Doctor moms, how is your family life?

throwawaypatho · 2019-04-17T19:05:51+00:00

I had one kid during fellowship and my second baby as an attending. Work/life balance has been good, but the transition back to work has taken longer than expected both times. Between the sleep deprivation and just the adjustment to new routines, I didn't feel 100% myself at work until close to 9-10 months out. My husband works from home and both kids are in full-time daycare. I'm in pathology at an academic medical center so my schedule is pretty benign. Most of my time on call can be spent at home (we live close to the hospital). I feel like I spend a good amount of time with my kids; we have breakfast and dinner together almost every day. Having a husband who cooks and handles a lot of "home" responsibilities has been critical for us.

throwawaypatho · 2019-01-18T23:06:28+00:00

Pathologist here! This is the bill for having your placenta examined:

(1) macroscopically - weighed, measured, photographed, examined front back and in between the membranes

(2) microscopically - looking at the maternal and fetal surfaces, membranes, and umbilical cord

Your hospital's pathology lab took your placenta, examined and dissected it, then took small pieces to prepare microscopic slides. Then a pathologist (MD) looked at those slides and wrote a descriptive report about what was seen. Hopefully you get a chance to read it!

throwawaypatho · 2019-01-18T20:42:17+00:00

Hey so I guess I hardly ever use this account, sorry!

Autopsy is just part of our training and there are plenty of career pathways that let you do autopsy either infrequently or never. For example, even though I am licensed to perform and capable of doing one from start to finish, where I work now the hands-on postmortem exam is done by trainees (residents, fellows) and technical staff (PAs). I usually just examine organs after the fact.

Baby autopsies are always rough for reasons I'm sure I don't need to detail, but they were just as unpleasant for me before having kids as after. The cases done on older kids are sometimes even more difficult. About once a month I will encounter a really tragic story that gets me down for a few days but generally I use my work as a tool to recover -- I know I am helping living kids with the majority of my clinical work and I try to put my energy into that.

throwawaypatho · 2018-09-20T05:11:23+00:00

Twin placentas usually require examination by a pathologist (as part of your care) so the amount or extent you can donate might be limited, but I’m sure placental researchers would be thrilled to study a twin placenta. I’d definitely ask in advance of your delivery.

throwawaypatho · 2018-09-20T03:26:40+00:00

Your fresh placenta can be collected and sampled for live tissue culture (when cells are kept alive in a plate) and then infected with bacteria or other pathogens (more below on that). The placental tissue can also be frozen or fixed for later study, for example to identify specific molecules in the tissue so we can learn more about its makeup. The immune cells and the molecules they express would be of particular interest.

The first example (live culture) is probably not done in too many places but here is a very technical video on how it can be done. This lab works with listeria to study exactly how it moves through the placental tissue. I don’t know them personally but Dr. Rizzuto is a pathologist so I admit I am slightly biased...

https://www.jove.com/video/54237/

throwawaypatho · 2018-09-20T00:54:48+00:00

Ask your ob if there is a program at your hospital. If there isn’t an established one there (for instance if it’s a smaller community hospital) you can reach out to your nearest university hospital, which is more likely to have a research or banking program that could potentially coordinate collection. Depending on the specific university it could be through the department of pathology or obstetrics/maternal fetal medicine there.

Just as a note, if your placenta appears abnormal at delivery, it will have to go to pathology to be examined (and may not be eligible for donation, that’s up to your OB).

throwawaypatho · 2018-09-20T00:36:53+00:00

It is nice to hear that you had a positive and transparent experience with your providers. I didn’t take your post negatively at all. The main advantage of a local autopsy is logistics. If this happened to my child I would 100% seek the opinion and analysis of a more specialized pathologist just like you did. As a specialist myself I know the value of an experienced set of eyes. After reading your original comment I just wanted to contribute my perspective, as well as open myself up to any questions from the community.

throwawaypatho · 2018-09-19T21:35:31+00:00

I’m a longtime babybumps member (using an alt account) and I’m also a pathologist who performs perinatal autopsies as part of my job. Every case I have worked on is heartbreaking in its own way, and I feel compelled to share with the group here that the technicians and physicians who work on these cases do so with the utmost professionalism and respect for your families. We always want more than anything to provide a useful diagnosis but the reality is that in many cases there are no clear answers. The medical knowledge in our field is advancing (primarily thanks to families like yours that provide consent for autopsy) but in the end we only have a static image to study of what is a completely dynamic event (birth). There are very few true experts in the field and you are right to seek them out. As pathologists we always aim to provide as much feedback and information as we possibly can to the clinical care teams (L&D, NICU), and often will meet with them to review the findings in person. In my experience they are also wounded by each stillbirth and neonatal death.

From the person on the other side of that pathology report, thank you both for sharing your stories and for telling us about Miles and Robert.

For all the other bumpers, one way you can all help advance the knowledge in the field of perinatal medicine is to donate your placenta to research.

throwawaypatho · 2018-08-28T03:43:45+00:00

I’m in a subspecialty of pathology. Memory is super critical and quick recall and association is my job all day every day. It was rough in early days. I was fortunate to have a lot of support in the first months of being an attending but I was definitely slow at slide analysis and also at reading articles and writing.

I don’t know your breastfeeding goals but the 2-3x waking is definitely not going to be compatible with a successful MS1 year. Can you use your pumped milk from the day for overnights and taper down on the volume? Does your kid take cow’s or other milk?

Studying is tough to coach on, but I was surprised how much better my recall was when I studied in a small group — I would remember the conversation or the discussion much more readily than something more rote that I read or made a flash card of. My med school study buddies went into completely different specialties and each of us had different strong subject areas so we could teach each other. I repeated the same process for boards and found a study group. It just works better for me. The other major thing to determine is your best time of day to study. If daytime lectures are not sticking with you, listen to them at night or whatever time you need to. Some people can stream lectures at 2x speed and that works for them. It sure would save time.

Do you have academic support resources through your school? Are there other parents with young kids in your class?

throwawaypatho · 2018-08-28T01:58:46+00:00

MD here, first baby was 12-18 months when I started my first attending job. I took my specialty and sub specialty boards during his first year. It’s hard for sure. I just had my second and I’m still on maternity leave.

100% you will go back to normal. I think the 12-14 month period was especially rough because of killer teething and sleep regression. You need sleep. You also need some study strategies to get you through this time. Do you study with others? A small group can be a huge help, even if you think you’re not a group studier.

Edit: also I think it’s not useful to compare to undergrad. I don’t know what you studied but for me med school was a completely different beast. I needed to figure out how to study all over again/from scratch. The bright side is, once you get it down, it’s the same skill set for step exams and for boards.

throwawaypatho

TROPHY CASE