At 24 weeks, I have now hit the 180lb mark. As such, I am learning fascinating things that 98% of the female population learned at puberty: Did you know that your breasts can "rest" against your rib-cage and form sweaty pockets? Or that they can bounce so much during exercise that it's uncomfortable?
I never knew how lucky I was to be an almost-A cup.
In other news, I am attempting to correlate my medical knowledge of pregnancy with what I'm actually feeling and going through. I, for example, was taught to tell pregnant women to work out regularly, to eat small, regular nutritious meals and to pretty much live life as though they were not pregnant.
I would like my patients to know that I am sorry.
I am lucky to exercise twice a week, and that has to be yoga and gentle cycling, cos the rest of the day becomes a write-off if I push too hard. I need to eat massive, all encompassing meals to feel full, plus snacks, plus litres and litres of water (doubled blood volume, woo!). I sometimes become rage-blackout angry at things in my life, or cry for 45 minutes. As such, I am not living my life like a normal version of me.
On the other hand, pregnancy is still less strenuous than residency. I can sleep as much as I need to. I can eat when I'm hungry (and not force myself to inhale Tim Hortons bagels in the 10 minute windows between OR's), I am getting stretched and walked and massaged and people are so fricking nice to me all the time. (Example: Pickle went missing this weekend. Large search party assembled. I was walking the streets calling her name and developed pain in my belly. All males in search party immediately dropped everything to escort me home and bring me glasses of water. So weird. Nice, but weird.) (We found her. She's fine.) I am getting worried about my waning desire to return to work.
I read too many pregnancy blogs, worry about what I'm eating but can't stop eating and am constantly taking off my clothes cos I'm 30 degrees too hot. I am actually seriously considering copying another prego blog I read and adding my own prego photos and stats to my posts. On the one hand; this is supposed to be a medical experience blog! On the other hand; this is the only record I keep of my life that is free of Mr G, colleagues, etc, and it might be nice to look back when the kid is trying to murder me in my sleep.
So many thoughts. Time for more fancy yoghurt, then perhaps a nap. Pickle has a good sunny spot picked out.
Monday, May 12, 2014
Monday, May 5, 2014
I was wrong.
You've heard of people who, after a lengthy jail sentence, refuse to leave prison when their time is up. They resist the change. The lack of structure. The total, terrifying freedom. The loss of social status that comes from being in a known environment.
I think that was me. For the first 4 weeks of my medical leave, I was terrified. Furious at all the free time, the lack of purpose. Admittedly, I was still spending a fair amount of time with my head in a bucket (old bluey), but when I felt well, I was crazed with anxiety.
Now, at week 8, I've hit my stride. I understand all those people who say they'd like more free time. Everything that needs to be done gets done in a timely fashion. I filed our taxes, early. I've booked our movers, cancelled the bills and found boxes, early. I'm writing my research paper, due next March. All of this is interspersed with long walks in the sunshine, yoga & lots of fancy cooking. I am so happy.
This is trouble, for the following reasons:
1. I'm getting a taste for the housewife lifestyle. Like, starting to think about buying fancy yoga pants.
2. My life/future economic plan has been built on the idea that I will work as much as is humanly possible. If I get comfortable not working, we may never get out of Ontario. This is unacceptable.
3. I'm losing my ability to tolerate shift work/24 hour shifts. This skill has been built up over the last 4 years, and takes serious effort to maintain. When I go back to work in March, I will not be allowed to stop for "first nap" when the going gets tough.
4. I am still in total denial about being pregnant. Notice there is no mention of "buying baby clothes", "refreshing infant CPR skills" or "choosing nursery furniture" on the list of completed errands.
To illustrate #4: I was at yoga this morning and the instructor said, "Now, those ladies who are pregnant should not attempt the following pose". I didn't even pause; flopped onto my (now enormous) belly and pushed into cobra. I got an angry poke from the inside in response.
So. I'm 100% on board with the yummy mummy lifestyle, which is unsustainable.
I'm 100% in denial about the mummy part, which is irreversible.
I think I'm in trouble.
I think that was me. For the first 4 weeks of my medical leave, I was terrified. Furious at all the free time, the lack of purpose. Admittedly, I was still spending a fair amount of time with my head in a bucket (old bluey), but when I felt well, I was crazed with anxiety.
Now, at week 8, I've hit my stride. I understand all those people who say they'd like more free time. Everything that needs to be done gets done in a timely fashion. I filed our taxes, early. I've booked our movers, cancelled the bills and found boxes, early. I'm writing my research paper, due next March. All of this is interspersed with long walks in the sunshine, yoga & lots of fancy cooking. I am so happy.
This is trouble, for the following reasons:
1. I'm getting a taste for the housewife lifestyle. Like, starting to think about buying fancy yoga pants.
2. My life/future economic plan has been built on the idea that I will work as much as is humanly possible. If I get comfortable not working, we may never get out of Ontario. This is unacceptable.
3. I'm losing my ability to tolerate shift work/24 hour shifts. This skill has been built up over the last 4 years, and takes serious effort to maintain. When I go back to work in March, I will not be allowed to stop for "first nap" when the going gets tough.
4. I am still in total denial about being pregnant. Notice there is no mention of "buying baby clothes", "refreshing infant CPR skills" or "choosing nursery furniture" on the list of completed errands.
To illustrate #4: I was at yoga this morning and the instructor said, "Now, those ladies who are pregnant should not attempt the following pose". I didn't even pause; flopped onto my (now enormous) belly and pushed into cobra. I got an angry poke from the inside in response.
So. I'm 100% on board with the yummy mummy lifestyle, which is unsustainable.
I'm 100% in denial about the mummy part, which is irreversible.
I think I'm in trouble.
Friday, April 25, 2014
Brainwash
I've been doing some reading.
As a medical doctor, you are trained in the genetics and physical symptoms of pregnancy. However, there is very little education around day to day questions that arise during your period of confinement.
Popular culture is another matter; thousands of books line the shelves with titles that range from cloying to faux-scientific. What to Expect When You're Expecting is the most commonly recommended (25 cents at the Salvation Army store, 6 copies left). Suggestions include avoiding warm climates, herbal teas and "spicy or aggressively flavoured" foods.
I bought another book, recommended by my Kiwi friend; "Up the Duff" is the Aussie title, but it's more politely titled "Bun in the Oven" in the US.
It has a much more relaxed approach to pregnancy, including the suggestion that a glass or two of booze will not condemn you to hell. Still, this book recommends not exercising beyond gentle walking, and taking shit-tons of dandelion-leaf extract to "combat swelling".
So. Nonsense.
The pregnancy-capitalistic machine seems to revel in telling you what you're doing wrong, with little reference to common sense.
Yes, there is a risk of contracting food poisoning from eating raw fish. However, this risk is equally present in eating any take-out food, or any partially cooked meats/eggs/veggies/salads.
Yes, there is a risk in undertaking strenuous exercise (dehydration, muscle strain), but no more than usual. The laws of common sense still apply; if it hurts, stop. If you're thirsty, drink.
A pharmacist refused to sell me Gravol's "ginger" anti-emetic a few months ago, saying that it hadn't been proven to be safe in pregnancy. She then recommended I purchase ginger from the health food store across the street.
Scientific research on these things is scant; no one wants another thalidomide scandal. This doesn't help those of us who require medications to maintain mental & physical health during pregnancy. A study of 600,000 women in Scandinavia showed that the medication I take, Zofran (ondansetron), is "not associated with birth defects", which is comforting. However, the drug has only been on the market for about 10 years and so there is no long-term follow up on babies who are exposed in utero. Given that ondansetron works by blocking serotonin receptors in my brain, I have concerns that my fetus may grow up with deficiencies in brain development. Then again, that could just be all the sushi I'm eating.
I suppose what I'm trying to convey is the overwhelming impression from popular culture that I'm doing it wrong. No matter what I do, or take, or eat, I will be wrong. Any subsequent issues with Little Pickle will be my fault.
I try to keep the voice of common sense in my head. But there's a lot of brainwash out there, and it's getting louder the tighter my pants get.
As a medical doctor, you are trained in the genetics and physical symptoms of pregnancy. However, there is very little education around day to day questions that arise during your period of confinement.
Popular culture is another matter; thousands of books line the shelves with titles that range from cloying to faux-scientific. What to Expect When You're Expecting is the most commonly recommended (25 cents at the Salvation Army store, 6 copies left). Suggestions include avoiding warm climates, herbal teas and "spicy or aggressively flavoured" foods.
I bought another book, recommended by my Kiwi friend; "Up the Duff" is the Aussie title, but it's more politely titled "Bun in the Oven" in the US.
It has a much more relaxed approach to pregnancy, including the suggestion that a glass or two of booze will not condemn you to hell. Still, this book recommends not exercising beyond gentle walking, and taking shit-tons of dandelion-leaf extract to "combat swelling".
So. Nonsense.
The pregnancy-capitalistic machine seems to revel in telling you what you're doing wrong, with little reference to common sense.
Yes, there is a risk of contracting food poisoning from eating raw fish. However, this risk is equally present in eating any take-out food, or any partially cooked meats/eggs/veggies/salads.
Yes, there is a risk in undertaking strenuous exercise (dehydration, muscle strain), but no more than usual. The laws of common sense still apply; if it hurts, stop. If you're thirsty, drink.
A pharmacist refused to sell me Gravol's "ginger" anti-emetic a few months ago, saying that it hadn't been proven to be safe in pregnancy. She then recommended I purchase ginger from the health food store across the street.
Scientific research on these things is scant; no one wants another thalidomide scandal. This doesn't help those of us who require medications to maintain mental & physical health during pregnancy. A study of 600,000 women in Scandinavia showed that the medication I take, Zofran (ondansetron), is "not associated with birth defects", which is comforting. However, the drug has only been on the market for about 10 years and so there is no long-term follow up on babies who are exposed in utero. Given that ondansetron works by blocking serotonin receptors in my brain, I have concerns that my fetus may grow up with deficiencies in brain development. Then again, that could just be all the sushi I'm eating.
I suppose what I'm trying to convey is the overwhelming impression from popular culture that I'm doing it wrong. No matter what I do, or take, or eat, I will be wrong. Any subsequent issues with Little Pickle will be my fault.
I try to keep the voice of common sense in my head. But there's a lot of brainwash out there, and it's getting louder the tighter my pants get.
Monday, March 17, 2014
Heal Thyself...
As soon as I realized I was up the duff*, I booked an appointment with my family doctor.
I had met this man once before. He was older ("I'll probably retire next year"), focused on telling me about his days in residency, and happy that I would see him "as needed".
Cut to January 2014.
I arrive, grey and shivering with nausea. I fill out my paperwork, pee in a cup and wait in the consultation room.
The door opens.
A cheerful, pudgy teen sweeps in the room.
"OMG, sorry I'm sooo late. I'm Dr D and I'm a first year family med resident and I'll be looking after you today!"
"um..."
"So, like, you're pregnant, right? How far along?"
"um..."
"Oh, it's like your first visit! So we don't know for sure. So, like, I'm going to give you some forms to fill out and...Oh! It says here you're a resident!"
"Yep. Family med. Doing fellowship in ER."
"Whoah! So cool! So, like, maybe you can help me - do I need to order the Rhesus titres today? Or can I leave that for the next visit?"
...
...
...
"Nope. Shut it down."
Consciously, I know I'm being unfair. She's finished medical school, she's a doctor, she can't be 19 and everyone has to learn somewhere.
However.
I was losing weight, unable to work and unable to handle a giggling, baby-talking little sprite who kept congratulating me on a pregnancy that was destroying me.
I've got a new family doctor. An old dude who used to deliver babies, has seen it all, and who knows what blood tests to order in each trimester.
This brings me to my next moral quandary; will I let a resident deliver my baby?
The short answer is no.
The long answer is; I have delivered about 40 babies, under varying circumstances, with varying outcomes. I would not want me or one of my colleagues to deliver my baby.
I want to give birth with someone who has caught 600 babies. Someone who will not think my birth process is, like, so amazing. Someone who will treat it as a run-of-the-mill, un-magical, totally routine experience. That way, if anything unusual happens, they can react to it.
I know, it's not fair to those learners out there, desperate to get their fingers in my cervix. It's hypocritical, considering how many chances I've been given over the years.
But I'm comfortable with it. If I wanted someone to revel in the magic of birth with me, I'd pop the sprog out on Pender.
*Aussie slang is the best. More to come.
I had met this man once before. He was older ("I'll probably retire next year"), focused on telling me about his days in residency, and happy that I would see him "as needed".
Cut to January 2014.
I arrive, grey and shivering with nausea. I fill out my paperwork, pee in a cup and wait in the consultation room.
The door opens.
A cheerful, pudgy teen sweeps in the room.
"OMG, sorry I'm sooo late. I'm Dr D and I'm a first year family med resident and I'll be looking after you today!"
"um..."
"So, like, you're pregnant, right? How far along?"
"um..."
"Oh, it's like your first visit! So we don't know for sure. So, like, I'm going to give you some forms to fill out and...Oh! It says here you're a resident!"
"Yep. Family med. Doing fellowship in ER."
"Whoah! So cool! So, like, maybe you can help me - do I need to order the Rhesus titres today? Or can I leave that for the next visit?"
...
...
...
"Nope. Shut it down."
Consciously, I know I'm being unfair. She's finished medical school, she's a doctor, she can't be 19 and everyone has to learn somewhere.
However.
I was losing weight, unable to work and unable to handle a giggling, baby-talking little sprite who kept congratulating me on a pregnancy that was destroying me.
I've got a new family doctor. An old dude who used to deliver babies, has seen it all, and who knows what blood tests to order in each trimester.
This brings me to my next moral quandary; will I let a resident deliver my baby?
The short answer is no.
The long answer is; I have delivered about 40 babies, under varying circumstances, with varying outcomes. I would not want me or one of my colleagues to deliver my baby.
I want to give birth with someone who has caught 600 babies. Someone who will not think my birth process is, like, so amazing. Someone who will treat it as a run-of-the-mill, un-magical, totally routine experience. That way, if anything unusual happens, they can react to it.
I know, it's not fair to those learners out there, desperate to get their fingers in my cervix. It's hypocritical, considering how many chances I've been given over the years.
But I'm comfortable with it. If I wanted someone to revel in the magic of birth with me, I'd pop the sprog out on Pender.
*Aussie slang is the best. More to come.
Tuesday, March 11, 2014
Goldfish: 1 Sam: 0
Today is the first day of my medical leave. I am officially too unwell to work.
Little Pickle (the spawn) is feeding me a cocktail of progesterone, estrogen and beta-HCG that somehow conspires to leave me nauseated, lightheaded and dizzy.
I think if I was still in family medicine, I could keep working. The regular, gentle hours, the slower pace and the flexibility of the days would all contribute to a puke-friendly environment.
This is in contrast to, say, ER. Where last night my patient revealed the thick yellow pus coursing from his foreskin, and I had to leave so I could throw up in the bin. His wife chastised me for making him feel bad.
Last weekend I was interviewing a psych patient who was being belligerent. He was yelling at me and the cops and kept saying, "Doc, doc! I just need you to tell me I can have a smoke!" I was trying to reason with him when I felt the dizziness rise. I had to get on the floor with my head between my knees so I didn't pass out. The cops were not happy with me.
Why do I tell these stories of weakness and failure?
Why not mention the awesome catch I made yesterday, when I discovered a hidden skull fracture under a deep laceration? Or tell the hilarious tale of the young woman who hadn't pooped in 11 days? (She's ok. We have stuff for that.)
Because I am riddled with guilt and confusion. I haven't been off work since 2005. I feel as though I have no purpose if I'm not working, or studying, or practicing something to make me a better doctor. So I write down the stories where my body couldn't keep up with demands of work to remind me: I can't do it right now.
Muy depressingo.
I suppose the blog will take a turn from now on. I can't bring myself to commit to the vicious, backstabbing world of mommy-blogs, but maybe I can continue to study and do fun facts and tips. Like managing an aortic dissection! Fun for the whole family!
Little Pickle (the spawn) is feeding me a cocktail of progesterone, estrogen and beta-HCG that somehow conspires to leave me nauseated, lightheaded and dizzy.
I think if I was still in family medicine, I could keep working. The regular, gentle hours, the slower pace and the flexibility of the days would all contribute to a puke-friendly environment.
This is in contrast to, say, ER. Where last night my patient revealed the thick yellow pus coursing from his foreskin, and I had to leave so I could throw up in the bin. His wife chastised me for making him feel bad.
Last weekend I was interviewing a psych patient who was being belligerent. He was yelling at me and the cops and kept saying, "Doc, doc! I just need you to tell me I can have a smoke!" I was trying to reason with him when I felt the dizziness rise. I had to get on the floor with my head between my knees so I didn't pass out. The cops were not happy with me.
Why do I tell these stories of weakness and failure?
Why not mention the awesome catch I made yesterday, when I discovered a hidden skull fracture under a deep laceration? Or tell the hilarious tale of the young woman who hadn't pooped in 11 days? (She's ok. We have stuff for that.)
Because I am riddled with guilt and confusion. I haven't been off work since 2005. I feel as though I have no purpose if I'm not working, or studying, or practicing something to make me a better doctor. So I write down the stories where my body couldn't keep up with demands of work to remind me: I can't do it right now.
Muy depressingo.
I suppose the blog will take a turn from now on. I can't bring myself to commit to the vicious, backstabbing world of mommy-blogs, but maybe I can continue to study and do fun facts and tips. Like managing an aortic dissection! Fun for the whole family!
Wednesday, March 5, 2014
TTC
You know you're working in a small town when the trauma team is activated for "a Bancroft".
In summer, a Bancroft is an ATV collision. In winter, it's a snowmobile crash. I was trauma team captain on Saturday, and we had a Bancroft of epic proportions. Chest tubes were placed, blood drained from lungs (600mL looks pretty impressive on the floor of the ER), eyeballs pushed back into place. All in all, an exciting and successful night. Nobody died.
That night I also worked an evening shift. (Trauma team sometimes doesn't get called in, so they try to maximize our working hours in a 24hour period.) During this shift, I chatted with the ambos as they brought in patients. You get to know them pretty well during our ride-arounds, and they start to recognize you. "Sam! We've got a Sydenham special for you right here!".
The police are also becoming familiar. This is both wonderful (Sam, I'm just gonna stay in the room cos this guy has already attacked two officers and we heard you're pregnant) and terrible. When I see Officer X, I know there's a troubled psych patient coming in. He has the kindest demeanour and most experience, so they call him out when someone is really frothing.
I don't know what it will be like to come back to a big city hospital. At St Mike's, we had regulars, but no sense of community. Too much turnover between police, paramedics, residents and patients prevents you from building relationships. Yes, you'll see more pathology and more exciting cases, but you may never get the high five from the officer when you convince your patient to take his meds. You won't get the heads up from the ambo that the patient has bedbugs, so you should be wearing a gown. You won't get a page that simply says, "Bancroft ETA 15mins".
I'm gonna miss this place.
In summer, a Bancroft is an ATV collision. In winter, it's a snowmobile crash. I was trauma team captain on Saturday, and we had a Bancroft of epic proportions. Chest tubes were placed, blood drained from lungs (600mL looks pretty impressive on the floor of the ER), eyeballs pushed back into place. All in all, an exciting and successful night. Nobody died.
That night I also worked an evening shift. (Trauma team sometimes doesn't get called in, so they try to maximize our working hours in a 24hour period.) During this shift, I chatted with the ambos as they brought in patients. You get to know them pretty well during our ride-arounds, and they start to recognize you. "Sam! We've got a Sydenham special for you right here!".
The police are also becoming familiar. This is both wonderful (Sam, I'm just gonna stay in the room cos this guy has already attacked two officers and we heard you're pregnant) and terrible. When I see Officer X, I know there's a troubled psych patient coming in. He has the kindest demeanour and most experience, so they call him out when someone is really frothing.
I don't know what it will be like to come back to a big city hospital. At St Mike's, we had regulars, but no sense of community. Too much turnover between police, paramedics, residents and patients prevents you from building relationships. Yes, you'll see more pathology and more exciting cases, but you may never get the high five from the officer when you convince your patient to take his meds. You won't get the heads up from the ambo that the patient has bedbugs, so you should be wearing a gown. You won't get a page that simply says, "Bancroft ETA 15mins".
I'm gonna miss this place.
Saturday, February 22, 2014
Feminism
This Friday, my 99 year old patient was trying to tell me his symptoms
and started retching. Instead of my usual response - holding a bowl, rubbing his back, reassuring him - I had to run out of the room and
throw up in the nearby eye-wash station.
So, I'm pregnant.
I always envisioned myself as a super-active, unflappable prego. Someone who could get up, drink a kale smoothie, exercise, then work brilliantly all day before coming home to nurture my partner and get a good night's sleep.
Instead, I've been Linda Blair. I have literally, LITERALLY, vomited every day of 2014. I have good days, where I throw up for a few minutes, then settle. I have bad days, where I am crippled by nausea and have to lie still for up to 8 hours.
I've been going to work as much as I can. Luckily, my work is incredibly supportive, but there are only so many times you can run away from a patient holding your mouth and mumbling, "Sorry!"
All my ideas about life, womanhood and feminism have been derailed by a creature the size of a goldfish. I can't work, I need a man to look after me (or someone with a strong stomach and endless patience) and I am delicate and weak, in thrall to my hormones. It has been crushing.
In 2 weeks I start ICU in Peterborough, which promises 14 hour days, 1 in 2 call and relentless activity. I'm terrified, but the alternative is a leave of absence; conceding that the baby is stronger than me. That my female body makes me unfit to work. I might as well just put my head in the oven now.
I'll keep working. My patients will keep hearing me retch behind curtains. The nurses will keep petting my back while I heave and telling me to take time off. But I'll keep working.
Damn the Man.
So, I'm pregnant.
I always envisioned myself as a super-active, unflappable prego. Someone who could get up, drink a kale smoothie, exercise, then work brilliantly all day before coming home to nurture my partner and get a good night's sleep.
Instead, I've been Linda Blair. I have literally, LITERALLY, vomited every day of 2014. I have good days, where I throw up for a few minutes, then settle. I have bad days, where I am crippled by nausea and have to lie still for up to 8 hours.
I've been going to work as much as I can. Luckily, my work is incredibly supportive, but there are only so many times you can run away from a patient holding your mouth and mumbling, "Sorry!"
All my ideas about life, womanhood and feminism have been derailed by a creature the size of a goldfish. I can't work, I need a man to look after me (or someone with a strong stomach and endless patience) and I am delicate and weak, in thrall to my hormones. It has been crushing.
In 2 weeks I start ICU in Peterborough, which promises 14 hour days, 1 in 2 call and relentless activity. I'm terrified, but the alternative is a leave of absence; conceding that the baby is stronger than me. That my female body makes me unfit to work. I might as well just put my head in the oven now.
I'll keep working. My patients will keep hearing me retch behind curtains. The nurses will keep petting my back while I heave and telling me to take time off. But I'll keep working.
Damn the Man.
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