Pontificum Scriblerus

Everyone should read this article in detail. http://www.nytimes.com/2011/06/12/opinion/12sibert.html Opinion Don’t Quit This Day Job By KAREN S. SIBERT Published: June 11, 2011 For female doctors, the decision to go part time isn’t just personal; it has consequences for patients and the public. Afterwards, should read http://www.psychologytoday.com/blog/wont-hurt-bit/201106/the-mommy-wars-medical-edition. The bottom line is this: the top article's writer, a female anesthesiologist from California, asserts that the fact that female physicians are choosing to work part-time is hurting patients and the economy, and has a negative impact overall on a societal level. She plainly suggests that women need to choose between being a doctor or being a mother, and that both is not possible. The bottom article writes an intelligent response. I applaud Dr. Au, the latter writer, for keeping her wits about her enough to write an eloquent response, when the only thing I could say after I read Dr...

1) Physical It's just a C section... But it's not. It's a surgery where they slice you open! They don't slice you open when they take out the gallbladder or the appendix anymore. (Funny aside: my father from Philly asked if they do the c sections "laparoscopically," which is just hilarious! I explained to him that when they remove gall bladders through a 1 cm incision, they chop it up first and then place it in a plastic bag before pulling out the mush through said incision. Can't usually do that with a baby, not unless you wanna get sued...) I was ordered for q 1 hour O2 sat checks, so in my haziness and exhaustion, I was subjected to sleepus interruptus every hour. I was confined to bed with a foley - and thank god for that. I wasn't allowed to eat, or drink; only ice chips. When they finally allowed me to stand up, I inspected the incision, and found some insane number of stitches, which I totally didn't expect. Trying to pee for the fi...

I just have to document this, because I've been dealing with it for days, and my patience is about this big (indicating tiny), and my temper is about this long (indicating miniscule). All the dumbass things people do and say to me are just unbelievable. We'll start with the plain old, "when are you due?" It's harmless by itself. But try answering that same question 10 times a day! July 6th. July 6th. July 6th. Then, I try to change it up: A few weeks. Pretty soon. Not soon enough. Then I try to ignore the question, but they usually repeat it, and I can't be rude, so I start over. July 6th. July 6th. I should have just had a Tshirt made and wear it, or a plaque or something. "When are you due" is okay, I can handle it. But sometimes, after it, comes some other brilliant comment. Usually, it's "Oh, my god! That's soon!" or "Wow, that;s coming up!" This is when I cock my head like a cat and look at the person. ...

We've graduated to weekly appointments now, and have the lucky privilege of internal exams at every visit. Last week, I was told I was 50% effaced and 2 cm dilated, which, apart from sounding disturbing to a lay person (my mom almost fainted when she heard the word "effaced"), also sounded really promising to me, so when I exhuberantly cried "What does that mean?!" and the OB cold-bloodedly answered "Nothing," I was pretty incredulous... Surely, I'd be in labor any second now? But I ain't. What I IS, though, is edematous, at least 1+, especially at the ankles. I look at them and I'm like, hey, didn't the medial malleolus (little bone) used to reside here? Also, I is a giant internal lava lamp. At least, that's how it feels. It's getting more and more science fictiony by the moment: the belly morphs into various shapes, vibrates and hops at random times, and occasionally, sprouts temporary limbs that later resorb back into the fl...

I think it's winning. The pregnancy, I mean. I've been coasting along, with an "see? it's not so bad" kind of attitude, despite occasional gripes about blisters on feet, but lately, I think it's taking over. The other day I went home early from work because I thought I was having contractions. After sitting around for two hours, going, God, this is SO uncomfortable, regularly every 5 minutes, it dawned on me that maybe these were the famous Braxton Hicks? I called the OB office, and was instructed to go home, drink a big glass of water, and lie on my left side. Yes, Please! I tried to sneak out unseen, but got spotted by the secretaries, and soon the news had spread, and panic ensued. Typical. WHO WILL COVER THE INVALID PREGNANT GIRL WHILE SHE IS GONE? Meanwhile, it escaped people to try to find out what's going on, and if I'm actually gone for good, or just enyoing a doctor-sanctioned 3 hour afternoon nap. So, now, everyone thinks I might be having ...

Part of Obama's healthcare plan is a provision that employers with more than 50 employees have to provide a private and secure place, other than a bathroom, and free from intrusion from the public and other employees, for breast feeding and pumping for new moms in the workplace. I had no idea about this, but when I found out, my first reaction was a healthy skeptical snort, especially based on my experiences as a female physician here at this institution. This is the place that made the 9 month pregnant resident cover some guy on vacation. This is the place where a person from a position of power told me that "as a woman, you need to learn to read capsules because it's not physically challenging, and you can do it as well as anyone." (Implying that as a woman, there are some things I can't do as well as anyone?!) Also, where another female physician, one that has three kids of her own, told me that if I need a snack after 12 hours of work, I need to run, or e...

The jig is up, I'm definitely pregnant. Strangers in the elevator are asking me when I'm due, and little old ladies at the grocery store are petting my stomach. So, that's fun story #1: I'm into the 3rd trimester, which, in and of itself, is a little unbelievable, considering I just found out I was pregnant in the first place. Fun story #2 is that, apparently, I've been cast in a remake of Alien, because on a daily basis, my own belly changes shape a la Lava Lamp, and occasionally, grows lumps that look like they're about to burst open and a release a little creature that runs off squealing across the spaceship. I no longer picture a seacreature doing nosedives across the uterus to romantic music; I now picture a very uncomfortable scrunched up little fetus who's a little whiney, and keeps trying to stretch his legs, but is constricted by non-compliant walls of smooth muscle. Sometimes, I take the liberty of pushing back, and then we get into a thumb war...

I'm not saying I do have preggy brain, and I'm not saying I don't. But the fact remains that I put on two plastic cover up gowns while performing colonoscopies at work last week. They're these horrible plastic full length, long sleeve bibs, essentially, that we wear to avoid getting splashed by never mind what when we do procedures. Usually, you wear just the one. Last week, I was doing a procedure, and suddenly, I was so hot, I could feel sweat dripping down my back and between by boobs and into my eyes - and I kept saying, Jeez, it's so hot in here, isn't it? God, I'm just so hot! I was accompanied by 2 menopausal nurses, who agreed heartily, and 1 less than sensitive male attending, who said, dismissively, "You're just pregnant." Then, I finished the procedure, and ripped of the gown, like I normally do. Imagine my surprise when the long awaited breeze of fresh endoscopy suite air didn't hit my sweaty body. Instead, my tactile senses...

A few years ago, we made a family trip to Spain. Among other places, we visited this little town called Ronda down near the Mediterranean. This little village is nestled in the mountains, and in certain places, gorgeous views of vastness open up to you. Should be enough to take your breath away - hence, the phrase, "breathtaking views." I remember, though, standing at the edge of a mountain looking over a huge rocky valley, dissected by a sharp line between shadow and coolness on one side, and rays of sun on the other - I remember standing there and thinking, this should be taking my breath away. It really should, and I know it here (points to head) but not here (points to heart). What happened to my ability to feel that shaky feeling in the pit of the belly, that odd combination of joy, happiness, anticipation, and awe? I pondered for a while, and decided, that the acuity of such feelings fades and blunts with age. Remember, when you were a kid and you'd run tow...

Well, I'm back in the country of the proud Basques, and I even took some very touristical photos of green mountains and greener seascapes with my awesome camera, but that will have to be a different post. Currently, I'm contemplating the whole pregnancy ordeal. My conclusion: the whole thing is very odd. I've done a brief inventory of all the changes I have gone through so far, and this is what I have noted, in no particular order: a) my breasteses are of unsafe proportions and seem to have no inkling of stopping their ever-expansion. I fear for the safety of others; I think I am liable to turn around and give some kid a black eye. I have been eyeing burlap sacks, and wondering what they would feel like on my skin with an underwire. b) I pee a lot. c) Being hungry makes me nauseous. Eating makes me nauseous. As a sublist, here is a brief summary of things that make me nauseous: 1) the smell of EVOO and garlic 2) car rides 3) perfume 4) soap that's ...

My primary care doctor, whom I've been visiting for the past (scary number) of years, was somehow an important figure in me setting my mind on, making my way to, and then through, medical school. When he found out that I was applying, he slugged me on the shoulder and said, "Don't listen to anyone. Don't listen to those old doctors who say things aren't what they used to be. Listen to me. I'm a young doctor. Not a day goes by that I don't think how happy I am to be a doctor." When I got into medical school, he shook my hand, and said "Welcome to the club!" and immediately stopped charging me copay - still doesn't charge me, to this day. He has four children - one time, when I was worried about some finding, he called with results late on a Friday night, and said, "Listen, I have all these children, I never get to spend time with my wife, and we're about to go out to dinner - alone - but I couldn't go and enjoy meyself unl...

So, yes, I did have a positive test on my hands, but when I used the phrase, "Now that I'm pregnant," my husband stopped in his tracks, and gave me the "look" that said "don't get your hopes up." I did still have to wait nearly 48 hours for the blood test. That was just not going to happen. The next day, I phoned Fruitless and Fabulous, and fooled everybody by telling them that I wouldn't be around on the day my blood test was due, and I needed it drawn that day. Longest 3 hours of my life! HCG = 119. Magic number!

That was the approximate email my mom got on October 27th. But let me start from the beginning. We left off where I had an IUI, this time, with a very pleasant nurse practitioner - yes, yet another individual to get upclose and personal with my hooha. At that time, I was told I only have 1 follicle, and although my husband's sample was "the best sample ever," and my endometrial lining looked "juicy," I was not optimistic, and sort of breezed through the IUI with very little expectations. I then proceeded to spend the next week and a half searching for other area fertility clinics, because I said, I swear, once this cycle doesn't work, I'm done with Fruitless and Fabulous! I wasn't even going to use any peesticks, because what's the point of getting all worked up and disappointed, but on Monday, October 26th, what the hell. It was a long shitty day, and I was tired, and the stick was there. My plan was to do it covertly so as to save myself the...

I really hated my OB/Gyn rotation as a medical student. I thought, nothing good can come of so much estrogen in one place, both flowing from the patients and oozing from the doctors and nurses, all of whom are women except for a notable few. One of the notable few was the chief resident - what the hell was his name? - who was like a bossy important solitary rooster among many clucking hens. He was very handsome, and very aware of that. I really hated that rotation. I've always found the whole conception/birthing process extremely embarrassing and unjust - and still do, to some degree. I mean, women are at risk for so many things with childbearing, from stretch marks and weight gain to liver toxemia, heart failure and death, for example, and all just for fulfilling their biological purpose! Not to mention, starting at the moment that second pink line appears on the peestick in your hand, you cease to be yourself, becoming instead a factory, a physiological machine, a vessel wit...

The second Tamoxifen cycle is well under way, I believe I forgot to mention anything about it. This time, I had bothersome low grade nausea, mis-perceived as hunger, leading to constant grazing but not sensible eating. Not sure what, if anything, this is doing for my weight and waistline, not to mention my GERD. That's a minus. Primed by my previous experience, I was heavily armed with Benzoyl Peroxide, 10%, and Salicylic acid, 2%, so the chest, forehead and backne was not as much of a problem. That's a plus. So the ultrasound and labwork were on Friday. They switched techs on me. You wouldn't think it matters, but it does: they have different techniques of twisting the darn wand within my nethers. Incidentally, am I the only one who thinks that calling the ultrasound transducer probe "wand" unnecessarily and unfairly romanticizes an utterly unromantic instrument and process? Plus, this lady doesn't turn the monitor towards me, so I have to crane my...

"Occasionally, people get pregnant from intercourse," the doctor told me. What a strange statement, I mean, isn't intercourse a requirement for procreation? Usually, but not in the infertility world. In the infertility world, intercourse is just the frosting on instrumentation. This cycle, we practiced "timed intercourse," per the doctor. "Timed" doesn't mean we click a stop-watch when we start.... and then when we finish (I've been doing that for years, doctor's orders not necessary. I jest.). It means doing the old school ovulation calculation, and daily procreation copulation - on purpose - during that time all the way to freedom a week later. You see, I was taking the tamoxifen, but was in Amsterdam for the would-be IUI date, and we didn't want to "waste" the cycle. After the Clomid debacle, and the havoc it bestowed on my psyche and my uterine lining (it was non-existent), I was picturing a healthy juicy layer of e...

Looks like after 3 whole days of summer, we're back in November - but in September. Absolutely black skies are spewing forth bucketfuls of water, and all is sad and dreary. My long awaited "friend" finally arrived (read: I got my wretched period, 2 months too late). As tends to happen, it brought with it cramps, backache and epic moodswings. On the other hand, "Epic boobs" are back to normal. Thus, a new cycle begins. Tamoxifen is in the mail. If I get a PE or have a stroke, you'll know, because I'll stop posting. Otherwise, I'll chronicle every pimple, every gained pound and, recent moodswings notwithstanding, every future moodswing, as I expect to have many more.

I have been toying around with many creative ideas about what to write next. For example, I was going to discuss the diurnal nature of my moodiness, stealing Kaverin's idea of the Hourglass man - losing my shit slowly throughout the day such that by night I'm a downright mess, and overnight am forced to stand on my head to get back to normal. There were other ideas, just as interesting - to me, at least, but this blog is about me, so... But all I can think about right now are my boobs!! And this is not some sort of auto-erotic or exhibitionist effort. And if boobs make people uncomfortable, don't read further. This is all about biology. Inflated and heavy, like water-filled ballons ready to pop, they are exerting compressive force on my ribcage, causing restrictive physiology, which makes me short of breath walking up the stairs. Clocking in at two pounds each (I imagine. I mean, I tried to weigh them, but it's difficult), they're causing painful shoulder and ...

Well, the nurse calls back, and the gist of our conversation is: "We're just gonna call today day 1 of your cycle. And we're gonna start you on a big-gun drug (well, not to us cause we use it all the time, so we're actually not gonna tell you anything about it, like, the fact that it'll cause hotflashes, and it has thrombogenic properties and it can cause uterine cancer in a small percentage of women, or instructions on how to take it), and we'll call you in a perscription." WTF!! First of all, I'd think that when a patient is a physician as well, they'd extend a small courtesy of having the doctor talk to me, not a nurse, so that I can ask my questions and get a semi-intelligent answer instead of "Polly wanna cracker" playback from rounds! Secondly, since when, even for laypeople patients, is it ok to have a nurse call you up and tell you you're getting started on a new drug without so much as an explanation of the drug? I'm t...

Went to the ultrasound today, accompanied by hubby, which is a deviation from the norm. It was good to have him there so that I could throw punches and bitchy quips his way when results were less than satisfactory. It was, however, admittedly interesting , to say the least, to have him awake and present when the tech said, "Ok, let's have you insert this ..." Although, I think it brought us closer together, as these things tend to do. Have I ever told the story about how and why he decided he would have to marry me? Let's just say, the story has the words, "acetaminophen suppositories" in it. Well, anyway, inserting this ended up showing that I a) continue to have thin lining, although, it's "not that bad" according to the tech. b) I have a collapsing follicle, which means I did ovulate, but who knows when, last cycle, this cycle, we'll never know. c) there is also a huge corpus luteum cyst on the left ovary, sized 7 cm. Last time this ...