Mental Health In America

I have many hobbies, one of them is reading. As with most working parents, I don't always put as much time into my hobbies as I used to.  That's probably why it took me almost two months to finish my recent book.  I highly recommend everyone reads Stephanie Giese's memoir, All I Never Knowed.  Since finishing her book, I want to reflect some more.

I'm a pediatrician. I have been called (yes I feel this is truly a vocation) to care for children and to be their advocate.  Some may think I mostly give shots, treat colds and ear infections, and make sure children are growing appropriately.  Those things are only a small part of my job.  Especially during the COVID pandemic, I feel more and more like a psychiatrist and therapist too.  I have families tell me, they've been waiting 3-4 months to see a therapist.  I have families tell me they took their child to the crisis center because their child's mental health deteriorated while waiting for therapy and they started performing self-harm.  I have families wait in the emergency room for days waiting for an inpatient psychiatric bed to open.  I have families tell me they agree they should see a psychiatrist but none accepts their insurance.  I have families tell me they found a therapist or psychiatrist, but they can't afford the self-pay rate.  Receiving treatment for mental illness shouldn't be this hard.

And now let's talk about the school system for a little.  These thoughts are not directed towards teachers.  I have not met a single teacher who doesn't want his or her students to succeed.  Tell me why our current educational model waits for students to fail before they investigate the need for special education?  Tell me why parents have to fight tooth and nail to get a child a 504 plan?  Tell me why schools receive funding based on standardized tests scores and not the social-emotional well being of the students?  And guess what!?!  Having a child fail in school, especially when it could be prevented with the proper accommodations and remediation, increases the rates of mental illness!!!

I honestly thought I had more to write, but I'm tired.  And I'm getting more angry as I think about the broken system, so that's it for now.  Go read Steph's book and keep fighting the good fight!

How COVID helped me identify my hEDS.

Well hello there!!!

It's been over 5 years since I've posted on here.  As expected, a lot has happened, but I will not recap all in this post.  I'm coming back as I need a place to type out my thoughts.

On May 13, 2021, I was officially diagnosed with hypermobile Ehlers Danlos Syndrome.  I say officially, because I kind of self diagnosed myself based on the 2017 criteria, but I wanted a physician other than myself to diagnosis it. 

Since I have last posted, the world has been experiencing a pandemic.  I remember sitting in medical school, attending a lecture on avian flu and fearing if it became a pandemic we would run out of ventilators.  Well, it's not avian flu, but sars-CoV-2 that is using up our ventilators.  I could go on about the pandemic and my thoughts on American society's response to it, but that's for another day.

Ok, so since my last post 5 years ago, I had some significant hip pain.  Long story short, I had a right hip labral reconstruction with the IT band of a cadaver and some bones shaved down in my hip.  That was December 2019.  Then by summer 2020 when I started doing yoga again, I was having thumb pain so badly it was waking me up at night.  August 2020 I was diagnosed with thumb joint CMC subluxation.  I was told to brace it and it would get better when I hit menopause.  I was 36.  

Let's fast forward a couple of months.  I referred myself to occupational therapy for my thumb, stopped doing yoga, kept trying to focus on my hip PT, and then, thankfully, the scientific community developed a vaccine to help prevent severe infection from sars-CoV-2.  After my first dose of my Moderna vaccine I had a horrible headache for a week.  I felt like I could hardly hold my head up.  I also learned a dear patient tragically passed away at this time.  I contributed my headache to my grief and not being able to sleep thinking about losing a child so young.  A couple of weeks later I had my second dose of the Moderna vaccine.  After my second dose I had the same headache, but this time I also had horrible TMJ spasms that lasted about 6 weeks.  I also felt unstable in every joint that ever bothered me.  I remember laying in bed, trying to tell my body if I fell asleep my TMJ pain, headache, hip pain, thumb pain, back pain, ankle pain, and calf pain would feel better.  It was that night I realized, "this isn't normal, you need to figure it out."  I had been toying with the idea I had a hypermobility disorder for a couple of months.  My astute physical therapist brought up that I was hypermobile in almost every joint, and then I found a podcast about labral tears in hypermobile individuals and things started falling in place.  I am currently still figuring out how EDS and it's comorbidies are affecting me, but I feel like I'm finally in a place (and with a great EDS specialist) to put the pieces to together.  I'm also figuring out how to accept I have a chronic illness and to give myself grace that I cannot work as many hours as I expected, be a mom and wife, and take care of myself too.

Looking back, I see multiple times other physicians may have been able to identify signs of my hEDS, but honestly, I think they probably didn't know enough about it.  If I knew I had hEDS, the only thing I probably would have changed is my exercise.  I wouldn't have done hot yoga after my long runs while training for half-marathons.  I can't help but think about all of the micro tears I gave myself during those years.  I'm also making it my goal to help identify hypermobility disorders in my patients earlier than identified in me.  I also can't help but wonder if the COVID vaccine caused an MCAS flare, would I still think I was just clumsy and prone to injury and joint pain? It's weird how the world works.

Oh, and yes, I'd still get my covid vaccines! 

I did it! 13.1 Miles!

About ten miles in.

Last weekend I completed my second half marathon.  I'm not going to lie, this meant more to me than just running 13.1 miles.  A couple of months ago I saw one of my family members sign up for the OC Maryland Island to Island 1/2.  I saw the date was in April 2016.  At that time I was still breastfeeding my son, working full time, and of course being a mom and wife.  I learned from my first child that I didn't have the will power to commit to running while breastfeeding and pumping.  My goal was to breastfeed Andrew until he was a year old, so that meant January 2016.  I breast fed Andrew until about March, but I started getting back to working out and training around February, so an OK amount of time!  And little did I know, that when I signed up, I was going to have two co-workers out on maternity leave around the time I needed to be training for this 1/2.  I didn't do the best training, I could have tried to do more speed work, I could have done more cross training, but I did the best I could with the time I had. 

I was feeling it here! Can't you tell?

Crossing the finish line for me wasn't about just finishing 13.1 miles running, it was about celebrating me breastfeeding my second child for over a year and celebrating me finding the motivation to get myself back in shape.  I shared my body with my son for over a year between breastfeeding and pregnancy, now it's my turn to have my body back.  It's time for me to continue showing my children how to live an active life.  Running has also helped me to embrace my new post-baby body.  I actually gained 5 pounds once I started running again!  There will be a time where I'm ready to lose these 20 pounds I'm still holding onto since before becoming pregnant with Andrew, but it's not right now.  Right now I run for me, not to lose weight.

As a freshman in high school I tried out for soccer, but I didn't make the team.  The cross country team was willing to take on new members, so I thought I would give it a try.  I was never the fastest runner, and I was always ok with.  I continued with cross country and track the rest of high school.  I never knew what I gift it was not to make the soccer team and to learn the joy of running.  It hasn't been easy getting back to running after taking off for over a year, but I knew it would get better, and it has!  Exercise soothes my soul.

I finished in less then 2.5 hours, my goal!  It wasn't easy, my legs hurt, but when that happened, I ran with my heart.  This run was for me!

As an added bonus, hubby did the 1/2 marathon too! Joe says we distance runners are a special kind of crazy.  He's probably right. 

Love him!

 I signed up for another 1/2 marathon in September.  I think I developed peroneal tendonitis from increasing my distance too quickly, so my goal is to do more cross training the month of May and pick up more miles come June.  We'll see how it goes!

On being a doctor and taking a sick day

I don't know if it's just me or the influence of society, but I have extreme guilt regarding calling in sick today.  Yesterday 1/2 through the day I started feeling sick.  I'll just say I tried to get through it and ended up getting sick between patients.  The other doctors told me I needed to go home, so home I went.  Overnight I developed a fever and I just feel like poo.  The hard part about my profession is that me taking sick days doesn't only affect me, but other patients and my fellow doctors.  It took a little talking to myself, but finally I realized I wouldn't want my well baby being seen by a doc who's fighting the GI bug and has a fever, so back to bed I go.

Oh, and can I just say, it sucks being sick as an adult!

I decided to wean

Shortly after 14 months I decided to wean and stop breastfeeding this beautiful gal.  When I went back to work just after her first birthday I decided to only breastfeed morning and night.  I was starting to feel a little violated though.  It seemed as soon as I came home from work, she was reaching for me, either lifting my shirt or putting her hand down my shirt.  I feel like she was mostly nursing for comfort, so I decided to stop.  I was fortunate enough to be able to nurse her for over 14 months; the transition has gone well.  After about two days she stopped reaching for me and now our bed time routine consists of more reading and cuddling.  My baby girl is growing up.

Ray of Sunshine

I had off work today so we spent some time enjoying the clouding weather out back.  She turned around just as I snapped my shutter.  She's my ray of sunshine!

Spilled Milk?

Yes!!!!  Thanks BabySteals.com for this so true photo!!!

Sayonara Breast Pump!

Well, for the most part, I'm done pumping!  The past couple of days I realized how nice it has been not to pump at work anymore.  I'm fortunate that we're still breast feeding about twice a day, but I decided once we hit a year and I started my new job I wasn't going to pump anymore.  I feel fortunate because I feel like I was able to multitask while pumping, but it's definitely nice to eat or do work without being hooked up to the pump.  I'm also LOVING wearing dresses again!  I love dresses, but it was always so hard to pump in them so I feel like I haven't really worn a dress regularly for a year. 

I work one night a week and Joe had to put Bri down to bed that night, so I'm still pumping when I come home, but I can deal with that.

And here's a picture from this morning

"No Mommy, you are not going. I'm going to block the door and I'll go ahead and call your boss."

First Week Down!

I successfully finished my first week at my new job!  I took 4 weeks off between residency and starting my new job.  I enjoyed the time off, however I think I mostly spent it preparing for R2D2's first birthday.  The last week off we did have the opportunity to spend two nights at the beach.  Oh, my, goodness, taking a toddler to the beach is a whole new experience.  Thankfully the weather was nice because she did not like being cramped up in the hotel room.

However, I digress.  I'm loving my new job.  I feel like I'm finally doing what I have trained so long for.  That being said, I am so glad I have had all of that training, it is certainly necessary.  I'm loving meeting new families and getting to know a new set of patients.  It's also great that I have several other doctors here if I have questions.

With having a little more time on my hands, I have ventured back into the kitchen.  I hope I'll get back to posting more recipes, but we'll see.  Now with a little one, I'm spending my free time with her and not so much on the computer.

12 Months!!!

As the bottom picture shows, R2D2 is beyond excited to be finished with her basket photos!  I can't believe our baby girl is one year old now.  It's been a great year.  We survived parenthood and finishing my last year of residency.  I am so grateful to my parents, Joe's mom, friends, and all who have helped us survive this past year.

Baby girl loves to play and I love watching her learn and figure things out on her own.  I think we're back to baths as her favorite activity.  This girl loves splashing water and we have to make sure Winston's water bowl is up or else she'll play away.  She doesn't like the ocean or big pools yet though.

At her one year check up she weighed 23 pounds (89%) and was 29.5" long (63%).  Well, I guess I no longer have to worry about failure to thrive in this little one.  Now that we have reached a year, I'm going to cut back on breastfeeding.  I'll see how long we want to continue morning and night feedings, but I'm going to stop pumping once I go back to work.  Fortunately she has no problem taking whole milk, and I still have some frozen breast milk we'll use.

In terms of clothes, she's hover between 12 month and 18 month sizes.  She still hates shoes and socks.

And, she's walking!!!  She's slowly started to walk more instead of crawling, but she can crawl faster than walking for now.

We're trying to figure out if she knows mama and dada specifically yet.  I think she knows hi too.  She will always say mama and dada, but sometimes she still says dada when looking at me, but other times she'll keep saying dada until Joe says hi to her.

Burnt Out

I feel like there is so much I want to do, but I either don't have the time or the motivation to do it. Honestly, I think I just need to just catch up on sleep. I feel the bank is depleted in that department. Tomorrow is hopefully my last 24 hour shift ever!!

7 Months!

I'm getting bad with blogging.  I think the truth is I feel I have so little free time now a days that I prefer to spend it with R2D2 and Joe, catching up on sleep, or reading.

Baby girl turned 7 months last week!  She's growing and developing in leaps and bounds.  I'm not going to lie, I was a little bummed that she wasn't sitting up on her own at 6 months even though the pediatrician in me knew it was ok.  Well, I don't need to worry any longer, she's doing great sitting up.  She also is one big talker.  I can't wait to hear what she has to stay when she understands she has words and can make sentences.  I'm already fearing the calls home from her teachers that she's talking in class.

We didn't have a doctor's appointment this month, but based on weighing myself with her, I think she's about 17 pounds 13 ounces.  Gone is my 5th percentile baby.  She received a box of size two diapers as a gift, so we've been squeezing her into them.  I officially used the last one today, so I guess we have officially graduated to size 3 diapers.  Clothes wise she's straddling 6 months and 9 months.  Most of the 6 month pants are too short for her now, but some of the onesies are ok.  I predict she'll be in solely 9 month clothes by next week.

Once R2D2 turned 6 months she had two teeth erupt!  It's neat watching them come up even more and now I'm getting used to her smile with those two bottom teeth.

R2D2 is sleeping much better now. She's more consistently only waking once a night.  My call schedule has been almost every 4th night and the night after I'm gone she wakes up more often (I think to make sure I'm still home), but nothing like she used to.

I'm proud to say I'm still breast feeding.  She's transitioned to a fair number of solids that we haven't really needed to supplement for the past couple of weeks.  I can tell she's starting to wean and it's making me a little sad.  I'm going to miss our breastfeeding sessions.

Along with talking, I think baby girl's other favorite thing to do right now is play in her exersaucer.  She jumps, and jumps, and jumps, spins herself around, and just has a grand old time.  (Funny, so I reread the previous month's post to see if I miss anything and I basically wrote this same sentence in her 6 month post!)

Oh, her eyes are still blue!

6 Months!

Ok, yes, she's about 6.5 months now that I'm posting this, but I wanted to wait for her 6 month check-up!

On January 31, 2013, she weighed 17lbs 4 ounces (66%) and was 25.5 inches long (25%).  To think I was worried she was a small peanut when she was less than the 5% at 2 months old.  She's still primarily breast milk, taking about 5 ounces every 3 hours during the day.  She gets a formula bottle about once every other day.  I mentioned in her 5 month post that I was going to try to cut out pumping a little bit.  I have stopped staying up just to pump, but I'm still finding myself pumping in the car quite a lot.  I still have a not in my shoulders/neck, but it's such a good use of my time to pump and drive.

I don't want to jinx anything, but I think R2D2's eyes might stay blue.  I hope so because they are such a beautiful color of blue!

In terms of sleep, we're getting there. As most babies are, she's very attune to my schedule.  Since I'm a resident physician, I don't quite have a great, consistent schedule.  Just when we get to sleeping well, my schedule changes.  She has ranged from sleeping 6-10 consecutive hours. She sleeps in her crib at night, but man, we're going to miss the swing for her day-time naps.

R2D2 is rolling around back and forth, it's quite entertaining seeing her use rolling as her mode of transportation.  She's starting slowly to sit up on her own.

Oh man is she a talker though!  We don't have mama or dada yet, but she will sing her heart out.  I love listening to her in the mornings.  She wakes up and talks to herself for a good 5-10 minutes before crying to be picked up.

With her growth spurt, some of her 6 month clothes are getting a little snug on her.  She's not quite in 9 month clothes yet though.  We have a whole box of size 2 diapers left that we received for Christmas.  She could probably move up to size 3 but for now the size 2 is working.

Along with talking, R2D2's favorite activity is the exersaucer.  She jumps, and jumps, and jumps.  Then she spins herself around, plays with another toy, then jumps some more!

Why We're So Tired - Our Child Care Arrangments

Joe and I keep telling each other how tired we are.  Well, let's talk child care.  Joe works nights part time.  When I was pregnant he offered to stay home with R2D2 during the day. For the most part, this has worked out very well.  We don't have to pack a bag for her every morning, she has yet to have a real cold, etc.  However, this leaves her parents very exhausted.  This week Joe worked 28 hours and I worked 72 hours with two overnight calls.  We are beyond, and I mean beyond, fortunate our families can help so much.  Joe's mom is retired and comes up about twice a week.  Joe runs some errands or catches up on sleep during those days.  We are also spoiled that when our moms come to visit they generally do our laundry as well.  I have also learned to not be shy and I have asked friends to watch her sometimes so we can give our parents a break.

We are exhausted, but this is working for us.  R2D2 and Joe have a great bond and she gets to see her grandparents at least weekly.  I really do not think I would have been able to complete my third year of residency (almost there) and have a newborn with out all of the help of our family and friends!

Bottle Feeding

About 10 days ago baby girl slept through the night and I went about 10 hours between feedings. I woke up quite uncomfortable so I had to pump for relief. Of course she woke as soon as I finished pumping and I ended up giving her some of what I just pumped. As I look at this picture, I love seeing her look up at me. I've been averaging 60 hour work weeks right now and I'm finding it hard to pump as frequently as I would like. Looking at the picture shows me though that we can still have special feeding times if I end up switching to formula. I'm hoping next week I won't feel as stressed and my supply will pick up. However, I keep reminding myself I'm not super woman and I I can only do so much. Baby girl prefers breast milk, but she's taken an occasional formula bottle and that's ok.

Christmas Reflections

As a child I remember going to Mass with my family and waking at the wee hours of the morning to open my Christmas presents.  This is our first Christmas with our little one and while she doesn't understand the meaning of Christmas and doesn't show the excitement for Santa yet, having a child makes Christmas a little different.  We're starting to make our own traditions as a family.  For some, Thanksgiving is about bringing family together.  For me, I feel more that Christmas is our family gathering.  This is our third Christmas without Joe's Dad and I miss him more and more as R2D2 becomes more interactive and social. He would love seeing her look of awe at the tree lights and eating the wrapping paper  Joe had a great role model as a father and I love seeing Joe step into this role of a father.  Mr. Joe would be so proud of him.

In November my mom was diagnosed with breast cancer.  She has since had surgery and will be starting chemo after the new year.  She has stage one cancer, so her prognosis is very good, however it's still frightening to know my mom has cancer.  She's already a survivor though and we will get through this.

While we exchanged actual gifts, I truly feel enjoying time with my family was my best gift I received this year.  I'm in a busy part of my residency right now and the time off was the exact gift I needed, especially with my mom's recent diagnosis.  Our families have blessed us with their gift of time and babysitting throughout the year which has helped more than Joe and I could ever return in words or Christmas gifts.

We are truly blessed.  Thank you Lord.

5 Months Old!

I'm not going to lie, I'm downright exhausted and I'm not sure how much I'm going to write.  I recently had two weeks of night work and it's so much harder sleeping during the day now that I'm a mom than it was before.

We didn't have a doctor's appointment this month, so her weight is the old school me holding her and subtracting.  So, Joe and I think she weighs approximately 14 pounds this month.  We didn't measure her.

R2D2's eyes are still bright blue! :)

Clothes: I've put away all of her 3 month clothes and she's comfortably fitting into 3-6 months and 6 months.  I'm still getting used to the sizing system.  Regardless, she has plenty of clothes.

Diapers; Comfortably size 2 now.  I have a wholesale size box of size 2s in the garage and I have a feeling she'll be in size 3 once we finish that.

Feeding: Other than a little bit of supplementing in the first week, R2D2 has been exclusively breast fed for 5 months.  That being said, I'm taking a step back.  I've been exhausting myself waking to pump or staying up late to pump after she's gone to bed.  I was keeping up, but I wasn't making time for myself.  I pumped daily while driving to work and my shoulder and neck ached so much.  I've decided to cut out pumping while driving to work unless I didn't get to feed her before I left and I'm stopping staying up late just to pump after she's gone to bed.  It took over a month for me to accept this, but I have.  I'm still making enough for her to have 3-4 bottles of breast milk a day and then she gets about 1 bottle of formula.  The first day Joe said she didn't mind it, but the second day she definitely made a face and pushed the bottle away.  I don't want to waste my milk, so I'm not going to mix breast milk with formula in one bottle.  If she's hungry, she'll get used it to.

We started solids this month too.  So far we've tried oatmeal, butternut squash, sweet potatoes, apples, carrots, and green beans.  She likes everything but the green beans. I've tried them on several occasions and she keeps spitting them out.

Milestones: R2D2 can now roll from her back to her tummy.  She rolled tummy to back when she was about 3 months and did that several times for about 2 weeks, then stopped.  She still doesn't roll tummy to back that much any more.

Sleep: We're still working on sleep.  For the most part, she can now fall asleep on her own in the crib, however she's still not consistently sleeping more than 5 hours before starting to wake every 3-4 to feed.

I know there is more.  I can't put down all of the changes and joys she's brought us in just one post, however, I hope she'll enjoy reading these when she gets older.

Four Months Old!

Our baby girl is a third of a year old!  Now that I'm back to work, the months are going faster :(  She had her 4 month check up on the 20th.  She weighed 12 pounds 4 ounces and she is 24 inches long.  Her weight is now about the 12%, so that makes me happy.

R2D2's eyes are STILL blue.  I love seeing her big blue eyes look up at me.  I really hope they stay blue because they're such a beautiful shade of it.

Clothes: 3 months clothes are getting a little tight, but the 6 month clothes are still a little too big.  I'm trying to rotate her clothes so that she can try to wear things at least once...

Diapers: She's comfortably fitting into size one diapers right now.


Feeding:  I'm happy to say we're still breast feeding.  I'm producing just enough milk, but just enough is still enough.  She's not sleeping through the night and I wonder if she had more to eat during the day if she wouldn't wake to feed overnight.  I'm not pumping enough for that to happen, so I'm ok with waking to feed her in the middle of the night.  I'm not going to lie though, I am reaching the extreme state of exhaustion.

Sleep: As I said above, she's not sleeping through the night just yet.  She'll sleep for about 4-5 hours when I first put her down and then wakes every 3-4 hours to feed the rest of the night.  We've transitioned to her sleeping in her crib though and she's been falling asleep on her own in the crib :) She takes 1-2 naps a day.

Activities:  She's become much more social, which I love!  Joe can get her to giggle up a storm and she's been talking more.  She enjoys tummy time more, but still doesn't roll over from tummy to back that often.  As you can see from the picture, she LOVES putting her hands in her mouth.  Mom said I had my first tooth around 4 months old, we'll see about R2D2.

As you can see, she's starting to outgrow the laundry basket :)

The difference a year makes

People tell you being a mom is unlike anything you've ever experienced before.  While I certainly listened to them, it didn't set in until I actually became a mom.  Seeing my baby girl look up and smile at me truly brought tears to my eyes today.  I have friends who have experienced losses and friends who are having difficulty getting pregnant.  I look at our daughter and hope these friends can experience this unconditional love too.

I've written before that I feel like I'm a mom to two children.  I think I would be in awe of our daughter even if I hadn't experienced a loss, but having experienced one, I know I appreciate our gift that much more.

When R2D2 gets old enough to understand, I imagine I'll tell her about my miscarriage (decades from now).  She and her sibling are connected.  I had my positive pregnancy test on June 10, 2011, unplanned, R2D2's baby shower was June 10, 2012.  R2D2 was born July 17, 2012, my D&C was July 18, 2011.  I hope one day to give R2D2 a living sibling, but unknown to her, she already has one.  So, while I will always grieve our little one that was never born, I'll love R2D2 that much more and be thankful for every day I have with her.

(This post also stems from being back to work and seeing terminally ill children and not even wanting to imagining what those parents are experiencing).

My Breastfeeding Woes

This past week was my first full week back to work.  I was fortunate enough to only work 3-4 days the first two weeks back.  This week, I'm definitely noticing a change in our nursing relationship, and not a good one.  R2D2 takes about 4 bottles a day and then I nurse her 3-4 times when I'm home.  This week the first feed she's almost always not taking a big enough latch and then often biting and pulling away.  Not fun!  I know that with her age, it could be that she's more easily distracted, but I definitely think it's laziness/nipple confusion because by our morning feed she has the pattern down again.  To help support my worries of laziness/nipple confusion so more, after having only the breast since Friday night and it's now Sunday, she's back to efficient and effective nursing.  I adore being able to nurse her, so I'm determined to make this work.  I have a medela pump, so right now we're using the medela bottles.  I thought about buying Calma Nipple but reviews state babies generally won't take it if they're already had other nipples since it's so much work.  Plus that darn nipple is expensive!  Others have recommended Avent, so last night I bought some Avent Natural bottles from Target.  The nipples are definitely wider than the the medela nipples so I'm hopeful.  I've also heard good things about Breastflow and Tommee Tippee, so those are options too.  I never thought I'd spend so long in a bottle aisle analyzing the shapes of nipples.  Again, such is the life of a working breastfeeding mom.

Oh! My other breastfeeding excitement for the week, I left my pump supplies home Friday!  Friday morning I pumped before going into work, washed my valves and flanges and put them by the sink to dry.  At work I go to pump in the morning and uh oh, no flanges and valves!  There was a Target about 15 minute from work, but I was carrying three pagers and it wasn't quite feasible to leave work for an hour.  Fortunately our hospital uses Medela for our breast feeding moms and our lactation consultant had extra parts.  That being said, we couldn't meet up until about 7 hours after my last pumping session.  Yowsers.  I know some moms hand express, so here I am in our resident work room looking up a you tube video on "how to hand express."  Thankfully no medical students walked in while I was watching that video.  But again, a breastfeeding mom does what she needs to do.   For some relief, I ended up trying to hand express.  Yeah, hopefully that will be the last time I have to do that.  It's not very easy trying to contain the milk and it's definitely a lot of work to get a little bit of milk.  All in all, I was still able to pump what she took by the bottle while I was at work, so that worked out and now I'll be carrying an extra set of pumping supplies in my bag.