I am now officially Amy DeBoer, RN, BSN!!
I am so relieved to finally be done studying! Now I can just go to work, and then come home and spend time with BJ! I am truly loving life after school and NCLEX!
I absolutely love my job so far and I feel so blessed to be a Vanderbilt nurse working in women's health! It is such a blessing to see newborn babies every time I am at work no matter which area of women's health I am working in! I'll find out in two weeks which unit I am being matched to. I will either be placed in Labor and Delivery (which I am hoping for!) or the women's health floor (antepartum/postpartum/post-op gyn). Both areas are fantastic and the people I will be working with in either area are amazing!
In just over two weeks, BJ and I will have been married for 2 years!! I can't believe how fast time has gone by! I can't say enough how blessed I am to be married to such an amazing man! =)
I am really enjoying living in the Brentwood area now and I am so glad that we decided to move here! We have been able to reconnect with several friends from our WKU days and it has been wonderful! Plus, best of all, we have found an amazing group of Christians to meet with and I am so excited to get to know them better and to start working with them! This is truly the greatest blessing of all right now!
Remember to pray without ceasing. There are so many that are suffering right now physically, emotionally, and financially and God truly has the power to comfort and change situations according to His will.
Have a blessed day!
I can't believe it is already 2009!!
2008 was full of challenges, firsts, accomplishments, etc...Here's a little recap of some pertinent events that happened in the life of the DeBoers..
-BJ started his first post-college job with an accounting firm in Nashville
-Moved to Hendersonville, TN where we pretty much didn't know anyone so that we could live between Nashville and Bowling Green to accommodate BJ's job and me finishing up school at WKU
-Met a wonderful group of Christians at Broadmoor, which definitely helped our transition into this new area
-Celebrated our first wedding anniversary!
-Spent my first day in Labor and Delivery and fell in love with this type of nursing
-Completed an 8 week internship with Vanderbilt in women's health
-Gained a part-time/almost full-time roommate (Derek Biard) in our extra bedroom...but we had to finally kick him out on his wedding day!
-Spent a week on Catalina Island with my family
-Witnessed several close friends enter into marriage!
-BJ passed his all of his CPA exams with flying colors and in a short span of time...so proud of him!!
-Offered my first nursing job with Vanderbilt Medical Center in women's health...exactly what I was hoping for!
-Graduated with my BSN
-Enjoyed my first white Christmas in Seattle
-Decided that we want to move back to Seattle in approximately 3 years or so...Lord willing
-Fell more and more in love with BJ DeBoer =)
I absolutely cannot wait to see what 2009 holds for us and how God is going to direct our lives! I already feel like this is going to be a blessed year for us and probably the best one we will have had yet! Some of the reasons for this include:
-We will have two consistent incomes for the first time since we've been married!
-We are moving to Brentwood, TN in two weeks and can't wait to get settled down there where we will live in the same apt. complex as some of our best friends
-I will no longer have to spend almost every day studying for school (after I finish the NCLEX) = free time to actually do the things I want to do!
Happy New Year everyone! May you be blessed!
So, it turns out that I get to make a trip back to California MUCH sooner than I had expected. When we got back last week, BJ found out that he has to go on a week long business trip to Richmond, VA during August. Now, this wouldn't be so bad if I was working or in school...but I literally have nothing that I need to do that week, so I would have been pretty bored and lonely here all by myself. So, BJ suggested that I go to California while he is gone if I could find a ticket within a certain price range...and I did! So, I will be in California from Monday, August 11 through Friday, August 15!!
Let me just say, I have the most wonderful, loving, and considerate husband ever! He knew that this past week was kind of a rough one for me and how much it would mean for me to get to spend a few more days in California with my family this summer. I'm so thankful that God has given me this opportunity...it definitely has come at a perfect time! =)
After studying obstetric nursing throughout this semester, I have learned SO much about pregnancy and birth! Before taking this class, I already believed that the complexity of pregnancy in itself was proof that God exists and is the creator of this earth and all that is in it. However, after learning even more about this process, my faith in God has been strengthened. So, I thought that I would share with all of you some interesting facts that I have learned about the pregnancy process that are so unlikely to occur just by chance. Just as a warning, this is a fairly long read and it is fairly complex (but I tried to write it in simple language), but this subject is SO fascinating and it is well worth taking the time to read. You are very likely to learn something new that you did not know before!
•There is a certain hormone called HPL that is only present during pregnancy. The purpose of this hormone is to make the mother’s cells less sensitive to insulin (a hormone that lowers blood sugar (glucose) so that cells can use the glucose for energy). Basically, this hormone is going to cause there to be more free glucose circulating in the blood so that it can be transported to the fetus for energy. If this hormone was not present, then the mother would continually be struggling with hypoglycemia (low blood sugar), since her normal level of glucose would be shared with the fetus, and/or the fetus would not have enough energy to facilitate growth and development.
•There is also a hormone called HCG that is released during pregnancy. This is the hormone that causes a pregnancy test to be positive. At the time of ovulation, the egg is released from its follicle, which is basically a sac that is made up of cells. This leftover sac of cells produces progesterone and estrogen until it is told to stop (if fertilization (joining of the egg and sperm) has not taken place) or to continue if fertilization has taken place. HCG is the hormone that stimulates the leftover sac of cells to continue to produce progesterone and estrogen until the placenta is developed enough to produce these on its own (~11 weeks gestation). Basically, this is significant because if this leftover sac of cells was not stimulated to continue to produce progesterone and estrogen, then the pregnancy could never be maintained because these hormones cause the uterus to grow, they prevent the inner lining of the uterus from shedding (during menstruation), they help the zygote to implant itself in the wall of the uterus, and they increase the blood supply to the uterus.
•Another interesting fact relates to the gastrointestinal system. It is one of the last systems to fully mature in the fetus and this occurs just a few weeks before the fetus reaches term status (week 38-42). When the fetus begins reaching term, a substance called meconium, which is comprised of particles from the amniotic fluid and also of cells from the intestinal tract, bile, and other intestinal secretions, begins to form in the intestines. After birth, this is the first stool that the newborn passes. Around 40 weeks, the fetus’ anal sphincter relaxes, which would allow this meconium that has collected in the intestines to be excreted. Generally, this relaxation of the sphincter is designed to occur around the time the mother goes into labor, which is extremely significant! If the anal sphincter relaxes and the meconium passes while the fetus is still in utero, then the fetus will essentially be floating around in and ingesting its own feces. This can cause serious complications in the newborn, such as pneumonia or sepsis (infection of the blood). Although this does happen on occasion (1/1000 have a complication as a result of meconium in the amniotic fluid), most of the time the infant is delivered before this occurs. Basically, this is significant because the anal sphincter is designed to not relax until about the time that the pregnancy is complete so that these dangerous complications rarely occur and a healthy newborn can be brought into this world!
•Before the infant is born, approximately 6 months worth of iron is stored in the liver. This is significant because the infant does not begin to eat any solid foods until around 6 months. In addition, there is low iron in breast milk. Therefore, the infant does not have many sources of iron intake until about the time that their iron stores begin to run out. However, another interesting fact related to this is that, despite iron being lower in breast milk than formula milk, 49% of the iron in breast milk is absorbed by the newborn compared to only 4% of the iron being absorbed from formula. Therefore, God designed breast milk to get the newborn through those first 6 months when their iron stores are beginning to deplete and then the infant is ready to start eating solid foods so that they can ingest more iron. This is all so important because iron is essential for carrying oxygen throughout the body and for keeping tissues and cells healthy. This is especially critical during periods of rapid growth, such as infancy.
•Another component of pregnancy that is so unlikely to have occurred just by chance is the fact that fetuses and newborns have a greater amount of and larger red blood cells than adults and fetal hemoglobin (a protein in the blood) carries 20-50% more oxygen than adults. This allows the fetus to have a higher oxygen carrying capacity than adults, which is extremely important for helping the fetus to endure the labor process. During labor when the woman is having contractions, the fetus does not receive any oxygen, so the fetus depends on his/her oxygen reserve. If the fetus had not been designed with a greater oxygen-carrying capacity, then it would be extremely difficult for him/her to endure labor.
•One of the biggest challenges that the newborn faces is regulating his/her body temperature and preventing heat loss. This mainly occurs because newborns have 3x more surface area to body mass compared with adults, they lose heat four times faster than adults, and they have very thin skin. However, there are certain mechanisms present in newborns that are only present at this time of life. Newborns have a type of fat called brown fat and this is only present at the time of birth. This brown fat is highly vascular (lots of blood vessels) and it generates more heat when it is metabolized than the normal white subcutaneous fat that is found in adults. When the skin temperature drops in a newborn, a process called nonshivering thermogenesis is initiated. This stimulates the release of a neurotransmitter, which causes the metabolism of the brown fat. When blood is passed through the brown fat, it warms the blood and then this heat is carried throughout the body. What is so neat about this is that this process occurs right when the skin begins to cool, even before the internal temperature begins to drop! Basically, infants could not effectively regulate their temperatures without the presence of this brown fat, which would lead to respiratory distress, extreme hypoglycemia (low glucose), decreased lung surfactant (which allows oxygen to be exchanged for carbon dioxide in the lungs), high acid content in the blood, and/or jaundice (which results from the break down of red blood cells). So, once again, it is just so hard to believe that this special fat is in the newborn by accident since it is so essential for preventing life-threatening complications!
•Another interesting fact relates to glucose stores in the fetus. During the last 4-8 weeks of pregnancy, the fetus begins to store glucose in the liver for use after birth. This extra source of energy helps the fetus endure the stress of the delivery, helps with heat production after birth, with movement, and with the activation of functions. If fetuses did not have this extra storage of glucose, then they would use up their glucose extremely quickly, which would lead to brain damage and respiratory distress. Therefore, the fact that the fetus’ body automatically begins storing glucose during the last weeks of pregnancy to prepare for the stress that is ahead is further evidence of design because of how perfectly this whole process is constructed.
•I have saved one of the most fascinating aspects of fetal development for last! What I am about to discuss is related to the fetal blood circulation through the heart and it is extremely complex and difficult to explain. However, I have included diagrams and have tried to explain it to the best of my ability. If you can’t make it through all of the explanations and your brain begins to feel overloaded, then you can at least read the part at the end of this section that is in bold.
While the fetus is developing in the uterus, the circulation of blood through the heart is opposite of adult circulation. In an adult, blood flows from the rest of the body through the veins back to the heart, and then it is pumped through an artery into the lungs so that oxygen can be exchanged for carbon dioxide in the blood. Then, blood flows back into the heart and it is pumped out through the arteries to bring oxygen to the whole body. (See first link below)
Now, in a fetus, blood flow is the opposite of adult circulation and the blood bypasses the lungs since the fetus does not breathe air through the lungs while in utero. The mother’s oxygenated blood is brought to the placenta (which is an organ that exchanges hormones, oxygen, waste, etc. between the mother and the fetus) and oxygen is exchanged to the blood in the fetus’ umbilical vein (in the umbilical cord). So, in the fetus, the vein brings the oxygenated blood to the heart. Now, in order to bypass the lungs, there are three little openings in the fetal heart called shunts and these allow blood to flow right across the heart instead of into the lungs (except a very small amount of blood that goes to the lungs to nourish the lung tissue). If you look at the second two links below, you can see how the blood flows straight across the right and left atrium through the foramen ovale (one of the shunts) instead of going into the artery up to the lungs. Then, a small amount of blood goes through the artery into the lungs to nourish the lung tissue and this artery also connects to the aorta (the artery that sends blood to the rest of the body) through the ductus arteriosus (another shunt). Thirdly, there is an opening between the umbilical vein and the vein that brings blood back to the heart from the body (the inferior vena cava) and this shunt is called the ductus venosus. This shunt also prevents all the blood from flowing through the fetal liver.
A Normal Heart
Two Different Diagrams of Fetal Circulation
Now, I am explaining all of this so that you will see how amazing it is when the fetal circulation transforms into adult circulation within minutes of birth. When the infant takes its first breath after birth, the blood flow to the lungs increases and causes increased pressure on the left side of the heart. This increased pressure causes the blood to try and flow back to the right side of the heart, which results in the closure of the foramen ovale, which was the shunt between the right and left sides of the heart. Then, as pressure rises in the aorta, which sends blood to the rest of the body, this causes the circulation to reverse and the shunt between the pulmonary artery and the aorta constricts (the ductus arteriosus). Lastly, since the umbilical cord gets clamped and cut after birth, blood no longer flows through the umbilical vein and the ductus venosus shunt closes as well since there is no blood flow. (Compare first diagram to the second two diagrams)
This may all have been completely confusing and over your head (because it is EXTREMELY complicated), but I hope that you can all see how incredibly amazing it is that the heart could be working one way while in utero and then spontaneously reverse simply with a few breaths of air. This is so amazing and it could not have just happened by chance…it just screams design!
McKinney, E. S., James, S. R., Murray, S. S., & Ashwill, J. W. (2005). Maternal-Child Nursing (2nd Ed.). St. Louis, MO: Elsevier Saunders.
If you read this, thanks for doing so! I hope that you learned something new and interesting!