The Mrs. The Mommy. The M.D.: March 2014
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Monday, March 24, 2014

Match Day Update and a HUGE THANK YOU!!!!

I cannot say it enough.

I am in AWE of the love and support that you all have given me over the years and as I experienced the whirlwind of Match Day you guys made sure I knew I was loved. Thank you so much for reading and cheering me on.

Match Day was awesome! It was right up there as one of the best days of my life.

At noon we opened the envelopes and.... :drum roll:

We will be taking our talents to North Carolina as I begin residency at....
University of North Carolina - Chapel Hill!!!

I am soooo excited!!!! If you are a new reader to the blog, welcome! I am so happy you are here.

Below are some of my favorite pictures from the ceremony:

Waiting with THEE envelope!!

After opening our envelopes we got to tell everyone where we were going, Natey did great when he yelled "UNC!" It was so cute :-D My little bro took these screenshots from the live feed online...

Photo Credit: Liz Kaye

We did it!!

Go Tarheels!!! 

Wednesday, March 19, 2014

Check Out My Guest Post on the Student Doctor Network!

If you are pursuing a career in the health sciences, then you are probably more-than-familiar with the abundance of resources and forums on The Student Doctor Network. If this is your first time hearing about it, go there now!

Today, I am super excited to be guest posting on the about parenting in medical school, and I would love for you to check it out and let me know what you think! [Link Here]

Have a great day everyone :-)

Monday, March 17, 2014

Started from the Bottom...Now It's Match Week!!!!!!! **UPDATED!**

Well, this is the big week! At noon today, I will get an email saying whether or not I matched into residency, and this Friday I finally get to find out where I will be for the next 4 years! Ahhhhhhhh!
From White Coat ceremony to soon-to-be resident!

If you are anxiously needing to kill time while we wait (eeeek!!!), please go check out an interview I did last week for here: Moms of the Week Feature

And also, one of my classmates (matching into internal medicine) was sweet enough to feature me on her blog last Friday: The Honest Doctor Feature

I will be sure to keep you all posted on the good news!

The good news!!!:
"And we know that all things work together for good to them that love God, to them who are the called according to his purpose." Romans 8:28

Friday, March 14, 2014

Working/Schooling Outside the Home and Still Breastfeeding

Everytime I talk about breastfeeding, this "Making the Band" Chapelle skit pops in my head...
:singing in "Bad Boy" voice : "Breast-miiiilk"
Isabelle will be 8 months old this week!! I cannot believe it. This week is doubly big because I decided that I am not going to pump anymore, and will just breastfeed her when she is with me.

My supply has been diminishing since my OB-GYN sub-I in January. Unfortunately, I just didn't have enough time during the day to pump as much as I should of. Despite the 12+ hour days, I continued to pump - usually once a day for about an hour when I got home. Babygirl has a healthily growing appetite, so in February, we decided to start supplementing during the day. This basically meant while she was at daycare, she would get half breast milk with half-formula.

Last month, when I would come home from my 10+ hour stints in the ED, I continued to sit on the pump for at least an hour trying to force my body to squeeze out 8 oz of milk so I could "break even". And because some of my shifts did not end until 2AM, sometimes I was up as late as 4AM (ugh it was ridiculous). It was exhausting and pretty much sucked.

As bittersweet as it is to see my freezer milk reserve dwindle, this is also a huge weight off my back. As Izzy has started sleeping through the night, it kind of eliminates the need for night time breast milk too, and my body got the hint pretty quickly. I'm so proud of how long I was able to exclusively breastfeed throughout rotations, traveling on interviews (yes, I took breast milk with me through airport security LOL), changing schedules, so I am not going to beat myself up for ditching the pump and leaning on formula a little bit more.

That being said, in an effort to help those student mamas who may be embarking on the daunting task of schooling or clerkships while lactating, here are some of the tips and tricks I picked up along my way...

1. Stake out all the lactation rooms ahead of time: Usually hospitals are pretty lactation-friendly and have at least one room designated for pumping. The children's hospital on campus, has like "The Bellagio of Pumping Rooms". It makes sense - with the place swarming with kids and one of the state's largest NICUs - you want breastfeeding to be common and accessible. I have noticed, however, that very few women sign out the pumping room key... I also had access to a great room at the Women's hospital while I was on my OB-GYN Sub-I.

Racks on racks on racks...of breast milk
2. Ditch the bags: I started out with storing my milk in the Lansinoh bags, but words cannot express how disappointed/sad/betrayed (yes, dramatic, I know) I felt when my milk started LEAKING from the bags during the thawing process. It was like a daily, not to mention stressful, toss up as to whether or not I would get the full 6oz from a bag or if it would just make a mess in my fridge. Grrrr I think I cried more over spilled milk with Isabelle than with Nate.

That's when I switched to the Mother's Milk Mate storage system (shown above) and loved it. The only drawback was that unless you buy two racks, and take up ridiculous freezer space, you can only store 10 bottles at a time. I know, 10 is decent, but at one point I was a lactating machine. Wasted liquid gold SUCKS, so stick to bottles! Easier to store, less spillage, great for mommies who bring milk back home. No they are not paying me for this endorsement. I'm just a satisfied customer :-)

3. Commit to pumping at least one time per day and "try" to stay consistent. I started pumping the day after we got home from the hospital with Isabelle. Every night I would have her dad give her a bottle so I could pump as close to 5PM as possible. Within a few days, I could feel that my supply had come in and I could pump 12-14oz in one sitting! Things of course changed when I went back to the wards. Pumping at the same time can be near impossible if your break time is dictated by whatever happens during that particular day. You may find that you don't have time to pump at all - like me. So just make sure when you get home you can pump at least once or twice throughout the evening. Even if you only can get a few ounces at first, stick with it! You will be surprised at how smart our bodies are, and it will respond by increasing galactogenesis (fancy, huh?) during times of "higher demand".

4. Relax: Stress inhibits let down, so try and not obsess over how much you are pumping while you are pumping.

5. If you find your supply going down, drink up! Try one of these...

Of course, first consult with your doctor to make sure that it's an option for you. I found that my body really responded to the teas with both babies, but they gave Izzy gas so I couldn't drink it as often as I would have liked. The Gaia tea is at Kroger and I think Whole Foods carries Milkmaid Tea.

6. DO NOT try to reinvent the wheel: You know I am always talking about working "smarter and not harder". So talk to other breastfeeding mamas!  Before I headed back to school, I picked the brain of one of my classmates who went through this a year ago with her daughter. She had SO MANY awesome tips for the best places to pump during our clinicals and for pumping-on-a-time-constraint. One of which was to keep your bottle-flange set up in a cooler/fridge in between pump sessions so you don't have to waste time washing them out during your precious break time. Genius, right?! KellyMom is a great resource too!

Happy Breastfeeding!

Monday, March 10, 2014

Music Monday

Hey guys! Hope you are having a great morning so far! This is definitely one of my most recent jams!

Friday, March 7, 2014

Things Natey Says: 5 Years-Old Edition; Volume 1

Nate is growing so much! He is definitely not "mommy's baby" anymore. And as always, he keeps us smiling with all the things he says and does. Here are some of my favorites since his sister has been born: 

While watching me paint my nails: "Sirs don't paint their toes or fingers."

"Mommy I want some chocolate milk. But not from your chest." 
I guess breastfeeding isn't for him haha

When Izzy was first born he would tell everyone who held her, "If she cries give her to my mommy because that is what I do."

And one day he was all, "I'm ready to walk her now." But we shut that down, fast. 

"Daddy can you give the baby to mommy now so we can play soccer?"

:in his cutest baby talk, high pitched voice: "Hi Izzy! You're so adorable!" 

Consoling his crying sister: "It's ok. Daddy's coming. He's coming baby. Brother is here."

While carrying around a little devotional book he found at my mom's house: "Is this the Word of God?"

Nate (while I'm getting Izzy dressed): "Mom, don't forget to do something important..."
Me: "What?"
Nate: "Brush her hair."

Over Christmas break when he was with his younger cousins and obviously feeling so wise: 
Blake: "What did you say Nay Nay?"
Nate (VERY matter-of-factly): "I said 'bang', B-I-A."
Me: "B-A-N-G, Nate"

When he found out Izzy was starting daycare: "You're going to daycare sweetie! Don't be scared. I wasn't scared on my day and you'll come home right after."

To his dad who was having an allergic reaction to something he ate (hives): "You have bumpy-itis."
Big Nate: "Bumpy-itis?! Oh no! Do you know a doctor who may be able to help me?"
Nate: "Well, my mommy is a doctor, but she can't help you. She only helps get babies out of mommy's tummies."

Big Nate and I will say, "____ look at your son/daughter" when the kids are doing something funny, so now when Izzy does anything, little Nate goes, "Mom, look at your daughter..." HA!
Happy Friday!

Wednesday, March 5, 2014

Reflecting on My Clerkship Experience: Emergency Medicine

From the AAMC Careers in Medicine Clinical Evaluation 

My cool Emergency Medicine doc look ;-)
1. Name and Location of Clinical Rotation: 

  • Indiana University Health - West: I was so excited to get placed at this hospital because it was close to our house and I thought a community hospital ED would be a slower pace. 
2. What did I like most about this specialty?

  • The speed. Even though you get all the pertinent information as far as chief complaint, medical history, family history, social history, etc., you have to be EXTREMELY efficient and I love that. 
  • The variety. All in one week I was ruling out strokes, managing vaginal bleeding, suturing lacerations, diagnosing cancer, and cardioverting an abnormal heart rhythm.
  • The shift schedule is different in that you can spend your whole day at home and then come in overnight - however, it is also tiresome...
  • Working on a team. The entire ED works so hard to make sure all of the patients are taken care of. I had a great time working with the attending physicians, the nursing staff, and the consultants. 
3. What did I like least about this specialty?

  • As stated above, the shift work got exhausting in that it was very variable from day to day. I would work a 2-11PM one night, a 5PM-2AM the next, and then a 10PM-6AM. My sleep schedule was all off by the last week. 
4. Did this clinical rotation give me a good sense of what practice in this specialty would be like? 

I think so. I thought that I would have a very limited perspective on what it would be like in an ED since I wasn't in one of the hospitals downtown. However, West has been extremely busy recently and many times I was seeing 10-15 patients per day. There was one day when patients had been in the waiting room for a little over 2 hours, but for the most part, the team was great about keeping things moving so we could get our patients seen.

5. Did my interests, values, skills and/or personality "fit" with this specialty? If yes, in what way did they "fit"? If no, why might they not be compatible? 

Although not having continuity (ongoing relationships and follow-up) with my patients was something I knew I would have an issue with, it did not bother me as much as I thought it would - at least for the month. I did find myself wondering about how patient so-and-so did. Especially when we made a new cancer diagnosis and or confirmed new pregnancies. Also, the ED has its "regulars" too and by the end of the month there were a few patients that I had seen two or three times...

I think my personality would not do well in the ED just because I do like to see that my work helped to "cure" or fix the patient's problem. In the ED, the priority is to address anything life threatening and then have the patient follow up with their primary care provider for anything else.

6. What are the possible practice settings for specialists in this field? Which of these settings interest me and do I know enough about them? 

Like most specialties, you can find ED physicians in academic and/or community settings.

7. What information do I still need to find out about this specialty? 

N/A. Everyone was really sweet and said that I was great at Emergency Medicine. My attendings even told me it wasn't too late to switch specialties, but I think I will stick to OB-GYN ;-)

8. Has my perception of this specialty changed based on my clinical rotation experience? 

Yes, before the EM doctors called a consultant in another specialty, it is very likely that they had done everything they could to make sure deferring to another doctor was totally necessary. One of the things my staff kept trying to impress upon me is that when the emergency department calls an OB-GYN doctor for a patient - for example, someone with vaginal bleeding, it is not because they don't want to take care of them. All of the basic work-up is done beforehand, and they really would like a second opinion/some guidance on the issue. I was told not to get jaded during my intern year while I'm returning pages from the ED. I'm sure I won't :-D

9. Did my clinical rotation experience influence the likelihood of choosing a career in this specialty? If yes, how did it influence me? 

I think that EM is a lot of fun, and I was excited to get more practice with women's health issues in addition to all of the other interesting cases I say, but I still absolutely still love OBGYN more, so I know I made the right choice.  

10. Right now, on a scale of 1-10, how interested am I in this specialty as a career option? 


11. Other comments or reflections about this rotation or specialty: 

When I first started medical school, many people suggested that EM would be a good specialty for me as a wife and mom because it is shift work. Sure, you do not take call, and when you leave the hospital for the day you are done with patients until the next shift, however, the shifts are long (9+ hours usually). And even after your "shift" is over, none of the physicians are able to go home right away because you need to follow through and make sure all the loose ends are tied on the patients you have that are still in the ED - i.e. waiting on tests, getting medications or fluids, waiting to see specialist or be transferred. Most of the time you stay at least an hour past your shift end time - and I watched my attendings charting sometimes 2 and half hours past their shifts.

Long story short, being able to explore the specialties for yourself is invaluable and you should always take other peoples suggestions with a grain of salt. Only you know what is best for you and your life. Don't let other people's opinions of what would be a good career for a wife and mom influence your specialty choice. Or career choice for that matter. Because if I had listened to all those with opinions, I probably wouldn't be in medical school right now :-)

Saturday, March 1, 2014

The Countdown Is On!

Yesterday was my emergency medicine shelf exam! I've probably already said this, but I'm done with all required clerkships of the year!

This week was literally a rollercoaster of emotions...

On Saturday, we noticed that Natey wasn't feeling too well. He wasn't his bubbly, slow-down-for-nothing self. Before my 10PM shift that night, his temp was an impressive 103.4. I am so done with these children of mine and high fevers. Two weeks ago, Isabelle had me freaking out over a 103 - double ear infections were the culprit.

So Monday, Nate was still spiking fevers, complaining of headaches and a stomachache.  Being on EM has me thinking headache + fever could be meningitis so, Mommy did a quick exam to rule out anything he could get some antibiotics for and/or needed hospital admission for.

Natey's at-home exam went something like this: HEENT (Head, Ears, Eyes, Nose, Throat): Pupils equal, round, and reactive to light. Lymphadenopathy (swollen glands) noted in throat. Tympanic membranes (ear drums) clear. Oropharynx (throat) erythematous (red) with white exudates (white stuff on his tonsils). Heart & Lungs - clear. Abdomen: Non-distended. Non-tender. 

"Trying" to study and be doctor mom at the same time
So after that exam, my suspicion for strep throat was pretty high, and meningitis was a bit lower on my differential. So we headed to urgent care to confirm. Sure enough, his throat swab was positive within minutes. He was home from school until Wednesday, and thankfully, he's doing a lot better.

It's almost comical how every. single. time. I have an exam block/need to study during this four years, my kid would get sick. This last exam was no different. And every time I say this will teach me not to procrastinate with my studying - eh but not so much...

While this was brewing, Isabelle's cheeks - that have been red pretty much her whole life - were getting more irritated. It was only by the grace of God that I called a pediatric dermatologist right after someone had cancelled their appointment, and we were able to get in the next day. I found out from her pediatrician that the wait for that doc is MONTHS in advance. Anyway, little miss is on antibiotics too and a steroid cream. Her cheeks look so much better!

And her regular doc said at her 7 month appointment she is already hitting all the 9 month milestones so she can start trying some soft solid foods. I also had a long talk with the pediatrician about how terrible my sleeping has been because I can't stand to hear Izzy cry when I put her in her crib. A lot of it has to do with mommy guilt and feeling like I was abandoning her at night when I was already abandoning her during the day on all these long-houred rotations. Needless-to-say, hearing how another mom who works long hours dealt with this stage was so encouraging, and it was enough to help me to give Isabelle what she needs and not what she wants. So we both have been sleeping better - in our own beds...haha

I still stalk her on the baby monitor though

Nom nom nom...

Wednesday night I finalized my rank list for residency! All of the medical students put the programs they interviewed at in order from most favorite to least favorite. The programs do the same thing, and we all had to give our final submissions by Wednesday night. I was super calm when I was doing it, but now I keep having freak out moments. Now we wait until March 21st to find out where I will be!

Wednesday and Thursday were my last EM shifts. I enjoyed this month a lot more than I expected. One of the things I like best about the field of medicine is building relationships with my patients and seeing them over and over again. However, I will say that I still felt good after the one-time interactions I had with my patients in the ED. I met some great docs and nurses, and everyone was so happy I wanted to go into OBGYN because all of the speculum exams deferred to me haha. Another surprise was that there is a ton of ob-gyn in the emergency room - which was awesome. The whole month I felt like part of the team, and like a real doctor. For those of you interested in more details about my EM month, I will do a Careers in medicine post :-)

Yesterday was my test, which was promptly followed by my usual and much-needed pedicure and brow waxing. Before picking up the kids and heading home, I met with Nate's teacher for parent-teacher conferences, He is doing awesome in PreK and I am so proud of him. This weekend is my first one at home in a long time. I told the hubby I want to try and get through all of the Oscar nominated best pictures before tomorrow night. And apparently I need to go get supplies for the snowstorm that starts this evening. Dear Winter, I am DONE.

On Monday, I start my month as a teaching assistant in the pathology lab. I love teaching so I think this is going to be a lot of fun - not to mention it is going to give me more free time for family and fourth year living :-)

Hope you all are having a good weekend so far! 69 days until graduation!!!
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