Monday, April 25, 2016

Week in Review: Babymoon

I'm participating again this week in a weekly linkup over on Clean Eats, Fast Feets called Week in Review. It's basically a chance to share what's gone on in the week in list form. The author of that blog just had a baby, so head on over to check out the other blogs and congratulate her!

This week a number of exciting things happened, most particularly because we're on a Babymoon.

Week In Review

1. Got my DEA number! It's $731 to apply for a DEA number. Becoming a legit doctor is so expensive.
2. Worked my last clinical day of residency (2 months of self-directed rotations to go).
3. Wore UNM scrubs for maybe the last time? I mean I could wear them again, but I don't need to, and that's exciting.
4. Drove 6 hours to Scottsdale, Arizona for a resort vacation long weekend.
5. Ate at about 7 new restaurants while on vacation.
6. Relaxed by the pool and floated in the lazy river.
7. Wore a bikini while 30 weeks pregnant. 
8. Went to the Desert Botanical Garden.
9. Walked around IKEA for some thoughts about furniture for when we move in a few months.
10. Was totally surprised to find a Warby Parker store at the shopping complex across from the resort and got my sunglasses adjusted. They've been falling off my face for months and I was nervous about entrusting them to just anyone to get fixed, but now they're perfect. The woman working there asked how long ago I had bought them because she'd never seen the style I had before. It's been discontinued. It has been close to 4 years I guess. They hold up really well.
11. Drank a Shirley Temple for the first time in years.
12. Got a pregnancy massage (my second of the pregnancy, hoping to budget for one more before we're done).
13. Watched cable TV in a hotel room, which always makes me feel like I'm on vacation.
14. Started Little Earthquakes by Jennifer Weiner on my Kindle. It's pregnancy/new baby/relationship-focused and I'm about 25% into it and I'm really enjoying it.  

Here are some photos from the week:

Coconut smoothie by the pool

View from our hotel room

On the drive from New Mexico to Phoenix

Desert Roots Kitchen

Warby Parker Store

Desert Botanical Garden

Desert Botanical Garden

Desert Botanical Garden

Desert Botanical Garden

Desert Botanical Garden

Overall I had a very nice vacation and am looking forward to tackling some serious studying and other productive things in the coming week.

Thanks for reading, see you soon.

Pregnancy Update: 30 Weeks

I really try to get up at least one non-pregnancy post each week, but this week I was unsuccessful. Fortunately it's mostly my friends and family reading you don't mind back to back pregnancy posts right? It's going up a little late this week because I'm on vacation and have just really been enjoying that. We're on a babymoon of sorts, a long weekend at a resort in Scottsdale, Arizona.

Bump: This week's photo was taken at the Desert Botanical Garden in Phoenix and the dress is from this Stitch Fix

1. How far along are you? 

30 weeks

2. How big is baby? 

A zucchini or a summer cantaloupe. Estimated weight according to my app is 2.89 pounds. Someone asked me this week if I had a basketball under there.

3. Total weight gain/loss

As usual I'll have my next update on this at my next appointment - which won't be until 32 weeks. As of my 28 week appointment I had gained 12 pounds total.

4. Purchases

I bought some shorts and a shirt from H&M in preparation for the trip to Arizona this weekend. I also bought my first nursing-style bra (which I've been wearing every day because it's also impossibly comfortable) and a tank top. That brings my short sleeve top count to 3, and my tank top count to 2 not including workout wear. I'm so far along now I'm trying not to buy more than I need, but the weather's turning hot so I'm needing different items than I did a few months ago.

5. Sleep

I wake up to pee of course, usually 2-4 times a night, and my dreams are kind of weird but I'm overall sleeping pretty well. I'm no longer sick with a cold so my sleep really improved this week compared to the previous couple. 

6. Symptoms

I just feel super pregnant. I literally don't understand how I have 10 weeks worth of growth left. I feel like I'm stretched to the maximum already. Obviously baby and I both have a lot of growing still to do, I just find it hard to believe.

7. Rings on or off?

After finishing in NICU on Friday I put them back on. They're comfortable now, but I'm probably going to take them off at the first sign of difficulty getting them on and off, because I don't want them to get stuck. No telling when that will be though. 

8. Belly button in or out?

The top part flipped a tiny bit a while ago but it hasn't really changed again yet. Still in. 

9. Food cravings

We've been on our mini resort vacation to Arizona this weekend and I've been eating all kinds of foods both healthy and decadent. One of my favorites was this salad from True Food Kitchen with a coconut kale smoothie.

10. Fitness

Since I was feeling healthier this week I've been doing yoga and made it into the gym a couple times. I didn't go to my yoga class because we're out of town, but I'm planning to go this week.

11. Feelings and Mood

I was moody during the week last week, which I think was just related to how close I was to being done with work and wishing for the week to be over. Since then I've been very happy, but that's sort of circumstantial since I'm on vacation.

12. Pregnancy Perks and Snarks

My snarks this week are just things I miss. I really miss being able to lie on my stomach. It was one of my most comfortable positions pre-pregnancy and I'm really looking forward to it in a couple more months. I'm also at a resort with a sauna, steam room and jacuzzi and really look forward to being able to use those again. 

13. Best moment this week

I have 2: 

1. Leaving work on Friday - my very last full clinical day of residency. I'll still have lecture, continuity clinic and plenty of work to do with research and boards studying but I am done with hospital-based rotations and it's very exciting.

2. This one: poolside with my coconut smoothie

And that's it - thanks for reading my 30 week update, see you soon.

Sunday, April 17, 2016

Pregnancy Update: 29 Weeks

It still feels like there's a long time left, but I'm about 3/4 of the way there. We took a childbirth class through the hospital this weekend (which was not that useful except to reassure us that we know what we're supposed to know already) but it did make it seem very real. 

Bump: In this week's photo I'm wearing a Motherhood Maternity dress. My mom actually got this one for me as a present when I was only 12 weeks along (Christmas) and it's worked great at every stage. 

1. How far along are you? 

29 weeks

2. How big is baby? 

An acorn squash. Estimated weight according to my app is 2.5 pounds.

3. Total weight gain/loss

As usual I'll have my next update on this at my next appointment - which won't be until 32 weeks. As of my 28 week appointment last week I had gained 12 pounds total.

4. Purchases

I spent lots of money this week on completely non-pregnancy/baby related things. I submitted my DEA application which is $700+ and a few other necessary business-related things like that. We did a lot of research this week on some important baby products (carriers, car seat, stroller) but we haven't bought them yet.

5. Sleep

I was pretty much recovered from my cold by Friday (I got 2 colds lasting about a week each 4 days apart), so my sleep improved a ton as soon as I stopped coughing so much. It also helped that I moved back to my bed from the guest room. I just really have a lot of strange dreams, but I still wake up feeling rested.

6. Symptoms

I have strange dreams as I mentioned above. I've also started getting round ligament pain (a sharp pain in my sides) just occasionally when I walk. I'm itchier than before, which I'm just dealing with by moisturizing which helps. Also, my skin seems less dry but I'm thirstier than ever. I feel like I cannot drink enough water.

7. Rings on or off?

Still on (though again, not wearing them during the week because of the NICU.)

8. Belly button in or out?

It's starting to flip outward on the top, but still mostly in.

9. Food cravings

This week I was craving vegetables. For my favorite meal this week I made a seitan salad (recipe in Salad Samurai) and put it in a whole wheat pita. The dressing is a homemade cashew-based ranch and I put a lot of basil in it. 

10. Fitness

As I mentioned above, I've only been feeling healthy for a couple days. I'm doing a little more yoga and squats and of course Luna and I go on walks. I'm hoping to ramp up the intensity a little this week if can just (please please) stay healthy. 

11. Feelings and Mood

I cry easily but usually it passes quickly - sometimes it's just at a commercial or TV show or something stupid, and sometimes it'll be something happening that just seems to bring several days worth of worries all together. I don't think I'm moody or hard to be around in general though (at least I hope not - you'd have to ask John.) In general I'm just counting. the. days. down. I have 1 week left of regular residency rotation. I finish the year on research and reading months, so I'm just counting down until Friday. This Friday. I will still have my regular continuity clinic after that, but the rest of my time will be self-structured and I can't wait. Also we're going on our little Babymoon to Arizona once I finish this week, so I'm really looking forward to that. 

12. Pregnancy Perks and Snarks

Up until this week, this section has just been Pregnancy Perks, but I've run out of positive ideas for the moment so I thought I'd share some negatives. 

This week, I just want to share the most unflattering maternity outfit possible: unisex scrubs. I wear scrubs for the NICU because we go to operating room and delivery rooms for deliveries, and they are not that flattering to start with but I feel like it's even worse now. You would also think they would be comfortable at least, but the pants are not elastic and are not designed to accommodate a bump. I tie them underneath but it's a constant battle between too tight and tight enough that they don't fall down.

I only have a week left of the rotation though, and then I can be back in clothes I like.

13. Best moment this week

The best moment of my week wasn't really my moment but it was still the best. John has been studying for a while for the Professional Engineering exam and this week he finally got to get it over with. He was pretty excited about having it done and this weekend felt like a celebration.

And that's it - thanks for reading my 29 week update, see you soon.

Friday, April 15, 2016

Friday Faves 4/15/16

Happy Friday! 

It's tax day, not one of my favorites (we've owed the past couple years) but here are some favorites.

1. Things My Sisters Say: A couple weeks ago I got some precious pet photos from my sisters via the magic of the cell phone, so here's a little roundup of the family pets.

Dobby [Shannon]

Lucy [Emma]

Penny [Nicola]

Luna [me]

This is an older picture - Chaucer [Mom and Dad]

2. Music: This song is from 2011 but that doesn't mean I can't love it today. The Head and the Heart: Lost in My Mind


3. Snack or Meal: Sometimes you're just in the mood for a classic veggie burger. This one has lettuce, tomato, pickle, avocado and vegenaise on a whole wheat bun. 

Look how happy John looks...actually that might be the beer.

4. Lifestyle and Beauty: I'm so sad it took me all the way until pregnancy to try using this. Palmer's Skin Therapy Oil. This is how I've finally fixed the dry skin on my face. I didn't like the scent of the "face oil" - kind of rose/floral. The regular one is still great for the face though and hasn't caused any breakouts - it's just enough to moisturize my crazy dry New Mexico dwelling skin. It rubs in easily, smells like chocolate and is super inexpensive so I can slather it everywhere including my ever-expanding stomach.

5. Recipe: Chocolate Covered Katie Thin Mint Girl Scout Cookie Cheesecake. Mint, cheesecake, cookies? Another window into my pregnancy cravings.

[Photo property of Chocolate Covered Katie]

Happy weekend!

Thanks for reading, see you soon.

Wednesday, April 13, 2016

Embarrassing Residency and Med School Moments

Today I'm going to share a couple personal embarrassing residency and medical school moments, because we'd all like to think we don't make mistakes - but I know I do. Here are some times I wanted to sink through the floor. Details have of course been changed in order to protect patient privacy.

1. As a 3rd year medical student I was presenting a patient on the inpatient rotation who had recently had an Echocardiogram (ultrasound of the heart). The report included that the patient had "levocardia." Without thinking about it, in reporting the results I said, "The Echo was normal except that the patient has levocardia."

Levocardia means the heart is on the left. That's where it's supposed to be.

2. I was performing a lumbar puncture as an intern. This was not my first time - I was probably capable of performing the procedure by myself but it was early in the year and wasn't nearly as experienced as I would eventually become. My attending, who did not know me well and had not supervised me in this procedure before, chose to talk through each and every step of the procedure as I did it even though the parents had chosen to stay in the room. It definitely led to an an atmosphere that maybe I didn't know what I was doing. So what did I do? I proceeded to accidentally stab myself with a needle in the process of drawing up the lidocaine (fortunately a clean needle). I was bleeding a little, had to ask for a new bottle of lidocaine, new needle, new gloves etc. The parents pulled the attending out of the room and I'm sure basically said, "I don't want that shaky first-timer doing a lumbar puncture on my kid." It was an awesome moment. I still did the lumbar puncture, and it went fine, but goodness I'm on their side with that one. Did not exactly inspire confidence.

3. Often when a kid is hospitalized, multiple family members are involved in the care and sometimes one will relieve another at the bedside so they can take care of some things. This is great, and we love to see kids with lots of family support. Sometimes though, the switch happens ninja-smooth. More than once I've left a room just briefly and not paid close attention upon returning. The aunt often looks a lot like the Mom and I've definitely tried to pick up a conversation I was having earlier and taken way too long to realize I'm talking to someone else.

4. On my pediatric rotation in the 3rd year of medical school, I was a constant basket case. I mean, I did well on the rotation, but my stress levels were off the charts. I would overreact to not knowing answers to questions, and I cried frequently. It was only my second rotation and I just put a lot of pressure on myself because it was what I wanted to do.

My attending sent me into the room to examine a kid with an "interesting physical exam." She had clearly done this plenty of times before because the family was super chill about it. He had some interesting skin findings but otherwise seemed normal. I didn't know what he had, but after spending a while asking questions I couldn't justify staying in the room any longer and stepped out with a mounting sense of irrational panic. My attending asked me what I thought and I just stammered. I could have at least come up with a guess, but at that point I had a hard time making guesses I wasn't sure about and also with saying I didn't know (this did improve). Inexplicably, I felt myself starting to cry. That would be embarrassing enough, but then my nose started to bleed - a lot. Like staining the carpet of the clinic. In a way I was relieved because that was a distraction from the fact that I was crying. We got that all under control and I was informed the little boy had neurofibromatosis. That diagnosis now always sticks in my mind and I have no idea if the blood came out of the carpet.

5. Put Your Clothes On
Also on my 3rd year pediatric rotation, sign out was at 0600 and I was always on time, sometimes running into the residents on my way into the hospital. I once ran into a couple of the seniors on my way in, said hello, and proceeded to walk a little in front of them to the sign out room - which was a long way from the entrance (multiple hallways, multiple floors). When we finally arrived, one of them informed me that my skirt wasn't zipped. And it wasn't. I had done the hook at the top so I hadn't noticed a feeling that it was loose, but my entire lower back and the top of my buttocks were exposed the entire time I had been walking through the hospital. My shirt was long that day, but I honestly have no idea what they saw. At least she told me before I'd gone through more of my day like that.

I'm sure there are more, but these are the ones that still make me cringe when I think about them. I'll write another post if I think of another collection.

I hope you all get some joy from my moments of shame.

Thanks for reading, see you soon.

Monday, April 11, 2016

Happy Birthday Emma!

My sister Emma has a birthday today!

You're brilliant and sweet and very funny and I love you.

She lives far too far away and I'm constantly angling for her to move closer, especially now that I'm headed back to Oregon. You could meet me there!

Fall 2012 when I went to visit her at college.

I love you, happy birthday!

Thanks for reading, see you soon.

Sunday, April 10, 2016

Pregnancy Update: 28 Weeks

Third trimester!

I'm working in the NICU right now and it's kind of crazy to look around and see babies that are only as developed as my baby in the isolettes all around me. In a way it's a relief, because most of them born this far along do pretty well, but it's a long difficult NICU course and I find myself walking around holding my belly praying he stays in there until he's due. 

Bump: In this week's photo I'm wearing a Stitch Fix dress. (Last Stitch Fix review here.)

1. How far along are you? 

28 weeks

2. How big is baby? 

An eggplant or a coconut. It's been the same 1.5-2.5 pound range for several weeks on my apps. I'm sure he's getting bigger and as usual, now coconut sounds really good. 

3. Total weight gain/loss

I had my 28 week appointment last week and had gained 3 pounds in the past 4 weeks. That's a total gain of 12 pounds. Just for fun, here's some photos side by side comparing those 4 weeks:


 I talked last week about how I thought it would be a lot more gain than that because my belly feels huge (I mean, not end-of-pregnancy huge, but much bigger than 24 weeks.) I guess realistically though, maybe it is only 3 pounds. I've been sick lately and doing less exercise, so I don't really feel like I've been doing everything I wanted to in order to keep weight gain healthy, but my body seems to know what it's doing for the moment.

4. Purchases

Nothing this week! We haven't made any baby purchases yet but we are starting to get some hand-me-downs and gifts, so that's nice since we have nothing for a baby. Plenty more on all of that probably in a month or 2 as we start actually doing some baby shopping. 

These were passed on from my friend Betsy who just had a gorgeous girl - her baby was too big for them from the start [they're newborn size but kind of tiny] so we'll see if they fit our little one. Otherwise I'll pass them on to my next pregnant friend.

5. Sleep

I recovered from my last cold and was doing pretty well with sleep (for a whole 5 days!), and then caught another illness starting on Thursday, so I'm back in the guest bed as of last night. I'm hoping once I get over this one I'll be well for a while, especially since I won't really be interacting with lots of kids with colds anymore...until October? Is that right? I'm pretty sure that's right. 

6. Symptoms

Again, I have another cold. The cough/sore throat/congestion is overshadowing any classic pregnancy symptoms, but I still consider them pregnancy symptoms related to my lowered immune reserves. I don't usually catch things back to back like that. I'm not saying it's totally my baby's fault, but it's kind of my baby's fault. As usual as long as he's healthy I'll take whatever symptoms come along. I say that now but the infamous aches and pains of the later third trimester haven't started yet. 

7. Rings on or off?

The rings were off this week but they still fit. I don't wear them in the NICU as that's the policy to protect the babies from any germs they might carry. They're back on for the weekend though.

8. Belly button in or out?

Still in.

9. Food cravings

My doctor confirmed that my hematocrit was fine and my gestational diabetes screen was negative, so there's no new restrictions or changes to my diet. This week I've been craving popsicles and smoothies. Most mornings I've been making some blend of frozen banana, soy milk, protein powder and other fruit. Planning a dedicated smoothie post soon.

10. Fitness

I did a couple mornings of gentle yoga this week, but it was a low exercise week again, and I skipped my yoga class this weekend because I think I might be contagious, and I thought all the coughing would probably be disruptive. Earlier in the week I was barely recovered from my first cold, and the transition to my new rotation meant being at work an hour earlier, so I had a hard time making it a priority over my sleep in the morning. I still walked Luna every day, but that was it.

11. Feelings and Mood

Mostly I'm feeling pretty good. I'm trying to make the most of my time in the NICU and pick up procedures where I can, but there's a fair amount of down time in between deliveries and admits. (I'm on a resuscitation rotation, not regular NICU, so I don't have patients I'm rounding on or primarily responsible for day to day.) I've been getting a lot of studying done which always makes me feel a little more positive. I'd feel better without this cold but hopefully it clears fast.

12. Pregnancy Perks

Sometimes people give me chairs. I'm talking particularly about work. Frequently if there's more than one parent or family member and other kids in the exam room for a visit, someone is sitting on the physician stool - there are usually 2 patient chairs in the room, plus the exam table. Lots of people kind of realize the stool is a nice place for me to sit, and I think in pregnancy people seem to reshuffle to actually give me the stool more.

It's not a big deal for me to stand for the visit, but the stool is nice for a few reasons: 
1. I can examine a kid more easily on the parent's lap, and for the younger ones that's often nicer because then they're less scared about it.
2. Studies indicate greater patient satisfaction and a perception that I've spent longer on the visit if I sit down: read about it here. I always sit if I can, even if I don't really feel like I need to. 
3. The stool makes it easier to keep my body language open when I'm jotting things down on the chart, because I'm not leaning over the counter.

I don't mind all the family being seated - I like people to be comfortable and I know sometimes it's a long wait. I only feel like it's kind of silly when there are enough chairs and someone chooses to take up the other patient chair with a bag or something, forcing the other parent to sit on my chair and me to stand. There's an easy solution to that. Your bag does not need a chair. 

...maybe I am moody this week.

Anyway, chairs. They're nice.

13. Best moment this week

We started a registry! As I mentioned above we haven't made any baby purchases yet but I have a very sweet friend from church who offered to host a baby shower for me, so we've started to put a few things on a registry. If we get a few smaller things from the shower that will be nice, and we'll put our bigger items on there as well so we can use the completion discount afterward. We picked Amazon and Target. We did the Target one in-store and it was kind of fun walking around with the scanner gun - haven't had an occasion to do that since our wedding.

And that's 28 weeks - and the start of the third trimester.

Thanks for reading, see you soon.