Part I  – Is this Normal?

Sara and Matt had a loving relationship and successful careers. With the birth of their daughter Kayla they felt their lives were complete. Kayla was a thriving1, beautiful, fair skinned baby with   sparkling blue eyes. Within the first few weeks of life she grew at an astonishing rate, developing the gentle, soft curves that make babies so lovable. Then suddenly the fairytale existence of the new family abruptly ended.

By the time Kayla was six weeks old her eyes were continually filled with tears. She cried throughout the day and most of the night. Kayla began to run intermittent2 fevers and Sara noticed that she had a lump that would periodically bulge from her groin. Motrin and Tylenol seemed to take care of the problem. Despite the use of cloth diapers and meticulous cleaning, Kayla also developed a raw redness and peculiar rash. Sara repeatedly called the pediatric nurse but she seemed to act as if Sara was just being an overly anxious new mother.

The physician, Dr. James, was not much more concerned. “I think it’s important for you to get back to work, so you have more diversity in your life. Kayla’s crying is most likely the result of colic3 causing her to experience indigestion. The rash is probably simply from not changing Kayla’s diapers enough. You may want to try some A&D ointment.”

Sara felt totally inadequate as a mother and vowed to do all she could to meet the needs of her daughter.
Sara began a bland, but balanced diet and routinely changed Kayla’s diaper every 30 to 60 minutes throughout the day. Sara noticed that her daughter’s diapers were never soaked and often were coated with a thick yellowish discharge4. This too was brushed off by one of the group pediatricians as probably due to a normal vaginal discharge caused by the withdrawal of maternal estrogen stimulation. When Kayla continued to cry and the rash worsened, Sara again called the doctor’s office.

“Continue to use the A&D and leave Kayla diaper-less for several hours a day,” the nurse advised.

Again Sara obliged. Kayla’s crying worsened and even her seasoned5 grandmothers were reluctant to hold or watch her. Sara decided to postpone returning to work for a year so that she could take care of Kayla.

By the time Kayla was three months old both she and Sara looked haggard6. The constant crying and sleepless nights had taken a toll on them. Matt insisted that they go to see the doctor. Kayla was no longer gaining weight or growing, and the groin bulge was now prominent enough for the doctor to acknowledge an inguinal hernia. Sara and Matt felt relieved, believing that this was the source of their daughter’s problems and the end to a nightmare existence, though they were worried about their daughter needing surgery.

“This type of surgery is routine,” Dr. Broward, the surgeon, said reassuringly. “It’s a simple, uncomplicated repair. When Kayla recovers she will feel much more comfortable.” The surgery went without incident and Kayla came home the next day, but the crying continued.  In fact, if anything, she seemed worse than before the surgery and now she was hardly taking in any nourishment.  Sara found that again Kayla was running a fever. She called the pediatrician, who advised her to call the surgeon. The surgeon felt that Sara was probably holding her too much and that the fever was unrelated to the surgery.

Sara was finally convinced by her mother that she needed to see a different doctor for a second opinion, so she found a doctor in a nearby town and managed to get an appointment.  By this time Kayla’s fever was climbing and her once pale skin was now a bright red.  In the waiting room, another mother made a comment to Sara, “you should really keep your baby protected from the sun.”   Sara again felt victimized and began to wonder if she would ever find anyone able to determine the cause of Kayla’s problems.

Questions

1. What symptoms has Kayla exhibited over the first months of her life?

 

2. What treatments were suggested by the nurses and physicians when the symptoms first appeared?

 

3. What is a hernia and why would this have been the source of Kayla’s medical problems?

 

4.  What was Sara feeling “victimized” by the ordeal?

 

5. For each of the underlined and numbered words in Part 1, suggest a short definition based on the context. If you are really stuck, you can google a definition but try to put it in your own words.