars worth of expensive laser hair removal treatments. That's why we don't seem to be much in the mood for "talking about it". As for this comment - 'Wouldn't you think they would just go get a good medical work-up' - well, a "good medical work-up" isn't going to do a thing for our facial hair. If we're lucky, we might find out what causes it, but that's about it. I must say, JC Jones MA RN, you must not have much of a bedside manner.

7:57 PM  
Anonymous Anonymous said...

am another 'bearded lady' who shaves daily...the purpose of this is not to whine or look for pity, but to give you an idea of the situation as it is for me...laser treatment is VERY costly, has to be done repeatedly to achieve full effect, leaves the treated area red, inflamed, sun sensitive, etc....my fear is that the treated area would be as red as Rudolph's nose!! and of course, no shaving or other treatment of the treated area...or the bits right around it....so i'd have a fringe, too! i know what i look like now, and i don't want to draw MORE attention to my looks... yes, i know the medical causes...but there is no medical treatment that would be effective....so, no, i am not stupid or lazy or blind...but i dont see any choices that are workable for me.

9:22 PM  
Blogger neonataldoc said...

Thanks, everyone. The words of welcome are very gratifying.

9:23 PM  
Anonymous Anonymous said...

danonymous said... I will pray for you doc you seem like a very rude and troubled person.

10:20 PM  
Anonymous NICUrn2B said...

so happy to see you are back. I work with a woman who has a full on beard. She shaves every few days. I'm sure there's a medical reason for it but it is quite striking.

12:39 AM  
Anonymous Anonymous said...

xsyWouldn't you think they would just go get a good medical work-up.

Got one, thanks. No PCOS, perfectly standard levels of assorted relevant hormones, nothing to be done but shave, shave, shave and glop on some outrageously expensive growth-inhibiting cream.

Well, at least I won't have to worry about sleeping sickness.

1:32 AM  
Blogger daedalus2u said...

I think the reason that ND sees so many women with facial hair has to do with low NO being associated with premature birth.

NO is what inhibits the cytochrome P450 enzyme that makes testosterone and so regulates the levels. In women, low NO leads to high androgenic steroid levels, and (in my non-medical opinion), PCOS (and other things). It makes sense to me that ND would see more women with facial hair, as women with low NO are more likely to have premature births.

10:28 PM  
Anonymous Future of hope said...

Welcome Back!

3:09 PM  
Blogger Ms. SuperScience said...

Welcome back, Doc - with stories as good as yours always are, how could you stay away??

9:58 PM  
Blogger kblog said...

Welcome Back! I read all of your archives!

12:39 AM  
Blogger Hannah's Mum said...

Welcome back ND! Definitely missed reading your blog whilst you were away.

My best friend has PCOS and has the thick hair growth. Luckily she's got two kids now, but it took a while.

7:31 AM  
Blogger Surgeon in my dreams said...

Well gosh NeoDoc - was the beard story for my benefit? Thanks. Welcome back old friend.

Sincerely,
Surgeon In My Dreams

PCOS survivor - fully bearded - had every "medical work-up" in the book - and have tried every option - shave every single day.

9:01 PM  
Anonymous Crunchy Mom said...

Welcome back!

10:58 PM  
Blogger Lin said...

Thank you, Sir, for returning to all of us who missed you.



Wheee! Yippee! Hurrah! Yahoo! Yeeesssss! Yeeeah!

11:43 PM  
Anonymous Anonymous said...

Another bearded lady here. I suggest that women with lots of facial hair are more common than most people think. I also I have had a full work-up, know the medical reasons for my condition. I used rx drugs for several years to treat the hair, but developed some worrisome side effects. I had electrolysis for YEARS, which was only minimally helpful. I have had 13 laser treatments, and I still have to shave every single day.

3:21 PM  
Anonymous Anonymous said...

Hi Neonatal Doc!

Glad to be reading your very entertaining posts once more.
Something I noticed not mentioned is that postpartum women have very labile emotions. PERIOD! sure, a premature birth is going to set a mom off a little more easily, but hormonal changes after birth certainly will cause havac no matter the gestation of pg.

And the great news is that in the majority of women, it settles down in time!

12:32 AM  
Blogger 2beautifulgirlsforme! said...

I'm thrilled to see you back! It made my night. :)

9:02 PM  
Anonymous Anonymous said...

I wanted to have my 27 weeker come home with me too! But I also wanted all the medical staff and equipment there as well. Sure it crosses bearded ladies' like me minds that the baby can't come home, but the whole thing is such a nightmare, that it is nice to pretend that everything was just a bad dream. If the baby can come home then maybe my body didn't fail me once again. Fear, hormones, and denial are such an volatile combination in these situations.

9:37 PM  
Anonymous isles said...

Oh, I'm so glad to be able to read your commentaries again. I love getting a little idea of what a doctor is really thinking about.

7:07 PM  
Blogger Tiff said...

Welcome back! I love reading your entries. As a Mother of a preemie that was in the Hospital for 3 weeks, I have to say that is was "nice" to have her in good hands while I was able to heal and rest. I delivered my daughter at 4:03 am and was out of the Hospital that same day at noon. Only because they had to transport her to a hospital across town that had a NICU.

Tiffany

3:50 PM  
Blogger JC Jones MA RN said...

OK, OK so you all hate me & think I'm cruel. Facial hair in women is called hirsutism & is an accepted medical diagnosis which IS covered by insurance therefore you can have some diagnostic studies done. Maybe there are some hormonal imbalances, maybe some medications would help. Maybe it's just me but I am curious about bodies, especially mine & wonder what makes it tick. So if something is different, maybe a few lab studies to see what's up would help. As for bedside manner, well se depende en la gente.

6:24 PM  
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1:39 AM  

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