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?

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!

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.

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.

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.

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

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 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

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...

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.

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.

10 until 4? Oh my, that would have been a vacation on surg or medicine LOL. I don't mean to sound flippant, but at my school, that would have been almost a vacation. Even if it was 6 days a week.

We have one group of students on IM that are expected to start pre-rounds at 5am and leave around 6-7pm 5 days a week, and every 4th day on call (including weekends). I feel fortunate right now I'm on bedrest, but my time will come too. Boo.

Megboo - that's my school too. In fact, it's kind of funny, because the surgery students, IM students and family medicine inpatient team trips all over each other at 5:15 am on the floors that our patients overlap.

Wow - harsh, guys - rounding from 10-4 likely isn't the extent of her day...

It pretty much all sucks. Even doing your most favorite thing on earth gets old after so many hours - add even the cushiest pregnancy to it, and it's all hard.

But, this too shall pass and someday soon you'll be in residency enjoying it all over again - with a different set of anxieties and unknowns, hopefully with the same passion that brought you to where you are now, and all the while with support from moms who came before, during, and after you.

I didn't think I was *that* harsh. I would love to have just rounded from 10-4 and have the rest of the day be easier... if that's the case KAL, live it up, because you're lucky....

Yeah, I wasn't meaning to be harsh. More just saying I'm also rounding at 5am on certain services...no big deal if you don't.

You guys have me wondering what time my medical students show up. The next time I'm on service I'm going to make sure no one rolls in before 6. That's crazy. There have to be *some* perks to IM.

Re: "surviving", this is all I've got:

1. Remember it's temporary.
2. Sit down. Whenever you can. Don't stand for hours on end just to prove a point. Because, really, what is that point? As I've said before, I did my MICU month at the start of my third tri and it was pretty miserable. I was initially worried about how I'd be perceived, but generally found this wasn't an issue. Recently got my evaluations from that month, and both attendings with whom I worked ranked me in the top 10% of residents in my program. Which leads me to: I should have sat down more. Like, all the time.
3. There is no such thing as too many compression stockings. If I had it to do again, I'd wear compression stockings OVER my compression stockings.
4. Remember it's temporary.

I was just talking about rounding with the attending, not pre rounds or call or any of the other fun stuff. I have been thinking about quitting lately because I don't feel like I spend enough time with my son. Sounds like it will only get worse from here so that may be the right choice.

Aw, don't quit based on your IM experience. At my school, that's actually the worst rotation for time demands. Even surgery wasn't as bad as IM for the most part, and it's only temporary.

When I come back in Jan, I'm going to do my FM rotation, which is 8-4 or 5pm, office-based. Psych is also similar for us. Peds, requires us to be there early, but days end at 4 or 5. OB is another ballgame, but only 3 weeks are on OB, the other 3 on gyn.

It gets better

I think, for the people that regularly post here lately, no one intends to be "mean" or "harsh". We all want to see each other succeed.

But, IMO, it does nothing to blow smoke up anyone's skirt. Sometimes getting to the nitty gritty is helpful, and if I'm mean about it, I don't intend to be.

Thanks for all the advice - keep it coming!

Sounds like sitting and compression stockings are key!

I know what you mean about not sitting enough, I tend to get vasovagal easily, and it's worse now that I'm preggos. Somehow I still can't force myself to sit until I'm about to pass out...

pssst, Kal, you can take a leave of absence if you need to. Don't quit--just take the time you need. No one worth worrying about will fault you for it.

IM rotation while pregnant was definitely the lowest point of my whole medical school career. (This is actually hard for me to say since I am *so embarrassed* that I was miserable on IM. Everyone's supposed to love IM, right? It's "real doctoring" and all....?!) But anyway, things will get better, and there are many sides to medicine besides the "internal" kind . Your next rotation might be perfect!

And dude, rounding for 6 hours per day is definitely not a walk in the park.

Kal - I hope you get a day off soon to recharge. It feels hard and overwhelming because it is hard and overwhelming. It's also the best job on the planet, and one I'm grateful to have had the opportunity to (mostly) love.

Pm me if you wanna chat, we've all been at the low point of med school (another whipple? Please, sir, may I have another?).

Find someone to talk to - don't forget your classmates, many of whom are struggling just as much as you are. Or just vent here, which is what a lot of us do

One rotation at a time (or one rounds at a time if that's better). And plan a reward for yourself for some time in the near future, it always helped me to have something to look forward to.

Hang in there.

Thanks for all the support and encouragement. Just trying to figure out how to find time to study and be with my family is difficult to do. My resident is not particularly fond of me either so I'll just count down the days until inpatient is over.

I am going thru this right now! I am 20 weeks and just finishing week 4 (of 8) in surgery. The unfortunate thing about my pregnancies (besides the nausea that ended 2 weeks ago) is that I get vasovagal reactions on random occasions...and I have overheated/almost passed out about 3 times thus far (while scrubbed in to surgery and retracting). I realize you are finished with surgery by this point, but compression stockings, bananas (and just eating/drinking non-stop), and the least amount of clothing possible is what has helped me get thru. Gotta love the unpredictability of pregnancy. I hope you are well!