By, Lori Boggan
Organ transplantation, according to the U.S. Department of Health and Human Services, dates back as early as 1869 with the first skin transplant. The first kidney transplant occurred nearly one hundred years later in 1954. Organ transplantation has saved countless lives. In 2014, transplantation history was made. It was the year the first transplantation bore life. Continue reading
by, Susan A Peck, RNC, MSN-APN
Adrienne felt fortunate and happy in so many ways. Since becoming “empty nesters” she and her husband Paul are really enjoying their new-found time together. Whether they take vacations, head to the movies, or just spend time at home, their friendship and love have flourished. In the past, no matter what stressors life sent their way, Adrienne and Paul would always cherish their alone time as a way to reconnect and maintain their intimacy.
Compared to her friends, Adrienne also felt pretty lucky with her menopause experience. She only felt hot flushes from time to time and wasn’t too bothered by insomnia. All in all, life was good….until she began to feel uncomfortable…down there. Was it a yeast infection? Why did she feel itchy and irritated, especially after her morning walks? And then, one weekend, when she and Paul became intimate, things just didn’t feel the same. She loved Paul and wanted to be intimate with him, but it seemed like her body was taking a long time to catch up to her mind and heart. This had never happened before – pleasure with Paul was never an issue. Continue reading
Parents consider health care professionals one of the most trusted sources in answering questions and addressing concerns about their child’s health. A recent survey on parents’ attitudes, knowledge, and behaviors regarding vaccines for young children ¾ including vaccine safety and trust ¾ found that 82% of parents cited their child’s health care professional as one of their top 3 trusted sources of vaccine information. With so many parents relying on the advice of health care professionals about vaccines, a nurse’s recommendation plays a key role in guiding parents’ vaccination decisions. Continue reading
by, Michelle Amstutz, RN
Saint Joseph Mercy Hospital, Ann Arbor MI
I would like to share what an impact attending nationals has been for me over the last few years.
A few years ago I went to hear Michelle Collins present on Nitrous. She talked about bringing nitrous to Vanderbilt University Hospital. I was so inspired by her talk that I reached out to her to find out how I could do the same thing. Continue reading
by, Shelly Lopez Gray, MSN, RNC, IBCLC
by, Lori Boggan, RN
Working in neonatal intensive care can be tough no matter how long you have worked in it. With time however, many things become routine. 500 gram babies are our business. Cooling asphyxiated babies is our business. We are used to this world – the ventilators, the treatments, the pumps, the alarms. The thing is, the parents and family are not used to this. It is shocking, frightening. It is our duty to remember this is their first experience in a world they never imagined, perhaps did not even know existed. How can we as care providers support them? Continue reading
by, Ashley Hodges, PhD, CRNP, WHNP-BC
As a teenager I would hear friends talk about the severity of their menstrual cramps, confident endometriosis was the culprit. I am fairly certain I understood nothing about endometriosis, but soon questioned whether I too was suffering from this disease. It took nursing school for me to realize that I had been blindly following the musings of these young women and likely sounded ridiculous in my own conclusions. It was graduate school and my work as a Woman’s Health Nurse Practitioner where I learned fact from fiction and became well versed in diagnosis and treatment options.
Despite my formal education, it was not until a dear friend; we will call her Lisa, was diagnosed with endometriosis and later labeled infertile that I began to truly see all colors of the disease. My use of the word color is intentional. Read on and you will see why.
Endometriosis is a chronic disease of estrogen-dependent lesions of endometrial glands and stroma found outside the uterus (Rogers, 2013). Endometriosis is most commonly found on the ovaries, the fallopian tubes, the bowel, and the areas in front, in back, and to the sides of the uterus. Endometriosis affects approximately 5 million women in the United States. (American College of Obstetricians and Gynecologists , 2010). However, the actual numbers are unknown since endometriosis is often goes undiagnosed due to lack of symptoms and difficulty or delay in diagnosis.
FALSE. It has been estimated that the time between the onset of symptoms and surgical diagnosis of endometriosis is 6.7 years.
FALSE. Not all patients with endometriosis experience pain. When women do experience pain, timing may be before, during, or between periods. Some women experience pain during or after intercourse. Others may experience pain with bowel movements, especially during the menstrual cycle.
FALSE.. There is no cure for endometriosis. Hormonal suppressive therapy does improve pain symptoms. However, recurrence rates are high after the medication is discontinued (American College of Obstetricians and Gynecologists, 2010).
FALSE. This is not necessarily the case although up to 50% of women with endometriosis have difficulty conceiving naturally (American Society for Reproductive Medicine, 2012).
Lisa’s Story
At the age of 24 Lisa knew something was not right. Being a nurse she could only justify so much about her heavy, frequent and painful periods. Sex was painful, but maybe it was her state of mind or the bad relationship. She had moved to a new town only 2 years before, far from her less- than- thrilled parents. She was working long hard hours in the Neuro ICU and had little time for a social life. Lisa and Brian had been dating for over a year and his anger over her long hours and lack of attention to intimacy was worsening. This, she thought, was why her health was so poor. Today, 22 years later, Lisa admits she knew something else was wrong, but denial was the easiest path at the time.
By the age of 28, Lisa’s symptoms were worsening, missed days from work putting her job at risk. She and Brian married that year. Her symptoms worsened over the next year with sex becoming unbearable. One afternoon at work she noticed blood in her stool following a painful bowel movement, but wrote it off to hemorrhoids, being on her feet all day as a nurse. That evening Lisa spoke to her mother, listing off her most recent symptoms of back and leg pain, abdominal pain, and nausea. Lisa decided it was time to see her provider and discuss her recent and recurrent symptoms. That night. Lisa woke in the middle of the night with severe lower abdominal pain which led her to seek care in the emergency department.
Lisa was taken to the OR and a right ovarian cyst the size of a softball was removed. Upon waking from surgery, Lisa was told of the ovarian cyst diagnosis. It was not until the next morning she was informed of the other findings. Lisa had severe endometriosis on her uterus, fallopian tubes, ovaries, ureters, bowel and bladder.
Lisa was told the chance of her conceiving naturally was likely nonexistent and that assisted reproduction was the only hope. Lisa underwent surgery to remove large areas of endometrial lesions and received six months of Leuprolide. She tried to conceive without any other medical intervention for three months without success. Fearful of worsening endometriosis she elected to take three months of ovulation induction medication, again without success. Lisa was given the option of moving forward with other reproductive assistance, but due to the cost, elected to wait and save money. Unfortunately, Lisa was back in the OR just six months later for additional surgery including a hysterectomy.
Today Lisa continues to struggle with complications from scarring and recurrent endometrial lesion implants. Lisa and Brian elected to adopt a child who is now 2 years old and are hoping to adopt again soon. Unfortunately Lisa’s story is not unique. More options are available for women today in the treatment of endometriosis but the struggle continues.
What is the reason behind the word “color” in this post’s title? Lisa saw many providers and sought support and guidance through more nontraditional methods. At one visit to an alternative methods provider, she was told to give a color to the endometriosis and then to not own anything of that color. She later told me that she gave endometriosis the color brown… because endometriosis was one big (beep).
Learn more about this topic at: http://endometriosisfoundation.org/
Dr. Ashley Hodges is an Associate Professor and Assistant Dean for Graduate Clinical Programs at the University of Alabama at Birmingham School of Nursing. She is certified as a Women’s Health Nurse Practitioner and has over 25 years of experience in maternal child nursing, administration and nursing education. She was recently named in the Top 20 Outstanding Professors of Women’s Health Nursing by Nurse Practitioner Schools. Dr. Hodges served a two-year term as Board Member for AWHONN beginning in 2014 and was the 2015 Chair of the Public Policy Committee. She is currently a member of the editorial advisory board for the journal Nursing for Women’s Health.
American College of Obstetricians and Gynecologists. (2010). Management of endometriosis (Practice Bulletin No. 114). Obstetrics & Gynecology, 116(1), 223-236
American Society for Reproductive Medicine. (2012). Endometriosis and infertility: a committee opinion. Fertility and Sterility, 98, 591-598.
Rogers, P. A., D’Hooghe, T. M., Fazleabas, A., Giudice, L. C., Montgomery, G. W., Petraglia, F., & Taylor, R. N. (2013) Defining future directions for endometriosis research. Reproductive Sciences, 20(5), 483-499.
by, Bree Fallon, BSN, RNC-OB, C-EFM
When I was told my administration would be sending three of us to the AWHONN Convention, my heart skipped a beat. Actually, I squealed like a child and jumped up and down. It was a dream come true! I couldn’t help but compare Convention to a labor and delivery nurse’s Disneyland. It’s funny to me now remembering that day, as I would have had no way of possibly knowing what a tremendous impact the trip to Convention would have, both on my own nursing career as well as my unit. Continue reading
March is Women’s History month where we pay tribute to the generations of women whose commitment to nature and the planet have proved invaluable to society.
Here at AWHONN we honor five nurses who contribution to women and newborn’s health has improved outcomes and saved lives through countless generations. Continue reading
by, Marilyn Pierce-Bulger, ANP
Jason is a 13 year old boy who knows he is different but he does not understand why. He blames himself for the difficulty he has had in school and with social relationships over the years. He thinks he is not trying hard enough or is not smart enough. His teachers and parents view him as willful, rather, than ‘unable’ due to his hidden disability. Continue reading