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Newborns with cephalohematoma are at risk of this becominginfected with secondary infection of the skull and conferring a risk of meningitis [16].Calcaneal OM following heel prick test for Guthrie screening has also been reported [17].All babies aged less than 3 months presenting with pyrexia greater than 38°C or unwellwith risk factors for sepsis should have a “septic screen” consisting of blood culture,lumbar puncture, urine culture, and consideration of chest x-ray. The preced-ing information is obtained and reviewed within 24 hours of anesthesia, to ensure themost recent and therefore most pertinent assessment of the patient

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Contraindications to conservativemanagement include perforations associated with a neoplasm or obstruction, and sepsis.Concerns for the conservative approach are sepsis, tracheo-esophageal fistula, and airwaycompromise, which occur in about 4% of such patients. Alsoon that day, Breiman announced the WHO team’s initial findings, whichpointed strongly toward an animal origin for this new strain of coronavirus.Their virologic forays uncovered traces of the virus in the restaurant wherethe twenty-year-old waitress worked, and animal cages known to containcivet cats in the back of the restaurant all tested positive for SARS

Alsoon that day, Breiman announced the WHO team’s initial findings, whichpointed strongly toward an animal origin for this new strain of coronavirus.Their virologic forays uncovered traces of the virus in the restaurant wherethe twenty-year-old waitress worked, and animal cages known to containcivet cats in the back of the restaurant all tested positive for SARS. Thisissue may have been exaggerated in the past, since it was frequently confounded with theuse of concomitant nephrotoxic medication in patients with chemotherapy. 2004) and used a “collaps-ibility” index to help guide ?uid administration inventilated patients with sepsis (Vieillard-Baronet al.

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I was scared, but like so many times when fear creeps in and threatens to take hold – the thought of what may happen was much worse than what actually took place.

What took place was nothing more than a breathtaking, exhilarating car ride around an island covered with the most lush, picturesque scenery I ever had the pleasure of laying my eyes upon.

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As we bumped and jerked and raced the sun around the twists and turns and eventually saw it drop below the horizon, and as the stars started to twinkle one by one in the night sky creating a blanket of sparkling lights covering us from above, I no longer felt afraid. I felt grateful. Oh so very, very grateful.

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We left the road to Hana and headed for our dinner reservations at the very popular, highly acclaimed Mama’s Fish House. And it completely lived up to the hype. It was beautiful and delicious and peaceful and everything you would hope a meal at a restaurant sitting on the beach would be.

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After stuffing ourselves silly with delectable fresh seafood, we headed back to the hotel with full bellies and full hearts. We went to bed that night with the knowledge that our vacation would soon be coming to an end, but that was ok. We were beyond happy.

Our next day was spent lounging around the pool and ocean and doing all the other great things you do when you are in Hawaii for the day.

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Our evening ended with another exceptional meal at a restaurant down the beach from our hotel. We walked back from dinner once again with full bellies and full hearts. We were content. We were joyful. We were breathing in fresh ocean air. We were together. It was bliss.

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We began to pack our bags in preparation for our flight home the next day. We laid our heads on the pillow. And went to sleep.

And then it happened.

The pain. The horrible, awful, feel like you must be dying pain. It felt like someone was stabbing my stomach with a small knife.

What was happening?

I was so sick. So. So. So. Sick.

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With each of my children I suffered from horrible “morning” sickness. You know, the kind that lasts all day that makes you wonder why in the world anyone was ever cruel enough to name it morning sickness when it should have been called “all day every day” sickness. I was used to feeling sick. I was used to throwing up. I was not used to this.

This was like something you would see out of a movie. I’m not even sure the word projectile does it justice.

After a couple of hours of the pain, vomiting and other unmentionables – I finally woke Pat up and told him I must have Gatorade. Now. Fast. My legs were starting to lock up and I was starting to feel like I was on the verge of being really dehydrated really fast.

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It may have been far from reality, but I was wondering if I would ever get up from that bed. I had never felt so bad.

He called the front desk. They asked if Ginger Ale would do, I politely responded with a faint, “No, it must be Gatorade.”  (This is starting to sound like a really long Gatorade commercial, isn’t it?)

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The kind man arrived in the early hours of the morning to bring my beverage of choice – I don’t have to tell you again what it was. For the next few hours, I continued to be sick and drink as much as I possibly could.

And as I lay there in all of my pain, I began to wonder if I would get home.

I was on an island and had not seen a hospital, or a clinic for that matter. While I am sure they existed, at that time I felt very. Very. Far away from home. I wondered where I would go to get fluids. I wondered how I would get on the plane. I wondered how I would endure the long flight back. I started to think about how Pat would have to leave me there and how I would have to come home later. I had never felt so bad.

My flight to Hawaii had been a sauna over the ocean and my flight home was about to be a whole different beast altogether.

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*This is part three of a now FOUR part blog series….oh my…..I just can’t stop…….

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After an unbearably hot plane ride where I thought I may not live to see another day; a 10-hour lay-over in San Francisco; an hour wait on the tarmac (they originally told us it would be two hours, so one seemed pretty awesome) and a bumpy second flight that may have been scary at any other point in my life (but because of what we had just been through seemed like a walk in the park) – we finally touched down.

Yes, it was 3:30 in the morning Hawaii time and yes we were supposed to be there at 1:45 in the afternoon the day before and yes we had been traveling for over 24 hours, but who cares? We made it.

We had arrived. Maui. Paradise.

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My husband and I were about to experience the vacation of a lifetime and we were beyond excited. And exhausted. Excihuasted.

We made it to our room and I would say we slept like babies, but I have never understood that analogy. My babies woke up every few hours, cried, wanted to eat, needed their diapers changed and sometimes refused to go back to bed. We absolutely did NOT sleep like babies. More like rocks. I get that analogy.

When we woke up the next morning we were greeted by sunshine, fresh ocean air and a breathtaking view. Our harrowing trip to the island was well worth it.

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That evening, we went to a luau and saw people move in ways I never knew possible. They danced with fire and told beautiful stories about their culture and while their hips were shaking and fire was flying, we ate….and ate….and ate some more – and I realized as I looked down and saw the deep purple hue on my plate that even the sweet potatoes in Hawaii are prettier – and I was giddy with happiness.

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We rode aboard a catamaran on a bright, sunny day and went snorkeling with exotic fish and gigantic, graceful sea turtles  – and I was sure if one of those sea turtles were to talk they would sound just like Crush – and I was giddy with happiness.

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We went whale watching and saw two enormous humpback whales breech and then a smaller, baby whale followed suit a second later. And even though it was only a baby, it was still one of the largest, most remarkable creatures I had ever laid my eyes upon. The whales flew into the air and landed with splashes that were so ginormous it seemed as if they could surely be seen for miles. The captain of the ship told us this was the first double breech they had witnessed all year (and we saw a triple!) – and I was giddy with happiness.

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Nearly every morning, we would wake up and go for a jog on a path that wound around the coastline. We ran with clear, baby blue skies above and the ocean beside us. We watched the waves roll in and crash against the rocks, spraying the air with glistening drops of salt-filled water. We ran and we talked and we laughed and we eventually would stop talking and laughing because we were tired from all of that running. My heart was full, my legs were sore – and I was giddy with happiness.

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We rented a car and drove along the narrow Road to Hana with its bends, twists, 617 hairpin turns and 59 one-lane bridges. The road to the quaint, isolated town of Hana is roughly 52 miles. Seems as if you should get there in no time. Right?  Think again. This trip took us an entire day. Close to ten hours to be exact.

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Part of the reason the trip takes so long is not just the hairpin turns and 25 mph speed limit, but because of the many stops made along the way. On more than one occasion, we stopped to hike and we hiked and hiked and hiked some more and saw the most beautiful sites  –

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God’s great beauty as far as the eye could see –

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and I was giddy with happiness.

We stopped at shacks on the side of the road where local food was being prepared with great love and care. The conditions were questionable and I am pretty sure they weren’t being regulated by the Department of Health, but that was fine. It was all part of the experience.

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At one location, our food was handed to us inside of a hollowed out bamboo shoot with small bamboo sticks to use as our utensils. It felt as if we had left our country and flown around the world to have our meal.

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It was delicious – and I was giddy with happiness.

And finally, after traveling and hiking and eating and just being present with each other and God’s glorious creation – we arrived at our destination, the town of Hana.

We were told that tourists are supposed to drive to the town of Hana, turn around and drive back because past Hana the road becomes more dangerous. We were told some rental car companies make you sign a paper saying you will not drive past the town. Ours did not. We spoke with some locals and they encouraged us to keep going past Hana, saying it wasn’t that bad. Being the rebels we are, we decided to go for it. We had already faced danger along the way.

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Driving past the town of Hana did make my heart skip a beat on more than one occasion. The guard rails on the ocean side of the road were rusted and crumbling apart. The volcano side had a flimsy net that was supposed to serve as some sort of protection from any falling rocks. I am pretty certain it would protect us as much as the guard rails. The road became very narrow and unpaved. We bumped and jerked and shook along the way.

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But the beauty. Oh the beauty. It was breathtaking. We had left early that morning, but found ourselves racing the sun on the last leg of our journey. As the sun was going down, we were both painfully aware of the plethora of twists and turns on the unpaved, unlit road. We could not go faster, we could only hope for the best. The race was on –

and I was scared.

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*This is part two of a now three part blog series.

 

 

 

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A Short Story about My Near Death Sandwich: Part One

The first slice of bread

Have you ever had a moment you thought may be your last?

In that moment, your mind takes off in the direction of all of the “what if’s” and you begin to feel like every part of you is being covered with a heavy blanket of anxiety. You feel like you may suffocate from the weight of it. Do you know what I am talking about?

Have you had that moment?

I have.

I wish I could say in that moment when my mind was all “what iffy” and the endless stream of possibilities were making laps around my head like race cars on the Indianapolis Motor Speedway that I was perfectly calm and not all sweaty and suffocatey feeling.

I wish I could say that, but I already told you – I was covered in an Is-this-the-End blanket of anxiety.

Not once – but twice.

The first time was at the very beginning of a vacation of a lifetime – a trip to Maui with my sweet husband.

The other was at the very end of that same vacation.

The vacation is now what I like to think of as My Near Death Sandwich – with both crazy experiences being the slices of bread and our amazing trip being all of the good stuff in the middle.

I have a gluten sensitivity, so it’s not a big surprise that my brain came up with this analogy. Bread has never really been good for me.

Anyways – to fully appreciate where I am going with this, let’s start with the first slice of bread.

The ancient airplane

Patrick and I arrived at the airport bright and early, eager to board the plane for our trip to Maui. We hadn’t slept much, but that was fine because we were heading to Maui for nine days of bliss. We would sleep later.

The first leg of our trip was uneventful (as you want your plane rides to be.) We flew to Dallas and enjoyed some breakfast during our layover while we waited to board the plane that would take us the remainder of our way. An eight hour flight to paradise.

Sometimes, when you’ve been up pretty much all night and it’s 7 am in Dallas and you have already had one flight – you make weird faces

I was excited to see what our plane would look like. I had never traveled for that many hours and was confident it would be something luxurious. I imagined it to be a little bigger than the usual plane – with personal televisions and Wi-Fi – a souped-up plane with all of the amenities.

I boarded the plane, looked around and thought, “This is the plane? This is what we will be in for the next eight hours? What? This plane looks like it may have been the first commercial plane. Ever.” All of my WiFi dreams came crashing down in an instant.

Let me paint a picture of our plane for you……

The plane came with ashtrays. You couldn’t open them. They must have been glued shut or something, but still…..ashtrays. How long ago could people smoke on planes anyways? I know I could Google this and find out, but I would rather just ask the question for effect.

And it wasn’t just the ashtrays. It was also the TVs. Yes, it had TVs (so that was a plus), but these were not the cute little personal screens I had dreamed of. These looked like they were modeled after my first ever computer – the Commodore 64. Seriously. They were small, sturdy boxes hanging from the ceiling. The screens were surrounded by a thick off-white border (teetering on the verge of yellow – maybe from all of the years of smoke exposure it had endured.) You know, like the good ‘ol TVs from the past – big and bulky. The opposite of a flat screen.

Oh well. My disappointment quickly passed. So what if it was an old plane? This old plane was transporting us to paradise. I could live with the ashtrays and the sturdy TVs. I am a reader anyways and had brought my own mini library along – a bag full of way more books than any person could read in nine days.

Patrick and I settled in to our seats. We enjoyed a snack. I even watched a movie on the old-time television. A funny one that made me laugh out loud. I read a little and began to do some work. This flight wasn’t so bad after all.

The heat

As I was working, I started feeling hot. It came on quickly and as the heat was rising, it felt like someone was taking all the air out of the plane. It was hot and stifling, like an intense summer day when there is no air movement and you long for a slight breeze to bring a little relief.

Was it just me? I am too young for hot flashes. I know they are around the corner, but I’m not there yet.

I looked up to turn on the air vent and didn’t see it. I saw the light, but no air vent. I must be missing something. I asked Patrick to help me with the air flow and he didn’t see it either. Of course the plane from 1960 didn’t have air vents. What was I thinking?

I touched the window and it was hot. Burning hot. Like fry an egg hot.

I had to get up. Now.

I wasn’t feeling well.

As I got up and began to walk toward the back of the plane, I realized it wasn’t just me. People were beginning to take off layers, they were fanning themselves, some people were beginning to look around uncomfortably and a lucky few were still asleep.

Something was wrong.

The flight attendant who was sitting in the back of the plane was reading a magazine and eating ice. Very nonchalantly. Wasn’t she feeling this heat? This must be flight attendant protocol. Rule Number One: always remain calm. Never panic or look even slightly phased.

I walked up to her and she raised her head from her magazine with her eyes peering at me over her reading glasses. She smiled.

What I wanted to say was, “Is this normal? I don’t think this must be normal. How hot can this plane get? What is the plan here?!” But I couldn’t say that so I said, “I think the plane feels hot. Is it hot in here?”

Calmly, with a slight southern drawl she said, “I know honey. We’ve had some complaints. Something is wrong with the air. The pilot called it in.”

Ok. My mind takes off like a rocket – Something is wrong with the air? What does that mean? We are an hour over the ocean. What do we do? How hot will this get? How hot is too hot? We can’t open windows. There is no air. What do we do?

“I’m just going to stand back here for awhile if that is okay,” I said.

“Sure honey.”

As I’m standing there, more and more people have the same idea and the back of the plane is starting to fill with people who are wanting to know what is wrong.

“It’s hot in here” and so on and so forth. Her response is always the same. “I know honey. Something is wrong with the air. The pilot called it in.”

Not too long after we have all gathered, a cooler is opened in the back of the plane so that people could stand by it to cool off. Temporary relief, but not a solution. I was still very hot. I was wearing a dress with leggings and realized the leggings were only a hinderance at this point, so into the bathroom I went to remove anything that could help me to cool off.

I realized I could not stand back there for the remainder of the flight, so I reluctantly made my way back to my seat. I was trying not to pass out, or panic. The last thing needed in that type of situation is for someone to start panicking. There was an overriding sense of people trying to keep their cool – literally. I knew I needed to keep it together and try my best not to vomit or do any of the other things that comes with feeling incredibly hot.

The flight attendants began to push carts around offering whatever comfort they could to the passengers. Even though they were pushing around the carts that were supposed to make people feel a little better, the male flight attendant couldn’t help but to grumble about his long sleeve shirt. I couldn’t blame him. I would grumble too. He was dripping in sweat and his face was bright red.

We still hadn’t heard from the pilot and were making our way across The Pond in this oven in the sky –  headed in the opposite direction that I would like to be heading. After what seemed like way too long – the pilot’s voice finally boomed out from the speakers to let us know the plane was hot and they were having some difficulty with the air. Hmm. Really? He went on to say that it was well over 90 degrees (I believe from the way that we were all feeling that means into the 100s….but he probably couldn’t say that) and it had been decided we would turn around and fly back. Because of the storms in LA, we are headed to San Francisco.

Thank goodness.. I did not want to continue over the ocean any longer in this plane. Unfortunately, the gentleman behind me (who may have started celebrating a little bit early…if you get my drift) did not feel the same way. He was determined to get to Maui and said if we could all just start taking off our clothes, then we could make it. He became his own Maui Flight Pep Rally. He said he was going to talk to the pilot.

Oh no.

A minute later he was back in his seat. Thankfully his talk with the pilot didn’t go as he had planned. I didn’t think it would. The idea of all of us getting naked didn’t seem like something American Airlines would go for. It wasn’t that kind of flight.

We were turning around and I was ecstatic, but still covered in that anxiety blanket of what-ifs and how-hot-is-too-hots and all of that stuff that comes to mind when you are in a plane over the ocean and that plane keeps getting hotter and hotter.

I closed my eyes and began to pray. I prayed for peace. I prayed for my family. I prayed for the people on the plane. I prayed.

The red-faced, sweat-covered flight attendant came back around. I asked him for water and he handed me ice – never acknowledging my request for water. I realized they must be out, or something like that. I didn’t ask, I just took the ice and started eating it and rubbing it on my forehead. The man behind me was persistent and determined and started to ask him why we couldn’t just go to Maui? Couldn’t we endure the heat? The flight attendant calmly reminded him there were elderly people, infants, children with asthma and pregnant women on the plane and they were not going to wait to see what would happen to them.

That was the last I heard the man behind me talk about enduring the heat to get to Maui.

As we turned around and headed toward California the plane did cool off a bit. Not much, but a little. I spent the rest of the flight with my eyes closed. Praying. Thinking. Holding on to Patrick’s hand and realizing that everyone will have a moment that really is their last. Whether this was my moment or not, that moment would eventually come. I became very introspective during the end of the flight and determined to make the most of my life. I felt my blanket of anxiety being replaced with a blanket of peace. I wish I could say that happened the minute something went wrong on the plane, but it didn’t. I got there eventually. It just took awhile.

It’s funny how those anxiety blanket moments are usually blessings in disguise. Like most of life’s challenges.

This is already long, so I won’t bother going into detail about the going up and down as we were supposed to be descending. Or the fact that toward the end of the flight the plane started beeping – and wouldn’t stop. Not a normal beep. More like a warning. Or the fact that when we left the plane the pilot was sitting in the first row of First Class staring at the seat in front of him. He wasn’t standing at the cockpit waving and telling us goodbye. He was sitting there. Staring. Straight ahead. He didn’t look well. I think he was as happy as the rest of us that the plane had landed safely on solid ground.

We walked out and felt the cool air – I had never been so grateful for cool air. I felt an enormous amount of gratitude in that moment. Deep, all-consuming gratitude.

Our trip was starting out differently than planned, but that’s how much of life is. We would get to Maui eventually. But for now, I was just happy to be anywhere at all. I was on solid ground, with my sweet husband, and I could not wait to call and talk to my children.

Many are the plans in a man’s heart, but it is the Lord’s purpose that prevails. Proverbs 19:21

 

 

*This is part one of a three part Blog post.

 

 

 

 

 

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