No TB for me!

As part of my return to work process, I had my annual tuberculosis skin test and I was sweating this one.

I was 7 months pregnant with my son when I decided it would be 'cool' to switch out someone's trach myself (instead of calling someone over from ENT). The patient was a recovering alcoholic and past IV drug user so I thought to myself, "hmmm, better gown up and put a mask on for this one." My senior resident actually rolled his eyes when I took these precautions. No sooner had I placed the new trach and started inflating the cuff, the patient panicked and started coughing through her stoma. Blood squirted everywhere, which includes drops landing on my face!!!

I forgot to mention that this patient had tuberculosis that was presumed to be dormant. As I tried to carefully wash the specks of blood away from my eyes I felt like the worst mother in the world for putting my unborn child in harm's way. . . again.*

Now that my boy is here looking healthy and I have this nice flat skin where the TB test was placed, I feel just a tiny bit better about calling myself a parent.

*I have a list!

A Quote From MedScape

"Obstetrics is a surgical specialty. So far, the significant numbers of women now practicing in the field have done little to change the surgical view of birthing women."

I didn't go into OB/Gyne so I definitely didn't help the situation, but I would like to have a discussion about this. The above line is from this article, which mentions an alarming statistic about the rate of maternal death rising.

I'll see if I can get more readers to review this information together. Should be interesting.

Curbside

When doctors 'curbside' each other, they ask for free advice based on the other's specialty.

One of the benefits of going to medical school is that I have several doctors on speed dial. In fact my son's pediatrician has been my friend for over a decade (I knew her in high school) and we chat about his progress about once a week, free of charge. I happen to have a good supply of urologist buddies, but I hope not to need them.

The other night I contacted my friend Liz, who is in opthamology residency. I was concerned because my son had a tiny hair just sitting on his eyeball for the past few days and I asked her what I should do about it. I was told to either leave it there or try some drops. I had to laugh when she said, "but if you do try wiping it out, don't freak if you scratch his cornea." - Oh, cornea schmornea. . .

Best of all, by talking to Liz I got to feel a LOT better about my situation. Like me, she has a son and had to resume residency with all of its hurdles. We empathised with each other in so many ways. I told her about my wardrobe fiasco, hating my abdomen with its persistent linea nigra, trials with breast-feeding, and difficulty seeing the light at the end of the tunnel. We didn't come up with any solutions, but I'm beginning to find that having an understanding ear makes a huge difference in my ability to push forward.

Maybe next time I go shopping I'll curbside consult a buddy of mine in psychiatry so that I don't get depressed when I see those Victoria's Secret models mocking me?

Mommy Makeover

I think I need to call Stacy and Clinton.

Almost every time I breastfeed I watch TV with the excuse of "what else can I do?" My thoughtful son has timed it so that his feeds coincide with What Not to Wear and I thank him for it.

Now I'm going to admit to something super cheesey, but true. I've learned so much from watching this show! There are a couple of episodes that really affected me. The first was of a young woman who couldn't get over how "different" her body had become and stopped caring about appearances because she thought she was a lost cause. The other was a young mother who had all sorts of excuses for why her outfits weren't that bad, like "I was just out for a quick errand." Both of these women were given makeovers and they looked gorgeous afterwards. You almost couldn't believe the before and after photos were of the same person.

As I sat there in my paint-stained shorts and over-sized shirt I had to examine myself. I started to say, "well, I'm going to be indoors most of the day. . ." but I knew I was falling into a trap. I also looked in the mirror and was appalled by how out of control my wavy hair had become (think Medusa).

I vowed to remedy things and styled my hair first, telling myself that I would wear it down most days and NOT in the classic resident pony-tail. I then went to put on a blouse and found that it didn't fit me anymore. NONE of my button-up shirts were working for me. I was relying on them and these nursing shirts from Old Navy. I suddenly realized I hardly have anything to wear when I start working again!

Now I'm scrambling to put together a Resident Mommy wardrobe. The requirements are daunting, I need clothes that:

• Look professional under a white coat
• Allow for easy nursing/pumping
• Disguise milk leakage
• Are affordable
  (bonus if they can be worn outside of work)
• Machine Washable
• Won't constrict me if I have to straddle a morbidly obese person to perform chest compressions (true story, while pregnant no less)
• Oh, and look flattering!

Will keep you updated on this one.

Aden & Anais Swaddling Blankets

Best summertime blankets EVER.

My son decided to come home from the hospital during the hottest time of the year. We received all sorts of cute receiving blankets, but they were way too heavy for swaddling in the summer. Then we discovered the Aden and Anais muslin blankets from Australia. They are super cute, soft, durable, and provide enough protection from the elements while remaining breathable. They also do the job of mosquito net or nursing cover.

I'm told they're popular among celebs, and were previously pricey but A&A now have a line with Target. YES!

I'll Shut Up Now

Throughout my pregnancy I kept telling myself that at least I didn't have it bad as my friend, Kate. The poor girl went through months of hyperemesis gravidarum then started her intern year of general adult medicine. She was put to work like you wouldn't believe, sleep deprived, and under an enormous amount of stress and pressure. After all that her maternity leave was short despite having to undergo a c-section.

The quote that will live in infamy was uttered by Kate's senior resident when her water broke during morning rounds and she was wheeled away: "Are you coming back?!"

Reflecting on my own pregnancy, labor, delivery, and recovery I've been thinking lately that I might not have it in me to do this again. It would seem even more daunting the second time around, knowing what I know now. So what news do I receive today? Kate is pregnant again and is due during her last year of residency. What?!

Birth Announcement

For the time and money challenged.*

I've heard of baby announcements taking over a month to produce and costing over a hundred bucks when all is said and done. I just ordered 50 of these prints and it cost me a whopping $5. The trick? Design your own image in whatever program you have available and upload it as a 'photograph.' My design was no fuss minimalism so it took me less than half an hour to construct it. Costco normally has the cheapest price, but Walgreens is currently having a sale online if you use the promo code: Summer50. Each print is only 10 cents.

I just received an e-mail notification that my prints are ready. Ain't technology grand?

*I blocked out his full name and date of birth to protect the young and innocent.

Dude, What a Diss

"Are you my mother?"

Remember that post about my sacred bond with my son during breast feeding? Well, this is a picture of Philippe mistaking the rounded end of a pillow for my bosom. He is trying his hardest to suck milk from it, even resisting me as I try to pull him away.

I felt like giving him that line from Beyonce's Irreplaceable: "Since I'm not your everything, how about I be nothing, nothing at all to you." Here, take your bottle! Two can play this game. From now on I'll spend time with my other child, Señor Pump-N-Style.

First Outing

Just the two of us.

I took Philippe out in his stroller today. I only walked a few blocks, but it was quite an adventure for me. Everything seemed different after being inside most of the day for the past few weeks. The first thing to surprise me was how weak I've become. I was told not to lift anything heavier than my baby until cleared by my OB, which happened only recently. So when I went to pick up the carrier it wasn't easy. Also, I didn't have practice using the stroller because of my restrictions so I'm sure it was very entertaining for my neighbors to watch me fiddling with this 'newfangled contraption.'

I felt really accomplished by the end. The best part is, I made a buddy! I spotted her down the block pushing her little boy in the same stroller and immediately I knew she was a new mom like me. We both had that what-the-#$%!-just-happened-to-my-life look in our eyes and uptight shoulders to disclose our status. As soon as we got within earshot of each other we started chatting. You could tell we were voracious for adult conversation and an understanding ear. In just seconds we discussed how our lives had been turned upside down, the anxiety that comes with breastfeeding, and the fear that we might never like our bodies again. The subject matter might not have been uplifting, but I felt so much better after that.

It's really funny to go from being a cool and confident woman in the face of things like a cardiac arrest and then nearly fall apart before leaving the house with a newborn. I know it's just a phase, though. What's more permanent, I believe, is this awesome sisterhood of which I am now privileged to be a part. Exciting.

Good & Bad News

I'll start with something lighthearted.

With my hormones all over the place, my hair has been just as crazy. The good news is that a lot of companies are producing travel size samples of their hair products. This way I can test what's out there without committing to a large bottle and shelling out the money when my hair needs keep changing. A satisfying discovery for yours truly, FroboCop.

Now on to the big stink-o. I was saddened to think I'd have to go back to work on Monday, August 3rd. Turns out one of my 'sick days' was applied to the 4th of July because, when you're on maternity leave, this is not considered a holiday. Thus, I'm due back on Friday, July 31st. -The last day of a one month rotation. Ugh! To top it off, because I didn't get my CPR certification during the month of June (when I gave birth), I have to pay $165 to obtain it on my own at a site that is far away from where I live.

My hair and I are about to go on a rampage.

15 Minute Etsy Hunt: Mobile

$32 by TalkOTTown


$20 by Hart's Desire


$32 by BuggaLove

Lots of cute stuff, except for this item. -There's not enough Ambien in the world to combat that one.

(This post is a follow-up to this one.)

We're all Peeing in Cups

The title is in reference to this earlier post and my mandatory drug test coming up.

In many ways this simple requirement encapsulates the rigid, unforgiving system of the medical career track. Just days after giving birth I received a request for my urine. Mind you, I recently had a mighty cocktail of benzos and opiods to get through 1.5hrs of post-partum repair. Add to that the dilemma of consistent bleeding from my nether region that is still an issue today.

I hope to see the lab tech's face when she gets a sample from what must appear to be a hemorrhaging heroin addict. -But hey, at least I'm meeting deadlines for residency!

So it Begins

I'm half way through my maternity leave now, just three weeks left.

What an awful feeling! The only good thing about this situation is that I was so anxious about the pain of going back to work after having my precious baby that I didn't have the time or energy to worry about labor and delivery like most new moms.

Today I had to check in with one of our program coordinators to make sure I was scheduled for the basic and advanced CPR re-certification classes. As I suspected, she goofed and I'm signed up only for the basic one. I'm not allowed to return to my residency until both are completed and a part of me was thinking "oh well, guess I just have to stay home with my son."

I was notified about this requirement just before going on leave. "Could you come back on July 3rd?" I was asked. I replied, "Hmmm, that would be just a week after I deliver. I don't think I want to be in an all-day class performing rigorous chest compressions and analyzing EKGs that soon after popping out a baby."

Duh.

Now I'm scrambling to find an ACLS class as late as possible, but before August 3rd. Just opening up my work e-mail and leaving messages with my residency coordinators to set this up made me feel the full weight of my residency obligations again. It's like I'm Wile E. Coyote, strutting along for a moment until I look down and realize there's been a pit below me, waiting to swallow me whole. Down I go.

Friend or Foe?

Jealous of a piece of plastic, a new low.

I pumped (what a weird experience, by the way) a couple of onces of milk this week and my husband attempted to feed our baby from the bottle for the first time. Instead of encouraging this process, I was quietly upset about being replaced. Feeding was our thing, something mommy and baby shared with no one else. Weaning off the breast also heralded the approach of my return to work. I know this is a necessary step so that baby can be nourished when I'm away, but I'm having a hard time accepting it.

My son, Philippe, took to the plastic nipple for a brief moment and then balked at it. -This means of course that mommy is superior! *Hmph*

(Someone, anyone, please help me deal. . .)

Etsy Bitsy Time Sucker?

I was introduced to the world of Etsy just a few weeks ago. I was enthralled by all the beautiful stuff out there and excited to have access to items that were far greater than the cookie cutter products sold in stores. Morever, since I lack a lot of the skill and time it takes to create these homemade goods, I thought Etsy would make my life easier because I could bypass the work and simply order what I want online.

But will it save me time? Or will I get distracted by all the tantalizing stuff and surf my way to misused hours on the internet? And what about cost?

I am going to perform an experiment. There are just a couple of things I still need (or want) for baby:

• Curtains
• Shoes
• Kimono (there may be a Japanese wedding in his future)
• Mobile

In the next few days check back and I will show you what I found using one whole hour of my busy schedule to search for these items, including costs.

It's Not that Simple

Would you like to pick your baby's gender?

One of my readers would, especially since she has two boys already. I am now asked to discuss Shettles' method of conceiving to increase your odds of having one of the sexes over the other.

The theory is that Y-sperm are fast swimmers, but are very fragile, particularly in an acidic setting. Thus if a couple is aiming for a boy (pun intended) they should have sex closest to the time of ovulation and use deep penetration, far away from the vaginal opening where the pH is relatively low. Conversely, those looking to have a girl should get going a few days before the egg is released (assuming the X-sperm endure while the Y- degrade) and deposit the goods along a more shallow domain.

The New England Journal of Medicine has discounted this theory after tracking the outcomes of over six hundred women who allowed their time of ovulation and sexual activity to be recorded and analyzed. You can read the summary here.

I know of people who swear by Shettles, though. "I had four girls in a row, we tried this method and now we have our boy" is one testimonial. Be that as it may, I think we over simplify things when we imagine sperm to carry ONLY the sex chromosomes as depicted above. I know people are guilty of this because time after time they attempt to support Shettles by saying things like, "You see, that X looks symmetric and sturdy whereas the Y has only one leg to stand on." Let's not forget that there are 22 other chromosomes packed in there which would, in my humble opinion, make the contribution of that tiny sex chromosome 'leg' negligible.

This is not to say that there isn't anything 'magical' about sperm. In fact, more and more research is being done on these gametes and the results have been fascinating to say the least. I once met a physician who was so renown in his field that he was given license to write about anything in a medical journal and chose to dedicate an entire article to sperm (totally unrelated to his field of study). The title was 'A Christmas Celebration for a Sexually Transmitted Fatal Condition,' that condition he's referring to is life itself. In this diatribe, he revels in the discovery of sacrificial and warrior sperm. The former type dies on the frontlines to neutralize the vaginal secretions (allowing their brothers to go forth) and the latter exist for the sole purpose of destroying sperm from other men!

Cue Pat Benatar's Love is a Battlefield.

Got Girl(s)?

Double post for today!

I found this sweet deal for Shabby Apple clothing at Kenzie Poo's website. Their clothes are hip, modest, and help fund micocredit endeavors. Enjoy.

Got Boy(s)?

This time it's not for drinking.

I had to call in a consult to urology for one of my patients and I was happy to learn that the doctor with whom I'd be speaking was an attending of mine when I was in medical school. After we talked professionally, I ended our conversation by informing him that I was pregnant with a boy. He congratulated me and said, "You need only do three things: Get him circumcised*, check for a strong stream, and make sure both testicles are well hung."

We're three for three, but that stream is one to be reckoned with! I've already lost track of how many times I've been sprayed or had to re-wash the changing pad. My solution has been to make these little cups from paper towels, using only a small amount of tape to hold it together. Instructions can be found here. I've talked this over with friends and I'm told the alternatives are draping a simple washcloth (if you don't mind the extra washing), positioning tiny Dixie cups stuffed with tissue, or applying the Pee-pee Teepee shown at this website by Beba Bean.

***Do YOU have a better solution or funny story about this joy of having a son?***

* There's actually no medical indication for this, he's just a big fan.

Have a Safe 4th of July

Consider the children!

[I realize that this post, coupled with the previous, will have people thinking I'm hellbent on using my medical knowledge to freak out parents everywhere. Sorry 'bout that.]

When I was a fourth year medical student I did a rotation in otolaryngology (ENT) and I'll never forget a discussion my classmates and I had with the chief resident. We wanted to know who the real "masters of the airway" are: Anesthesia vs. ENT. The chief said it depends on how you look at it, when someone is choking you'll want to call him because ENT uses a rigid scope to retrieve all sorts of things. He went on to list a few of the items he's pulled out from little kids like broccoli, chips, quarters. . . but never hotdogs.

You're wondering, as we were, why not hotdogs? His reply: "Oh, those kids are always dead on arrival. . . hotdogs, just the size of their airspace with a consistency that gives too much to be pushed or pulled out. *sigh* People, cut your hotdogs LENGTHWISE."

You thought this post was going to be about fireworks, didn't you?

Skincare Products: Think Twice

You don't need to be a doctor to notice that the incidence of cancer continues to rise. The cause is multifactorial, but in a general sense the medical community has come to accept that it is the combination of genetic predisposition plus insult(s) that starts the chain of tumor development.

Put another way: Everyone is born with a certain number of safety nets between them and cancer, with each toxic exposure a safety net is removed. Given the increase in cancer cases, it appears that our exposure to carcinogens has been rising over the years. Some people have a lot of safety nets to buffer them from harm; others are not so lucky.

I don't know what my baby inherited to protect him against these dangers, but as a mother I feel it is my duty to limit his exposure as much as possible. Here is an excellent website that allows you to check the toxicity of many popular baby skincare products: Skin Deep. It will amaze you to know what hazards may be creeping around your nursery.

In a Word: Handy

Itzbeen too long without this gadget in my life!

OK, so I've had a newborn for only a week, but really this little device has greatly improved things. The post-partum nurses successfully scared me into scrutinizing every wet and soiled diaper with its time of arrival. Thus at one point I could be found juggling baby in one hand, and dry erase board plus flashlight in the other to record nighttime activity. -What a debacle!

Now that I have the Itzbeen Baby Care Timer, things are going relatively smooth. It keeps track of how long it's been since baby was last fed, diapered, or went down for a nap. There is a night light and it even has a tab to help you remember which breast was offered last. This device fits in one hand and can be clipped to your clothes.

You can also opt to set an alarm if baby sleeps past the time his feeding is due. This is not yet a problem for us, but I would certainly welcome that sound over the buzz of my pager going off.

This Just In: 25% Off The Container Store

The online promo-code is CLUTTERCREW.