Denial

I think I'm kind of in denial about this pregnancy. I mean, I know I'm technically pregnant, but that has never resulted in anything more than an empty sac + a lot of physical and emotional ache for me. So it's just so hard to imagine it any other way. Part of it is also that I'm unable to even talk to my doctor right now. I'm probably going to call this week but the office has been closed for Christmas and stuff, and it might be closed next week too. It's also in Sweden, and I am in Hawaii.

Yeah, did I mention that?! Maui, to be exact. I'm here with Mr. E and 5 other friends. We are having a blast so far. Yesterday was our first full day and we went on a snorkeling trip, and then to the beach, then out to dinner. It is really freaking beautiful here.

Anyway, so I'm on vacation and short of going to the emergency room, there's nothing I can do right now. I'm trying to relax and not worry about it, but....well, you can imagine how that's going.

This pregnancy has been so different though. I've only taken the one test (well, plus the negative one the week before). With both my other pregnancies, I took a million tests and they all got darker, and my betas the second time around even looked great for a while. It didn't matter. At this point there's not really anything they can do. It sucks though. I wish I could just know already if this has a chance or if it's just another empty sac.

But right now, it doesn't feel real and when I do think about it, it's usually just like well, I will probably spend all of February in the miscarriage process, so I'd better plan for that. I hate that that's how I think now. :( I still feel jealous of the pregnant women I see, because it doesn't feel like I am really pregnant. It's hard to explain. It just feels like I'm waiting for the other shoe to drop.

Well, here we go again.

On December 8, one of my good friends got married in NYC. DH came over for the wedding, and after that was going to head to MN to be with me. I wanted to go to the wedding but due to school stuff, I didn't know until about 10 days out that I would be able to go. Tickets were really expensive at that point ($741, to be exact), but after much hemming and hawing, I decided to go. You only live once, and all that. As a bonus, we would hopefully not be out this cycle because I knew I would be O'ing that weekend. If I hadn't gone, I wouldn't have seen DH until after O and we would have no chance. So I went, and we had a blast at the wedding. And we had sex, of course. I wasn't able to temp that weekend because I basically didn't sleep at all, but it seemed like we would have a chance. But honestly, it took 4 cycles with our first BFP and 8 with our 2nd (all with perfect timing), so I wasn't optimistic.

At what I think was 12dpo (although, like I said, no temping), I got a nosebleed. I had a nosebleed the same day I got my last BFP. I also had a nosebleed last cycle and immediately tested. Wasn't pregnant. I decided to test this time though. I walked through a super sketchy area of Minneapolis to find a CVS (didn't bring my wondfos!) and found what I thought was a FRER, but was actually just an ER (get your result in 1 minute, but wasn't a super sensitive test, I don't think). I tested. BFN. Bummer, but not unexpected. Packed a shitload of AF supplies and headed off to NYC for Christmas.

On 13dpo, I had some mild spotting. It was, ahem, provoked. But I figured AF was on her way. However, after that one time, there was no more spotting. Weird. 14dpo, still no spotting. 15dpo, still none. My longest LP has been 15 days but it's usually 13-14. On 16dpo, which was Christmas Eve, I started to get a little antsy. Could it be? Nooo, I had already tested. Stop getting your hopes up, Mrs. E!

OK, are you ready for my crazy confession? It's crazy, I admit. We went to 11pm church with my family and I had to pee before the service. I realized while in the bathroom I had an OPK in my purse. I took it, knowing that a lot of pregnant ladies turn OPKs positive. It was super positive. Oh man, WHY did I do that?! I told DH what I had did and he told me I was insane. But now my hopes were up.

A stealth mission to get an HPT without tipping off my parents ensued. DH and I volunteered to walk the dog. DH walked him while I booked it down to the 24 hour CVS 5 blocks away (it is now 1am on Christmas Eve). I made sure to get the real deal FRER this time. A stealth mission to pee on said HPT without tipping off my parents ensued shortly after. It involved a ziploc bag and making my dad wait to shower. It turned positive almost right away.

HOLY CRAP.

Third time's a charm?

Busy bee

Well I've been super busy here in MN. My day goes something like this:

5:41 - alarm goes off (I have to set my alarm for certain times. Some numbers are good, some are bad. I know, I'm crazy. But I digress.)

7:00 - arrive at the hospital and try to see my patients that are still on our consult list

7:30 - they change the list, and DAMMIT my patient is gone. I did all that work for nothing. Start looking to see which new patient I should go see.

7:50 - get a page from a resident telling me to go see Mr. X

8:00 - go see Mr. X and start my note.

8:45 - get paged again, go see another new patient and start the other note.

9:30 - Start rounds

12:00 - lunch conference (lecture with free lunch. Which is sometimes good, and sometimes bad, like when they have meatloaf, mashed potatoes, and green beans. For the vegetarian, that means mashed potatoes + green beans. Luckily there are always cookies, which happen to be delicious. Particularly the M&M cookies. But I digress again.)

Anywhere between 3:00-5:00pm - finish rounding on all our patients.

Anywhere between 4:00-6:00pm - finish writing my notes and go home.

After I get home: Make dinner, watch an episode of a show, and crash.

Rinse and repeat.


Some gems from my most recent attending:

"I'm hypo-impressed by these findings."

Me: Can you please explain how you can tell that that EKG is afib and not aflutter?
Him: I'm a cardiologist, that's how.

"I don't use smartphones. Everyone has a finite amount of intelligence and if you use a smartphone, that uses up some of it."

"I don't believe in text messaging."

Him: I like my Motorola Razr.
Fellow: I liked mine too. IN COLLEGE.

Week 1 = Steep learning curve!

Well, I have officially survived my first week as a US med student. Phew. It was pretty rough, actually. I've felt really overwhelmed. Everything is different. The chart system, the way you write your notes, the way you present, the way the team works, the responsibilities of the med students, what you are expected and not expected to do, etc. etc. etc. Not to mention I couldn't even find the bathrooms my first day, let alone where my patient's room is.

I'm upset because I don't feel like I've been making as good an impression as I want/need to. I've studied up on a lot of things I've forgotten (like mechanisms for drugs, stuff like that). But, of course, I haven't gotten pimped on those things, just other things that I didn't know. I prep my presentations, but then when I start talking in front of all the residents, fellow, and attending, I freeze up and make stupid mistakes. Even though I'm reading from a freaking paper!!

I'm hoping next week will be better.

And now, I leave you with some memorable patient quotes:


African lady with a thick African/French accent: "How ya doin', sugar?"

Confused lady: (pointing at me) "She's the minister."

Nice man: "You're a good listener. I mean, keep honing your skills, of course. But you already are a good listener."

First impressions of Minnesota

I've been in MN for about 48 hours, and here are my first impressions:

1. The people are so incredibly nice, friendly, and helpful. Puts us East coast-ers to shame. Not to mention the Swedes!

2. It's windy, and the wind is cooooold.

3. There is nothing to do in downtown Minneapolis. But there is a Target.

4. SUPER TARGET!!!! Even better than regular Target.

5. Apparently parking garages are called parking ramps. Who knew?

6. The Twin Cities are much more ethnically diverse than I expected.

7. People talk like the mom on Bobby's World.

8. Tons of buildings, streets, etc have Scandinavian names.

9. The U of Minnesota mascot is the gopher. Seems kind of lame, I mean, are gophers aggressive? Maybe they are like the gophers in Caddyshack.

10. All the buildings at the University, and all the buildings in downtown, are connected so you can walk anywhere you need to without going outside.

Well, that was a first

In general, customer service in Sweden is pretty terrible. Usually when I call a bank or a phone company or something, I talk to people who don't seem to know anything at all. Today, I had to call my insurance company to try to get reimbursed for the registration fee for the race I couldn't run a few weeks ago because of my hip. I had been to the doctor and had a note, and I needed to know what information they needed and where I should send it.

When I called, the guy who answered sounded a little cranky, and I was thinking, this is going to be difficult. He asked me some basic questions, and when he asked me what the diagnosis had been, I said overuse, because that's what the doctor had told me. Then he asked me what I did for a living, and I told him I was a med student. He said, "oh, well have you diagnosed yourself?" and I was annoyed, thinking he was accusing me of lying about having been to the doctor. So I said "No, I went to the doctor at XX Clinic." He said "oh, I just meant maybe you had a better idea of what the specific diagnosis is, since overuse is so general." Ha! After that, the conversation went something like this:

Him: So, how far have you gotten in med school?
Me: I graduate in January, so I'm almost done.
Him: OK, so after that, you have internship and residency, right?
Me: Yep.
Him: Do you know what you're going to specialize in?
Me: No, I haven't decided yet.
Him: May I make a suggestion?
Me: Um....sure...??
Him: You should go into renal medicine. <<and then proceeds to explain why he thinks it's the most interesting thing ever>> I'm involved in lobbying work with politicians in this area.
Me: Oh, like as part of the patient organizations?
Him: Yes, I had a kidney transplant.
Me: Oh wow, it's really great that you are active in that organization and everything.

We kept chatting, he asked me where I'm from, why I live in Sweden, the usual. He then got all my information, and said that was all, we were done. Then:

Me: Don't I have to send in the papers?
Him: ....Naaah, I trust you....as long as you go into renal medicine! Kind of like blackmailing you.
Me: Haha! OK, well I promise I'll think about it.
Him: And preferably in Northern Sweden, that's where I live, and we really need more renal specialists.
Me: OK, well I'll think about it, but I think I might freeze to death and/or die of the darkness up there.

Then he starts explaining how "people in Stockholm" think it's so dark up in Northern Sweden but that's not true at all. They get lots of snow so it's really bright, and the winters are great. Um, yeah, ok buddy, sure, you keep telling yourself that!! I promised him I would consider it.

So, there you go, a friendly customer service guy who made my life easier by saying I didn't even have to send any paperwork in. As long as I go into renal medicine (which happens to be, like, the most boring type of internal medicine, in my opinion) in Northern Sweden (which is never gonna happen.) HA!

Defeated

Well, this cycle is a bust. For some reason, I stupidly thought we might have a chance, even though this is only our first cycle this go-around. I just feel so defeated. Mr. E and I are going to be on different continents for the next few months and while we will hopefully be together for one fertile window, it's not a sure thing and what IS a sure thing is that we will miss several cycles.

I'm starting to really give up hope that we'll ever get our take-home baby, but I am not giving up yet. But today, I'm feeling really down.

I vow to never...

I've had a hellish week, loss-wise. Surrounded by pregnant people and new moms, many of whom have said some very obnoxious and hurtful things. One of these people dealt with infertility for years, and I couldn't believe the things that were coming out of her mouth. It's like she has no recollection of what it's like to be on the other side (she doesn't know about my situation).

I told Mr. E about some of the comments and things that have happened, and made him promise that if we ever have a baby and I ever do stuff like that, to punch me in the face.

And I'd like to go on the record and say that *IF* I am ever lucky enough to take home a rainbow, I vow to never:

Rub my belly constantly during a conversation.

Brag-plain about pregnancy having a baby (for example, "well, I never sleep or eat hot food anymore thanks to this kid!" or "This stupid kid is causing me so much back pain!")

Not complain about pregnancy or baby-related stuff to anyone except a select group of people who I know for a fact will not be hurt by it.

Talk about nothing except being pregnant/the baby.

Relate every conversation topic back to the baby.

Ask someone (besides, like, my mom) if they want to feel the baby kicking in my belly.

Show someone 948362648 pictures of the baby without them specifically asking.

Say deep things like, "I never knew what love was until I felt him kick." That stuff is like a knife in the heart to people like me.

Ask anyone, ever, when they're having kids. Ever.

My life right now

What's going on in my life right now:

1. I am leaving for the US in 16 days!

2. I graduate in 96 days!! Oh.my.gosh.

3. I think I am 2DPO in our first TTC cycle since our most recent loss. I am obsessing like a newbie, even though I know the chances are low that I would get pregnant this cycle. It's impossible not to hope!

4. I went to the doctor about my hip and she said it was overuse. That's good, but she said a lot of things that made me pretty sure she has no idea what she's talking about. I didn't really trust her. *sigh* She ordered an x-ray, but being the crazy TTCAL-er I am, I obviously cannot get a hip x-ray done during my 2WW! Even Mr. E said that he understood and that he didn't think I was crazy for waiting.

5. I have been gradually, sloooowly, increasing my running again, making sure not to run 2 days in a row to reduce the risk of irritating my hip. I ran 4 miles today and so far, no pain. We'll see how I feel tomorrow. Last week it hurt the day after 4, but 3 was ok. I am bummed that I had to skip my 10K today, though.

6. I am drowning in schoolwork. It's ridiculous. The amount of papers, presentations, group projects, and tests is astounding. I'm not sure how I'm going to get it all done before I leave, but I guess I will just have to find a way!

7. I have my plane tickets booked, found an apartment, and made my holiday plans. But I still don't know what rotations I'll be doing, because they don't know yet. How is that possible? I don't know.

8. Re: #4, I should confess I lied to FF (Fertility Friend). I told it I had a + OPK but that's not really true, it was just reeeeeally close. However, it followed my typical pattern and I've had a temp spike so as long as my temp stays up I'm leaving it as +. Crazy, I know.

9. It is really cold in Sweden right now. Around freezing at night. And the heat's not on yet. Brrrrr.

10. I learned in school that Sweden has a much higher than average level of background radiation, due to the ground being made of granite as opposed to limestone, as it is in most of the world. I told Mr. E this and that we should add it to the list of things that make me wonder why I live here (see #9 for another item on the list).

...And with that, I'm back to work on the endless assignments!

Grieving

I am really grieving the loss of my first angel this week. Tomorrow would have been his/her 1st birthday. I can't believe we've been TTC for over 2 years and....nothing. I'm just kind of in a state of disbelief right now, especially after meeting a friend's new baby a few days ago (and we're meeting another new baby tomorrow). We're good people, and I think we would make good parents. Will it ever be our turn?

On the bright side, we are medically cleared to TTC and have decided to go for it this month, even though a pregnancy (and possible loss) would be very difficult due to me going to the US at the end of the month. But if it happens, we'll figure it out.

What has happened in the past week

The past few days have been a whirlwind!

1. I got my formal letter of acceptance for my away rotation in the US. FINALLY.

2. Because of #1, I could finally book my flights to and from the rotation (making a stop on the way to see family and friends, of course), back to the East Coast for Christmas, Hawaii for New Year's with the husband and some high school friends, back to my rotation, and then back to Sweden. Phew. I leave on October 29, which is now less than 4 weeks away!!

3. I found a place to live! I am going to be living with my 2 classmates doing rotations at the same school. One of them I'm pretty good friends with, the other one I don't know well. I did most of the legwork, which was stressful, but we ended up with what I think seems like a pretty nice place. 3 bedrooms, pretty close to the campus.

4. I went for my first semi-successful run today since my half. My hip has been really, really painful but the past few days I've been able to walk without pain. I tried to run on Tuesday but it hurt. Today, my whole hip and quad area felt kind of weird, but it didn't hurt. I ran one lap around the small lake near my apartment, which is probably not even a mile. But whatever, I'm happy, I didn't want to push it.

5. Other than that, I've been swamped with schoolwork. It's presentations, papers, and seminars up the wazoo. Trying to hang on for dear life.

Half Marathon Playlist

When I was getting ready for my half, I obviously wanted to make a killer playlist. I know a lot of people don't run with music, but I do, so I wanted a good playlist to get me through the race. I took my favorite songs off my regular playlists, asked other runner friends, and scoured the internet looking for ideas. I decided to post my playlist in case it helps anyone!

The whole playlist is about 2:45 (the cut-off time for the race, I wanted to make sure I had enough to get me through even if I came in last place!)

A Place to Stay - Jenny Silver *
Amusement Park - 50 Cent
Black or White - Michael Jackson
No Church in the Wild - Jay-Z and Kanye West
No Superstar - Remady **
Moves Like Jagger - Maroon 5 feat. Christina Aguilera
Kill Yourself - Timbaland feat. Sebastian and Attitude
I'll be Waiting - Talisman
Evacuate the Dance Floor - Cascada
Lose Yourself - Eminem
Born This Way - Lady Gaga
Pump Up the Jam - Technotronic
Superstar - Jamelia
Without Me - Eminem
Check On It - Beyonce
Enter Sandman - Metallica
Low - Flo Rida feat. T-Pain
Live While We're Young - One Direction
Wake Me Up Before You Go Go - Wham
Jag Måste Kyssa Dig - Nanne Grönvall *
Applause - Lady Gaga
Thrift Shop - Macklemore and Ryan Lewis
Can't Be Touched - Roy Jones Jr.
My Body - Young the Giant
All I Ever Wanted - Basshunter
Troublemaker - Olly Mars feat. Flo Rida
Independent Women Part I - Destiny's Child
Shake That - Eminem feat. Nate Dogg
True To Your Heart - Mulan
Party in the USA - Miley Cyrus
9 to 5 - Dolly Parton
When We Stand Together - Nickelback
Stronger - Kelly Clarkson
Remember the Name - Fort Minor
Paddling Out - Miike Snow
Survivor - Destiny's Child
She's Not Afraid - One Direction
Till I Collapse - Eminem
Footloose - Kenny Loggins
Gangnam Style - PSY
Raise Your Glass - Pink
Call Me Maybe - Carly Rae Jepson
Real Wild Child - Christopher Otcasek


* = Swedish songs that might be difficult to find. (More on Swedish running songs to come in a later post...there are some great ones!)
** = This is a song by a guy who I think is Swiss or something (?) I heard it in a spinning class and fell in love, it's a great running song.

Switzerland!

Here is a recap of our trip, with some pictures.

Zurich

We started in Zurich. What a beautiful city! It was in the 90's and humid (with no air conditioning anywhere), so it was hot, but we had a great time anyway. We stayed at Hotel Rössli. It was ok, but not equipped to deal with the heat. We only got a tiny little itty bitty fan, which didn't really do much. The room was fine though. I can't complain.

Boat on the Zurichsee

Chocolate at Cafe Sprungli

Bern

Our next stop was Bern. We were only there for one night, but we managed to see the Parliament, the famous Bear Park, and walk around the beautiful city. The Aare River, which flows through the city, is a popular place to swim. But the current in the river is so strong, so what people do is they jump in and float down the river for a few miles, and then get out. We thought about doing this but decided against it since we didn't know our way around at all, and were worried we'd end up somewhere really far away.

Clock tower in Bern, supposedly where Einstein got his inspiration for the Theory of Relativity

We stayed at Hotel Kreuz. It was all right, nothing special. Overpriced, in my opinion, but all the hotels in Bern were super expensive.

Bern (taken from the Bear Park)

Lucerne

Then we headed to Lucerne. We splurged for a nice hotel (Hotel des Balances) and it was worth it. Not only because of this killer view from our balcony (from which we ate a lot of pretzels and chocolate):

View from our hotel balcony

But also because the weather was total crap. So we were forced to spend time indoors, but at least we had a nice place to hang out. It was a beautiful hotel, and I would definitely recommend it.


Interlaken

After that, we took what was supposed to be a scenic train ride to Interlaken. However, it was pouring rain so we didn't see much of anything other than rain and gray clouds.

We stayed at Hotel Rössli (no relation to the hotel in Zurich. Everything in Switzerland was named Rössli). It was more of a hostel, but we had our own room and bathroom. Unfortunately, there was a problem with the reservation. Long story, but we had booked through hotels dot com but changed the dates of our stay at one point. We were told that they had informed the hotel, but they hadn't. So we ended up having to stay at another hotel for the first night. It was really stressful, but the nights that we were at Rössli were fine. Great breakfast that was included.

After the rain stopped and the clouds dispersed, we got our first glimpse of the alps from our bedroom window.

View from Hotel Rössli in Interlaken

I had never seen anything like this, and I could not stop looking at the mountains. They were breathtaking.

Our first full day in Interlaken, we went up to the Schilthorn/Piz Gloria. It's a summit you can reach via cable car and train. The weather was great on the way up, and we stopped in a few villages and had awesome views. But as we went up the last cable car, we ended up in this gray cloud:

And couldn't see a darn thing from the summit. We were just in a huge cloud. Bummer. We did do a hike in the afternoon, from Gimmelwald to Murren. It was steeeep but very pretty.

The next day, we went up to Jungfraujoch, an almost-summit you can reach by train. We lucked out and had great weather. It was amazing! You could walk out onto a glacier that was 1km thick. It was so, so cool.

Summit of Jungfrau from Jungfraujoch

Don't know which mountain this is. But wow.

Glacier

We took the train partway down and then hiked from Kleine Scheidegg to Männlichen, which was a beautiful (and pretty flat) hike.

View from the hike

View from the cable car station in Männlichen.

Zermatt

From Interlaken, we hopped on the Glacier Express (panoramic train) and headed to Zermatt. Zermatt is a car-free town at the base of the Matterhorn. We got picked up by our hotel in an electric taxi!

The Matterhorn

Yeah, this was the view from pretty much everywhere in the town. Absolutely gorgeous. We also ended up staying at a hotel that was the steal of a lifetime. The Coeur des Alpes is a family-run hotel that was considerably cheaper than many of the hotels in the town. We had an excellent room, awesome breakfast, outstanding service, a free Hammam and spa/pool area in the basement, and countless other perks. We had the cheapest room, and it really was a steal. If you ever go to Zermatt, I highly, highly recommend it. I can't say enough good things.

Hiking on the Matterhorn Trail

Gornergrat Bahn

Montreux

Our next stop was Montreux, a lakeside town in French Switzerland on Lake Geneva that we mainly visited to see the Chillon Castle. We stayed at the Best Western, which was surprisingly nice!

Chillon Castle

Sunset over Lake Geneva

Geneva

Our final stop was Geneva. A really pretty city! We stayed at the Ibis Centre Nations, which is a brand new hotel not super centrally located, but it was a really good deal.

Square in Geneva

We had a great time and I highly recommend going to Switzerland!

Surgery was successful!

After my attempted septum resection in June, I was feeling really discouraged. But this new doctor was confident that if anyone could remove it, he could. I went to my primary care clinic yesterday morning as planned, but left at lunchtime (without being able to eat lunch, obviously!) to head to the hospital.

I got there early, but I checked in anyway. Mr. E  was meeting me there, but he wasn't there yet when I got there. I went up to pre-op and was told to change into my gown and lock my stuff up in a locker. Then the nurse told me they would be taking me back. Commence breakdown. I wanted to at least give my husband a hug! The nurse was all like, well is there something specific you need from him? And I was all like, well, no, you stupid emotion-less Swede, I just need to see him.

OK, so that's not exactly what happened but I explained that I wanted to see him before I went back. She said ok, and told me she would come get me when he arrived. A few minutes later, he did. I gave him a quick hug and a kiss and then they took me back.

I met with my surgeon again and he was very reassuring.  He explained again that the way he performs this surgery, he doesn't actually remove any tissue, just cuts the septum. Then, the endometrium grows back over that tissue. It's amazing that the body can do that.

I also met with a very kind anesthesiologist who understood that, as a med student, I want to know all the details, as that makes me feel the most at ease. She explained that I would be given all the drugs they had for PONV prophylaxis (post operative nausea and vomiting, something I've unfortunately experienced before), which were meclozine, ondansetron, and betamethasone. Then I would be given Propofol and Fentanyl and go to sleep. I would have laryngeal mask anesthesia during the procedure. Great, all sounds good. I was super nervous, but she was understanding and calmed me down.

A few minutes later, they took me back. I was amazed that it went so quickly! Before my failed surgery I had to wait for over an hour, which felt like forever since I was so nervous.

They made me get into the stirrups, which was annoying, I was hoping they could just do that after I was asleep, but oh well. This is Sweden, land of no modesty. They did put the sterile drape over me, at least, so there's that. A little O2 by mask and then they put me to sleep.

I remember waking up in the OR briefly and asking if it worked. And they didn't really answer me clearly, but said something like yes, he removed it. I remember saying great!!! I was in pain so they gave me some Ketogan. And then I was out of it for a while longer.

While I was waking up, I was given antibiotics (a single dose of Zinacef), due to my 2 immunosuppressive meds. Miraculously, I had no PONV whatsoever. It's a miracle! I drank some water and ate a banana. The pain was there but very tolerable, it felt like cramps.

After I woke up, I spoke to my surgeon, who explained that it went well. He was able to remove the septum. Although my uterus still has a small dip at the top, it's nowhere near as severe as it was. He gave me no restrictions, since I had had the ABX. I was surprised, and will probably take some precautions just to be safe.

He also gave us the green light to TTC again after my next AF, which should be around the end of the month!! I kind of can't believe it. I've already ovulated, so hopefully my period will come on time. After 7 months of TTA, 1 failed and 1 successful surgery, and many, many tears, we will hopefully be able to try again. It'll only be one cycle at most, since I'll be leaving for the US of A in November, but 1 is more than 0.

I was very happy with the care I got and thrilled that it worked!! TTC, here we come!

13.1

I DID IT!!! I ran a half marathon! I'm really proud of myself :-D

Yesterday I woke up, and my throat was still sore, and my hip was still bothering me. I was starting to worry it's not just my adductor but something in my hip joint itself. I was considering not even going, because I didn't want to do permanent damage. I talked it over with Mr. E, and decided to go and do my best. I was worried my hip would hurt immediately, since the last time I tried to run (on Thursday), it hurt the very first step I ran.

I had picked up my bib and stuff the night before, so we got to the race about an hour before the start. The race started at 3:30, but my corral didn't start until 4pm. It was a really late start, and it was stressful because I had all day to stress out about it!

There were so many people there! About 17,000, actually. It was crazy. I had a last-minute snack, let Mr. E take some pictures of me, and dropped my stuff off at the bag check and walked to my corral. After one last stop at the porta potty, I waited to start. By the time my corral was almost ready to start, the elites had been running for half an hour, so they were almost halfway done!

At 4pm, we were off! I started my music and my (well, borrowed from Mr. E) Garmin, and took a few steps, seeing how my hip felt. No pain so far! That was a good sign. Hey, I might actually be able to run this. After 5K, I was still feeling good. I saw Mr. E for the first time and gave him the thumbs up (he ran around the whole city, following me around using Glympse, and I saw him 6 times I think during the race, plus at the start and the finish). After that, my hip started hurting, but it wasn't unbearable. The next time I saw Mr. E, at about 11K, I was still feeling good. He was taking pictures of me while I was running by, but not cheering! So I said, "Are you gonna cheer me on or just take pictures?!" Some people around me laughed at that.

At about 15K, I started feeling tired. My hip was hurting, as were my feet. I could feel a few blisters coming on. But I pushed through. At 17K, I knew there was a killer hill that lots of people talked about. It came at a point where everyone is already really tired. I slowed down a little and prepared myself. We started going uphill, but it wasn't that steep. I kept thinking, where is this big hill everyone keeps talking about?! It ended up being a very long, but not steep, hill. I don't know if it's because I did many of my training runs on hills or what, but I was fine. I mean, it was a tough stretch, but I had expected much worse.

At 19K, I saw Mr. E for the last time, and he said, "see you at the finish!!" At that point, I realized that I was going to finish this race. Even if I had to walk or crawl across the finish line. Up until then, I was kind of chugging along, hoping for the best. But at that moment, I knew I was going to finish. It was awesome. The last 2 miles were really hard. I told myself I could walk if it became unbearable, but it didn't. I was teetering on the edge of unbearable, but I was ok. At one point, my Garmin said 13.0 miles, so I picked up the pace for a minute, only to realize that we weren't really that close to the finish line. You can't see the finish line until you're like 100 yards from it, which was really discouraging.

The last minute or so, I thought I was going to die, but I was soclose! I pushed through. The last 100 yards is on a cobblestone street, and I almost fell because my legs were so wobbly.

I finished in 2:26:56. Not a great time, and I know I could've done better if the circumstances had been different. But considering the hip injury and cold, I am thrilled. I got a medal and hobbled over to the bag check. The Garmin said I ran 13.34 miles, which I guess makes sense because it was a very twisty/turny race, and I'm sure I didn't take the shortest route. I also didn't take any walk breaks, other than the water stops.

Even though I'm not thrilled with my time, I am really happy. Woohoo! 

The universe is conspiring against me

Just as my leg was starting to feel better, I woke up with a killer sore throat. WHY?! I'm trying not to panic too much, since I still have a few days to hopefully get better. But man, this sucks. I am going to be devastated if I can't run on Saturday.

Also, my surgery is in 9 days. Yikes. I haven't really thought about it too much, on purpose so I don't freak out, and also because I've just been so preoccupied with training, traveling, etc.

Stupid leg

I woke up this morning and my leg felt good, so I let myself try to run a short, super easy, super slow run.

My leg started hurting immediately as soon as I started running. I gave it a few minutes to see if loosening up would help, but it didn't. After 1/2 a mile, I called it quits and walked home.

I am so discouraged right now. It doesn't help that Mr. E has been away all week. He usually keeps my crazy in check when I get stressed out, but he hasn't been around to do that. Luckily (but maybe unfortunately for him?! haha), he'll be home tonight.

Either way, I am running this frickin' race next weekend. Even if I have to crawl across the finish line. I've worked too hard for this.

Well, I almost made it without an injury

I almost made it through my half training plan without an injury.

Almost.

Last Saturday, the day after I got back from the US, I needed to run 9 miles. It was POURING outside, but I figured I would run outside. You can't predict the weather on race day, right? I drove out to the trails I usually run on. Usually I run there, too, but my plan was to keep some sports drink and a banana in my car and run loops that passed by the car so I could refill and refuel. When I got to the trails, they were basically a lake. It wasn't really run-able, there was like a foot of water everywhere. I didn't want to slip and fall, or end up with mega blisters, so I decided to hit up the treadmill.

Since Winter ended, I've done all my runs outside, but I've previously run on a treadmill before, so whatever. I felt fine. It was a boring run, but I made it through.  I did get a few blisters on my toes though. Ouch.

A few hours later, I started to have pain in my right inner thigh, in my adductors. NOT GOOD. It wasn't soreness, it was pain. The next morning, though, it felt significantly better, so I lifted. Still felt fine. Monday morning the pain was worse, but not unbearable by any means. I set out on my 5 miler. I could run through the pain, but it definitely hurt. I knew I was being stupid by continuing to run, so I cut it short at 4 miles. I rested Tuesday and Wednesday and skipped my 3 and 5 mile runs.

Today, I was supposed to run 10, but the pain is still there. It is getting better though, which is encouraging. As much as I wanted to get out there and bang out some miles, I know that the most important thing is being injury-free on race day, not getting that last long run in. At least I hope that's the most important thing.

I made it through 10 weeks of half training feeling good, and then, bam. I'm so discouraged. This training has basically been the glue holding me together through my second loss, failed septum resection, 7 months of TTA, etc. etc. etc.

The pain right now, on Saturday evening, is the best it has been since last Saturday. If I still feel good tomorrow morning, I'll try a super easy run.

Please, please, please get better, leg!

First Race Ever!

On August 25, I ran my first race ever! It was the Shore Road Summer Classic 10K. The race was a 5K and a 10K, and I chose to run the 10K. I lucked out since I was able to find a 10K the exact week I was supposed to run a 10K for my half training, which was really great since I wasn't able to run a 10K.

In the days and weeks leading up to the race, I was trying to figure out what a reasonable goal time would be. I had run farther than 10K several times before, so I knew finishing shouldn't be a problem. But I didn't want to totally burn out and have to crawl across the finish line, either.

Most of my longer training runs have been on hilly trails, and this race was pavement and flat, so it was hard to say what my pace would be. But I ran a pretty flat 5 miles in Switzerland in about a 10:24 min/mile pace, so that gave me a jumping off point. I talked to Mr.E and said I hoped to finish in 1:05. He thought that was too easy of a goal and that he thought I could break 60 minutes. I was all, what? no way. But he said he thought I could do it, and that it would be better to try and die in the end than be disappointed knowing I could've given more. So, I decided to set my goal for sub-60 minutes, which would be a 9:37 pace to finish in 59:45.

Race day was beautiful! It was mid-80's and not too humid. You can't ask for much better than that in NYC in August. I got up at about 5:45 and my stomach was really upset. The combination of nerves + Crohn's Disease is no good. I expected it would be like that, but it still sucked. Anyway, my parents actually drove me down to the race and stayed to cheer me on!

When I got there, I picked up my bib (!!) and pinned it on my stomach. I don't know exactly how many runners there were, but it was pretty small, a few hundred. We milled around and I stood in the long porta potty line. When it was 8:00, we all gathered by the starting line, and then all of a sudden we were off! I started the Garmin I was borrowing from Mr.E and started my 10K playlist I had created on the plane ride.

It was an out-and-back course along the water, and it was really pretty! I tried not to start out too fast, and I just moved over to the right hand side and tried to find my running zen. I kept looking at my watch and seeing I was too fast. I just chugged along for a while, trying to keep a steady pace. There weren't any spectators or anything, so after a few minutes, it didn't even really feel like a race. There weren't that many runners, so we spread out quickly. After 1.5 miles, the 5Kers turned around. So far, my pace was good. The first water stop was at about 2.5 miles. I took a cup and walked while I drank, as I had planned. As we approached the turnaround point at 5K, I found myself unable to stop accelerating to make sure I made it to the 5K in under 30 minutes. That way, if the rest of the race went to hell, at least I had that! I thought we would get splits, which we didn't, which sucked. But I did make it in under 30 minutes, so that was good. And I was on track to finish in less than an hour if I could keep it up.

At the second water stop, at about 4 miles, I was starting to feel tired. I drank and walked, but did so a little slower than I had done at the previous stop! At about 45 minutes, I was really starting to fade. I had been able to maintain a sub-9:40 pace the whole time, but at that point, it was getting too hard. I decided to take a quick walk break and try to stay on track afterwards. That didn't go so well, and resulted in me having to walk another minute. I almost never walk in training, so this was very frustrating.

At that point, I knew that I was super close to making it in under an hour, but that I didn't think I was going to make it. I did my best the last 10-ish minutes, but I was pretty sure I was going to be just over 60 minutes. My dad had walked out to the 6-mile marker and cheered me on, which I desperately needed! I run as fast as I could the last 0.2 miles, and gave it everything I had. I crossed the finish line as the clock said 1:00:20. While I was happy to have finished, and with a decent time, I was SO disappointed.

My official time was 1:00:16. 16 lousy seconds! I was pretty frustrated. But I tried to focus on the positive. I knew I had done my best and that I had had nothing more to give.

Next time, I WILL break 1 hour!

#11

I forgot to add one very important thing to my list of things you need to know about Switzerland:

11. ALL THE TOILET PAPER IS SOFT.

Seriously. Even on the trains, in the gross train bathrooms (which, incidentally, are not that gross in Switzerland), the TP is soft. It's amazing.

Which brings me to the fact that Swedes somehow think that brown butcher paper is OK as toilet paper. News flash: it's not. That stuff hurts, and I don't know how the Swedes do it.

As someone with Crohn's Disease, I use a lot of TP. And the brown scratchy stuff is no fun. We buy the nice stuff at home, but at the hospital, sometimes I want to die.

10 Things You Need to Know About Switzerland

We had an amazing trip!! 2 weeks in Switzerland, it was awesome. More to come later, but in the meantime, here are 10 things you need to know about Switzerland.

1. The people are very friendly.

2. Swiss pillows are terrible. I'm pretty sure there's nothing in them except air, so when you put your head on them, your head just sinks down.

3. There are mountains everywhere, and they are truly breathtaking.

4. There is this thing in Switzerland called fresh chocolate. It is divine. It's exactly what it sounds like, freshly made chocolate that just melts in your mouth.

5. When the Swiss describe a hiking trail as "flat," what they actually mean is not steep enough to require crampons and ropes to climb up/down it.

6. If you think Maine is outdoorsy, think again. The Swiss give a whole new meaning to the word.

7. Everything, I repeat everything, is super expensive. There's no point in trying to find a cheap dinner because it does.not.exist.

8. In German Switzerland, all the train announcements are in German, French, and English. In French Switzerland, the announcements are only in French.

9. All forms of transportation are really freakin' on time. Very impressive.

10. They drink wine. All the time. A lot of it. Our requests for water with dinner were met by a lot of strange, questioning looks.

I never thought I'd say this....

But it's HOT here! It's like 88 and humid, and there is no air conditioning anywhere. I mean, I can't really complain, because when the summers here are cold and rainy I am miserable and whine to my husband all the time. But when it's this hot, and there's no air conditioning, life can be miserable. I ran my scheduled 6 miler this morning on a tough, hilly trail and I almost died. It was so.freaking.hot. I have been having a lot of trouble sleeping because it's so hot!

Buuuuut...I don't want it to go back to being 55 and rainy so I guess I will just shut my mouth!

Week 5 of 12

I'm in the middle of week 5 of my half marathon training. It's been going surprisingly well **knock on wood.** I have been able to get all the runs in, although I've missed some of the cross training days. I'm really proud of myself for what I've accomplished so far, and I'm exciting to keep progressing.

Work has been going well. It's been busy, especially this week since I have a delirious patient who is taking up a lot of my time! That has been interesting, to say the least. On Monday, she was convinced she was in labor (she's 85). On Tuesday, she thought her life was over. On Wednesday, she kept talking about bears and angels. Today, she was singing children's songs. Never a dull moment, that's for sure!

They call me Doctor

Yeah, I know, I haven't updated in a while. Life has been crazy. My hysteroscopy on June 19th ended up being a disaster...they couldn't do the procedure. Long story short, I have a new consult on July 30th, and then we'll see. So we'll be TTA for a while.

Things have been going really well at work though! People call me doctor. Or they say "Are you the nurse?" And I say "no...I'm the...um...doctor..."

The old people are hilarious. One day, this happened:

Nurse: "E [old man with dementia] just told me he broke one of his teeth while eating. Can you take a look at it?"
Me: "Sure..." OMG I don't know anything about teeth. What do I do if it's broken? Call a dentist, I guess...

Me: "Hi E, the nurse tells me one of your teeth is broken."
E: "Yeah...it hurts."
Me: "OK, can you show me where it hurts?"

E then proceeds to take out his fake teeth and put them in my hand.


My attending said some really nice things to me last week, so it's nice to feel like I'm making progress and am not just a total disaster!

1 more semester!

Last week I finished my 10th semester of medical school, which means I only have 1 left. It's been a long journey, but I can see the light at the end of the tunnel! And I'll be spending the last few months of school doing an away rotation in the US, so I'm excited. I'm trying to ignore the fact that all this means I really have to pick a specialty........

So Monday was my first day of work as a doctor. I kept almost introducing myself as a med student, and I had to stop myself. When I was dictating my charts, I had to stop myself from saying I was a med student dictating for Resident'sName. It's just me. I dictate and write the charts, and no one checks my work. Yikes!!

A few funnies from my first 2 days:

Little old lady (LOL): Oh, my son is a doctor in SwedishTownI'veNeverHeardOf.
Me: Oh, really?
LOL: Yes. And where he works, there are a lot of young immigrant doctors.
Me (young immigrant doctor): Oh...
LOL: So his patients love him. They are SO HAPPY to be able to talk to someone who speaks Swedish. It's so hard when all the doctors are immigrants.

Me: Hi, my name is Mrs.E, I'm one of the doctors here.
LOL#2: Oh. And a woman, too!
Me: Yep.
LOL#2: A doctor and a woman.
Me: Yep.
LOL#2: So what do you call yourself if you're a doctor and a woman?
Me: .......A doctor.......
LOL#2: Well, there must be another word for it. A more feminine word.
Me: No, there's no other word, just doctor!

What happens when you don't have window screens

Here in Sweden, it doesn't get very hot in the summer, at least not very often. As a result, no one has air conditioning. No one. Instead, you have to deal with opening your windows and hoping it doesn't get too hot inside.

BUT....Swedes don't seem to have discovered screens. So you open all your windows, and think "Ahh, what a nice breeze." But then, your apartment quickly gets overrun with bees, flies, and mosquitoes. Then you have to make The Choice - a hot apartment, or dealing with the bugs?!

Today I had this problem. It's 75 degrees-ish and humid. I opened all the windows, and the balcony door. Within minutes there were bugs everywhere. I went into the bathroom and saw a huge (like, 5 inches wide, and I'm not exaggerating) mosquito-looking thing. I took a picture and sent it to my husband. He didn't reply, so I called him. This is how that conversation went:

Him: Hello?
Me: Did you see the picture I sent you?!
Him: No, what picture?
Me: You need to look at it. Now.
Him: Ok....
Me: WHAT IS THAT?!
Him: It's a....I don't remember what they're called in English.
Me: It's a giant freaking mosquito is what it is!!!!!!!!
Him: It doesn't bite.
Me: HOW DO YOU KNOW THAT? You can't know that.
Him: The big ones don't bite.
Me: I don't believe you. Can you please come home and kill it for me?
Him: I'm at work...
Me: So?
Him: I have to go. They don't bite. Calm down. You'll be fine. I love you.
Me: Fine. Bye.

I mean, he seemed to think it was unreasonable to ask him to come home and kill it. The nerve.

First, I did what any sane person would do, I closed the door and locked it in the bathroom. But then I realized I couldn't avoid the bathroom all day, especially since I was going for a run and would need to shower.

So I manned up. I went in the bathroom with 4 sheets of paper towels bunched together (you don't want to risk getting pieces of bug guts on your hand). I stood on a chair, and took a deep breath, and squashed it.

Then I ran some water over the paper towel. You have to make sure it's dead.

Then I put the wet paper towel with the bug inside in the trash. And then I tied the bag up and took it outside. What if it comes back to life?! You can't take that risk.

The bug is gone. I closed all the windows and left the balcony door open a crack.

The moral of the story: Sweden, you need to discover SCREENS. They're like magic, you put them on your windows, and then the bugs can't come in. Please, please, can you work on this for me?

11 days

(I'm still working on my Moscow recap, it will be posted soon!)

Warning: This is a random post about all the thoughts running through my head right now.

11 days left of school!! June 5th is my last day. Then I have 4 days off, and after that I start my summer job. As a doctor. As in, I am going to the the doctor. On a real live ward. With real live patients. Not just as a student. Holy crap. **commence hyperventilation**

I will be doing that for 8 weeks, after which E and I are headed to Switzerland for 2 weeks. And after that, I will hopefully be going home for about 10 days but that's still up in the air. A lot of that will depend on whether or not my operative hysteroscopy can proceed as scheduled on June 19. Hopefully everything will go smoothly.

In addition to waiting impatiently for school to be over, I am waiting impatiently to ovulate. If I don't ovulate soon, I will not be able to have my surgery as planned, since I can't have my period during the surgery. Ugh. Please, body, come on! Do your thing.

Making a difference

First of all, E and I just got back from 4 days in Moscow, which was quite the experience. Full report and pics to come.

In January 2012 (actually, the day before I found out I was pregnant the first time, but that's beside the point) I was doing a rotation in the ER, seeing surgical patients. During this rotation, we got our own patients and treated them ourselves, did everything that needed to be done (under the supervision of an attending, of course!). One Monday morning, I walked into the office and saw an envelope with my name on it. Except my name had "Dr." in front of it. Obviously that made me giddy, but also confused. I opened it and inside was a card from a patient I had taken care of the week before. He was a 40-something-year-old male with some vague abdominal symptoms who turned out to have pancreatitis due to gallbladder problems. Nothing extraordinary. I admitted him for a cholecystectomy and went on my way. In the card, he thanked me for helping him with stomach problems that had bothered him for years.

I was so incredibly touched by his card. I also felt a little guilty, since all the decisions were made by my attending. I was the one performing the first exam and coming up with a preliminary assessment and treatment plans, but my attending made the final decisions. But in any case, I was really moved by his gesture.

Today, I got thanked by another patient. Well, a patient's mom. On Monday, a baby came in severely dehydrated, going into shock. He needed a lot of fluids, but ended up being ok. It was scary, he was drifting in and out of consciousness for a while. I ran into the mom outside the entrance to the hospital and she started profusely thanking me, and asking me to please thank the doctor who was in charge. She said that what we did was amazing. Again, I was truly touched. I wasn't the one deciding what to do, but I did help.

It's nice to feel that you really make a difference sometimes.

Back to spinning

After not being allowed to work out from the day I got a BFP in February until a few weeks ago, I am finally starting to get back into my workout routine. I was able to run 3x this week, which felt great! The runs were not as long or as fast as the runs I had been doing earlier this year, but it's ok.

In an hour, I will be going to my first spinning class in over 2 months. I've been going to the same class almost every Saturday for years (except for this hiatus, and a longer one last year due to my first loss). The instructor is amazing, and the regulars are great. Well, except for this one guy who has horrible BO and stinks up the whole room. Gross! The class is super hard, and makes me want to die every time. So needless to say, I'm expecting a rough morning. Hopefully I won't pass out or puke all over my bike!


Gotta get my game face on!! GRRRR!!

Holidays I Don't Understand

Happy May 1st! Or första maj, in Swedish.

Today is a national holiday here. Why? I don't really know. This is a great example of not understanding different cultural traditions. There are a few Swedish holidays that just make no sense to me. Today is one of them.

May Day is a historically socialist holiday that is only celebrated in a few countries. My understanding is that traditionally, there have been socialist marches and protests for different causes in the city. This tradition is still somewhat alive, and one party (the Social Democrats, Socialdemokraterna) usually arranges a few marches. I don't know anyone who goes to them. Instead, people use this day off to go shopping and enjoy the weather, if it's nice.

In addition to all of that, the day before May 1st is a holiday called Valborgsmässoafton, or Valborg (VAHL-bore-ee) for short. The English translation is Walpurgis Night, but that is irrelevant since the holiday is only celebrated in Northern Europe. Valborg is a very strange unique holiday that I don't really understand. I've asked many Swedes to explain it to me, but I get slightly different explanations each time. It has to do with witches and bonfires. I believe that you build the bonfires to scare away the witches. I'm not sure why the witches come around on April 30th each year, though.

So there are bonfires and big parties in parks all over the country. One city, Uppsala, takes these festivities very seriously. Uppsala is a moderately-sized city but it is home to one of the largest universities in Sweden, so there are tons of students everywhere. They start the day off with a champagne breakfast, and party all day. There is some kind of boat race on the river, where you have to build your own boats. And at one point all the students gather at the top of a hill and run down together. And throw their hats. Or something.

Yeah, I don't really get it.

But today is a holiday. Our schedule for this week looked like this:

Monday - Reading Day
Tuesday - Practical Exam
Wednesday - OFF
Thursday - Reading Day
Friday - Written Final

Um....what? As Dr. Evil would say, "Riiiiiiiight....."

Needless to say, I am not frolicking around outside today, I am inside, studying. I did go for a run this morning and saw what I can only assume is everyone who lives in my neighborhood enjoying the sunshine.

So, um, Happy May Day, I guess? I'm just going to keep studying.

"Are you fluent?"

I often get asked if I'm fluent in Swedish. This is such a difficult question to answer. I speak Swedish well and I usually understand everything that is said to me. I get by just fine most of the time, although sometimes I have to say "I'm sorry, I don't know what that word means." My dictated or written charts are perfectly understandable, although they do contain grammatical and spelling errors (although when I dictate, the secretaries fix that kind of thing, which I'm very thankful for!!)

But - I don't speak well when I'm nervous. I can't understand people with strong accents from certain parts Sweden. I can't understand spoken Norwegian like Swedes can. I write like a third-grader. My medical vocabulary is very good but my normal, day-to-day vocabulary is not. I mess up articles and prepositions all the time. If people start talking about politics, parts of a car, or types of animals, I'm lost. But then again, do I know the names of all the parts of a car in English? No.

I can't really make jokes in Swedish the same way I can in English. I don't feel like my personality is the same in Swedish, it's like I can't really be myself 100%. It's really hard to explain to someone who's never experienced it, but everyone I've talked to who's moved abroad and learned a new language feels the same way.

So, am I fluent? I don't know. Most people would say that I absolutely am, considering I speak Swedish all day long at school, and when I'm out and about, and with my Swedish friends. But I constantly feel insecure about my Swedish. When I mess up, or when I don't know the word for something, or people misunderstand me. When I try to make a joke that ends up offending someone because it just didn't translate well. When I sit through an entire lecture in Swedish, go up to ask the professor a question in Swedish, and he responds in English, saying "Should I answer in English or do you understand Swedish?"

My Swedish will obviously never be as good as a native speaker's. But can you be fluent without having the language skills of a native speaker? I think so.

When people ask me if I speak fluent Swedish, I usually say yes. Because I know what they are getting at is, Can you get by in day-to-day life, talking to different types of people? Which I can. But every time I have to write an email to a professor, or call the phone company, I panic and mess up. I have to have my husband proofread every email I send and every school essay I write. (Thankfully I don't have to write very much for school, and when I do, I usually ask to write in English and they say that's ok.) When that happens, I don't feel fluent.

I guess by most people's standards, I am fluent. But I certainly don't always feel like I am.

Well-traveled?

One of the awesome things about living in Europe is that there are tons of awesome places closeby to travel to. E and I have been able to travel to a lot of really great places the last few years, and sometimes I forget how lucky we are to be able to do that.

I've been talking to my cousin, S, recently because her husband and son are going on a sports-related trip to Europe. Their family doesn't travel much at all, and certainly not internationally. She's been asking me tons of questions, most of which are at the novice traveler level. I'm so happy I've been able to help her. It's also been a real eye-opener to me because it's made me realize that we really do travel a lot! Today she told me, "Wow, you're so well-traveled, you should start a blog about it!" I don't really think I am that well-traveled, but I have certainly traveled more than a lot of other people.

So, I've decided to start trying to dedicate some blog entries to travel tips so that I can help other people who are novice travelers.


Today's Travel Tips - Transatlantic Flights 101

1. Dress comfortably when you fly. There's nothing worse then squirming around trying to get comfy in your jeans on an 8-hour flight. Wear comfy pants (sweatpants, yoga pants, warm-up pants, etc.), a t-shirt, and a long-sleeved t-shirt or zip-up. Avoid hoodies, because they interfere with the neck pillows when you're trying to sleep (see #2).

2. It is crucial to sleep on the plane if you're traveling on an overnight eastbound flight. Get yourself some earplugs, an eye mask, an inflatable neck pillow (the non-inflatable ones take up precious room in your baggage!), and Benadryl or something similar to make you sleepy. Take the Benadryl when you get on the plane, because if you take it too late you'll be tired once you arrive at your destination. Inflate your neck pillow, put your eye mask on and your earplugs in, and go to sleep! Don't be tempted by the in-flight entertainment, trust me. You'll thank me the next day.

3. If you travel a lot, invest in some noise-canceling headphones. They are expensive, but well worh the money if you are going to use them a lot. E and I both have Bose headphones, and we use them all the time. They're great.

4. Melatonin is the only thing scientifically proven to help with jetlag. There was even a New England Journal of Medicine (very prestigious medical journal) article published about it. For adults, take 3mg daily at bedtime in your new time zone. I take it when I get on the plane for an eastbound red-eye overnight flight, and then every night for a few days. I also take it at bedtime for a few days when I travel westbound. It doesn't really make you tired, but it helps reset your circadian clock faster.

5. Get to the airport early. At least 2 hours for any international flight. You never know how long it's going to take to get through security. And go through security right away. Worst case? You've got time to spare, so what? E always likes to say that there are 2 types of people in any airport: 1) the people who have plenty of time to spare, so they're walking through the airport at a leisurely pace or eating a snack. And 2) the people who might miss their flight, so they're running like maniacs towards their gate. Don't be #2, it's not fun.

6. Bring lots of stuff to entertain yourself. Bring books, some music to listen to, a Sudoku book, a magazine, etc. You never know if your flight might get delayed. Being bored is no fun!

7. Pack heavy stuff in your carry-on. Nowadays, most airlines only let you bring one piece of checked baggage, even on long flights. This is a problem, since often, when you're going on a long flight, you're going to be gone for a long time and therefore need to pack a lot of stuff. By packing heavy stuff, like shoes, in your carry-on, you leave more room in your checked baggage for other stuff. (Bonus: stuff your shoes with socks to save even more room!)

8. Bring an empty water bottle in your carry-on. Then, after you go through security, you can fill it up with water and bring it on the plane. That way, you don't have to buy the super-expensive water they sell after the security checkpoints, but you'll still have something to drink on the plane.

9. Always bring an extra pair of underwear in your carry-on. If you miss your connecting flight or your baggage gets lost, at least you won't have to wear dirty underwear. I usually pack a pair of underwear, a shirt, and a pair of socks in my carry-on. Also, bring your toothbrush and a travel-size toothpaste so you can brush your teeth after your long flight.

10. Figure out ahead of time what your game plan is for getting from the airport to your destination. After a long flight (especially if it's overnight), the last thing you want to do is stand there thinking, ok, now what? Even if you don't decide what you're going to do, it's good if you've at least discussed it.

Patience

Patience is not something I have a lot of, but is unfortunately something you need a lot of throughout the miscarriage/TTCAL process.

I was supposed to get a follow-up appointment with my doctor 4 weeks post-loss. Apparently somewhere along the way, this fell between the cracks and I didn't get an appointment. So I have to wait another few months until I can see my doctor. But I talked to her on the phone today because I wanted to plan for my operative hysteroscopy. First she was like oh yes, I'll start that process right away. But then she was like, actually, to be completely honest with you, you should go to this other hospital and see if this other doctor will do it. He's the best in Stockholm. I'm obviously grateful for her humility and her recommendation, but couldn't she have mentioned this A MONTH ago?!

Of course when I called, the office had already closed. But I'm going to call again in the morning. I hope I can get in to see this man, this King of Hysteroscopies, soon. This waiting is torture. If we didn't have to do all this testing, we could start TTC again after my first post-loss AF, which hopefully will be arriving some time soon. But instead, we have to wait. And wait. And wait. And wait some more. I'm not good at waiting.

I'm so ready to get this party started!

Monday Randoms

1. Spring might finally be coming to Stockholm, after a long, long, LONG winter.

2. The Pediatric Neurology ward is a tough place. The kids are so sick, but they're so brave. And the parents are unbelievably strong.

3. I went for a run yesterday, which was the first not-cold day since like October. It wasn't a long run, due to my current physical restrictions, but it was amazing.

4. My permanent retainer is broken. I've tried to get it fixed twice but both times the glue has broken. So I went to a new orthodontist, hoping she would tell me I could get a removable one instead. But she thinks I should keep the permanent wire. Navigating this system in Swedish has been such a challenge! My orthodontics vocabulary is limited, to say the least.

5. I went to a Michelin-star restaurant for the first time two weeks ago. The food was delicious, and it was so much fun. The restaurant actually had 2 stars. (I'm hoping to write a separate post about this soon).

6. This website: http://whatshouldwecallmedschool.tumblr.com/ is the best website ever.

7. In less than 2 months, I will be working as a physician. On a ward. With real patients. Just a summer job, but still. Exciting, and terrifying.

8. After my day today, I decided I need to choose a specialty in which you don't have to do rounds. Unfortunately, this strategy is not very feasible since it would eliminate like 99% of specialties.

9. I can't believe people think it's ok to throw themselves a baby shower. Yes, a friend of mine sent an email saying she was going to do this (but it turns out another friend was already going to throw her one, so it was, as Joey says, a moo point.)

10. Friends is the best TV show ever.

Nothing wrong with the patient

On Monday, I was cleared to exercise and have sex. So what did we do? Have sex, of course. It had been almost 2 months, after all. After a few minutes, there was blood on the sheets. Cue freak out.

The bleeding was worse the next morning, so I called the office. They told me that as long as it slowed down by the end of the day, I didn't need to come in. It did, so I didn't. But this morning, I was bleeding a lot again.

Now, I have learned in school that bleeding after a pregnancy has ended (whether it's from delivery, abortion, or miscarriage) can mean 2 things: retained tissue or infection. So naturally, I tried to figure out which one I had, but my symptoms didn't really match up well with either one.

Fortunately, miraculously, everything looks ok. Blood tests are good, hCG is down to 237 from 1120 a week ago. She couldn't see anything in my uterus, and my endometrium was thin (4mm). No signs of infection.

Wait....what?  So you're telling me I don't have either of those 2 differential diagnoses? That's not possible. Every time we go through cases in a seminar, it's always one of those 2 things. How could it be nothing?

And then it hit me. In med school seminars, the patient is always sick. There's always a diagnosis, otherwise, what's the point? IN REAL LIFE, some people are fine. Not everyone is sick. Some patients are actually completely fine and there's nothing wrong with them.

They think the bleeding must've been caused by the "trauma" of sex, but they do think it was strange that I am still bleeding so much. They couldn't find any other explanation though, and couldn't find any evidence whatsoever that there is a problem, so that's great news. I just have to hang tight until my next hCG draw next Wednesday.

So the moral of the story is - there is not always something wrong with the patient!

Med student vs. scrub nurse

As a med student, I come in contact with all different types of medical professionals. It's challenging to constantly be moving from rotation to rotation and have to meet new people all the time. You feel like you're constantly surrounded by people you don't know, and you're always trying to make a good impression, while obviously trying to learn as much as possible. I usually spend a lot of time with residents and attendings (obviously), and nurses. Although there are some exceptions, most nurses are very nice, and understanding of the fact that I don't know everything.

Scrub nurses, however, are an entirely different breed. Now, if you're reading this and happen to be a scrub nurse, please don't take offense. I'm sure you're a Type 1. And if, by some chance, you're not, please remember to give us poor med students a break once in a while!

(Side note: For those of you who don't know, a scrub nurse is a nurse who works in the operating room. He/she (but usually it's a she) is, among other things, responsible for maintaining the sterile field, and for all the instruments involved in the surgery.)

Seriously, though, a good scrub nurse makes ALL the difference in a surgery. They are excellent at what they do and are often grossly underappreciated by some surgeons. Additionally, they are responsible for maintaining the sterile field, which is an extremely important and difficult job. People often walk in and out of the OR, and they have to constantly make sure no one contaminates anything. It can't be easy, and I really do get that.

In my experience and opinion, there are 2 types of scrub nurses:


1. Type 1: The Nice Ones. These scrub nurses are friendly, and understand the fact that med students can't possibly know all the ins and outs of every type of surgery. They make you feel comfortable, and are open to questions.

Examples of Type 1 (all things that have happened to me):

"Have you seen this type of surgery before? No? Oh, well then let me walk you through all the instruments used, so you can be familiar with them. That will make it easier for you to assist."

"Are you scrubbing in? What size gloves do you wear? Great, I'll get some for you."

"Oh, when you cut that type of suture, you should hold the scissors like this, that'll be easier."


2. Type 2: The Nasty Ones. These scrub nurses are sick and tired of being bossed around by arrogant surgeons and have apparently decided to take their anger and frustration out on poor, innocent med students. What have we ever done to them? Nothing! But, alas, we find ourselves getting yelled at for merely existing. We do our best, honest. We don't know everything and we know we don't, but pleast don't hate on us for trying. We are there for a reason - we have to learn surgery. We're not just there to bother you, I swear.

Examples of Type 2 (again, all things that have happened to me):

Me, after opening the door to an OR where there are already 2 med students : "Hi, my name is C, and I'd like to observe this surgery."
Type 2 scrub nurse (T2SN): *rolls eyes* "Get in line."

While standing at least 3 feet from any table covered in sterile drapes: "You CANNOT touch anything that's blue!!!!"

After a non-sterile person backed into me: "You just contaminated yourself!! You can't touch anyone who's not sterile!! Go re-scrub!!"

I mean, if I had a nickel for every time I've been yelled at by a scrub nurse for something I didn't do, I'd be rich!!


But to all nurses, scrub or otherwise, thank you for all you do. Good nurses are at the core of a good hospital. I know your work doesn't always get recognized.

** This post was inspired by spending the morning with some arrogant surgeons and one of the nicest scrub nurses I've ever come across. She got yelled at by one of the surgeons a few times for stuff she didn't do, but she didn't retaliate. She was friendly, helpful, and very nice to me. **

Fly

This song came up on my phone as I was walking from school to the bus stop. I've heard this song before, since I've had this album since I was a teenager. I've always thought it was a pretty song, but today, the lyrics touched me in a whole new way.



Fly, fly little wing
Fly beyond imagining
The softest cloud, the whitest dove
Upon the wind of heaven's love
Past the planets and the stars
Leave this lonely world of ours
Escape the sorrow and the pain
And fly again


Fly, fly precious one
Your endless journey has begun
Take your gentle happiness
Far too beautiful for this
Cross over to the other shore
There is peace forevermore
But hold this mem'ry bittersweet
Until we meet


Fly, fly do not fear
Don't waste a breath, don't shed a tear
Your heart is pure, your soul is free
Be on your way, don't wait for me
Above the universe you'll climb
On beyond the hands of time
The moon will rise, the sun will set
But I won't forget


Fly, fly little wing
Fly where only angels sing
Fly away, the time is right
Go now, find the light

It's over.

On Tuesday we found out my hCG had gone down a bit. Ultrasound on Wednesday confirmed that. After getting yet another ultrasound yesterday, everyone is in agreement that the pregnancy is in the uterine cavity, which means we can hopefully take care of this with mifepristone and cytotec. I'm hoping to avoid methotrexate or surgery. I'm really scared of the pain, and scared that it won't work.

This meant that I also had to cancel my trip home, which is really just rubbing salt into the wound.

The multiple ultrasounds also led to a more in-depth discussion of the possible role my small (10mm) subseptum may be playing in all this. We are going to look into it more after this is all over, and also do some other testing. So that's good, at least.

I just hope that, someday, we will get our rainbow.

Bad English

In general, Swedes speak excellent English. I am constantly impressed by how good they are. The main exception is adults older than 50-ish. They didn't take English classes in school, and they are definitely not as good.

Today I had to witness some of the worst English I've seen since moving here. I was sitting in the peds outpatient clinic, next to the attending I was spending the day with. He had to write a note explaining why a patient needed to bring special food and asthma medicine onto a plane. I sat there while he typed what must be the most horrendous letter, in terms of grammar and spelling, that I've ever seen! Many of the errors were classic Swedish mistakes (like combining two words into one, as they do all the time in Swedish but we do not do in English), but some of the other things I just can't figure out.

Some examples:
"Certificate of need of specialfood"
"The patient needs to bring hers own food and asthmamedication"
"Consultant Pediatrichian"
"Therefore neither can she be exposed to food with nuts or gluten."

Needless to say, it was painful. It took every ounce of willpower I had not to grab the keyboard out of his hands and type it myself! I faced the dilemma of either a) sitting back and doing nothing, forcing innocent airline and airport employees to try to decipher the code, of b) saying something. I chose to mostly do b) but I did point out a few of the worst offenders, because I couldn't help myself.

More bad news

My hCG is not rising as fast as my doctor would like. She was happy with my numbers last week (6000 and 11000 on Wednesday and Friday), but not this week (36000 and 42000 on Wednesday and Friday).

At this point I'm not expecting any good news, but it still hurt. I want a baby more than anything, and I love the little sac inside me, but I just want this to be over. I know this isn't going to work out, and I also know that no matter what intervention is necessary, it's going to be a long, long road. :-(

Changes

Well, regardless of whether or not this is our take-home baby, I am certainly starting to experience changes in my body.

I'm exhausted all the time. Yesterday I could hardly keep my eyes open in clinic while talking to a patient! It's definitely a problem.

I've been getting waves of queasiness at odd times. It usually passes pretty quickly, but it can be difficult to finish meals.

My otherwise enormous sweet tooth has eased up into what I can only assume is a normal person's desire for sweets. Last weekend, I didn't finish my dessert because I just didn't want any more. I don't think that's ever happened to me before.

My hair is so gross. My normally oily hair is even more greasy than usual, and I've noticed some dandruff flakes! I've never had that before either. Ewwwwwww!

My normally enormous boobs are even more enormous, and very sore. My bras don't fit. I'm obviously not going to buy new bras until I know if this pregnancy may work out.

I'm feeling crampy on and off. Not painful cramps, just like dull period cramps. I've had this since I got my +HPT. This and the sore/big boobs are the only 2 symptoms I had last pregnancy, so it is reassuring to have more symptoms.

I am not complaining, I mean if this means we get our baby, I will be thrilled to have to go through all of these things. It's just difficult right now because it's a daily (hourly!) reminder of what may not last.

Not looking good

Yesterday we saw a gestational sac and a yolk sac, measuring right on track. It was truly amazing to see something inside the sac, since my last pregnancy was just an empty sac. But the pregnancy is basically in the same spot as my last pregnancy, high up near my left tube. They don't know yet whether or not it's too far up or not. I go back next Wednesday for a new ultrasound. My hCG levels look good though, so that means either this pregnancy has a chance of turning out fine, or we will have to terminate due to the location.

Right now there's a big, big chance that this pregnancy is not going to work out and that we're going to have to terminate. The thought of having to do that is gut-wrenching, to say the least. I'm also terrified I'll have to have some complicated surgery that would make it impossible to ever carry a baby.

I love my little yolk sac so much already, even though we can't even see the baby yet. Please, please, please let this work out.

Losing my mind

All this waiting and not knowing is making me lose my mind. Today I got an appointment for an ultrasound on Monday, which will probably not be definitive regardless of whether the news is bad or good, but it will give us more information. In the meantime, I'm just running through all the scenarios in my head.

• The baby hasn't developed at all and we can still only see an empty sac.
• The empty sac is too high up and I'll have to go through the same thing as last year.
• The baby has developed, but it's too high up near the tube and I can't continue the pregnancy.
• The baby has developed a little bit, but not enough to know which way it's going to go.
• We're not sure exactly where the pregnancy is and whether or not it's potentially dangerous.

And then there's also the tiny, tiny possibility that

•  Everything looks good. The baby has developed and the location is fine.

That feels very unlikely right now, after everything I've been through. But maybe. Just maybe.