Tuesday, January 31, 2017

Pumping By Rotation

Pumping while completing my rotations has been awkward, even though no one has ever made me feel that way.  Before third year started I wasn’t’ sure how I was going to get pump breaks or who to email. One day I sucked it up and emailed the clinical coordinator about having to pump. Fortunately, the clinical coordinator was someone who breastfed their son for a year and had just recently ended her breastfeeding journey. She completely understood. I met with her before school started and she actually took me to my first attending doctor, let him know I would need to pump, how frequent and asked if I would have a room there to pump. I was also lucky that the hospital provided me with a lactation room that was ah-maz-ing. 

Amazing door to my pump room

    Dimly light, cozy, comfortable and with relaxing background music.
It is located within the Women’s center and every time I entered I am greeted warmly and met with encouragement!

When I first thought about pumping, I thought it would be a relaxing break every few hours. Even though I would be hooked up to a machine, I could get a few minutes of studying in. In reality I could of, but most of the time I am frantically massaging -trying to get at least 12 oz. out and back to the hospital floor as soon as possible.

My biggest concern was looking like an absent student, even though I all attendings said they understood. Because of this, I was able to make it so I could survive on one pump session a day without significantly dropping my milk supply. I just had to be sure to get the same amount of milk as I would before. I was able to accomplish during my first rotation, though I don’t recommend it because I feel like I was just lucky. A week before 6 months my supply did start to go down, and I was on my psychiatry rotation. Which meant my days ended early so levi wouldnt need as much milk sent. Also at this time I added a 2nd pump session earlier in the day.

Overall pumping can be time-consuming, inconvenient and annoying, but overall, it is so rewarding knowing that no matter how busy medical school is, I can provide the best for my son.


Pumping by Rotation

Pediatrics
Pediatrics was my first rotation. Even though I was nervous when I had first started my pumping journey, I knew that pediatricians would be the most likely to understand and welcome the pumping breaks. I found that I could easily manage my patients and attend any teaching session without my pumping breaks interfering. For this rotation, I just used one of the empty exam rooms in the outpatient clinic. This saved so much time.

Rating 10/10
Based on ease, timing and my comfort level

Ob/Gyn
My second rotation was Ob/Gyn-another field that is very pro breastfeeding. The first day I went to pump at 1pm and both of my patients delivered during the 30 minutes I was gone. I was a little letdown (no pun intended), but lucky this wasn't the pattern for the rest of the rotation. For the most part, I was able to balance predicting when a patient was going to deliver and would sometimes go and pump sooner so I didn't have to worry about painful engorgement or missing the delivery..
My rotation partners have really included supporting me as a part of 'team work"
One time during this rotation while pumping one of my patients was going to have to be brought back for a C-section and my classmate texted live updates so I was able to make it to the OR just in time.
I did push pumping a little too late once and leaked, but overall I was able to make it through the rotation Without any significant difficulty.
-I did have overnight shifts and that was a little tricky. I would have to pump during the shift for milk during the day, and while sleeping during the day I would still have to wake every few hours to pump for milk. It really threw off my rest and puming at night was hard to balance because I had no idea how much Levi ate overnight.

Rating 8/10
-Points lost because of missing deliveries and possible difficulty detecting appropriate pump breaks

Psychiatry
With shorter shifts, I thought psych would be one of the easier rotations to pump on, but during this rotation, I found pumping to be the most inconvenient. Even though we were at the hospital for 7 hours. We were only with the doctor from about 9:30-130 or 2. An hour of this time we spent on our lunch lecture and about 1 hour a day was spent pumping (two breaks about 30 min each). The psych unit is locked and often times the psych team was asked to do multiple consultations within three different buildings of the hospital. I felt like I wasted a lot of time in transport, waiting for someone to open the psych ward door or chasing the team down on one of the consults. During this rotation I felt like having to pump significantly impacted my learning experience.

Rating: 6/10.

Neurosurgery
The potential of a 10-14 hour surgery had me nervous about this rotation, but it was actually pretty relaxing and I didn't feel uncomfortable at all. When I told the neurosurgeon I would have to leave to pump he was like ' 'that’s’ so cool!' Not that I was pumping, but the fact that I have a son & breastfeed. He even made a short Comment as how awesome it is for long term benefits. He left it up to me if I wanted to get scrubbed back into a procedure after pumping. 
Also the OR is located right under my pumping lounge, so no scrambling between buildings.
The PA would talk about the details of the operation that allowed me to adjust the times I pumped to align with slower parts of the procedure, while patients were being prepped or in between operations without to much discomfort.

Random story: In the middle of an operation the surgeon asked me how long I plan to breastfeed. (everyone could hear). I told him at least a year and he was like "Well I really think you should go longer than that!" Apparently, he has family members who are very involved in Le Leche League! I do want to go longer than a year but am normally questioned about that decision and didnt want to "risk' having to defend it in te OR, so I downplayed my answer. Itgreat reat to have some pro breastfeeding encouragement, even if it was akwardly in the middle of a quiet OR!

Rating: 9.5/10
Even though pumping was manageable, I did have to leave procedures to pump.

Neurology
I was pretty nervous about neurology because it has a busy schedule but the time in between rounds were pretty independent. You were expected to see all your patients, new consults and write your notes before afternoon rounds. It was pretty easy to manage, I never even told the attending I needed to pump, and was never behind. On an occasional busy day, I would skip lunch or snack on the go, but overall it was manageable

Rating 10/10


Overall I have found the hospital to be very supportive of my breastfeeding goals. I look forward to updating you more on this journey!

Love Well,
WifeMD

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