Thursday, January 15, 2015

How medicine has changed me

I wanted to share a post I wrote in Dec 2013-the forum wanted to know how medicine and medical training changed the mothers in medicine group, for better or worse. Here's it is: Mothers in Medicine Blog link

How Medicine Has Changed Me
Since the age of 22 I have been entrenched in medicine-went right from college to medical school and residency. The formative years of my 20s have been busy dissecting bodies, studying dense medical textbooks, giving case presentations, rounding, taking call, eating bad cafeteria food, searching Up To Date, and learning how to adapt to different classes/teams/attendings/colleagues every month. I also took A LOT of tests. Looking back now 4 years post-residency, I am simply not sure how I did it! 

Medicine has changed me in ways that could be viewed as “good” and “bad.” Medicine has given me more empathy; it has showed me the importance of compassion and hope; it has made me a better listener; it has given me confidence and the strength to be vocal; it has given me a career to be proud of. Medicine has also given me my husband! (We met, married, and couples matched in medical school.) It has shown me the value of wonderful friends and family, which many people do not have. It is a privilege to help people in their times of need and share intimate details of their lives. I trained in emergency medicine and have a valuable breadth of medical knowledge from excellent training. The knowledge helps me daily both on the job and off. 

On the flip side, medicine has changed me in some negative ways. I am more judgmental-there is a need for quick (instantaneous) decisions when talking to a patient in the ER. I am cynical-while practicing medicine is considered a privilege, it is also a burden, and we usually see people at their worst. I take frustration out on my family because I know they will always be there (I hope). Medicine has been consuming and I have missed out on a lot of experiences….like family birthdays, funerals, weddings, parties, leisure, travel, holidays, and such. These missed experiences have caused me to be resentful and bitter at times. 

I am not sure about you, but I feel like one of the most important things medicine has done is make me a better mom! I have 2 young kids and am grateful everyday for my medical knowledge. I know how to observe, study and treat my kids. I also know where to look for the answers I need for them. This medical knowledge helped immeasurably with my son’s near-death from kidney failure when he was 2 weeks old and all the subsequent care he has needed. Some mommy physicians complain that they “just know too much”....but I would never trade in that knowledge for ignorance.

No field or career can only have positive impacts on a person, and overall, I am proud and grateful to be a physician. Being a ‘mommy’ physician is an even bigger badge of honor in my mind. There have been a lot of challenges/walls/ceilings to break through….and a huge inner struggle to conquer the mommy guilt and “just keep swimming….” (Thanks, Dory.) Time out of training has brought more clarity with this issue and the compromises needed to make work and life, work. I wish all of you luck with making medicine work, as well.

The End

Thursday, January 8, 2015

The MAGICAL formula for SLEEP is...

For those of you who read one of my last posts about sleepless nights, I mentioned that I found the magical solution to my 3 year old's sleep problems. It has been magical indeed.

He has been sleeping through the night AND falling asleep on his own for about 6 weeks now. He has never done this before! You might be wondering, WHAT have you been doing these past 3 years??? Most people get their babies to sleep between 6-12 months old, it seems. I have tried:

  • The obvious stuff, with consistent routine, cry-it-out straight up and cry-it-out from a distance, sleeping near, with, on, over, and around him
  • Black out shades
  • External window shades for cooling
  • Bedtime music cd (clinically proven to induce sleep)
  • Cooling or heating fan, humidifier if ill, white noise air purifier nightly
  • Various visual sleep clocks
  • Various sized beds-crib, twin, and now, full size bed
  • Soft, cool sheets
  • Room is sensory sensitive, no toys, only stuffed animals and books, minimal plain d├ęcor without stimulating patterns
  • Light lavender scent on pillow
  • PJs without tags, soft
Gets more serious and pricey here:
  • Several types/sizes of weighted blankets
  • Occupational therapy techniques of joint compressions and brushing
  • Chiropractic treatment
  • In-home sleep consultant x2-Sleep Sense program (interesting stuff, check it out if you are having problems)
  • Surgery = ear tubes
  • Developmental pediatrician evaluation
  • Medications: tylenol, melatonin, reflux medication, benadryl, homeopathic options and finally a prescription sleep aid

We were about to sign up for another surgery (tonsil removal for possible sleep apnea), but then we tried a method a sleep medicine physician suggested. How he knew this would work-I will never know.

He gave me a prescription to go away for a week and let someone else take care of Ben's bedtime routine and evening wake-ups. 

I thought I was dreaming (since sleep-walking and daydreaming were a normal thing) when he said I HAD to be out of the picture. That would be amazing, right? Somehow he knew that Ben needed to separate from me and rely on his own self-soothing to get to sleep.

He gave me a list of rules that included I disappear when the bedtime routine begins. Some other loving caregiver must get him ready for bed, have a meticulous routine, and put him to bed at night while he is still awake. That person had to leave the room so he could learn to fall asleep on his own. If he got up, that person was to be a "robot" and say "back to bed, night night, I love you, " and walk him back to his room.

Now I swore I had tried this before, sometime during the previous 2,000+ nights before. But I was MOM. And he was relentless and knew how to wear me down, so it just didn't work.

But we paid our babysitter to help for a few nights with this new routine and wouldn't you actually worked! And it has worked ever since.

I can now put him to bed without a fuss. But sometimes he tries to trick me and he pats the bed near him as if to say, "sleep here tonight?" I kiss his cheek, tell him I can't, and he looks away in the distance like he's thinking, "I know, but I just had to try this once." It really has been life-changing for me. As you saw in that prior post, lack of sleep was really affecting me on many levels.

Sleep is SO important-for kids and adults alike. Many illnesses have been linked to improper amount of sleep, like obesity and heart disease. It is important to build good sleep habits as children and I HOPE/PRAY that our streak continues. I think this specific routine worked specifically at my son's age for a few reasons-he was emotionally ready, physically ready (not having so much thirst at night), and mentally ready (knew that mom would still be there in the morning).

Preserving my family's sleep time will always be a #1 priority in my house. To keep us all at our best, ready to learn, and ready to tackle daily stress. My kids will know that being really tired or 'staying up all night' is not a badge of honor! Their bedtimes will be changed accordingly if I hear this...

Sunday, January 4, 2015

2015 Mantra

What does it mean when people wish you an “awesome,” “amazing,” or “magical” New Year?

Does it mean that we hope the New Year will be without turmoil? That it will somehow be suddenly different than all our other years? That it will be free from trauma and drama? (BTW, I call my 3 year-old son ‘trauma’ and my 6-year old daughter ‘drama’, for obvious age-related reasons.)

Having now experienced 35 new years, my wishes and resolutions are different than they used to be. Perhaps with youth, we wish for the magic of a new year’s clean slate. But as we get older, we are settling into our slate’s etchings. Our past experiences make us who we are and a ‘clean slate’ is an idealistic notion. As we look back, we have so much to gain from a slate that is full of experience, perspective, wisdom, and resiliency. I don’t hope for a turmoil-free year. Turmoil is a part of life. What makes us special is how we emerge out of it. 

I keep reading about how "resolutions" don't usually hold up-we lose sight of them within weeks or months into the new year. This is probably because they are too big or too drastic or too unreasonable. Like at the gym, for example, I can never find a parking spot in January but things are back to normal by February. Instead of making big declarations of unrealistic changes we will make, maybe we should create a mantra to live by-something(s) you really want to embody in the new year. An embodiment of meaningful thoughts or actions that you can do while just sitting on the couch.  

My new year's mantra is this:
I want to live more in the present and not dwell on the future or the past. (I have spent a lot of time anticipating the future and in turn, have probably missed out on a lot of joy "in the moment.")

I want to recognize joy when I see/feel it and revel in it a few seconds longer than before. (Indulgent, perhaps, but I want to hang on a little longer.)

I want to see my kids grow and enjoy not only their major milestones, but also all the little steps along the way. (Noticing the little steps usually doesn't come with any fanfare, but our kids lives are made up of hundreds of little steps, and relatively few Big ones.)  

I want to really be present for those little kisses, hugs, and smiles. (I know they won't be there forever.)

Perhaps these are idealistic as well, but they are notions that I want to be more aware of. I have posted them as a reminder to slow down and take notice. There are already "awesome," "amazing," and "magical" moments taking place every day, if we take the time to notice them.
I wish you a RESILIENT new year with many JOYFUL moments every day!

Drama taking a joyful pose and Trauma about to fall into the lake...

Tuesday, December 30, 2014

Chronicles of a Sleepless Mama

Here is a glimpse into my 3 years of sleep deprivation, due to a disorder known as “sleepless baby syndrome.” It's been a rough few years- my son has had a very hard time sleeping through the night due to constellation of reasons I won't get into right now. Perhaps they are "excuses" not reasons? In any case, here you go...

During the first 6 months:
What you think: This is totally normal, right? All the other mommies talk about their fatigue too so we must be on the right track. Just give it some time.

What you feel: A mixture of exhaustion, joy, and love. You love this bundle with your whole heart figure that sleep will come eventually.  Everyone keeps telling you it will work out and you believe them.

What you do: You kindly take in advice from others and try techniques to help baby sleep. You have hope that those swaddling and shushing methods actually work.

What you look like: A proud mama, with the sleepless badge of honor. Hair in a ponytail, rocking the yoga pants because you are tired with a baby, of course.

At 12 months:
What you think: Wow, nighttime is really hard. I didn’t think it was supposed to be this hard. Every other baby seems to be sleeping well at this point. Maybe I’m doing something wrong. Maybe I have the wrong color night-light or the sheets are too scratchy? 

What you feel: Tired, but probably within the normal limits for a mom of a 1-year old.  After all, you are caring for your family and it is hard work.

What you do: You start investigating baby sleep a little bit more and realize you need a temperature monitor in the baby’s room and maybe some room-darkening shades. You get a night-light with a red hue because that’s shown to help. You double-check your white noise machine since we know if it’s TOO loud, it can hurt baby’s sleep. You rub baby down in lavender oil because, why not? You play music that is clinically shown to induce sleep. You know a routine is important and have it posted on baby’s door for all to see. You know this HAS to work.

What you look like: Not quite put-together. A little behind the rest of the mommy crowd, most of whom can manage to shower and get dressed these days. 

At 18 months:
What you think: Maybe I just have a stubborn baby. I have tried everything. Everyone tells me I need a good nighttime routine and I want to punch them in the mouth. I KNOW, OK! It’s posted on the door!

What you feel: Exhausted. Resentful. You hate other moms not for their beauty, but because they are sleeping a LOT more than you. You regret your husband putting you in this position in the first place. You aren’t sure how he can keep going, but you are spiraling out of control.

What you do: You seek out doctors’ opinions and start looking into more extensive sleep programs. You pay people to help you at night. Even if you DO get a decent stretch of sleep time, it is impossible to sleep because of your anxiety about NOT sleeping. You are just waiting for baby to wake up.

What you look like: It’s starting to really show now, the bags under the eyes and a slight grayish tint to the skin.

At 2 years:
What you think: None of my friends have this problem. All the babies in the world are sleeping except mine. The universe hates me. I might as well get some work done instead of lay down because I will be up again in an hour or two anyway.

What you feel: You dread the nighttime. Most days, it is hard to put one foot in front of the other. Your shoulders are heavy. Your body hurts all the time.

What you do: You want to give up. Motor skills are altered, slower. You know you should get outside and wear the kids out so they sleep bett….oh wait, that doesn’t work. You want to exercise to feel better, but can’t muster the energy. You look to take any pain reliever or sleep aid because you have run out of inner coping skills. You consider counseling.

What you look like: Now you look pale and grey from the sleep deprivation and stress. You try to hide it, but usually don’t make it past the concealer. Nothing fits because you can’t exercise so you buy cheap, ill-fitted clothes for the time being.

At 3 years:
What you think: I really can’t take this anymore. Friends, family and doctors don’t even try to help anymore because this is hopeless. I have a cranky kid who doesn’t nap and keeps waking up all night. There is no way I am having any other children. This is ridiculous. I guess I have to hang in there until he’s 18 and then kick him out so I can recover, if I live that long. (Really, it gets this bad.)

What you feel: The word exhausted doesn’t even cover it. It’s really hard to smile with any bit of authenticity.

What you do:  You seek out new doctors. Consider getting your baby (now in preschool) a sleep study or having his tonsils out. Maybe that will help, right? You pay a lot to have other people watch your kid. You get counseling. You stay up all night on the Internet, oh, and soothe your kid back to sleep every other hour.

What you look like: In a word, ragged. In a list of synonyms: frazzled, fragmented, shoddy, broken, dilapidated, frayed and rough.

I will stop at the 3 year mark, and notice, how large the font is at 3 years. Because it is RIDICULOUS. I wonder if any of you can relate to my condition. If so, please comment and I will send you personal condolences. The only comfort I can give my fellow zombie moms is that I FINALLY found the magic formula for my son's sleep. OR, he was just finally ready for it. OR, it was just pure luck. I'm not really sure. But things are getting better right now and I am embarking on a healing journey to restore sanity to my brain, rest to my muscles, and love back into my heart. True sleep deprivation is an awful feeling and has all sorts of horrible medical consequences that maybe we will explore later. I will also share the advice I got from my child's sleep specialist in an upcoming post...IF it continues to work, that is!