Resident Mommy

A Studied Life

2010-07-17T13:29:00.006-05:00

I use the internet and purchase books to prepare for and perform nearly every aspect of my life!

Why? Because I study all the time, so naturally I'd have my nose in a book for whatever else comes my way. Also, having been in medical school and residency for so long means that I'm dreadfully behind in sorting out how to live my life. I don't have time to do things the wrong way so I do a lot of online research and talking to people so that I can skip ahead to the good stuff.

The big things I have been working on are my wardrobe, home decor, and cooking. -These are my outlets for happiness, and after a brutal day I like to come home to happy things. Below you will find my current study sources:

WARDROBE

I use The Lucky Shopping Manual, as it says above, to build and improve my wardobe piece by piece. Medical students are poor, very poor, but during our clinical years we have to look professional. I remember one time I went to the Ann Taylor Loft at an outlet store far outside the city limits and I ran into three other doctor friends that day. ATL is a staple for the broke professional! Now that I'm moving up in my training I've come to the realization that my wardrobe needs to be taken up a notch, as well. This is a cruel reality as I'd like to pay off our student loans in this decade. I really like the Lucky Manual because it shows you how to work with what you already have in your closet and even provides a guide on how to take care of your clothes so that they last longer.

What I'm also finding is that investing in some nice accessories really helps to make more outfits and look sophisticated.

DECOR

Thank goodness for Home Goods and paint. These are the cheapster's secret weapons. For inspiration and how-to advice I've been reading Domino: The Book of Decorating. It goes room by room and offers a low of how-to tips. Also, I get a lot of ideas from Young House Love. Their style may not match my own, but I'm always inspired by their DIY attitudes and ways of doing things as cheap as possible. They also have a lot of good tips of paint schemes, which is the least expensive way to change up an entire room.

COOKING

Now that we're on high alert for a potential egg allergy, I'm looking at Vegan Lunch Box and Food Allergy Recipes.

Which brings me to something that wraps up this post very well. Because I've done a lot of research on how best to be a mommy, I was able to notice right away that or son was having some sort of reaction to breakfast the other day (thank you Marketing Mama!). This may sound cheesey, but we are living in such a blessed time to have so many resources literally at our fingertips. Nerdy or not, I will continue to do my research.

My Final Answer

2010-07-07T13:40:00.003-05:00

I know it may not look like much is going on here in this blog, but I continue to get e-mails from people asking the same question:

As a doctor, when's the best time to have baby? Before or during medical school? How about during residency or as an attending physician? Which specialty should I go into based on my desire to have kids?

I think I have my final answer, really, the end all be all answer. It's beyong cliché. . . but here goes: Accept your callings in life.

If you're a family wo/man, have a family. If you always saw yourself with six kids, think about how much time that would take and subtract it from the latest you'd like to be pregnant and go to it. Something will work out, it alway does. Yes, it will be unbelievably hard, but chances are if you signed up to become a doctor you're a glutton for punishment anyway.

This blog has been brutally honest (as I've been told) about the challenges of becoming a physician while trying to start/raise a family. So long as you go into this process with your eyes wide open, good coping skills, and at least one supportive buddy everything will turn out fine.

Deal with the fact that you'll miss 'firsts.' -You should have known that when you sent in your medical school application. Since none of us remember if mommy and daddy were there when we began walking, just remember that you're more likely to suffer emotional damage than Junior when it comes to absenteeism in the first years.

What children need, says me, are parents who give them their best selves in their formative years (generally accepted as age 3 and beyond). This doesn't necessarily mean, but doesn't exclude, staying at home with them. If you were called to be a homemaker, do it. If you were created to be a doctor, do it. It really doesn't matter what occupation you find yourself in so long as you set a good example of using your talents and giving examples of service. Consider the opposite: A mother who resents her children because they kept her from her career aspirations, or the work-horse who returns home too burnt-out and bitter to enjoy her kids.

The trick here is to choose a specialty (or profession for everyone else) that will build you up to be a better person. -This is where the caveat to my final answer comes. If God blessed you with the skills of a surgeon, but the lifestyle would make you and everyone else miserable, don't do it. Pick the next thing on your list of favorites. Trust me.

Finally, doctoring isn't always the thorn in the side of parenthood. The one perk to being a resident mommy is that when I have to say goodbye to my son, I can always tell him that I must go help others who are less fortunate. I was on-call last night and missing my little guy terribly when I was summoned to see a six-year old boy who was complaining of pain at his gastric-tube site. On the way to his room I saw several children with broken skulls and displaced eyes. You better believe when I came home I held onto his perfect little body longer and with more appreciation than I would have otherwise.

Coming eventually:

Patriotism and Decluttering - A match made in heaven.
Living life pre- and post-call
Are women the cause for the healthcare crisis?
The "I can't seem to lose this stomach so I'll just have another baby" option.

Suits & Résumé

2010-07-05T20:34:00.005-05:00

I totally passed my boards, all three of them.

Now it's time to suit it up, get my résumé out there and control my destiny. First, I need to update my wardrobe. Do you like any of these?

This may seem like a silly question, but have you ever worn a suit before? If so, doesn't it make you feel more powerful and dynamic? I really dig 'em. (Click on the pictures so see where they came from.)

Unclutter My Life, Please

2010-06-29T19:22:00.005-05:00

Courtesy of Peter Walsh for Unclutterer.

The past seven years of my life have been spent studying, working, studying, working and recently trying to raise a baby. It is safe to say that in this mix my domestic life suffered. Oh, don't worry about the marriage part, I have the most loving and patient husband ever. I'm talking about cooking, cleaning and just plain having a routine.

You'd think that after nearly 7 years of being married, we'd have some semblance of a routine. But it seems like everytime we've got something under control, things change on us. Take for instance my schedule. Every 1-2 months my job duties and hours change. -THAT is the life of a resident. To make matters even more complicated, a growing boy adds extra variety. One day you can leave him in the bouncy chair while you make lunch, the next he's flipped it over and is trying to crawl.

I realized we needed a set routine the other day when I was running up and down the stairs in only a towel while trying to find baby's shoes & food, and my white coat, and Daddy's phone. I forgot to mention the shades were drawn and we have HUGE front windows, so this must have made for an entertaining show.

In the next week I hope to come up with some organizational tips that will streamline my life, if at all possible. And as I always say, if it works for Resident Mommy, it will probably work for you, too.

I'm BAAAAAACK!

2010-06-20T12:06:00.006-05:00

A monumental time.

I have a year's worth of experience being a mother! Can you believe it? One of the quickest lessons I learned was that you can't juggle it all. Hence the HUGE gap in posts.

During my absence from the blog world I took my 16 HOUR board licensing exam and faced several other trials that I can't even get into here. I have lamented my choice to be a resident and mother at the same time, but I wouldn't trade my son for anything. As I spent many long days at the hospital, lost countless hours of sleep, and missed meal after meal I questioned my career choice, too. Then something happened yesterday. . .

My adult cousin choked on her food at the birthday party.

I was sitting at another table enjoying my meal and having fun mommy-to-mommy discussion when I heard: "HELP HER!!!" I turned around to see my family swarming around my cousin who was in obvious distress. Here is what happened next, in step-wise fashion:

I think "Is this really happening? People over-react all the time!"
I approached my cousin quickly to judge for myself.
I can hear my name being yelled to do something, anything.
Iasked my cousin if she can say something, anything.
She puts her hands around her throat and shakes her head desperately.
I think "Ohhhhh man, this is REAL."
"Call 911!" I tell them.
No one moves, everyone (30+) is staring at me.
My cousin is turning blue and remains silent.
I think "She's going to die. I'm not in a hospital. I can't page anesthesia."
I tell myself "All you can do is what you've been trained to do."
People keep staring at me.
I think of all the children around and tell God it would be cruel if tragedy were to strike here, in front of them, and on my little boy's birthday.
I perform the Heimlich maneuver three times.
My cousins gasps for air and begins to speak.
I make sure she's OK.
I sit back down and my uncle says "That med school tuition was worth it!"

I Am Not Dead

2010-05-02T21:52:00.000-05:00

But this blog is close to expiration, no?

I will resurrect it when I'm done studying for Boards (June 8th), thanks for your patience. . . and prayers!

This is What I do When I'm Stressed

2010-03-01T20:06:00.006-06:00

OCD much?

I painted the backdrop of those shelves black and organized my books by color. I think it's better than doing drugs, and such.

Full view of the fireplace/bookshelves can be found here. If you're curious to know what that white pile is in the hearth, it's my white coat from intern year that I plan to burn very soon.

Had Enough?

2010-02-19T12:37:00.005-06:00

I was having this conversation with a friend:

Friend: I'm coming out and telling people now that I'm going to do a fellowship.

[A fellowship is at least one more year of training AFTER residency. For those of you keeping count, that's about 25yrs of education.]

Me: Oh, good for you if that's what you want to do.

Friend: How about you?

Me: I feel like I have to choose between doing fellowship and having another child. These eggs aren't getting any younger.

Friend: Yeah, you're right. That's the reality of the situation. If you're going to do fellowship, that's gotta be your main focus for that year or two.

Me: Didn't you want to have another one?

Friend: Yes, I'm going to try and crank one out while I'm still in residency.

Me: Good luck with that, too.

Does it bother anyone how unnatural this child planning business is for female doctors? What about this idea of being 'in school' forever?

My YouTube Picks

2010-02-07T16:48:00.006-06:00

Meet my babysitters.

I am guilty of sticking my son in this, placing a laptop in front of him and playing the following videos so that I have time for myself. Enjoy!

Sesame Street with Feist singing 1-2-3-4

Sesame Street with Nora Jones singing "Don't Know 'Y'"

Mister Roger's 'Good Feeling.'

The wedding aisle dance (my boy loves this for some reason)

Fantasia's Pines of Rome & the third part live by Von Karajan.

And for more classical tunes, Barry White's My First, My Last, My Everything.

Am I The Targeted Audience?

2010-02-02T16:37:00.004-06:00

Always so cool.

There I was lying on my sofa feeling drained of all life and energy when a maxi-pad commercial comes on showing this beautiful woman jogging, presumably while she's menstruating. The next scene is of her showing up for rounds as a medical resident, after which she goes out for a night on the town with her girlfriends.

Really? All those months in pregnancy and breastfeeding seem silly now when I think about the joys to be had shedding my uterine lining. From now on I'll think of it as a career boost!

Grab Your Ankles

2010-01-21T18:09:00.005-06:00

In the tradition of higher learning.

So imagine you landed the lead role in your high school play. Yippee, right? But now envision giving your lines on opening night without much practice, and as you make mistakes in front of everyone you get called out by your director. Oh, I forgot to mention that in this exercise of imagination, each goof-up puts someone's life in danger.

That's what it's like to be a resident learning procedures. I got a nice verbal equivalent of a paddling in the OR today. I know the Socratic method is "see one, do one, teach one," but how about 'see many, get hand-held through a few, and then do one'?

When I'm told that I am not good at something, and it's because I'm either inherently incapable of the task or that I'm a screw-up it's really hard not to cry. But that's the last thing I'm allowed to do. Plus, it makes all female doctors look bad.

I was feeling pretty down when I grabbed my lunch. Across from me was a surgical resident and as soon as he finished his sandwich an attending physician came in and started pimping* him. He didn't have the correct answer and the same thing happened. The poor guy was told, in front of everyone, that he really needed to wake up and start learning.

Frankly, there's not a seat soft enough for our bottoms today.

*This is the actual terminology for blasting your inferior medical resident/student with questions on the spot.

Booby For Life

2010-01-16T09:53:00.005-06:00

I had to laugh when I read about this 'breast-feeding diet.'

Feed your baby the natural way and you'll look like Angelina Jolie! The bottom line from this article is the same ol' thing you'll hear in any diet debate: calories in needs to be less than calories out. The end.

I am not yet back to my pre-pregnancy weight. I have those last 10 pounds to go. When I was breastfeeding I did use that as an excuse to say, finish off an entire box of cookies, or more. Well, it's a new me and a new year. Time to get on the stationary bike and watch what I eat.

Getting thin is different from getting into shape. There are so many obstacles stacked up against mothers, though. We're extremely busy, have fluctuating hormones, and told "don't lift anything heavier than your baby" at discharge. -The perfect storm.

I've noticed that the first thing that goes is the lumbar/core strength, which is key for happy living. What's the number one reason for a doctor's visit? Back pain. How do we remedy that? I actually found the perfect solution online, no joke. If you follow these magnificent instructions from the Mayo Clinic I, Resident Mommy, promise you better quality of life.

Don't wait until you have spinal arthritis, I'm serious. Otherwise you'll see me coming at you with one of these.

Haiti Needs You

2010-01-15T08:31:00.003-06:00

She needs all of us.

Haiti has had a soft spot in my heart for a long time. My father was born in Puerto Rico, which is the next island over from Hispaniola. I have always thought of the Haitians are my poor, neglected cousins.

We cannot look away anymore. The amount of suffering since the earthquake, which struck near Port-Au-Prince earlier this week, has caused unimaginable suffering. Of particular concern to me are all the orphans and injured children. No doubt there are many brain injuries and traumatic amputations that need medical attention now.

If you're looking for a place to donate, I'm a fan of Doctors without Borders.

Breast is Still the Best

2010-01-15T08:06:00.004-06:00

Don't get me wrong from my previous post.

Breastfeeding is still the best choice for mothers, no matter how difficult. I would not have struggled as I did if that weren't true. Breastmilk gives babies their greatest nutritional support, decreases their chance of infection, while lowering mommy's cancer risk. -You can't top that!

For working moms, however, it is not always possible to continue producing milk due to the demands of their situation. When I write that I have in mind couriers, factory line assemblers, and surgeons. Regardless of what you do for a living, please consider the following if you're a lactating mom thinking about quitting before the 1yr finish line:

Dr.W: Another resident mommy, pumped for months in between 4+ hour orthopedic surgeries. When she got engorged, Dr.W wasn't allowed to adjust her bra because not only was she 'scrubbed in,' she also had a lead apron on top!
Lanisa Allen: Had to sneak away to use a public bathroom to pump her milk and was fired for it. See her story here.

So, if you have it any easier, please take advantage. For them, for me, your health and your child.

An Unfair Depiction

2010-01-11T18:31:00.005-06:00

But I'm not tied down to my breast pump.

Y'know, when the Mormons were first asked to practice polygamy most of them went kicking and screaming into the practice. Then when they were commanded to stop, they had a hard time letting go. That was my experience with breastfeeding.

The gap in posts had to do with me being on my most demanding rotation while soaking in the reality of my academic situation. . . all the while working to save someone's life (I'll explain later, on 1/20/10). I had always said that I would stop pumping at the 6 month mark, but just before the finish line my supply went down. . . WAY down. It had to do with a ton of stress and my inability to find time during the day. I became all hung up on the idea of stopping on my terms, not because I was 'failing' to produce.

So I got all worked up, pumped more, fell behind in my work, this added stress, which produced less milk and the cycle continued! Until now, that is. Last week I produced 2.5 ounces, gave my boy this meager portion, and put my supplies away. The large box of nursing pads, bras, tubes, valves, shields, etc got sealed up and put into storage. Part of me was elated; the other part felt terrible for withdrawing this part of myself from my baby. The next week as my normal pumping hour approached I had pangs of regret and actually tried to collect whatever I could manually squeeze out. I came home quite upset when my husband finally said, "It's time."

He's right. 6 months of breastfeeding for a resident mommy is a lot. My baby is on solids now and I can help him to progress in other ways. I'm told I can still feed part-time, but the truth is I need every minute of the day (except for necessary sanity breaks such as this) to reclaim my life.

A Good Laugh - The Seal

2009-11-21T07:00:00.001-06:00

Been reading this way too much.

And I think I'm a little sleep deprived. This is the true story of what happened during our nighttime routine last month:

Hubby: Will you say the prayer tonight?

Me: Sure. [closes eyes]

Our Father in Heaven, we're thankful we could touch such a BEAUTIFUL animal. . . and that it is a seal. . . [wakes up] Wait what?!

Me & Hubby: [laugh uncontrollably]

Soon to come: What does Nacho Libre have in common with my boob?

Baby B'Air Product Review

2009-11-15T13:00:00.006-06:00

Two firsts: Flight and a head cold. Doh!

I was oh-so-fortunate to win this little item from The Marketing Mama. The Baby B'Air is a vest meant to be worn by small children during a plane ride while sitting on their parent's lap, which fastens them to the seat belt. If you go to Baby B'Air's website and watch the video, you'll learn why the inventor was inspired to come up with something more secure than mommy or daddy's interlaced fingers.

I'll start out with things to keep in mind when using the Baby B'Air vest, just to get that over with:

When sitting upright, the child has to face away from you. My baby loves to make eye contact so this was a little hard on him.

You can lie your baby down, which is nice. . . but the harness becomes more taught in this position and can cause skin breakdown. I found this out when I went to change Philippe's diaper and discovered an area on the thigh that had been chaffed.

On to the good stuff:

The Baby B'Air makes total sense! If you strap your kid down in a car, why not on a plane?

It makes you feel prepared. This was our first flight with baby and having the B'Air made us feel like pros.

Peace of mind. I won't name names, but I know someone who let her newborn roll from her arms to the floor as she dozed off on the sofa. Things happen. And there are worse consequences if all of a sudden turbulence strikes. I have to say our plane got jostled from time to time and I felt better knowing Philippe was secured by the Baby B'Air.

Finally, it's cute! We got a lot of compliments.

Herbal Help

2009-11-07T10:21:00.005-06:00

Hey, this actually works.

Since I'm on my most demanding rotation now, I need all the help I can get to keep up the milk supply. My average output was on the decline and I decided to give this herbal tea stuff a try. The active ingredient is fenugreek, which can also be found in curry. The result? I went from 9oz to 12-15oz at the end of the work day (depending on how much I get to hydrate).

The taste isn't spectacular, but it's fine with a drop of honey. The downside is that I think my sweat now smells like tandoori chicken.

Sidenote: As a follow-up to my neck injury, it still hurts! One of the young male nurses called me Dr. Batman. -Which I thought meant I was heroic in all my doctorly pursuits. Alas this is not the intent. It's in reference to the rigid mask Michael Keaton wore, which didn't allow him to turn his neck during Batman's fight scenes.

A Pain in the Neck

2009-11-04T15:03:00.004-06:00

I had hope for the future . . .

But then I destroyed my neck. I hurt it by using a bad side-lying position to breastfeed my sick baby all night on Saturday. The following day I went to pick him up and heard an awful tearing sound coming from my cervical spine.

The irony is, people in the medical field get the least mercy when they are ill or hurt. If you're having fevers, puking, or got the runs you're still expected to come in. A torn muscle? Puh-leez. So I tried to endure the first few days of my new rotation, but here I am typing this post from home. . . unable to look anywhere except straight ahead.

I actually don't have any sick days to use because my maternity leave (a whopping 5 weeks) ate them all up. I'm using the last of my vacation days, which I had reserved for emergencies such as this and/or my brother-in-law's upcoming wedding . . . in Japan. Sadly, this time off might mean I can't go anymore. (If you're reading this Paul and Mayu, I'm soooo sorry!!!)

I couldn't have imagined I'd hurt myself this badly. If you consider that I gave birth to my son who was face-up without an epidural and now I'm tearing up from pain you know that this is bad.

Just trying to rest up and pray that I'm OK by tomorrow. Because this resident mommy must get back to work.

Thanks for Your Love & Support

2009-10-31T12:00:00.003-05:00

I know that last post was shameful, but your follow-up comments and my recent experiences have taught me something . . .

I might just need this blog to get through the rest of residency.

This being the end of the month, I went over to the ward where I'll be doing my next rotation. I explained to them my needs for pumping and requested a private room, preferably with a computer. Everyone there was amazed by the gadgets I had and the insight given to me to navigate motherhood.

"You must have a lot of mommy friends" one of the nurses commented.

I started to think about my friends, both in my community and on the web. Sappy as it is, I felt particularly grateful for all the love and support at my finger tips.

The next day I spoke with a mommy-to-be who is overwhelmed at the thought of going back to work post-partum. She told me that she visited my blog and it reassured her that if a resident mom could do it, she could do it.

Now this blog and my bella band have something major in common, I'm crawling back to it.

(If you want to know why I had my little breakdown, you'll have to send me an e-mail. It's just too much to write about here.)

Out with a Whimper

2009-10-28T22:04:00.006-05:00

I think this blog is going to die.

It has positive Q sign if ever I saw one.

Who cares about injury prevention anyway? Or pelvic health for that matter. -I can't believe I just typed that. How pathetic!

The real reason I'm pessimistic right now is because I don't even know if I have it in me to finish residency. I had one of those last straw moments today. Attacked yet again about my breast milk.

I give up. This blog was a paradox anyway, the life of a resident mom is much too hectic for the blog world, right?

Back from Conference!

2009-10-25T15:43:00.003-05:00

Sorry about the pause in posts (did anyone notice?), I just got back from a medical conference in Austin, TX. There's me with my poster about a device that can help paralyzed patients get around, and with a fellow resident mommy!

Many, many way cool pictures to follow. . .

The Nursery

2009-10-19T22:31:00.002-05:00

Monkeys, goats, fish. . . the usual.

By the time he's off to college I think I'll have it all put together.

"That Girl is Poison"

2009-10-15T21:00:00.007-05:00

They're singing about my milk.

I'm doing another out-patient rotation this month and thought I had the perfect setup for pumping. Unfortunately, the private clinic rooms were all in use last week and I had to search for a new spot to do my thing. I asked a young woman who works as a medical assistant where I might go and she said, "You have no where to go, everything's taken, there's a bathroom around the corner."

If there's one thing I'm firm about, it's that breastmilk should NOT be expressed in the bathroom. I politely declined, and set out to continue my search for a place to pump. At a point of desperation I decided to use the common room for hospital employees. I wasn't excited about this, since people (both men and women) come and go through, but it was my best option and I was literally about to burst.

As I was getting set-up, the same medical assistant comes in and looks at me like I have leprosy. "You're not doing THAT in here! Why don't you go to the BATHROOM?! People eat in here!" her words were dripping with disgust. It was then that I realized how offensive she found my milk to be. I said, "it's just not sanitary in there." To which her reply was: "Oh, like it's that much cleaner in here?" Without pause I stated "I'd like to think there's a lower fecal count where you prepare lunch, yes."

She left in a fury.

Today as I returned to clinic that woman gave me the stink-eye and conspicuously whispered something to a coworker while looking in my direction. I know she can't wait for me to move on to another rotation, and take my poisonous nipples with me.

The whole situation would make me very upset, except is reminds me of one of my favorite videos on the web.

Baby Monitors: Whatcha Gonna Do?

2009-10-13T20:55:00.004-05:00

Peace of mind, some say.

I've been hearing and reading a lot about new mothers who monitor their babies all night. At the slightest beep they're up and running to check out what's wrong.

Personally, I wouldn't be able to live like that. We were given a monitor at our baby shower and haven't used it. I figure, if something truly dramatic were going on I'd hear it down the hall.

The morbid thing I have to wonder is, what would the average parent do if they found their lifeless baby in the crib? -A scary image, I know. I remember one time my son was in such a deep sleep that he didn't move a muscle when I caressed his face during a nap. I poked his belly and I still got nothing. Finally I yelled his name and whisked him into my arms, only to have him stare back at me like I was crazy. I was all ready to jump into my basic resuscitation skills, though it felt extremely different when the 'patient' is your own child.

I highly recommend that parents and caregivers be comfortable with basic CPR. All the nursery gadgets in the world would be useless without it. I know a lot of hospitals offer community courses for certification. If you don't have time for that, check out these links (I have to say that the YouTube stuff isn't official, but it's better than nothing):

Of course I hope and pray you'll never have to use this information.

Dear Bella Band,

2009-10-11T23:11:00.007-05:00

Thou art my frenemy.

You were super cool in the beginning. Thanks for helping to make my wardrobe last through the months of pregnancy. I used to show you off, my inseperable buddy.

I remember the day I went into labor and I placed you in a container and put you in storage. Like all good things, I thought our relationship had come to an end. We were parting on good terms, though. I would have fond memories of you hugging my bump and growing with me.

Sad was the day I returned from the hospital and realized that I still needed you. Yes, I came crawling back and unsealed your container. There you were, rolling your fabric in a way that could only mean "I-knew-it."

It's been almost 4 months post-partum and we're still together, a fact that frankly depresses me. Sometimes I blame it on the skinny jean fad that spiked in my fertile window. -But you know better. You've been gossiping with my nursing bras, haven't you? Laughing about your permanence at my expense.

(Were you the one who slipped that coupon for cookie dough into my purse? Figures.)

You're lucky I don't have the time to exercise, but once this nursing business is finished it is SO over between us. That is, until I get pregnant again and we're BFFs.

The 15 Minute Pervert

2009-10-05T07:52:00.004-05:00

May I re-emphasize to you just how difficult it is to be a resident and lactating mother?

I have explained how as a resident, I'm constantly going from place to place and don't have a steady location for pumping. Last week we had seminars in a new part of the hospital. We were given a tour and this allowed me to check out my prospects. In between lectures I returned to the one room with a manual lock. As I looked around to make sure I wouldn't be intruding, a man startled me from behind and angrily asked "can I HELP YOU?" The look in his eye was so vicious that I stood there almost unable to reply. I finally mumbled something like "sorry, was wondering if anyone needed this room. . ." His response was a condescending "YEAH" as he glanced at his beloved coffee machine.

At this point I was able to turn and face him, he then realized I was a doctor from my white coat and not some rapscallion out to take his treats. That's when I said firmly "I need to be alone for 15 minutes." The man's eyebrows raised when he heard that, and his cheeks pinked up as he looked upon my mysterious leather bag. Quickly he pulled out his keys to usher me into another room, no longer making eye contact with me. Now he was the one mumbling, "I'd put a 'Do Not Disturb' sign if I were you."

The man's reaction left me wondering, what the heck does he think I'm doing for fifteen minutes in a private room? Clearly he didn't want to know.

There were no materials to make a sign, so I found a place in the back of the room and barricaded the door with a chair and a foot stool. About five minutes into pumping I heard keys turning. . . "I'm in here!" I yelled out. No use, my words could not be heard over the banging of the door against my makeshift barricade. -Wouldn't that be a hint to most people not to come in?!

Finally a man pokes his head through and sees me sitting there with my back towards him and two tubes coming out of my torso that meet a strange machine, which happens to make a sucking sound. He might as well have seen a ghost, he was that mortified.

I can just imagine the conversation in the break room that day, the one about that pervert resident and her 15 minutes of shame.

Mama MacGyver

2009-10-02T15:00:00.000-05:00

With the clock ticking, no less.

I wanted to stay for the clinical skills session of a professor led lecture, but had forgotten to bring my ice pack with me to keep my milk cool.

I went to the nearby cafeteria and asked for a plastic bag, but was told they had none. I asked if there was anything that could hold ice for the next couple of hours and was offered foil (really now?).

The employee behind the food counter was getting annoyed with my request and put her gloved hands on her hips. Aha! As a doctor, I know a thing or two about latex gloves. . .

I asked for a pair, went to the ice machine, filled 'em up and tied them down. I got a lot of strange looks as I walked out, and when asked "what on earth do you plan on doing with that?" the answer 'slapping' did come to mind.

Young Children are like Brain Injury Patients

2009-09-29T17:00:00.005-05:00

A lot to learn, or re-learn

I used to get asked a lot why I'm so good with kids before I became a mother. The truth is, my medical training has prepared me in this regard. Young children have a lot of connections to make in their brains, much like my brain injury and stroke patients. These are my gems for interacting with both groups of people:

Give positive commands
Instead of saying "don't step in that puddle," say "walk around that puddle, please." It's harder for the human mind to process negative statements.

Prepare them for new situations
I've seen mothers become mortified when their kids run wild around a restaurant. This could be avoided, or at least minimized, if the children are given instruction as to what to expect and do when going out to eat. Remember that the developing mind handles new environments by comparing and contrasting to previous experiences. Thus if the dining booth looks like a fun hide-out or the row of chairs appears to be a jungle-gym, you know what follows. If, however, you talk about what's appropriate for dining out and even give a preview then the chance that you'll need to pry your child off the waiter will diminish.

But don't explain too much.
Keep things developmentally appropriate or confusion/fear may develop about a situation. Example: "On the airplane they teach us how to be extra safe." -That's better than "pay attention to these instructions, you might need them in case of an emergency."

Offer lots of encouragement
When the world doesn't seem like it's built for you, this can take its toll. Kind words to bolster up the spirit are necessary to get through life's challenges.

Be patient, let them work it out
It's easy to fill in sentences or help with tasks when it takes longer for someone else to do this alone. Unfortunately, this only fosters dependence.

Do it the same way every time
If you're teaching someone how to tie their shoes, do it one way each time you repeat a lesson. This is how the brain makes connections fastest.

When reason fails and hysteria ensues, a dark padded room is best

My Heart is Tenderized

2009-09-27T22:34:00.004-05:00

Disney's Lambert the Sheepish Lion

A friend of mine told me "once you have kids, you won't be able to bear the thought of any child being hurt." At the time, I thought that was a weird thing to say seeing as how no person with a heart delights in the misfortune of the little ones. Now that I'm a mother, however, my very soul is rocked at the slightest hint that a child is suffering. I get it now.

The other day a coworker recalled the above movie from our youth and I decided to watch it again here. OH.MY.GOODNESS. When those frickin' lambs go after sheepish Lambert for being different. . . I'm telling you I just about gave myself heart block! Of course YouTube decides that a nice follow-up video would be The Ugly Duckling. . . with Elton John's "I Want Love" song as the backdrop.

Now someone needs to peel me off the floor and give me Zoloft, STAT.

When's the Best Time to Have a Baby?

2009-09-25T06:39:00.006-05:00

Female students, residents, and physicians ponder this ALL the time!

From a pure medical standpoint, before age 30 is when you can reduce a risk factor for breast cancer. 35 and beyond is when the label "advanced maternal age" gets placed on your chart and it's like wearing a scarlet letter.

Professors in medical school know that most women come out of training in their 30s, and yet they still throw that danged chart on the big screen to make all of us cringe in the lecture hall. It's like you can feel your ovaries drying as you contemplate the curve.

So what's a female doctor to do? Most of us ask around, and the usual answer is: "there is no good time to have a baby." That's pretty true if you consider:

Years 1-2 of med school: All work and no play. Study, study, study. If you goof up your scores in this time period, you'll never get a desirable residency position. -This could mean the difference between matching at a program that is family-friendly versus indentured servitude. Don't forget that you finish this section with an 8-hr exam (try that with a baby sitting on your bladder!).
Year 3: A lot like the previous years, but all clinical. Put another way, you're studying AND have physical demands. Good luck having morning sickness and making it to your surgery rotation at 5AM.
*Year 4*: Easiest year of medical school. Many women opt to have a baby at this time. . . BUT there are drawbacks. This is interview time, and illegal or not, if you show up with a big bump to a potential residency program that will most likely be a strike against you. -Being honest. Also, no pregnancy is predictable and should anything happen that puts off graduation that will conflict with the start of intern year. Keep in mind that having the baby is one thing, being able to be there for your child when you're about to start one of the most demanding careers in the planet is another.
Intern Year: NO!!!! NOOOOOOOOOO!!! It's been done, but not without torture. I don't care what your specialty is, having a baby at this time is insanity. Usually 80+ hours/week, not including commute time is what you're looking at. My friend did this, her water broke during morning rounds and as she was wheeled away her senior resident asked "are you coming back soon?!"
*Post-intern Residency*: Feasible if your hours drop from 80/week. If you haven't taken the third board licensing exam, that's TWO days in a row of 8hr exams waiting for you. This is when I had my baby. I was a lot sicker than I had hoped, which really put me behind in my studies. Maternity leave ate up all my vacation and sick days for two years. . . There were times I'd see a patient, excuse myself for a moment to vomit in a nearby sink, and go back to finish my work because I knew that any time I took off for myself would be time taken away from the post-partum period.

Something else to think about are workplace hazards such as radiation and infectious disease exposure.
Attending Physician: Now in the work force, you're probably part of a group that expects 'dynamic performance.' It's all about bringing in the money to pay off all those school loans. Can you really afford (figuratively and literally) to have a baby at this time?

Rough stuff, huh? I'm hoping to collect data on other professions and when their 'windows for fertility' occur. If anyone finds the perfect solution, do tell.

Crying Over Spilled Milk

2009-09-24T09:56:00.002-05:00

I think I'm entitled to shed a few tears over this.

Oh the irony, I tilted back the valves of my pump to get those last few drops that were sitting on the rim. Next thing I know I got a warm, sticky mess on my lap.

Now I know the following:

Check Out My Son (and Blouse)

2009-09-22T19:43:00.001-05:00

You might recognize the latter from this giveaway.

Houlihan's

2009-09-17T17:50:00.003-05:00

Don't let the bar section mislead you into thinking this is not a place for kids. I've found this restaurant to be very accomodating, especially with its outdoor section. All the food is made from scratch and there's nothing on the menu that I haven't loved. They really pay attention to customer feedback, which is why they brought back the incredible S'mores dessert you see above. Yes, in the pot is melted chocolate and marshmallow. Oh, and desserts are free on Tuesdays. The prices are good, too.

Bono = 4 onces of milk

2009-09-14T20:25:00.002-05:00

When an invitation comes my way, I think "Hmmm, how many onces of stored milk is that going to cost me?"

We got free tickets to U2's 360 tour this weekend and I was happy to spend some liquid gold for the rocking out cause. At first we felt so 'hardcore' for leaving the house at night to go to a concert, but when we arrived we found ourselves surrounded by 40-somethings and their kids. (The concert attendee next to us couldn't have been older than twelve.)

All signs that we're getting old. . .

Remember to Take Your Vitamins

2009-09-12T22:01:00.002-05:00

I have this kit by Med Sun.

This is a great organizer because you can fill up each capsule way in advance and take only one with you each day. In mine I fill in the slots with fiber pills, DHA, and a multivitamin. I think you can pick up a case like this at any drug store. I highly recommend.

Hangin' with Mr. Cooper

2009-09-11T19:07:00.006-05:00

There's not much natural support.

"You sacrificed your boobs, you know." I've been told that a few times since becoming a mother. My fellow residents are the only ones to say it that way. As doctors, we've seen a lot of boobies and the saggy grandmas leave an indelible impression that makes many hesitant to have kids and breastfeed.

The only thing keeping the breast suspended are Ligaments of Cooper that are very, very fine elastic fibers. With time and strain they can give out and cause, what we call, "T4* to the floor."

I'm a big supporter of breastfeeding, but I also don't want to carefully maneuver my cane around my boobs one day. So I take the following steps to fight the good fight against the sag.

Rotate bras.
If you wear the same bra all the time, it loses its support. Also, I invest in the good stuff.
Wear a sleep bra at night.
It doesn't have a strong hold, but it's better than nothing.
Use the side-lying position for feeding.
If I do breastfeed upright, I bring my baby to my boob and not the other way around.
Pump before I get engorged.
Not dance like this (courtesy of my friend, Brenda).

*T4 is the spinal cord level that innervates sensation in the nipple.

The So-Called Landing Strip

2009-09-04T20:34:00.006-05:00

Where'd I put the . . . oh, yeah!

On Unclutterer there was discussion of the need for a landing strip, an area by the door* where the day-to-day stuff that falls out of your hands when you enter the home can go. Our dining table was plagued by such items until recently. My husband fixed the lettro wall organizer by Umbra above this formosa side table by CB2 and voila, we have our formal eating space back.

More important, our morning routine is running a bit smoother. I have, hanging from the envelope, the following :

Baby's pediatrician appointment card
Don't-leave-home-without list:

Purse and cell phone
White coat and badges
Pump and parts
Cold pack and milk
Lunch box and water bottle

Do you have a similar system? What's YOUR morning routine like?

*Note that leaving your keys near a mailbox slot, or any other opening to your home is not a good idea (a burgular can get easy access).

Wordless Wednesday: My Brest (Party) Friend

2009-09-02T20:18:00.001-05:00

How to Give Your Kid a Spinal Cord Injury:

2009-08-28T21:20:00.006-05:00

Purchase one of these.

Let 'em loose with this one.

And use this device while driving.

That's how my pediatric patients got theirs.

(Yet another scare-you-straight post from Resident Mommy)

I Won My First Giveaway Prize!!!

2009-08-26T21:14:00.005-05:00

Check it out, y'all!

How perfect is this win for my wardrobe project?! After the crappy week I had, this is just what the doctor ordered. EEEEeeeeeeeeee!

Thanks so much to Kay at The Van Gogh Cafe for the CZ Fashion Springwear tops.

I will have to post pictures modeling the clothes when I receive them.

My Tailbone May Never Be the Same: Part I

2009-08-17T21:05:00.003-05:00

I hope not to need a cushion for sitting for the rest of my life.

The medical literature doesn't mention coccygodynia (tailbone pain) until 1726, either women weren't forthcoming about this common problem or men didn't pay attention until then!

Anywho, from my brief literature perusal I've come to discover that it's not uncommon for women to be told that pain in their tailbone is all in their head. The reasons for this are that nothing can be seen on X-ray or MRI, and/or the pain does not improve with standard treatment.

To aid diagnosis, any imaging study should be performed to include views of the patient sitting down. This would seem like a no-brainer, especially since that's when most people complain of discomfort, but it is not a traditional way of looking at things!

Alas, my baby has decided to teeth early. . . I'll discuss more later.

Coccygodynia, Otherwise Known as Pain in the Tailbone

2009-08-16T21:11:00.002-05:00

I have it and let me tell you, getting up from a chair is quite the ordeal.

I'm going to dedicate this week to discovering the causes and treatment options for this ailment. Follow along!

The Essential Scarf

2009-08-15T15:20:00.005-05:00

From H&M, only $7ish

Let me tell you why I can't live without this accessory. I have used my scarf to:

Look put-together, without the effort.
It may seem impossible to look stylish when you have a child consuming all your time and energy, but adding something as simple as a scarf really does wonders to make an outfit.
Cover myself during public breastfeeding.
I have the standard shield, but in summer it gets unbearably hot under there. I discovered this use when I was in a parked car trying to feed my boy and my scarf, still around my neck, fell perfectly into place. It's very light and Philippe got a lot less sweaty during the feed.
Hide nipple leakage.
This was my initial reason for buying scarves.
Block out smoke.
A bonus! When I pass by cigarette smokers I hold my scarf to my face. Do you think that's rude of me? I don't, in fact when people have said something about my conspicuous dislike for tobacco smoke I say "Sorry, but I'm allergic to cancer."

This post is part of my follow-up to The Resident Mommy Makeover.

Women: Made to Suffer?

2009-08-12T17:05:00.006-05:00

I felt nauseated the other day, told a male relative of mine, and all I got was "oh, too bad."

I then realized that the many months of pregnancy-induced vomiting had given the impression that pukey was my baseline status. This bothered me a bit as I began to ponder all the horrible things that could befall me, and garner little or no attention from others, simply because these are 'women problems.'

There's no one to blame. The notion that each pregnancy ends in a medical emergency (i.e. labor and delivery) makes it seems as though women are accustomed to extremes. Add to this the fact that vaginas are known for discharging blood, mucus, and people and it's no wonder many gynecological symptoms/complaints appear unimpressive.

Did you know this is the reason STDs are caught sooner in men? When a woman spots something unusual on her toilet paper, she's more likely to dismiss it. Men, however, when they see something funky coming out of the penis they get it fixed right away because it's not acceptable.

I would like to reclaim my 'baseline status' today. I, Resident Mommy, am not supposed to double over in abdominal pain, puke my guts out, or stain my pants. -Geez, how did I even get to this point in my life where I need to declare such a thing?

True Story

2009-08-08T18:42:00.000-05:00

Tips for Pumping - Thanks Marketing Mama!

2009-08-07T18:48:00.007-05:00

Check out this awesome how-to guide from Marketing Mama on how to pump successfully at work. It is an awesome resource!

I would like to add a few things from my limited experience. These are tips specific to being a doctor, but can be applied to any mother who is extremely pressed for time.

Check in with the RN station beforehand = Get things in order first
All residents quickly learn that if you want uninterupted time, you speak with the ancillary staff to find out if they need anything from you before you take care of yourself. Nothing cuts off a milk letdown like hearing your pager go off in the middle of pumping, and I imagine the same is true for moms who hear their children screaming for something when they've just gotten settled.
Say it straight-faced = There's no need to get embarrassed over pumping
Doctors hardly blink an eye when they hear about body parts and functions. The truth is, if you don't make a big deal about something it doesn't become one. In contrast, if you're red faced every time you say 'breast' that's going to have a positive feedback response from the person hearing it. So just say what you need to say to communicate with people your needs for pumping breast milk. -Tee hee.
In case of a Code Blue = In an emergency. . .
Detach the tubing from the breastshield and bolt. If you remove the tubing from the pump itself you will not be able to lay the bottles on a flat surface and run. And don't even think about spending the time to transfer your milk to another container when your adrenaline is pumping.
Type progress notes while you pump* = Go hands free
There's that goofy looking bra you can wear to hold the breast shields in place and many mothers swear by it (I'm not knocking them, but c'mon, don't tell me that picture doesn't make you crack up). I recently found, however, that my Playtex nursing bras have enough elasticity in them that they can be clipped around my pumping parts and actually hold them in place!
Consider your rotation schedule when returning to work
Don't jump back into residency with an in-patient month if you can help it. You'll be too tired and literally drained to get through it well. If your schedule has already been made, see if you can switch with another resident for an elective month.
Create an involuntary pathway = Train your brain
Repetition will limit the amount of time it takes you to pump, and hopefully limit mistakes that will eventually happen when you're sleep deprived.
Build your reserve by the end of maternity leave
This is really difficult as a resident because most of us get only 6 weeks off, the end of which usually marks the time when baby is going through a demanding growth spurt. But if you can push yourself to have a nice supply sitting in your freezer, a HUGE weight will be taken off your shoulders and you'll be a milk machine.

* Marketing Mama brings up a good point that you should just focus on your baby when you're still getting into pumping.

A 'Private' Place to Breastfeed

2009-08-06T21:53:00.013-05:00

Have a good laugh on me.

Pumping at work requires a lot of preparation. As a resident, it's particularly difficult because we're on a rotating schedule and that means I'm moving from place to place.

I've saved a template for my requests to have enough time to pump, in a clean and private place, with access to a power outlet and fridge. I sent this to my current hospital site, but failed to realize that I would be spending time at my affiliate medical school for lectures. It's not my alma mater, so I'm not familiar with its layout. Almost frantically I called a male friend who is currently a student there the night before saying "I just realized I'm going to be at your school tomorrow for many hours, I'll need to pump my milk over there, where can I go?"

The poor guy felt bad for not having an immediate answer, but obviously he'd never had to think about this before. He called back to tell me that I could use an 'OSCE room.' Of course, I thought!

OSCE stands for Objective Structured Clinical Exams, and most med schools have rooms set up like actual doctors' offices so that students can be observed in a real life setting. It would be perfect because I could lock the door, plus there'd be a sink in the room.

I was glad everything worked out. As I got myself settled I pulled a privacy curtain around me to make me feel extra secure. After all, it's a vulnerable position one's in with plastic funnels gripping the breasts and both nipples pointing out like torpedos.

That's when my own OSCE exams played over in my mind. I used to hate having the video cameras hover over me to screen my performance. . . DOH! There they were, two lenses pointed right at me! I hoped no one was filming, and I nervously finished pumping with the assumption that there's not a lactating porn market out there.

(If someone calls me Dr. Galactasy one day, I'll know I've been had.)

Coming soon:

Scarves - The essential mommy accessory

Cancer prevention - Why breast-feeding helps

Residencies - Which are the most pump-friendly?

Return to Work

2009-08-04T18:22:00.004-05:00

Sorry about the pause in posting, I'm back at work.

I cried for the first couple of blocks during my commute, but I felt very comforted knowing that my family members have stepped in to help watch my boy. When I arrived at work I was humbled by my new surroundings. I'm starting with a pediatric rehabilitation rotation and it broke my heart to see so many children with injuries, making me appreciative to have my healthy baby even if I don't get to see him as much as I'd like.

Pumping is going to be a challenge. My setup isn't bad, but with my doctor responsibilities crashing on me like waves I'm having a hard time getting into the 'mood' of producing an adequate supply. Thanks goodness for the Medela Microwave bags for sterilizing my pumping parts, it saves me a bit of time.

Here we go. . .

No TB for me!

2009-07-30T12:25:00.004-05:00

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

2009-07-28T18:44:00.002-05:00

"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

2009-07-28T10:58:00.002-05:00

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

2009-07-24T12:16:00.012-05:00

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

2009-07-23T17:32:00.004-05:00

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

2009-07-22T16:51:00.003-05:00

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

2009-07-20T16:20:00.006-05:00

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

2009-07-19T10:20:00.005-05:00

"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

2009-07-16T15:29:00.006-05:00

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

2009-07-15T16:00:00.005-05:00

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

2009-07-14T14:55:00.014-05:00

$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

2009-07-13T14:40:00.007-05:00

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

2009-07-10T21:47:00.009-05:00

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?

2009-07-09T12:11:00.005-05:00

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?

2009-07-08T14:28:00.004-05:00

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

2009-07-07T05:21:00.004-05:00

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)?

2009-07-06T10:56:00.005-05:00

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)?

2009-07-06T05:00:00.002-05:00

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

2009-07-03T06:00:00.006-05:00

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

2009-07-02T07:51:00.011-05:00

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

2009-07-01T07:47:00.006-05:00

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

2009-07-01T06:09:00.001-05:00

The online promo-code is CLUTTERCREW.