Wednesday, March 23, 2016

Dealing With The Transition From Maternity To Reality

A good reason to take time off of work

This article on KevinMD was published a week or so before the end of my maternity leave. As I read it, steam emanated from my ears. How dare the author insinuate that physicians lose their technical skills from taking time off equivalent to more than a mere weekend? What about those who must take prolonged time off for sick leave? And what about maternity leave? Are all female physician mothers, by the sheer reasoning that they had babies, now deemed incompetent?

First off, we all need ideal vacations from time to time. Unused vacation time can lead to higher stress levels and lower productivity (see how Americans compare to other countries here). The more likely scenario after a nice chunk of time off is to come back refreshed, not stale and rusty. When we become sick (as we inevitably all do from time to time since we are human beings), we need adequate time to heal physically in order to perform mentally.

I have now taken significant periods of time off of work for vacation, maternity, and sick leave, and I've never had a problem integrating back into the basic flow of my job. In fact, on my first day back to work this month, I had a patient go into anaphylactic shock in the OR - a very rare and deadly event. He literally had no blood pressure for a moment, but once I identified it I knew exactly what to do. I counteracted the reaction and saved his life with the fortunate and timely assistance of a couple of colleagues who I immediately called into the room (getting help is essential in these situations).

Integrating back into my work environment and performing the required tasks seemed like almost no time had passed. Of course there were a few changes to personnel, policies, etc., but mostly things were the same. What feels different is the transition each day from mom to MD and back to mom again. The preparations before a workday seem endless, and morning routines take longer than they used to. I must pick up my daughter from childcare at the end of the day, increasing my commute time and anxiety depending on how late my time in the OR has gotten. The evenings go by so quickly, and I feel I have barely seen her before she has to go to sleep. This is what other moms warned me about: not enough at work, not enough at home.

At the same time, I am excited to be working on this balance of career and motherhood. I'm currently fortunate to have the choice of both and to be able to explore their interplay. What about you? How did you feel returning to a work endeavor or other practice after a longer period of time away? Share your thoughts here!

Friday, March 4, 2016

Lessons From My Daughter: Focus On People, Not Stuff

Happy and not impressed with stuff

As I begin to navigate this crazy journey that is parenting and mix it into my ever-changing practice of balance, I'm sure my daughter will be teaching me lots of things along the way. At 13 weeks old, she is now quite alert and adept at exercising her observational skills. She often watches us do things like our myriad preps and cooking projects in the kitchen from a little rocking chair or a floor mat a few feet away. Her gaze is strong, and I can see that she is making connections with what's happening around her. She smiles, laughs and makes plenty of eye contact. What she doesn't care about? Stuff. She could care less about toys, rattles that I shake in front of her, etc. She wants to know about us and reacts to our faces the most. Leaving her with a stuffed toy and walking out of eyesight does not bode well.

During this early stage of development, she's already figured out an important lesson in life. People have more to teach her than things. People have more to give. How to apply this to my life? As I do some spring cleaning this month (yes I'm on that bandwagon), I'm going to remember this and be ruthless in my decluttering. I'm going to make efforts to connect with good friends again now that I'm back from taking my maternity leave out of state. I will smile at strangers in the store, strive to make eye contact, talk to my neighbors more, and listen to my patients at work.

Have you learned anything new (or old) from your own children? How about your pet? Share your thoughts here!

Wednesday, February 3, 2016

You Don't Have To Be Retired To Enjoy Walking

A walk with baby in the desert sun

The first physical activity I resumed after my baby's birth was walking. Oh how I missed being able to walk without waddling in pain, which had become the norm during my last trimester due to massive fluid accumulation in my legs. The joy of walking pain-free again has been compounded by the absence of, for the first time since I knew I was pregnant, shortness of breath on any and all hills! We have been taking long walks every day (weather permitting) during my maternity leave. Other folks run by, logging the miles and most likely hurrying to get done with their workouts. Most of the time, they carry a look of suffering on their faces. But we are not on a schedule.

He is hoping we will hurry up

Walking at least 30 minutes most days has been linked to all sorts of health benefits, but I've also noticed other advantages to making this regular practice a priority in my life:

It's meditative. Are you one of those people (like I am!) who understands the benefits of meditation but has a hard time incorporating it into your daily activities? Try taking a quiet walk to have a meditative experience that also gives you other benefits. It's win-win. This applies more to solo walks, which can be a nice change from walking with a partner. The key is to clear your mind by dismissing thoughts that emerge (without judgement) and focus on noticing your surroundings, your breathing, or possibly a mantra. Check out this site for a beautiful guide to walking meditation written by Thich Nhat Hanh.

It connects you with your community. I love walking in my neighborhood and noticing the diversity of homes and front yard landscapes. It's a fun practice to walk a different route or take a different street each time so that you have the opportunity to notice new things each time. When we do these types of walks, we also make an effort to smile and wave at other walkers and neighbors. I also enjoy the exposure to nature when we walk on trails or in mountains and canyons.

It's a good foundation for an exercise program. Walking is a great first step in an exercise regimen for those who have not been previously exercising, who are overweight, etc., but it is also beneficial for more athletic people. It promotes recovery and natural movement patterns (especially when walking on uneven surfaces such as trails) with very little negative effect on other training performed during the week. Low intensity walking can help to promote fat burning when combined with other intense activities such as strength training in already trained individuals.

I started walking as much as I could tolerate the day after I came home from the hospital. While I admit that a big component of this was an impressive amount of diuresis, I had lost all of my pregnancy weight (50 lbs!) by 2-3 weeks postpartum with walking as my only form of exercise. However, the lasting effect is that I have managed to maintain that weight loss and even begin some good body recomposition postpartum with continued long walks and a minimal kettlebell lifting program. And walking is a way to move that doesn't add stress to my (already stressed and sleep deprived) system.

It facilitates brainstorming/creativity. When we walk together, my husband and I have the best and most productive conversations. We talk about home improvement projects, finances, trips we want to take, philosophies on parenting... I could go on. I always come up with great ideas, including subjects to write about on this blog, during our walking sessions.

What about you? Do you walk regularly? Share the benefits you've encountered here!

Thursday, January 21, 2016

Controlling the things I can control

My eye twitch is back. That nagging flutter of my left outer eyelid last reared its ugly, annoying head during the sleep-deprived days of third year anesthesia residency and ICU call nights. Before that, I remember its presence while frantically finishing laboratory experiments and writing my Master's thesis in chemical engineering. Fifteen years ago.

But the reason it's here again is so worth it!

I demand your attention!

Infant care is a new kind of stress, one that I have not experienced before. The sleep deprivation is different than residency because it's more of a low level every night as opposed to a punctuated period every X number of nights while on call. And there is no period of reprieve post-call where you can take a nap and be free from all caregiving duties. You are essentially "on call" for your baby. 24/7. Every day.

I was feeling particularly overwhelmed by the feeding/burping/changing process, which seems to occur on an all-day cycle that starts up again soon after it is finished. I had hoped to breastfeed her of course, to seamlessly provide food for her on demand, but my pituitary tumor surgery left me with a deficiency of prolactin (the major hormone responsible for milk production). I knew there was a possibility that I would not be able to produce any milk, and my fears did unfortunately come true after an initial and encouraging period of good colostrum. Mourning this lack of ability and coming to terms with needing to use formula made it initially hard with my "mom" blinders on to see the potential for optimization. I was drowning in the equipment and foresight needed to carry out this repeated task smoothly. My husband, in his logical wisdom, said, "Just engineer it." He came up with an assembly line system of bottles and pre-measured containers for her formula, so it can be prepped within seconds of her demanding cries.

All of the necessary items for her care are stored in easy to reach stations throughout the house. Certain tasks, such as diaper changing, are performed only in specific locations. When the volume of available formula dips to a certain level, I push the button on my phone to order more. Throughout this experience, I've learned more about myself because it has required a shift from my usual nature, which is more intuitive and less planned. I've always been more of a procrastinator... and a spontaneous shopper. I like to walk into my closet and pick my clothing for the day based on my mood. I choose to make dinner for the evening based on what I "feel like" eating. However, I've come to find that this M.O. results in more stress (usually in the form of a fussy, crying baby) when complex tasks need to be performed in a timely manner and another person is dependent on me to complete them!

So the way I've mitigated this unique kind of stress is to be as prepared as possible for the basics, control the things I can control, and do as much as possible to focus on the present moment. I can't control when she cries for food. And I can't control the fact that my body was not able to produce it on demand. But I can streamline the processes needed for her care, and I can change my attitude toward said processes. There will no doubt be many things in her life that I cannot control, so I'd better get used to identifying those that I can.