If I was tagging my blog entries with certain themes, this one would certainly go under the "TMI" tag. So continue reading at your own overloaded informational risk.
Today I am mourning the (reversible if I am ever crazy enough) end of my fertility. When Nina was born, I looked at Josh and asked, "Are you sure you don't want to do this again?" Her baby-ness was just too perfect--soft, cuddly, cute, innocent.... a second chance for me to be softer and cuddlier through the infant and toddler phases than I had been with Elena. "Yeah, I'm sure. We're done." Matter-of-fact, no room for argument, not even entertaining romantic ideas of having 8 kids.
As Nina started daycare and our monthly bill swelled to just $20 shy of our mortgage, the financial realities of having multiple children started to set in. When Elena turned two just a few weeks before my brother's wedding, her mandatory plane ticket purchase tipped our family's east coast flight costs into the quadruple digit range. Before we had kids, the adage about kids being expensive was just some vague cliché. Now I get it.
Money aside, there's also an adjustment to the time and attention you are able to spend with your children. Most kids are resilient enough to handle this adjustment well, and eventually most enjoy having a sibling to pal around with, but it doesn't mean that the adjustment period is easy or without moments of meltdowns. I tend to over-analyze things, leading to not-so-helpful feelings of uncertainty or guilt, which may explain my feelings of inadequacy when trying to meet the needs of my girls. Nina is just about 10 months old. I can't believe it's gone by so quickly. With Elena, I felt like I was able to savor her baby-hood a bit more. Nina's just raced by as I was losing my mind trying to keep things together at home, at work, and in my head. She doesn't know the difference, but I do. Most of the time, I feel like I'm doing okay. When the two are simultaneously melting down and howling about the pain of it all, I do feel a little paralyzed. Which one do I comfort first? How will that affect the other child in the moment? And in the long-run? Should I just let them both cry and get us to our next destination?
Leaving the house in the morning was hard enough when I just had myself to get ready. With Elena as a baby, she was always pooping on the way out the door or spitting up all over herself. Now she's amenable enough, but I can't get her to eat breakfast before getting into the car (thankfully it's just the timing she's been most picky about--she still eats a variety of things willingly). Nina wakes up happy, but she starts to get cranky and tired when it's time to leave and wails if I put her on the floor to get dressed, brush my teeth, eat breakfast, etc. Our tear-filled mornings are constantly cited by Josh as a major reason we shouldn't have more kids.
And then there's my selfishness. You know, the desire for "me time". I need time for myself, and that is inversely proportional to the number of kids we have.
Watching Josh's sisters gain back their freedom by taking their kids with them to later than 9 pm social events, eating/peeing/showering without children climbing on/towards them, leaving the house alone without kids, etc makes me hopeful that we'll get to that place at some point. That point would just grow more distant with another child, and my sanity has been thread-bare at best lately. Not really advisable to drawing out the journey towards greater independence.
So I guess I've drawn out a good enough argument to myself why having an IUD placed today was a good idea. I'm just sad to be done having babies. It's weird to be on the other side of having kids. Before having children there was a wide open world of procreational possibilities. Even after one, there was still the realistic possibility of more. And now.... we're done.
But I suppose it's just being done with the beginning, and now we're just at the start of the middle which as I've mentioned above, is the parental sweet spot between toddler tantrums and teenage drama. I've been savoring Nina's early bedtime followed by Elena's request for snuggles. Indulging Elena is made all the more easy by her clear little girl voice asking politely, "Mommy, can I please have some special time wiff you?" How can I say no? Let the parental sweet spot.... begin!
Tuesday, May 22, 2012
Tuesday, May 8, 2012
Pick Me Up, Dust Me Off.
This past month has been one of the single most challenging periods of my life. (I think.) In one month, I have become totally depleted. I think perhaps January of my intern year was the last time that I felt this bodily and emotionally exhausted--January was my 7th month as an intern, and I had just finished two consecutive months of obstetrics rotations, one of which was in Phoenix. I was on my ICU month, and was still waiting for my first vacation that year. One of my co-interns had already had her second vacation. I didn't care about anything at that point--I was just numb with exhaustion.
That's how I've felt the past two weeks, only now I have a 2.5 year old who goes from happy and independent to wailing and clingy at the drop of a hat. Since I am fresh out of reserves, it doesn't take much to set me off these days. Elena is in parrot mode, repeating everything that is said to her or around her, only she does so at often painfully poignant times. We visited a college friend, her husband, and her daughter while in Boston a few weeks ago. Elena's ear-splitting high-pitched laugh was a bit too much for her new friend, who lamented that Elena's laugh was "hurting her ears." In being the nighttime single parent for three weeks, I've said a few times to Elena in melt down mode while trying to get Nina down, "This is a sleeping bed. You can cry, but you can't do it in this bed."
Those two things have come together recently. When Nina starts to cry, Elena says in halting staccato, "Stop. Cry. Ing. Ni. Na! You're hurting my ears! No. Cry. Ing. Ni. Na!!!!" Not soothing. I get that now.
When we got back from Boston/RI, I thought maybe Weeks 1 and 2 of single nighttime parenting had weakened me to the point of catching Josh's 2-3 week laryngitis virus. I had weird alterations in taste (salty, scratchy), so started slamming myself with all sorts of herbal concoctions so that I could make it through Week 3. I had bought some sage and thyme to make tea (bunch of herb in a mug, boiling water, cover and steep x 20 minutes, sweeten with maple syrup or other), but didn't get around to using the thyme until this week. Everyone commented on how wonderfully it smelled yesterday at work. I looked up wearily at a coworker and said, "It's my thyme. I just wanted to feel nurtured."
I've been living off of caffeine and borderline crappy food. I've still been eating relatively well, though I've also become an expert at justifying my treats. Trust me--if you were nursing two, were partnerless for three weeks, still working nearly full time, flying cross country alone with two, and trying to keep it all together, you'd find the justification, too.
But now we're in recovery mode, which started last week. I was half-dreading seeing friends of ours for dinner their first night visiting from NY. I felt SO BLAH. But it must have been just what I needed. Michele, apart from her prenatal yoga teacher training, is home with Elijah, and has been for all of his 19 months. Our conversation reminded me of an Onion article, which I highly recommend reading. But validating each other's mommy concerns and successes and failures (okay, let's just say "failures" since they're not really all that bad) must have been just what I needed, because I left dinner feeling hopeful and rejuvenated. Sitting on the U of A campus on a warm sunny afternoon with Ranee, Michele, Elijah, and Josh was lovely (sorry, girls, daycare for you!) and further movement in the right direction. I felt compelled to do a cartwheel, and then work a little on my handstand--cartwheels: the ultimate symbol of freedom and happiness.
Now this week is back to the routine since our friends have left. Wow, have I missed the routine. I think when you are young and/or don't have many responsibilities, routine sounds like a horrid boredom trap--the allure of safety tethering people down to pitiful little lives. It's in the routine that I have found freedom--the freedom to know which yoga classes I can make at lunch time, the freedom to buy food and prepare nourishing meals that will fuel my family, the freedom to schedule massages and acupuncture treatments, the freedom to finally write a blog entry. Basically, the freedom to care for myself. If you don't have this time carved out in your life in some way, there's a good chance it just won't happen.
Today I went to acupuncture for the first time. I'm probably cheapening Charlie's skills by just calling it acupuncture, but you get the point. I've had "Mommy-Baby Hip Carry Syndrome," so named by me, characterized by pain along the upper portion of your pelvis on the side that you carry your child. Coupled with my above depletion, it has made me exceptionally irritable at home. Nina craves physical contact, and I've been happy to give it to her until the past couple of months when it just causes me pain. Apparently I've strained my obliques and sartorius muscles on my left side (at least I'm free to use my right hand!), and all of my yoga stretching has been causing my tendon attachments to become inflamed and "frayed" according to Charlie.
So here's to being gentle with ourselves, even in our journey towards healing. I hope we both find the time to put our oxygen masks on first before attempting to do so for others.
That's how I've felt the past two weeks, only now I have a 2.5 year old who goes from happy and independent to wailing and clingy at the drop of a hat. Since I am fresh out of reserves, it doesn't take much to set me off these days. Elena is in parrot mode, repeating everything that is said to her or around her, only she does so at often painfully poignant times. We visited a college friend, her husband, and her daughter while in Boston a few weeks ago. Elena's ear-splitting high-pitched laugh was a bit too much for her new friend, who lamented that Elena's laugh was "hurting her ears." In being the nighttime single parent for three weeks, I've said a few times to Elena in melt down mode while trying to get Nina down, "This is a sleeping bed. You can cry, but you can't do it in this bed."
Those two things have come together recently. When Nina starts to cry, Elena says in halting staccato, "Stop. Cry. Ing. Ni. Na! You're hurting my ears! No. Cry. Ing. Ni. Na!!!!" Not soothing. I get that now.
When we got back from Boston/RI, I thought maybe Weeks 1 and 2 of single nighttime parenting had weakened me to the point of catching Josh's 2-3 week laryngitis virus. I had weird alterations in taste (salty, scratchy), so started slamming myself with all sorts of herbal concoctions so that I could make it through Week 3. I had bought some sage and thyme to make tea (bunch of herb in a mug, boiling water, cover and steep x 20 minutes, sweeten with maple syrup or other), but didn't get around to using the thyme until this week. Everyone commented on how wonderfully it smelled yesterday at work. I looked up wearily at a coworker and said, "It's my thyme. I just wanted to feel nurtured."
I've been living off of caffeine and borderline crappy food. I've still been eating relatively well, though I've also become an expert at justifying my treats. Trust me--if you were nursing two, were partnerless for three weeks, still working nearly full time, flying cross country alone with two, and trying to keep it all together, you'd find the justification, too.
But now we're in recovery mode, which started last week. I was half-dreading seeing friends of ours for dinner their first night visiting from NY. I felt SO BLAH. But it must have been just what I needed. Michele, apart from her prenatal yoga teacher training, is home with Elijah, and has been for all of his 19 months. Our conversation reminded me of an Onion article, which I highly recommend reading. But validating each other's mommy concerns and successes and failures (okay, let's just say "failures" since they're not really all that bad) must have been just what I needed, because I left dinner feeling hopeful and rejuvenated. Sitting on the U of A campus on a warm sunny afternoon with Ranee, Michele, Elijah, and Josh was lovely (sorry, girls, daycare for you!) and further movement in the right direction. I felt compelled to do a cartwheel, and then work a little on my handstand--cartwheels: the ultimate symbol of freedom and happiness.
Now this week is back to the routine since our friends have left. Wow, have I missed the routine. I think when you are young and/or don't have many responsibilities, routine sounds like a horrid boredom trap--the allure of safety tethering people down to pitiful little lives. It's in the routine that I have found freedom--the freedom to know which yoga classes I can make at lunch time, the freedom to buy food and prepare nourishing meals that will fuel my family, the freedom to schedule massages and acupuncture treatments, the freedom to finally write a blog entry. Basically, the freedom to care for myself. If you don't have this time carved out in your life in some way, there's a good chance it just won't happen.
Today I went to acupuncture for the first time. I'm probably cheapening Charlie's skills by just calling it acupuncture, but you get the point. I've had "Mommy-Baby Hip Carry Syndrome," so named by me, characterized by pain along the upper portion of your pelvis on the side that you carry your child. Coupled with my above depletion, it has made me exceptionally irritable at home. Nina craves physical contact, and I've been happy to give it to her until the past couple of months when it just causes me pain. Apparently I've strained my obliques and sartorius muscles on my left side (at least I'm free to use my right hand!), and all of my yoga stretching has been causing my tendon attachments to become inflamed and "frayed" according to Charlie.
So here's to being gentle with ourselves, even in our journey towards healing. I hope we both find the time to put our oxygen masks on first before attempting to do so for others.
Wednesday, February 8, 2012
Healer's Art: On Awe.
In medical school, I took an elective class called The Healer's Art. Healer's Art is a course that was created by Rachel Naomi Remen, an author of many books on healing. Remen's own medical training was a huge influence on the creation of this program; medical school and residency are hard academically, physically, and emotionally. It's really no wonder why so many physicians are calloused and have difficulty relating to patients, but Remen rejects this "thick skin" defense mechanism and urges young physicians-in-training to explore themselves as people, people who have vulnerabilities and can recognize and empathize with others regarding their vulnerabilities.
We are on week 4 of 5 of our course at the University of Arizona College of Medicine. This is my third time through the course (once as a student, now a second time as a facilitator). Tonight will be my first talk in the large group setting, and the topic for tonight is "Beyond Analysis: Allowing Awe in Medicine." Life has been busy for our family lately, with scant time to reconnect with each other, let alone ourselves. My blog has always facilitated the latter process, so it seemed fitting to draft my talk here. Forgive me if there are topics that I've explored in the past!
I had been present at many a delivery before Elena was born, coaching moms push, directing their baby's body to the outside world, and handing the prize to proud parents. Watching my daughter make her entrance into this world was amazing. When pregnant, I often wondered what my children would look like, but a blurred face would be the closest I could get in my daydreams. After Elena's head and shoulders emerged, my doctor had me reach down and pull her onto my chest. The first thing I said to Josh, in true Rhode Island fashion, was, "She's wicked cute." She was taken to get dried, weighed, and medicated, and then given back to me as a nice little bundle. I spent the next two weeks in utter bliss as my baby snoozed away, happy to nurse when she was awake.
When Nina was born, the same birthing process ensued, but this time I asked my doctor and attendants to allow her to rest on my bare chest until she had nursed. In retrospect, my separation with Elena so shortly after her birth made me sad--I think we've more than made up for it, but I wanted to experience the magic of "skin to skin". When Nina, wet and wriggly, was placed on my chest, her warmth just melted into mine into a little love puddle. I believe that sensation will stay with me forever, as no experience has left so strong an impression.
These two exceptionally intimate moments of my life were shared with my husband, and no other family members. For that reason, they are incredibly special to me. Interestingly enough, they were also shared with 4-5 other people in the room--my doctor, nurses, techs. To me, the privilege of sharing in these intimate moments of people's lives is one of the most amazing things about being a physician.
I've always been nosy--maybe that's one of the reasons that I love being a doctor so much. People tell you *everything*. My patients have disclosed stories of their most happy and proud moments; devastating sexual and physical abuse; complacency with marriages of convenience; and thoughts regarding the last moments of their lives and beliefs of the afterlife. I'm not sure what I am doing to create such a safe space for people to share these things that they ordinarily keep secret, other than letting people talk. Often times there's not much I can do but raise my eyebrows, shake my head, and say, "Huh," allowing for silence as the other person finishes their story and their mind shifts back from their memories to the present moment. These disclosures work on so many levels--patients often feel better sharing things they've kept bottled up, and these stories help me to see the person in front of me in a richer context. The combination of those two things leads to a deepening of my relationship with my patients.
True understanding of the context of life often comes at the end of it. I met R and his wife my intern year during a hospital rotation. R had been having some nagging pain in his shoulder and a bump on his head--sadly, these ended up being metastatic tumors. R followed up with me in the office; he was healthy and in his 40's, and didn't have a primary care physician prior to his hospitalization. I managed his pain as he underwent chemotherapy and radiation; both were palliative rather than curative, but I don't think R understood that fully. He kept rallying himself to "get better." Before one of his last appointments with me, his wife called me to say she didn't think they'd be able to make it to the office, so I went to their home instead. R was lying in bed, with agonal breathing, and didn't respond to my touch or greeting. His wife had been trying to medicate his pain with the oral tablets I had been prescribing--how that was working was beyond me, as the man could clearly not coordinate a swallow. We changed his medication to a liquid form, and all I did during that visit was sit and listen to his wife tell the story of his life, and of their love. He died in a couple of days, and I went again to their home to pronounce him dead. His whole family was present, mourning. His brother asked me if I was his oncologist--I had to stifle a smile, as I don't know how many oncologists make two home visits in a 3-day span (though I'm sure there are some!). I went to his wake, and a few months later, his wife sent me a gift for Easter.
More recently, I was able to spend some time with J, an elderly woman with a strong Brooklyn accent and a lot of spunk. We spent time together in her hospice room, where she pondered what was going to come next. I asked her if she was afraid of dying, and she told me she was looking forward to death, as it meant seeing her mother and husband again. We talked about her childhood, her marriages, her daughter and grandson. We talked about her faith and mine, and how to address spirituality with my children.
These conversations and experiences inspire awe in that they happen between relative strangers who are brought together in a professional setting. There is great mystery to be uncovered when view our patients as people, and exploring the unknown based on our experiences. How lucky we are as physicians to be privy to such meaning in our day to day lives.
We are on week 4 of 5 of our course at the University of Arizona College of Medicine. This is my third time through the course (once as a student, now a second time as a facilitator). Tonight will be my first talk in the large group setting, and the topic for tonight is "Beyond Analysis: Allowing Awe in Medicine." Life has been busy for our family lately, with scant time to reconnect with each other, let alone ourselves. My blog has always facilitated the latter process, so it seemed fitting to draft my talk here. Forgive me if there are topics that I've explored in the past!
I had been present at many a delivery before Elena was born, coaching moms push, directing their baby's body to the outside world, and handing the prize to proud parents. Watching my daughter make her entrance into this world was amazing. When pregnant, I often wondered what my children would look like, but a blurred face would be the closest I could get in my daydreams. After Elena's head and shoulders emerged, my doctor had me reach down and pull her onto my chest. The first thing I said to Josh, in true Rhode Island fashion, was, "She's wicked cute." She was taken to get dried, weighed, and medicated, and then given back to me as a nice little bundle. I spent the next two weeks in utter bliss as my baby snoozed away, happy to nurse when she was awake.
When Nina was born, the same birthing process ensued, but this time I asked my doctor and attendants to allow her to rest on my bare chest until she had nursed. In retrospect, my separation with Elena so shortly after her birth made me sad--I think we've more than made up for it, but I wanted to experience the magic of "skin to skin". When Nina, wet and wriggly, was placed on my chest, her warmth just melted into mine into a little love puddle. I believe that sensation will stay with me forever, as no experience has left so strong an impression.
These two exceptionally intimate moments of my life were shared with my husband, and no other family members. For that reason, they are incredibly special to me. Interestingly enough, they were also shared with 4-5 other people in the room--my doctor, nurses, techs. To me, the privilege of sharing in these intimate moments of people's lives is one of the most amazing things about being a physician.
I've always been nosy--maybe that's one of the reasons that I love being a doctor so much. People tell you *everything*. My patients have disclosed stories of their most happy and proud moments; devastating sexual and physical abuse; complacency with marriages of convenience; and thoughts regarding the last moments of their lives and beliefs of the afterlife. I'm not sure what I am doing to create such a safe space for people to share these things that they ordinarily keep secret, other than letting people talk. Often times there's not much I can do but raise my eyebrows, shake my head, and say, "Huh," allowing for silence as the other person finishes their story and their mind shifts back from their memories to the present moment. These disclosures work on so many levels--patients often feel better sharing things they've kept bottled up, and these stories help me to see the person in front of me in a richer context. The combination of those two things leads to a deepening of my relationship with my patients.
True understanding of the context of life often comes at the end of it. I met R and his wife my intern year during a hospital rotation. R had been having some nagging pain in his shoulder and a bump on his head--sadly, these ended up being metastatic tumors. R followed up with me in the office; he was healthy and in his 40's, and didn't have a primary care physician prior to his hospitalization. I managed his pain as he underwent chemotherapy and radiation; both were palliative rather than curative, but I don't think R understood that fully. He kept rallying himself to "get better." Before one of his last appointments with me, his wife called me to say she didn't think they'd be able to make it to the office, so I went to their home instead. R was lying in bed, with agonal breathing, and didn't respond to my touch or greeting. His wife had been trying to medicate his pain with the oral tablets I had been prescribing--how that was working was beyond me, as the man could clearly not coordinate a swallow. We changed his medication to a liquid form, and all I did during that visit was sit and listen to his wife tell the story of his life, and of their love. He died in a couple of days, and I went again to their home to pronounce him dead. His whole family was present, mourning. His brother asked me if I was his oncologist--I had to stifle a smile, as I don't know how many oncologists make two home visits in a 3-day span (though I'm sure there are some!). I went to his wake, and a few months later, his wife sent me a gift for Easter.
More recently, I was able to spend some time with J, an elderly woman with a strong Brooklyn accent and a lot of spunk. We spent time together in her hospice room, where she pondered what was going to come next. I asked her if she was afraid of dying, and she told me she was looking forward to death, as it meant seeing her mother and husband again. We talked about her childhood, her marriages, her daughter and grandson. We talked about her faith and mine, and how to address spirituality with my children.
These conversations and experiences inspire awe in that they happen between relative strangers who are brought together in a professional setting. There is great mystery to be uncovered when view our patients as people, and exploring the unknown based on our experiences. How lucky we are as physicians to be privy to such meaning in our day to day lives.
Friday, December 23, 2011
Gentle Reflections on 2011.
I just baked my first loaf of bread, and the house smells amazing. Nina is sleeping, Josh and Elena are playing in her room, my coffee is still hot. At this moment, life is good and there is time to reflect.
Each year I choose a different one word phrase to add to my routine intention for my yoga practice. At the start of each practice, after the Anusara invocation, I add "May I cultivate..." and then I run through each one. Some days/weeks/months/years I need the recitation to remind me that I wanted to work towards that ideal. Other times the ideal just begins to take shape in my life and/or my practice, which always takes me a little by surprise. Wise teachers will always say that the physical asana practice is just practice for real life--the physical challenges are a metaphor of sorts for the challenges of our daily lives. I suppose that is why each word of my choosing tends to have both literal and deeper impacts on my life.
I think I practiced fewer times this year than I have since medical school. As a result, I can't really remember this year's word. Patience, maybe? I certainly have lost my patience *many* times this year, but in my better moments have been able to access an amazing vault of calm that I didn't know existed. (Note to self--visit there more often!) A couple of years ago I chose the word "gentleness", if that even is a word. And really it's this intention that I wanted to write most about today, because I think 2011 has been a turning point in my quest to better emulate this virtue.
Things I have done in 2011 to live a more gentle life:
1. Have a second child. She has softened my heart even further and makes me coo softly even when I want to scream.
2. Continue to nurse my older child. My nursing relationship with Elena helps us both recenter ourselves during tantrums, and now that I've mastered the nursing two at once maneuver our post-work/daycare time is more peaceful and recharges us all.
3. Switched to Charlie's Soap. Given our copious laundry, choosing a detergent that doesn't pump chemicals into the earth makes me feel much more environmentally responsible. It also works great as a surface cleaner on counters and such.
4. Started to cook vegan meals. I stopped eating meat January 1, 2010. I can remember sitting in Corner Bistro, surrounded by the saliva-inducing aroma of grilled beef, having just ordered my Bistro Burger (beef + cheese + bacon = YUM) when Toni ordered a chicken sandwich. "Why didn't you order a burger!?" asked Jen, echoing my thoughts. I think I may have even said that I could never do without beef--my burger cravings were not common, but strong and in need of fulfillment when they did hit.
Nixxing beef was no big deal, especially after going out with a Swedish meatball bang on New Year's Eve. But vegan? NEVER. The cheese! I always cited as my biggest obstacle. Really, for me, the biggest obstacle might be my two-a-day egg habit. I just haven't found anything that offers that much satiety, and for a mom nursing two babes, keeping my appetite at bay has been really challenging.
Michael Pollan eats vegetarian until dinner. I have been trying to eat vegetarian at breakfast, and then transition to vegan for the remainder of the day on most days. We ate at B-Line the other night, and I ordered my usual Feta Jack Burrito. With my first bite, I tasted meat and spit it out. 'There's chicken in here!" I told my dining compatriots. How embarrassed was I to bring my dish up to the better-lit counter to point out the chicken to the staff, only to discover that my "chicken" was tortilla? The salty feta and smoky beans were so flavorful, I mistook them for meat. Woah, retrained tastebuds.
I watched Isa's video for making Mexican Hot Chocolate Snickerdoodles and she states that the chocolate, cinnamon, and cayenne flavors meld and stand strong in the absence of butter. I know most people won't buy that, but the cookies are awesome, and my morning cold-pressed gingerbread coffee smells awesome but tastes blah with cream added.
In any event, I like the idea of minimizing animal products in my diet. I am still eating rich and delicious foods, but no animals are suffering to make that happen, nor land ruined to raise those animals.
5. Changed out wasteful baby products. New parents have no clue on so many levels. We depend on other more seasoned parents to help us make decisions on what do do and buy for our babies. With Elena, I started out with "earth-friendly" disposable diapers on the advice of an earth-friendly friend. We both made the switch to cloth eventually, and felt much better about the absence of so much waste. I had told numerous new moms that I felt okay using disposables since liquid-fed baby poop is so liquidy and another friend had told me that her experience with cloth early on was messy. Elena was out of diapers and thankfully Nina was big enough to jump right into the same ones, and let me tell you, liquid baby waste is SO much easier and less gross than solid stool. Oh well. Live and learn, then pass along the message.
With Nina I also bought cloth wipes. She still has disposable ones at school, but at home the cloth ones are so easy to use and then just pop in our diaper pail along with the dirty diaper. Again, kicking myself for the waste with Elena, but glad I am moving on to the creation of less trash.
Another friend had been using the Playtex Drops Ins, which are sort of like a bottle with a female condom--sorry to be graphic, but I don't think anyone can see the inserts repeatedly and not have that thought at least once. We bought those, as well as lots of Medela storage bags for my milk. Now that our bottles are falling apart, I've invested in washable Medela bottles, which I can just pump into and screw on a nipple/ring/top apparatus. Same amount of cleaning than the Playtex, less waste. Oh well.
__________________________________________________________________________________
So that's it for now. Josh just eyeballed my work and said, "Holy long blog!" so I suppose I should stop before you stop reading.
If you don't have any New Year's resolutions, I would urge you to consider how you can be more gentle to yourself, your loved ones, your Earth. I think I still need to work on being more gentle to people in my daily life, but that's the nice part about keeping these words in a regular recitation--the work is ongoing, and practice makes perfect.
Each year I choose a different one word phrase to add to my routine intention for my yoga practice. At the start of each practice, after the Anusara invocation, I add "May I cultivate..." and then I run through each one. Some days/weeks/months/years I need the recitation to remind me that I wanted to work towards that ideal. Other times the ideal just begins to take shape in my life and/or my practice, which always takes me a little by surprise. Wise teachers will always say that the physical asana practice is just practice for real life--the physical challenges are a metaphor of sorts for the challenges of our daily lives. I suppose that is why each word of my choosing tends to have both literal and deeper impacts on my life.
I think I practiced fewer times this year than I have since medical school. As a result, I can't really remember this year's word. Patience, maybe? I certainly have lost my patience *many* times this year, but in my better moments have been able to access an amazing vault of calm that I didn't know existed. (Note to self--visit there more often!) A couple of years ago I chose the word "gentleness", if that even is a word. And really it's this intention that I wanted to write most about today, because I think 2011 has been a turning point in my quest to better emulate this virtue.
Things I have done in 2011 to live a more gentle life:
1. Have a second child. She has softened my heart even further and makes me coo softly even when I want to scream.
2. Continue to nurse my older child. My nursing relationship with Elena helps us both recenter ourselves during tantrums, and now that I've mastered the nursing two at once maneuver our post-work/daycare time is more peaceful and recharges us all.
3. Switched to Charlie's Soap. Given our copious laundry, choosing a detergent that doesn't pump chemicals into the earth makes me feel much more environmentally responsible. It also works great as a surface cleaner on counters and such.
4. Started to cook vegan meals. I stopped eating meat January 1, 2010. I can remember sitting in Corner Bistro, surrounded by the saliva-inducing aroma of grilled beef, having just ordered my Bistro Burger (beef + cheese + bacon = YUM) when Toni ordered a chicken sandwich. "Why didn't you order a burger!?" asked Jen, echoing my thoughts. I think I may have even said that I could never do without beef--my burger cravings were not common, but strong and in need of fulfillment when they did hit.
Nixxing beef was no big deal, especially after going out with a Swedish meatball bang on New Year's Eve. But vegan? NEVER. The cheese! I always cited as my biggest obstacle. Really, for me, the biggest obstacle might be my two-a-day egg habit. I just haven't found anything that offers that much satiety, and for a mom nursing two babes, keeping my appetite at bay has been really challenging.
Michael Pollan eats vegetarian until dinner. I have been trying to eat vegetarian at breakfast, and then transition to vegan for the remainder of the day on most days. We ate at B-Line the other night, and I ordered my usual Feta Jack Burrito. With my first bite, I tasted meat and spit it out. 'There's chicken in here!" I told my dining compatriots. How embarrassed was I to bring my dish up to the better-lit counter to point out the chicken to the staff, only to discover that my "chicken" was tortilla? The salty feta and smoky beans were so flavorful, I mistook them for meat. Woah, retrained tastebuds.
I watched Isa's video for making Mexican Hot Chocolate Snickerdoodles and she states that the chocolate, cinnamon, and cayenne flavors meld and stand strong in the absence of butter. I know most people won't buy that, but the cookies are awesome, and my morning cold-pressed gingerbread coffee smells awesome but tastes blah with cream added.
In any event, I like the idea of minimizing animal products in my diet. I am still eating rich and delicious foods, but no animals are suffering to make that happen, nor land ruined to raise those animals.
5. Changed out wasteful baby products. New parents have no clue on so many levels. We depend on other more seasoned parents to help us make decisions on what do do and buy for our babies. With Elena, I started out with "earth-friendly" disposable diapers on the advice of an earth-friendly friend. We both made the switch to cloth eventually, and felt much better about the absence of so much waste. I had told numerous new moms that I felt okay using disposables since liquid-fed baby poop is so liquidy and another friend had told me that her experience with cloth early on was messy. Elena was out of diapers and thankfully Nina was big enough to jump right into the same ones, and let me tell you, liquid baby waste is SO much easier and less gross than solid stool. Oh well. Live and learn, then pass along the message.
With Nina I also bought cloth wipes. She still has disposable ones at school, but at home the cloth ones are so easy to use and then just pop in our diaper pail along with the dirty diaper. Again, kicking myself for the waste with Elena, but glad I am moving on to the creation of less trash.
Another friend had been using the Playtex Drops Ins, which are sort of like a bottle with a female condom--sorry to be graphic, but I don't think anyone can see the inserts repeatedly and not have that thought at least once. We bought those, as well as lots of Medela storage bags for my milk. Now that our bottles are falling apart, I've invested in washable Medela bottles, which I can just pump into and screw on a nipple/ring/top apparatus. Same amount of cleaning than the Playtex, less waste. Oh well.
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So that's it for now. Josh just eyeballed my work and said, "Holy long blog!" so I suppose I should stop before you stop reading.
If you don't have any New Year's resolutions, I would urge you to consider how you can be more gentle to yourself, your loved ones, your Earth. I think I still need to work on being more gentle to people in my daily life, but that's the nice part about keeping these words in a regular recitation--the work is ongoing, and practice makes perfect.
Saturday, November 19, 2011
In the end, it's all the same.
Yesterday I was invited to an integrative medicine meeting of minds, otherwise known as "patient conference." Patient conference has always been a feature of the integrative medicine fellowship; a time to share a consultation case with a panel of providers specializing in various modalities to offer a wider variety of treatments. I was in the office in the morning, and arrived at the meeting late. When I walked in the room, I saw a group of people who have been my teachers for the past four years--what an honor to be invited to give *my* input to the current fellow! I did have to laugh as Rubin was giving his advice regarding the patient's insomnia--he has obviously trained me well as my own treatment plans are directly informed with his advice:
--Sleep hygiene, with a big emphasis on limiting screen time of any kind
--Melatonin if sleep onset is an issue (though I think he starts lower than the 3 mg I advise)
--Retraining the body/mind associate bed with sleep rather than wakefulness (i.e. reserving the bed for only sleep and sex)
--Early morning sun (to help mood and reset circadian rhythms)
--Exercise early in the day
--Some sort of mind/body therapy if there is an anxiety/overactive mind component (is it a surprise that I always feel people out to see if they'd be up for journaling?)
Anyway--getting off track. Two of the practitioners were from Traditional Chinese Medicine (Tucsonans--click the link to get info--their school has really cheap, but amazing, clinics for the public!) and Ayurveda. The day before, the residency integrative medicine conference included a western-trained gastroenterologist turned energy healer. In listening to these three practitioners make their recommendations for abdominal symptoms, I was struck with the similarity of the rationale for each practitioner's recommendations. I just find it interesting that different traditions of healing arose simultaneously in different places, but yet are so similar. Kind of like us, as humans. Please excuse me as I tend to my crying baby--something moms everywhere can relate to!
P.S. And to follow up on the Bean--Nina is now taking bottles at daycare. It took a full 5 weeks, but she finally caught on!
--Sleep hygiene, with a big emphasis on limiting screen time of any kind
--Melatonin if sleep onset is an issue (though I think he starts lower than the 3 mg I advise)
--Retraining the body/mind associate bed with sleep rather than wakefulness (i.e. reserving the bed for only sleep and sex)
--Early morning sun (to help mood and reset circadian rhythms)
--Exercise early in the day
--Some sort of mind/body therapy if there is an anxiety/overactive mind component (is it a surprise that I always feel people out to see if they'd be up for journaling?)
Anyway--getting off track. Two of the practitioners were from Traditional Chinese Medicine (Tucsonans--click the link to get info--their school has really cheap, but amazing, clinics for the public!) and Ayurveda. The day before, the residency integrative medicine conference included a western-trained gastroenterologist turned energy healer. In listening to these three practitioners make their recommendations for abdominal symptoms, I was struck with the similarity of the rationale for each practitioner's recommendations. I just find it interesting that different traditions of healing arose simultaneously in different places, but yet are so similar. Kind of like us, as humans. Please excuse me as I tend to my crying baby--something moms everywhere can relate to!
P.S. And to follow up on the Bean--Nina is now taking bottles at daycare. It took a full 5 weeks, but she finally caught on!
Saturday, October 29, 2011
The No-Bottle Bean.
Two simultaneous sleeping babes = awesome. "Would you like another cup of coffee, Mommy?" "Oh, yes, please, Mommy. Thank you!"
This past week was Nina's fourth at daycare. After a couple of days of taking a "full" bottle (my full bottles these days are 3 oz since so much milk has been wasted--Elena would suck 5 oz down 4 times in a full day at daycare) once during the day, we've come to another standstill. No more smiley faces following the ounces consumed on her daily report. From what I understand, she flips out the minute she feels that artificial nipple graze her lip. On Friday it took one of the women an hour to dribble in one single ounce.
I've been a little stressed by this situation, feeling obligated to keep her with me on half days that I am not in the office, or traveling back to daycare in the middle of the day to feed her if time allows. That being said, she's goes 6-7 hours at night not infrequently, and she certainly has the fat stores to prove her staying power. As a result, I'm not too bothered by the situation since I know that the perceived problem of Nina not taking a bottle is really just mine and those that are caring for her. I asked two of them yesterday what the longest learning period was that they had seen for adapting to a bottle. They both looked at me a bit with pinched smiles and agreed: "Um, she's the longest that I've seen." Great.
Is one month of non-bottle accepting an absolute predictor of never-bottle accepting? I'm beginning to think it's a pretty strong one, at the very least. My over-analytical side has taken over a bit, and I've been doing some google searches this morning. Google searches are, after all, the best way to get the most accurate information (that was a joke, in case you missed it). So I read Dr. Sears' suggestions for getting baby to take a bottle, which, in true Dr. Sears fashion is lovely and touchy feely. But I think they've done all of that at daycare, and it hasn't really paid off. I did, however, feel deeply justified for not "training" Nina at home since that would mean me giving her a bottle--it was nice that Dr. Sears has deemed this task as not the mom's job.
I looked at some other sites, and was really looking for a blog or personal witness regarding this issue. I stopped looking after reading some unhelpful piece of garbage that basically said it boils down to a "stand-off" or the baby accepting the bottle. A little too much like cry-it-out for me, and I just don't think that provision of nourishment should be a battle or unpleasant in any way for the baby.
At the breastfeeding conference that I attended in August (with newborn Nina), Dr. Newman mentioned that the advice to exclusively breastfeed until 6 months before introducing solid foods was great as a public health policy, but neglected the needs of individual babies. If a baby has the motor skills and the interest to safely eat solids, he argued, given him/her solids! So that idea has been in my mind for some time, and I've been saying that perhaps this no-bottle issue might push us to start solids sooner. But then I realized that in doing this, if Nina wasn't ready, we'd be ignoring more of her cues. His section on feeding babies when mom isn't around really helped me with this realization, and will hopefully guide my stress levels over the next few months. I love that he opens up the FAQ on this topic by saying in bold type, "This is no tragedy."
Basically, this bottle issue with Nina has been another lesson for me in listening to my intuition, which has always been saying, "She'll be fine. The bottle is no big deal--she'll either learn, or she won't." I LOVE reading about parenting and the wealth of information and experiences that are easily accessible on the internet. I think in being raised Catholic, it has prepared me for handling this overabundance--I pick and choose what recommendations to follow as I see fit. (Half-kidding, Mom!) In all seriousness, the picking and choosing is really where that intuition comes into play. What I've learned is that the easiest decisions to make are the ones that feel the most right. It's incessant remembering of this lesson that continues to be the challenge.
Thursday, October 27, 2011
Okay, fine. It's not that bad.
I am reveling in the quiet that has enveloped my house tonight, and rejoicing in the tiny buzz that the mostly-full decanter of wine from dinner has given me.
Today we had meeting after meeting after meeting after meeting for work while the residents took their in-training exam. "We" meaning my fellow residency "core faculty" and me. We started the meeting with a "check in" (sorry for the overuse of quotes--I truly blame the wine), which was really nice. It was so lovely to hear the faculty that trained me speak of their position in both their personal and professional lives. I, of course, broke down after stating, "Well, I'm back. And it's been hard to keep it together." I couldn't really eek out more that that for a while, but was happy to witness the old adage of "this too will pass" through the lives of my colleagues.
A section of our meetings today focused on the mentor/mentee relationship. I've always been attracted to the idea of having a mentor, and envied those that casually throw in the, "Well, my mentor so-and-so..." The article we discussed was about how the onus should be on the mentee for the establishment and upkeep of the mentor/mentee relationship. So I guess that's why I don't really have an established mentor, but rather a collection of faculty that I depend upon for professional advice and advancement prodding. Though I lack the confidence to officially propose to a mentor, I was struck today at how so many in the room have mentored me over the past few years, and how grateful I am to their service and support. Most of all, however, I am grateful for the gift of their friendship, and the freedom to share my tears over my current struggles knowing that when I am ready to regain the professional momentum that I had pre-second-baby, that support will still be there.
As an adolescent trying to find herself, I participated in countless retreats, turning inward again and again. Over the years, I have found great solace in my yoga practice as the same sort of introspection begins (and often ends) each asana practice. But I am truly indebted to my professional life and the community that I have found through this residency program--including my integrative medicine fellows--for the obligatory retreats and self-evaluation that have fostered my growth not only as a physician but as a person and as a teacher.
I don't know why I'm so bad at asking for help. When pondering the inherent nature of our daughters, I suggested that perhaps Nina would be like her Daddy--indefatigably happy. Josh replied that he's not always happy, but rather doesn't "put my stress on other people." That's really not my intent, and maybe this perception of my tendencies speaks more to the conversation I had with Julie a few weeks ago about the trend for women to overanalyze and underdiscuss until all sorts of shit hits the fan. I think this scenario is where the verb "blurt" was born.
Anyway, I don't know what I'm trying to say, other than thanks for letting me vent, thanks to coming to my aide (when for instance my security door wouldn't open) and thanks to those who have let me know that I am not alone. I appreciate all of your support because it helps me to move one foot in front of the other, and to see the light at the end of the tunnel.
Today we had meeting after meeting after meeting after meeting for work while the residents took their in-training exam. "We" meaning my fellow residency "core faculty" and me. We started the meeting with a "check in" (sorry for the overuse of quotes--I truly blame the wine), which was really nice. It was so lovely to hear the faculty that trained me speak of their position in both their personal and professional lives. I, of course, broke down after stating, "Well, I'm back. And it's been hard to keep it together." I couldn't really eek out more that that for a while, but was happy to witness the old adage of "this too will pass" through the lives of my colleagues.
A section of our meetings today focused on the mentor/mentee relationship. I've always been attracted to the idea of having a mentor, and envied those that casually throw in the, "Well, my mentor so-and-so..." The article we discussed was about how the onus should be on the mentee for the establishment and upkeep of the mentor/mentee relationship. So I guess that's why I don't really have an established mentor, but rather a collection of faculty that I depend upon for professional advice and advancement prodding. Though I lack the confidence to officially propose to a mentor, I was struck today at how so many in the room have mentored me over the past few years, and how grateful I am to their service and support. Most of all, however, I am grateful for the gift of their friendship, and the freedom to share my tears over my current struggles knowing that when I am ready to regain the professional momentum that I had pre-second-baby, that support will still be there.
As an adolescent trying to find herself, I participated in countless retreats, turning inward again and again. Over the years, I have found great solace in my yoga practice as the same sort of introspection begins (and often ends) each asana practice. But I am truly indebted to my professional life and the community that I have found through this residency program--including my integrative medicine fellows--for the obligatory retreats and self-evaluation that have fostered my growth not only as a physician but as a person and as a teacher.
I don't know why I'm so bad at asking for help. When pondering the inherent nature of our daughters, I suggested that perhaps Nina would be like her Daddy--indefatigably happy. Josh replied that he's not always happy, but rather doesn't "put my stress on other people." That's really not my intent, and maybe this perception of my tendencies speaks more to the conversation I had with Julie a few weeks ago about the trend for women to overanalyze and underdiscuss until all sorts of shit hits the fan. I think this scenario is where the verb "blurt" was born.
Anyway, I don't know what I'm trying to say, other than thanks for letting me vent, thanks to coming to my aide (when for instance my security door wouldn't open) and thanks to those who have let me know that I am not alone. I appreciate all of your support because it helps me to move one foot in front of the other, and to see the light at the end of the tunnel.
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