anna in med school

John took the video above last week.  The weight is light and my form could be better, but it feels good to be able to get the weight up at all (partial credit, of course, goes to my 25-lb rugrat who insists on being “up-ah!”).  I know I’ve lost a lot of strength in the last several months, mostly just due to lack of time (since clinics started in January, I’ve only made it to the box 1-2 days/week, weekends only).  I hear about pregnant women with hormone surges PR-ing deadlifts and bench presses.  Not me.  But at 38 weeks pregnant, I’m pretty thrilled with my merely trace pedal edema and negligible back strain.

Sunday’s WOD was particularly heart-warming (can I describe a workout as “heart-warming” or just “heart-burning”?).  A mixture of running/rowing and back squats, it took me over twice the time as it took most of my fellow crossfitters to finish.  Everyone stayed.  Everyone counted down my last set of back squats.  Everyone cheered when I finished.  And then, by the time I returned from the water fountain, somehow all my equipment was mysteriously cleaned and put away.  I freaking love this community!

It must also be said that nearly all of my local mom friends I made through crossfit.  When Ari was three months old, it was dreary January, most of my friends were studying for boards in the city, and I felt a bit isolated by myself with an infant in the suburbs.  Since I could only go out for a real run when John’s schedule permitted and I wasn’t peal-myself-off-the-couch exhausted, I was also feeling soft and doughy around the edges.

Enter our local box.  John comes home one day and says, “So there’s the gym that recently opened.  It’s different.  There are special work-outs for each day, and you all do them together.  There’s weight-lifting involved, and you’re kind of in competition with yourself.  Basically, I think you’d hate it.  But there’s free babysitting.”  Sold.

Despite my initial skepticism (it’s a cult, it’s a goddam cult!) and, frankly, fear (the first part of my first WOD was max number of burpees in seven minutes–kill me now), crossfit has had innumerable benefits for our family.  It’s been an engaging activity that John and I can do together (and that we can’t shut up about–sorry friends and family).  It helped me shave off the baby weight due to both the kind of work out it provided as well as the option to work out without having to organize alternative childcare.  It taught us both new skills–putting aside the weight-lifting component, I can climb a rope!!  (I could never do that before!)

But by far the greatest component has been the friendships cultivated <insert sappy “Wonder Years” or other similar theme music here>.  Since babysitting is offered at 2 WODs daily, there are regular strong mamas who show up for those particular WODs.  Nothing initiates a friendship like the great demonstrator of trust and respect that is spotting.  These women (mothers or not) have become those I turn for help and guidance, regarding my body, my profession, my family, child-rearing, health, you name it.  They have also come through for me/us in ways I would have never expected from relatively young friendships: from watching Ari at a moment’s notice when childcare fell through, to picking us up from the airport at the end of a long weekend and even bringing us dinner since they (rightfully) assumed we would have nothing in the house, to answering my every paranoid question about pregnancy and it’s many dramas this go-round.  I am indebted to these women (and to crossfit by proxy); they have brought so much happiness and support into our lives.

Oh wow!  Hello again!

Today officially begins my maternity leave.  I’m due in just a little over two weeks.  Last pregnancy at this time, I was chugging raspberry leaf tea and trusting the power of evening primrose oil to get things rolling, convinced that I would need to be induced at 41+ weeks.  This time, I’m kind of hoping she stays put for another two weeks.  Not that I cannot wait to meet her, but I am under no delusion that I will be successful in getting anything done in the months following her birth.

As a feeble excuse for my absence recently (my husband’s even been giving me grief), I’ve just been tired.  I can’t complain about pregnancy, because it’s been lovely, but I’ve reached the point where I just don’t do more than bare minimum.  I show up for my shifts, try to go full throttle while there, take the train home, spend some time with the family while inevitably shoving some semblance of food into my mouth, put Aurelia to bed, and crash not long after, often waking around 2:15am for second dinner/first breakfast.  I think I’ve been a somewhat decent mother and med student (though my daughter so obviously prefers daddy, it’s no longer comical but disheartening), but a pretty poor wife, daughter, sister, friend, and blogger.  Hoping to reconnect a bit in the next couple weeks.

And then of course soaking in as many snuggles with this sweet one (thank you, Ellen!!!):

Poor thing is not going to know what hit her when the sister arrives.  I sort of think she always has an inkling.

She’s not the most verbal 18-month-old, but she’s started to imitate the way we coyly coo, “I LOVE YOU!”  It comes out as vowels, “AH!  OH!  OOOO!”  But it’s pretty damn cute, and I’ll take it with her kisses that are more like nibbles.

There was about 30 minutes left in my ED shift and I was tidying up some patient notes, prepping some kiddos for discharge, when I saw a new patient pop up on our screen.  The triage note read: “11 month-old female, sudden refusal to use left arm, no other complaints.”  I became embarrassingly giddy.  I turned to my attending and asked if I could squeeze in a new patient.  She smiled and replied, “Did you see who just arrived in room 8?”  By this point I was blushing as I enthusiastically nodded.

A nursemaid’s elbow is a partial dislocation of one of the forearm bones (the radius) from the other bone of the forearm (the ulna) where they meet at the elbow.  It sounds a lot worse than it is.  Basically, when kids are young (generally under three years), their ligaments are looser and their bones aren’t fully developed.  The nursemaid’s elbow is called such because it happens often in small children who are pulled up by their hands or forearms by their caregivers.

Most physicians in the ED really love this diagnosis.  You have a parent come in with an otherwise healthy child in minimal to no pain.  The parent is often beside him/herself, feeling horribly guilty because he was just trying to get the kid from point A to B, and now the kid suddenly can’t move his arm anymore.  The doc gets to come into the room, reassure the parent, pop the bone back into place with a very fast and simple maneuver (SO much less traumatic than popping a shoulder back into place), present the patient with a lollipop, and watch the kid and parent delight as the the child miraculously uses the arm like nothing happened.  It’s pretty gratifying.

Of course I ended up failing my first attempt at the reduction (I was too ginger with the sweet child) and the attending just performed it quickly to avoid the patient (parent?) getting worked up.  I’m optimistic for my next opportunity.

I also failed my recent attempt at a spinal tap in a febrile neonate.  The kid, however, slept through the whole thing, so maybe a partial success?

Let’s end with some true successes:

Last month I placed an umbilical line in a 26-week gestational age newborn without complication.

And I don’t mean to toot my own horn, but I think I’m developing a skill for performing decent quality EKGs on newborns while keeping them asleep.  (10 is a lot of electrodes to fit onto such a small surface area!)  It’s one of the rare occasions where my performance elicits a “strong work” from my resident/fellow.

On the topic of early childhood injuries, it is a miracle that, by the way my child launches herself down a slide head first, we haven’t ended up with more injuries, other than the face plant and the broken wrist before her first birthday.  Thanks so much, Ellen, for capturing this great moment!

John and I have a not-so-funny running joke: every time we want something any time near the vicinity of our birthday, we’ll spout off, “But, honey, it’s my birth<insert interval of time (week, month, etc.)>”  I think it started when John made the observation that men only get a birth-day, whereas with women it becomes a birth-month or some equivalently decadent ritual.

Fittingly, the expression always sort of turns true with us.  It seems like we’re often ships in the night…to get an entire day spared for celebration with one another, it just doesn’t happen.  Not meant as a complaint.  Life is very good.  But it just gives us an excuse to spread out the birthday without guilt: a dinner out here; a gift of a full-night of sleep there…you get the point.

Today my love is one year older with more jubilance and energy than I ever thought possible.  He’s asleep in preparation for his night shift; I just woke up for my late shift in the pediatric emergency department (my current rotation–it’s awesome!  I got to drain an abscess yesterday!  Very satisfying.).  Unfortunately, I won’t see him today.  So I’m wishing that our daughter pulls out all the stops for him this afternoon.  I think a yogurt run and a playground excursion might be in order:

More tame, but of comparable joy to that experienced during last year’s birthday.

This weekend I had the privilege of presenting a poster at the Women’s Health Conference  (hosted by the Journal of Women’s Health) in D.C.  It’s pretty energizing to be surrounded by thousands of academics, listening to passionate talks by experts in their respective fields, and getting to share your own research to the mix.  As I struggled to throw the poster together last week, I became simply in awe of all my classmates, so dedicated to research and discovery, for whom this is all old hat!

The weekend was made invariably happier because John and Ari were available to join me, and we squeezed in the good times.  Initially, we had hoped to take a little babymoon, kind of sneak away for a night in a hotel or something; we didn’t get our act together, and changing work schedules make planning challenging.  After bedtime hours, I broke out for a few hours with some in-town yayas.  (You’ll never imagine the look of shock and judgment I got from the waiter when I ordered a drink [that I didn’t even finish, btw] at 8+ months pregnant.)

And John and I did get a date.  Tapas and froyo in Clarendon, followed by a walk (well, woddle really) around the Jefferson Memorial amid the cherry blossoms.  It was our last trip before number two!

Really excited to share these pictures.  I had always wanted to be part of Spoof…imagine a med student version of Saturday Night Live meets Jimmy Kimmel in a piano bar operated by some marriage of Disney and Bollywood.  But my participation was always hindered by something: broken shoulder; clerkships and pregnancy; infant child; some combo of the above.  I know, I know…excuses <sigh>.

Anyway, I was ecstatic when a fellow classmate asked me to take the above pictures to be part of the “Weekend HUPdate.”  Unfortunately, since I had to dodge out after the first two hours of the 3.5-hour production, not sure if these made the final cut, but wanted to wait until after the show to share.  While I wish our life resembles the above, most often it’s some variation of this…

…which is exactly what I feared when I took my daughter to the matinee of the Spoof production after a…let’s just say dramatic morning and early afternoon.  I had already dragged her into the city literally kicking and screaming earlier that morning, let her get utterly soaked by the cold “spring” rain, broke her heart by not letting her walk the full mile back to the parked car, and pretty much ruined any sense of a real nap.

But with John in Alaska, this was our only opportunity to see the show as well as our girl friend Sally who also has kids and is soon moving across the country for residency.  I brought snacks, sat in the very back, and prepared for quick escapes.

Aurelia pulled it together in a way I didn’t expect.  I need to remind myself that she is so much her father’s daughter: extroverted; playful; distractible; loves music and laughter; feeds off others’ energy.  She could not get enough of all the new people, the costumes and, of course, the music!  At one point, we were sitting on the stairs of the auditorium and she was literally springing to her feet, jumping up and down and clapping to the beat of the Bollywood piece.

Thanks so much to everyone there for being kind and generous to her/us (like our friend Hayley who we miss terribly; she took for her a quick walk while I went to the bathroom by myself and watched a skit undistracted).  And thank you to Jen Olenik for these pictures that so beautifully capture her spirit: