I can’t believe I was pregnant the last time I dropped a post on this blog – Katherine has long since been born, is a darling joy in our life but starting to get real spunky, our boy Andy is a benevolent big brother, and my sweet husband has already been wrapped around Katherine’s little finger and yes she’s totally a daddy’s girl!
And I’m in the final sprint. Residency has proven quite arduous – big shocker, I know. Not only have I stored up unimaginable hours away from home bent over my notes from clinic or rounding on my patients “just one more time” or squeezing one more triage patient or one more admission in before the end of my shift – for seemingly endless days on the wards and in clinic, but I’ve also found myself in mild state of mortification in my life as an “over-achiever,” “type-A,” “perfectionist,” personality. This past summer, there was a miscommunication regarding my vacation start time, and, due to this, my program brought me before the Graduate Medical Education Committee (GMEC) to determine my punishment. My program’s recommendation was to place me on probation for professionalism and delay my residency graduation date another 3 months (it’s already 3 1/2 months behind my peers for maternity leave). At the time, I wasn’t really even aware of what probation meant, had never imagined I would ever merit this status, and I was freaked out by this drastic route of punishment chosen by my program. However, by God’s grace, the GMEC voted to not delay my graduation. I am, however, on probation indefinitely, and it feels like there is no end in sight, but thankfully this had very little to no impact on my future career. I just need to survive past this.
Aside from this big stress in our lives as a family right now, we are rounding a corner here – finally starting to think about new chapters in our lives, new places we are going to go. We just got the word that we’ll be moving soon to Florida! The thought of knowing/dreaming/planning our next home is so exciting, and the idea of BEACHES of the emerald coast is thrilling!
So we’re in the final sprint! 2020 – residency graduation year! 2019 was a very interesting year – a mix of 2nd and 3rd year of residency. I’ve cumulatively been sicker than ever before – though almost comparable to my 4th year of medical school. Likely multifactorial – having a child aged 9 months – 18 months in daycare means that they are CONSTANTLY collecting nasty viruses and giving them to you during your snuggle times! The added stress and sleeplessness from residency I’m sure does not help. I got strep throat so bad I requested narcotic pain medicines just to get me to be able to sleep through the pain! I lost at 10 pounds of water weight in one day from diarrheal illnesses twice this past year! And I went to the ER with crazy weirdness fever illness that rendered me so weak and feeble, I thought I had a blood infection or meningitis or maybe pyelonephritis – yes I have quite an imagination – it improved massively after about 48 hours so I guess it was none of the above, but man I was sick. I also have migraines which not been good to me since about 6 months post-partum.
Also in this past year, I’ve discovered several health podcasts which I’ve really enjoyed listening to. The DietDoctor and BrokenBrain podcast and WellnessMoma. I’ve been eating up all these interesting shows which talk about wellness. I somehow, despite the good education about weight loss/maintenance have been gaining weight slowly since weaning Katherine. I know its from all of this stress probably – the late nights and the racing mind as it’s growing into this new high stress job. I do love to learn about all of this health maintenance stuff though and I hope to implement some of the tips and tricks when I’m out of residency. I’ve pushed my family to start to buy more organic and grass fed and non-GMO foods because I feel those arguments against the less sustainably farmed products are fairly strong, and we have money, so it’s not a huge lifestyle change to do the switch. I also got an Oura ring. This is a sleep tracker – its supposed to help motivate me to make better decisions before bedtime (no TV or snacking) but it doesn’t always work haha. Sometimes I think it is more harm than good to know how bad my sleep was, like last night I slept terribly based on my Oura ring analysis. There is such a thing as the nocebo (where you feel worse because you’re being told that you aren’t doing well). I don’t need a ring to tell me that I am not sleeping well, I know that by how crapy I feel. But it is nice when I get a good nights rest, makes me feel really good about myself and the decisions that I made before bed. Lately I’ve just not been able to resist a bowl of my air-popped popped corn and a nice glass of wine to go with an episode of the latest interest on Hulu or Netflix, and since I’m getting home so late, getting the kids to bed so late, that leaves me going to bed with a full stomach and only 5-6 hours left to sleep – NOT good. I have periods where I’m back to making good decisions (usually after a week of really crapy sleep haha), then I go back to doing what I want before bedtime.
This morning I woke prematurely after James accidentally rolled into me in our king-sized bed. It’s not his fault, and this is by no means a pattern for us. But I just couldn’t fall back to sleep, just kept imagining this one vaginal delivery yesterday. It was the first delivery in a while where I was the only one with hands on the baby as she came out, and it was this really amazing slow and controlled delivery – one where the mom was doing it all perfectly, but I had to control the head to keep it from shooting out, and then when the head was out, the shoulders came with relative ease, I just had to do a lot of guidance – and everything happened so perfectly, I had my bottom hand both guiding and protecting the perineum, and that baby girl came out so nice and controlled – was so funny because she had her bottom arm swept across her body with the hand placed on her opposite cheek as she came out. This is what we call a compound hand or compound presentation – as I eased her out, her arm came waving at me – like HELLO world, I am here! And I had my bottom hand braced against that perineum when she flung that hand out, so she didn’t tear her mom wide open when she did it! It was just so crazy to see how when the baby was crowning, the vaginal opening just did not seem flexible enough to allow passage of that head. I had run my fingers around its inner circumference, and felt a definitive tight, inflexible band which held back that baby’s head as it was crowning. I was just so certain she would tear fairly significantly (I’ve done almost 100 deliveries at this point), and yet, when that baby delivered, the mom’s body miraculously stretched to accommodate, and then just shrunk back up – like it never happened. Just amazing. I don’t know why, but as I was lying in bed I just kept replaying it. That was just such an amazing moment – it my 3rd delivery for that day, but I think this may have been the first time in a long while that no one was at my side with their hands also participating in the delivery and also required my own participation (slow controlled guidance and bracing that perineum to keep it from tearing as that arm flung out). So I guess it left me feeling fairly badass, and I guess as I am lying awake in this early morning I am basking in feeling this really good feeling of having done some good in the world.
It’s a nice change. It is a really cool feeling when you are a the top of your training, feel like everything feels fairly comfortable now, and like you’re doing a good job. There are still plenty of moments where I have the opposite problem – lying awake replaying a mistake that I’ve made or worrying about a patient. Waking up the next morning to rush to my computer to see if my patient is doing OK or to call them back to see if there is anything I missed. But these last couple days on the Labor and Delivery Deck, and even a few weeks ago while on the hospital ward, I’ve really had some lovely moments, and they are addicting. Make me feel like maybe I should just keep doing residency-type work; I think it’d be amazing to go in to teaching and keep doing all of these different things (labor and delivery, hospital work, vasectomies) as well as clinic.
But my next job will be only clinic AND only healthy young adult patients. But my next journey’s focus – which I am definitely ready for – is to finally be more present with my family. I miss them and I try not to think too much about all that I am missing right now being at work so long. The other day Katherine didn’t even want me to hold her after a long day at work. This just broke my heart. And she was sick and vomiting – all she wanted was daddy. I felt like such a failure when this happened. But at the same time, I know there is much out of my hands right now – and I will just all the more cherish them when I do finally get off work because all of this away time. It’s also so amazing to see how James fills in my absence and cares for them so wonderfully and with such undivided attention when he’s with them. It’s humbling and makes me so grateful!
Well that’s the extend of my reflective writing for the day – now to hopefully get some nice yoga in and sit down and enjoy some tasty coffee! Maybe I’ll work on some dough for cinnamon rolls! MMMmmmmm….
Pansy Pantaloons 