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#80589 - 07/10/11 06:56 PM Surviving rotations while pregnant
KALNUMBER2 Offline
Plus Member

Registered: 07/10/11
Posts: 32
This was probably really bad timing on my part, but I am currently 11 weeks pregnant. I am just starting 3rd year rotations and had a rude awakening when I had to scrub into the OR and stand in a 1x1 foot area for about 4 hours twice in one day. I felt like I was going to pass out. This can't possible be good for the baby.
Anybody have any tips on how to survive this?

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#80592 - 07/10/11 07:29 PM Re: Surviving rotations while pregnant [Re: KALNUMBER2]
jonesie Offline
Elite Member

Registered: 10/25/09
Posts: 114
The good news is you should (may) start to feel better in the next few weeks. The bad news is scrubbing in for cases first trimester sucks no matter what you do.

I used anti-emetics (zofran), tried to stay well hydrated (with gatorade type drinks) and well fed (with protein, little amounts but every possible second I could - pocket food is a blessing even now in residency!), sat down whenever possible, and was really nice to the OR nurses (who somehow knew I was pregnant even when none of the MD's I was working with did). I was working with an extremely malignant resident doing Whipples of all things and have no idea how I kept myself off the floor. I didn't have the confidence at the time to speak up for myself - something I now regret.

When I was a second year med student I was observing a spinal surgery and suddenly got flush and pre-syncopal. My preceptor took one look at my diaphoretic and pale face and snagged a stool with his foot and got it under me just in time. Although terribly embarrasing, he was really nice and said that most people have had the experience at least once. He also said that it is always way better to fess up if you aren't feeling well than to face plant onto a sterile field.

If at all possible, talk to the folks you are working with or your admin to see if something can be worked out (at the very least, switch rotations so you are doing this when you're feeling better?). On my rotation, we had 2 med students and we could swap duties if we worked it right - she took some cases for me and I took some clinic for her (she hated clinic so she actually thought I was doing her the favor!), not sure if you have that option or not.

I know how hard it is to ask for help and how desperately you may want to avoid accomodation, but I really wish I had talked to my admin at the time - that was really the lowest of the low point of my medical training (intern year was nothing compared to 14 hour whipples first trimester, being asked incessantly about anatomy and roux-en-y's and all kinds of senseless things while trying not to vomit into my mask. For pete's sake.). I think I was afraid they'd make me quit the rotation or that somehow my already malignant work environment would get worse if I asked for help. Those were silly thoughts and in the long run if I had to have finished the rotation some other time it would've been better for many reasons.

One day at a time, and hang in there. We're here for you!

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#80594 - 07/10/11 07:44 PM Re: Surviving rotations while pregnant [Re: jonesie]
megboo Offline
Elite Member

Registered: 06/22/05
Posts: 376
Loc: Illinois
I'm almost 16 weeks PG and started my surg rotation last week. I posted in another thread about needing more frequent potty breaks, but that's about it. On surgeries where the ENT is using the microscope, I'm not scrubbed in, so I can sit on a stool and watch the monitor while he's describing the surgery. We had a long day on Friday, with about 12 hours on cases, and my back killed me and my feet were burning, but the interest in the cases won out. Each case was about 3-4 hours long, and I got to rest 30 minutes or so between each. I think I needed better shoes, and have some to try out this week. There were a couple times when I felt warm when scrubbed in, but stepping back from the table with care not to break sterile field helped a lot. Those bright lights can take a lot out of you in this condition.

I will be at the end of my 2nd trimester when I'm done with surg, and I go right into internal med for my last trimester LOL. Not as much standing from what I gather from my fellow students on the IM rotation right now. Just longer hours than surg, if you can believe that!

I've been pretty lucky with my pregnancy with exception to one scare - no morning sickness to speak of, and just having to pee frequently. If my preceptors can work with me on that, then it won't be too bad.
_________________________
"Some of it's magic and some of it's tragic but I had a good life all the way."
- He Went to Paris by Jimmy Buffett

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#80595 - 07/10/11 07:50 PM Re: Surviving rotations while pregnant [Re: megboo]
KALNUMBER2 Offline
Plus Member

Registered: 07/10/11
Posts: 32
I was in a gynecologic oncology rotation (for my first rotation, how cruel is that?) and after the first day I asked the dean to be excused from the rotation (3 weeks long). I go back in 2 weeks, so I'll be about in the 2nd trimester.

I start with neuro, then psych, then internal med, then baby is due right smack dab in the middle of peds. Is there much OR time in any of these? Any tips for getting through these particular ones while pregnant?

After baby I have family and community med, then Ob/gyn, then surg.

Thanks for your responses. I will be asking for some Zofran before I go back just in case.

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#80596 - 07/10/11 08:25 PM Re: Surviving rotations while pregnant [Re: KALNUMBER2]
Emily2651 Online   content
Super Elite Member

Registered: 02/27/04
Posts: 919
Loc: California
Originally Posted By: KALNUMBER2
This can't possible be good for the baby.

Eh, it's probably fine. I found this citation reassuring:

Klebanoff MA, Shiono PH, Rhoads GG. Outcomes of pregnancy in a national sample of resident physicians. N Engl J Med. 1990 Oct 11;323(15):1040-5.

Clever control group, I thought, and the only sig difference for the residents was an increase in the rate of pre-e. Keep in mind too that this study was done before the 80 h work week was instituted although, bizarrely, they were only reporting 70ish h/w.

As for how to survive, you'll probably start to feel better soon. I'm 25 weeks with my second child, an R3 in internal medicine. I took q4 overnight call (30 h shifts) during my first trimester which was kind of a drag, definitely a mind-over-matter deal. But since about 10 or 11 weeks, I've felt great. More or less normal. I think I may be starting to slow down again, and in three weeks, I'm back on q4 overnight call in the MICU ... so that may suck. We'll see.
_________________________
Too easy!

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#80969 - 07/31/11 09:19 PM Re: Surviving rotations while pregnant [Re: Emily2651]
Emily2651 Online   content
Super Elite Member

Registered: 02/27/04
Posts: 919
Loc: California
Originally Posted By: Emily2651
In three weeks, I'm back on q4 overnight call in the MICU ... so that may suck.


Took my first pregnant ICU call last night. More or less on my feet continuously for 28 hours. Verdict: super suck. Five more calls!
_________________________
Too easy!

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#81816 - 09/23/11 02:47 PM Re: Surviving rotations while pregnant [Re: Emily2651]
MomtoXan Offline
Member

Registered: 09/23/11
Posts: 2
36 weeks pregnant here, fourth year student. I just finished my medicine Sub-I. I will say it gets difficult in your last trimester with the long hours and constant rounding, although this depends on your attending as well. the first two weeks, I had an attending who had this goal of having rounds done by noon everyday. I LOVED him. Then another attending came on, and he would round until 1 then excuse the residents but make the students continue rounds with him until 3-4pm. That was tough. My best advice is to sit whenever you possibly can and don't even worry about looking "tough". I was pregnant enough that I don't think anyone would have dared say anything to me for pulling up a chair on rounds. I also had to buy bigger shoes and some support socks for swelling, but you won't have to worry about that for awhile. As far as surgeries go, I did gyn-onc about mid-way through my second trimester, but luckily had it pretty easy because I always got the job of "driving the uterus" with the manipulator which meant I got a stool smile Again, sit whenever you can! And if you don't feel good, let someone know, most people are understanding in my experience. Good luck and congratulations on the baby smile

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#82102 - 10/08/11 04:56 PM Re: Surviving rotations while pregnant [Re: MomtoXan]
PeggySue Offline
Member

Registered: 06/28/11
Posts: 8
Any other advice for surviving rotations in the 3rd trimester? I'll be on my sub-i (although in a chill specialty) starting at week 35...

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#82106 - 10/08/11 05:41 PM Re: Surviving rotations while pregnant [Re: PeggySue]
megboo Offline
Elite Member

Registered: 06/22/05
Posts: 376
Loc: Illinois
I wish I could give better advice. At the end of my 2nd tri (and last week of surg) I ended up in L&D with preterm labor. I've been on bedrest ever since (will be 29 weeks tomorrow) and will be until 36 weeks.

I'm missing what would have been my IM rotation, but I will do it all next year. I'm going to have to take a short maternity leave, but my dad and mom are going to alternate weeks staying with the bebe until he's ready for daycare.

I'm not so worried about myself as long as the boy is attended to.

I think if I were on rotation, I would be making sure to keep all eyes on where the bathrooms are, and just sit as much as possible.
_________________________
"Some of it's magic and some of it's tragic but I had a good life all the way."
- He Went to Paris by Jimmy Buffett

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#82110 - 10/09/11 10:57 AM Re: Surviving rotations while pregnant [Re: megboo]
KALNUMBER2 Offline
Plus Member

Registered: 07/10/11
Posts: 32
I am now in my medicine rotation and the worse part has been rounding from 10 am until 4 6 days a week with only one day off per week. I feel chronically sleep deprived and stressed out by all the residents and attendings I've had. Not sure how much different that would be if I weren't pregnant though. None of them have kids and don't seem to understand how little time you have when you have a child at home and one on the way.

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