MINDFUL OF MEDICINE

Hello!

From the moment we got pregnant I had a feeling we were having a boy. But then, at our 12 week ultrasound, the so-called "angle of the dangle" (aka the angle at which the genital tubercle sits in relation to the spine) suggested that the baby was most likely a girl. So we got used to the idea of having a baby girl on the way. A part of me felt like my instincts were off but I went along with it. After all, a healthy baby is all that really matters!

Two weeks ago J and I went through arguably the most exciting part of pregnancy - finding out the sex of the baby! As soon as the ultrasound tech placed the probe on my belly I saw a little penis, lol. Having seen my share of anatomy scans during my obgyn rotation I knew exactly what I was looking at and it was clearly a little boy! I kept quiet, and gave the tech a chance to share the news with J and I. We were overwhelmed with happiness! It also meant that my initial intuition was spot on :P.

We're so excited to bring a little boy into this world and hope to be the best parents we can possibly be! Here's a glimpse of our little one.

[caption id="attachment_833" align="alignnone" width="364"] For all my Muslim sisters out there, please say mashaAllah <3[/caption]

 

19 weeks (I know, super late - but Melo makes up for it right? :P)

Hi guys!

If you've been following along you know that I'm pregnant - 20 weeks today to be exact! We go in for the anatomy scan tomorrow and we're hoping for a healthy baby, plus we'll finally get to find out the sex which is the most exciting part. Now that I'm five months into my pregnancy I've had a lot of time to reflect on how we got here. I wanted to share our pregnancy journey since the moment we started planning but decided to hold off until it happened for us. The two biggest parts of our pregnancy journey have been planning for a baby during medical school and getting pregnant. Since I get a ton of questions about planning for a baby in med school, we'll start with that!

Planning. Ever since I started med school I've heard the phrase "there's never a good time to have a baby" as a woman in medicine. I think that's true, but there are certainly better times than others. Besides, is there ever a perfectly convenient time to bring a little life into this world? Probably not. The first step in planning for a baby in medical school for us was to commit to our decision to pursue such a goal. J and I have always wanted to be parents so finding a time wasn't just a task it was an exciting adventure to embark on.  In terms of financial planning, J is an engineer who is still early on in his career so finding a time to have a baby also depended on our financial situation and making sure that we could comfortably afford to provide all the things a baby might need. I also had to meet with my financial aid office to discuss funding (in the form of student loans) for all potential childcare and baby expenses. We're definitely not the first to have a baby in med school so the financial aid office was really helpful in giving us a game plan on how to get enough money for our potential baby.

My health was another barrier to our baby plans. If you know my story you know that I had a long battle with coccidioidomycosis, also known as Valley Fever, for which i was on high doses of anti-fungals for about five and a half years. As far as my ID doctor was concerned I would never be able to come off the meds and that inevitably meant that pregnancy was contraindicated (at the risk of craniofacial and congenital heart defects). There was even more worry that my cocci would disseminate if I were to become pregnant and discontinue my meds. Luckily I'm really involved in cocci research and I convinced my ID doctor to talk with attendings from my research group and go over my case. With their blessing we decided to start a trial of no medications 1 year ago and thank God (alhamdulillah) my antibody levels are stable and I feel great. The only catch? I have to see my ID doc every month to make sure I'm doing okay and get blood work just as often.

And finally, how do you fit a baby into a medical school timeline? This was such a huge question for J and I. There's no guide that can tell you when to have a baby in med school. That's because there are so many factors that go into it including finances, your partner's career, specialty choice, research, childcare, and how a baby would interfere with courses / rotations and overall graduation date. I feel very lucky to have seen a couple of my friends have babies in med school because their advice was so helpful. One friend had a baby at the end of MS1, which was good for her since she had a full summer without any school responsibilities. But that also made taking step 1 and starting clerkships the next summer more challenging with a toddler. Another friend had her daughter after match, which was convenient in that she had a difficult pregnancy and was able to take care of herself during a relatively relaxed fourth year. However, she started intern year with a three-month old which had it's drawbacks as you can imagine. I admire my friends and their ability to tackle motherhood early in their medical careers but it wasn't easy for them. And this left me even more confused about whether there is ever a good time to have a baby in med school. And the truth is there isn't; you really have to find your own path and make it work for you. Taking a year off for research / to have a baby was never in our plans so that was ruled out from the beginning. Eventually, J and I decided to aim for a due date during the first few months of fourth year (July - September).. That way I could complete my 1-month sub-I and another 4 week rotation before going into labor. This timing was also important because residency applications are due in early September and residency interviews start in middle to late October. This timing meant that I would be pregnant during the last half of third year, which included physically demanding rotations like obgyn, general surgery, and trauma surgery. Though being pregnant during those tough clerkships would be challenging, we thought it was worth it - and I can now happily say that I made it through! This timeline was the best approach for us, and it's important to remember that you have to do what works for you and your partner! A plan is a valuable component of having a baby in med school, but what about actually making a baby?

Getting pregnant. So you're ready to have a baby, now what? Being a meticulous person (J included!), my plan for getting pregnant was also calculated. I'll start with the changes I made before delving into the emotional aspects of the journey.

I had started tracking my cycles a year before we started trying so that I could get "in tune" with my body. I also made diet changes like cutting out caffeine (I love green tea) and purchasing more organic vegetables (see foods you do and don't have to buy organic). I also started to exercise more and tried to be smarter about my workouts - incorporating both cardio and strength training. In particular, I started doing something called "belly pumping" to establish core strength before pregnancy which I found on instagram @thebloommethod (check them out!). Side note, you can belly pump during rounds or in surgery and no one knows you're exercising but you, lol. In terms of ovulation tracking I used a free cycle app, ovulation test strips and my own symptoms. My symptoms were pretty in line with my app so that became our main resource. I didn't really like the ovulation strips because they're so subjective in their reads and often the quality varies between strips.

After a few months of trying I could feel myself getting stressed and even sad about each month that passed without seeing those two pink lines on a positive test. I'm usually a very rational, mellow person but trying to bring a little life into the world and feeling as if it's not going to happen is on a completely different emotional level than I've ever experienced. Many couples try for so many years to have a child and my heart truly goes out to them. Once I noticed that J and I were both starting to fatigue and worrying that perhaps it wasn't meant to be, we changed our approach. We only had two cycles of "trying" left before we would have to stop and wait to try to have a post-match baby or even until after intern year. It was high stakes, but I'm proud of how we handled it. We had been praying to have a baby, but now we prayed that we would have the strength to leave it up to God entirely.

In December 2015 J and I sincerely believed that if it was meant to be it would happened and if not, it wouldn't. And we were absolutely at peace with that. We stopped stressing. One of my attendings recommended a book she had read when she was trying to get pregnant called Be Fruitful by Victoria Maizes, MD - one of the integrative medicine gurus in our academic community. I needed some clarity and honestly wanted to know if maybe I had missed something and could be doing something better. What I found in the book (which I highly recommend!) was helpful on multiple levels. Among the many lessons I learned from the book, a few of my favorites are:

- it's okay to pray for yourself.

- Come off of birth control with enough time to get to know your body, its cycles and your symptoms at all points in your cycle.

- Make your body a suitable vessel to grow life through diet, mindfulness and lifestyle.

Later that month, I finished up my Family Medicine shelf exam and we traveled to Calgary for a family vacation. On December 22, I missed my period and figured it was just a fluke haha. But then I realized I hadn't been late for over a year. I knew something was up, but I wasn't fully convinced. I asked my sister in law to bring me a pregnancy test so that I could find out and possibly surprise J. And to my sincere surprise, two little pink lines showed up - I had finally gotten my "big fat positive" as the internet pregnancy forums like to say! I wanted to cry but also felt a little dizzy, lol. I called J upstairs. He looked very confused and silently walked out to the car and we drove to buy not one but 3 more tests! They were all positive and J teared up. Then we went out the next morning and we bought one more, just to be safe. It felt so surreal! It wasn't until 8 weeks later that we got to see our little bean on one of my obgyn night shifts when my chief kindly performed an ultrasound that J got to come see. Seeing that little heartbeat was so special.

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I hope this post helps those planning for a baby in med school because I know how hard it can be to find a good time. I also know that making a baby isn't always easy and there may be a lot of challenges along the way. If I could give one piece of advice it would be to just relax. Seriously. Stress only makes things harder and we're all stressed enough already! Enjoy the journey, it's among the most noble of all. Also please feel free to email me if you'd like to talk about your own journey, I'll do my best to help!

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