PracticeBalance

Pursuing simplicity in work, home, community, and self

(Anesthesiology) Ladies Who Lunch

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Laughing and lunching in cute outfits isn’t just for babies

I practice in a large group at an academic hospital, where I might go weeks or months without seeing some of my partners at work. Many of us (including me) work part time, and lots of anesthesiologists in the group wear varied hats that take them to other places such as a clinic, classroom, or research lab vs. the traditional OR setting. Anesthesiologists are a unique breed of physician who practice almost completely alone. While there can commonly be an anesthesiologist taking care of a patient along with a nurse anesthetist, anesthesiologist assistant, or resident physician in training, it would be very rare to see two “bosses” in the same OR together.

The autonomy of practicing anesthesia in the OR paired with the variety of perioperative roles and locations available for anesthesiologists are definite advantages of my specialty, but they can leave us feeling like we’re practicing in somewhat of a vacuum. While we may chat in the lounge during lunchtime, we can easily feel isolated. As an introvert, this does not always bother me, but if I have a bad day or just a clinical question I may wish for more support. If you work part time and do all of your own cases like I do, it takes a conscious effort to connect with other physicians. Which is why I’m so grateful that many of the female physicians in my group got together last weekend for a potluck lunch. We do this every once in a while, about on a yearly basis, and I wish we did it more often!

It was so much fun to see these ladies in a different, more casual environment. The blue pajamas and hats were traded for sundresses and sandals, and the conversation turned from patients to children, schools, and summer vacation plans. Resident MDs who have yet to venture into practice ate lunch alongside veteran tenured professors. Many of us are moms, with children ranging from 8 weeks to 19 years old. I learned some useful school information from a few of my colleagues with gradeschool-age girls. It was also interesting to talk to a couple of the ladies who work exclusively in the pain clinic, sharing stories about work environment and frustrations with the medical system. Two babies even made appearances: one wide-eyed, active 11 month old and one brand new infant attached to her mother’s breast at the buffet table!

Our Ladies’ Lunch experience left me hoping not only to make more social connections with my peers at work, but also to continue making efforts to schedule “girl time” into my life. I know that a lot of moms suffer from the same feelings of needing and yet missing female friendship; I’ve found that I just have to set reminders and take initiative to schedule meetings with friends, even if it’s only for an hour or two at a coffee shop. And despite the drawbacks of filtered experiences and easy comparisons, I feel like this is an area where social media really shines. It helps me to keep up with people that I haven’t seen or would otherwise be off of my radar for long periods of time.

How do you keep up friendships and connections with colleagues despite being busy balancing the realms of work, home, community, and self? Let me know your tips by leaving a comment!

Not A Cruise

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“A luxury, once regularly experienced, becomes necessity.” – Unknown

I’ve never been on a cruise, but I would imagine that the focus is on luxurious convenience. You’re craving escape from your current life, your job, your routines. You need – no, you DESERVE – relaxation and pampering. To have everything you want at your fingertips: a soft bed, any. possible food choice you could imagine, sunny days and shimmering pools, and of course ocean views in a temperature-controlled environment. It sounds… perfect.

Convenience and perfection have their place, and yet they can set us up for dissatisfaction. Once we’re used to certain luxuries, we need more and better to achieve the desired effect. The same goes for richness of texture and flavor in food, visual stimulation in entertainment, basically any pleasure-seeking practice. What I’m really saying is that a cruise or all-inclusive type of vacation is the junk food or porn of traveling. Just like when we eat too much sugar, we might get to the point when we need a detox to reset our dopamine receptors.

I’d like to make the case for imperfect travel, using our most recent trip to Spain as an example. I’ve talked about ideal vacations before, giving criteria for what I feel are the perfect conditions for a major trip. While we did meet my normal requirements, things were far from easy or luxurious. Baby was nine months old when we went to Greece last fall, and while that trip had some expected challenges, it worked out to be a nice blend of climbing, relaxation, and family time. Part of that success was owed to a lack of logistics on the small island of Kalymnos, the ability to easily meet other traveling climbers, and the relatively young age of our girl. We started this trip to the Chulilla wilderness area of Spain comparing everything to Greece – which we quickly realized was a mistake. Baby is now an 18 month old toddler: mobile, vocal, and a strong-willed disease vector, on the verge of getting hurt at any given moment. Spain is a vast and spread out locale. We knew no one at our destination, and only one of us (me) knows a little bit of Spanish.

Washing machines are still interesting: Greece on the left, Spain on the right

Travel began as a two-leg flight with a 30 pound lap child, a response by me to a medical emergency on board, and little rest for all. Our arrival was punctuated by a four hour drive with a real struggle to stay awake. After setting out to try some climbing the next day, we quickly realized that most of the crags were on ledges with no good area for children to sit or play at the base. The first week involved allergic stuffy noses all around, a scavenger hunt for our rental car keys (which were found in the toilet), and my accidental addition of diesel to our (unleaded) rental car gas tank.

Hubs and baby passing the time while I have my “oh shit” moment at the gas station

To say that things could only get better at that point was an understatement… and of course, they did get better despite not being able to climb as much as we would have liked. We saw someone we knew from our hometown who was near the end of a trip, and he gladly included my husband in his final Chulilla climbing days. It turned out that our AirBnB apartment host had just returned from years of work as an au pair in London. Not only did she speak perfect English, she was more than willing to watch our girl while we spent some days climbing over the next couple of weeks. It only rained a twice, confined mostly to overnights, and otherwise we spent lots of time in the balmy sun. We discovered a cute playground two blocks from our apartment and ended up walking there every morning. Baby would play, but we adults also played. We exercised there on our non-climbing days, using the trees as pullup bars and the benches as obstacles for jumps and squats. You would think that going to the same park every day for 2-3 weeks would be boring, but it was so interesting to watch how baby played differently each time she encountered the playground structures. One day she would slide down the big slide six times; the next, she would confine herself to the little shaded hut under the slide platform, organizing seedlings and leaves that had fallen from the nearby trees. We watched her go from barely being able to balance as she walked on uneven ground to bounding down the path to the playground.

Functional movement practice at the playground

Note that I mentioned our AirBnB. I should admit that, analagous to the individuality of life’s stressors, one person’s imperfect travel could be considered another’s luxury. Pre-parenthood, our years of imperfect travel involved 8 hour bus rides sitting next to a cage of chickens on the dirt roads of Nepal, thatched roof huts in Thailand with mice running on the floors and monkeys running on the rafters, and many a sketchy stealth camping spot in the American wilderness. A whole apartment at that time would have been heavenly, and yet it is now a necessity. We all have our own minimum requirements for comfort and functionality; ours involve a real bed, a kitchen since we cook almost all of our own meals, and access to wifi either where we stay or closeby so that my husband can work when needed.

Refusing to hold my hand

Experiencing some difficulties and hardships while traveling not only make trips memorable, they also permit us to grow. About a week or two into any travel scenario, no matter how many conveniences are available in our locale, I realize the small things I miss from home and take for granted regularly: my dog, who hasn’t had enough attention since the baby came around; the 13 foot window in my living room that bathes me with morning sun, my fully automatic espresso maker – a gift to myself after earning my MD that has more than paid for itself by providing us
cups upon cups of daily happiness at the touch of a button for over 10 years. And being that we are avid home cooks, it is an exercise in creativity to make yummy and healthy meals using ingredients found in the local markets and tools found in the apartment. Upon returning home, my blender gave me great happiness!

I understand the place of vacations that don’t involve a lot of thinking and suffering, and I sometimes take them too. Many people breaks from stressful jobs and living arrangements, but over my years of practicing balance and making conscious choices to work less, I’ve found that I don’t need a complete escape from challenge and I’m happy to go back to work after traveling.

What kind of trips do you prefer? What are your minimum requirements when you travel? Do you have any imperfect travel memories you can share?

International Travel With Baby

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(Yes, she rode on the scooter. My mother will likely have a heart attack when she sees this picture.
Baby’s face is hidden to protect the innocent.)

Our first real vacation as a three-member family is now complete! We had a great time in Kalymnos, Greece for the majority of October. In fact, the post I just linked in the first sentence was inspired by our last trip to the same destination in 2012. Things were definitely a bit different this time, mainly due to the addition of the baby. We still met my criteria for an “ideal vacation”: long enough period of time, minimal logistics required, lots of physical activity, and rich social interaction. However, on this trip we did hire one scooter to open up transportation options a bit more, in terms of both climbing crags that we could visit and locations where we could purchase amenities/etc.

The internet is awash with detailed tips for international travel with babies and toddlers, and I’m ashamed to say that I didn’t take good advantage of it prior to embarking on our trip. A really thorough website with lots of articles can be found here, and this blog is geared more towards practical preparation for the whole family. An old friend of mine who seems to be somewhat of an airplane connoisseur also wrote about his air travels to Europe with baby here. These are my general tips based on my experience:

Prep early and often. Depending on the age of your child and his/her specific needs, every parent will have a different list of essentials. The key is to think about them well beforehand and be prepared, as collecting the items on your list may take more than just a day. With young children, the tendency is to pack everything but the kitchen sink; the key is figuring out what you absolutely have to have, that you care about most, that you WON’T be able to get easily at your destination. For me, this was a particular high-quality baby formula which I know is difficult to find and would be difficult to ship to a Greek island. I made sure we ordered and packed plenty of it for our trip, and yet I still had to buy an additional canister of mystery formula (likely with low-quality ingredients written in Greek which I gladly ignored). Yet I knew that we could get the kind of diapers she uses anywhere, I knew I could buy toys if needed, etc.

Also, make sure to have enough essentials for the entire period of air/road/boat travel; this may vary anywhere from a few hours to, in our case, two whole days! So in a carry-on I made sure to have: copious diaper changing equipment, a change of clothes, formula, finger foods, a light jacket because planes are cold, a light blanket for sleeping, and an interesting toy or two. One highly-recommended thing I failed to properly do was bring enough of this gear in the carry-on
for 1-2 days of post-travel coverage in case of lost luggage. In the setting of
hungry appetites, dirty hands, and blowouts, this could be much more
important with a kid in tow than it ever was on our previous trips as a
couple.

Pull the “baby” card (with a smile). You hear of airplane horror stories from both sides of the coin when babies are involved, but for the most part, everyone loves a baby. I’ve gotten smiles from the most hardened-looking airport dwellers when she engages them with her beautiful blue-grey eyes. I’ve had more conversations with strangers who asked me questions or made comments about her then I ever would have by myself. This phenomenon crosses cultural lines as well; although the caretakers of the house we rented in Greece spoke no English, they fawned over our baby every day and treated us like family. They gave her toys and brought us home cooked Greek food on a regular basis.

Having a cute baby on your arm opens up lines of both communication and sympathy. It seems that even if your child is struggling or crying, people who have had children understand and may even try to help. Our 13 hour international flight had bassinets, but you had to be sitting in one of two rows. At first we tried to ask people if they would switch, and they graciously said no… but our flight attendant came through and made it so that we could use one. It was SO nice!

Lower your expectations. I don’t mean to say that you should start with negative expectations, but it’s important to take it slow and not expect much out of the first few days in your new destination. On a typical trip, my husband and I would normally move at a much faster pace, including heading out to climb as soon as possible after arrival. However, on this trip, I personally didn’t climb for the first two days. Baby and I spent time decompressing, getting used to the surroundings, and napping. On days that we did take her to the crag, we just didn’t get as many pitches of climbing done. As I talked about before, any climbing with a happy baby in tow is a double-send! Little excursions we happen to take around the island were also made with full awareness that things may have to be cut short. Which leads me to my next point…

Divide and conquer. One way to absorb some of the adjustments with baby is to have you and your partner divide some of the necessary tasks for getting settled. Only one of us shopped for groceries or went to the bank at a time. And it turned out that mostly, we had climbing days one at a time. With roped climbing requiring belays, how did we do this? We met others there who were willing to help us out and climb with either one of us on an alternating schedule. Kalymnos is the perfect place to do this, as it hosts a close-knit group of climbers of all levels from all countries in a well concentrated area. I identified a few potential partners for each of us before we traveled by posting about our situation in an online forum, and we also met other travelers while we were there. We’d never done a climbing trip where we barely climbed with one another before, and while I sometimes missed climbing with my husband, it turned out to be a very positive experience. We both got to climb at places that we wouldn’t have possibly gone if we were together (and/or with baby), and I got to do a lot of lead climbing on my own without having my husband “help me” by putting up the routes.

I ended up climbing fewer days than I would have compared to past trips, and yet I climbed as much as I felt that I wanted to climb this time. Baby had a more stable daytime lifestyle, and everyone seemed satisfied. Our arrangement is just one example of how you can divide duties and activities while on a long trip with a baby; this same kind of setup would work very well for trips that focus on individual activities such as surfing, paddling, yoga, or even conferences.

Look past yourself. Of course, jet lag sucks for everyone. But usually, after a few strategically-timed medications and some coffee, I’m read to climb, hike, or do whatever the destination affords. Our baby traveled so well on her three flights to Greece (even sleeping a substantial part of the long haul flight). Two flight attendants whispered to me that I “have a really good baby”…. Coming from them, I took this as quite a compliment! But
once we arrived she had three days of bad jet lag that translated to
desiring high-energy play (lest bawling in the middle of the night) and
moodiness during the day. The first night I totally didn’t get it; why is she crying so much? Why isn’t she dead tired like I feel? Once I opened my sore, burning eyes and saw her trying to pull my hair and play, I realized that this is another human being with a different constitution and different reactions to things than I would have. She needed to work through the time and location change on her own terms.

A friend of mine described international travel with a child as “two steps forward with one step back”. Our girl really did seem to grow on this long trip away. She’s eating so much more solid food, and she’s on the cusp of walking now. Her sleep habits, which I had diligently worked on in the month before our trip, slid into a regression. I didn’t worry about it and just let her be her. Now that we’re back home, we’re slowly returning to our normal routines. She may not remember much of the trip, but I’ll never forget my time with her and her dad in a completely foreign environment – a great experience for body and mind!

Do you have any other must-know tips for international travel with babies or young kids? Share them here!

You Don’t Have To Be Retired To Enjoy Walking

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A walk with baby in the desert sun

The first physical activity I resumed after my baby’s birth was walking. Oh how I missed being able to walk without waddling in pain, which had become the norm during my last trimester due to massive fluid accumulation in my legs. The joy of walking pain-free again has been compounded by the absence of, for the first time since I knew I was pregnant, shortness of breath on any and all hills! We have been taking long walks every day (weather permitting) during my maternity leave. Other folks run by, logging the miles and most likely hurrying to get done with their workouts. Most of the time, they carry a look of suffering on their faces. But we are not on a schedule.

He is hoping we will hurry up

Walking at least 30 minutes most days has been linked to all sorts of health benefits, but I’ve also noticed other advantages to making this regular practice a priority in my life:

It’s meditative. Are you one of those people (like I am!) who understands the benefits of meditation but has a hard time incorporating it into your daily activities? Try taking a quiet walk to have a meditative experience that also gives you other benefits. It’s win-win. This applies more to solo walks, which can be a nice change from walking with a partner. The key is to clear your mind by dismissing thoughts that emerge (without judgement) and focus on noticing your surroundings, your breathing, or possibly a mantra. Check out this site for a beautiful guide to walking meditation written by Thich Nhat Hanh.

It connects you with your community. I love walking in my neighborhood and noticing the diversity of homes and front yard landscapes. It’s a fun practice to walk a different route or take a different street each time so that you have the opportunity to notice new things each time. When we do these types of walks, we also make an effort to smile and wave at other walkers and neighbors. I also enjoy the exposure to nature when we walk on trails or in mountains and canyons.

It’s a good foundation for an exercise program. Walking is a great first step in an exercise regimen for those who have not been previously exercising, who are overweight, etc., but it is also beneficial for more athletic people. It promotes recovery and natural movement patterns (especially when walking on uneven surfaces such as trails) with very little negative effect on other training performed during the week. Low intensity walking can help to promote fat burning when combined with other intense activities such as strength training in already trained individuals.

I started walking as much as I could tolerate the day after I came home from the hospital. While I admit that a big component of this was an impressive amount of diuresis, I had lost all of my pregnancy weight (50 lbs!) by 2-3 weeks postpartum with walking as my only form of exercise. However, the lasting effect is that I have managed to maintain that weight loss and even begin some good body recomposition postpartum with continued long walks and a minimal kettlebell lifting program. And walking is a way to move that doesn’t add stress to my (already stressed and sleep deprived) system.

It facilitates brainstorming/creativity. When we walk together, my husband and I have the best and most productive conversations. We talk about home improvement projects, finances, trips we want to take, philosophies on parenting… I could go on. I always come up with great ideas, including subjects to write about on this blog, during our walking sessions.

What about you? Do you walk regularly? Share the benefits you’ve encountered here!