Tuesday, September 25, 2018

sleep is amazing + various updates

Lest anyone think I have ghosted (or uhh, GOMI'd?) after the last two posts, I am popping in for a much lighter update today.

First and foremost:

1) GENEVIEVE SLEPT 7 - 5:30 AM last night, and I slept 9:20 - 5:15 AM.   Honestly, I feel amazing, which highlights the fact that my 'baseline' lately is to feel like garbage.  She has had a cough/cold for the past 2 weeks (no fever, thankfully) and it has been terrible.  I am sure this added to my short fuse during my call week.

Sleep deprivation is not something I am 'good' at.  While I wouldn't say I need a ton of sleep, there is an enormous difference between 6.5 interrupted hours and a nearly-8 solid stretch.  Genevieve is an incredibly sweet, gorgeous, bright baby and I am so happy to have her in my life.  But she has not been terribly on-the-ball with the whole sleeping at night thing.

Combine that with pumping and feeling incredibly behind all of the time, and well -- yeah.  It has been a rough 6.5 months!

sometimes you just need a countdown

2) This li'l blog is getting a makeover!  Through a plea on the podcast, I found an experienced self-described Wordpress Pro and got an actual quote.  It is a bit of an investment, but I have decided that  I AM WORTH IT.   I have spent, cumulatively, thousands of hours writing on this blog.  However, I have spent something like 0.5 hours making it a user-friendly space that people a) can find and b) want to click on.  I have decided that since I am dedicating some of my 'off' time to the podcast/this space for the time being, I'd like to up my game.  Just a little.

I am researching other ad networks, too.  I am not sure I am 'big' enough for some of them, but perhaps a makeover and optimizing other aspects will help get me there.  I like to think I have something to offer on this site:  honesty (which used to be a common thing on various blogs and sites, but things are so curated now that I believe I am a bit of an outlier in the new landscape) + ideas about planning/organizing (ie one of my favorite things in life).  

I also clearly need to update the tabs above, which haven't changed in many years.  While we're at it, I can probably take down my expired running PRs :)  Oh man.  It will be a project and likely will take several months to complete, but I think it will be worth it!

3) I am taking a Six Sigma course for work today!  I am intrigued by the idea of process improvement.  I am also excited at the prospect of spending the morning in learning mode.  

4) We had a lovely weekend (definitely didn't pack in as much as Laura, but it was social / fun / full nonetheless).  I will say I have reached a point however where my 'getting things done' time on weekends has really dwindled.  I feel like I spent 50% of my time following G around, 25% cleaning up (not in any perfectionist way but just to prevent our house from being utterly trashed), and 25% on various big kid things including helping with an elaborate homework project (Annabel) comparing and contrasting school in China vs the US (this project seemed like a little much for first grade, but what do I know!?).

Josh and I coordinated well -- he took the big kids on multiple outings while I was with G, and all 3 in the pool Sunday while I made dinner -- but I still felt a bit spent and behind (on life maintenance + on sleep) by the end. 

We managed to cram in:
- one workout each (both of us ran -- one after another -- on Saturday morning)
- a day each to sleep in (him Saturday, me Sunday!  After feeding G overnight x 2 though so it wasn't the most rejuvenating . . . )
- parenting book club (done as a dinner party, with wine, which is the best way to discuss parenting books).  We dissected Amy Chua's Battle Hymn of the Tiger Mother.  It was so much fun.
- organization/weeding out of the kid's clothes (me)
- ordering of new kid's clothes (me) including matching dresses from Tea Collection that I JUST HAD TO HAVE

I have never put A&G in matching outfits before but something about these just spoke to me

- play date for A on Sunday
- impromptu playdate Sunday afternoon (another family!)
- A's piano lesson

I guess that's pretty good!  I did not get time to:
- write (and I had plenty of feelings stirring after my last post, but perhaps the break was a good thing)
- complete my weekly review (uh oh)
- answer emails (sincere apologies to everyone who emailed me, I WILL respond and appreciate it!!)
- bake

Maybe I need to process-improve our weekends -- or just accept that the above is pretty great as is.  Probably the latter :)

Wednesday, September 19, 2018

regroup / response

14 years of blogging, and just one deleted post.

I just could not leave it there if it was somehow giving people the impression that I am not a good clinician, or that I do not care about my patients.  I absolutely care.  I also always provide what I feel is appropriate advice overnight.  Is it always delivered in a warm/fuzzy/empathetic tone?  No*, though I do my best to provide the right instructions to keep the patient safe.  It can get emotionally and physically exhausting at the end of a long week, and (per my prior post), my coping mechanisms are not particularly effective.  Maybe this is a flaw of mine, but I would also venture to guess I am not alone.

In analysis of last week, Josh and I concluded that perhaps 168 hours on in a row is not the best setup for call, and for me the challenges have been compounded this year by a baseline of sleep deprivation that has lasted the longest of my 3.  A practical solution that we came up with is that I am going to see if there are other clinicians that would like to share the overnight calls over two weeks, so that there are breaks to get reasonable nights of sleep.  I also love the idea of creating more easily available literature (love this chart that a reader linked to) for our specific types of patients about what necessitates an overnight call, so perhaps in the coming years access to the right kind of care will improve.

To the few people who felt my post was a personal attack on their choice to call their after-hours pediatrician:  I absolutely NEVER meant it that way.  I know how scary things like croup or baby fevers can be, and have rushed to the ER with a severely wheezing child more than once (C, always C).  Just because it's tough to receive these calls doesn't mean people should not make them.  I believe I am allowed to find some calls more appropriate than others, but I absolutely accept that it is my duty to deal with all of them.  I was hoping to come up with solutions for how I, as the receiver, could better deal with the challenges that come with multiple nights of consecutive wakeups.   I do not believe that just because I have an MD after my name that the expectation is that I am invincible.

* and I do believe that as a woman I may be judged more harshly for this, but that is another story

Tuesday, September 11, 2018

the flip side

Of course, after I wrote the previous post filled with despair, we had a truly lovely weekend.  

A laundry list of good things:
1) I have been using a sticker chart for the big kids' behavior and it has been working!  Better-behaved children = much much happier household.  Let's hope we can keep the momentum going . . .

2) We had 2 big family events for Rosh Hashanah, and both were -- dare I say -- relaxing and fun.  Perhaps I am settling into his family-of-five deal?  G is just such a good baby and A&C are really getting very independent.  I will remember this feeling of peace when G hits the toddler stage (always a challenge for me!).

3) G had her 9 month visit - she is 21 lb (86%) and 28.25 inches (75%).  It is 5:32 AM and SHE SLEPT ALL NIGHT LAST NIGHT!  THERE IS HOPE!!!  (Note, this was an anomaly, but I'll take what I can get!!!!).  She's pulling to stand nonstop and is not minding her helmet one bit.  Whew.  

4) I have several planners being sent to me for review (for the podcast, but I am going to do a series here!) and this makes me irrationally excited.  Below you can see some shots of an older version of the Full Focus Planner, which I am currently using to time track and add a little (needed) structure to my days.   Want more pix?  I am reviving (again) shubox_plans on instagram.  Enjoy :)

5) Josh and I saw Crazy Rich Asians last night - our first movie in the theater since G was born.  And I absolutely LOVED it.  (As many of you know I am a huge fan of the book series - pure candy.  I hope Kevin Kwan writes more!).  

I am entering a call week today (first in a while) and I am filled with less dread than usual.  Probably because I had some extra time yesterday to do a proper weekly review (crucial) and feel relatively organized for the first time in a long while.  


Annabel came to G's ped appointment and to Rosh Hashanah services armed with Field Notes.
Love her phonetic spelling . . .

G @ the pediatrician 
(flu shot #1 + hep B #3 - check)

pulling to stand on EVERYTHING

Full Focus Planner shot


unicorn butt.  LOVE.

Out of commission!??  AGHGHGH

No training wheels!  He and A seem to have learned at the same time.
(that's C in the distance)

G is channeling baby A in one of her old dresses

(last week)
((to keep it real!!))

M - total body cardio (Beachbody), 8 lb weights

T - 3 mi run 10:30/mi 81F

W, Thurs, Fri, Sat - NOTHING (oops)

Sun - 3 mi run 10:20/mi 83F

Well, better than nothing :)