From Land to Shining Sea

March 14, 2022 4 Comments

Oh my! The last month was busy! Before I dive into what I’ve been exploring lately, I want to first address the horrifying things happening in Ukraine right now.

War has always been horrible. There are constantly wars and conflict happening around the world and often times, we are ignorant to them. To a certain extent, we have to be. If we knew about every human suffering occurring in the world, we’d all constantly be depressed and distraught. So we focus on news and events in our more immediate surroundings. When horrible things then happen to people that easily could also be us, it hits harder and deeper.

Since I’ve become a mother, my emotions are on steroids. I love harder, I grieve deeper, and I empathize more intensely. Where I used to see mothers and children of the world suffering and would feel terribly saddened by it, now I see myself and my baby in the women and children being bombed in the Ukraine and fleeing for their lives and its heart wrenching. I walk a fine line between staying informed and protecting my mental health. Since I’m on a contract right now, I can’t be in Germany helping the refugees. So instead, I am supporting various humanitarian aid charities that are helping the people of Ukraine. Hopefully, you’ve been able to do the same.

The clever ways people have been helping the Ukrainian people has been proof of human ingenuity. I’ve seen people booking AirBnB’s in Ukraine with obviously no intention of staying there but rather getting financial aide directly to those Ukrainians. I’ve read about information being shared as reviews on various sites because the Russian government is censoring social media.

It is absolutely despicable that one man can cause so much trauma, heartache, death and destruction. I don’t know how, but this war needs to stop.

Coming to America

A few days after my last post, my AuPair Ally arrived from South Africa. The first few days were spent giving her some orientation and letting her adjust with the jet leg. 10 days after her arrival, my aunt and uncle visited from Germany for 10 days. Thus, the last few weekends were rather busy and I enjoyed them fully. We initially wanted to take a trip to Crater Lake. My aunt had seen a TV show discussing blue colors around the world and Crater Lake was mentioned as being particularly beautiful. It’s still winter season here in Oregon however and the road circumventing the lake is closed at this time. We had a great alternative weekend adventure instead!

Let me share some of the fun things we’ve been up to!

Spencer Butte

The second day Ally was here, our local nanny (and now good friend of ours) took us on a hike up Spencer Butte. It’s located a short drive outside of Eugene. There is a steep ascent and a gradual one. We took the steep way up. My nanny and I each packed a baby and Ally packed our two backpacks. The ascent was not a walk in the park. It had rained a bit before we started our hike, so the paths were a slightly muddy at times. There was also a bit of boulder climbing involved but it was a lot of fun and provided some amazing views. We even saw a full rainbow once at the top!

McCredie Hot Springs

On her second weekend here, Ally, my baby and I drove an hour southeast of Eugene to take a dip in the McCredie hot springs. This was Ally’s first time seeing snow! There were a few pools available. We shared one with just 4 other people. Baby loved it! They love bath time so this was a special treat.

Sweet Creek Falls

The first stop on our weekend tour with my aunt and uncle was at Sweet Creek Falls. Located about 1h15 west of Eugene and on the way to Florence, is where you’ll find the beautiful forest and water falls. The hike was easy and took us through lush greenery up along the river to the waterfalls. The water was cold but I can see myself coming back on a hot summer day and splashing around a bit.

Heceta Lighthouse & Cape Perpetua

After a short stop in Florence to visit the marina and grab lunch and coffee, we headed north up the coast. Our first stop was the look out area overlooking the coast with the Heceta Lighthouse in the background. When I was here with my mother, we discovered hundreds of sea lions hanging out directly below us. Unfortunately, none were to be found this time around. So we snapped a few pictures and headed to the Heceta Lighthouse.

The parking lot for the lighthouse is located at sea level across from a beach. To get to the lighthouse, you have to take an uphill walk past the Bed & Breakfast to the lighthouse. From the top, I was able to take some nice pictures of the coast line. The blue, green, gray and white color palette of the nature is right up my alley.

Upon our decent, we spent some time hanging out on the beach and letting baby play in the sand. Afterwards, we drove 20 minutes north and up to the Cape Perpetua Lookout. From here, we could look down on the coast line and watch as the sun started to set. We didn’t stay for the actual sunset because we still had to find a hotel for the night and cellular reception was nonexistent for us where we were. We had intended to visit Yachats as well but decided to continue north to Newport for the night.

Newport

A few miles north of Yachats, I finally had cellular service and was able to look up a motel for us. We headed to the port of Newport to grab dinner. It was already pretty late and restaurants were close to closing. Luckily, the Clearwater restaurant was open longer than the others. It is situated right on the port. The best part was truly what was happening in front of the restaurant on the marina side. The floating docks were filled with sea lions! They were the first thing we heard when we got out of the car. It was dark, so we were only able to see the ones illuminated by the dock lights. It sounded like there were hundreds more hanging out in the dark bay.

The next morning, we grabbed lunch at the Nye Beach Cafe before going on a walk along Nye Beach. The ocean seems to really ebb and flood on this beach. We found beautiful sea anemones (amenonemomne?) amongst the rocks. There are some pretty cool shops in Nye Beach. We stopped by the Blue Pig Bakery for some delicious treats. The bakery is worth visiting even if you don’t have a sweet tooth because every room, nook and cranny is filled with gifts and goodies.

After stuffing my face with a scrumptious cinnamon roll, we headed back to the port where we had been the night before. The port is lined with a lot of shops, many quite unique. We browsed, snacked, and shopped for a while before heading back to Eugene.

Svikki MD

Work has been good. The patients I see have medical issues all across the board. I’ve had a few no-shows (not uncommon for a FQHC- federally qualified health center) which allowed me to catch up on the copious amount of tasks that flood my in basket. The team I work with is really great and I enjoy my time at work.

We are already looking ahead for the remainder of the year. Usually, jobs don’t get confirmed until 2-3 months before the start date. The job I’m currently at was confirmed unusually early and I’ve don’t it again with my next assignment. I’ve also been able to negotiate a pay raise which feels really good. Anecdotally, I’ve experienced women be less direct about pay raises and negotiating. It’s definitely still a work in progress for myself as well but I definitely scored a win this round.

Starting in August, my baby, Ally and I will be headed to…. Wisconsin! Go Badgers! lol

I will be working in a town close to Milwaukee, Madison and Chicago. I’m excited to show Ally the state I grew up in and it’ll be nice to be close to so many lovely friends I have in that area. Eugene doesn’t really get any snow, so we will definitely have to prepare Ally for a Wisconsin winter. She saw her first bit of snow here in Oregon but I’m going to blow her mind with a legitimate snow storm in Wisconsin should we have one this year.

So, to all my Wisconsinites, I look forward to seeing you and introducing my baby to you later this year!

mfg

Food & Drinks, Locum, Motherhood

Local Leisure

February 13, 2022 1 Comment

I’ve spent the last few weekends here in Eugene starting to explore what the city has to offer. We have several different people visiting us over the next months and my AuPair FINALLY arrives this coming Friday. Once she is here and has adjusted, we plan on exploring all sorts of things in Oregon. Knowing that our future weekends will be busy (and thankfully so!), I decided baby and I could spend a few weekends in Eugene. That feeling didn’t last longer than 3 weekends though seeing as we took a day trip to the coast yesterday because I needed a change of scenery.

Food

My local nanny (who is the bees knees, y’all, seriously) gave me a whole list of restaurants to try out. Since eating out is more fun in a group, I’ll try most of them when guests and my AuPair are here. Keeping in mind her and I try to eat mainly vegan, here are her suggestions with notes:

Peaceful Palette Food Truck: only open Spring-Fall
Bo&Vine: veggie burger & tots
Jazzy Ladies: farm fresh brunch
Govindas: fully vegan & gluten free
Glory Days: veggie-heavy breakfast
Wandering Goat: vegan biscuit & gravy and good coffee
Grower’s Market: bulk & organic co-op
Cornbread: cornbread, vegan chili
Vero Espresso: breakfast and lunch in a house with a porch and outdoor seating area

I’ve done a bit of exploring myself and have found a bakery that makes delicious croissants. Croissants are one of my favorite baked goods but I’ve been spoiled and fortunate to have eaten many french croissants, so I have high croissant standards. Noisette Pastry Kitchen is not too far from where we are staying so it makes for a nice walk to pick up some treats. Check out their instagram below. Delicious!

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A post shared by Noisette Pastry Kitchen (@noisettepk)

Activites

This is another category where I will have much more to report once I have guests and we check things out together. Baby and I have spent a good amount of time in the public library (also only a short walk away) and local playgrounds.

Cascades Raptor Center is a nature center and wildlife hospital open to the public year-round. We are home to nearly 40 resident education raptors, most native to the Pacific Northwest.
https://cascadesraptorcenter.org

Last weekend, we met up with the nanny and her family at the Cascades Raptor Center. Per their website:

All of the birds have signs posted with their origin story and information about their species. I’ll definitely have to do some more reading the next time I’m there. We witnessed a few feeding and were able to see some of the birds up close. The admission fee is $10 for adults ($9 students age13+ and seniors, $7 for ages 2-7), but it’s money well spent to help keep the place running and saving bird lives.

The glorious world of public libraries

I have always apprecitated the existence of public libraries. There is something sort of magical about them. I remember our small public library in Muscoda where I felt so grown up when I got my own library card. The public library in Poland, OH was a beautiful place to study for the board exam. In South Dakota, it was loacted only a block from my apartment and supplied me with the books I read written by or about the Lakota tribes of the area. Here in Eugene, it’s the place my mother took my child and met our local nanny! It is also a place we’ve been to several times now to explore their giant selection of children’s books.

Proud new member of REI

Considering the plethora of hiking trails in Oregon, I figured it was time to get a pair of hiking boots. With a baby on my back or chest, I want to make sure I’ve got a good grip. Furthermore, I also purchased a new baby carrier as my wrap isn’t as functional as I’d like it to be for hiking. I’ve recieved several hiking recommendations (many with waterfalls!) but a lot of them are located outside of Eugene and are on the list to explore with our AuPair/guests. There are however plenty of trails here in Eugene as well.

We checked out one of the trails around Spencer Butte. The trees are so tall here and covered in moss. I’m assuming thats because we are in a valley and there is often heavy fog that rolls through… or stays put for several days. Side note, my collegue told me the Eugen area is one of the worst for seasonal allergies. The pollen content is extremely high here.

Shopping

This is not a category I’ve explored extensively but I did find a few really cute shops the first weekend we stayed in town. Located between Charnleton & Olive Street and 5th & 6th Ave is a row of four adorable and fun shops. Down to Earth Home & Garden has a huge selection of kitchen ware, home decor and garden supplies. Pre-pandemic, they often had workshops there too, according to my medical support staff.

Across from that is Mountain Rose Herbs Mercantile, a store filled with herbs, spices, tea, coffee, lotions and potions. I bought Nurse-Me Rhyme loose-leaf tea and it is delicious. They also are a big supporter of the Raptor Center as evidenced by their logo on many of the signs on the aviaries.

Directly nextdoor, is Farmer’s Union Coffee Roasters. They sell specialty coffees from small co-ops and farmers around the world! The interior decor is light and fun. I enjoyed a decaf oat-milk honey and lavendar latte.

The final store in that lineup is Oak Street Vintage. It’s not just vinatge clothing they sell but also a large selection of cool furniture and decor. Check out their Insta pages for more!

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A post shared by Down To Earth (@downtoeartheugene)

https://www.instagram.com/p/CXewYJOvOx2/

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A post shared by Farmers Union Coffee Roasters (@farmersunionroasters)

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A post shared by Oak Street Vintage (@oakstreetvintage)

I guess I should pause here for a second and just say that none of the links I’ve posted are sponsored in any way. These are just local places I’ve found and their instagrams do a heck of a lot better job showing what they do than any picture I could take. Additionally, I want anyone coming to the area to have a easy way of finding the places I mentioned. I promise to let you know if I ever get paid or free stuff for something I mention.

Svikki MD

Work is busy. From the moment I get there to the moment I leave, I am non-stop working. I work while I eat and I work while I pump. Between seeing patients, I hurry to finish up notes, refill medications, review labs/image/consults and answer messages. It’s never ending. My inbox usually was empty when I went home during residency. That is nearly impossible now. Some of the other clinics have a refill team that weeds thorugh their refill requests and if certain criteria is met, it gets refilled without needing to ask the provider. I don’t have that service due to staff shortages.

The panel of patients I cover is from a previous provider who worked here for 6 years and accumulated a panel of about 1200 patients. My inbox fluctuates between 20 to 100 tasks throughout the week. It’s usually more on Tuesdays when I first come into work. However, even with working off many of those as the days go on, more tasks come pouring it. I’ve come to terms with the fact that my inbox won’t be empty when I leave for the day and just have to do my best triaging the tasks.

I’ve seen a wide variety of patient presentations in the office and have performed a few procedures. My medical support staff is great! My roomer “scrubs” the charts the day before and makes notes on what the patients are coming in for, which preventative items need to be done, etc. She also knows many of the patients and can provide some context and backstory.

Solo working mom

As busy as I am at work, I’m equally as busy at home during the work week. This will lighten up once my AuPair is here. Currently, my workday mornings are either spent getting ready quickly and packing our bags before the baby wakes up or doing it all with a baby on my hip.

Depending on where the in-home daycare is that day (it varies between two locations) I pack up the car and we drive either 10 or 20 minutes to the daycare. I like to spend 5-10 minutes chatting with the other moms and saying hi to the kids. They adore my baby and my baby absolutely adores the time with the bunch. Then it’s off to work. I’ll usually fill this time listening to music and singing along loudly. As I mentioned previously, when I’m at work, I’m working non-stop.

Before my replacement parts came for my Willow pump (a breast pump that you tuck into your bra without cords), I was using a corded pump and would sit in an empty exam room and pump for 15 minutes twice a day while awkwardly trying to write notes without bumping off the bottles. Thank goodness I can now use my willow. I just pop them into my sports bra and write my notes looking like Pamela Anderson. I’ve even pumped while seeing patients if I don’t have a break. There is time blocked off on my schedule to pump but patient encounters rarely follow an exact schedule.

Once I get home, my baby gets dropped off by the nanny about 15 minutes later. I use that time to quickly unpack my lunch stuff and organize anything I can. Then its time to cook and eat dinner. Following that is our bedtime routine of brushing teeth, reading some books and nursing to sleep. There was a stretch of time where baby would want to stay up until 8 or 9. Luckily that has passed for the time being and baby is usually sleeping by 7. I spend the two hours I have before going to bed largely with cleaning up the kitchen, washing the dishes, the lunch containers and baby’s bottles, and essembling everything for the next day.

The four day work week goes fast because there is so much to do. I am so grateful for my three day weekend. Once my AuPair gets here, I’ll gain back quite a bit of time at home during the workweek. The commute to daycare will no longer be necessary and neither will the packing of baby’s bags. I do still want my baby to see the group of kids so there will be play dates.

I’m so excited for my AuPair to arrive in a few days and look forward to all the guests that will be coming to see us over the next several months! As before, any suggestions of things we should eat, see, or do, send them my way!

mfg

Food & Drinks, Locum, Motherhood, Travel

Weekend Shenanigans

January 23, 2022 3 Comments

Although I am spending this weekend exploring our immediate surroundings in Eugene, I spent the last two doing some traveling. We went to check out Portland with my uncle two weekends ago. Last weekend, we headed to the coast with my mom. I can’t wait for my AuPair to get here so we can start planning all our weekend trips!

Portland

In my head, Portland was going to be this green oasis brimming with bike paths and eclectic people roaming the streets. To be fair, visiting a city in January is hardly ever the time to see a city at its best. Throw in an ongoing pandemic and things look a bit different than you might expect.

We booked a hotel downtown, thinking we would be close to all the action that way. After checking in, we walked directly to the one farmer’s market that was open (again, it’s winter). The walk there was not exciting. However, the Farmer’s Market was a rather decent size and had some delicious things. We grabbed a breakfast burrito, apple cider, and some really yummy, single-source chocolate.

After that, we made our way back towards downtown. While doing so, we passed a lot of empty storefronts and even more tents at seemingly every corner. We stopped at a few coffee shops along the way. While looking at GoogleMaps, we realized that an area northwest of downtown seemed to be rather busy. After a bit of research, we learned that 23rd Ave was lined with shops and restaurants. So, we walked there to see if it was a bit more happening than downtown was.

23rd Ave definitely had more going on. We saw quite a few of the eclectic people I thought might be running around. There were some delicious-looking restaurants but it was still too early for dinner. So instead, we decided to walk back towards downtown and check out Old China Town. Maybe we just weren’t on the right streets, but we basically found nothing interesting in Old China Town. For dinner, we decided my uncle needed a good ole American burger before heading back to Germany and ate at Deschutes Brewery.

Day 2

After a fast and pretty decent breakfast at Cheryl’s on 12th, we took a walk along the Willamette River. I’m sure it is even nicer in the spring or summer when the trees are full of foliage and the temperature is warmer. Before heading back to Eugene, we spent a couple of hours at the Oregon Zoo. It is one of the more beautifully laid out zoos I’ve visited. At times, you feel like you are taking a walk through the woods. We didn’t see as many animals as I had hoped. Perhaps that was due to it being winter. The walk through the zoo itself was already worth our time though.

Someone slept through most of the zoo visit

In the end, Portland didn’t wow us as much as we thought it might. I’m not giving up on it wowing me in the future though. I’m hopeful that with warmer weather, flourishing flora and fauna, reduced pandemic restrictions, and a bit more research, Portland will be more like the Portland I imagined.

Oregon Coast

Last weekend, we headed to the coast with my mother. A little over an hour’s drive due west of Eugene lies Florence. It is a small coastal town with a population of just over 9,000 people. There is a road along the Siuslaw river known as the historic Downtown. The streets are lined with shops, cafes, and restaurants. I immediately felt like I was on vacation when I saw a store selling Salt Water Taffy. For some reason, likely my childhood, I associate that with vacation.

We grabbed some hot drinks at Magnolia Bakery and walked along the historic Downtown road. We stopped to check out a few galleries with local artists before taking a nursing break at the harbor. I grabbed a bagel at River Roasters to eat while we drove to the beach. I’ll have to return to River Roasters sometime though. It was a comfy coffee shop with a fireplace and a back porch overlooking the river.

Hello Ocean!

A quick 10-minute drive from downtown Florence got us to the beach! Getting to the beach was a bit of a workout. First, you had to climb up a dune. Then, once at the top, if you wanted to get to the ocean, you had to maneuver down a steep dune side of sand. After taking in the beautiful view from on top of the dune, I took the baby to go see the ocean up close.

For a while, we were the only two people on that stretch of beach. My baby had never played with sand before and had a blast! We took a walk along the beach and looked for an intact shell. I can’t wait for the weather to warm up a bit to spend the whole day on the beach.

After a good while soaking in the beach views, we headed north up the coast.

Hello Sealions!

The drive along the coastal 101 Highway is very scenic. Every couple miles, there is a sign that reads, “Entering Tsunami Hazard Zone”. The day prior, there had actually been a tsunami wave weather warning due to the underwater volcano that erupted near Tongo. Lucky for us, the warning was over and the sun was shining. This led to some great views.

We stopped along the way to see the Heceta Lighthouse from afar. Little did we know, when we looked down from the cliff, we looked right onto the sealion gathering spot. There were so many of them! They even seemed to have their own little ocean pool.

Our intention was to see the Heceta lighthouse up close as well but when we tried driving there, we realized you actually had to walk a bit to get there. My mother had hurt her foot the day prior, so we decided to skip that part.

At this point, we were hungry for a real meal. Another 20 minutes north, in a town called Yachats, we went to the first place we saw, called Ona. It was very delicious and a co-worker later told me, it’s one of his favorites in that town. So that worked out well.

The last stop was for some ice cream before we embarked on our 1h50 drive home.

The Wishlist

I am making a list of all the recommendations people have been giving me. My AuPair should get here mid-February and I am so excited to spend our 3-day weekends exploring Oregon!

Svikki MD

Work has been going really well. They still had me on a lighter patient schedule these past few weeks. And gee was it necessary! I am getting better at using their electronic medical record system but still feel like I’m not as efficient as I could be.

The patients, for the most part, have been kind. Some are more complicated than others. Some are very complicated. I try to compartmentalize and prioritize, knowing I won’t be able to help fix all their problems in one office visit.

They also closed the previous locum’s in-basket of tasks the other week and all the unfinished tasks, labs, and medication refills dumped into my in-basket. All of a sudden I had nearly 100 tasks to complete. I was quite overwhelmed by this since I tend to have my in-basket cleared before the end of the day. I spent a few hours over last weekend in the office working on tasks. It wasn’t until two days ago, however, that I officially got through it all. Naturally, new things started coming in but 7 tasks aren’t as terrifying as 100.

It takes a village

The first week at work, my uncle was in town watching my baby. The second week, my mom was here to babysit. I had signed up for care.com and messaged about 20 people to see if they’d be interested in babysitting while I am at work and await the arrival of my AuPair. Only two got back to me saying they’d be interested. For many others, our schedules didn’t align. I was starting to get nervous.

The Universe (and my mother) had my back

My mother took the baby to the library the first day they were together. There, my mother observed a woman walk in with a few toddlers and a baby strapped to her back. My mom was impressed by how this woman interacted with the kids. The woman overheard my mother speaking German and struck up a conversation. She told my mother that she had spent an exchange year in Germany (in nearly flawless German pronounciation). My mother then proceeded to tell her of my current childcare situation. The woman said I should give her a call and that she could probably help us out.

I called her that evening. She was amazing. She agreed to add my baby to her cohort of kiddos. They spend their days between the homes of the two families whose kids she watches. One is in the city and the other is out in the country. She stopped by with her two kids last Monday for a face-to-face meeting. Our babies loved each other. I knew my baby would thrive being around this woman and her kids. She is so creative. Her parents were actors and she grew up around the theater. She has puppets to help the kid communicate their feelings, plays instruments, and works on sign language with them. I really hit the jackpot here.

Hopefully, play dates can continue to happen once my AupPair gets here too. The local nanny also gave me a huge list of restaurants to check out. Seriously, she rocks.

mfg

Locum, Motherhood, Travel

Welcome to Oregon

January 17, 2022 No Comments

Holy moly, time flies! I’d really like to be posting more than once a month (or a month and a half!) and I think it’ll be more likely in the future.

This past month has been exceptionally busy. First, there was enjoying the last few weeks of maternity leave with family and friends in Germany. We celebrated Christmas with some of my aunt’s family by having a nice raclette feast! Shortly thereafter, my aunt and uncle drove us to Frankfurt where we all spent the night before baby and I caught our flight to Ohio.

During our short three days stay in Ohio, we visited my residency program to see everyone. I also had an OBGYN appointment for my Pap smear (make sure you are up to date on your Pap smear, my cervix possessing friends!).

Our journey to Eugene Oregon the next day was a doozy.

Connecting Time – Indefinite

Our journey from Cleveland to Eugene started really early on December 30th. Our flight out of Cleveland was at 6:10 AM (!). The flight to San Fransisco was fine, Baby didn’t sleep much at all but did make friends with the passengers around us. Shortly before landing, I checked the airline app to see if our connecting flight was on time. It was not. Au contraire mon amie! It was CANCELED. Due to staff shortages.

Remember hearing in the news how United had to cancel a bunch of flights between Christmas and New Year. Yeah, mine was one of them.

Once on the ground, I contacted a United agent to see what my next option would be to get to Eugene. The best they could do was put me on standby for a flight at 4:30 PM. Not great, especially since it was only 8:30 AM at the time. All of the flights the next day were only on standby as well. I neither liked my chances nor did I like the idea of being stuck at the airport with a baby for 8 hours. So after some deliberation with my family, I decided to rent a car and drive. Also not ideal with an 8-month-old baby but at least I was getting closer to my destination.

Road Trippin

We were looking at a 540-mile trip ahead of us. It took forever to get out of San Fransisco. Driving over the Golden Gate Bridge somewhat made up for it though. I only made it to Redding, California before booking a motel and spending the night. I don’t typically experience jet lag but I kept us on sort of a wonky schedule in Ohio because we had such an early flight to catch. Now being 3 hours even further behind, we were in bed by 8 PM. However, we then left the motel by 3:30 AM.

The morning drive was adventurous. Once we crossed the Californian border, we were in the mountains. The fog was so thick and it was snowing. At one point, I was only driving 15 mph downhill and hoping my little economy car wouldn’t fail us. Eventually, I started to get hungry and really wondered if there would even be a place to eat since I hadn’t seen an exit in quite some time.

Heaven on Earth

I asked GoogleMaps where the nearest restaurant would be. It suggested a place called Heaven on Earth which was only 20 minutes away. Well, with a name like that, and my options very limited, I decided to give it a try! We left the highway and quickly pulled up to a wood cabin with a big sign that read “Home of the Famous Cinnamon Rolls”. The sun was just starting to rise. We walked in to find cinnamon rolls as big as a plate! A lovely lady seated us. The only other folks there was a table with 4 older gentlemen who all seemed to be cowboys.

The omelet I ordered was exactly what I needed. The open fire made the place very cozy. We chatted a bit with our server and the chef before heading out again for the last 2 hour stretch of our journey. Before dropping off the rental car at the airport, I stopped by the gas station to fill up. I was quickly informed by a nice man that I better not touch the pump or I could be looking at a $1500 fine. … Wait…what? Turns out, you are not allowed to pump your own gas in Oregon and New Jersey. Good to know!

Eugene

I spent New Year’s Eve going to bed around 9 PM. I was in a new city, knew no one, had a baby, and was perfectly content with it all. The following day, we walked around the city a bit and ran some essential errands before picking up my uncle late at night. He flew in from Germany to watch the baby while I went to my first week of work.

My first impressions of Eugene:

Weed is omnipresent. There are so many dispensories in and around the downtown area. Holy Grail, Spacebuds, Oregon Weed Oulet… so… many…shops.
Homelessness is omnipresent. There are large lots filled with tents. Tents are set up at seemingly random places along the neighborhood. As a co-worker would later let me know, the numbers of homeless people is so high in Eugene due to a combination of skyrocketing rent, strict city expansion laws and liberal policies which make it a more welcoming place. In contrast, in Springfield, a more conservative town, which is literally right next to Eugene, it is illegal to hand anything out of your car window. Apparently its a law to stop people from giving food or drinks to the homeless. Supposedly, other more conservative cities in Oregon give the homeless a one-way ticket to Eugene and tell them they’ll be taken care of here.
Kindness is omnipresent. Everyone I have met has been kind. There are countless Black Lives Matter signs in the businesses and “Choose Kindness” signs in the neighborhood.

Svikki MD

My first week at work was all orientation. I work at a community health center. There are several offices throughout Eugene and I was able to shadow at several of them throughout the week. Not only was it nice to shadow providers to get a feeling of how their electronic medical record program works (vastly different than the Epic program I am used to) but it was also nice to shadow them seeing patients. It’s been 9 months since I’ve seen patients. Although I wasn’t afraid of having forgotten how to use a stethoscope, it was nice to ease back into the clinical setting by being a fly on the wall.

Everyone, from the providers to the support staff, really seem to enjoy the work that they do. The patients we see in the clinic are mainly Medicare, Medicaid, uninsured and underserved. They tend to be fairly complex, both medically and socially. However, the people working in the clinics really seem to have a passion for helping these people get the healthcare they deserve.

I was happy to find out that I would be working in a clinic closer to home than the one I originally was told I would be at. Since I was all over the place for orientation week, I was able to stop by at home for lunch a few times. My first week was Monday through Friday. Going forward, I’ll only be working Tuesday through Friday.

My first week of orientation went well and my first week of being back at work went well for Baby too. My uncle did a great job and I really enjoyed having him here with me.

I receive very intense kisses when I get home from work.

Three Day Weekend

I’m so excited to spend our 3-day weekends exploring Oregon. My coworkers have given me some fun suggestions of things to check out. My uncle, the baby, and I spent our first weekend in Portland. I’ll write about that and my first week back seeing patients in the next post (which hopefully will be next weekend…truly, I hope). If you have any suggestions of what I need to see, eat, do, or experience in Oregon, PLEASE let me know! I’m here for 7 months and I want to explore!

mfg

Happiness, Travel

Getting into the Christmas Spirit…sort of?

December 1, 2021 No Comments

Over the last several weeks, I have been back and forth between Stade and Göttingen. I’ve been visiting family and friends. I’ve also been spending some time looking through old pictures at my grandparents’s home and working on putting together a family tree.

I haven’t really done much exploring as I intended to. This is multifactorial. Firstly, going back and forth between Stade and Göttingen so frequently eats up quite a bit of time. Especially when I get back to the house in Stade, its grocery shopping, doing laundry, getting organized. When I leave the house, there is a checklist of things that need to be done and trying to pack as minimally as possible for the baby and myself.

Secondly, the weather has been a bit of a bummer lately. It’s not exactly an appealing thought to go on a long walks in the rainy, windy weather.

Thirdly, the COVID numbers have been rising dramatically again in Germany. These numbers are mainly fueled by the unvaccinated. About 68.6% of the eligible population is vaccinated. The distribution is not proportional. There is a clear north-south divide when you look at a map of the cases. The north is more vaccinated and has less cases. Northern states are taking ICU patients from the southern states because the southern hospitals are overwhelmed. With these rising numbers comes increased restrictions on public life. As of today, many parts of Lower Saxony have a 2G+ rule.

German Covid Regulations

In Germany, they have the 2G and 3G regulations. The G’s are geimpft (vaccinated), genesen (recovered), and getestet (tested). Many places already had 2G regulations in place. If you were vaccinated or had recovered from Covid in the past 6 months, you were good. As I mentioned, as of today, many increased the restrictions to 2G+. So in order to partake in certain activities (Christmas markets or going to get your hair cut), you need a few things. You have to be either fully vaccinated or have recovered from Covid no more than 6 months ago AND need to have a negative test result from that day as well. Oh, and you still have to wear a mask.

The rising numbers have also caused many Christmas markets to shut down after only being open a few days or not opening at all.

Christmasmarket Adventures

I briefly visited the Christmas market in Göttingen last week when I was in town to grab some chocolates and flowers for my friend’s birthday. I had to show my proof of vaccination and ID to obtain a wristband. This wristband had to be shown to vendors to be able to buy anything. I quickly grabbed some fried mushrooms as a little snack. Back in the day when I was a medical student, we would head to the Christmas market as much as possible in the evening to drink some Glühwein (hot, spiced wine).

Yesterday, I drove to Buxtehude, about 20 minutes from Stade, to check out their Christmas market. Buxtehude is associated with fairytales. The city’s mascots are a hare and hedgehog. The story surrounding the two is similar to the American story of the tortoise and the hare. You’ll find statues and depictions of the two in stores, on the street and on street signs. For Christmas, they set up statues of various fairytale characters throughout the city. To enter the Christmas market, I had to show them my proof of vaccination and ID. I read a few of the stories posted under the fairytale statues and grabbed some Schmalzkuchen. That is fried pieces of dough topped with powdered sugar. Similar to funnel cake in the USA. Overall, it wasn’t really busy. Maybe I was just too early. But it didn’t feel like the typical Christmas market experience.

Mission: get into the Christmas market!

Today, I drove in the opposite direction and wanted to see the Christmas market in Himmelpforten (Heaven’s Gate). On the radio, I heard that Lower Saxony was now using the 2G+ rule and wondered if this would already apply to the Christmas market. When I arrived, I saw the large poster at the entrance gate announcing the 2G+ rule. I asked the gate attending where I could get tested. Luckily for me, there was a testing location in walking distance. Their website said they weren’t open for another 40 minutes but I decided to head over anyways. The walk was filled with light rain and fairly strong winds. My baby was tucked in the baby wrap under a cashmere sweater and oversized winter jacket. If it weren’t for the imminent threat of Christmas markets potentially closing soon, I would’ve gotten back into my car and driven home.

My wait at the testing center was maybe 15-20 minutes before being tested. They had opened early. When I exited the building, I saw that the line had quadrupled in length. I apparently wasn’t the only one surprised by the 2G+ rule. In Germany, you can use an App on your phone at testing centers. Your individual QR code is scanned and then the result is automatically uploaded into the app. Germany actually has a few Apps it uses. There is one for checking in at restaurants and such by scanning a QR code so that you don’t have to fill out the contact tracing paperwork. Another App verifies your vaccination status and one even alerts you if you have been in the vicinity of a person who recently tested positive. All pretty nifty.

Mission accomplished

Since it was going to take about 15 minutes for my test result to be ready, I headed to the grocery store to grab a few items. When the test result was on my phone, I finally headed to the Christmas market. All in all, about an hour after I originally arrived.

It was a bit depressing to see how empty the Christmas market was. This was likely due to all the people still standing in line to get their Covid test. There were a lot of vendors with handmade crafts as well as several food and beverage vendors. I walked around a bit looking to see if they had potatoes pancakes (one of my favorite Christmas market foods) but unfortunately, they didn’t. Nonetheless, I wanted to support the vendors, so I found one selling deep-fried apple rings. At this point, baby was over being in the carrier, so I decided to head back to the car and head home. Again, the real feeling of Christmas market was lacking a bit unfortunately.

The church in Himmelpforten (Heaven’s Gate)

Practicing gratefulness

I really am grateful that I’ve had the few Christmas market visits so far. There are a few more on my radar I’d like to visit in the near future. I’m even willing to take on some of the increased security measures to do so. But I also fear many will shut down or not even open because there won’t be enough visitors. It’s a bit sad because if it weren’t for Covid, I’d visit the markets in Hamburg, Hannover, Kassel and so on. They would be filled with people, laughter, food, drinks, snacks, lights, decorations and fun. It would be a time to spend with family and friends and make memories. Maybe I’m idealizing the experience a bit because it’s been so long since its been that way for me. The first few years after graduating medical school because I wasn’t in Germany and the last two years because of Covid.

If pandemics of the past are any indication however, this time of restriction too shall pass. I guess I’m also grateful that my baby is just that, a baby and won’t remember this time anyways. Hopefully, by the time long-term memory kicks in, Christmas markets will be back to their old glory and we can eat, laugh, drink, play and make memories together then.

mfg

Motherhood

Let’s talk about Postpartum (Part 1)

November 9, 2021 1 Comment

Peanut is now 6 months old and it feels like just yesterday but also oddly really long ago that I was in the postpartum phase of my fertility journey.

As a medical student and resident physician, I did not receive a lot of training about the postpartum period. The postpartum period is generally considered the 6-week timeframe following delivery. I knew the big pointers and things often tested on exams:

the difference between Baby Blues and Postpartum Depression
vaginal bleeding goes through different phases of coloration
the uterus size decreases over several weeks
breastfeeding does not necessarily come naturally to the birthing person and/or baby
sore nipples if breastfeeding
how to monitor baby’s weight gain appropriately

That’s about it. I would venture to say that most of you reading this know about most of those things even if you or your partner haven’t gone through the postpartum period personally.

My co-residents/baby doctors visiting us Postpartum Day 1

Learning from experience

I definitely did not feel fully informed/prepared for the recovery time after delivery. All of my knowledge was so generalized. Yes, I knew I would bleed, but for how long? I knew that I would have sore nipples if I was successful with breastfeeding, but for how long? And I figured the vaginal area would hurt after pressing a human out of it, but again, for how long? When would it be ok to start working out again? Which workouts would be best?

I had a great birthing experience, was able to do it without pain medications, but I did have an episiotomy. Every birthing story is unique and I can only speak from my own experience from the singular birth I’ve ever gone through (as the birthing person). So the experience is likely very different for someone who had an epidural or difficult delivery or there were problems with the baby.

Talking to my tribe

Speaking with my friends in Germany who have given birth and following their postpartum journey, I was reminded of how very different the postpartum period is depending on your location. It’s a special feeling speaking with others who have gone through labor and delivery because they can understand and relate so much better than someone who hasn’t. That’s essentially the case with any experience in life though really. That’s why support groups can work so well.

I asked my friends and my Instagram followers to share some of their stories and experiences with me. I want to summarize some of the things they shared over several posts. Additionally, I’d like to highlight some of the differences between a postpartum journey in the USA versus Germany. Finally, I’ll share some of the products birthing people and their partners shared with me which they found particularly helpful during the postpartum period. (I am not receiving any merchandise or financial reward for mentioning any of the products. These are purely recommendations from people who felt it made their postpartum lives a bit easier.)

Postpartum Surprises

Personally, I didn’t anticipate how hard it would be to just sit down anywhere after my episiotomy. Healing from that was really the only thing I disliked during my postpartum period. Everyone gets instructed on perineal care after delivery even if you don’t have a tear or episiotomy that needed suturing. Essentially every time you use the restroom, you have to flush the area with water to keep it clean. Now imagine a major wound healing in the perineal area. It made walking uncomfortable and sitting comfortably nearly impossible.

Add to that the normal bleeding after delivery. Going to the bathroom was such a process. Changing the blood-drenched padding, waiting for the water to be somewhat warm so you could fill the squeeze bottle with it, flushing the area, patting the area dry, applying the pain-numbing spray, and getting all dressed again, every. single. time.

Poop PSA

Speaking of using the bathroom. Let’s be very frank about pooping after delivery. (Pooping during delivery is totally normal and I assure you neither the nurses nor the doctors care one bit. If you are worried about your partner feeling some type of way about it, maybe reevaluate your choice in a partner) Postpartum pooping is not a joke. My advice to everyone having a delivery… DO NOT FORGET TO TAKE STOOL SOFTENERS! Between the hormonal changes, not drinking sufficient (if any) water during or after delivery, the organs shifting into a new place after the baby is out, and extremely decreased physical movement after the delivery, constipation is nearly unavoidable.

I was very diligent about taking Miralax during my pregnancy. In the hospital, I was given a stool softener. When I arrived back home 24 hours after the delivery,… I forgot to continue taking the Miralax. BIG MISTAKE. I have never been so constipated in my life. I was also worried about the episiotomy wound healing ok while trying to have a bowel movement. If you remember anything from this post, please remember to take your stool softeners after delivery!

What surprised the Tribe?

Here are some of the responses I received when I asked, “What surprised you the most about the first few weeks after birth?”

How I slept with the light on because I was afraid of everything!
How awful breastfeeding is./The struggles relating to breastfeeding./ That breastfeeding is not a given and works right away
All the blood. All the belly. And how quickly it went away!
The impact of sleep deprivation on every. Single. Area. Of my life
How little sleep I actually needed
My joints did not feel strong for a long time! They almost felt wore out. Boo!
That first post-birth poop. Nothing prepared me for that lol (Remember people, stool softeners are your friend)
No time for anything – even though we were two people. Sometimes hardly found time to eat
How tired/emotional I felt, how terrified I was of doing something wrong
Bladder control after, cramping while nursing, overproduction of milk
Crying for no reason!
How the baby was emotionless until week 4-6. Cried at birth, but within 10 minutes just quiet and examining.

I can relate.

I could relate to quite a few of these. It took me a few nights to figure out just how much light I needed in the room to sleep and function when the baby was awake. I tried different night lights and having the lights on in the hallway. Eventually, I landed on just having the light from my Owlet base station be enough for me to see in the dark once my eyes adjusted. That is still all the light I have on during the night now.

My breastfeeding experience was rather uncomplicated except for the sore nipples. Oh my. It is quite the transition from not using your nipples and trying to avoid wardrobe malfunctions to having them constantly being used and whipped out in all sorts of settings. I’ve been a rather flat-chested person for most of my life. The engorgement and sudden seemingly Pamela Anderson-sized boobs were an experience. There were definitely a few days where it hurt pretty bad for the first 30-60 seconds when the baby latched on. With time, lots of nipple cream, and repeated use, the pain disappeared and the cracks healed. My boobs had a different shape, size, and consistency to them multiple times a day for the first several weeks. Eventually, those changes become more subtle.

Sleep deprivation was not a huge issue for me. It just feels like I have been on call for the past 6 months lol. Medical school and residency definitely trained me well. A while back, I learned that breastfeeding parents don’t interrupt their sleep cycles like non-breastfeeding parents do when they are awake with the baby. The body is wired in a way that allows breastfeeding parents to quickly fall back into the sleep cycle pattern they woke up from. Mother Nature’s way of trying to help with the sleep deprivation a bit, I guess.

Postpartum awareness

Society at large knows more about pregnancy than it does postpartum. There is also the weird fact that pregnant bodies are admired and praised while postpartum bodies are immediately judged and misunderstood. I hope to raise some awareness about postpartum and normalize it. It’s the fourth trimester and belongs to pregnancy as much as the first three trimesters with the baby still in the belly. It has its own unique challenges and I would say a much steeper learning curve than any of the trimesters with baby still on the inside.

I would love to hear from you about what surprised you the most about your own or your partner’s postpartum journey! Let’s share our experiences so postpartum parents don’t feel so alone in their experience and soon-to-be postpartumers are a bit more prepared for what’s to come!

mfg

Happiness, Travel, Uncategorized

Oh The Places You’ll Go

October 26, 2021 4 Comments

Well hello again!

It feels like forever since I last posted…almost two months ago! It definitely wasn’t my intention to wait this long but I’ve been rather busy.

I spent the first week of September visiting my sister and her family in Rochester, New York. Then it was back to Ohio to get things moved out of my apartment and into a storage unit. Since I wasn’t going to be working in the area, it didn’t make sense to keep an apartment. When choosing the storage unit, I wanted one that was climate-controlled and big enough that I could set up my garment racks, dressers, and shelves in it. I didn’t want to have to look through boxes when I make pitstops in Ohio to exchange items between contracts.

Once the storage unit was found, I spent the next couple of weeks slowly moving things into it. At the same time, I was in the process of selling the car I had been using. I was also interviewing and working out details with the Au Pair agency. All of this didn’t leave much time to write.

Then, on October 7th, I flew back to Germany with my child and this time, Omi (my mother) came along!

Quarantine Baby

At the time of our arrival in Germany, children under the age of 12 had to go into quarantine for 5 days. This even applied to infants. Luckily my mother and I did not have to quarantine since we are both vaccinated. In order to make the most of the time either one of us could leave the apartment, I booked us an AirBnB right by Jungfernstieg in downtown Hamburg.

I’ve visited downtown Hamburg many times but usually only for day trips or I’d be in the suburbs visiting family. It was nice to be able to leave the building and be in the middle of the action. I let my mom be out and about most of the time. I spent my time playing with my child or crocheting (I’m really into that at the moment).

The Car Seat Saga

When I did leave the apartment during nap times, I spent most of the time looking for and buying cloth diapers. The car seat I had checked in at the Cleveland airport didn’t make it to Hamburg when we did. I had fastened the entire cloth diaper collection I had into the seat before checking it. I wasn’t about to buy disposable diapers. Luckily, I found some muslin cloth diapers and a new diaper cover I quite liked.

Three days later, I received the notification that they had found the car seat in Amsterdam and would be sending it to Hamburg the next evening. This would’ve given them a whole day to deliver it to the apartment (a 20 min trip from the airport) however, the night before our planned departure, it still hadn’t arrived. There wasn’t anyone I could call either, it was all done via email with the airline (not the baggage handlers).

I ultimately gave them the address of my uncle’s place and told them I’d have to rent/buy a car seat in the meantime since we had a long driving trip ahead of us. They said the car seat was already with the delivery service and that they would inform them of the new address. We took the train to go pick up my uncle’s car that was parked at my grandparent’s house. I went to a children’s store fully expecting to buy a new seat but the owner was so cool and offered to rent one to me instead.

Can a car seat earn airline miles?

Several days later, I received a call in the middle of the night (luckily unnoticed since I silence my phone at night) from Cleveland. The voicemail informed me that my car seat had made it back to Cleveland and they were wondering where they should send it. I called the baggage department back and actually got the same guy on the phone that left the message. We agreed that he would send the car seat back to Hamburg and that it would then stay there until I came back to drop off my mother for her return flight.

Luckily, this saga has a happy ending since I was able to retrieve the seat when I dropped off my mom.

The Germany Road Trip

The three of us covered quite a lot of road… about 2000 kilometers or about 1250 miles. The map below doesn’t include all the stops because Google Maps wouldn’t allow me to add more stops. You can get a pretty good idea of the distance we covered.

For my American friends, driving from Hamburg via Stuttgart to Munich is just a bit further than driving from Milwaukee, WI to Pittsburgh, PA. However, driving that distance in a European country means spanning various cultural differences in dialect, food, landscape, and traditions.

We had a fabulous time visiting family and friends along the way. Below are some pictures from our journey!

The First Illness

During the second to last leg of our tour, we were in Göttingen, the town I went to medical school in. Amongst other activities, my child and I went to visit some of my college girlfriends who now both have daycare-aged kids. We had a great time visiting, catching up, and playing with the kids. The day after our visits, however, my baby started the morning off by vomiting up all the milk they had just consumed. They then continued to frequently vomit copious amounts over the next two days. All that counseling I had done with new parents during residency when they were dealing with their baby’s first illnesses was taken from theory into practice. At one point, I was feeding just drops of pumped breast milk at a time with a little dropper bottle in the hopes that my baby would keep it down.

Many more outfit changes and long snuggles ensued before my little one felt better. Luckily, we didn’t have any baby vomiting incidences the day we traveled back to Hamburg. Unfortunately, now I had become a bit nauseous and developed body aches. The driver seat heater in the car was much appreciated. Fortunately, I didn’t have to vomit. I can’t say the same for my poor mother. She was not feeling well at all the night before the flight and I was contemplating changing her flight.

Luckily, I had a small home pharmacy of Zofran, Protonix, and Ibuprofen with me that got us through it. I felt back to normal the next day and my mom managed her flight back home fairly decently as well.

I guess I’ll have to be a bit more specific when it comes to “sharing is caring” with my kid. Sharing your germs is not ideal.

So what’s next?

As of right now, I will be in Germany until the end of December. I have a few more people I want to visit. I’d also like to explore a bit more of my immediate surroundings. I haven’t often been a tourist in Germany since I spend so much time visiting family and friends. I’m hoping to see a few new places and revisit a few old ones. Pre-christmas season is one of my favorite times of the year. I wrote about it last year. You can read that post here. I’m so excited to be in Germany for it again this year. It’s been 6 years since I was last here to enjoy the Christmas markets. With the way Covid is currently looking, I should be able to enjoy some markets again this year.

I have a few ideas for things I’d like to write about. I’d also like to share more of Germany with you as I explore it. It definitely shouldn’t take another 2 months before my next post. But you never know what life throws at you.

Hope you are happy, healthy, and well!

mfg

Locum

From Sea to Shining Sea

September 2, 2021 6 Comments

Originally, I thought I would be starting a new job this week. I’m so happy I’m not. It was a bit of a rollercoaster ride getting here though!

{Bridge near where I was living in Germany}

The Search

Often, with locum work, a job is found and agreed upon a few months prior to the start date. I work with two locum agencies. Doing so provides me a broader range of job offers. I told my recruiters that I would like to have a job near my mother in Ohio for September through December and starting January 2022, start traveling again.

One of my recruiters reached out in April with a job offer in Oregon. We presented me with a start date in January. Simultaneously, we were looking for a job for Sept-Dec.

Ohio Option #1

One of the first offers was an outpatient position about 3.5 hours from my mother’s place. I offered 4 days a week instead of 5. They countered and asked if I would work 3 days. Heck yes! More time with my child? I’ll take it. They offered to pay for a hotel as our accommodations. I found an Airbnb in the area and suggested that instead. That way, I could get set up in one place for the duration of the contract. Now that a child is in the picture….so is their crib, diapers, toys, etc. I did not want to move all of that every week. I also didn’t really look forward to a 3.5-hour drive twice a week but I did like the possibility of a 3-day workweek.

Ohio Option #2

While option 1 was being discussed back and forth, my recruiter from the other company reached out with an urgent care option 3.5-hours in a different direction from my mother’s place. They were looking for a physician to work 8-10 twelve-hour shifts a month. I figured I’d at most want to do four shifts in a row. That would cut down the 3.5-hour drives from weekly to about every other week. More pros included fewer workdays, freedom to create my schedule, and a higher hourly wage.

This option moved quickly and within a few days, I had an interview. The interview went really well. They even actively helped me look for child care options. I started filling out paperwork for credentialing and handed in the days I wanted to work in September. However, a few days later, they decided that they only needed night shifts covered. … Well obviously that wasn’t going to work.

Ohio Option #3

While option #2 was falling apart, my recruiter was already working in the background to find a backup option. Usually, hospitals or clinics reach out to the locum company with a need for a doctor. However, my recruiter and her co-worker flipped the script and started reaching out to clients around Ohio. A clinic 50 mins away took the bait. At this point, I was already in Germany. So instead of telephone interviews, we did Zoom calls to avoid international charges.

The first interview was with the CEO and COO. It went well. The second interview was with the medical director. It went well also. A few hours after that interview, the medical director called me back and asked if I would seriously consider a permanent position. I told him that I am a traveler and I could commit to four months. They were looking for at least a 6-12 month commitment. With that, this option was over.

Many, many options

After option #3 fell through, I reconnected with my agent from the first agency. I had told her about option 2 when it seemed like that was going to happen so she didn’t need to continue looking for Sept-Dec. Since we weren’t finding an option in Ohio, I opened up our search to everywhere. Within a few hours, I had so many options emailed to me. There were offers including New Mexico, Colorado, New Hampshire, Kansas, and Washington. I really liked the Washington offer but getting a license in Washington can take several months.

Simultaneously, my other agent really wanted to get me placed somewhere (I’m pretty sure they get paid a commission for placing physicians). She called me with an option in Indianapolis. I got really excited because one of my best friends and former co-resident/roommate lives and works in Indianapolis. The office looking for a locum was located RIGHT NEXTDOOR to the office of my friend! I was so excited.

An interview was scheduled a few days later. I know I mentioned that the other interviews went well but this one didn’t only go well, it was also a lot of fun. I instantly connected with the ladies. The work environment they described sounded great: a very diverse patient population with many non-English speaking patients. I like caring for patients from different cultures and working with translators. My friend and I discussed all the fun we would have if/when this option worked out.

Of course, the Indianapolis job was just too good to be true. They wanted me but there was an issue with licensing which wouldn’t allow me to work there in time.

Running the numbers

After the Indianapolis job fell through, I decided to run some financial numbers to see if I could afford just not working for the remainder of the year. Having saved most of the money I earned in South Dakota, falling into a lower tax bracket if I didn’t make any more money this year and that freeing up the money I had put aside for taxes, I was fortunate enough to be able to afford to extend my maternity leave!

If the perfect job had presented itself (the Indianapolis job was indeed my favorite), I would’ve liked to be back in the office seeing patients. My mom guilt would likely be a bit reduced for a job I truly enjoyed rather than just working any job. I definitely could have found just any ole job if I wasn’t the one being so restrictive. However, I refuse to work more than 4 days a week while my child is so young. I didn’t want to go to such a remote area that child care options weren’t available. Additionally, I wanted to be somewhere new and not work somewhere I’ve worked before. I’m grateful that I am in a position to be that picky.

So, I have extended my maternity leave through the end of the year! I’m back in the US for a few weeks before heading back over to Germany until shortly after Christmas.

2022

The job I mentioned at the beginning of this post, the one in Oregon, worked out! I am scheduled to work in a Family Medicine Clinic four days a week starting in January through July 2022. I’m currently in the process of finding an Au Pair to come live with us.

I am beyond excited to spend a few more months full-time with my child and family/friends. It’s great that I have new adventures to look forward to in January.

The process of finding a locum contract might seem messy and stressful. However, I actually find the journey rather exciting and thrilling. It can definitely be an emotional roller coaster to imagine yourself in various places from coast to coast in a 24 hour period. The process is not for everyone. But as of right now, it’s exactly what I want and need.

mfg

Herstory, Motherhood

How to make a baby. No birds or bees necessary.

July 31, 2021 No Comments

Fertility treatments are on a spectrum of how much is involved in achieving a pregnancy. On one end, you have home insemination kits where you buy the sperm and it gets injected into the vagina. The sperm then have to find their way through the cervix to the uterus, up the fallopian tube where they hopefully find an egg coming their way. On the other end of the spectrum lies IVF. This can involve many hormone shots, egg retrieval procedures, fertilization of the egg with a single sperm, genetic testing of the embryos, and implantation into the uterus.

My journey as one step up from home insemination. No turkey baster for me!

Intrauterine Insemination (IUI)

The procedure I had performed was called intrauterine insemination. In other words, washed sperm is injected with a syringe and tubing that has been placed through the cervical opening directly into the uterus. It’s essentially a fast pass for the sperm because they don’t have to find their way through the cervix themselves. “Washed” sperm means that any mucous and non-motile sperm have been removed. This leaves the good swimmers left and increases the chances of pregnancy.

Eisprung

Eisprung is the German term for ovulation. Literally translated, it means egg jump. I’d like to think of my eggs as little athletes who have to jump to get where they want to go, lol.

Before the IUI could be performed, I had to predict when my ovulation was going to happen (i.e. when the egg gets released from the ovaries). To do this, I would start using an ovulation predictor kit (available at drug stores/grocery stores and online)about 4 days after my period ended. Each woman has her own cycle length. I had recorded mine for many months prior to starting to try to conceive using an App. That way, I had a pretty good estimate of when things might happen since my cycles were fairly regular.

Ovulation occurs about 14 days before the next menstruation starts. That’s only helpful information if you know the average length of your cycle. Otherwise, when your period starts, you can only say you ovulated about 2 weeks prior. That’s not helpful when you need to know when you’re going to ovulate for a procedure. There are some physical signs you might be ovulating soon. The consistency of the cervical mucous changes to become more watery around the time of ovulation. This allows for sperm to more easily get through the cervix to their destination.

Smile! You’re about to ovulate!

To use the ovulation predictor kits, you have to either pee on the tester or dunk it in a cup of pee in the morning and wait. The one I used showed a smiley face if your ovulation was likely to happen in the next 24 hours. The test looks for the LH (luteinizing hormone) surge. The surge in LH triggers ovulation.

For the first round of IUI, my smiley face unfortunately presented itself the day before my family medicine board exam. I wouldn’t have been able to move that so I spoke with my doctor and decided to do it a day later. This drastically decreased my chances of it working out. However, I had ordered two vials of sperm and was only going to be in the area for two months. I didn’t want to pay for storage or shipping fees if I would’ve had sperm left over.

Not surprisingly, the first round didn’t work (even with my fertility dance). I wasn’t too upset about it since I knew the chances were slim.

Round two went much more smoothly.

Making a baby with my mom in the room

My mother was with me for both of my IUI sessions. I felt it was really nice to share that moment with her and I think she quite enjoyed it as well. Great story to tell my child someday.

So when the smiley face showed up the second time, things really fell into place. I was able to get off of work to have the procedure done the next day.

First, we had to show up an hour before the scheduled appointment to sign off on the sperm. This allowed the fertility clinic to process the frozen sperm for the procedure. An hour later, my mother and I were sitting in the exam room. A nurse practitioner came in, verified my identity, and had me verify my sperm donor’s information on the vial. Then I laid back, relaxed, put my feet up and the NP injected the sperm into my uterus. Afterwards, I laid there for about 10 minutes. That was it. Pretty uneventful. Not painful. And less fun than the alternative way of getting pregnant.

Two lines!

Two weeks after the IUI and on my last day of residency, I took a pregnancy test and it was positive!

My excitement was contained. I was very happy that it worked. I had never been pregnant so I was excited that I now knew I could become pregnant. Knowing how many more steps there were until I would be able to hold my hopefully healthy baby, my reaction to the positive test was not comparable to that in the movies. But I was definitely excited for the many milestones ahead and knew that with each of them, my excitement would grow.

Check, please!

One of the questions I often get is how much this all costs. I can only say what I paid. Each fertility journey is different with MANY different factors that can effect the cost. Some fertility clinics have all-included packages or reduced prices for self pay. I was self pay since my health insurance didn’t cover fertility treatments at the facility.

My expenses, including office visits, genetic testing, labs, imagining, IUIs, and sperm came to about $3,750.00 total. Each additional round of IUI would’ve cost me about $820 (sperm + IUI procedure).

I was grateful to be a position where I was able to save up and afford this. It would be nice to see health insurances increasing their coverage of fertility treatments. Maybe not primarily in my scenario but rather for people dealing with infertility. Infertility is a medical disorder, it’s not something people choose to have. My opinion is that it should be treated as such and be funded like other medical disorders are too.

Correction

Before I wrap up this post, I did want to make a correction to my previous post. I have since then learned that it actually IS possible for single women and lesbian couples to have fertility treatments done in Germany. I had someone come visit me a few days ago who is currently pregnant, a single mother by choice and had her procedure done in Germany. Apparently, the laws have changed somewhat which created a gray zone in the legislature. This made it possible for fertility clinics to start offering the services. So YAY to that!

mfg

Herstory, Motherhood

The Workup

July 15, 2021 2 Comments

Greetings from Germany! Peanut and I have been in Germany for almost two weeks now. Family and friends are stopping by to get to know peanut and I’m eating a ton of yummy German food.

In the last post, I explained how I chose my sperm donor. Before I could try becoming pregnant, however, there was a list of things I needed to do first. Keep in mind that each person’s fertility journey is unique and every clinic has its own unique protocols. I can only speak from experience about my journey with the clinic I chose.

The R.E.I. Specialist

No, not someone who is really into camping and works at the Recreational Equipment Inc. but rather a Reproductive Endocrinology and Infertility specialist. First on the list was a consultation with an REI specialist. As I had mentioned, a lovely woman I met during residency, who was finishing up her REI fellowship, recommended I have a consultation with her friend and co-fellow. This was during the beginning months of the pandemic, so it was a virtual visit.

We discussed my general medical history, sexual history, and desire to conceive. She explained the process and the steps that would be necessary to move forward. She ordered some basic labs as well as labs more specific to fertility such as follicle-stimulating hormone (FSH) and anti-mullerian hormone (AMH). Sexually transmitted infections testing was also done. A pelvic ultrasound was ordered to take a look at my ovaries and uterus. A hysterosalpingogram (HSG) was ordered as well. An HSG is a radiological procedure where a contrast solution is injected into the uterus through the cervix to show the contour of the uterus and assess if the fallopian tubes are open.

I also opted to have genetic testing performed to look for an exhaustingly long list of recessive genetic disorders. My sperm donor did not have genetic testing done prior to being allowed to donate. The sperm bank I used now requires all new donors to be tested. I really wanted this particular donor and felt that if my recessive gene test panel was negative, then I could move forward with him. For those of you who don’t remember how recessive genes work, both parents have to have the recessive gene AND pass it on to the child for it to affect the child. So, if I wasn’t positive for any recessive genetic disorders but the donor was, my child wouldn’t be affected. They could still be a carrier for the disease but I’ll end the genetics lesson here. Thankfully, my entire workup was unremarkable.

The Cardiologist

Prior to my REI appointment, I had an echocardiogram done to assess my heart. I have always had somewhat hyper-mobile joints and am quite tall with low back issues at times. The possibility of Marfan’s disease had crossed my mind on several occasions. I was never too worried about it until I was seriously contemplating becoming pregnant. It didn’t necessarily help when a physician assistant at one of my rotations told me the story of how she knew a girl whose mother died during childbirth from aortic rupture due to undiagnosed Marfan’s syndrome. Thankfully, my heart is fine.

The Geneticist

Despite the normal echo, I also met with a geneticist to discuss genetic testing for Marfan’s syndrome and other connective tissue disorders. I had a genetic connective tissue disorder panel done. Again, thankfully it was all normal. Now I felt like I could definitely move forward with trying to conceive and carry a child.

The Psychologist

A mandatory step prior to trying to conceive with the fertility clinic was meeting with a specialized clinical psychologist. We discussed my desire to become a mother, why it hadn’t happened with a partner yet, and how I plan to raise the child. She gave me really great insight into several topics.

Motherhood: this means different things to different people. There are also different aspects to motherhood and you may use all of them or just some. Motherhood can mean contributing your DNA to create a child and/or being pregnant and/or raising a child. I am very, very fortunate to be able to have all three aspects with my child. Some people use surrogates or require an egg donor. Some (myself hopefully included someday) adopt and raise children. These people are all mothers. For some, certain aspects might be particularly important. I really wanted the experience of pregnancy and knew I would be very sad if I couldn’t.
Sperm donor children: apparently, there are online sites where you can register with your sperm donor’s number/sperm bank information and find other families that used the same donor. This way, the half siblings can meet up. I do not plan on doing this unless my child decides they would like to. Then, I’ll support it 100%. My family is big and I have a lot of friends, so I don’t currently feel the need to expand that even further.
Single mother by choice: there is definitely a community of women, like myself, who have decided to be single mothers. There are websites, forums, Facebook groups, etc. where I could go and find support should I need it.
Raising a donor child as a single mother: the psychologist told me that there are multiple children’s books available that address this topic. In today’s world, there are so many different types of family structures raising children: mom & dad, mom & mom, dad & dad, single mom, single dad, step-parents, grand-parents, aunts & uncles, etc. I have to raise my child showing them all these different structures so that they don’t feel like someone (“dad”) is missing.

Checklist complete

Luckily, my entire workup was unremarkable and I received the green light from the psychologist to move forward with trying to conceive. I selected my sperm donor and ordered the sperm. Although the fertility clinic recommended I order four vials of sperm, I only ordered two. They had told me that most people conceive within three rounds of intrauterine insemination (IUI) (I’ll go into more detail about this in a future post). I was only going to be in the Ohio area for two more months before traveling and then heading out to South Dakota for work. If it hadn’t worked in two rounds, I would’ve established care in South Dakota and would’ve shipped more sperm there.

My appointment with the REI specialist was June 1st, 2020. My first round of IUI was July 14th. It took about a month to get the entire workup completed. I was then able to start the routine for the IUI. That will be the subject of my next post!

Svikki MD

On a different note, things are in the works for my next assignments! The first assignment will be somewhere in Ohio from September through December. In January, I will most likely be out in Oregon for 7 months! I’ll share more details once things are locked in.

As always, feel free to reach out with any questions you may have. I’ve really loved the outreach so far and getting to speak with people about sperm donor pregnancies. Really exciting news pertaining to this came out of France this week. France has passed a law allowing single women and lesbian couples to get fertility treatment! This was previously only allowed for heterosexual couples. Similar rights exist in 10 EU countries, the UK, Norway, and Iceland. Germany is unfortunately not one of the 10 EU countries that allow single women and lesbian couples to receive fertility treatments.

I am so thankful I was allowed to pursue my dream of motherhood on my own terms.

mfg

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