Saturday, June 23, 2012
Last day
I’ve half drafted about 4-5 entries that still are unfinished in my MiM folder. I definitely plan to eventually post the ones about my journey as daughter and doctor dealing with my mom’s recent breast cancer diagnosis. It has been a difficult, emotional, strengthening, family building, strange, roller coaster of an experience. So far, things are going well. However, I’m writing just a short entry today. Today is my last day of “freedom.”
Tomorrow I’m back in the hospital, a resident again after my two year lab hiatus. I start off as transplant chief. I am completely terrified and completely excited. My life has changed so much in these two years. My special necklace with a pearl and my daughters name on it just arrived from Etsy yesterday. I love my beautiful girl so much!! I hope I’m doing the right thing. I’m completely motivated to make her proud. My life these two years has been a roller coaster of emotions. I’ve gone from loving my anesthesiologist who put in my epidural so much that I was convinced anesthesia was my new calling. Then I was convinced that I must find a way to be a stay at home mom - otherwise I thought my life would be impossible to balance. But, now the hormones are fading, the Zoloft is working (prob TMI - but you’ll hear more about that if I ever post the post-partum depression entry I wrote), and I’m amped up to be a surgeon. Two years of cancer research has given me some clarity. I feel confident that I want to be a breast surgeon (also one of the entries on file). So, I have 3 more years to get as much out of all the other amazing types of surgery that I also love.
Wish me luck!
Cutter
Thursday, June 21, 2012
Guest post: We are growing up
Tomorrow is my first day of Intern orientation. I have
wanted to become a doctor for my entire life and tomorrow I officially work at
my top choice hospital. This moment is bittersweet, mostly because it is the
beginning of being a working mother and it is the end of my 9 months as a stay
at home mother to Lil’ Zo. I am already missing him but I am so excited to
begin my career as a Pediatrician. Pause for my Happy Dance!
I have grown so much as a person since becoming a parent. I am
very in tune with Zo’s moods and cues; I know hunger before he cries, when he’s
tired by the slightest rub of his eyes or ears, and that a certain face and
eyebrow raise mean a poop is on the way. I have learned how to simultaneously
nurse, compose emails, and catch up with friends.
I have learned how to be less rigid. For one, Zo sleeps on
his belly even though I know it is not the current medical advice. As a
newborn, Zo refused for weeks to sleep on his back for more than an hour.
During one of her visits, my mother suggested that I try letting him take a nap
on his belly. I watched him like a hawk for a week and saw he could turn his
head left and right during sleeping, then I slept in his room for an additional
week, and his sleeping went from 30 minutes to 3 hours, and I gradually made my
way back to my shared bed with my husband.
I have learned that baby wearing is like baby chamomile tea;
it soothes and lulls him into a state of contented bliss during which I can
clean the house, read blogs, and cook dinner (with him on my back). I have
learned that a nursing pre-toddler likes to test out acrobatic moves during his
brief, but oh-so-efficient nursing sessions. I swear my boy moves and grooves
more than I thought possible all while maintaining a proper latch without biting
me with his fresh new teeth (he’s amazing!).
Tomorrow I start my life as a seasoned mommy and Pediatric
Resident who still has so much to learn. I know that I will be a better, more
compassionate physician because of all of the love my precious little one has
showered on me since his birth. Now, off to bed where I will sleep and cuddle
and nurse him until I am off for work. We are officially growing up.
-Mommabee is a Pediatric Resident in "The South" with a background in public health. She is married to O, a Librarian turned Doctoral Student and is the momma to Lil' Zo (Fall 2011). She enjoys reading, traveling, spending time outdoors, and of course providing excellent patient care.
-Mommabee is a Pediatric Resident in "The South" with a background in public health. She is married to O, a Librarian turned Doctoral Student and is the momma to Lil' Zo (Fall 2011). She enjoys reading, traveling, spending time outdoors, and of course providing excellent patient care.
Wednesday, June 20, 2012
the off-cycle job hunt
I was recently at ASCO and having dinner with a friend from residency. I asked about his post fellowship job hunt and he shared the details of what sounded like exhaustive process that had finally resulted in a position with a large pharmaceutical company. He asked me what networking I had done - or was planning to- do while at the conference.
Networking?
Yeah, like to get a job.
Uh, I haven’t started thinking about it.
And thus ensued a forty-five minute lecture. How could I have not started this process already? I should have a letter of intent and an updated CV. I should have started cold calling large oncology practices. I should have come to the conference knowing who was going to be here and how I was going to introduce myself. The fact I will be graduating late should have spurned me into starting the search earlier.
I sank lower into my chair and, as he continued to berate my lack of preparedness, accidentally finished the massive slice of chocolate cheesecake we had intended to share. I left the restaurant not knowing if the queasiness in my stomach was from anxiety or a butter bezoar.
Although technically I am about to enter my third and final year of fellowship, because I started late due to my first maternity leave (in residency) and owe this program time for my second leave, I won’t finish until October 1, 2013. The heme and onc boards are in late October, so I wasn’t planning on starting “a real job” until November 2013. Factor in a possible move, I might not be ready to start work until December 2013.
But I have to start the search now? My friend is an intensely driven and consummate go-getter. Both of his parents are successful academic physicians, his older sisters are also physicians, and I suspect he learned about RVUs and impact factors at the family dinner table. He knows a shocking amount of information about the business end of being a physician – how to get grants, publications, protected time, compensation, promotions, jobs, etc. During residency, fellowship, and now, apparently at the start of my job hunt, he was, and is currently, trying to tell me what-I-should-know in order to be successful. Although I know the constant “advice” comes from a place of caring (and it does, despite the fact I am making him sound like a jerk), he can drive me a bit insane.
But he might be right. I will be graduating off cycle, perhaps almost six months after other fellows are ready to start working. I want to move back to my hometown, a medium-sized city with its own set of fellows graduating from the local university. There are some cities where the heme/onc job market is saturated and if I wait to start the search, I might not be able to find a job at all. He reminded me of a mutual friend who couldn’t find a position until a community oncologist actually died.
I think in the writing of this post I have convinced myself of what I already suspected to be true – as daunting as it may seem, I should start looking now.
A real job. Like a grown-up. Who doesn't procrastinate.
A real job. Like a grown-up. Who doesn't procrastinate.
Monday, June 18, 2012
MiM Mailbag: 7 on and 7 off
Hello MIM! I love this blog and have been reading it for a
couple of years now. I think its wonderful that a group of female
physicians are able to talk at liberty about their personal lives and
struggles with motherhood.
I am currently a hospitalist who has been in practice for a few
years. I love hospital medicine and I really enjoy my job but after I
had a child, everything has changed. Although I never particularly
cared for my 7 on/7 off, I have begun to resent it. I this roller
coaster of a life where I either am with my child 24/7 or only see her
for an hour or two a day and its not working. I've spoken with other
mothers in the same situation and I have heard it. "7 on/7 off is
great! You can be a part time SAHM!" "7 on/7 off is awful! How do you
ever see your kid??" People also bring up the point that at least with
shift work, you don't feel the pressure of trying to get out early each
day and that your time at home is protected. I'm truly unable to make
my own assessment because I have not had the benefit of working another
schedule for comparison. Now I am at a crossroads because I have the
opportunity to leave this group and go to a more conventional schedule:
Monday through Friday where you rotate morning and afternoon ER admits
and can leave when you're finished. I'm worried that the naysayers will
be right and that my life will be more stressful if I have the
opportunity to leave early because I will be rushing through my work.
On the other hand, there are days here when there really is no need for
me to be at work for a 12 hour shift and I feel frustrated that I can't
leave when I'm finished. I also feel that my life needs more stability
on a regular basis. Its difficult to keep up with friends, exercise
routines, house work when I'm working 12 hour shifts 50% of the month.
Everything tends to go into disarray when I start my work week and I'm
hopeful that can change if I am able to have more time in the evening.
Has anyone had experience with this dilemma? Any insight into either schedule?
Thank you.
Wednesday, June 13, 2012
MiM Mailbag: When to disclose your pregnancy at work?
Two MiM Mailbags with a similar theme...
Hi,
Hi,
I am about to start Internal Medicine internship at a
medium-sized county program. I have a 2 year old son. I had
originally applied to residency when I was pregnant with him, but
withdrew my application. The Program Director of the program I matched
in told me at that time "We wondered what you were going to do when you
had the baby. Glad you made the choice to take time off before
starting." Well, now I find myself pregnant again. I am due Dec 20. My
current schedule has me scheduled for Medicine wards from Dec 13-Feb 6.
I know that I will definitely need to make a schedule change. I am
nervous to tell my Program Director. Luckily, I am not showing yet at
all (so my family and friends tell me).
Regarding childcare, my husband is taking a leave of
absence from his career to care for our son and for our future child.
So, While I do not really "want" a short maternity leave, I am prepared
to only take off the minimum I will need.
Thanks,
S
***
Hi,
I am pregnant with
twins and going to start my new job in the fall, and I am trying to
decide whether to tell the hospital/group I am working with before I
start which is right at the beginning of the second trimester. Or
should I tell them before they pay for my move in case they don't want
me? I think they will as it took them a long time to recruit me and
recruiting has been an issue since it is somewhat rural. And they knew I
was planning on becoming pregnant at some point and were fine with
that.
What would you do?
Thanks,
A
A
Tuesday, June 12, 2012
Water water everywhere...
If you haven't heard this news, Mayor Bloomberg has proposed a ban on sodas larger than 16 ounces in NYC, as a response to the obesity epidemic.
I'm not a big fan of laws designed to save us from ourselves. I appreciate the smoking bans, because I've been in restaurants where I couldn't enjoy my meal because there was smoke being blown on my face, but it doesn't keep me from enjoying a movie if the guy next to me is drinking a 20 ounce soda.
I know I've written a few posts here that make me seem like I'm some kind of champion of bad health, so I'd like to do the opposite today. I'd like to ask that instead of making laws to save us from ourselves, like no large sodas, they should make laws to help us be healthy.
For example:
A few years ago, I gave up soda. I used to drink one can of Coke every evening with dinner, and I decided I wasn't going to do that anymore. Now I mostly only drink water (or Gatorade when I get very dehydrated). I do think soft drinks are pretty unhealthy, although I mainly stopped doing it because I wanted to eliminate caffeine. Thanks to my example, my husband stopped drinking soda at home too. And my daughter drinks mostly water or milk.
On a recent road trip, we stopped at a McDonald's off the highway. I got a chicken sandwich and I wanted a water to drink. Was it actually possible to get tap water to drink in a cup? No. I had to purchase a bottle of water.
Then when I went to fill the bottle up with more water later, there was no "water" option at the soda station. I could have gotten any sugary beverage I wanted, but not water. So I went to the counter, hoping they could help me:
Me: "Can you fill this bottle up with tap water for me?"
Cashier: "No."
Me: "Really? You mean there's no way I can just get plain water?"
Cashier: "Nope, sorry."
I finally filled it up in the bathroom. Still, it's an outrage that in mall food courts and many chain restaurants (ranging from McDonald's to Chipotles), you can't just get plain water to drink. This happens to me all the time. I'm at the mall food court and I ask for a cup of water with my food, and they look at me like I'm crazy. I've been refused or I've been given a tiny cup that contained three swallows of water. Even if I offer to pay for price of the cup, sometimes they won't give it to me.
Instead of trying to save us from ourselves and banning 20 ounce drinks, I think Mayor Bloomberg et al. should make it easier for those of us who want to avoid sugary drinks to do so! Whatever else you can say about the health value of these foods, soda is certainly tons of empty calories. If you agree, urge local vendors to make water more readily available!
I'm not a big fan of laws designed to save us from ourselves. I appreciate the smoking bans, because I've been in restaurants where I couldn't enjoy my meal because there was smoke being blown on my face, but it doesn't keep me from enjoying a movie if the guy next to me is drinking a 20 ounce soda.
I know I've written a few posts here that make me seem like I'm some kind of champion of bad health, so I'd like to do the opposite today. I'd like to ask that instead of making laws to save us from ourselves, like no large sodas, they should make laws to help us be healthy.
For example:
A few years ago, I gave up soda. I used to drink one can of Coke every evening with dinner, and I decided I wasn't going to do that anymore. Now I mostly only drink water (or Gatorade when I get very dehydrated). I do think soft drinks are pretty unhealthy, although I mainly stopped doing it because I wanted to eliminate caffeine. Thanks to my example, my husband stopped drinking soda at home too. And my daughter drinks mostly water or milk.
On a recent road trip, we stopped at a McDonald's off the highway. I got a chicken sandwich and I wanted a water to drink. Was it actually possible to get tap water to drink in a cup? No. I had to purchase a bottle of water.
Then when I went to fill the bottle up with more water later, there was no "water" option at the soda station. I could have gotten any sugary beverage I wanted, but not water. So I went to the counter, hoping they could help me:
Me: "Can you fill this bottle up with tap water for me?"
Cashier: "No."
Me: "Really? You mean there's no way I can just get plain water?"
Cashier: "Nope, sorry."
I finally filled it up in the bathroom. Still, it's an outrage that in mall food courts and many chain restaurants (ranging from McDonald's to Chipotles), you can't just get plain water to drink. This happens to me all the time. I'm at the mall food court and I ask for a cup of water with my food, and they look at me like I'm crazy. I've been refused or I've been given a tiny cup that contained three swallows of water. Even if I offer to pay for price of the cup, sometimes they won't give it to me.
Instead of trying to save us from ourselves and banning 20 ounce drinks, I think Mayor Bloomberg et al. should make it easier for those of us who want to avoid sugary drinks to do so! Whatever else you can say about the health value of these foods, soda is certainly tons of empty calories. If you agree, urge local vendors to make water more readily available!
Monday, June 11, 2012
Guest post: Heavy heart
It's
been a long day on ICU, and I'm patiently waiting for the night float
resident to relieve me of my duties so I can go home, sneak into my kids
bedrooms and kiss them goodnight. Although they won't see me with
their smiling faces for another 2 days. I am a second-year family
medicine resident in the southwest, and am at this point officially
burned out and miss my kids terribly. I had my second child (a girl) 8
months ago. My son is 2 1/2. Dad works full-time as well, but carries
the brunt of the duties when I'm on challenging inpatient rotations.
"Guilty" does not go far enough in describing the perpetual feelings I
harbor about leaving home every day to take care of others, when all I
really want is to be taking care of my family. Don't get me wrong, I
love being a doc, and have worked years and years to achieve this goal.
But I can't help but wonder whether I will regret this all when my kids
ask "Mom, did you stay at home with us?" or "Mom, who did you leave us
with when you were at work?" They are cared for by a very good friend
of mine who cares for a few other kids together in her home. She is the
mother we all want and want to be for our children. And they LOVE her.
But I can't get past the fear that they will somehow resent me being
gone when they are older, and realize just how much I have been
absentee. Thus, I carry a heavy heart, nearly every day that I am away.
I've never felt like this about anything. It's always been about me,
about my goals, about my plans. Now it's about them, and I want
to give them the best of everything. Can I still do that even when I'm
away?
-Gem
Monday, June 4, 2012
MiM Mailbag: Medical school interview advice
Hi Mothers in Medicine,
I have been
reading this blog for a year now, and all of your stories and triumphs
(heartache too!) have inspired me to fulfill my dream of being a doctor.
I was told when I was 18 that, "if you really want to be a good mother
dear you shouldn't be a doctor, I've just never seen anyone be able to
pull if off." So I went and did nursing school. A fabulous career, but
after three years I am pretty bored and ready for something more
challenging. After reading almost every single post on this blog, I've
realized I can be a mother and a doctor. I also married a wonderful man
who is encouraging me to pursue medicine.
The point of this post is to ask for some help to prepare for my interview. I have one in three weeks with my top medical school pick (an overseas institution, hence the summer interview).
Seeing as many of you (maybe many years ago) all
went through the interview process I am asking for any tips, do's/dont's
and general advice.
How did you answer that favorite question
- "Why do you want to be a doctor?" other than saying, "well I want to
help people"... I mean, that's why I want to do it, but doesn't everyone
say that?
Warm Regards,
Amy
Saturday, June 2, 2012
My Postpartum Overhaul: First Physical, and Now Mental
OK, It's a rainy Saturday. I am not on call. My husband is watching our 2 kids (under 2 years old) so I can work out. I just jumped on our Spinning bike and banged out 15 minutes of hard up-down cycling, while watching Cupcake Wars (It makes the time go really fast, and I vicariously enjoy the cupcakes, while actually burning calories!).
I thought up this post in the midst of the workout, and I jumped off the bike. Now I'm sitting here, sweaty, trying to bang out the writing. Meantime I can hear my toddler boy yelling. He's got a cold and is just cranky, and he wants me. The baby is whimpering, and Hubby will have to make her a bottle one-handed, while our toddler howls and hurls things around the living room.
So let me be brief.
Quick backstory: I'm a part-time internist in group practice, and I had my second baby 5 months ago. My last few posts here on Mothers in Medicine have focused on my journey back to fitness after baby #2. I was 4 weeks postpartum, and realized that at 5' 2" and 163 pounds, I was officially obese. In spite of the fact that I was breastfeeding exclusively, I was gaining weight (and yes, that is common). It was my eating habits. Carbs, carbs, carbs. Bowl of Cheerios here, toast with butter and jam there.
I was shocked, but motivated. I got on the South Beach Diet and I lost a ton of weight. Listen, folks, the low-carb diets work. (I get no endorsement monies from them, BTW) (Though I would take some in a second, if they offered :)
I also started exercising again. For the first 3 months, I just ran outside when I could (though to call it running would be exaggerating. More like jog-walking) and did some Pilates on the floor before bedtime. This month I added back the gym.
And in 4 months, I have lost 30 pounds, down to 133 pounds, only 10 pounds away from my goal. I am well out of obese BMI range, and I feel great. Physically.
However, mentally, I am sagging. Now, Babygirl is still not sleeping through the night. My husband travels for work, alot. Though we have great family support, it is just a hectic schedule. My reserve is low.
But, some days, I find myself just suffering through clinic. The day will start out OK and manageable, and then, as happens not infrequently, I will encounter a difficult patient, and I will just get so down. I mean, so down that I come home and start surfing the net for non-clinical doctor jobs.
Now, the vast majority of my patients are absolutely lovely. Honestly. I have been so boosted, even blown away, by the interest people take in me and my family; by the unsolicited support for my working part-time; by thoughtful cards or baby gifts; by positive feedback on my clinical work
But just one angry/ blaming/ abusive/ demanding patient, and I am just crushed. Even when I am in the right (like in diagnosing an alcohol problem, or not prescribing narcotics). Even when I know the patient has psychological issues, and is only acting out at me because I happen to be sitting there. The negativity will get to me, even if there is no overt confrontation, or raised voices, or complaints. If a patient is unhappy, I feel like a failure. I get shaken, even to the point of physically shaking. I feel like I will have a panic attack in the office.
Colleagues are supportive. We all see many patients a week, and we all have similar experiences, day in and day out. There is plenty of camaraderie, and I can always find someone with whom to vent, and feel validated.
But, at the end of the day, I hate these negative encounters. They make me want to quit my job.
I'm trying to look into this, to see what steps I can take to build resilience so that I don't feel like I need to please everyone; so that I don't feel a failure when a patient is unhappy. I used to be much better at this.
I'm currently looking at the concept of Compassion Fatigue. This is new territory for me. What do other MiM know about this? Is this something that applies? Or am I just an exhausted new mom with little reserve in a demanding profession having a normal experience?
I thought up this post in the midst of the workout, and I jumped off the bike. Now I'm sitting here, sweaty, trying to bang out the writing. Meantime I can hear my toddler boy yelling. He's got a cold and is just cranky, and he wants me. The baby is whimpering, and Hubby will have to make her a bottle one-handed, while our toddler howls and hurls things around the living room.
So let me be brief.
Quick backstory: I'm a part-time internist in group practice, and I had my second baby 5 months ago. My last few posts here on Mothers in Medicine have focused on my journey back to fitness after baby #2. I was 4 weeks postpartum, and realized that at 5' 2" and 163 pounds, I was officially obese. In spite of the fact that I was breastfeeding exclusively, I was gaining weight (and yes, that is common). It was my eating habits. Carbs, carbs, carbs. Bowl of Cheerios here, toast with butter and jam there.
I was shocked, but motivated. I got on the South Beach Diet and I lost a ton of weight. Listen, folks, the low-carb diets work. (I get no endorsement monies from them, BTW) (Though I would take some in a second, if they offered :)
I also started exercising again. For the first 3 months, I just ran outside when I could (though to call it running would be exaggerating. More like jog-walking) and did some Pilates on the floor before bedtime. This month I added back the gym.
And in 4 months, I have lost 30 pounds, down to 133 pounds, only 10 pounds away from my goal. I am well out of obese BMI range, and I feel great. Physically.
However, mentally, I am sagging. Now, Babygirl is still not sleeping through the night. My husband travels for work, alot. Though we have great family support, it is just a hectic schedule. My reserve is low.
But, some days, I find myself just suffering through clinic. The day will start out OK and manageable, and then, as happens not infrequently, I will encounter a difficult patient, and I will just get so down. I mean, so down that I come home and start surfing the net for non-clinical doctor jobs.
Now, the vast majority of my patients are absolutely lovely. Honestly. I have been so boosted, even blown away, by the interest people take in me and my family; by the unsolicited support for my working part-time; by thoughtful cards or baby gifts; by positive feedback on my clinical work
But just one angry/ blaming/ abusive/ demanding patient, and I am just crushed. Even when I am in the right (like in diagnosing an alcohol problem, or not prescribing narcotics). Even when I know the patient has psychological issues, and is only acting out at me because I happen to be sitting there. The negativity will get to me, even if there is no overt confrontation, or raised voices, or complaints. If a patient is unhappy, I feel like a failure. I get shaken, even to the point of physically shaking. I feel like I will have a panic attack in the office.
Colleagues are supportive. We all see many patients a week, and we all have similar experiences, day in and day out. There is plenty of camaraderie, and I can always find someone with whom to vent, and feel validated.
But, at the end of the day, I hate these negative encounters. They make me want to quit my job.
I'm trying to look into this, to see what steps I can take to build resilience so that I don't feel like I need to please everyone; so that I don't feel a failure when a patient is unhappy. I used to be much better at this.
I'm currently looking at the concept of Compassion Fatigue. This is new territory for me. What do other MiM know about this? Is this something that applies? Or am I just an exhausted new mom with little reserve in a demanding profession having a normal experience?
Study: Breastfeeding Results in Increased Morbidity and Developmental Delay
Abstract: Breastfeeding has long been touted as improving immunity and having other benefits. However, this study demonstrates that the opposite is true, and that breastfeeding results in increased infections and delayed development.
Introduction: Many studies have shown benefits of breastfeeding, but there are limitations to all these studies since the breastfeeding and non-breastfeeding groups are different. This study looks at babies of the same sex from the same parents, so obviously they're exactly the same.
Methods: Two babies, both girls, from the same parents were studied, examining the number of infections, rate of growth, and developmental milestones. Subject #1 received breastmilk for only six months and got formula supplementation during that time. After six months, Subject #1 received only formula. Subject #2 received only breastmilk for the first six months, then very minimal formula supplementation for the rest of the first year.
Results: At the end of the first year, Subject #1 was at the 99th percentile for both height and weight. She had zero ear infections and zero infections requiring antibiotics. At the end of the first year, Subject #2 was at the 5th percentile for weight and 50th percentile for height. She had been treated for two cases of conjunctivitis and three ear infections. She also threw up a bunch of times. Subject #1 crawled and pulled up two months earlier than subject #2. Subject #1 walked at 10 months of age (data on Subject #2 still pending).
Discussion: Subject #1 showed significantly decreased infection rate compared with Subject #2, in addition to improved growth and reaching milestones. Since Subject #2 received more breastmilk than Subject #1, this likely accounted for the differences.
Conclusion: Breastmilk, once thought to be so great, is actually a source of infection and developmental delay. Who would have thought it?
Introduction: Many studies have shown benefits of breastfeeding, but there are limitations to all these studies since the breastfeeding and non-breastfeeding groups are different. This study looks at babies of the same sex from the same parents, so obviously they're exactly the same.
Methods: Two babies, both girls, from the same parents were studied, examining the number of infections, rate of growth, and developmental milestones. Subject #1 received breastmilk for only six months and got formula supplementation during that time. After six months, Subject #1 received only formula. Subject #2 received only breastmilk for the first six months, then very minimal formula supplementation for the rest of the first year.
Results: At the end of the first year, Subject #1 was at the 99th percentile for both height and weight. She had zero ear infections and zero infections requiring antibiotics. At the end of the first year, Subject #2 was at the 5th percentile for weight and 50th percentile for height. She had been treated for two cases of conjunctivitis and three ear infections. She also threw up a bunch of times. Subject #1 crawled and pulled up two months earlier than subject #2. Subject #1 walked at 10 months of age (data on Subject #2 still pending).
Discussion: Subject #1 showed significantly decreased infection rate compared with Subject #2, in addition to improved growth and reaching milestones. Since Subject #2 received more breastmilk than Subject #1, this likely accounted for the differences.
Conclusion: Breastmilk, once thought to be so great, is actually a source of infection and developmental delay. Who would have thought it?
Monday, May 28, 2012
MiM Mailbag: Dreaming of Emergency Medicine
Hi Mothers in Medicine,
My name is Christina, and I am a recent graduate with my Masters working as a family practice physician assistant. My dream career has always been to be a doctor, specifically, an ER doc. I avoided the med school route because I knew I wanted to get married and have a family at some point. However, I wasn't in a serious relationship so this was just a distant hope. Now that I finished my Masters and still not in a serious relationship, the idea of going to medical school is still nagging at my heart.
So my question is a little different than your typical post here. I have some worries that going to med school will impede me from finding a good relationship and becoming a mother because I am so concentrated on school. I would love to hear some encouraging stories and words of advice or just good plain reality checks! Did anyone here have the same concerns? Are there any moms here that work in emergency medicine that could share their perspective with me in terms of family and being an ER doc? I am 25 years old and would be applying to medical school this year or next depending on how the MCAT goes this summer. Also, I am thinking of applying to both osteopathic and allopathic schools. Any DO ER moms that can speak about how residency was for them? I admire all of the women on this blog and hope that someday to be in your position: a physician, wife, and mother. I know it's a hard combination, but it's a blessing and is what my heart is telling me! Thank you for any advice you can share with me!
Sincerely,
Christina
My name is Christina, and I am a recent graduate with my Masters working as a family practice physician assistant. My dream career has always been to be a doctor, specifically, an ER doc. I avoided the med school route because I knew I wanted to get married and have a family at some point. However, I wasn't in a serious relationship so this was just a distant hope. Now that I finished my Masters and still not in a serious relationship, the idea of going to medical school is still nagging at my heart.
So my question is a little different than your typical post here. I have some worries that going to med school will impede me from finding a good relationship and becoming a mother because I am so concentrated on school. I would love to hear some encouraging stories and words of advice or just good plain reality checks! Did anyone here have the same concerns? Are there any moms here that work in emergency medicine that could share their perspective with me in terms of family and being an ER doc? I am 25 years old and would be applying to medical school this year or next depending on how the MCAT goes this summer. Also, I am thinking of applying to both osteopathic and allopathic schools. Any DO ER moms that can speak about how residency was for them? I admire all of the women on this blog and hope that someday to be in your position: a physician, wife, and mother. I know it's a hard combination, but it's a blessing and is what my heart is telling me! Thank you for any advice you can share with me!
Sincerely,
Christina
Saturday, May 26, 2012
I can see clearly now
Today is the last anyone can say to me "You should know, you're a doctor," and I can answer "Nuh uh, not yet."
Tomorrow is graduation.
Tonight will be a dinner party at my mom's house. I am really looking forward to it. There will be people from so many segments of my life. There is someone I haven't seen since elementary school coming. My favorite cardiology fellow. My closest friends from my thirties. A friend from undergrad who knew me when I worked the graveyard shift at Denny's.
Nothing is how I thought it would be right now, but I am still relieved, happy and proud. And, I am thrilled the week of rain finally cleared up, because we are having the dinner party on the back patio.
Tomorrow is graduation.
Tonight will be a dinner party at my mom's house. I am really looking forward to it. There will be people from so many segments of my life. There is someone I haven't seen since elementary school coming. My favorite cardiology fellow. My closest friends from my thirties. A friend from undergrad who knew me when I worked the graveyard shift at Denny's.
Nothing is how I thought it would be right now, but I am still relieved, happy and proud. And, I am thrilled the week of rain finally cleared up, because we are having the dinner party on the back patio.
Wednesday, May 23, 2012
Guest post: My brain doesn't function anymore
I’ve just experienced one of the most embarrassing (not
worst patient outcomes, just down to the core of my doctor-ego embarrassing)
moments so far in my academic career. I need some positive reinforcement,
honesty, and maybe reassurance that maybe it wasn’t as bad as it felt. Here’s
the backstory… I wrote MiM about a year ago when I was trying to decide
between a fellowship application to Endocrine or applying for the Chief Medical
Resident position. I got some really helpful opinions and turns out I got the
Chief job and will be putting off fellowship for a few years, probably with
some hospitalist work in between. I also, in the meantime, got pregnant again
and had our second child. It was all part of the grand plan to get as much paid
maternity leave as possible before the bubble of residency is over and to spend
more time with my new baby as I could, because chief year was supposed to be
more flexible than being an attending... Plus, I’m already super tired
and overworked, might as well just do it all now… right? It doesn’t
get any easier? (this is my rationale… flawed as it may be)
So now baby boy #2 is 3.5 months old, older boy is 3 years
old. I’ve been on maternity leave for 8 weeks, and then research for 8
weeks. It’s been blissful bonding time with baby boy #2. Now I’m
coming up on the end of unstructured time in residency… and today I
presented my research at the resident research symposium. I only had to get
some slides together to fill a 20 minute time slot with my results. Pretty
simple. Not presenting at ACP or other Fill-in-the-blank Big Subspecialty
Conference. The slides were good and I had some positive results. Problem is…
my brain is not what it was a few months ago. I haven’t had to interface
with a lot of people at work in MONTHS. Major clinical rotations were done for
me over 6 months ago. Let’s face it: I have Baby Brain and this
phenomenon is real. With my first son, I started intern year when he was 4
months. So okay, I had an excuse for not knowing anything then, because no
intern really knows how to do their job in the beginning. What’s my
excuse now? No one really remembers that I just had a baby 3 months ago. Or
that this is my first real public presentation outside of my data crunching at
home.
So here’s what happened tonight and why I can't stop
crying. Okay, that part is likely hormonal. But I am honest-to-goodness
downright embarrassed…
My slides went well. People were impressed with the
findings. Then came questions. I am not a fan of public speaking on a normal
day, but now I felt like I was having an out of body experience. I could not
think. Initially, I was able to say “yes, good point, that would be an
excellent idea for future study… blah blah blah” Then the Chair of
Medicine asks a question. In hindsight, he was prompting me to recall part of
the lipid metabolism mechanism which may explain part of why my research
finding was the way it was (without getting too detailed). I couldn’t
come up with anything. My program director then tried to prompt me again to
answer with a knowing sparkle in her eye. She practically winked (may be an exaggeration).
Again – MIND BLANK – nothing… I asked him to repeat the
question. I couldn’t even come up with filler. It was like the dream
where you are naked at school. “uh… uh…” That’s
all I could say. I couldn’t believe it. I thought I was going to
vasovagal right in front of everyone. Saddest thing is, I knew the answer; I
just couldn’t recall the words. Maybe I had a TIA. Nah… it’s
baby brain.
The worst of it: My next major work project is…
presenting GRAND ROUNDS for the medicine department. In 3 weeks. It’s a
tradition for all the incoming chief residents in my program to present grand
rounds and I have been preparing, stressing, and thinking about this for 6
months. But now I’m downright terrified. I’m so scared my brain is
going to fail me again and leave an auditorium to fall silent to simple
questions that I should know the answer to. Here I am people – the new
face of our Big Academic Internal Medicine Program.
I need my brain back. There are so many patients I need to
care for, medical students to teach, a residency to effectively run, and the
ABIM to pass in a few short months… I need it back. I need to know that I
can still do this job.
Niquekee
Monday, May 21, 2012
No more pumping!
I have been given the go ahead by our pediatrician to start giving whole milk in June, so I have two more weeks of pumping, then I am done for good! I'll keep breastfeeding for as long as she wants it or around 18 months, whichever comes first, so I won't be saying goodbye to that just yet. But I refuse to touch that pump ever again.
Things I'll miss about pumping:
1) Automatic excuse to disappear in the middle of the day at work
2) Get to eat whatever I want, yet still had calculated BMI of 18 at last doctor's appointment
Um, I think that's it.
Things I absolutely won't miss about pumping:
1) Always having to do it every day, no matter how crazy busy I am at work
2) Trying to figure out how to pump at conferences (especially fun when power goes out on entire block)
3) Having to carry the pump everywhere
4) Realizing I'm at work and forgot pump at home
5) Storing and transferring pumped milk to bottles
6) Drinking constantly yet still always being dehydrated
7) Waking up 30 minutes early every day to pump
I met my goal of pumping for a whole year. I didn't meet my goal of not supplementing with formula, thanks to unexpected mold growth on my breast pump tubing, but I'm not crying over it. I only used two cans total the whole year. And as I've said before, I don't think there's actually anything wrong with formula.
My older daughter self-weaned at one year, but I have a feeling it's going to be harder to do the final weaning this time. This one is mega clingy... her first word was "mama," and if I'm home, she refuses to be held by anyone else. But I'm not going to worry about that until the winter.
Things I'll miss about pumping:
1) Automatic excuse to disappear in the middle of the day at work
2) Get to eat whatever I want, yet still had calculated BMI of 18 at last doctor's appointment
Um, I think that's it.
Things I absolutely won't miss about pumping:
1) Always having to do it every day, no matter how crazy busy I am at work
2) Trying to figure out how to pump at conferences (especially fun when power goes out on entire block)
3) Having to carry the pump everywhere
4) Realizing I'm at work and forgot pump at home
5) Storing and transferring pumped milk to bottles
6) Drinking constantly yet still always being dehydrated
7) Waking up 30 minutes early every day to pump
I met my goal of pumping for a whole year. I didn't meet my goal of not supplementing with formula, thanks to unexpected mold growth on my breast pump tubing, but I'm not crying over it. I only used two cans total the whole year. And as I've said before, I don't think there's actually anything wrong with formula.
My older daughter self-weaned at one year, but I have a feeling it's going to be harder to do the final weaning this time. This one is mega clingy... her first word was "mama," and if I'm home, she refuses to be held by anyone else. But I'm not going to worry about that until the winter.
Friday, May 18, 2012
Career day embarrassment
I am one week and three days from graduation. WOOOHOOOOOOOOO!
I am incredibly busy, which means I am also paralyzed in the face of all the crap I have to do, and procrastinating on the internet. Hello!
Yesterday I was a presenter for career day at my 7 yr old son’s school. I wore my white coat, wore scrubs, and brought my stethoscope and other tools. I presented in six classrooms (exhausting!), but started off in my own son’s first grade class. I had an apron with sort of anatomically correct removable velcro body parts, which I used to play a matching game with the kids. If a kid guessed which organ I was describing (this organ is a muscle that pumps blood to the body!) then that kid got to put that organ on the volunteer kid who was the “body” wearing the apron. It was especially fun when we got to the kidneys and the large intestine. Poop! Pee! “EWWWWWWWW!”
There were only seven body parts, though, so I brought in my ragtag collection of toy doctor tools. Several people bought toy doctor sets for my kids when I got into medical school, so I had four plastic stethoscopes, a plastic syringe, toy otoscopes, etc. I passed those out to the kids who didn’t get to put on an organ, so they could guess what they were used for, and was one kid short. So, I gave that kid my coffee mug. I made a joke about how that was the most important doctor’s tool, since it helps keep doctors awake, and remarked on how much coffee I drink.
My son rose his hand, and offered, “She drinks beer, too!” I said “And, goooodnight everybody!” and quickly defended myself. “I didn’t drink any this morning! I didn’t have any last night!” and spent the rest of the half hour trying to convince my son’s teacher that I don’t have a drinking problem.
*facepalm*
Cross posted at Mom's Tinfoil Hat
I am incredibly busy, which means I am also paralyzed in the face of all the crap I have to do, and procrastinating on the internet. Hello!
Yesterday I was a presenter for career day at my 7 yr old son’s school. I wore my white coat, wore scrubs, and brought my stethoscope and other tools. I presented in six classrooms (exhausting!), but started off in my own son’s first grade class. I had an apron with sort of anatomically correct removable velcro body parts, which I used to play a matching game with the kids. If a kid guessed which organ I was describing (this organ is a muscle that pumps blood to the body!) then that kid got to put that organ on the volunteer kid who was the “body” wearing the apron. It was especially fun when we got to the kidneys and the large intestine. Poop! Pee! “EWWWWWWWW!”
There were only seven body parts, though, so I brought in my ragtag collection of toy doctor tools. Several people bought toy doctor sets for my kids when I got into medical school, so I had four plastic stethoscopes, a plastic syringe, toy otoscopes, etc. I passed those out to the kids who didn’t get to put on an organ, so they could guess what they were used for, and was one kid short. So, I gave that kid my coffee mug. I made a joke about how that was the most important doctor’s tool, since it helps keep doctors awake, and remarked on how much coffee I drink.
My son rose his hand, and offered, “She drinks beer, too!” I said “And, goooodnight everybody!” and quickly defended myself. “I didn’t drink any this morning! I didn’t have any last night!” and spent the rest of the half hour trying to convince my son’s teacher that I don’t have a drinking problem.
*facepalm*
Cross posted at Mom's Tinfoil Hat
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