寶寶的第一次呼吸

Made in His Image: Baby's First Breath.
By Guliuzza, R. 2009. Acts & Facts. 38 (12): 10-11.

In 1967 Dr. Christiaan Barnard performed the first heart transplant. Until that time, if someone's heart was taken out, they died. People were astounded to learn that not only was a man’s heart removed, but a non-beating donor heart put in, restarted, and he lived. Years of design efforts and testing resulted in a sophisticated invention that circulated blood and functioned as patients' lungs to bring them oxygen--the all-important "heart-lung" machine.



No doubt in the same hospital in 1967 was a brand-new mother. Her baby had just made a similar transition of survival on an exceedingly better "lung machine," but no reporters covered it. Although the first event was a great feat of human engineering, the second has never been explained by any natural process.


Childbirth is so common it is easy to overlook the fact that a baby thrives in a total water world for nine months--a world that is utterly impossible for any person to live in immediately after their very first breath. That feat is accomplished by the baby possessing--only in the womb--blood vessels with a different arrangement and structure than an adult's.






The Adult Circulatory Arrangement

In an adult human heart, the bottom two chambers, the ventricles, do most of the higher pressure pumping, pushing the blood through one-way valves away from the heart through arteries. The upper two, the atria (plural of "atrium"), receive blood under low pressure from veins and rapidly preload the ventricles by pushing blood into them, also through one-way valves.


The heart is also divided into left and right halves, separated by a solid wall of tissue called a septum. There are two circuits for blood flow from the heart: one to the lungs and back, and one to the body and back. The right heart starts blood on its circuit to the lungs, where less-oxygenated blood picks up a new load of oxygen. The left heart pumps freshly oxygenated blood at "normal" blood pressures (much higher than the right side) to the rest of the body.


In adults, oxygen-rich blood travels away from the heart through arteries under high pressures, and oxygen-poor blood flows toward the heart through veins under low pressure. Clearly, the heart and lungs are completely codependent in accomplishing the purpose of getting oxygen to all places in the body.






The Fetal Circulatory Arrangement


For a baby in the womb, almost everything about those vital functions is just the opposite for one important reason: the baby develops fully functional lungs that are yet inactive for oxygen exchange. Consequently, in order for a baby to survive, three major structural differences must exist that enable life in his temporary home.


First, the baby must have a substitute lung--a pretty tall order for even brilliant biomedical engineers. The placenta, a remarkable organ, has a brief existence, but it fulfills a myriad of vital functions--especially as the fetal lung and kidney. Second, the circuit to the lungs must be bypassed, so vessels must change to allow this temporary detour. (A new route that detours around a circuit is called a shunt.) Third, blood vessels must not only connect placenta to baby, but also inside from the point of attachment to normal vessels that lead to and from the heart. The umbilical cord meets the need for a placental-fetal connection, with one large-diameter vein and two smaller arteries. Inside the baby, these continue as the umbilical vein and umbilical arteries.






The umbilical vein carries oxygen-rich blood toward the heart. At a spot next to the liver, it connects to a large vein carrying less-oxygenated blood back to the heart. Interestingly, the two combined streams of blood do not tend to mix. It just happens that when they reach the right atrium, the more oxygenated blood stream is adjacent to a temporary opening in the septum, where it passes through to the left atrium because the blood pressure in the right side of baby's heart is higher than the left side--the opposite of the post-birth situation. The right heart still pumps blood to the lungs, but because the lungs have not yet expanded, the resistance to blood flow is very high and, therefore, the pressure is high. Some blood does make it to the right ventricle (about 10 percent) and flows through the lungs, which is the right amount to meet metabolic needs but not for oxygen-carrying purpose--which does not yet exist.




The temporary opening has a piece of septum tissue over it that is located in the left atrium. Thus, it acts like a "trap door" valve so that high pressure on the right side can push it open with each beat. In adults, it would make no sense for the artery carrying oxygen-poor blood to the lungs to connect by a big blood vessel to the artery carrying oxygen-rich blood (the aorta) to the body. But the baby does have this big connecting vessel in order to bypass the lungs and send oxygen-rich blood from the placenta to the body. Most of this blood travels to the part of the body with the highest oxygen demands--the growing brain.


So baby is content in the womb with temporary umbilical arteries and vein, a temporary opening in the septum, the temporary pulmonary artery-aorta shunt vessel, high pressure in the lungs and right side of the heart, and low pressure on the left side. With the onset of labor, culminating in delivery, that world is set to radically change. However, crucial mechanisms are built into the temporary structures that enable a safe transition out of the womb.






Vital Circulatory Changes Occurring at Birth


The umbilical cord vessels have features that respond to changes in quantities of oxygen dissolved in blood, stretching, substances commonly called adrenalin, and trauma. Obviously, during delivery and the severing of the cord all of these are present. The cord, which has an unusually strong muscle layer surrounding the vessels, reacts with a rapid and powerful constriction of the arteries and vein that is complete in less than a minute. This stops blood flow to and from the placenta, which has two effects. It greatly reduces the risk of either baby or mom losing a lot of blood and also causes an immediate drop in the amount of oxygen baby is getting.


Very sensitive sensors--inside certain blood vessels measuring carbon dioxide content, and also on the skin detecting temperature drops--stimulate the nervous system's breathing center. Under normal circumstances, increased carbon dioxide blood levels coupled with decreased body temperature after exiting the birth canal trigger an irresistible urge for baby to take a strong breath and inflate his lungs for the first time. The lungs have been prepared for this event by special cells producing a compound called surfactant, which significantly reduces the tension holding non-inflated lung tissues together--otherwise, forces required to open the lungs would be too high for almost all newborns to accomplish. Once inflated, pressures necessary to pump blood through the lungs drop 90 percent from their intra-womb high values.






Thus, pressure in the right side of the heart immediately drops well below the pressure in the left side. The "trap door" valve (actually two flaps of skin that neatly fold and interlock when pushed together) covering the septum's temporary opening in the left atrium is pressured shut. Cells begin to grow over the edges of the valve, fusing it to the septum. Less than a minute after birth, signals from baby's nervous system cause strong sphincter muscles to close off the umbilical vein where it attaches near the liver and also close off the temporary pulmonary artery-aorta shunt. (That large vessel permanently closes over the next one to two days.)




The baby's body has started all changes that continue through adulthood. During the next year, those internal umbilical vein and arteries transform from blood vessels into stabilizing ligaments. So in the one critical minute after delivery, the baby's body has initiated actual structural changes enabling it to survive in its radically different environment with all temporary vessels, shunts, and openings functionally closed in the first 30 minutes.


Conclusion


The reality of fetal to newborn circulatory changes is this: structures indispensible for life in the womb are incompatible with life out of it, and at birth all structures are rapidly reversed, resulting in the opposite effect on survival. In either case, if the offspring dies, evolution ends. Darwin wrote, "If it could be demonstrated that any complex organ existed which could not possibly have been formed by numerous, successive, slight modifications, my theory would absolutely break down."1


Consider it broken...if not a catastrophic failure. Why? Given that a transplanted heart living inside someone is truly an incredible achievement--at what level of accomplishment is getting a whole person to live inside another person? Absolutely incredible--which is what the Lord Jesus Christ is! As clearly seen, He creates, He directs, He provides, He cares--indeed, everything He does is beautiful beyond description.

Reference

1.Darwin, C. 1859. On the Origin of Species. London: John Murray, Chapter VI, 189.

Will & Selene's Baby Shower

今天晚上我們在Orchard Park Community Center為Will和Selene即將出生的小寶寶辦了一個 Baby

Shower, 來美國這麼多年了,這卻是我第一次參加 baby shower呢! 大部分的台灣朋友們還是習慣

等寶寶出生滿月後再辦滿月酒, 不過我覺得baby shower這種老美的玩意其實很有意義, 跟bridal

shower一樣, 在朋友即將步入人生另一個重要的階段前, 大家齊聚一堂,獻上最真誠的祝福, 我想

肚子裡的小寶寶一定也能感受到大家的期盼與愛吧! 而美國人的習慣通常是在baby shower之前,

準爸媽會在網路上的店家進行 gift registry, 選定一些他們想要的禮物, 朋友們就可以根據這個清

單決定要送什麼禮物給準爸媽. 就跟結婚前一樣啦, 這樣不但可以省去挑選禮物的煩惱, 也可以

避免買到重複的禮物, 根據準爸媽的需求送給他們最需要的東西!　


這次因為時間比較匆促, 所以Will他們並沒有做baby registry, 不過大家還是帶來很豐富的禮物喔!

參加的朋友也好多阿! 幸好借了community center,不然在家裡辦的話一定會擠不下! 團康高手永

遠的主持人永信也準備了刺激又有趣的活動, 從尿布裡的驚喜到以baby為主題的小隊對抗賽, 大

家玩得超high的! 謝謝永信和凱尹精心策劃的活動, 也謝謝Will & Selene為大家準備了豐盛的晚

餐和小禮物~


藉這個機會和許久不見的大家見面聊天也超開心的! 不然每天的生活圈只有家裡與實驗室, 都快

發霉了~~ 還是好懷念以前每個星期五/六晚上的紅酒趴阿...跟好朋友一起聊天喝酒打麻將真是

紓壓的好方法!


Will和Selene的寶寶出生後,他們一定也會忙得昏天暗地, 暫時不能常常和大家一起hang out囉! 今天聽

Will 說他們去上產前衛教的課時, 那位女醫生告訴他們說生產的痛苦會比你想像的再痛苦十倍! (據說

聽到這準媽媽們的表情都凝結了...)



但是, 小孩所帶給你的快樂, 卻會是你想像中的一百倍!!!

(這時新手爸爸奇芊在一旁洋溢著幸福的表情,以過來人的姿態猛點頭說"真的!真的!")

(然後Will就吐槽他說 "阿你又沒痛到....又不是你生的....")


用十倍的痛苦換來一百倍的快樂, 怎麼算都是非常值得的投資阿!!

看身邊的朋友紛紛結婚生子, 一個個"家庭"正在誕生, 只是身在他們周圍, 都可以感受到那強烈的緊密

的力量, 家庭,真的是可以支撐一個人奮鬥努力的最大支柱與動力呀! 尤其是小生命的誕生, 總讓人充滿

無限的希望.


祝福Will & Selene, 祝福奇芊&小黃, 祝福姊姊&姊夫, 祝福所有已經或即將擁有新生命的朋友們, 願光與

愛永遠圍繞在你們身旁, 願每一個小天使的降臨, 都讓這世界更美好!

2009 is not my year...what about 2010?!

我很少下這種武斷性的結論,或是用"衰"來形容自己的遭遇. 生活總是有起有落,而一向樂觀的我也總相信命運掌控在自己手上, 一切總會有轉機. 但是最近的我, 真的已經到了一個臨界點. 心力交瘁, 甚至開始有玉石俱焚的念頭.

從2009年中開始, 身邊好友開始紛紛離開, 然後九月, 眼睜睜看著死神從我面前奪走心愛的貓貓. 接下來又是一連串紛爭的開始. 和實驗室的好友因為莫名其妙的小事鬧的有些不愉快, 然後樓上和隔壁新搬來的鄰居開始不停的製造噪音,溝通無效, office和警察都找過了還是一樣, 非得要我忍無可忍衝進去跟他們吵架,只差沒真的打起來.

除了實驗的不順, 工作上的壓力,連晚上回到家都不能好好休息. 這世界是怎麼了?

每當我開始想要振作,開始告訴自己不要陷在負面的情緒裡頭, 開始試著相信生命是美好的, 就會有另一塊大石頭掉下來把我壓得死死的, 又把我推回絕境.

我真的不知道我還要忍受多久, 還可以忍受多久

還有什麼

一起來吧

通通來吧

就不要逼我變成惡魔

新的一年，晴天會來臨嗎?

我告訴自己
未來的這半年
再怎麼辛苦 再怎麼痛苦 犧牲什麼
都無所謂了
這是我能為自己當初的夢想所做的最後一搏
結束後
我就要頭要不回的離開實驗室

因為
我不屬於這裡

給你，貓貓

天氣變涼了
你走後的第二天七點不到，我就自動醒來
清晨的天光從百葉窗的縫隙微微透進來
伴隨著 阿 阿的烏鴉叫
這是秋冬來臨的訊號
烏鴉又回來了

你在秋分的這一天離開了
這樣也好
你享受了北加州最後一個夏天 金黃飽滿的陽光
你最喜歡躺在後院的地上懶洋洋的翻滾著 曬太陽
或是在夏夜晚風中到屋後的play ground及草地上玩耍

你不用再經歷又濕又冷的陰霾冬天
像是上一個冬季
滂沱大雨中的那天
我們看見你痛苦的縮在牆角 喘不過氣來 又拒絕吃藥
那天 布魯斯還冒著大雨 全身濕淋淋的跑來探望你
只是我們沒讓他進來
他是否也知道他的好朋友正在和生命拔河呢？

你知道嗎?
Yolo Fruit Stand旁大片的向日葵花田已經收割 了
濕地開始變得熱鬧
鳥兒們紛紛來到這個驛站休息停留
不久之後這裡將會是一場盛會
天光映在水潭裡 加上蘆葦的倒影
這裡總是我每天必經的路上 最美麗的風景之一

你會知道嗎
你看得到這些美麗的風景嗎
你眼裡看到的世界又是如何的呢?
你是否在天上 也正看著我所經歷的一切呢?
我要幫你看 幫你活 你來不及享受的美好

今天我會去見你最後一面
再看一眼你可愛的模樣
如果可以 再撫摸一次你那令我愛不釋手的毛

然後我會帶你回家
你就可以永遠徜徉在你所熟悉且喜愛的Russell Park了
貓貓 請讓我堅強

I love you, forever....

親愛的貓咪寶貝

你好乖，好貼心，你永遠是媽咪心中的寶貝

今天晚上8:40的時候

我們讓你當貓咪天使了

在那個世界裡，你可以像小時候一樣跑跑跳跳

追逐玩耍、匍匐前進、抱抱踢踢

媽咪多麼想念你撒嬌的喵喵聲

想念你柔軟舒服的毛

想念跟你碰碰頭，看你瞇起眼睛舒服的呼嚕嚕

想念你可愛的大眼睛與端正坐在廚房等餅乾吃的模樣

想念你的鯊魚尾巴

想念你的抓抓

想念你的白領巾與白手套

想念你睡覺時翻過來的白肚肚

想念抱著你跟你親熱的時光



你有沒有感受到我滿滿的愛呢

媽咪沒辦法給你一個新的心臟

但是媽咪承諾要守護你一輩子 悉心呵護照顧你

我沒有食言喔

不要害怕 不管你到哪裡 我一直都跟你在一起 陪著你 保護你

你帶給我們的快樂是無可比擬的

你是人見人愛的可愛貓咪

你融化人們的心 化成飽滿的愛



希望你永遠在慈愛的光輝裡

平安 健康 快樂

希望你能夠再回來陪伴我

因為我對你的愛 沒有盡頭

奧修禪卡 - 雷電

天是農曆七月十五中元節，月亮比昨天更亮更圓呢～ 連貓先生都跑到到外面草地上去慵懶地趴著欣賞月色。今天白天很熱，入夜後卻涼得很快。我在playground跟貓先生玩了一會兒後就自己盪起鞦韆來，邊盪邊欣賞月色。真是奇妙呢，一樣的月亮，怎麼昨天和今天看起來就是兩種截然不同的心情呢? 昨天孤苦無依的悲傷難過，現在雖不能說完全消失無蹤，但只剩下心底淡淡的痕跡了。

我不能逃避孤獨的感覺，越逃避就越是害怕。寶寶和好人都在的時候我很依賴和你們相處的依存感，以致於漸漸失去獨處的能力，就算獨處也僅只是短暫的。現在必須面對只有自己的時候，習慣性的尋找依託，當發現依託不在，便開始失落與恐慌...。我必須正面面對自己，當害怕出現的時候，好好看著它、經歷它，徹底的去體會它，唯有如此，才能脫胎換骨、浴火重生。

奧修禪卡真的很奇妙喔，我昨天抽了一張，結果抽到的是主牌XVI「雷電」。書上說，在抽牌讀牌當中如果有主牌出現，它具有特殊的意義，它告訴我們說我們目前的情況給了我們一個機會去檢視我們個人心靈旅程的核心主題之一。它也可以告訴你說有一些重要的改變在進行。

而當我閱讀關於這張卡所要傳達的訊息時，發現它真的是直接碰觸到我當前最重要的課題呢～

這張卡顯示出有一個塔被燒毀了、被摧毀了、被吹散了。有一個男人和一個女人從塔上跳出來，並不是他們想要這樣做，而是因為他們別無選擇。這個塔的背景是一個透明的、靜心的人像，代表觀照的意識。

現在你可能會覺得搖晃，就好像地球在你的腳下搖動，你的安全感受到了挑戰，自然的傾向就是試圖去抓住任何你所能夠抓住的，但是這個內在的地震是非常需要而且非常重要，如果你讓它發生，那麼在經過那些破壞之後你將能夠從殘骸中浮現，而且變得更強壯，更有能力去面對新的挑戰。在火燒之後，大地會再被補充；在暴風雨過後，空氣會變得更清新。帶著超然的心情來看那個破壞，好像它是發生在別人身上。對那個過程說「是」，接受那個過程，勇敢地去面對、去經歷。

很美的訊息，不是嗎?