one week from today

our little firecrackers on the 4th of July!

Wow.  I have one more week of residency.  ONE MORE WEEK.  Seven more days in New York.  Five more work days.  Than we are gone...living in a different state...on the other side of the continent.  After we move out of our apartment, we will be going to visit with family in Rhode Island for a week...than we fly to Arizona! We are having one car shipped, and are selling the other...we hired movers to haul all of our stuff out west.  The idea of driving across the country with two little ones and a truck full of stuff sounded like a nightmare...and we are so happy to not have the stress of that on our shoulders right now!

In so many ways it feels like a blinked and three years zoomed by.  There is still so much to learn...so much to know.  But I am ready.  I'm ready to move on to the next adventure of ours.

Here is the scoop...we are relocating BACK to Arizona.  I will be taking over the practice of a retiring practitioner...so I am now an official small business owner!  My husband has a teaching gig all lined up!  And we will be living with family for a couple of months until we decide what area we want to settle in.  There is still a lot to figure out and a lot to organize.  But we are pumped for this next chapter in our lives!

I'm looking forward to our week in Rhode Island.  A little relaxation before the next whirlwind of activity.  I want to take the kiddos to the beach a couple times...eat lots of Iggys...drink lots of Del's...and play in grandma's pretty flower garden.  Sounds like a perfect summer vacay to me!

See you on the other side!!

I thought I had a heart attack

Picture this:  I'm in the middle of my eight hour long surgical boards.  All of a sudden I can't move my neck and I have extreme pain shooting down my left arm making my hand go numb and pain radiating into the left side of my face and jaw.  And picture me wanting to freak out...but not letting myself freak out until after my exam.

I was fairly convinced I was having symptoms resulting from a pinched nerve - but I called my sis (an internal medical resident) and told her I it was having some symptoms consistent with a heart attack. Of course, Tommy wanted me to go to the ER and get checked out.  I didn't want to make a mountain out of a mole hill. But she and Tommy convinced me to go get worked up...and it was probably nothing...but I should get checked out anyway.

So, I walk over to the ER and check in.  I'm alone because Tommy had to take care of our sleeping kiddos.  Well, I sortof lost of my bravery and shed a few tears during the initial check in process.  I felt like an IDIOT.  These are the nurses/PAs/doctors/aides that I work with all the time...so they were sweet to me.  They kept referring to me as Dr.  And I was fighting back tears the whole time.  I kept thinking about my two sleeping babies at home...and if something happened to me, or if something was really wrong with me...what would we do...yada yada...worst case scenarios kept creeping into my brain.  Not to mention my boards!?  Geez - such stress!

Long story short, I had an EKG...and it was beautiful.  No heart attack.  A CT wasn't warranted.  It was a muscle spasm in my neck that pinched a nerve causing pain to shoot down my arm and up into my face.  A soft collar neck brace and a slew of muscled relaxants, anti inflammatories, a steroid and a handful of pain meds later I am OK (I couldn't take any of the meds anyway...I'm still nursing Jack).  My numb fingers have resolved, but I still can't move my neck normally.  Ugh.

So that's my story of how my boards exam [almost] gave me a heart attack.

What an overwhelming day. 

life rocks

me and jack (I'm in scrubs in 90% of the pictures with my children...ha!)

So as soon as I was done with my surgical boards last Tuesday, I started studying for my medical boards that are slated for next Friday.  And next Friday night is the residency graduation ceremony.  Big day...in many ways.  It's hard to believe that residency is just about over (I actually have to stay a couple months past graduation because I had my babies and I have to make up the time I used to be home with them...but I will still "graduate" next Friday.)  Three years have never flow by so fast.  I feel like my first day was yesterday....when I was trembling in my Danskos...nervous if school prepared me for taking care of people...and then realizing the whole journey is part of that preparation.

This past Thursday we had our Podiatry graduation dinner, with our attendings and co-residents, and our SPOUSES.  It was so nice to spend one last evening all in one group together.  And it was so amazing to have Tommy by my side at that dinner.  Our spouses sacrifice so much for our success in this field.  I'm not sure that any of us realized what would be given up in order to pursue this career that we chose...and I'm not sure that all of us would have chosen it again - and I'm certain that most of our spouses would not have chosen it for us again.  Despite all of the challenges and frustrations of residency, tt's amazing how much we have grown and learned together.  Not to mention all of the LIFE that we experienced in our personal lives...there were engagements, marriages and babies...new cars...new jobs...new houses....more babies...and lots of dreams coming true. 

I'm waxing nostalgic right now, but what I need to do is to keep hitting the books hard until next Friday.  And then I'm not going to crack a book for a while (I promised my husband.)

Speaking of my husband...tomorrow is our three year anniversary!  Three years.  Three years and two kids!  We've been busy.  He is my stud muffin and I adore him more deeply than ever (which I didn't think was possible...but it is.)  I type this through misty eyes when I say that my husbands love and unfaltering support keeps me standing tall.  He is the epitome of wonderful.   While I study in the evening, he is SuperDad...and my kids are the luckiest.  Jack and Clara continue to be the sunshine in our home.  And the moonglow.  And the stars that twinkle.  

Disappearing act

Dearest bloggy friends -

I am currently locked away in the basement of our hospital library...studying and praying for my upcoming surgical and medical boards. I'm actually sitting for three separate boards in the next 30ish days...which means I am a big fat ball of nerves.

I will be back blogging once these crazy boards are over and calmness washes over my life again.

By the way - my babies are doing beautifully...and my husband (and mother law!) are deserving of some special award for awesomeness!

See you soon! (Wish me luck!!)
:-)
Jes

First day back at work

So. Little Jack turned 5 weeks old yesterday - and it was also my first day back at work.

I had planned for 6 weeks of maternity leave - yet due to circumstances beyond my control I got called to come back to work a week early. I was initially broken hearted to miss that last week with my newborn...than I got mad.

My first day back was rather uneventful. There were no tears this time - I think I was a little too scorned for tears. So i gave myself ONE day to be upset... one day to feel sorry for myself, to curse my professional choices. Residency is so weird - your life doesn't always feel like your own. Anyway, I refuse to feel sorry for myself today. Life and responsibilities go on. I can do this.

residency, baby building and sanity

35 weeks - in front of our little guys crib :-)

Besides being the size of a house these days...and wobbling down the hallways with the intense back pain of sciatica while wearing my white coat...work is crazy as a pregnant resident.  It's a crazy experience for anyone...but I happen to be partial to the thought that being 9 months with child vamps up the drama a bit more.  I am just sooo uncomfortable...and slow...and blah!  Thankfully, I am not in the operating room for this rotation...I would have been miserable. 

I am having to take my ACLS (Advanced Cardiovascular Life Support)  re-certification this week.  FML.  I hate those courses. (They are stressful....granted...they prepare us for THE most stressful of hospital situations...and it's imperative that I know and harness this material...it's just hard and scary and well, stressful.)

I also have been having a hell of a time finding a contract lawyer to help me navigate the multpile employment contracts that are in limbo right now.  And I HAVE to get on this.  The sooner this step is accomplished the sooner I will be able to apply to the insurance companies to cover their clients when I am out in the real world.  And to remind you, I enter the "real world" 6 months.  Dear me....

I also have a couple articles, a major research project,  and a couple mini power point presentations that I am working on....not for "fun" mind you...but as requirements for residency participation and my graduation is contingent upon.

Oh - and I should be studying for my boards...everyday I should be studying a couple of hours for my boards.

Did I mention Clara has a cold?  Oh...and our baby boy is coming in 3 weeks?  I spent the weekend washing baby blankets/baby boy clothes/nursing tanks/nursing bras in baby detergent (Dreft), purchasing newborn sized diapers (so small!), going crazy over what type of baby bottles to get, and helping Tommy assemble the crib, the new stroller, and some of the baby gear (eh..I pretty much watched and cuddled Clara while he assembled all of those things to be honest.)

I can do this.  I can do this.  I can do this.

Right?

being a pregnant surgeon

Here is a picture from my LAST pregnancy...at 30 weeks!  I'm 31 weeks now...I should really have a picture of me taken this time around in the OR too!

Anyhow.  Being a pregnant surgeon has been trickier this time - especially since when I was pregnant with Clara I was an intern, and rarely in surgery every day...now that I'm in my last year of training I am in the operating room almost every day.

For the most part people are pretty understanding of my situation.  Now that my belly is really prominent I don't quite fit at the surgical table so well, and I have to stand sideways to access the patient...that can really kill my back.  Also wearing heavy 20+ pound lead (my lead is crazy heavy and wraps all the way around my body to protect my insides from all sides) presses against my stomach and is insanely uncomfortable.

But do you think I make comments about that stuff at work?  Oh hell no.  I work with a bunch of guys...and I'm positive they don't want to hear about my pregnancy pains.  Plus, there isn't anything anyone can do about it...and I don't want to seem ungrateful for the blessing of growing a baby.    And more importantly, I don't want to miss out on those cases!  So I do what I need to do to keep actively participating... obviously...I'm a surgeon and I enjoy being in the OR.

At one point early in my pregnancy someone told me that I was crazy to keep doing surgery because I was pregnant.  I was looking for one of the super heavy lead wraps and was told that there weren't any available.  I was shocked and asked, "well surely there is SOMETHING I can use...what do other pregnant surgeons use?"  The response I got was,  "well, that's why there aren't many women surgeons."  (which I thought sounded preposterous.)  Ultimately, the radiology department found me a heavy lead wrap...it gave it away that I was pregnant...weeks before I wanted to announce it...but the super duper lead wrap comes out and everyone knows.  No surprises here.

I have made this situation work for the past 31 weeks...successfully.  I've been so very cautious about the radiation exposure...just like the numerous nurses, scrub techs and anesthesia ladies do when they get pregnant.    That being said, I will be thankful to be in the OR again sans big baby belly!!

Disappearing act

Outside the hotel conference center.

bone saw workshop - inside the hotel conference center.

I have been somewhat of an invisible presence on this blog these past few weeks.  I haven't just been away from the blog, but I've been away from home to boot!  It has been non stop go go go - living out of suitcases - kissing my loves good bye and eating lots of restaurant food.

toured a pretty plantation in Georgia

watched my belly expand while I was working at the lab those two weeks! (this is 21 weeks!)

Spent a week in Florida on the gulf coast at a surgical conference - the the next weekend I moved to Atlanta for a couple weeks for a training fellowship opportunity - then four days after my return from that my childhood BFF flew to NY and the two of us spent the weekend adventuring in NYC! Now I am exhausted and ready to be a homebody for a while. Fortunately the fun came to us this weekend - as my aunt and uncle from Seattle came to visit for the weekend - and it was so delightful! (pictures from our glorious fall to follow...I promise!)

I love the City.  I just love it.

at Carnegie Deli.  (a little too intense for me...but it was a fun experience none the less!)

All this travel reminded me how fun it was to be free to do whatever. I did a lot of exploring and traveling and adventuring as a single gal...it was a blast! And god bless my husband for giving me the opportunity to do these wonderful things recently - what a champ!  No matter how much fun I have on these trips there is never anything so blissful as walking into the arms of my husband and daughter upon my arrival back home. It is the best part of my every work day too. That sigh of relief to know that we are all together... Blessed.

on our road trip...just outside of Ashville...so beautiful.

*On a side note - I made a pumpkin pie milkshake tonight. I wanted to bathe in it is was so good! Tommy thought it was disgusting - hahaha - pumpkin can do no wrong in my book this time of year!

i accepted a job offer...

the last time I was in AZ I snapped this on my cell...pretty isn't it?

I may have alluded to this in a previous post somewhere along the way...but I GOT A JOB!!!!  Wahoo!!

We've decided to move back to Arizona!

It feels so good to have a direction and a plan right now.  It feels as though a huge weight has been lifted off of our tired shoulders...we can breath...and begin to dream and scheme about this new adventure of ours.

Bring on the burritos and sunshine and cacti and road runners and magnificent sunsets! (and grandparents!)

We are feeling so so so so so blessed....AND JAZZED!

(Contracts have yet to be signed...and I had to hire a contract lawyer to help me navigate the tricky field of complex medical-legal terminology and such....which was ca-razy expensive....but I find that expertise is a necessity in such things.)

disability insurrance

I just signed up for disability insurance...soooo expensive..no...no...SOOOOOOOO EXPENSIVE.  And I even qualified for the top health rating (meaning mine was the cheapest available price!)!  It's basically a car payment.  Coverage for women is nearly double what a man's coverage costs...apparently more women experience some form of disability in their life.  (And, podiatrist who perform surgery apparently suffer disabilities more than many other surgical specialties...who knows why.) It's pretty basic coverage ...with the opportunity to purchase more coverage as my salary increases from resident to doctor over the next couple years.  And it will last until I am 65...which is pretty impressive...since 65 seems light years away.  Except, I remember when 30 seemed like light years away...and I'm currently 6 months into it! 

I also signed up for life insurance...that was a fair and reasonable price.  Tommy is in the process of finding great coverage for himself.  I want to make sure we are well protected...but not OVER protected (fine line.)

Being a grown up is full of these scary conversations and expensive necessary evils that you pray you never need to cash in on.  I swear I have been brought to tears more than once over the past couple weeks thinking about these issues.  You see, I have these recurrent thoughts that something really bad is going to happen to me.  I'm not sure if this is because I work in a hospital and I see nice normal people who have been in horrific accidents, or been diagnosed with debilitating disorders.

 It's hard not to put myself in their position...what would we do if I was in a hospital for months and months and unable to work?  Or was diagnosed with cancer?  Those things happen to real people...everyday.  The thought makes me sick to my stomach.  (I recently saw that lovely movie "We Bought a Zoo" and literally cried...no no...sobbed through the entire thing because I kept thinking how horrible it would be to have my little Clara grow up without me.)  What the hell is wrong with me!?   Ugh.  I digress...

Do you have life insurance?  Disability coverage? 

lil vacay

I need a little summer vacation from my blog.  Well....it's not what you think....I won't be lounging pool side, sipping drinks with mini umbrellas in them or anything.  No no nothing like that.  I'll be cramming like a mad woman for my boards exam and state license exam.

Oh goodness gracious.

See you in a couple weeks!!

if you could live anywhere?

My third, and final year, of residency is approaching fast.  My chief residents are about to graduate...and jobs/contracts/locations/licenses/taxes/scope of practice are the topics of discussion  around every lunch table and break room lounge.

The biggest topic....where to live.  If you could live somewhere, anywhere, where would it be?  We talk in circles about moving for good jobs, or good locations, or to be near family?  We all have our own dream destinations and dream job ideals.  I wonder where we will all end up. 

Things I "dream" about...(but in no way expect or demand these things of our next "home")
-  waking up with a glorious mountain view out my windows...(but I would go for being surrounded/nearby/quick drive away from beautiful nature... ie: mountains, trees, flowers, splendor)
-  family friendly stuff to do (parks, children's programs/activities, sporting events etc.)
-  cultural activities to keep our minds engaged in our world (museums, live theater, festivals etc.) 
-  flexible job...obviously (this component has a huge dream list all on its own)

-  employment opportunities for BOTH of us - this is a given...we will move where we can both pursue our professional dreams (Tommy is a teacher...a tricky field for jobs these days.)
-  close to family and/or friends (doesn't have to be down the road...but at least within a couple hours!)

Where would you live?  

residency is rockin' my world in all the right ways

this picture was taken by one of my medical students - all of the fun stuff had to get cropped out.

 
So.  It turns out that I'm obsessed with the rotation I am on.  It is AMAZING.  We are doing surgeries that change lives... save lives... and give people their lives back.  I'm working at a special clinic for limb deformities where people come to from all around the world for treatment and care.  The vast majority of these patients are children, and they are an inspiration.

I jump out of bed everyday to get to work because everyday is full of crazy cases that leave me in awe of these doctors I'm working with.  THESE SURGEONS ARE PHENOMENAL*.  They are lengthening limbs and reconstructing limbs on people with deformities....and casting babies with clubfoot deformities, saving the limbs of trauma victims and are salvaging limbs of diabetics with Charcot deformities.  Miracles.  Everyday I witness these miracles.  In the OR and in the clinic.  Boggles my mind.  Makes me want to learn more, know more, study harder.   I have been selected to assist with a Van Ness procedure during my time here...Google that...Van Ness rotationplasty (in a nutshell, the foot is rotated 180 degrees and becomes a functioning knee joint!) I am beyond thrilled to take part in such a rare and brilliant procedure.  I get goosebumps thinking about it!

It's been a rough transition away from my family, but this experiences is not only making me a better doctor, and a better surgeon, I think it's really making me a better person. If I could move my fam down here for the next year and half I would...this is an extraordinary place and I will surly miss it when I am gone.

*and just so you know, when these docs aren't here busting their humps in clinic and the OR, they are on mission trips all over the globe.  *sigh* thank God for talented doctors with big hearts.

vacation from mothering?

OK.  It's going on my 7th consecutive day of not seeing Clara...and there will be another 14 days to go BEFORE I can actually hold her in my arms once again.  I clearly feel sorry for myself in this situation so I've tried to pamper myself a little bit in her absence...doing things I only did when I was a single lady a couple years ago.

This weekend, for example, I went to the gym...for as long as I wanted.  Slept in reallllllly late.  Went to the mall for a long ass time and tried on loads of clothes...and bought some.  Walked lazily through the aisles at the grocery store.  Showered multiple times in one day and just stood under the hot water for a ridiculously long period of time.  Spent 45 minutes looking at birthday cards at the store.  Talked to my parents for over an hour.  Called my sisters...my grandparents.  Sent lots of emails.  Updated my Facebook page.  Cleaned my apartment spotless.  Drank a Coke.  Watched The Fashion Police on TV. 

I tried to study...a million times...but couldn't.  I tried to work on a couple projects...but couldn't.  I kept looking at Clara's picture on my phone...and allllll the pictures of her on my external hard drive.   So ...I bought her some birthday gifts online and spent two hours selecting four new books to add to her library (including a couple of those indestructible books that feel like paper but can't be torn or ruined - very excited about those).  I bought her first baby doll.  Looked at her pictures some more.  Called and talked to my husband so I could hear her playing in the background.  Harassed him to send me more pictures of her on the phone.  Checked out Zulily, The Mini Social, Gilt and Totsy multiple times...just to see if there was something I would like her to have.   

And cried.  Lots and lots.  Not wailing or bawling or anything.  Just a steady stream of water leaking from my eyeballs.  I miss her so.   Babies are only babies for a year.  And I'm missing two entire months.  Ugh. 

My work week is jam packed full of responsibilities and surgery and clinic and on and on and on.  There isn't time to drink coffee (can you believe that?) or eat lunch (most days...unless your bathroom break also consists of shoving a granola bar down your throat while you are peeing.)  And for some odd reason I LOVE IT.  Seriously.  As crazy as this rotation has been - it has been the BEST EXPERIENCE OF MY ENTIRE RESIDENCY TRAINING.  Seriously.  The stuff I'm seeing is phenomenal.  The surgeons I am working with are gods.  I feel so lucky to be a part of it all.  I'm becoming a better doctor. I know it. 

Except I wonder if it's worth it.  And I'm not sure it is.  I dunno. 

what it's like

this has been an unusual experience so far....being in Baltimore...at a new hospital with different rules, different systems, different protocols....and being away from my family.  I miss them so.  I'm not alone, however, there are a few guys here with wives and kids that they left behind in order to take part in this experience.  We are all exhausted with the amount of responsibility on our plates.  Yet, it's a good opportunity...so we stay positive.

I do know one thing...I am married to the most wonderful man I know.  He Facetime's me throughout the day so I can see Clara playing, or eating, or crawling around....so I don't feel so disconnected from her.  Isn't that sweet?  He is taking such beautiful care of her...and he's all by himself.  And he doesn't complain or make me feel bad about the situation.  He is so completely and utterly supportive of me...I feel so overwhelming love for him these days.  Even when I'm being pessimistic about the whole thing...he is there to turn my frown upside down!

Personally, I think Clara might be the luckiest little girl in all the land.  She and I share the same best friend.  Lucky ladies we are.

a new adventure begins

me and clara last night...she fell asleep  in my arms while I was reading to her...i miss her so much already.

Today is my first day in Baltimore...I'm terrified.  Most of my greatest adventures begin with my stomach in KNOTS and super sweaty palms....scared shitless.  Nobody really knows or senses my nerves....I fake it pretty well.  Slowly, the fear of the unknown becomes challenges that I can conquer one by one...and in the end, I'm pretty proud of myself for surviving (and sometimes thriving.)

Wish me luck friends...I am so nervous I could puke.

moving to maryland

it's possible I've shared this picture before...I LOVE THIS PICTURE!!  I will miss my lil Muffinhead so much!!

This weekend I relocate...to Maryland!  It will be a two month gig - and I will be training with world famous orthopedic and podiatric surgeons.  I've heard that the program is INTENSE...and CRAZY...and AMAZING.  I'm pretty nervous...and sad to say goodbye to my family... but at the same time I'm really excited!  I will be taking part in some SUPERB surgical training.

I am so happy that I decided to embrace this opportunity.  I want to be the best surgeon I can be...and I am grateful that my residency is helping to make that happen.  (Can you tell I'm in a "good place" right now?  I've been enjoying this residency ride lately...who knew?)

I've never been to Maryland before...so this will be exciting in so many ways. 

(The downside will be missing out on my little one's FIRST BIRTHDAY - ugh - stab me in the heart.  I was throwing a small pity party for myself when someone reminded me of our service men and women who go overseas for months at a time...and miss out on some of the milestones of their little ones...put everything in perspective.  Pity party over.)

Have you ever been to Maryland?  Anything I should DEFINITELY do?

new york city

via Etsy

Friends - this is a big weekend.  I will be in NYC attending a conference from Thursday through Sunday...which will be a really great adventure.  I'm attending the conference with a doctor who  is from the city - she's made reservations at all of her fave restaurants.  I don't think this will be an "explore the city" type of weekend...we will be in meetings all day long...but the vibe of Times Square will be right outside the window (how do I concentrate??)   The only flaw to the weekend is that Tommy and Clara have to stay behind.  This is the first time I have ever left Clara before.  I'm nervous about it....I wish I could bring her in my pocket.

AND at the same time I'm totally excited about the weekend.  Hummm....strange to be so excited and so sad at the same time.

residency is funny

visiting with Clara during a spare moment during an on-call weekend - in clean scrubs mind you.

Residency is funny....well....more like hysterical.  Or maybe it just makes me hysterical.  Especially in the...

"You want me to do what [because you have to be kidding!?]" realm. 

Not exactly a comedy...but there had to be some dark humor lurking in it somewhere.

Oh man.  

intern year

Today is a big deal in my little world - the new class of interns start today, which means I am no longer an intern. That's right...I survived the first year...the year that most residents believe to be the hardest...and I did it (pregnant none the less!)!  I'm officially a second year...a real resident. 

It's been a bit of a roller-coaster ride - with days that obviously sucked mixed in with days that left me inspired.   I no longer get nervous when my pager goes off - I know all the shortcuts to navigate the hospital - and I have memorized allllllll the different codes to the supply closets/resident lounges/computer rooms on the floors (there are a lot of codes!).

One year down, two more to go.  It'll be over in the blink of an eye I'm sure.  Residency is funny - the days are sooooooooooooooooo crazy long, but the years are short.  I'm proud of myself...really really proud of myself.