Wednesday, 31 August 2016

Recovery Planning: How To Have a Baby In Med School

I had a meeting with the faculty yesterday and finally officially confirmed the 'plan A' for my recovery from delivery as well as what will happen if X, Y, or Z situations occur.

Basically, the plan is that if all goes well, I'll have the week she's born totally off. I'll do as much of the work for that week ahead of time as I can, but I can't do my tutorial prep ahead of time since we have to set the objectives as a group, so the plan is that I'll still do my reading for that week and just send my notes to the group. So I won't be completely without school work, but a bit of tutorial prep isn't the end of the world and nursing (which is pretty much all I'll be doing that week) is really not the most mentally taxing of activities. I'd be sitting on my arse reading my computer anyway.

The next two weeks I'll be attending my mandatory sessions via Skype, and then I'll be back in the classroom for the last week of the foundation with my classmates. The week after that is the 'transition to clerkship' week and since I'll basically be nearly a month postpartum at that point, I expect to just attend with my classmates, just taking time as needed to pump.

If I end up needing a c-section, I'll just attend that last week via Skype too, unless I feel well enough to attend in person.

If things go completely badly and I end up completely incapable of even working from home - this does happen sometimes and I think it's entirely reasonable to address the "but what if you end up in the ICU" scenario - then the possibility of me doing the final bits of the MF at a later point (the way someone with an 'incomplete' would) or having to either extend my clerkship and graduate later in 2018 or take a full year off to recover, would have to be considered. The policy is that the faculty reserves the right to make me take a year off if they don't feel it is possible to accommodate my needs while still ensuring I've met educational goals, and I understand why.

We'll be in our psych unit during this time, so it's stuff that lends itself very well to self-directed learning at home. A lot easier to learn and practice the mental state exam than it would be to learn MSK exams when my ability to move around is limited because my whole body hurts.

The thing is, in the States it's incredibly common for women to take short maternity leaves, and while it's much less common here some people still do it. I have several friends in the States who took extremely short leaves, including one who pretty much didn't take leave at all. My pregnancy peer group (all women due in the same month) has a member who is a psych resident and she only gets 2 weeks of leave.

I think my plan is reasonable. The first few weeks are going to suck, I have no illusions about that whatsoever, but it's just a matter of persevering through a hard few weeks and things will get easier with time. This is the sort of thing that many, many women have done before me, and many, many women will do after me.

I'm glad the faculty is being very reasonable about this and is listening to me. We have a plan A, plus contingencies in place in the event things go off track since biology doesn't always like to play by the rules.

Overall, I think this is coming together nicely. Having a date in mind (which is a goal but not a guarantee since things depend on biological factors that are out of my control) makes things easier to plan around. It also alleviates my anxiety too, since a lot of my worry coming into this has to do with what happened during my last delivery, not just the scheduling bit of things. But anything that can help with anxiety during this period is appreciated.

Off to study MSK anatomy and clinical exams for this evening.

Friday, 26 August 2016

A Bit of Patient Perspective

I have several risk factors for GDM - gestational diabetes mellitus. I'm fat, I have a family history of T2DM, I have PCOS, and I use corticosteroids (I realize that the inhaled steroids I currently use are a very tiny dose relative to systemic, but there's still some evidence that risk of DM is increased, and I'm on a fairly high dose for inhaled.)

With my other two kids, I managed to avoid gestational diabetes, but this time, nope. I am literally at the threshold for one value to be considered high, and the other value was barely elevated, but it's enough to be considered diagnostic, so I now have sore fingers.

Considering I'm literally only one pound above my prepregnancy weight at nearly 30w, I think my OB believed me that I'm already being pretty cautious about my diet (I always am, but my body seems to be playing by the rules in some ways this time, which is a definite plus.) Still, I'm on 4 times daily monitoring for now.

I really hoped to dodge this bullet a third time, because I absolutely hate pricking my very sensitive fingers. The finger prick to check my haemoglobin is my least favourite part of donating blood (which I do whenever I can.) I don't even care that much about the large needle they use for the donation - it's the finger prick that bugs me. And now I get to do it four times a day for the foreseeable future.

That said, it's helpful to be doing it myself so that I really understand what it will be like for the patients I'll be asking to do this. While I don't disclose personal health information to patients, which is obviously expected (though I will say that my doctor telling me how hard it was for her to quit smoking was helpful to me when I was quitting,) I think just having experience with what it's like to deal with something like this will just help me get a little more perspective, and give me potential suggestions to draw on. If I tell a patient about an app or reminder system that I found useful while dealing with GDM myself, I don't have to explain that I am the patient who used it successfully.

Still, while the experience is helpful and all, I'd still rather not be dealing with it at all since it puts my daughter at increased risk of negative outcomes. The degree to which that is true is within my control for the most part, though, and so I'm trying to keep that in mind. Plus, small perk, I get another ultrasound.

In unrelated, but generally positive, news, I have a slightly less rough date to work with around delivery. It's obviously going to depend on how things look as the time approaches, and I very much understand that, but it was very nice to have the talk today and really initiate that conversation, particularly since I'm going to be talking to the faculty about accommodations around delivery next week.

Wednesday, 24 August 2016

More Level-Headed

I realize my last post was very 'poor me' whining, and it wasn't particularly professional. I was venting, and being rather emotional and dramatic, and re-reading it, it's cringeworthy. I've been rather self-pitying of late, and I'm making it a personal goal to smarten up after this.

I do want to make clear that I don't blame my school for the difficulty I'm running into. We do have services and people to help us navigate things. I do not want to give the impression that my school abandons us to the wilds, because they don't. We are given some resources to call on, but figuring it out for ourselves is a part of the learning process. We'll have to work through lots of less-than-optimal systems as practicing physicians and I need to be able to do that without losing my head or giving up.

I have unique circumstances, which are of my own doing, that add some additional frustration but that's on me. I'm trying to be as independent as possible about getting this stuff done because I prefer it that way. Having another child while in med school and not taking time off is my choice, it's not anyone else's problem to have to figure out.

That said, emailing doctors I've never met to ask them to do stuff for me (even if it is to supervise part of my learning, which is something many physicians assure us they enjoy doing) is very far outside of my comfort zone. I feel like I'm annoying them, and I don't want to be a pest. I've been assured repeatedly that this is not at all uncommon practice, but I've still been trying to accomplish things my own way with causing as little fuss as possible and I've gotten to the point where it's clear that what I'm doing is inefficient and isn't working.

I'm just frustrated with myself that I've wasted so much time, and I need to adjust my approach in a way that pushes my comfort boundaries a bit. Particularly so since my social anxiety has been cranked up a few notches thanks to pregnancy hormones so I'm pretty much always convinced that I annoy people simply by existing. But I knew going into medical school that I'd have to push my boundaries, and so I need to just stop whining and get on with what needs to be done.

Ultimately, it seems it's pretty common to get frustrated with booking electives at any school because we get conflicting information and a lot of it is just that there's no one universal way of doing things. It feels very much like medical school admissions; many ways to make it work, but lots of different advice that doesn't always match up, and no for sure way to know what's the best way to go about meeting your goals. There is no universal formula for X + Y + Z = Program-of-choice. If only.

Tuesday, 23 August 2016

How Not To Book Electives

It's now the end of August. I start clerkship in 13 weeks, with four weeks of electives. Then 8 weeks later I have another 6 weeks of electives.

I have precisely one elective confirmed for during that time, and it's one I'm really looking forward to, though not a specialty I intend to pursue.

This is not for lack of trying, but I am discovering that my approach has been completely and totally wrong.

While apparently my classmates have sent out a lot of emails and requests via our system in the hopes that something will stick, I've actually tried to take what I thought was a carefully considered approach. I haven't been making multiple requests for the same dates; I've been waiting to hear back from people/services before I consider the time available to request again.

I have wanted to make sure that I'm not being rude or wasting anyone's time, and I didn't want to go cancelling electives after confirming them because something 'better' came along, but really all it appears I've done is caused further problems for myself over by trying to be courteous.

Most of my class also starts with 4 weeks of elective time, so mostly everything in the city is full, it seems. I have not yet found anyone who will supervise a reading elective for me for the first week, either. I'm actually going to ask my OB on Friday if he knows anyone who does that (can't hurt to ask, right?)

That first four week block is really, really worrying me because it's so critical that I not get stuck doing something more physically demanding than I will be able to handle, and that's most of medicine. As I learned this summer, it's not always clear ahead of time which services those are, either. It doesn't help that many of the people I've been advised by have no idea what recovery from childbirth is like (they are trying to help and I'm grateful, but without fully knowing it's hard for them to advise me.)

I have an appointment with my OB on Friday and I plan to really push the issue of delivery planning so that I at least know how far postpartum I will be when that elective block starts. There's a huge difference between 5 weeks postpartum and 2 weeks. My biggest reason for wanting a scheduled delivery is medical (because of how my last delivery went) but the timeline issue just kind of makes it more urgent to figure out.

My plan to start out with a week of reading elective and then do something not physically demanding for a few weeks is not working out and I am starting to panic because pretty much everyone has their electives for this period set and I have nothing. I'd hoped to do research, so I asked around, and I emailed, and I never heard anything back.

I even thought of trying to get permission to do an elective over the two week winter break so that we could just all go back to the Island for two weeks and I could do a visiting elective there over the break. Unfortunately, the medical education coordinator is out right now so they aren't accepting any elective requests at the moment, and the elective options are mostly in services that will probably be mostly shut down during that holiday period even if I could apply.

I have so little elective time, particularly pre-CaRMS, and I want to actually use it for stuff that has some relevance to my career path, but it looks like that's not happening. In June I submitted an application for an elective in March. I was just told yesterday that I'll probably hear back in October. Of course if it's declined, I then have relatively little time to fill up that space, since everything seems to fill up at least 6 months in advance, and so I'll have to take whatever I can get for that time.

The 6 week block from Feb-Mar is shared with most other streams too, so lots of stuff locally is full. I really, REALLY don't want to end up having to travel during that period because M will still be very young and it's really highly unlikely that I can pump enough of a freezer stash of milk to keep her going for two weeks while I go somewhere on elective. The only other option involves just putting her on formula for a couple of weeks an pumping to maintain my supply while I'm away.

Having to leave my family for weeks when I have a very young infant at home is a crappy option, but I'm currently in the process of trying to book a visiting elective for February because I don't think any of the ones I have tried to book through my home school are going to work out.

The fact that it literally takes months to hear back from some specialties is really frustrating - and this is pretty clearly not an issue at just my school. It means you either need to try to book a 'back up' in case your specialty of interest doesn't work out, or you risk being declined and left having to take whatever you can get closer to the dates, which is what I'm trying to sort out right now. I do like pretty much everything, but I really want to use my limited elective time for stuff that's of greatest interest, and I also don't want to end up taking up spaces that could go to a student who is interested in actually pursuing a certain specialty.

Frankly, the electives booking process is my absolute least favourite part of medical school. There is no clear-cut guidance and there is a constant influx of conflicting information about what you actually should do. Policies and practices vary widely and it often isn't easy to find out the information you need.

Right now my priorities are in this order:
1. Book anything I can get for Nov-Dec block.
2. Hope I can then manage to book something that I'll actually physically be able to do. If not, take painkillers, hope I don't cause any lasting damage or do something embarrassing like pass out.
3. Try to book two more electives for the Feb-Mar block. Preferably 1 family, 1 OB/Gyn. Visiting if necessary.
4. As soon as registration opens for visiting electives for July and August, submit requests for east coast schools.

Sunday, 21 August 2016


My husband and I have been married for ten years today. 

We had a very quick courtship. We met in late 2005, started dating in January 2006, knew we wanted to get married by the end of April, and found out I was pregnant with our first child two weeks after we'd decided for sure to get married. I was 19. He was 25. Pretty much everyone thought we were idiots, and to this day many people still think we only got married because I was pregnant.

But really, we actually were just crazy about each other from the start and saw in one another just what we needed. We have exceedingly different personalities, but our differences are largely complementary - he shores up my weaknesses instead of making them into challenges, and vice versa - instead of being sources of conflict. Not that things are always or have always been perfect. But we've always been willing to learn together. Been willing to be wrong, or make changes. My husband has made me better than I thought I could be. I hope I have done the same for him. 

Ten years on, and I'm happier now than I can recall being. We've been through a lot and we're now settling into what I hope will be many years of stability and happiness, the sort of enjoyment of our prior sacrifices that we've never really had before.

I am exceptionally fortunate. Life happened faster than I thought it would, but it's worked out far grander than I ever thought it would. 

I can't help but wonder where the next ten years will take us, and what I'll be saying on August 21st, 2026 when I reflect back on spending more than half of my life with this man. All I know is that we've got grand possibilities ahead of us, and I look forward to the journey. 

Saturday, 20 August 2016

A Very Long Day

Today started at 4:45am. 

Had to get up, have a shower, get dressed, not wake up the family, pick up my classmate and then get on the road to London. 

Unfortunately the wrong part of London, since I made a very dumb mistake when navigating and took us to the wrong hospital first, so my classmate and I were late. I would totally blame baby brain for this, but no, it's totally something I'd do when not pregnant too. 

We did get there only fifteen minutes or so late, though.

It was definitely a nicely structured event. We'd have teaching on particular scans before going up to the skills lab to try them. Lots of instruction, lots of hands-on. I definitely did not retain my skills from the prior short POCUS course I did and so it was really good to have a refresher closer to when I start clerkship. 

Something different at this one was doing ultrasound-guided central and peripheral lines (on phantoms/sims) which was really fun. I feel like I learned some skills from the IR elective when it comes to seldinger technique which we used for a central line. I found I'm actually pretty comfortable doing ultrasound-guided needle procedures; they're really fun. We had a biopsy station during the team challenges component later in the day and I had a lot of fun playing with that. 

Overall it was actually a really fun day. It was nice to get to chat with students from other schools and hear about their programs. Everyone was really lovely.

Completely exhausted now, though! I sat down as much as I could (especially since I get dizzy if I stand for long, which is so annoying) but my energy reserves are pretty much non-existent now so I'm wiped anyway. It was very much worth it, though, and I'll sleep in tomorrow. 

Kudos to the Western POCUS group. It was a well-done event and quite enjoyable. :)

Friday, 19 August 2016

Elective Check

My post-MF4 electives are now done. Little bit of paperwork left to do, and then that's it.

I'm still trying to arrange my clerkship electives and I am getting quite nervous about not having any solidly booked at this point, but I know I will get things figured out. I always do.

This weekend, I'll probably write a longer, more reflective post about my electives this summer, but right now I am way, waaaay too tired. It's been a very long few weeks, and I very much need to rest. While I very much enjoyed the time away from tutorials and whatnot, I think right now that slower pace is exactly what I need as I finish out my pregnancy, and I'm eager to get back to some time in the classroom.

Incidentally, I'll be in the classroom tomorrow, more or less. I'm heading to an ultrasound course at another med school. A few of my classmates are going as well. I did do one short course, but this one covers exams that the other course didn't so I will get the opportunity to practice things I've already learned - which I've not had a chance to try since that course several months ago - as well as learn new useful things. I find doing ultrasounds to be very enjoyable and while my ability to interpret images is emerging, I still need lots of exposure to get the experience I need to develop any level of confidence. Plus, the point of the ultrasound course is to develop skills not just in image interpretation but also formation and knowing when ultrasound is appropriate.

I'm very much looking forward to it. Plus I get to meet students from another medical school, which I hope will be fun.

Provided I don't randomly cry. I've burst into tears for no reason at least 5 times this week (twice in front of my supervisor!) and it is intensely embarassing and very frustrating. Quite probably my least favourite part of pregnancy: crying about completely random things. Then I get frustrated because I'm crying and that makes it worse. My poor husband gets so very confused! This better not happen tomorrow.

Crap. Now I'm getting anxious thinking about the possibility of that happening and I'm going to cry over it.

This pregnancy cannot be over soon enough!

Wednesday, 17 August 2016

On Specializing and MD Motherhood

Last night, my husband and I were sitting on the couch, and I rattled off something random about pregnancy that I found interesting. He looked pensive for a moment and said "I really think you should just go into OB."

"But it's a five year residency," I replied. my usual response.

"Yeah, but you said you were probably going to do an extra year anyway, so it's really only two more years."

"It's a very intense five year residency. There's a lot of call. And then there's a lot of call for the rest of my career." These are the things I tell myself a lot.

"But it's obviously what you'll be happiest doing."

"Is it really right for me to put us all through that, though? Just for my career?"

We went back and forth about it for a while.

My husband knows me well. He knows that my interest in this area has been around for a very long time and isn't going anywhere. He's spent years listening to me go on about womens' health issues.

He knows I want to be an OB/Gyn and that while I do honestly think family is the more logical choice, I've spent so long trying to talk myself into it that it's hard to decide what is preference versus actual enjoyment. I truly do think that family physicians are exceptionally important. I do think it's a good career. I do think I'd be good at it and that family med has a lot going for it.

But while I've gone through periods where I've tried to talk myself out of my interest in OB/Gyn - I've even written posts trying to convince myself (others?) that I'm not interested in pursuing it - as a way to keep it off of my table of options, it still keeps cropping up. Over and over. It's the idea that won't go away.

So I need more information. I need to really understand the reality of it. I need to talk to people who do it to try to decide, once and for all, if I actually should shift my focus to OB/Gyn from rural family.

When it comes to seeking advice on deciding on my career path, though, people always seem to automatically assume that my career will always take a back seat to my kids. Not that my kids aren't important - obviously they are - but the default assumption is that mom is primary caregiver and that my being here less will be inherently harmful to my kids. People say things like "well, you wouldn't want to be on call all the time with kids at home." "Think of all the things you'll miss." "Would your kids really be okay with you being a resident for five years? They'll never see you!"

Do people say this stuff to dads in medical school? Or men planning to become dads? I somehow doubt it. Men are expected to grab their careers by the horns and make whatever sacrifices are necessary. Women are expected to put their careers on hold for the family. The expectation is so rampant that the mere existence of the so-called 'mommy track' can actually limit womens' options when employers make those same sorts of assumptions about us, even about women who don't want to have children, or for whom career sacrifices aren't a necessary part of being a mom.

I've never been terribly fond of traditional gender roles. Once Miss M is here this fall, my husband is staying home. And he'll do that as long as is practical and he desires to do it. We've always intended for him to be a stay at home parent once it became feasible; he's far better suited to it than I am, and that's what'll work for us. I feel absolutely no guilt about my husband being the primary caregiver for our kids, and I find it frustrating that so many people seem to think I should.

I really need to have a sit down talk with some OBs, and really decide if my interest in the field is enough to make the very challenging five years of that residency (and the challenges of a career in OB/Gyn) worth it.

Because maybe, just maybe, I might shift my focus instead of just 'keeping the door open.'

This is just getting ridiculous

I was off yesterday as my supervisor was also. We'd kept the kids home since my son had been extremely sick on the way home Monday and my daughter had shared a drink with him; there's a 24h exclusion rule for vomiting, so my son wasn't allowed back anyway but keeping my daughter home was just a precaution.

I thought I was doing okay, but by yesterday evening felt a bit peaky. Wasn't sure if it was just pregnancy-related ickiness or not since that's pretty common for me and I can just suck it up and get through. Went in this morning - bright and early at 7:30am to print stuff out for the day and organize whatever I can.

Was very nearly sick on the desk while I was putting together the papers for the day. I'm now at home because I didn't want to expose any patients to this.

This is really frustrating because I wanted to actually be there, to be working, to be learning. I didn't go to medical school to be lazy. But I'm in a near panic because I'm worried that I've left the supervisor with the impression that I'm just trying to get out of work. I'm really not. I like working! It should be pretty apparent to anyone who knows me that I am not afraid of hard work.

But the last week and a half is just a series of unfortunate events and am getting incredibly frustrated!

I have missed out on the opportunity to see a lot of things that will help me in my later practice. I'm doing the online modules and looking at the other resources that were recommended but it's just not the same. I need to be hands-on to best learn this. That was the whole point.

So right now I'm so damn frustrated because I was finally going to have a good stretch of time and be able to see and learn quite a few things, but I'm home sick instead. I feel like I'm wasting my supervisor's time and I hate that. I'm very worried what the missed time will mean for me when it comes to school.

But more than anything, right now I just want to not be sick so I can get back to what I need to be doing.

Friday, 12 August 2016

Family Calendar - On Practical Matters

After the failure of a number of attempts at electronic calendar-keeping, I went and bought a huge, magnetic calendar for the family and stuck it to the fridge. I went through the school year calendar for the kids, and then went through my schedule when it came out, as well as my clerkship stream schedule, and put everything on. 

PD Days, doctors' appointments, reminders to book checkups, school holidays, CAEs, my tutorials and clinical skills, they're all on there. It's a 16 month calendar so I went and put what rotations I'll be on through December 2017. When I get the location information for each rotation, I'll put it in the calendar so my husband can always know at a glance where I am. 

It was a bit sobering to go through that all. The calendar on my fridge right now starts next month and goes until three months before the end of clerkship. 

I only have 21 months of medical school left. Precisely speaking, I have 20 months and 29 days until the last day of my program. That is terrifying. Twenty one months is a very short period of time! 

Putting the majority of the remainder of my medical education down on paper felt odd. Instead of looking only at the long, exhausting journey ahead, I was filling in the particulars of the home stretch. When I tick off the last box on that calendar, I'll be a handful of weeks away from CaRMS interviews. Will I be interviewing for family, or OB/Gyn, or something else entirely?

There is so much I don't know about the coming months. I don't know how things will go when miss M is born, I don't know how my husband will handle being home (it can be harder than you might think!) I don't know how well I'm going to handle the transition period when the baby is born and I still need to attend to my school duties. I don't know what specialty (ies?) I will apply to. 

I do know that because I was so distracted in June, I didn't do that well on my OSCE (I am in the green zone, but below average and I am not satisfied with that because I am very strong in clinical skills generally so it does not represent my abilities.) I do know that I am going to have a very challenging transition to clerkship, and looking at my schedule for the fall makes that alarmingly clear. There is so much mandatory stuff going on right around the period when the baby is going to be born that it is going to be extraordinarily challenging to keep up. 

But what I can do to help with the challenges ahead is ensure we are as organized as possible. Ensure that family stuff moves smoothly, that my husband has the tools he needs to keep the gears going at home while I pour every bit of energy I am able to into school. And it's a fairly simple thing, but a big, old-fashioned family calendar on the fridge might be just the tool we need to solve some time-consuming and frustrating issues we've run into in the last year. 

I hope so anyway. 

Wednesday, 10 August 2016

Guess I Just Have to Go Be Productive

I had a pity party for myself, wrote some terribly whiny posts, but then decided to suck it up and get done what I can get done, even if it's not what I wanted to be doing.

I'm having some challenges relating to being pregnant at the moment and these are making it somewhat frustrating to do anything that requires moving around. So since I ended up basically lying in bed most of the day, I read. I have been reading the additional resources modules that I'm required to read for this elective, and I also spent some time applying for my clerkship electives which is something I have left way too long. This is partly because I've been partly waiting to talk to my OB about delivery since that's going to modify what electives I apply to for the Nov-Dec block.

I'll be almost 29w at my next appointment so it's definitely time to start talking about the end game, I think, With my history, I absolutely want to avoid a spontaneous labour because last time I went so fast I couldn't get pain relief and ended up experiencing a complication that had to be managed quickly and in such a way that I literally still have nightmares about it and wake up shaking five and a half years later. I want to ensure that I have access to a prompt epidural if things go quickly (or badly) again and so for that reason I want to ensure that I'm already in the hospital at the onset of active labour. History of rapid labour is fortunately considered an acceptable indication for induction according to the practice guidelines so I've got that going for me.

I will be 37w on October 17th. If I deliver at 37-38+0 (my second was born spontaneously at 37w so this is not an unlikely range) and then do a reading elective for my first elective week, I'll be 5-6 weeks postpartum by the time the rest of my elective period rolls around. I think it'd be pretty reasonable at that point to do a fairly normal elective, considering that it's not at all uncommon for people to return to even fairly physically intense jobs at that point. In the States, anyway. Less common here, but not unheard of.

The thing is that I need to get my doctor's feelings on all of this which is why I'm going to make a point of bringing it up at my next appointment. If I know I'll have 5-6weeks to recover, I'll probably try to book different electives than I will if it's left up to chance/biology, in which case I might end up with only a couple weeks to recover, which is a completely different set of circumstances.

Anyway, I did get some stuff done today anyway, even though I wasn't doing what I'd expected I would. It was productive time, at least. And I'm still learning what I should be learning, since I'm working on these modules, so there's that.

Time for bed, though. Going to be up early to keep reading.

Saturday, 6 August 2016

The screaming sounds of summer

My daughter has decided that our next door neighbour's four year old is her absolute best friend ever. They spend a ton of time together mostly outside particularly now that it's warm, (awfully so half the time... Ontario summers suck) being little kids. They run back and forth from our house to hers and whichever parent is nearest feeds them at mealtimes. It's how summer should be and I'm glad our neighbours are as laid back as we are and let their kids just play. 

While it took a while, my son has finally realized there are a couple older boys now living there too - the house is split into a couple of apartments - and so he's joining in. The boys speak very little English, just a few words, but the language of play is universal and he seems to finally be discovering that. It's the first time my son has really just stopped talking about video games and gone off to run around screaming with other kids. The tendency to cling to a preferred subject and talk about it endlessly without regard to others' lack of interest is an autism-related thing, and so it's really interesting that in a situation now where his go-to socialization method - talking about video games - isn't an option, he's chosen to just follow the other kids' leads and engage in physical play at a level he usually wouldn't. 

It is nice that we've finally started building these sorts of relationships here. Our neighbours are really nice. We'll stand around talking for a while as the kids play. They borrow our lawnmower, we share food, I'll keep an eye on the kids while one of them runs errands. The kids all play freely and openly and loudly outside the way children should, and there's always an adult with an eye out, but not hovering. 

Their daughter doesn't even knock when she comes over. She just pops in, calls for my daughter, and the two go off to play. I did have to send her home today because my daughter had work to do before she was allowed to play, but it actually got done fairly quickly since C really wanted to go play with her friend afterwards. 

Also, I've been so exhausted the last couple of weeks that being able to kick the kids out and knowing they are entertaining themselves has been incredibly helpful. 

Interventional was a blast. I learned a ton of stuff I'll be able to transfer to other fields as I progress through my training, learned that I do enjoy procedural stuff more than I thought I would, and I met lots of fantastic people who were so warm and welcoming to a student. It was a really amazing experience. But holy cow was it ever exhausting!

So the fact that my kids are completely wiped, and that required no input from me, is the best part of this weekend.

Next week, on to dermatology!

But first I have to do my eval and finish my reflection on my last elective. 

Wednesday, 3 August 2016

Holy crap it's August.

I only have two days left on radiology, then two weeks in derm, then that's it for post-MF4s. I've learned a LOT while I've been here. Like my last supervisor, this one gives me homework which I enjoy, sometimes only peripherally related to cases we do but it's all stuff that will translate well across specialties. He's been really incredible about ensuring that I get hands on access to patients. I've really been enjoying this elective. Like I thought, I'm getting a lot out of it that will come in handy. 

I now have my full schedule for MF5 and I'm getting a bit worried. There's a lot scheduled in the last couple weeks of October and start of November and that's when I'll be delivering.  I have a meeting with the MF5 director to discuss things so I'm sure we'll sort that all out. I am seeing my OB one more time before that meeting so I plan to discuss it with him. No sense worrying about it now, although I totally will anyway. 

I'm planning to spend some time in diagnostic radiology before I finish up on Friday since I'd really like to ensure I spend some time doing that before I go. Conveniently, one of my MF3 clinical skills preceptors is a radiology PGY2 at the site I'm at so I'm going to bug her for a bit. She is extremely knowledgeable and I'm looking forward to spending some time learning her favourite subject from her. 

At the moment, though, I'm getting a pedicure, a very rare treat. My feet are killing me since I'm running around a lot (interventional has more of that than diagnostic...) and I can't consistently reach my feet for long periods anymore, at least while being able to breathe, so the massage and soak is totally necessary.  I'm calling it antenatal foot care...