Wednesday, May 23, 2007

Post Traumatic Stress Disorder In Preemies

While reading a post about childhood PTSD over at corpus callosum, it brought me back to our discussion on PTSD here on this blog, and how parents of preemies endure so much continuous stress from their NICU experience and subsequent thrust into parenting a preemie.

I wrote to the blog author and asked his thoughts on whether or not preemies themselves could be suffering from PTSD and what could be the cause of the mental health issues they face in infancy and as they get older.

He was gracious enough to write a post on the subject.

As I speak to various docs and read studies on the long term effects of prematurity and learn what is being done to improve the outcomes, I hardly hear anyone discussing mental health issues. Thank you to Corpus Callosum for addressing my question.

Out of all of the long term effects of prematurity that Paige currently deals with, mental health is the hardest to treat. It is takes its toll on her and all of us in the house. She suffers horribly at times. And, because we have to deal with the "she looks good to me" mentality, it's hard to find help. She is not alone. I talk to many parents who are at the end of their rope because of the behavior of their preemie. Adult preemies suffer as well.

How can we help future preemies if no one will acknowledge the mental health issues that plague our kiddos?

Saturday, May 19, 2007

Glucose Intolerance and High Blood Pressure in Adult Preemies

Glucose Regulation in Young Adults with Very Low Birth Weight

Petteri Hovi, M.D., Sture Andersson, M.D., Ph.D., Johan G. Eriksson, M.D., Ph.D., Anna-Liisa Järvenpää, M.D., Ph.D., Sonja Strang-Karlsson, M.D., Outi Mäkitie, M.D., Ph.D., and Eero Kajantie, M.D., Ph.D.


Background: The association between small size at birth and impaired glucose regulation later in life is well established in persons born at term. Preterm birth with very low birth weight (<1500>Methods: We performed a standard 75-g oral glucose-tolerance test, measuring insulin and glucose concentrations at baseline and at 120 minutes in 163 young adults (age range, 18 to 27 years) with very low birth weight and in 169 subjects who had been born at term and were not small for gestational age. The two groups were similar with regard to age, sex, and birth hospital. We measured blood pressure and serum lipid levels, and in 150 very-low-birth-weight subjects and 136 subjects born at term, we also measured body composition by means of dual-energy x-ray absorptiometry.

Results: As compared with the subjects born at term, the very-low-birth-weight subjects had a 6.7% increase in the 2-hour glucose concentration (95% confidence interval [CI], 0.8 to 12.9), a 16.7% increase in the fasting insulin concentration (95% CI, 4.6 to 30.2), a 40.0% increase in the 2-hour insulin concentration (95% CI, 17.5 to 66.8), an 18.9% increase in the insulin-resistance index determined by homeostatic model assessment (95% CI, 5.7 to 33.7), and an increase of 4.8 mm Hg in systolic blood pressure (95% CI, 2.1 to 7.4). Adjustment for the lower lean body mass in the very-low-birth-weight subjects did not attenuate these relationships.

Conclusions: Young adults with a very low birth weight have higher indexes of insulin resistance and glucose intolerance and higher blood pressure than those born at term.

The full article can be found here.

Wednesday, May 16, 2007


Doc's_Girl tagged me for 8 random thoughts about me.

(The rules: Each player starts with eight random facts/habits about themselves. Write a post about your own random things. Post these rules. At the end of your blog, tag 8 people and post their names. Don't forget to leave them a comment and tell them they're tagged.)

Only one problem. I don't know 8 people who have time to have some fun. If any of my regular readers would like to have some fun with this and post some random facts about themselves on their blog, please let me know in my comments section. I would love to read it.

Here's mine.

1. I grew up in the late 70's and was really into rock (Led Zepplin, Aerosmith, Ted Nugent, etc). But, I was a teenager at the turn of the 80's. Damn those teenage years! Somehow I (clearly taken over by something evil) started listening to Culture Club. Yikes! Then came Air Supply. What got into me! Thankfully along came Metallica, who rescued me before I liked Wham!

2. Love. (warning sappy, mushy, gushy info comin') Hubby and I have been married for almost 13 years (despite his spending habit). Many didn't think it would last. For starters he is 5 years younger than me. We started dating when he was 18 (his dad's a lawyer-I sure wasn't going to go to jail-lol) and got married when he was 21. Add to that the stress of having a micropreemie and it's a miracle we are still together. I truly love him. I knew it early on. I can remember one day we were looking at backyard swings. We were sitting on one in a store and I had completely lost track of where I was or how long we were sitting there. It's that kind of peace that I wish everyone could feel. It's what has gotten us through our crazy life. He still tells me, every day, how much he loves me and how beautiful I am, despite my issue (see #3).

3. I miss being thin. I used to model. Tall and thin. I was 110 pounds (5'8") when hubby and I started dating. I'm not that anymore. I will be again one day though (in another life??).

4. I'm a vegetarian. Yep, an overweight vegetarian! (only I could pull this one off) I went to a meat packing plant (was supposed to be a field trip to a farm) on school field trip when I was 10. No more meat for me!

5. I used to be anorexic. 86 pounds (when I was a teenager-wonder if it had anything to do with Boy George-lol-it's all his fault) at my lowest. Hmm... an overweight vegetarian who is an ex anorexic. Any psych blogs out there?

6. I want a tattoo.

7. Suzy Homemaker and I do not come from the same bloodline. My house is not neat (clean but not neat). I hate doing dishes and don't ask me to wash windows. Hubby just finished cleaning our bathtub. (in all fairness-he replaced our brand new toilet with a super toilet and he wanted the whole bathroom to sparkle to show off his work-gotta love those male ego moments).

8. I am fascinated by all things relating to the ghost world. I love the show Ghost Hunters.

Sunday, May 13, 2007

Knowledge Of Birth History

As I sat and listened to Paige tell her classmates how she came into this world, and all of the little letters that the docs use to describe her, I smiled at how comfortable she was talking about her world.

See, we have never hidden the truth from Paige. Never. She is present at EVERY doc visit, consult and always during the time we give history. When the docs ask us questions regarding her health, we tell the docs to let her answer for herself.

Over the years we have had mixed responses from docs and nurses. Some give that pouty look to Paige when we give her history. It's hard for them to hear so they assume that it's hard for Paige to hear. Some docs are impressed with her maturity and understanding of her own body and issues related to her prematurity.

The bottom line is that Paige lives in her body, with those lingering issues. Hearing about them does not make them worse. But, giving them a name has helped her understand herself and why she feels the way she does.

Monday, May 7, 2007

Boy Was My Face Red!

The next few weeks will be bringing some serious topics that I will be writing about. I thought I'd start out with something funny. Stay for the laughs, share some of your own embarrassing moments and come back for the serious stuff too.

When Paige was about 5 years old, we were on the way to one of her many doc visits, listening to a CD with a song that was recorded 2 different ways, both with an electric guitar and an acoustic one.

As we entered into the lobby of the doctor's office, Paige asked (in her normal incredibly loud voice), "Mommy, which virgin do you like?" I was signing in and being handed the millionth HIPPA form to sign so I ignored her. Her actual question didn't register with me until she yelled it again.

"Mommy, which virgin do you like?"

I think it was the giggling from the nurse behind the glass window that caused me to replay what I had just heard. Before I could answer Paige or at least throw her "the mommy look" she yelled once more.

"Mommy, which virgin do you like?"

"Paige, the word is version and I like the acoustic one better."

"Version? Then what is a virgin?"

(laughter could be heard from every adult in the room)

"Paige, could you please lower your voice. We will talk about this on the way home."

Tuesday, May 1, 2007

Dental Issues Related To Prematurity

We have now added yet another specialist to the group.


"Not a big deal" you say? "Many kids need braces" you say?

It's true that, in the scope of things, this is not really a huge deal. Or, at least it wouldn't be if Paige just needed braces, or if she didn't have sensory issues or if she had a few extra pounds on her so she won't be even more dangerously thin when she looses a few pounds after all of the work that will be done in her mouth.

Prematurity has, yet again, left its mark on my precious baby. She has escaped the stained teeth and enamel hypoplasia that some preemies get. But, she has a high palate and small facial structure. She will need a palatal_expander and appliances on her lower jaw. Her teeth are coming in where ever they can. She has pressure in her mouth. What she is feeling now will pale in comparison to what she will go through when she gets her expander. I know she will not eat for days. She will cry.

Last year she had a ph probe (tube down her throat), for 24 hours, to measure her reflux. She didn't sleep. She barely ate. She cried. The worst part, according to her, was the feeling of the tube in her mouth.

How in the world will she manage with the expander in her mouth?

I've been very emotional over the past few weeks. Paige's anxiety is better, thanks to finding a med that works for her. She still has mental health issues but at least one part of it is better. Yesterday she said to me, "some days I wish I could be normal." She feels it. No matter what I do to protect her, she feels it.

Why can't I hug away the pain in her life? Isn't that what a mother is supposed to be able to do?