So, when Cameron contacted me and asked if he could blog about his experiences as a caregiver for his wife who has mesothelioma I was ecstatic. The chance for my readers to hear a story about how medicine doesn’t stop at the door to their clinic – invaluable.

Let me introduce you, this is Cameron, his gorgeous Mesothelioma-butt-kicking wife Heather, and their adorable daughter, Lily.

And here’s what he had to say about how becoming a caregiver for his wife in her fight with Mesothelioma gave him a new perspective and mission in life:

My wife, Heather, knows that I went through a great deal after she received her diagnosis of mesothelioma. Although I briefly told her about my experience, this information will show her, and anyone else currently struggling through a similar difficult situation, more about my emotions as I cared for her.

We were blessed with the birth of our daughter Lily three months before the devastating diagnosis. Instead of being able to celebrate such a joyful event, we were instead plunged into misgiving and trouble when the doctors gave their diagnosis. From that first moment, I had trouble imagining how our family would be able to get through this time.

While I mostly wanted to take time to process my emotions, the doctors required Heather and me to begin making important decisions regarding her healthcare and treatment. This was a small portion of what I could expect over the coming months, as I would continually be needed to make more choices that were demanding.

When I was able to process my emotions, I found myself full of vexation, frustration and uncertainty. I displayed these emotions outwardly in much profanity. I was only able to curb this when I remembered that my wife and daughter needed me to be their steady support. While I certainly failed at times, I always tried to be positive for my family.

Another part of the process for me was learning how to deal with such a large number of tasks. Besides work, I also had to care for my family and pets and coordinate traveling schedules. This caused me a great deal of stress in the beginning, but I soon found that tackling one important task at a time was vital. In addition, I readily accepted the help of family and friends who graciously came to our aid during this time when I do not believe that I could have made it by myself.

The hardest time was the two months when Heather and Lily were staying in South Dakota with Heather’s parents. Heather took this time to rest after her surgery and to prepare for further mesothelioma treatments. However, I was only able to see my family once during this period.

The weekend that I visited was a snowy one. In fact, I had to wait out part of the 11-hour drive in my car as I waited for the snowplows to clear the roads. Once I arrived in South Dakota, I had a little over one day with my family before I had to return to work.

I readily admit that while the decision to be apart was hard, it was completely necessary for all of us. I needed to work while Heather needed to rest. I see this, as well as all the other exacting choices that we made, without any dissatisfaction because they were vital to Heather’s health. Through all of our struggles, Heather is still here and still healthy over six years later. I hope that our story can be a source of hope and help to those currently battling cancer, as well as those battling alongside them.

I don’t usually do sponsored posts, but very occasionally someone contacts me with a request I feel like will benefit my readers, includes some cool perk for me, and fits well with the themes around here (on that note, BabyGap…I’m not even kidding…my twins. your clothes. this blog. make it happen). 

Uniformed Scrubs asked if I wanted to review one of the Dickies Spring Line scrub tops and sent me a top in their “Right On The Dot” print to try out.

• Shipping: They are really quick with their shipping and everything. I’m so behind in posting, so this is delayed significantly (sorry, scrub peeps – two four month olds, med school, buying a house, selling a house, moving…nothing too time consuming), but they got that shirt to me in like 3 days. Awesome.
• Fit: A little bigger than expected based on the size charts, but still fits well. It’s cut nicely, I wish our hospital-issued scrubs would take a lesson from the people over at Dickies so I wouldn’t feel like a big blue water balloon every time I went in the OR.
  • On that note, I’m not a fan of the squared neck line, I’d prefer a rounded or v-neck to this.
• Quality: Great! This top is way nicer than the cheapo tops I used to buy when I was working at the allergy office.
  • But, I’d prefer something a bit softer and more breathable. It’s not the most comfortable or cool thing I’ve ever worn. It might be more comfy after a couple runs through the wash, though. It just feels a bit stiff.
• Design: The fit is flattering, which is nice and the pockets are in a useful location for pens and stuff. The material is very pretty – a nice, bold print with colors that are quite vibrant.
  • However, I don’t think med students or doctors would typically wear the top they sent me. There are tons of options on the site, though and I’m sure the solid color tops are just as vibrant and pretty. My nurse & tech friends would be adorable in this, though.
• Bottom Line: I doubt I’ll be wearing printed or fitted scrub tops for a while, since almost all hospitals issue physician scrubs, but if I were still working as a tech I would 100% wear these scrubs!! They are relatively comfortable and very well-made. Uniformed Scrubs appears to have very competitive prices for these scrubs and they’ve sent over a 15% off coupon code (15pbrm) for y’all. So, if you’re in need of scrubs, take a gander.

* Clearly I was given a compensation for this review. These are still my own thoughts and opinions, nobody black-mailed me into saying happy things.

(P.S. Mind On Medicine could be abbreviated to M.O.M. Can we all take a moment to relish how ridiculously fitting that is?)

I knew when I was pregnant that I wanted to give breastfeeding a good ole college try. I would give it a go, see how it went, and hope for the best. When I found out we were having twins I became even more okay with supplementing formula or completely formula feeding if nursing didn’t work out. My number one goal was happy babies and happy mommy, however that happened was fine. However, I did know I wanted to give it my best shot, since breastfeeding is the best thing for babies and has some awesome benefits for mom as well (lower rates of some cancers, weight management, lower risk of post-partum depression, etc.).

Somewhat out of character for me, I didn’t read a bunch of books or investigate a bunch of websites. I read up a little and went to Twitter for tips and tricks and hoped the lactation consultants (LC) in the hospital could guide me through the early days. What I didn’t expect was to be sick before and after delivery, to be recovering from a major abdominal surgery, or to have two slightly premature babies with immature lungs in the NICU on respiratory support. But, we rolled with the punches and moved forward.

After my c-section I was started on Magnesium for pre-eclampsia (my blood pressure was really high – 180/110 when they put me in the hospital – and I was losing protein in my urine) and had to stay in bed for monitoring, so I wasn’t allowed to go to the NICU and see my babies until they were over 12 hours old. All the Twitter peeps had told me to put the babies to the breast early and often so I could establish good feeding habits, but clearly that wasn’t an option for us. So, now what?

When the (amazing) L&D nurses finally wheeled me to the NICU the (equally amazing) neonatology team was rounding and asked if it was okay if we started feeding the babies. I can’t remember hardly anything about the first 24 hours after my surgery, Magnesium does weird things to your brain, but I do remember asking if we had any options other than formula. They told me we could use donor breast milk (um, freakin’ awesome that moms choose to donate their extra…THANK YOU) and we all agreed that our number one goal was getting some weight on these babies so I could take them home, so donor milk  it was.

At some point in that first day a LC came by and hooked me up to a breast pump. Holy weirdness, people. Those things are strange. She explained it to me and told me not to expect more than a few mL in the first days, especially with the babies away from me in NICU. She wanted me to pump every 2.5 hours around the clock for 20-30 minutes at a time in order to establish a good supply. Welcome to mommy-hood!

So, I diligently followed orders with the overwhelming love, support, and encouragement of my husband. I’m so thankful he was so helpful when I was sore, exhausted, and sad in those first few days.

They mixed what I pumped with the girls’ bottles of donated milk and 6 days later we were leaving the NICU…with no decent amount of milk in sight from me. I was sure I had a milk-dud situation on my hands.

The NICU gave us feeding guidelines and loaded us up with bottles of Neosure, so that when we got home they’d have something to eat.

Almost instantly as we got home my milk came in. Something about having the girls with me kicked my production into high gear and I was able to start pumping enough for them.

It was a rough road and I won’t discuss it all here, because it would be the longest post ever, but it involved  a month of exclusive pumping, a slow transition to nursing with a shield, a long process of weaning off shields, and finally mastering exclusive nursing in time for me to put away the pump a couple weeks before going back to work.

I’m now back at the hospital with 180+oz of milk in my freezer (oh, did I mention the massive oversupply once my milk finally came in?), pumping enough for them to eat while I’m away, and incredibly proud of my decision to breastfeed despite our obstacles.

Another thing I’ve gotten out of all of this – a very clear understanding of why exactly people choose not to nurse their babies. It’s freaking hard, people.

If you’re pregnant or have a new baby and have questions, shoot me an email. I’ve picked up some tips and tricks along the way and I feel like since I’ve made about 60 gallons of milk (yes, seriously) in the past 18 weeks I am somewhat of an emerging moo-cow extraordinaire.

This is a clerkship I was extremely excited about, because it was a field I was seriously considering going into! In fact, up until my third year Ob/Gyn rotation I was almost positive I would be a pediatrician some day. The clerkship was a lot of fun and definitely made my decision difficult, but as you already know Ob/Gyn ended up winning my heart…but not because Pedi let me down.

Pediatrics

This specialty is focused on children, there’s a lot of “normal” in pediatrics and you tend to get to know your patients and their families very well. The residency to become a general pediatrician is 3 years and you can specialize in any number of things, from neonatology to oncology, after you finish.

The Clerkship

• 8 Weeks: One week is spent in specialty clinics, one week with neonatologists in the NICU, two are dedicated to inpatient pediatrics and the rest are spent in general pediatric clinic.
• We had frequent morning lectures and case presentations by the residents to help prepare us for the NBME exam. These were *key* in doing well on this exam for me.
• One overnight call while on the week of Neonatology.

Daily Life

• Clinic Weeks: Basically 8am – 5pm.
• Inpatient: Usually pre-round about 6am, round about 7am and spend the day admitting patients and making sure all is well with admitted patients. Checkout around 5:30pm.
• Neonatology: Pre-round about 6:30am, round about 7:30am, and spend the day attending deliveries, taking care of procedures (lumbar punctures, circumcisions, etc.), and checking up on lab work/radiology for patients

Pediatrics Clerkship Books

• At our school we have a wonderful physician who provided excellent clerkship notes that were key in doing well on the exam. I wish everyone had those notes.
• Case Files Pediatrics: Easily the best-written book you can buy for preparing for the shelf exam. If you know this book well, you will score high on the shelf.
• Blueprints Pediatrics: This book is decent if you need a text-book style, rather than case-style, book to read. I had it as a free hand-me-down and referenced occasionally, but I don’t know that I would have been very happy with it as a purchase if I had to pay for it. It was just ok.
• First Aid for the Pediatrics Clerkship: Again I had this book as a hand-me-down and it was just okay. However, had I not had the notes from our clerkship coordinator, this & Blueprints may have been a tad more useful to me. I think we are spoiled on this rotation with great teaching.
• The Shelf: This shelf exam is very age-oriented (whoda thunk it?). What I mean by that is knowing key things like what heart defect causes a “blue baby” immediately after birth and what heart defect causes a “blue baby” months after birth is what will help you do well on this shelf. A lot of the diseases have similar symptoms, but appear at different ages and this is key. Also, knowing basic milestones and developmental timelines will gain you easy points. I felt like it was heavy in infectious disease, cardiology, and respiratory.

What I Like

• The Patients…well, most of them: I love kids and I loved that on this rotation I got work with kids all the time! They are so resilient and seeing them overcome things is really amazing.
• Pediatricians: In general, this is a very upbeat, happy field. People tend to have great job satisfaction and be overall happy with their life as a pediatrician and it definitely shows in working with them. I loved the positive morale and environment.
• Family-Friendliness: Pediatrics tends to be one of the areas of medicine that is relatively family friendly. Most of the residents have children and if they don’t already have them most want them some day.
• The Hours: Compared to surgical specialties, the time-commitment of this specialty is a little bit better. Because pediatrics is heavily clinical, it offers a more consistent routine. Although, there are definitely rotations in pediatrics that are more intense.

What I Didn’t Like

• The Patients…a few of them: I loved working with babies and toddlers and little kids, but the ins and outs of adolescent medicine made me feel like I was not cut out to be a pediatrician. I simply am not hard-wired to effectively discuss tobacco and alcohol use with a 13 year old. 
• So. Much. Clinic: I like clinic in small doses, but Pediatrics involves so much clinic and very few procedures, no surgeries, and  a lot of chit-chat. 
• Well-Child Checks: To be a good pediatrician I believe you truly have to be interested in normal development of children and, unless it’s the normal development of *my* children, it honestlyjust doesn’t fascinate me.
• Lack Of Intellectual Interest: The subject important to pediatrics just don’t fascinate me like some other areas of medicine do.
  

Overall, I did really enjoy this clerkship. I loved most of the patients, the parents didn’t bother me, and the work was okay. Nothing about pediatrics really fascinated me the way reproduction and women’s health does and nothing caught my attention and heart the way reproductive endocrinology has, but pediatrics is a great field. The hours were tempting, the morale was attractive, and the people were great…but in the end it just wasn’t me. 

My Take On The Other Core Clerkships

Image Credit: imagerymajestic | FreeDigitalPhotos.net

As A Twin Mom, Always Be Prepared To Answer The Following Questions:

• Are they twins?
  No, they’re triplets…oh my gosh, have you seen their brother?!
• Are they identical?
  No.
• They look the same. Are you sure they aren’t identical?
  Yes.
• How do you know they aren’t identical?
  They have different blood types. And hair colors. And eye colors.
• Are they “natural?”
  No, actually we made them from MSG and Red Dye #40 in our garage.
• You had a c-section, right?
  Yes, because they tried their hardest to come out feet first…not because they are twins.
• Are you getting any sleep?
  They’ve slept 10 hrs straight every night since the day we brought them home. Why? Do you think I look tired?
• Are they your first?
  And second.
• Will you have any more?
  I’m due in 8 months!
• How do you tell them apart?
  I can’t really, each morning I just pick one to be Amelia and one to be Reese…surely it will balance out eventually.
• Do twins run in your family? 
  They can’t even walk yet…but they’ll probably run some day.

In all honesty I don’t mind the questions – I’m so proud of these two that it makes me really happy other people are interested in them! Sometimes it does get old being able to predict every conversation I’ll have while I’m waiting in line at Baby Gap, but I’m so grateful to have healthy babies I could answer these simple questions all day long.

Speaking of Baby Gap, though – that place is the holy grail of adorable baby clothes. I wish I could get them to sponsor this blog – surely one of you has the connections to make that happen. MAKE THAT HAPPEN!

Any other twin moms out there get asked the same questions over and over? 

I remember when I was considering applying to medical school being terrified that becoming a doctor meant I’d never be able to have a family. Every Google search led to horror stories about divorce, blogs berating physicians that chose to have children, and forums full of miserable doctors. I almost chose a different career path purely out of fear.

As I’ve mentioned before I strive to make this blog a balance of medicine and other things – particularly family. I want my blog to serve as a place for pre-meds and medical students with these worries to find a positive story.

I love blogging about medical training and education, but the goal of Mind On Medicine has always been to create a place to write what we might sit down and talk about over a cup of coffee…and I can guarantee right now there would be lots of talk about mothering multiples, being a working mom, breastfeeding twins, returning to work, sleeping in 2 hour chunks, etc.

So, in order to continue in my endeavor to have work-life balance on this blog, I’m going to be starting what we will oh-so-creatively refer to as “Twin Tuesday.” On Tuesdays I’ll share anecdotes about adorable babies (obviously), but I also hope to delve into some of the challenges and excitements of being a mother in medicine.

I hope if you stumbled on this blog and you’re worried about medicine and family life and marriage that you will stick around! It’s not easy, but it is possible…it’s an adventure that I’m so glad I have chosen to embark on. And, while I still have a ways to go, knowing what I know now I’d still choose to do it this way!

Also, if you’re considering throwing your dreams of medicine out the window because you think you have to choose one or the other, I hope you’ll email me first so we can chat. I’ve been in your shoes!

First off – I’m back from blogging maternity leave – celebration dances may commence! Oh, you thought you got rid of me because I birthed two babies at one time? Oh no, friends, it won’t be nearly that easy to get rid of me.

Now, for our regularly scheduled post of insightful information.

If I had a dollar for every time someone has asked me “hey you did all those interviews (while ridiculously huge and pregnant), did you get a job yet?” I’d probably have 14 pesos by now. Nobody outside of medicine understands how this works…and quite honestly, I can’t imagine why they would want to…but I’m going to try to break it down into simple bullets as well as I can. This is an extremely basic overview.

Applying To Residency – The Basics

• Medical school is four years long.
• Sometime during the third year most people choose a specialty. I chose Ob/Gyn.
• In the Fall semester of your fourth year residency applications are due.
• Some specialties have different application processes, this blog discusses the most common.

Interviewing For Residency Positions

• After applications are in programs offer interviews.
• Interview season is generally from September – January of fourth year.
• People do an average of 10 interviews, depending on competitiveness.

Applicants Make A “Rank List”

• After all interviews are completed we rank each place we interviewed based on how badly we would like to go there. I interviewed 10 places and ranked 7 – you’re allowed to leave any places you don’t think you’d want to go off your list and this guarantees you won’t end up there.
•  Rank lists this year were due February 20, 2013. (yesterday! eek!!)

Programs Make A “Rank List”

• Programs rank applicants who interviewed according to how badly they want them to join their program. Like applicants, programs are allowed to choose not to rank a certain person if they really don’t think they’re a good fit for the program.

Match Day – March 15, 2013

• MATCH DAY! Friday you gather with your classmates for a big, fancy ceremony and celebration. At our school we have an exciting morning filled with friends and food. Everyone gets an envelope with their name on the outside and destiny on the inside. At 11am we all open them together to find out where we will be spending the next 3-7 years. Obviously, everyone hopes for their #1 choice, but most people are happy with any of their top 3 or 4.

 
So, no I haven’t technically gotten a job from all those interviews I did…yet! I will find out on Monday, March 11 IF I got a job and Friday, March 15 WHERE I got a job.

There, clear as mud…now how should I spend all these pesos?

One month ago today I was 35 weeks pregnant and headed to the hospital for a non-stress test and ultrasound to check on “Baby A” due to concerns about restricted growth. At my appointment I was swollen like a balloon and had a blood pressure of 180/110 and “3+ protein” in my urine (in other words, I would have made a super easy USMLE question on classic presentation of early/mild pre-eclampsia).  I was sent straight to Labor & Delivery – no time to even go home and pack a bag (which my husband may or may not have so kindly asked me to do the weekend before this day)! My abdomen was somewhere along the lines of ginormous when I snapped my last “belly picture”…

We got all ready to welcome The Elves, who would arrive late in the evening of December 3, 2012 by c-section because Baby A was trying her hardest to enter into this world feet first.

If you follow the blog you know we had opted out of knowing the babies’ sexes before the birth, so the delivery was all sorts of exciting!

SURPRISE! It’s a girl!

Baby A – Amelia 

DOUBLE SURPRISE! It’s another girl!!

Baby B – Reese

They were 5 weeks early and having some trouble breathing, so they headed off to NICU after kisses and hugs from their dad and I. The next time I saw them, 12 hours after they were born (because I was busy enjoying the lovely side effects of magnesium sulfate – every horrible thing your patients say about that drug is true), they were hooked up to all kinds of wires and breathing with CPAP assistance.

They were rockstars, though and did awesome in NICU! After a few days they were able to reunited for the first time since birth.

And just 5 days later we were able to go home as a family of four (+ 3 crazy canines!). The girls each weighed about 4.5 lbs when we left the hospital – if putting a four and a half pound baby in a carseat isn’t terrifying, I don’t know what is!

Happy one month birthday, Amelia & Reese – you bring an unexplainable joy to our life.

Anyhow, I really have been traveling around Central Texas the past week for residency interviews and along the way the most commonly asked question has been:

“Why exactly do you blog?”

Most often the question has been posed with genuine interest and good intentions, but it has been occasionally paired with a single raised eyebrow and skeptical tone. Both reactions I understand and both are great reasons for me to address the question here. Would it be appropriate to refer someone to a URL mid-interview?

No? Oops…maybe I really have been in the blogosphere too long.

So, here are the 6 best reasons I can come up with on this half-cup of coffee I’ve had:

#1: I enjoy it.

I initially started writing in this blog 2 years ago (holy wow, have I really been typing random rants and information for two full years? You people are so tolerant.) because I felt like medical school had sucked the creativity out of me. I can’t paint or draw (except those awesome stick figures cursed with Streptococcus agalactiae and Pseudomonas), so naturally blogging was my only option.

#2: Before medical school I worried…about work-life balance, about studying, about family.

I feel like I have a perspective to share that would’ve given me hope as a pre-med. I wanted to write about whatever we might sit down and talk about over coffee. I wanted to show that a work-life balance was not impossible for a woman in medicine and I wanted to share my experiences. Everyone doesn’t go to medical school, but a lot of people seem to be genuinely interested in our experiences here, particularly those considering a career in medicine. This feeling to share the possibility of balance in medicine became even more urgent after seeing that everyone was not promoting the fact that it is possible.

#3: Our patients are online…and they have so much to teach us.

I feel like I’ve now written ad nauseam about the utility of hearing people’s stories…feel free to hop on over to “Following Patients On Twitter…” or “What Medical School Doesn’t Teach Us” for my take on learning from patients online.

#4: Our pateints are online…and they have a right to reliable information.

We have this unique opportunity to share information on things we are passionate about and know to be evidenced-based, like flu shots and how they’re safe in pregnancy or the fact that endometriosis is related to infertility. Though I don’t blog in this manner too often at this point in my career, I do plan to share more health information in the future (you know…when I’m really a doctor and stuff).

The bottom line is our patients are going online to find their health information and, in my eyes (and the eyes of some awesome health bloggers like SeattleMamaDoc) that means we have a responsibility to be online with them.

#5: It’s a fun challenge.

Make no mistake, friends – maintaining a blog is no easy feat. It’s a fun and interesting endeavor, but it does take some time and patience. I’ve enjoyed seeing Mind On Med evolve into what it is today and I’m excited to see where it’s headed in the future. I love the challenge of putting my thoughts into words and of designing and orchestrating the back end of the blog. It’s exciting to see what posts get a lot of chatter on the Twitters (usually not the posts I expect) and it’s fun to hear others opinions on what I have to say.

#6: I get to learn from people I never would’ve met if I wasn’t online.

I’ve interacted with people from more countries than I can count, specifically through the Medical Education Monday series. People from all over the world have taught me what it’s like to train to be a physician in their country and I’ve had the opportunity to share it with y’all. I’ve also had the chance to meet (or “meet”) medical students, doctors, and other providers from around the US and learn about how medicine is practiced in different parts of our country. These are not conversations I would have had without my involvement in social media and I think there’s a lot to be said for a tool that makes it so easy for us to step outside of our little bubbles…and comfort zones!

Why are you involved in social media and/or blogging…as a patient, provider, or student? I’m interested to hear what keeps you coming back to the wonderful web-world every day.

Let me start off by saying I’m learning so much at this conference. Dr. Larry Chu has done a fabulous job organizing and orchestrating, a true class act of knowledge, technology, and passion.

Everything about this conference has me nodding my head and saying, “Yes! THAT is why I’m involved in social media & health technology.” Med X has maintained a human side by giving a loud voice to patients, something I think is incredibly important to maintaining compassion in healthcare, and still managed to be on top of medical information by including a great mix of emerging health technology.

We’ve heard from patients, investors, lawyers, doctors, professors, engineers, computer scientists…all kinds of people.

So, what’s missing? The voice of students.

I’m so disappointed in the lack of involvement given to those of us in the throws of medical education. We are here. We are watching. Many are even help organize and offer ideas to the planning of the conference. But, we have no voice…

This is not a new thing at medical conferences, medical students and young physicians (residents, newly practicing docs) are often left out of speaking positions and panels. Perhaps it’s due to time and money constraints. Or maybe the reason is that we don’t have the expertise that many of these wonderfully seasoned docs have and we aren’t a traditionally valued opinion group. I don’t think those are great reasons, though. In fact, I think that lack of experience is a great reason we should have a voice.

Why do we deserve a voice?

We are in a unique place in our lives – not quite general population, but not quite healthcare provider. We still have the idealism that not fully understanding the medical system allows, but we have enough insight into the medicine to express ideas that are consistent with medical practice.

Why are we valuable in the ePatient realm?

One of the biggest echoings I’ve heard from the amazing patients here is that their stories aren’t being heard by their providers. I talk a little in this post about our role as medical students allowing us to be more present with patients. We have time to listen to patients. We are afforded an opportunity to hear their stories, because we don’t have 25 patients to round on – we have 2. We can offer an infantile medical perspective mixed with a healthy naivety of knowing patient stories.

We deserve a voice at these conferences, because we have a lot to offer. We deserve a voice, because we are the future. We deserve a voice, because sometimes being an expert isn’t always the best way to develop new and innovative ideas. Steve Jobs could’ve told you that.