Lessons from balancing work and life

25 Sep

I’m not going to lie, this doctor** and parenting balancing act has been hard these past couple of weeks. You have so much invested in both and want to do both well…be a good physician, make a difference in the lives of your patients, be alert and efficient, interact well with your colleagues, and then as a parent and wife you want to spend quality time with both your child and husband, you want to cook dinner, play with your daughter, spend some alone time with your husband, as well as take care of some of the househould duties….both are full time jobs and you want to do both at 100% and yet keep both nicely separated from one another, work at work, home at home. You want to be that strong, calm, put-together woman that has everything under control–after all, doctors are supposed to be strong, right?– and some days you feel like that, but other days you feel anything but that, and the nice outfit and makeup and smile you put on feels like a facade.

It’s been a hard week, on so many levels. For so long, I have felt that I have been doing well handling all the stress, keeping it together, staying balanced, etc, but this past week, I have felt my shell cracking. The long days, the sleep deprivation, the stress of performing well at the new job, of trying to get home and spend some quality time with Addison and Dean, of trying to fit in time to study for an exam I feel very ill-prepared for…it’s all starting to hit me, and amongst all this, what has really affected me the most this past week, though, are the patients I’ve had.

Like on a recent morning. When I opened up the mammogram from two of my patients, my heart sank: they both had cancer, and they are both young. They’ll need a biopsy to confirm it, but there’s no doubt based on the imaging. After each one of their exams, I had the patient get dressed and wait in a consult room, where I then ran into meet her face to face with the nurse in between my other cases. I sat down, told her I was very concerned. I used the “c-word”…I try to be compassionate and comforting but I also don’t believe in sugar coating things and giving false hope in a situation where there’s no doubt what it is..she was like, “ok, what do I need to do next?” I briefly went over the next steps. She was trying to stay strong, stoic, but I could see the fear in her eyes as they started to tear up. I wanted to do more, but I had other patients waiting, so I left her with the nurse, who would go over all the details with her…just like that, in just a span of a couple of minutes, I walked into this woman’s life, told her she had cancer and turned her world upside down, and walked out. I hated myself at that moment, for being the bearer of horrible news and then not being able to do anything for her at that time. I hated medicine at that moment, for allowing me so little time with this patient. I hated that other patients were impatiently waiting to be seen, probably angry at me because of the wait. By the end of the day, I was emotionally drained. There was still so much work to do, but there was a daughter and husband at home waiting for me. I had to let it go and walk out the door, still pick up some groceries, and then try to make it home in time before Addison’s bed time, while still hopefully squeezing in some studying afterwards.

These patients were not the only two patients to leave me emotionally drained. In fact, I have cried over multiple other patients/situations this week… like the other day, I quietly sat by myself in my reading room that evening, tearing up as I read another woman’s imaging. Her cancer had spread. Her condition was terminal. She was 38, with two kids. I did not meet her in person, but the technologist said she was so grateful for all the care she was receiving here. Someone facing death and still being thankful for what she has. Admirable, a lesson for us all.

And then there was another very young woman. Her biggest concerns should be enjoying life, dating, going out for drinks, etc…. I mean, she is in the prime years of her life and should have her whole life in front her her…marriage, kids, a family…instead, there I was biopsying a mass in her breast…the beginning of a very rough road for her. No one should have to go through this.

These cases break my heart. I wish I could do more, but there’s only so much that I or medicine can do for them, which leaves me feeling angry and sad.

In regards to the parenting aspect of this whole physician-parenting challenge, all I can say is that I’ve been blessed with an amazing husband, who has picked up so much of the parenting and household duties for me over the past couple of weeks without complaining or making me feel guilty about it, and yet I can’t help but feel bad. Is this intrinsic to all moms to feel that they should play a large role in parenting and housework? And honestly, it’s not that I feel I should ever be the main parent–we are a team–but I just feel bad when instead of it being 50-50 it’s more like 90-10% right now, but I know it’s temporary. I did the same for Dean last year when he was working at the brewery, but it’s hard letting go.

The one thing that has been a highlight and therapeutic for me this week is getting home in time (barely) to put Addison to sleep. For the past couple of months, she has not wanted to fall asleep in my arms, but she has this week, and it’s the most wonderful thing in the world…to feel the weight of her body on mine, her head nuzzled into my neck, feeling her breath on my skin…me being forced to slow down and sit there, just me and her, quietly. My heart has been so full of love during these moments, and I have cried yet again this week during these moments, as I am reminded of what really matters…. that God has blessed me with a healthy child snuggling in my arms, a loving, helpful patient husband, another life growing inside me, good health, the skills and opportunities to work at a job to help provide for our family….

And here’s the lesson of it all..these experiences with my patients, the anguish I have felt for them this week, the quiet moment with my daughter following the stress and chaos of getting home in time and getting her ready for bed, these moments and interactions that have left me in tears so many times this week, questioning my strenth and fortitude….I am grateful for them because they teach you lessons and make you wiser and ultimately stronger. While I have been shocked at the number of times I have cried over the past several days, I don’t ever want to be immune to emotion…to feeling another person’s pain. How can I be a good physician if I don’t care, if each person with a new cancer diagnosis is nothing more than another “cancer case”.  How can I be a good mother and wife and person if I am not grateful for what I have…if I let trivial, non life and death situations affect my stress level so much that they obscure all the blessings I have? I bet that gracious young woman who’s scan I was reading would do anything to only have a job, family, and test to stress about rather than a terminal illness. Sometimes I think we all–or at least I-need to take a step back and look at the big picture, remember what is important, and be grateful for the things we do have : )

**details related to patients have been left out or changed.

21 weeks

21 Sep

WEEK 21

Due date:  February 1st by ultrasound, which puts me at 21 weeks Monday 9/21/15

Sex of the baby:  Boy

Baby size:  Banana; per my ultrasound today, he’s about 13 oz.

Weight gain: 10 pounds.

Bump:  Too lazy to take one right now, and plus, it’s probably not going to be drastically different than last time.

Running:  27 miles

Monday:  3 miles

Tuesday:  4 miles

Thursday:  3 miles

Saturday:  10 miles

Sunday:  7 miles

Cravings:  Definitely had a craving for wine the other day, probably because of all the studying I did that day, and yes, I did have a glass that evening with dinner.   I am of the belief that occasional alcohol is OK during pregnancy, and there’s data to support that.  Some studies have even said 3-8 drinks per week is OK, which seems like a lot to me!  Yikes!  I really hardly drink at all other than an occasional a sip or two of whatever Dean’s having for taste (mostly because I just don’t feel like it), but if I’m really craving it, I have no fear in having 1/2 to 1 glass of wine, drunk slowly with food.  So far, that craving has only hit me twice during this pregnancy.

Highlights:  Having a normal anatomy scan today!  Yesterday I was reviewing congenital heart/thoracic anomalies for my boards, which wasn’t probably the best thing to review right before my ultrasound!  I just kept hoping that nothing on my scan would look like what I had been reviewing!

Got a look at Baby #2’s face today, and let me tell you, it looked like something from a Halloween horror movie.  haha.  Seriously, though, I hate to break it you future mommas, but your child looks like a scary looking alien in utero.  It’s ok, though, because everybody’s does.  I do, though, think it’s awkward when people post pictures of their fetus on social media.  Won’t be doing that myself…I just figure I’ll keep pictures of the inside of my uterus and my now scary looking fetus to myself ; ) (but I won’t judge you if you do…I get it…very exciting getting to see your future child : )  )

Funny part of the exam:  when the sonographer was like, “Oh!  Well that is definitely a boy!”  haha

Lowlights:  Same as every week the past several weeks:  this dang board exam.  Still just trying to focus on one day, one task at a time.  If I start thinking how few days I have left and how much I still have to learn, I start panicking.   I have to do a little bragging, though:  I am pretty much the luckiest girl around in that I have the most supportive, patient, loving husband in the world who has been doing more than his fair share of parenting and house work the past couple of weeks.  Thank you Dean!!

From now on, I’ll probably do updates averaging every 2 weeks or so, because not a lot changes one week from the next and it’s kind of pointless.  I actually wasn’t going to post one today, but hey, I felt like procrastinating a little before jumping head first into the world of nuclear medicine.  Ugh.

I did it! I signed up! May not be ready to run all of it at 2.5 months postpartum, but at least this leaves the door open and gives me something to look forward to...this is one of my favorite marathons and I would love to participate if possible.

I did it! I signed up! May not be ready to run all of it at 2.5 months postpartum, but at least this leaves the door open and gives me something to look forward to…this is one of my favorite marathons and I would love to participate if possible. Also, congrats to my high school friend Ashley, who just ran a 3:30 marathon less than 4 months after having #2! So awesome! See you in Boston : )

Scenes from my run.

Scenes from my run.

Scenes from my run.

Scenes from my run.

Week 20: Half way there!!

14 Sep

WEEK 20

Due date:  February 1st by ultrasound, which puts me at 20 weeks Monday 9/14/15, January 25th by my dating (which would put me at 21 weeks)

Sex of the baby:  Boy

Baby size:  Mango (6.5 in, 10 oz)

Weight gain: 8 pounds.  I do not weight myself more than once a week, but do so weekly to make sure I’m about on target.  I use this website to assess recommended weight gain, which is based on your pre-pregnancy weight and height.  Eight pounds is in the normal range for me at 20 weeks.   In terms of eating, I really don’t eat that much differently when I’m pregnant.  The only differences are that I never let myself go really hungry (I always carry snacks with me), and I try to avoid artificial/highly processed foods.

Bump:  Funny how I felt like I showed so early, and now I feel like I’ve hardly changed at all bump-size-wise over the past several weeks.

IMG_1661

Symptoms:  Better this week from a physical standpoint, but really emotional/hormonal.  Embarrassingly emotional..like on Thursday evening I went downstairs to look for the package I was expecting from Purple Carrot (like Blue Apron).  It wasn’t there and the doorman said that it if it came during normal business hours, the management would’ve sent it back, because they don’t accept perishable food items.  But I paid for that!  I literally started tearing up.  Right in front of him. Families and innocent children are dying trying to escape war torn countries like Syria and there I was crying because the boxed meal I had purchased to have delivered wasn’t there.  Pathetic (turns out it came later that evening anyway).  One of those days where I just needed to go to bed, reset my attitude and mindset, and start fresh the next day.

Pregnancy intensified Pet Peeve of the week:  That song that goes something like, “oh I think that I found myself a cheerleader…”  SO ANNOYING AND STUPID.  RADIO STATIONS, STOP PLAYING THAT SONG!”  Ok, that’s all : )

Cravings:  Soup and cheese.  At night before I go to bed I get REALLY thirsty and drink a ton of water, probably making up for not drinking enough during the day.

Baby Movement:  He’s starting to get a little stronger, although it’s still pretty subtle…pretty much just feels like a few butterflies were let loose in my belly and flutter around from time to time.

Running:   21 miles total

Tuesday:  3 miles

Saturday:  14 miles

Sunday:  4 miles

I had a lot of stuff going on, so I didn’t have much time during the week to fit in a lot of running, but boy, I don’t know what got into me but the desire to run this week was INTENSE.  Maybe because it’s my outlet for stress and there’s been a lot of stress (both good and bad) in general over the past few weeks?  Who knows, but literally every day I have been dying to run.  Finally this weekend I had time.  Saturday morning I told myself I should run on the treadmill, because I really needed to get some studying in, but that just sounded repulsive.  And it was in the 50s outside, with a little bit of rain.  PERFECT for running.  How could I possibly waste that kind of running weather by running inside?!

I set out to do 8-10, but the miles just flew by (minus that stretch between Ohio street beach and Oak street beach where I felt like I was running against a wall of strong headwinds), so I kept going.  It was wonderful, peaceful, calming.  I am 110% introverted, so to be out running by myself, not having to talk to anyone, not having to think about anything intensely…to just get lost in the rhythm of my run, the beat of my music, with the vast lake to my East…oh man it was wonderful and exactly what I needed.  I didn’t want it to end.  It was literally one of those days where I felt like I could run forever (and as I head into the second part of 2nd trimester, I’m not sure how many more of these kind of days I’m going to have!)

Full confession: that pace is not my true overall pace...I stopped my Garmin during the 4 times I had to pee during that run as well as during some of my water fountain stops...not something I would normally do when actually training for something.

Full confession: that pace is not reflective of my true overall pace…I stopped my Garmin during the 4 times I had to pee (ugh) during that run as well as during some of my water fountain stops…not something I would normally do when actually training for something.

On a side note related to running, Boston Marathon registration for me is this Friday.  I’ll be about 11-12 weeks postpartum at the time of the marathon.  I qualified last year with a 3:29, 15 weeks (3.5 months) postpartum.  A lot of improvement happened those last 3-4 weeks.  I’m probably being totally irrational even considering signing up, but I am so tempted to.  It’s been 10 months since my last marathon and that’s just too long for me!  haha.  I’ve been bit with the marathon running bug so badly.  I’m leaning towards signing up, and if I run/walk it like I did the LA Marathon when pregnant, or if I don’t run it at all, I can at least hang out with my good friend Mel!

Job:  Really enjoying it.  I’m feeling more and more comfortable and confident with what I am doing, and I really love the variety.  One day I’ll be doing breast and thyroid biopsies, screening mammograms, and reading general ultrasound (of any body part).  Another day I’ll be reading diagnostic mammograms (patients who have a specific complaint or need additional imaging and may need a biopsy) and perhaps a breast MRI or additional screening mammograms, and then one day a week I read STAT CTs and other studies from the ER.  Things are never boring!

I will say this:  you learn A LOT as an attending.  When your name is the final name on that report, you don’t leave anything to chance.  I feel like I’m constantly looking up recommendations and data to support appropriate follow up and management of various findings (I feel pretty comfortable with breast imaging related findings but have had to refresh my memory a lot when it comes to general radiology).  Constantly at the back of my mind is the question How would this image and how would the wording of your report hold up in court?  Can you defend your decision to ______ (follow up, biopsy, not biopsy, call benign, etc.).  

Board studying:  Nothing to add to this is.  As I said last week, it is what it is.  I’m just continuing to plug away at the studying whenever I have free time.  On the bright side, I feel like all the studying has really helped me feel more comfortable and confident with the studies I’m reading at my job.

Some misc. pictures from the week:

Dean and I at the Gala at the Four Seasons. It was a charity event for Elmhurst Memorial Hospital, which included a silent auction. Words of advice: keep a close eye on your husband at an auction if he's been drinking. He may have upped one of our bids without my approval. And we may have won. Yikes. Well, at least it's all for a good cause! haha

Dean and I at the Autumn Gala at the Four Seasons. It was a charity event for Elmhurst Memorial Hospital, which included a silent auction. Words of advice: keep a close eye on your husband at an auction if he’s had a few drinks. He may up your bid without your approval. Yup, that happened.  “Don’t worry Julia, someone will out bid us!”  Nope.  Well, at least it’s all for a good cause! haha

Scenes from my heavenly run on Saturday.

Scenes from my heavenly run on Saturday.

Has anyone else done this? I was cold when I started my run and was wearing a long sleeved shirt. I quickly realized it was way too hot for that, so took it off shortly into my run, and who wants to carry a shirt for several miles? So, as I have done multiple times, I hid it in a bush and picked it up on the way back ; )

Has anyone else done this?  I was cold when I started my run and was wearing a long sleeved shirt. I quickly realized it was way too hot for that, so  I took it off shortly into my run.  Who wants to carry a shirt for several miles? So, as I have done multiple times, I hid it in a bush and picked it up on the way back, and there it was, just as I had left it  ; )

Came back from my run just in time to catch Dean and Addison going for a stroll. She LOVES this trike!

Came back from my run just in time to catch Dean and Addison going for a stroll. She LOVES this trike!

Addison and her cousin! How cute are those two?

Addison and her cousin! How cute are those two?  Picture credit:  Dean’s brother’s girlfriend, Katie.

Addison at her well check up doctor's appointment. I love that the practice we take her to has weekend hours!

Addison at her well check up doctor’s appointment. I love that the practice we take her to has weekend hours!

19 weeks

8 Sep

Week 19:

  • Due date:  January 25th by my dating (which would put me at 20 weeks), February 1st by ultrasound
  • Sex of the baby:  Boy
  • Baby size:  Tomato (6 in, 1/2 pound)
  • Weight gain:  7-8 pounds
  • Bump:
IMG_1582

Not a whole lot different from last week. One of these days I swear we’ll put a picture in that picture frame. Do you like Addison’s banana brush sitting with our toothbrushes?! haha. She LOVES chewing on that brush, due to her teething.

  • Symptoms:  Not the best week, and I recall hitting a rough patch around the same time last pregnancy.  This past week I’ve been getting full very quickly when eating and nauseous after just a little bit of food.  Was also hit with a pretty awful headache one day, which I guess is typical of second trimester.  And finally, the worst of all…the continued congestion.  I just don’t get why it’s so horrible this time.  I had to sleep sitting up the other night because I was 100% stuffed up and couldn’t’ breathe through my nose at all laying down.  I don’t think the antibiotics for the sinus infection did much of anything.  Sinus infection + hyperacute sense of smell from pregnancy….not a good combo at all.  Do they make Febreeze for the nose?!  I really need to stop complaining about my sinuses.  I know I sound like a broken record.
  • Running  27.1 miles total
    • Monday:  3 miles (6.7-6.8 mph)
    • Tuesday:  4 miles (6.5-6.6 mph)
    • Thursday:  3 miles (6.7 mph)
    • Friday:  4 miles (6.8 mph)
    • Saturday:  13.1 miles (8:50 pace)!!  Now baby#2 can say he’s ran a half marathon, too!  Although Addison still has him beat with a full marathon ; ).  Hmmmmm….
  • Life:  I’ve survived 3 weeks as an attending and am getting into a routine.  The hardest part, though, is knowing I have boards in 3.5 weeks.  Holy crap.  Actually seeing 3.5 weeks in writing just gave me a mini panic attack.  Yikes.  But seriously, it’s been challenging fitting in the studying.  For part I, we had twice daily review sessions and lots of free time during the day to study.  In the evenings and on the weekends, it was just me and Dean, so I had a lot more free time outside of work as well.  Now it’s just really hard finding the time amongst working full time, adjusting to a new job and caring for a child.  Yes, I could’ve studied more in between fellowship and the new job, but there was a lot of life stuff going on at that time, and I needed a little mental break after 6 years of post-medical school training before jumping into the stress of a new job.  Oh well, it is what it is (my mantra this week).  When faced with something you don’t like, you really have only two choices, either 1) change it or 2) deal with it and do the best that you can.  No where in there is there any point to whining and complaining and/or feeling sorry for yourself (which I have been guilty of).  Serves no purpose.  I can’t change the fact that this exam is happening at the time it is, so I have to just study when I can, leave out the emotion and anxiety, concentrate on the current task at hand, do the best that I can under the circumstances, focus only on what I can control, and let go of what I can’t control and leave it to God… That’s what I’m trying to do : ).  So from this point on, I won’t whine anymore to you about this exam.
  • And in light of the above bullet point, I oughta get a little studying in before I pass out for the night.

A few pictures from the week:

Saturday morning's run.

Saturday morning’s run.

Taking a stroll outside.

Taking a stroll outside.

Love the concept of Rent the Runway. Renting this stretchy dress (hence fits over the bump) for a work related charity gala this upcoming weekend. Who wants to spend several hundred on a dress when you're pregnant (or any time really) and won't fit in the dress for more than a week or two?! Now if only I could do something about that permanent sports bra tan line : /

Love the concept of Rent the Runway. Renting this stretchy dress (hence fits over the bump) for a work related charity gala this upcoming weekend. Who wants to spend several hundred on a dress when you’re pregnant (or any time really) and won’t fit in the dress for more than a week or two?! Now if only I could do something about that permanent sports bra tan line : /

It's so much easier feeding Addison with dogs around, because they clean up every bit of food she drops on the floor. haha.

It’s so much easier feeding Addison with dogs around, because they clean up every bit of food she drops on the floor. haha.

Labor Day weekend pool party. Addison absolutely loves the water : )

Labor Day weekend pool party. Addison absolutely loves the water : )

Love these two : ) Picture credit: Katie (Dean's sister).

Love these two : ) Picture credit: Katie (Dean’s sister).

What my Labor Day morning looked like.

What my Labor Day morning looked like.

We stayed for ONE overnight at Dean's aunt and uncles place, and this is how much stuff we brought. I don't know how we're going to pack for a week long trip with Addison this fall! Yikes.

We stayed for ONE overnight at Dean’s aunt and uncle’s place, and this is how much stuff we brought. I don’t know how we’re going to pack for a week long trip with Addison this fall! Yikes.

Week 18

2 Sep

Week 18:

  • Due date:  January 25th by my dating, February 1st by ultrasound
  • Sex of the baby:  Boy
  • Name:  Don’t know and wouldn’t tell if I did know, but just commenting on this, because Dean and I are having such a difficult time coming up with boys names.
  • Baby size:  Sweet potato (5.5 in, 5 oz)
  • Bump:

IMG_1514

  • Weight gain:  6-7 pounds
  • Maternity clothes?:  I have two “regular” pairs of work pants that I can still button up.  The others require a belly band.  I’ve also started using my maternity work pants as well, because they’re just super comfy…really, they should just make all pants like maternity bands…elastic waist bands?….Why would anyone want to wear anything else ; ).  I haven’t started wearing my maternity shirts yet, but I stick to looser, longer shirts.  My slimmer fitting work tops look sorta weird on me now.
  • Baby movement:  Pretty sure I’ve felt him kicking around on occasion for about a week now.  It just feels like little gas bubbles, though, so it’s hard to tell for sure, and plus, I’m so focused on other things that I don’t really notice it.  I’m looking forward to when I can definitely feel him (which happened at 19 weeks last time), because then I’ll know he’s doing well in there.
  • Exercise:  19 running miles for the week
    • Monday 8/24:  6 miles outside @ 8:20 pace
    • Tuesday:  3 miles TM (6.7-7.0 mph)
    • Thursday:  3 miles TM (6.7 mph?)
    • Sunday:  7 miles TM 6.7 mph
    • I have been forced onto the treadmill for two reasons:  One, I have been running very early in the morning on work days…on the TM by 4:30 am and don’t feel comfortable venturing out in this neighborhood at that hour (I was off Monday, so I was able to fit in a later run outside).  Two, running on the TM allows me to fit in studying at the same time.  I am now in study mode for my boards October 2nd.  Working full time and adjusting to a new job + wanting to spend time with a 13 month old and having to prepare food in the evenings leaves me very little time to study,  which means I feel like I have to make the most of every moment.  So, my workouts have now turned into study sessions, or you could say my study sessions have turned into workout sessions (hit two birds with one stone, right?).  Normally if I were actually pushing myself working out, I wouldn’t be able to study at the same time, but because I am pregnant and thus working out at a really low intensity, I’ve actually gotten in some productive study time in while running.  Having an IPad has made this possible, as I have hundreds of electronic flashcards on it that I made in residency as well as video lectures, articles, and PDF books.
  • Pet peeves:  decided to throw this category in today because at times I’m just astounded at the number of things that get me worked up or drive me nuts during my pregnancy, thanks to hormones (at least that’s what I blame it on).
    • Idiotic drivers.  Oh my goodness…my road rage during this pregnancy has been out of control.  I was literally brought to tears TWICE this past week because of it.  A friend on social media posted a quote that went something like, “….Let assholes be assholes.  You’ll sleep better.”  I literally have to repeat that to myself every morning when I drive to work.
    • Taylor Swift’s music.  Sorry Taylor Swift fans.  I really want to like her.  I really do.  She seems like such a good role model, but I just CAN. NOT. STAND her music.  Not a single song.  They all annoy me.  And damn it, when one of her songs comes on the radio, I’ll switch stations, and then ANOTHER radio station will be playing one of her songs.  Ugh. I just can’t escape her.
    • HuffPost Parents on Facebook.  I actually disliked them weeks ago.  Their stories are so sappy and corny.  I found myself rolling my eyes at almost every story I clicked on (there are a FEW good ones).  It’s like the mothers who write these posts were sleep deprived and really emotional at the time they were writing (understandably)…I would click on a story because it sounded all melodramatic and interesting at first and I was expecting there to be some dramatic punch line to the story, and then it would just end, and I was like, did I miss something?  Is there more to this?  She sounded all dramatic and emotional about THAT?   Where’s the dramatic ending?
  • Highlight of the week (so that I don’t end sounding negative regarding my pet peeves, haha):  Sunday Dean and I went to see Dirty Dancing (Broadway in Chicago) followed by dinner on the river, just the two of us : )  So nice just to be out together, to be able to sit down and enjoy a slowly eaten dinner while talking and not having to worry about feeding and entertaining a baby.  That being said, as much as I treasure Dean and my quality time alone, I always get excited to get back home and see Addison : )

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First week of the new job and 17th week of pregnancy

23 Aug

I should be studying for boards right now, as Addison is sleeping and Dean is out running some errands, but of course I found something else to do (blog).

So, I’ll start off doing an update about life from this past week, which involves my first week as an attending!  Then, I’ll throw in an update about the pregnancy.

LIFE:

So….I made it through my first week as an attending, and parts of it were as expected and some things were better!

I’ll start off with the “better” parts:

  • I really love the people I am working with in the Breast Center.  The techs and my two colleagues over there are great.  I seriously don’t know how I would have survived without having someone so nice and patient to work with.  The people you work with make such a difference on your overall experience somewhere.  Really, everyone I’ve interacted with at the hospital has been really friendly so far.
  • The commute is not nearly as bad as I thought:  about 30 minutes in the morning and 40 coming home.  I actually sorta like the the time to myself to just zone out and listen to music or talk radio.
  • The hospital has a lot of nice features and support for their staff.  In the physician lounge there is free lunch every day, drinks (water and soda…although did you know that in France they serve wine with lunch to their house staff every day??), a coffee/cappuccino machine, and snacks.  There’s also a staff workout room and adjacent locker room with showers.  I’ve used it once and will probably start using it more regularly once I get into the swing of things with work.
  • I really do like what I do, despite dealing with the insecurities I have right now as a first time attending (described below).  It’s good to be back at work with structure to my day.

The “as expected” part:

  • We as radiologists are very dependent on technology.  After spending 4 years of medical school and 5 years of residency and fellowship at Northwestern and getting really used to their technology and PACS system (for those not in medicine, PACS is the system that we use to review images at our reading stations and compare them to prior studies), it’s been challenging adjusting to a completely different system at my new hospital.   In radiology, it’s very important to have a pattern for how you view things so that it’s habit and you don’t miss things.  Well that pattern has been all thrown off for me, because I can’t view things the way I’m used to.  So, that’s been frustrating, and this technology adjustment makes me feel really inefficient, and when I’m inefficient, it not only drags on my day but it also affects the technicians and the patients.
  • It’s going to be an adjustment having the “final” say!  As a resident or fellow, you go about your duties and do the best that you can, but at the back of your head, you always know someone else will sign off on your reports.  You’re not the one making the final decision, so if you make a mistake or miss something, it can still be caught by someone and corrected.  As an attending, you have the final say.  If you miss a breast cancer because you were behind and rushing through a study, you’re the one to blame.  It definitely brings the intensity and anxiety up a few notches!  At the same time, you can’t be spending tons of time triple checking everything, because you’ll get behind in your work.  In a way, it’s nice having the final say, because I can do what I want and don’t have to worry about trying to guess what my attending will want to do, but as I just said, it’s stressful.  I already had our nurse navigator call a patient back for more imaging after I had sent her home because when the onslaught of studies were done at the end of the day and I was going back and reviewing some of the images more carefully, I realized I had missed a finding that was new in that patient.  It was honestly probably nothing, and so I debated for awhile whether or not it was worth having the patient come all the way back in, but then what if it WAS something?!
  • I spend 4 days a week doing breast imaging and 1 day a week reading a little bit of everything else.  That one day a week happened last Friday.  Now, I like the idea of having that one day to read other types of radiology cases, as I enjoy all aspects of radiology, like the variety, and don’t want to lose those skills, but Friday was pretty humbling for me.  I haven’t looked at general radiology imaging in over a year.  Some things, like pediatrics, I haven’t looked at in like, 3 years?  And so there I was Friday, having to interpret and sign off on types of studies I hadn’t looked at for what seems like eons ago.  I felt like I had to look up articles for every study I was looking at to make sure I was making the right recommendations (do I recommend a biopsy for this nodule?  What’s the follow up for this ovarian cyst?  What’s the RECIST criteria that I need to use for this cancer follow up?, etc. etc. etc).  This on top of the unfamiliar PACS system made me feel like the most inefficient person ever, and I kept worrying that my colleagues would think that they had made a mistake hiring me, because I was so slow.  I know, I know, it’s my first week and no one expects me to be super fast, but it’s hard not to let those thoughts creep in your head when you have such high expectations set for yourself.  I WILL get better though.  It’s just getting used to the system and getting back into the groove of things.  Just think positive vibes for me next Saturday when I cover the ER!!

The good thing is that my insecurities as an attending have REALLY motivated me to review things and study in order to get more efficient and confident.  I love Mindy Kaling’s Guide to Killer Confidence:

Confidence is just entitlement….entitlement in and of itself isn’t so bad. Entitlement is simply the belief that you deserve something. Which is great. The hard part is, you’d better make sure you deserve it. So, how did I make sure that I deserved it?

….Hard Work….People talk about confidence without ever bringing up hard work. That’s a mistake. I know I sound like some dour older spinster chambermaid on Downton Abbey who has never felt a man’s touch and whose heart has turned to stone, but I don’t understand how you could have self-confidence if you don’t do the work…Work hard, know your shit, show your shit, and then feel entitled. 

: ) So, I just need get my shit together and start studying and reviewing areas of radiology that is not just related to breast imaging. This motivation is a good thing not just for my overall performance at work, but because I have part II of my board certification process coming up in about 5 weeks!

PREGNANCY

Gestational Age:  17 weeks by ultrasound on Monday (and almost 18 weeks by my dating).

Fetus Size:  the size of a pear, 5 inches head to bottom

Bump:  My stomach feels about the size it did when I was around 23-24 weeks last time!!  I used to think people were exaggerating when they said you show a lot earlier the second time, but it is soooo true.  I just hope this means I don’t end up waaaaay bigger!  I had mild rectus diastasis the first time, and I would prefer that not get worse this second time.

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Bump picture from a week ago, because I haven’t taken one this week yet.

Weight Gain:  About 6-7 pounds.  This stage of the pregnancy is just awkward, because my “bump” to the average person probably looks like I just had like, 5 servings of a Thanksgiving meal, depending on what I wear.  haha.  It’s a lot more fun later on in the pregnancy when the bump is a very obviously pregnancy bump.  A couple of weeks ago, Dean patted my stomach and was like, “ahhhh, I can see a bump!”  Then he tried to be a good, kind, empathetic husband, “But I can see why you would feel awkward about it.”  At first I was like, “THANK YOU [for understanding]” but then as I processed his comment, “….wait a second…what exactly do you mean by that?”  Hehe : ).  It’s all good…just so many body changes that happen during pregnancy, that probably feel a lot more exaggerated to the person going through them than the observer.  The one good thing is that some of the weight is finally going to my….well lets just say my bras are finally starting to fit a little snugger ; )

Symptoms:  Congestion and headaches.  I’ve had sinus infections throughout this pregnancy (confirmed in the office during my appointment), but I think the pregnancy associated nasal congestion/mucosal swelling has contributed to this.  I think I am literally killing a tree a day with the amount of tissue I go through.  And the headaches, ugh, they can be really bad some days.

Cravings:  Cheese and salt.  I’ve also probably been pushing the limit some days on my caffeine consumption.  This little boy is going to pop out wide awake and ready to attack this world …maybe that will mean he’ll power his way out with a very short labor? ; )

Exercise:  very little this week, which was what I expected with the start of the new job.  Will probably give myself a few weeks before getting back into an exercise routine.  One thing I will have to get used to if I want to keep up any sort of regularly exercise is that I will have to be ok with “just” doing a 3-4 mile run or a 25-30 minute workout and counting that as my exercise for the day.  While I was off from work last month, most of my runs were anywhere from 6-12 miles at a time (while pushing a stroller on most days!).  That won’t be happening on week days any more, at least not for awhile!  And I’m ok with that, because there are a lot of more important things that need my time and attention (Dean, Addison, my job, boards studying, managing life in general).

The view from a short run I did with Addison after picking her up from daycare. Turns out, taking a baby for a run when it's dinner time was not the best idea. Lots of crying and screaming on the way back, with lots of people turning to look at me. eek! I just turned my volume up really loud on my iphone, haha.

The view from a short run I did with Addison after picking her up from daycare. Turns out, taking a baby for a run when it’s dinner time was not the best idea. Lots of crying and screaming on the way back, with lots of people turning to look at me. eek! I just turned my volume up really loud on my iphone, haha.

Being back at work full time really makes me appreciate and make the most of the time I have with this little one : ). My hours are 7-4 (obviously going to be a little longer at first while I'm adjusting to stuff). I will arrive extra early if I need to, but Addison and Dean are my priorities in the evening.

Being back at work full time really makes me appreciate and make the most of the time I have with this little one : ). My hours are 7-4 (obviously going to be a little longer at first while I’m adjusting to stuff). I will arrive extra early at work if I need to, but Addison and Dean are my priorities in the evening.

Summer Happenings and Addison at 12.5 months

15 Aug

Best thing ever:

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Pack N’ Play makes it possible to relax and not have to keep your eye on her every second.  Kathy, if you read this, that is your gift in there with her!  She loves it!

*Much needed:  Shot of espresso at 7:30 on a Friday night.  Only way for me to stay awake to watch a movie with Dean after putting Addison to sleep.  Any other parents with this problem??

The truffle, btw, is made from dates, cashews, and carob powder!

The truffle, btw, is made from dates, cashews, and carob powder blended in a food processor!  Super easy, thanks to Purple Carrot (see below)

*I think I just became sold on those companies that send you a box of pre-measured ingredients to make meals with.  I decided to give the Purple Carrot a try.  It’s like Blue Apron, but is all plant-based.  Our first box came this week, and I made this:

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I am by no means vegan, but when at home, I try to eat plant-based when I can. Too difficult in my opinion, though, when eating out or with other company.

*Very delicious and refreshing and easy to make!  As hard as I try to enjoy cooking, I typically hate it, but when all the necessary ingredients arrive at your door with clear instructions, it’s hard not to mind it, and to…omg actually enjoy it!  : )

*Thank goodness for antibiotics.  Finally decided to treat this sinus infection that has been lingering around since the beginning of May.  A class B drug considered safe in pregnancy.  No point in making your life miserable and avoiding everything just because you’re pregnant.

* Dean and I finally got away for a weekend trip sans Addison, thanks to my mom and especially my SIL Katie!  Parents…please do this for yourselves if possible!  So worth it and all the pre-trip planning and headache of making the baby arrangements!  We drove up to Madison Friday early afternoon and came back Sunday.  It was so fun and great being able to be spontaneous…like we went out to dinner and didn’t have to worry about Addison making a mess.  After dinner we walked over a block, spontaneously hopped on some bikes (the ones you can rent at a station and then park at another station), and then rode down the streets of Madison to what’s called the Union on the U of W campus…huge concert going on so we enjoyed that for awhile and then biked back.  Slept in the next day…able to leave the hotel without having to first feed Addison, change her diaper, change her clothes, pack her bag, and put her in the stroller….rented bikes for the day and biked around the lake…and so much more!  We packed a lot into a weekend!

Biking around the lake!

Biking around the lake!


We also spent a couple of hours at the New Glarus Brewery, a short drive away from Madison. Super cool place! And yes, I am pregnant, and yes I sampled some beer unshamefully.

We also spent a couple of hours at the New Glarus Brewery, a short drive away from Madison. Super cool place! And yes, I am pregnant, and yes I sampled some of their beer unshamefully.

*Today Dean, Addison, and I spent the afternoon at the Air and Water Show.  I’ve been in Chicago for 11 years now and this is only the second time I’ve gone to see the show.  Sooooo impressive!  I’m not a crowds person and get serious “people rage” when around lots of people (ESPECIALLY with a stroller), but this was totally worth it.  The Breitling Jet Team and of course, the Blue Angels were my favorite performances to watch.  Their degree of precision just blows my mind.

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Btw, lulu running skirts are officially my favorite pregnant piece of clothing…even more than yoga pants (and this is coming from someone who used to LOATHE the idea of running skirts). I would live in these the rest of my pregnancy if I didn’t have to go back to work.

Quick update on Addison:

  • She is now ~12.5 months old.  With my job starting Monday (yikes!) and part II of my radiology boards coming up this fall, I probably won’t have time for an update for awhile so figured I’d do one now.
  • She isn’t quite walking on her own, but is just about there.  It’s just a confidence issue at this point.  For now, she loves walking while holding onto one or both of our hands:
  • She is mostly a happy baby except during the following:  changing her diaper, changing her clothes, putting sunscreen on, or putting her in the stroller (doesn’t mind being in the stroller, but my goodness, those 10 seconds when I’m trying to get her into the stroller…).  I sometimes (all the time?) literally have to wrangle her down on the floor with my legs in order to keep her in place and free up my hands to put her clothes on.
  • Is becoming little Ms. Independent.  I used to be able to feed her myself with a spoon when I didn’t feel like dealing with a mess, but she wants none of that now.  She, and only she, can feed herself, and you better not get in her way!  haha
  • We are down to about 10-12 oz of formula a day now.  She enjoys her milk and apparently LOVES vanilla soy milk, which we discovered one day when we ran out of whole milk.
  • Lots of “real” food–>holy shit her diapers smell bad now (which has been the case now for awhile)!  At least her poop is more solid which means she doesn’t have blow outs anymore.  This, however, has been replaced by clothes with food stains on them.
  • We are phasing out her binkie.  She now only gets it at night…no more binkie during the day or during naps except in an “emergency” (like we’re at church or a restaurant and she starts getting impatient).  It actually has been going really well.
  • Can mimic us and say mama or dada depending on what we just said to her.  Doesn’t quite know what they mean, but it’s still really fun hearing her mimic us or seeing her mimic other things we do.
  • She now has 4 teeth.  We use a banana brush with a dab (like smaller than rice sized drop) of toothpaste on it to rub her teeth and gums down each night.  She loves it.  I think it feels really good on her gums.
  • I used to enjoy rocking her to sleep in my lap at night and cuddling with her, but now she’s getting so big that she just doesn’t seem to get comfortable in my lap anymore : (, so after reading to her we cuddle for a couple of minutes and then she is put in her crib.  Fortunately, we have been blessed with an excellent sleeper whether I rock her to sleep or set her down in her crib awake (I take no credit for this, as we have done no sleep training with her), so it’s not issue for her, but makes me sad.
  • Loves the water and loves playing in the water fountain downtown.  I’m going to miss these summer days!
  • And one final pic of Addison in her tricycle, just because I think it’s cute and makes me smile : )IMG_0102

~

QUESTIONS

  1. What shoes do you recommend for babies/toddlers just starting to walk?
  2. Double stroller recs??  Getting a double Bob is probably going to be a must for me with all the running I do, but is it practical for everyday use?
  3. Addison needs a new carseat.  Recs for kids her age?
  4. Anyone use Blue Apron or any of those other meal delivery companies?  How do you like it?
  5. Is it possible to travel overseas with 15-16 month old?  The thought of such a long plane ride with her sorta terrifies me.  Any advice is much appreciated!
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