Tuesday, January 29, 2013

Starting my clinical fellowship

I'm in the fourth week of the semester and 4 weeks in to my clinical fellowship.  My first semester is spent learning about primary care and basic gynecology, so my hours of clinical are spent in an outpatient clinic.  This clinic is set in downtown Cincinnati and provides care to urban and under-served areas of the city.  While it is overwhelming at the moment, it occurs to me how lucky I am to have this opportunity.

I'm learning from 8 nurse midwives.  My main preceptor has been doing this for nearly 25 years.  She has practiced all over the country and seen pretty much everything.  They have taken me under their wings in an attempt to teach me everything they know.  Right now, it feels as though I will never learn it all, but I imagine this will come in time.  Although one of the midwives said something that stood out to me yesterday.  During a tense moment in which I was frantically trying to answer my main preceptor's question about which oral contraceptive I would give a patient, she leaned over to me and said, "the minute you have all the answers, you need to leave this field."  Which I'm sure is true for every line of work, but especially so in the uncertain world of midwifery. 

This week also happens to be the week we are beginning to study women's health care and midwifery around the world.  Reading about midwives from other countries and how they practice is fascinating.  Especially reading about African midwives who have been trained as surgeons because the maternal death rate is high and there are only 3 doctors per 100,000 people living there.  Can you imagine?  These midwives practice from trunks and work on mud floors of huts.  They are 100+ miles from the nearest city or running water.  Still.  In this century.  While expected, reading their stories astounded me.  I was particularly moved by the book Monique and the Mango Rains.  About a young midwife from Mali who had women from a day away walking to get prenatal care from her clinic.  Her birthing house was without a roof or bed.  Straw mats with buckets to catch placentas were really the only equipment available to her.  She herself died while giving birth and the book was written by a member of the Peace Corps who spent several years under Monique's wing.

Reading this and seeing many documentaries about the current practice of midwives from around the world, makes me want to help in some way.  Maybe after my kids are grown and I have been practicing awhile, I can go volunteer in some of these places.  Although I'm hopeful by then, problems will be fixed, but doubtful.

All in all, the semester is going fine so far.  But I will admit to hanging on to small shreds of my sanity at times.  When my to-do list surpasses the amount of hours I have available, I get stressed.  The work continues to pile on and the boys are continuing to get bigger and into more things.  I still need to work to pay the sitter so that I can go to clinicals.  But I'm still grateful for the opportunity.  Eventually, all this will be worth it. 

Saturday, January 12, 2013

Letters to my 3 year old boys...

Dear Gavin,

Happy 3rd Birthday sweetheart!  I cannot believe that you are already 3!  Time seems to have flown by this past year.  Life gets better and better with you every day.

You are 33.8lbs and 38.5 inches tall!  You've grown 2 inches this year and gained nearly 4lbs.  You are finally a bit taller than Kai.  Although you both weigh the exact same.  :)

You are a big chatterbox.  You love to talk.  You can talk about anything, all day long.  Your favorite foods are salad from Mom's plate, spaghetti with no sauce but lots of Parmesan cheese, and pizza.  You fight daily with your brothers and crack yourselves up at your antics.  Injuries are an hourly occurence around this house.  You all seem to have a gift for getting into trouble.  But there are times when you are so absorbed in each other that it is so sweet.  You love Nathan so much.  You wait for him to get home and demand hugs and kisses from him the minute he walks in the door.  When Kai and you are separated (when one of you has a doctor's appointment) you are oddly quiet.  The minute you both are reunited you run up to each other and give hugs.  Then one of you always says "you came back!" as though you are so surprised.  It is so sweet.  This letter was written a couple of days late, so we have already had your 3rd birthday party.  You had a wonderful time and loved every second of it.

Recently you had to get tubes in your ears, just like Kai.  You kept getting ear infections that wouldn't go away.  The surgery went so smoothly partly because you are the best patient I have ever seen.  You sit so still when the doctor or nurse is in the room.  You are quiet, but very kind to them.  Recently you went to the dentist for the first time too.  You did so amazing!  I was so proud of you.  I'm always proud of you though.  

You love both Grandmas and Grandpa so much.  You get so excited to see them.  You are sleeping in your own bed in the same room as your brothers now.  Although you sleep with plenty of stuffed animals too.  Your favorites are Dora and Lucy (a stuffed boxer). You have absolutely no interest in the potty.  Nope, you aren't doing it.  Never.  Or so you say.

You know colors and some shapes.  You recognize your name and can count to 10.  You love playing with cars, Legos, and Buzz Lightyear.  You get cranky in the morning and can be counted on for one or two tantrums before 8am.  Guess you aren't a morning person either.

And so sweet boy, 3 years has passed.  Some moments are hard, especially working through the twin dynamic, but most are moments that I try to tuck away to remember you exactly as you are now.  Well, maybe without the diapers.  :)

Love you always,


Interview with Gavin:

What is your name? Gavin Quinn

How old are you? 65. 

Who is your best friend? Kai-bear.  No wait!  Nathan.  Yep Nathan.

What is your favorite food? Chocolate milk

What is your favorite animal? A horse!

What is your favorite color? Black.

What is your favorite movie? Phineas movie, mom!

Who is your favorite person? I don't know.

Who are your brothers? Kai-bear and Nathan and me.

What does mommy do? Works with Daddy.

What does daddy do? He works.

What do you want to be when you grow up? A doctor!

What do you love?  Mommy.  (Nathan's same answer from his 5 year interview, I love them).


Dear Kai,

You are perhaps the sweetest, most loveable kid ever.  While your brothers are charming and adorable, you have this divine innocence about you that can't be explained.  You are 3 years old now, Kai-bear!

You are 38inches tall and 33.8lbs.  You've gained an inch and nearly 4lbs this year.  I wonder how tall you will end up.  You are growing so differently than Nathan.  Gavin has surpassed your height but you are the exact same weight.

The biggest thing in your life this past year has been speech therapy.  We started shortly after your second birthday and had our last session a couple of days before you turned 3.  You saw Julie, Nathan's old speech therapist weekly.  We thought that you may have some of the same issues that Nathan had, but your course has been much different.  We know that before your tubes were placed, you couldn't hear well.  The doctors and speech therapist think that this delayed your speech and altered your speech pattern.  Now however, we recently took you to be evaluated by the school system and they think that aren't behind at all anymore!  You test in the 5 year old range for certain areas.  I was amazed and stunned by how well you did in the evaluation.  You apparently are absorbing a lot of things that I wasn't even aware of.  We are so proud of all the progress you have made this year.  Next year, both you and Gavin will be off to preschool for two days a week.  The thought of all my babies in school has me a little nervous!  But you both will do so well.

You, like your twin, are not, ever, never, notgoingtoever, go to the potty. You both are resisting with all your might.  So we have shelved the whole potty issue. We are hopeful maybe this spring, we can get you both to go.  :)

Your personality is radiant as I mentioned before.  You are rarely upset, but can be counted on for starting some fights with your brothers.  You like to pick on both of them and can be found frequently in the timeout corner.  That being said, I've never seen a kid with attention to detail like you.  You are constantly watching things to try to figure out how they work.  You love playing with cars and trucks. You are currently obsessed with your "spy car" and if you can't find it, you get so distressed.  You also love, love, love playing with the iPad.  That is probably your favorite thing to do, well besides fighting with your brothers.  :)

3 sweet years have passed.  Each day is easier than the one previous.  You are such a wonderful and amazing soul, Kai.  I love you so much.



Interview with Kai:

What is your name? Kai. 

How old are you? Kai.

Who is your best friend? Gavin

What is your favorite food? Lemonade

What is your favorite animal? Nathan.

What is your favorite color? Green

What is your favorite movie? Cars

Who is your favorite person? Ummm....Nathan

Who are your brothers? Gavy and me

What does mommy do? Goes to work.

What does daddy do? Goes to work too.

What do you want to be when you grow up? A doctor with Gavin.

What do you love? You Mommy.  Awww.....perhaps Gavin's answer influenced him, but I read this as love and adoration from my babies.  Just as love and adore them. 

Wednesday, January 2, 2013


Every year, I make New Year's resolutions and examine how well I did with the previous year's. 

2012 resolutions:

1. Kick ass in school!! Classes start in 2 days! I'm nervous and excited. More nervous. I just want to do well.  While it has been a tough and crazy year, I have done really well so far.  I'm maintaining as close to a 4.0 grade point average as I can get (damn you, A-). 

2. Maintain my weight loss and fitness level. I've done pretty well.  I fluctuate between 5lbs of where I was when I wrote this resolution.  My fitness level is pretty much the same.  I'm still running and enjoying it.

3. Complete another 5K with a better time. I actually went above and beyond this goal!  I completed my first half marathon this year!  I worked so hard to train and it paid off.  My time per mile was better in my half marathon than both of my 5Ks. 

4. Go on date-nights with Brandon at least once a month! This is so important for our sanity. We did amazing with this!  Thankfully we have willing sitters, because we went somewhere and did something nearly every month.  In April we went to Chicago.  In May, we had a date night in Louisville.  In July, we went to Las Vegas by ourselves!  It was an amazing trip.  In August, we went to a friend's wedding in Chicago.  In September, we went to New Orleans with some of our friends!  That was a blast.  In October, we went back to Las Vegas for my friend Carrie's 30th birthday!!  In November, we went to Gatlinburg, Tennessee for Brandon's 30th birthday.  We stayed in an amazing cabin in the mountains.  Went zip-lining and just enjoyed each other's company. And finally, we just returned from a trip to St. Louis for New Year's with our good friends.  An amazing year of travel and fun. 

5. Be a better friend. Spend more time working on my friendships. I worked hard on that this year.  Spending more time with our close friends, developing new friends at work, and just being a better person in general.  It was nice.  

1. Continue to do well in school.  Keep my grades up, learn everything I possibly can, and try to make it through.

2. Continue running and lose this last 10lbs.  It seems stubbornly attached to me! I'm also going to complete a couple of races this year.  I will definitely be returning for the Monumental Half Marathon in November.  I'm also completing a relay Marathon in Carmel this April.  I'm on a team of 4 women and will be doing the 8-mile leg. 

3. Continue with travel.  Every other month or so, travel to another city and be alone with Brandon.  We already have a couple of trips planned out.  We will for sure be going back to Vegas at some point this summer.  We also have a wedding to attend in Kansas City in November. 

4. Turn 30 with grace and a hell of a party.  :) My 30th birthday is this year.  We have plans to travel somewhere and do something!  I just have to plan it. 

5. Be a good mom.  While everything seems to be so hectic, I need to remember to focus on my babies.