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Nursingmatters September 2017 • Volume 28, Number 8

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Miranda and Brad London are seeking help as they deal with the costs of adoption after failed attempts with in-vitro fertilization.

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On ,youcaring.com Brad and Miranda London say, “We want our little one to know how loved and how unwavering our desire is to be someone’s mom and dad. We are creating a baby quilt and would like to include all who are able to donate to welcome our new baby and wrap them in the love and support we have — near and far.”

WOCHIT/USA TODAY NETWORK-WISCONSIN VIA AP

Brad and Miranda London are looking for help with the heavy costs they have faced while trying to start a family.

Nurse aims for kids despite struggles ‌NATHAN VINE Stevens Point Journal via AP Associated Press‌

PLOVER, Wis. (AP) — Miranda London knew her path to becoming a mother would be unconventional. As a 17-year-old at Stevens Point Area Senior High School, London — then named Miranda Sexton — was diagnosed with gonadoblastoma, a form of ovarian cancer so rare that at the time doctors were able to find only one other person her age who suffered

from it, USA Today Network-Wisconsin reported. The cancer had been caused when female cells divided abnormally, with one or three X chromosomes in some cells rather than the normal two. Surgery removed the cancer, but also Miranda’s ovaries and fallopian tubes. At the time the concern was less about the future than about returning to a normal life. During the early stages of recovery, Miranda was unable to lift her arms and needed assistance to walk up and down the driveway. With support from family and friends, she returned

to school in just a couple of weeks. She eventually went back to playing basketball and softball at SPASH. Now 31, she lives in Madison with her husband, Brad London, and works as a nurse in the neonatal intensive care unit at St. Mary’s Hospital. It’s a career path based in part on her experience as a teen patient. “I longed for a family and chose to be a (neonatal intensive care unit) nurse where I care for the most fragile babies and their parents during the long and desperate hours of

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September • 2017

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Nursingmatters

What if ...

More than $1 million can be saved Brenda Zarth

My girlfriend was reporting that her hospital is looking at budget planning for the next year. Because there is a nursing shortage they are pulling back on registered-nurse Care Coordinators to work as staff nurses. I was dismayed by this but in a roundabout way it reminded me why I love nurses. When threatened Brenda Zarth with losing something you love, you hold on tighter. I see nurses as the best resource for the future of our health-care system. The training that Care Coordinators receive prepares them to make a real difference in the lives of complex patients. They can save a tremendous amount of money by keeping patients out of hospitals and improving their overall health. I would love to see all triage nurses receive the additional education and tools that Care Coordinators are receiving. Triage nurses are in the front line of health care; the information we gather can help direct the care of our patients. If our patients are calling the clinic in stress, it makes sense to me to have a good triage nurse listen to the stories and help decipher how serious their concerns are. They can help patients decide what they want to do. I like to give patients options, listen to their feedback and help them decide next steps. They are usually scared, stressed and having decreased ability to cope. Often it’s their fear and stress that causes them to call and worry they have cancer or some other horrible disease. They read something on the internet. Or a friend of a friend was recently diagnosed with a cancer and she feels pain in the same spot. As they are talking I am listening for trends and patterns. I try to see if there is a story behind their words. A few years ago I had a patient call in asking for a refill of her anxiety and pain medication. She was having migraines again. I asked her the questions I ask of all my patients. When did this start? How severe are the headaches? Are you having any other symptoms? As she was answering my questions, I was checking when she had last taken the medication. I noticed she had not had pain or anxiety medication for about five years. When I ran out of routine questions and she finished her answers, I said, “Please excuse me for asking, but did something happen that you needed these medications in the past and now you need them again? How did you get rid of the migraines and

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A patient asking for a refill of anxiety and pain medication might actually need counseling instead.

We are looking for freelancers to write articles and feature stories, as well as take photos and videos, for this publication. Prior writing and/ or photography experience, and nursing knowledge, are required. Please send resume, writing samples and photography samples to nursingmatters@madison.com with “freelancer” in the subject line.

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Unresolved emotional and psychological trauma can come out as pain. Unless we deal with the true cause of suffering it keeps resurfacing.

anxiety five years ago?” She said seven years earlier when her family was fishing, her husband reached over the side for the bait bucket. He was drunk; he fell overboard and drowned. He left her alone with two small children. I said, “I’m sorry. That must have been awful.” She said it was okay. It had been a long time ago and he wasn’t a good husband. She said five years ago she met a wonderful new man and was able to pull her life back

together. At that point she didn’t need the medication anymore. But now her headaches and anxiety were back. She admitted that she was having some issues with the new relationship, plus her children were creating some stress. I asked if she had ever gone through any counseling after losing her husband; she said no. She said she hated to admit it but losing him was a relief because he was abusive and

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September • 2017

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What if

continued from page 2 they were better off without him. She said she was offered counseling but believed she didn’t need it. I said her story sounded painful to me. I said I was sorry for the difficult years of marriage with her husband. She said, “It was difficult.” I said it must have also been difficult to be alone. She said, “It was.” I said we each go into a marriage or a relationship with dreams and plans for a perfect life but it seldom works out as we planned. It usually takes a lot more work and is a lot more challenging than we expect. Timing, luck and opportunities often play a big part – but also lack of opportunity and unforeseen circumstances. I told her that unresolved emotional and psychological trauma can come out as pain. Unless we deal with the true cause of suffering it keeps resurfacing. She accepted my offer of a Behavior Health referral. She was ready to stop the cycle, and decided she didn’t need the medication right now. She could have scheduled an

appointment, and not mentioned her social and psychological history. She could have had a battery of tests because of her headache. But an MRI of the brain costs about $7,000. This woman needed counseling not medication.

I believe a good nurse triage could prevent the need for at least one CT Scan or MRI per month. During one year this nurse could save at least $84,000. Multiply that by 12 good triage nurses. That’s a savings of more than $1 million. Plus the

Struggles

continued from page 1 watching their newborn struggle to maintain life,” she says on youcaring.com on the couple’s page. The couple, married three years in October, sought to start a family, going through a donor-egg program and four failed attempts at in-vitro fertilization. That process resulted in a bill of about $60,000; the procedure is not covered by insurance. After taking time off, the Londons opted to pursue adoption. They are working with American Adoptions — a national nonprofit domestic adoption agency billed as one of the largest in the United States — and say there will be an additional cost of at least $50,000 to $55,000 to complete an adoption. The entire process has strained them financially. They have maxed out credit cards. They rent an apartment rather than own a home, and both drive vehicles with more than 100,000 miles — vehicles they hope will survive another year. Brad London, a deputy with the Rock County Sheriff’s Office, has pulled his share of 60-hour work weeks. The Londons have also on YouCaring.com created a fundraising page. “I think it changes your priorities,” said Brad London, 30. “Something you thought was important a few years ago is a lot different when you experience something like this. I think it’s been good for us and our marriage, to have these struggles and be

WOCHIT/USA TODAY NETWORK-WISCONSIN VIA AP

As a 17-year-old at Stevens Point Area Senior High School, Miranda Sexton was diagnosed with gonadoblastoma, a form of ovarian cancer.

able to lean on each other.” Beyond the expenses, Miranda London said the process of bringing a child home is exhaustive. Like other prospective adoptive parents, they’ve gone through meetings with social workers and a study of their home. They’ve had paperwork, parenting classes and background checks. Like other couples working with American Adoptions, the Londons have put together

video and text profiles that would be viewed by prospective birth mothers. “It’s been crazy, but we feel like there is more of a light at the end of the tunnel,” Miranda London said. “And we’ve been lucky to have so much support from people.” Their experience, including the lengthy and taxing process, isn’t rare. About 135,000 children are adopted in the United

patients would have been provided more appropriate care. Email BrendaZarth@gmail.com or visit brendashealthplan.blogspot.com with comments or questions.w

States each year. Organizations like American Adoptions are regulated by state agencies such as the Wisconsin Department of Children and Families. Wait times and costs can vary. American Adoptions, which focuses on domestic adoptions, says on its website that most adoptive families who join the agency first hold their new baby within a year. Adoption costs for families working with the agency averaged between $38,000 and $48,000 for 2015-2016, although the Londons said they would be prepared for a higher amount. Support for the Londons has come in the form of encouraging words, positive adoption experiences shared by others who have been through the process, and fundraising support by family and friends. Lona Sexton, Miranda London’s mother, said the support has been uplifting after a difficult few years. She’s watched her daughter struggle with fertility treatments, and in January 2016 Sexton lost her husband and Miranda London her father, Jerry Sexton, to melanoma. “They are excited again, and I’m looking forward to seeing them as parents,” Lona Sexton said. “Even when she was younger, when there was a fussy baby people could give (the baby) to Miranda and she would calm (the baby) down. Jerry used to call her a baby magnet.” Copyright 2017 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


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Nursingmatters September 2017