Tuesday, August 28, 2012

A happy ending of pink fishy jammies

It was a dessert kind of night. You know, the kind preceded by a terrible, horrible, no-good, very bad day. Edie was being lazy this morning and decided that biting me was a-ok. I, however, was not a-ok with this, and tried flicking her cheek when she did this, but she got such a quiver lip and cried tears--real tears--that I was at the brink of tears too. And this was all before 6:30am.

I was at the beginning of my ED shift taking care of a man who I spent 30 minutes with taking a thorough history and performing a complete physical exam including a real, full, neuro exam (which any good medical student will tell you takes 15 minutes to properly perform start to finish) for his complaint of new-onset headaches...when I simultaneously get chewed out by the attending for taking too long because "we're just going to scan his head anyways" and paged by our clinic administrator frantically wondering where I've wandered off to this morning because I have a list of patients waiting for me in clinic. (note to self: evidently there are two clinic schedules and one is not correct).

--Whereas in any normal job telling your supervisor that you are in the Emergency Room will surely get you some sympathy--

I go to clinic.

First patient is an extremely complicated morbidly obese woman with a sad history and recurrent infections in her pannus (look it up--urban dictionary). And...not really my patient. She sees another resident who is on vacation (note to self: thank the residents seeing my patients when I am on vacation). But she is nice enough.

Second patient is the mother of a 3 year old with recurrent scabies. Because we all know that the real patients in peds are often the moms, let's be honest. And she was kind of mean about it when I told her the whole family needed to be treated again and for crying out loud wash the stuffed animals! Only after I told her my diagnosis did she offer up information about how, oh yeah, their cousin has scabies and hasn't been treated. Also their house has a cockroach infestation and could that possibly be causing the rash? Do cockroaches bite? Let's just say I wore gloves in there. And for the record, only Philippine cockroaches bite. That is purely anecdotal, but I believe it to be true. Please leave a comment if you know otherwise.

Have I mentioned I haven't pumped all day? At least my poor nipples got a break from all that biting this morning. Ahhh motherhood.

Back to the ER and some guy who's not very sick and not very emergent is going berserk because he was told at urgent care that he needs a surgery to pin his wrist in place and he wants it NOW. Can I call the head of ortho? Oh and by the way, no pain meds work on him EVER for ANYTHING and he's in 10/10 pain. He proceeds to laugh at some joke he makes that I do not find funny. I'm pretty sure that when I was in 10/10 childbirth pain I was not laughing. Just for the record.

I spend the next 1.5 hours trying to find someone--anyone--in radiology (where are those doctors anyways? Have they all moved to Hawaii?) who will be willing to load his x-ray from urgent care. Evidently there is a protocol for that and paperwork yada yada. So can I get the patient to sign the financial consent form that he might be charged for a re-read? Oh he's going to love that.

I am just now realizing while typing this that my patient had narcissistic personality disorder.

All's well that ends well though. I got to come home to Boyd and Edie and plenty of smiles and babbles. She is scooting around pretty successfully these days which proves to be quite amusing as she discovers all sorts of treasures on the floor. She loved eating the little cubes of beet I roasted for her for dinner. And I got to snuggle her and put her to bed in her pink fish jammies.
So happy 

Sunday, July 8, 2012


And it begins...

Residency I mean.

Can I stop the post right there? Naw. That would be too dramatic. It probably doesn't deserve that much drama. Well, the nurses might think so, but I digress.

What are the stats you ask? Since July 1st I've...

-Delivered 4 babies
-Stitched up 2 moms all by myself
-Broken one woman's water
-Been first assist surgeon on 3 c-sections
-Helped one woman get started breastfeeding
-Pumped milk 22 times
-Done about 20 cervical exams
-Managed 8 women in labor
-Been in clinic 8 hours
-Written 4 prescriptions
-Missed bedtime twice
-Woken Edie up 3 times to feed her before I leave
-Unintentionally skipped 4 meals
-Been chewed out by 1 attending in front of the entire nursing staff
-Been reprimanded by 2 senior residents
-Been late 0 times
-Made cookies twice
-Cried 3 times
-Been called "honey," "sugar," and "sweetie" by 3 separate nurses in front of my patients
-Been asked by 2 separate clinic support staff, "how could you leave such a precious baby girl at home and come to work?" when my nanny brought Edie in one afternoon for me to feed her. That may or may not have been one of the times I cried.

And I've also made a pan of brownies. What can I say? I feel deprived missing meals so I clearly deserve extra dessert. Thankfully, while breastfeeding this doesn't seem to matter to my waistline. I do not, however, want to ask my pancreas how it feels about the sugar overload.

I love being on OB because childbirth is truly such a miracle. It is so painful and so awesome all at the same time and it is so incredible to be a part of that in someone else's life. I get to be the first person to hold their baby! I also hate being on OB. There is a lot more sadness and burnout there than a lot of people realize. It's hard. Being an intern is really hard.

I miss Edie. I miss Boyd. Only 155 weeks to go!

Edie eats sweet potatoes. Mmmmm.

Um, guys, I have a question (brightest witch of her age)

Friday, March 16, 2012

Match Day Disappointment

This is such a cruel irony. I am so incredibly humiliated and disappointed right now I have no words for it. I know I need to count my blessings, and I think tomorrow I'll be able to do that, but right now I just can't. I just feel defeated.

Let me break it down for you. I've worked incredibly hard in medical school. In December I was awarded a scholarship for being #1 in my class. Not #2. Not #3. Number 1. The UofA doesn't even officially release their rankings, but the top three students won this award--so they know who they are. It was an incredible honor. During my first two years of medical school I published three papers--one first author paper--in peer reviewed, highly regarded medical journals for my research that I finished at Mass General in Boston during my internship after first year of med school. I scored A's on every test. EVERY ONE. And when I took the medical boards--steps 1 and 2--I blew them out of the water. Scores that people going into plastic surgery would kill for. Scores like that. I volunteered at our school's refugee clinic and loved every minute. I was awarded AOA--the medical school honor society--as a junior, and Gold Humanism Honor Society as a senior, which looks more at how you interact with patients instead of just academic achievement. I honored every clerkship during 3rd year. Even psychiatry. And surgery. I really cared about the patients I was asked to see and take care of, and I would come in early and leave late. I scrubbed into hours-long surgeries pregnant and had things thrown at me during psych, but you know what? It was worth it. Because I learned things I wouldn't have been able to learn any other way.

So when I walked up to the stage this morning, Edie in tow, to read my residency placement, I was really excited. I just knew I would match into one of my top two choices in Seattle. Everyone said so. Everyone. Even the programs themselves. I doubted myself so many times during the process. Worried and fretted that for some reason my top programs wouldn't like me. But friends, family, and every doctor I talked to at the medical school said I was a shoe-in for my #1 choice. Why wouldn't I be? It is well known that family medicine is one of the least competitive specialties in medicine. And I was one of the most competitive applicants.

So when I opened that envelope in front of hundreds of people and I matched at my #4 choice in Renton, WA--Valley Family Medicine--I was crestfallen. Not because Valley is a poor program, on the contrary. It's a great program. Flexible with talented attendings, happy residents, and a beautiful hospital. Its adult medicine, pediatrics, and OB services are all run by family medicine, and it's only 30 minutes outside of Seattle. I'm sure I'll be reminded of all these things when I start there. But I was humiliated. I have never been more embarrassed. It is practically unheard of for someone going into Family Medicine to have to go down more than three ranks to match. I was pretty conceited going into the whole process that I would get my first choice. I never dreamed it would be different. And if I started to waver in my pride, someone was always there reminding me that I couldn't possibly need more than 3 ranks.

I'm not sure why it ended up this way. I hope there's a reason behind it that I discover when I'm there and think, "that's why we're in Renton." School has never let me down before, and I think it was time to be humbled. I have a great marriage, a beautiful daughter, and I am privileged to become a doctor in a country with exceptional medical training.

But for today, I'm just disappointed.

Wednesday, February 29, 2012

On Breastfeeding, Cloth Diapers, and Sleeping Through the Night

Let's start with this: I live and breathe baby. School? What is that? The dean of students actually had to call me the day my rank list was due for my residency choices to ask me if I was going to do it before the 6pm deadline. Three months ago I would have had obsessed over and finished that list weeks before the deadline. I did think about it, but let's just say it was more of an afterthought to my recent obsessions with breastfeeding, cloth diapers, and sleep, just to name a few.

Oh sleep. How I miss you.

I've never thought of myself as the motherly type. I still don't. I didn't immediately bond with little Edie. It's been a slow process. This is likely partly because breastfeeding was a nightmare at first. For school I've been doing a reading elective on breastfeeding...learning all its benefits to mom and baby and society at large. I was determined to make it work. I knew deep down that it wasn't going to come easy to me. For starters, I've always had really sensitive skin and I thought it might be painful. What I wasn't prepared for was the absolute ripping, searing pain that occurred nearly every 2 hours like clockwork for Edie's first 3 weeks. Instead of the loving bonding that was supposed to be happening during those precious awake hours with my little girl I spent most of it sobbing. Ha, labor was easy and finite compared to this never-ending torture. 2 midwives, 1 pediatrician, 3 lactation consultants and 1 occupational therapist later, we finally got a diagnosis I had never heard of--Edie had a posterior tongue tie so her tongue didn't work the way it was supposed to. Two hours driving up to Phoenix and one five-minute procedure later and 7/10 pain was now 2/10. We still had to spend some time teaching Edie to un-learn the bad habits she had picked up with her odd anatomy, but finally, after 5 weeks of post-partum depression directly correlated to my pain level, I felt sunny again.

Right around the same time Edie started sleeping a longer stretch at night. First 5 hours, then 6, and then 7-8 hours starting around 7-8pm. So for the past two weeks I've felt soooo much better since she only wakes up at 3am to nurse. Except tonight as I write this it is 8:30pm and after an hour of complete silence in her crib from 7-8 she is screaming. However when I picked her up, worried that something was really wrong, she started cooing and smiling so I'm pretty sure she's fine. I'm not looking forward to the nights ahead if this is going to be a new normal for her. I was just starting to enjoy sleeping through the night (which is evidently defined as 6 hours straight). And I'm not sure if I should let her cry it out or not. Most books say it's too young for that (she's only 7 weeks), but she seems to know exactly what she wants (to play and not sleep), so I feel like I'm creating a bad habit by giving in to her. Sigh. I just don't know how to do this parenting thing. OK-so after 20 minutes of crying she gave it up and I can see on my video monitor that she is sound asleep. Hmmm...it's all so frustrating really. Can you tell I'm not exactly into attachment parenting?

Lastly, we've decided to do cloth diapers. I LOVE them. When our diaper sprayer broke we did a few days of disposables that we had been given and she got the angriest diaper rash I've ever seen. One day of cloth diapers again and it was gone. I realize that's completely anecdotal, but I love our little TotsBots tinyfit newborn diapers. I'm trying to decide what to put her in when she outgrows these around 12 pounds. I want to do a one-size diaper next. Suggestions?

So that's what's been on my mind. Mommy stuff. This is so much harder than I expected. Part of me wishes someone would have told me, but I realize that I wouldn't have really listened--wouldn't have really heard it--anyways. I do love our little girl, but the newborn stage just isn't quite my thing. I'll take my next one potty trained, thank you very much.

Thursday, January 26, 2012

The long awaited...the birth story

For pictures of the birth (everything PG) visit my friend Elizabeth Ashdown's amazing photography blog: http://elizabethashdownphotography.blogspot.com/

Ok, deep breath. Here goes:

A couple things happened the week I went into labor. One was that the blue and black cohosh didn’t work. I tried diligently for about 4 hours, alternating the tiny sugar-tasting pills, which I wouldn’t even blame the manufacturer if they truly were placebo. I was making enchilada sauce that day and taking the stupid little pills every 15 minutes instead of tasting my creation was truly maddening. Another was that I started up running again. At least if I wasn’t jump-starting labor I could lose myself in my ipod and work on getting fit for labor. Lastly, was finding two things online that really helped—the UK babycenter January birth club and a friend’s birth story. Both included women who were well over their due date and into their 41st week and still hanging in there. And with that I cancelled our original induction date/time at TMC for Saturday morning.

On Wednesday I called the birth center to see if I could get my membranes stripped. Somehow I knew I was close. Wednesday had been different; I just felt more somber. My 5 miles turned into 2 ½. The midwife did the strip which I laugh now thinking that I even though it was uncomfortable at the time. After the excruciating pain of labor it was like eating ice cream. Then I promptly went home and like anyone about to give birth, I made a lasagna from scratch. Best lasagna ever. Also hardest to make ever. I was contracting during cooking and they weren’t exactly painless. I was getting hopeful, but as the night wore on and Boyd and I enjoyed out last night together as a twosome the contractions died out. I went to bed at 11pm thinking I would wake up to enjoy yet another day baby-less. Wrong. And I was in for the roller coaster ride of my life.

At 5am on 01/12/12 I woke up to a pretty painful contraction. I had never felt anything like THAT before. Excited I laid in bed with my heart pounding. But nothing. Then 5:30—wham. Like being hit in the abdomen by a baseball. From the inside. Then nothing again until 6:00am. Then 6:20, 6:40, 7:00am. I wondered how long it was going to go on like this and if it would die off again like it had so many times before. But somehow I also knew this was it. I remember not wanting Boyd to see me during a contraction because I didn’t know how to hide my pain and I thought it might just be false labor. I didn’t want to be silly. But he came in the room to say he was leaving for work at 6:40am and saw me crouched over the bed. We didn’t talk about it. He went to work anyways, letting me save face like he knew I wanted to. I know that might seem strange, but it was what I needed. Come 7am, though, I was screaming it from the rooftops. He needed to come home and come home NOW!

My contractions were so intense I suddenly had this overwhelming panic about natural labor—if I was still only dilated to a 3 like I was during my visit the day before how was I going to do this? In the moment I did everything I could just to rinse the shampoo out of my hair. In a matter of minutes every class we had on relaxation, every technique we had learned was out the window and the only way I was dealing with the pain was by throwing up when the contractions hit a new level of intensity which they seemed to do every 20 minutes or so. Boyd came home by 8am (he had run to work, !?*&%!). At this point I didn’t know how I was going to sit in the car for the excruciating 20 minutes to the birth center. I also realized in that moment that waiting for real labor to start to pack my bags was a bad idea in general. I kept remembering things in between contractions and Boyd was frantically trying to stuff it all into a too-small suitcase. I truly regretted later not packing anything but a bar of dove soap for my shower afterward. A nice-smelling shower gel or at least shampoo and conditioner would have been a real bonus. Ah well, there’s always next time!

Boyd started out driving fast to the birth center, and I have to imagine that he was probably excited to use the “my wife’s in labor” excuse just in case. Because truly, there was no mistaking my state. But we hit that first speed bump on the way out of our complex and I think I squealed in hysterics. So much for a Hollywood entrance into the birth center. We did manage to make it there, albeit with a little more throwing up, and the first thing I hear when the nurse met us outside in the parking lot was, “ah a true sign of labor” at the sight of my bile-stained bowl.

I hobbled into the birth center and for the first time all day things started to feel under control. The midwife met me and instructed me to tone down my hysterical soprano notes a few octaves and to relax my pelvis during a contraction. She showed Boyd how to squeeze my hips during the worst of it, and before we knew it we were whisked into the pink room, bath running and ice chips waiting. Ice chips. Can I just have a moment of silence for this amazing invention? It was the one thing I specifically requested on my birth plan because I have an irrational love affair with ice chips. Since the birth center didn’t have the crave-worthy hospital ice (you know the airy kind), the nurse put the cubes through the blender for me! Ahhh such spa treatment! But I digress. At that point it took every ounce of effort I had just to hoist myself onto the bed so the midwife could check me. The whole time I just kept thinking, if I’m only 4cm we’re going to TMC and getting an epidural because this pain is ridiculous. Thank goodness I was a solid 7cm. That gave me a lot of motivation—transitional labor already! I could do this!

The next 3 hours were a blur of contraction upon contraction upon contraction spent in the bath tub. I only really remember Boyd staying by my side the whole time and feeding me ice chips. It’s ironic, because one of the reasons I thought I wanted to deliver at a birth center was because I wouldn’t be hooked up to anything, and so could walk around and eat etc…HA! To even imagine that someone in that kind of pain could walk is ridiculous to me. And eating? Well, we already heard about my propensity to toss my cookies, so that was out of the question. After 3 hours there was a still a small lip of cervix that was keeping me from the elusive 10cm and pushing. But the midwife said I was making sounds like I was starting to push (this was all news to me) and she was worried about me tearing my cervix so she gave me the option of either manually pressing my cervix back through a contraction and having me continue to gently push or having me stop any type of pushing while I finished dilating. At this point I felt like I was going to die with every contraction. I remember thinking—this is why women get epidurals.

They say that pushing is a relief, but I think that the contractions are just so painful when you reach 9-10cm that pushing is just enough of a distraction to keep you from going crazy. All I can say about the pain is 1) it felt like someone punching me in the abdomen every 2 minutes except that the punch was sustained for about a minute; it took all the energy I had just to remember to breathe and 2) it was so intense and such an out-of-body experience that I’ve already forgotten the sheer terror of it. So naturally, not pushing was NOT an option. But having her fingers hold back my cervix during a contraction was torture too. Needless to say my first hour of “gentle” pushing on the bed felt like the longest hour of my whole labor. Once I was fully dilated I still didn’t feel the intense urge to push and evidently this was because the head still wasn’t full engaged. My midwife had me get up on hands and knees and push as hard as humanely possible to try to break my water, which shortly afterward exploded on the bed.

The final hour of my labor was spent on a birthing stool on the floor. I gripped that thing so hard I’m surprised I didn’t bend the metal frame. After my water broke it was amazing how much pressure I felt. Her head felt like it was tearing and burning me from the inside, but once the head was delivered it was so strange how the rest of her body was perfectly smooth. I know now why I have been able to deliver so many babies as a medical student—because frankly, I could have cared less who was down there catching her. My first thought when they handed her to me was just how loud she was and how I hoped she wasn’t as traumatized by it all as I was. But I also felt such an amazing relief that the contractions were gone. I kept bracing myself for a few minutes afterward but then felt these amazing gushes of relief that the pain didn’t come.

I thought I would cry, but I didn’t. I also thought I would have some sweet image burned in my head of Boyd holding her for the first time but when they handed her to him while they sewed me up I couldn’t see his face. I wish I wouldn’t have missed that.

I also remember how beautiful I thought she was when she was born. And how perfect her little body was. Later that night after taking a shower and looking into the mirror at the hundreds of tiny popped blood vessels on my face and in my eyes, I remember how unbeautiful I looked. And how haggard, swollen, worn-out, and almost destroyed my body felt.

It was an amazing experience. One that I don’t think can be adequately described. One that already the snows of memory have softened. But one thing I can say, even when I felt so kicked to the curb that night, was the amazing sense of accomplishment I had. And when, at 3am, everyone was sleeping and I was overcome with the greatness and gravity of it all, I finally understood the scripture, “Mary kept all these things, and pondered them in her heart.” Truly, that says it all.

Sunday, January 15, 2012

Baby Edie!

She's here and she's wonderful!

Edith Lucy Gunnell was born at 3:09 PM on Thursday the 12th. She weighed 6 pounds, 11 ounces, and was 20 inches long. She has long fingers, toes, and fingernails, and lots of hair. She likes riding in the car and being wrapped up nice and tight. She does not like cold hands.

Many thanks to everyone who's given food, diapers, books, clothes, and so on!

Just before leaving the Birth Center--this is the room where she was born!

She's so little, she almost gets lost in her car seat.

Baby's first spa day. She relished having her hair washed.
Mowgli has been eager to introduce himself.

Wednesday, January 11, 2012

40 weeks 5 days and counting...

I posted pictures of my beautiful nursery on my facebook profile. Check them out! Here is proof that I am still pregnant. Taken today with my budding skill at using my fabulous new Christmas present Canon Rebel and tripod!

Tuesday, January 10, 2012

I'm starting to think it might just be a tumor...

I'm getting pretty disheartened, discouraged, depressed...call it what you want. I know that many pregnancies are late, especially for first-time moms, but I'm starting to lose faith in my body and my ability to have this baby. I feel like I have absolutely no control and that I'm spiraling down the path of losing the kind of birth I really want to have with every passing hour of uterine silence.

Everyday for the past two weeks I've woken up and thought, "maybe today!" with excitement. Sunday I even had contractions getting closer and closer together (for a grand total interval of 8 minutes!!) which helped me be strong in church to face the constant, painful barrage of "what are you doing here?" and "not in labor, huh?" comments. Well, I'm not even excited anymore.

Every morning now I wake up and think, "oh man, I didn't go into labor overnight" (which is the most likely time because of our natural hormone circadian rhythms). Then I spend my days trying to come up with semi-productive activities to fill the annoyingly long and arduous next 16 hours. Everything from massages, cooking, cleaning every last spotless corner of our already clean house, washing baby clothes and cloth diapers, reading, researching medical questions (mostly about pregnancy, let's be honest), rearranging the baby's room AGAIN, texting and calling back well-meaning friends and family that, NO, our baby is NOT here. Painful. My mom even tried to recruit me to strip an old bench of hers and--gasp--I'm actually considering it!

I've run (ok, more alternating power-walking and running) about 5 miles a day since 39 weeks and the midwife has told me two weeks in a row that this baby's head is still floating in deep space nine, also known as NOT MY PELVIS. I've been dilated to a pathetic 1cm for two weeks despite cervical evening primrose oil, membrane sweeping, red raspberry leaf herbal tea, and yes, sex, which if I can be perfectly frank, is just ridiculous this pregnant. Effacement? Let's just say I went backward from last week from 50% to 30%. Is that even possible??

When I started writing this, I was kind of sad, and listening to Rascal Flatt's "Easy"--you should youtube it, it's a great song. But now after this long rant I'm more mad about it all and my itunes has crawled down to Glee's mashup of "Rumor Has It/Somebody Like You" which is a more appropriate angry/sad montage. The first verse aptly starts off with, "She...she ain't real." Yep, that pretty much sums it up about how I'm feeling about this mystery baby who I don't even really know.

On a final note, I have a gorgeous new camera and this post probably deserves a picture of my 40+ weeks pregnant self, but I'm still trying to muster up the courage to let Boyd take one of those. Stay tuned and you may get lucky in the next few days with just such a pic.

I really don't want to go to TMC or be induced. I had visions of something in my life not being shrouded with medicine, so I hope something happens in the next 3 days or that's where we're headed, sadly enough. I'll even happily accept a Friday the 13th birth. And if you've read this far into my horrible rant perhaps you should win the "delivery date" prize from my previous post because it looks like everyone's guesses are going to be under.

Ok, with that off my chest, here's to some positive thinking!