Emergency Series - The Sun Does Not Always Work..

Some people are just stone-cold deaf. Like there is literally nothing you can say to them that will go down well with them, they are the bigots who refuse to listen to any other person’s opinion and think they know too much, so full of themselves.

The irony is that their brains are myopic and limited, they don’t realize things are going to get out of hand until it is much worse, then they come running for help, panicking like they just overdosed on LSD, and hoping for a miracle that is almost impossible.

To be honest, it takes a lot of patience to be a health worker, whether you’re a nurse like me, a doctor or a pharmacist, because a lot of things patients do are baffling, sometimes they get you raging mad and make you feel like giving them a punch in the throat.

 They are hard to believe and make you begin to question humanity sometimes. That’s just what this story is about.

 A baby was rushed to the emergency room, not even a baby, a neonate, because he was less than 4 weeks old. I have never in my career as a nurse seen a baby’s eyes that yellow before. The baby’s skin looked wrinkled and looked like he had lost some weight. He didn’t even have the energy to cry properly and was pale-looking. The parents brought him, with the father’s mother and sister tagging along. 

They had requested to be discharged against medical advice to go and perform ‘family rites’ on the baby as they claimed it was their custom to do so. They were supposed to wait for phototherapy as the baby’s blood bilirubin level was high but they only waited for two days after delivery before deciding to go home. 

The mother said she was putting him in the sun at home for ‘fresh light’ to reduce the severity of jaundice and when she noticed it was not working and that the boy was looking pale and yellow that she decided to visit the hospital. She said she was surprised as to how the boy deteriorated fast. 

The boy’s blood was taken for bilirubin test and it came out to be terribly high, 36mg/dl. It was the highest I have ever heard of or seen before. The baby’s blood level was also low and he had high WBC, about 18,000. The baby was in a bad shape and even had to be placed on oxygen. He was also placed on antibiotics. Phototherapy couldn’t help the child anymore at that point because the bilirubin was waaay too high and had to get his blood totally removed and exchanged for new donor blood in a procedure we call, exchange blood transfusion, EBT.

 The parents were asked to sign a consent form. The boy’s parents would have to spend way much more money, only if they had been patient enough to wait for phototherapy at birth. The baby’s weight was even a little over 4kg at birth, which could increase the level of jaundice as well. While we got the blood ready, a fight started between the mother of the baby and the father’s sister, the father’s sister called the mother something in a language I don’t understand, then the child’s mother pushed her sister in-law hard till she fell down and hit her knee on an iron door close by. 

The child’s mother held her cloth and we had to call the security to take them out. The father of the baby just ignored them completely. Later on the mother came back alone. I didn’t know what led to that. 

Anyway, we got blood ready and a pediatrician was called to perform the procedure, it involved passing tubes in and out of the baby, one tube transfuses new donor blood while another removes the baby’s toxic blood. It’s a procedure done with extreme care and very slowly, as if it is done fast could cause the baby to be hypoxic or cause abnormal cardiac changes which aren’t good. That’s why a pediatrician was called to do it. It was successfully done.

During the procedure, the parent were told to wait outside and were let in after. The baby was then taken to the neonatal unit for further care. I hope the baby has not had any complications yet because high bilirubin can cause brain damage which would slow down the rate of development and learning.

 The complications were explained to the parents. The mother was looking so sad and exhausted. I don’t know where they got the idea that sunlight works for jaundice, even if it does, there is a level of jaundice that sunlight cannot effectively cure and the child will have to be on phototherapy. If you are currently pregnant or you just had a baby, it is important you listen to the doctor's advice as regards jaundice checks and phototherapy, don't be a hurry to go home for naming party. Its only a baby that's alive that can be named.