We are currently looking at ideas to help our school system move to year round school. The reason for the push is that we have 2 parents working in the family. The benefits are highlighted that kids possibly retain their learned topics better. I definitely think it would help with summer planning as well as enable us the ability to take OFF season vacationing throughout the year. I think kids could be better focused for a shorter time period. I think it promotes a sense of routine that may be better tolerated by kids as well as families.
I made the very difficult decision to change jobs. I was with Anesthesia Service Medical Group (ASMG) from 2011-2022. My time at Scripps Memorial Hospital in La Jolla was incredible. There are wonderful and competent surgeons, stellar nurses, fabulous anesthesia techs, dedicated ancillary staff, and collegial anesthesia partners. The reason for my departure: work-life balance. For me, work-life balance is being able to spend time with my family. The way our call structure is designed is to constantly be available to the hospital for add-ons without knowing a time that you are done with work. This often leads to 2-3x/week of not knowing when I can give my husband and kids a set time when I will be home. My kids are 4.5 and 3.5 years old. I want to be more available to them for school activities, dinner, and bed times. My husband and I both have very demanding jobs and I could see the toll my current job was taking on him as well as the kids.
This led me to look at other models that may be more receptive to a working mother who wants to work hard as well as be a present-mom with less mom guilt. This is a personal decision.
I landed on a model at Kaiser where I will know when I will be done everyday as it is primarily shiftwork. Yes, I will still take call, work weekends/nights/ holidays,etc… but when I am done, I will be done. I am excited knowing that I will be able to tell my kids that I will be home for dinner or home to tuck them in. The littles are growing so quickly. Kindergarten will start for my oldest in 2023 and G will follow in 2024. If I break down their ages in 5 year timeframe… 0-5 is almost complete. Next will be 5-10 and 10-15 and 15-20. The first 5 year time frame went by quickly. Everyone says it goes by so fast. I want to stop and enjoy this time.
I still want to work hard and push myself career-wise, and I do plan on doing that. My goal is to continue evidence-based practice focused on patient care, dive into more ERAS guidelines, bring my private practice experience to the Kaiser model, encourage well-being mentally and physically, and lean into more leadership roles acting as a mentor and role model.
In November 2022, I opted to try a continuous glucose monitor (CGM) to track my blood sugar readings. Granted, I am not diabetic, however my father and my aunt are diabetics and I had gestational diabetes during my 2nd pregnancy. I’m a bit of a data nerd and like to see how my body responds to the things I eat. So, I signed up for a program through Zoe and started following the app and logging my food. After I completed the 14 days, I then stumbled upon Glucose Goddess and want to try another 14 days with the CGM. Here’s the data from the first trial.
I felt that my blood glucose was actually pretty well maintained. My average reading was 94 and I fluctuated from 72-138. That’s pretty much carrying on with my regular lifestyle: protein shake for breakfast, whole food plant based meal for lunch, and regular dinner and a snack before bed. After reading the Glucose Revolution book, I find that I have an even better understanding of what I can do to improve my stability and consistency of my glucose curve. 2nd trial coming soon!
April 2023
I opted to try the CGM again for a two week period. Similar results with the diet/nutrition and knowledge that I had from before. Biggest issue is will power.
Breakfast: ACV water when wake up. Vedge protein shake
Lunch: PBM or balance of veggies to protein w ACV
Snack: Vedge protein shake
Dinner: ACV, balance of veggies and protein
Kept wine/bevies to 1-2 on weekend only. My body just doesn’t like it and I sleep like crap. If I am to have alcohol, it’s better at lunch for me so it doesn’t mess up my sleep.
After listening to the Huberman Lab podcast (and you should too! He’s got nuggets of info on health!), I decided to schedule a Dexa Scan as well as VO2 max test. I want to have a baseline of where I am at my age. This year has been a huge year of change. I’ve committed to my health (yes I’m currently 7 months in with a strength program called Rise; I started 1-2x/wk rowing; MMA 1x/wk). I’m changing jobs. I have cut back or cut out unnecessary or harmful things to my life. I’m participating in a glucose monitoring study. I wish I had done these metrics every decade of my life starting at 10.
The more I dig into the world of health and wellness, the more there is to learn. Hormones, gut health, nutrition, supplements, macros/micros, exercise (role for mobility, flexibility, cardio, strength, functional, etc). I wish they taught this stuff in medical school. This is the real foundation of health and wellness.
It started after a trip to Cabo. We went to a friends’ wedding and we stayed at a cute hotel right at a surf break. It was so wonderful just walking out to go surf and then coming back to have a bevie and snack and then do it all over again!
I had an upcoming week for a vacation and wanted to do a surf camp to get better at surfing. I started researching the various womens’ surf camps and stumbled upon one in Sayulita. The more I researched the town, the more I wanted to immerse myself and our family in the culture. Great people, yummy food, stellar surf….I’m in!
An opportunity came up and it has been an experience for sure trying to buy beachfront in Mexico. But, the stars have aligned and we will be vacationing in the beautiful town of Punta de Mita.
Surf Spots
The Central Pacific Coast of Mexico is surrounded by jungle and receives 345 days of sunshine per year. Located on the same latitude as the Hawaiian Islands, its sub-tropical climate is often compared to Hawaii’s. Temperatures reach 90 degrees F (32 C) during the summer, along with high humidity, but at night, the onshore breeze from the Bay of Banderas brings cool air that makes for pleasant sleeping conditions. The rainy season is June through September, however, August and September are considered the two “rainy” months. On average, September has 15 wet days per month, while January has only two. Rain usually doesn’t start until late in the afternoon, leaving most of the day free for outdoor activities. The Bay of Banderas also offers shelter from harsh Pacific winds and hard weather in winter. December and January, the peak tourist season, are generally warm, sunny and dry, with comfortable, balmy nights.
Monkey Mountain Trail: Vallarta Hiking Route: Higuera Blanca to Monkey Mountain. Difficulty: Intermediate [3.5/5]. Duration: 3 hours. This trail is also known as the Monkey Mountain hike. It is a bit off-the-beaten-path since you must drive past Punta Mita and head towards Litibu Beach to get here. You can take a guided tour or go on your own to the top of Monkey Mountain with an amazing 360° view of coastline and jungles! The hike takes about 1.5 hrs each way, so make sure to take some water and sunscreen. To start the hike, go to the main square of Higuera Blanca, walk along Juan Escutia street until you reach a marked gap in the jungle that indicates the rest of the way. The hike takes about 1.5 hrs each way.
Now that my oldest is almost 4 years old and my youngest is almost 3… it’s a good time to reflect back on my time during pregnancy, post-partum, breastfeeding, maternal/family leave, full-time work, and raising 2 toddlers.
Pregnancy really was a wonderful time. Aside from the GERD, waddles, having to pee all the time and drinking a ton of water… it was wonderful feeling the little kicks and getting the attention of people to always help me (open a door, lift things, walk with me, etc.). I worked up until I went into labor… literally.
Hours worked baby #1Hours Worked Baby #2
The most difficult things to do during MY pregnancy: make appointments, drink enough water, peeing every 2 hours (even during the night), eating (I could only take 4-5 bites before getting full), sleep.
Post-Partum
No one tells you what to expect post-partum. It’s a rude awakening when it’s really difficult to have a BM, wipe, breastfeed, wake up, and think clearly. For me, the SI joint pain from pregnancy lingered on even until today. Bonding with baby is unique and special. It was a wonderful time to watch my babies explore their senses. Sleep and breastfeeding: It’s really tough to get in enough sleep and breastfeed constantly. But after 2 weeks, breastfeeding got better for me. Maybe I was lucky. Sleep got better for me after 2 months After the 2nd kiddo, I think I had a bit of postpartum depression. Coupling the lack of sleep while also trying to be present for a 13-month old really wore me down. I was in a really dark place: the thoughts, the lack of care of harm to myself, the total loss of happiness for things I previously enjoyed. It was all very real, very memorable, and something that I look back on with sadness bc I wasn’t my best for the kids, my hubs, or myself. I’m thankful to have moved beyond that. The Peloton saved me on this one. I told NO ONE.
Breastfeeding:
Rent a hospital-grade breast pump prior to leaving the hospital. Visit with the lactation consultant while at the hospital to really learn how everything works. I was lucky to have a great LC for both deliveries. The first one really encouraged me and taught me good technique. The second was fabulous as she supported me and encouraged my efforts while also allowing me to opt for normalcy and not beat myself up if my milk production wasn’t 100%. Both excellent teachers and perspectives. Breastfeeding is new and it’s hard. Get help early and often! When you come back to work, do what you can. I oftentimes pumped in the OR and immediately put my stash in the freezer during breaks. This became really tough for me as breaks are uncertain and you don’t want to burden people who also need breaks. My milk supply went down fast, but I did what I could and that was my best. Don’t beat yourself up.
Maternal/Family Leave:
I was really lucky to be able to have 3 months off work. My anesthesia group was absolutely wonderful in allowing bonding time. I took the full 3 months. My husband then took his 1 month and we were able to do a solid bond with the kiddos for 4 months and then put them into daycare when they were 5 months old. Would it be great if we had full pay for 1 year of maternal/family leave? Yes. But, in the US, this is the best I could get and I’m grateful for it!
Full-time Work:
This was my own decision to continue working full-time. You can see in the charts above. After my second baby, I came back and still worked full-time. This was a personal choice. Kids are innocently demanding…. so is my job. I don’t really know how to find that right balance just yet. I miss out on my babies, and I miss out on work. In the end, you have to be ok with not being the best at everything. You will make sacrifices and you will feel awful. It was be a gut punch that you readied yourself for, but still feel every ounce of hurt when you miss things. The first tuck-in, the first goodnight kiss, the many goodbyes, the bathtime shenanigans, the sweet baby smells…. you will miss them. It gets easier. But, it still hurts when you miss these things. It’s almost like life moves on without you. That is…. until you get back and see the smiles and feel the hugs and kisses from them.
Raising 2 toddlers 13 months apart:
This is something! We brought home our second baby just after our 1st baby turned a year old. I don’t think the concept of a sibling coming to the house was even a concept that a one year old can grasp. Having two kids so close in age, but at different stages of development was REALLY HARD. They are just now starting to play together and sharing appropriately. It is still hard for us despite both kiddos being potty-trained (nighttime diapers only for my sanity). Everyone says 5 years old is the magical age where things get easier. We’re almost there!
During the delivery of our 2nd kiddos, I had a moment of weakness and thought a third child would be great. The second delivery was significantly easier than the first. Perhaps my body and mind were playing tricks on me. We feel complete. We have two beautiful and healthy kids. We couldn’t ask for more.
Everyone has a role within their expertise. We can all work together as a team.
“Doctor” should be reserved for physicians who have earned that title and clinically trained as one.
Health care providers have a duty to honestly represent their roles to patients. Because “doctor” unambiguously means “physician” to patients, only physicians should introduce themselves to patients as “doctor.” Because “anesthesiologist” implies “physician,” only residency-trained physicians should adopt the term “anesthesiologist.”
Perceived lack of support at work and at home were most strongly associated with burnout syndrome on multivariable logistic regression modeling
Age was the only personal factor that was associated with burnout syndrome
I’ve felt my own burnout throughout the years. The earliest times I remember it was in my childhood. I would be in school activities and extracurricular activities until about 9pm and then come home and then start my school homework. That was my initial taste of burnout. Luckily, I was able to work on my time management skills. In college, burnout reared its ugly head again when I had a ridiculous idea of taking 21 hours in a semester with honors and research and made a 4.0 that sememster. Just for reference, 12 hours a semester was full-time. Then, there was medical school. Talk about hooking yourself up to a full throttle fire hydrant and devouring the info. Residency was more about lack of work-life balance. It was all work and occasional play. Fellowship was more relaxing, more focused, and less burnout. Finally, real-life job. The hours can be grueling as well as unpredictable. The only predictability is knowing you will be done early or working late. This became much harder when we had kids. It’s impossible to say with certainty that I will be home for dinner or for activities or be home in time to tuck in the kids. This is also burnout.
I’m not the only one. Clearly. Study after study are coming out looking at the toll of burnout on healthcare workers. One of my colleagues with kids has said she’s starting to feel the burnout as well. We’ve been in private practice for 10 years. It’s not like we’re new to understanding the nuances of our jobs. Throw in family life and being a mom and it really gets tough.
Best thing to do is knowing how you feel when you are burnt out. What will you do to get help? Who is your support system? What can you do to decrease the workload/burden of work/family? Know that you are not alone and that help is close by.
Sleepy Time 