Thursday, June 11, 2015

It is Done: Milk Memoirs

A little over three years of my life have been spent producing nutrition for a trio of fat healthy little girls. Of the things I've accomplished over the last 35 years, this is one of which I am pretty proud. Maybe because it wasn't easy. Maybe because of all the uncertainties about being a Mom, I felt like I got this one right. Maybe because I get to take full credit for these cheeks. 

And these thighs.

And these rolls.



I preface by saying, in my interweb all-caps shouting voice, THERE IS NOTHING WRONG WITH FORMULA. A gazillion healthy, smart, well-adjusted babies have thrived on it and loads of wonderfully intentioned, loving, dedicated moms have used it. Breastfeeding was just the right choice for our family. And the nursing part was easy. All three babies were voracious eaters, and seemed to enter this world knowing exactly what to do. I was exceedingly fortunate on that account.

Dignity and social graces were pretty much out the door with the whole childbirth process, so it wasn't much of an adjustment to accept my role as an all-you-can-eat, open 24 hours milk buffet. We nursed in a host of awkward places. I treasured the early days before each baby reached the developmental milestone of abruptly and enthusiastically jerking her head around to look about the room, without of course, taking a break from nursing. Before trying to nurse under a cover became a task equivalent to trying to put a tarp on a spastic elephant. "Embarrassed" has been long deleted from my emotional vocabulary.

I'm sure there were nights when I wished baby sobs could be assuaged by anything other than me. Meals I wished I could have eaten with both hands, or before they got cold. Clothes it would have been nice to wear regardless of whether they were immediately accessible to hungry infants. Outings I might have enjoyed that took longer than the 2-3 hour maximum I could be away from a nursling or her mechanical equivalent.

But those inconveniences seemed minor amidst the soft sweet snuggles, the uncannily few infant sicknesses, and... let's face it... not having to wash bottle parts.

Going back to work, however, was not effortless. Pumping is evil. A necessary evil, but evil nonetheless. Inconvenient, inefficient, and awkward.

I had an E in residency, one in fellowship, and one as an attending so I experienced the pumping-at-work adventure from the extremes of underling to "the boss". Each had its challenges, but they had one thing in common. A year's worth of constant looking at the clock, working harder faster more efficiently than everyone else so that my 15 minute disappearance couldn't be considered lazy. So that my "breaks" didn't leave anyone else with more work to do. And then there was the Guilt. The inexorable Guilt for being late for (or heaven forbid, missing) a pumping session because a biopsy ran long or a patient's family had extra questions. And the can't-win Guilt of pumping instead of using those minutes to read more studies or spend longer with patients.

And then the logistics. As a resident, I pumped in the call room. Often interrupted by janitorial staff. Always multitasking. And once, while on the phone with the peds ED resident when the conversation went like this:

Me (trying to direct the phone away from the characteristic PumpNoise: So, your patient's CT shows blah blah blah...
Him: Ok. Wait, is that sound what I think it is?
Me (a little mortified): Oh, no. No. Definitey not. Whatever you think it is, it is most certainly not that.
Him: Ummmm, I have a newborn at home.
Me: Ok, well then, yes. It is that.

As a fellow and attending, I pumped in a dressing room in the peds subwaiting room, separated only by an easily-drawn curtain from countless curious kids.Many tried to enter. Plenty succeeded.

I had many conversations with techs through that curtain, who always knew where to find me and that I was always available for questions.

In mammo, I pumped in the quality control room or the consult room, depending on whether I thought there was a lesser demand for QA or consults that day. Like picking a checkout line at Costco, I inevitably chose poorly.

There were the days I forgot some random part and had to run to 4 different drug stores before spending $32 on a tiny plastic thingamajig, made all the more painful because I have a dishwasher full of them at home mocking me in their need-to-be-washed abundance. The days when I had an irrational theworldisending breakdown because milk spilled or someone left the fridge door open or the pump's suction... well... sucked. The pathologic panic that, no matter how robust my freezer stock was, supply might-- at any moment-- just go away.

I endured several rounds of clogged ducts and a few bouts with mastitis, the latter of which is every bit as treacherous as they teach you in medical school. Turns out a latex glove filled with warm water is a rather effective warm compress. And let me tell you, working in a dark room comes in handy when you have a water-balloon-glove stuffed bra.

I got notes from daycare about my kids "feeding" the baby dolls at school, and found Elise "pumping milk" for her baby on the couch one morning.

See the ice pack in her lap? She's prepared.
Now that I am several months on the other side of it all, I think back to A Day In The Life of ye olden times, and wonder how on earth I found time to do it all. But it somehow all worked out. And now, with The Three advanced out of the baby stage and perspective on my side, I realize it wouldn't have been the end of the world if it hadn't.

And so it ends. A chapter I'm at peace with closing, but one I am so happy to have written.