Category Archives: Journal

My One Month Postpartum Food Photo Journal: Day 3

Posted on by

Breakfast was oatmeal, goji berry tea, and a tea that helps with getting rid of lochia. We waited until 4 days postpartum to start the red blood cell production and decreasing anemia first. This tea is taken for 7 days daily.

For lunch, I had leftover soup from last night and added pork in.

For dinner, I had pork, eggs, bok choy, noodles and goji berries soup.

I started to feel more weak today compared for the first couple of days. I am resting quite a bit and I have to thank my mom mostly for making all this delicious food. This one month postpartum period is an important time for healing.

We are entering day 5 of life for my son. Colostrum has transitioned to milk. He gained 3 ounces in from day 3 to 4 reaching a low weight of 7 pounds. He does eat and poop a lot and his latch has been great so I really cannot complain. Since our first son had high bilirubin levels (thus his jaundice was above 20), he needed to go to the hospital for phototherapy. So far with the second son, his bilirubin levels are lower so it is unlikely that we will need phototherapy this time around!

My One Month Postpartum Recovery Photo Journal: Day 2

Posted on by

For breakfast, I had oatmeal again. There are berries, nuts, apples and banana. Great for milk production. There’s also a goji berry tea.

For lunch, I had a soup. It’s made with lotus root…

山藥 (shen yao) translated as yam but it’s not the same as a sweet potato.

Sparerib soup with red dates and seaweed.

For dinner, we used the same soup base and added lamb, tofu, and udon noodles.

My One Month Postpartum Recovery Photo Journal: Day 1

Posted on by

Dear journal,

I haven’t updated this website in a long time. Earlier this year, I got pregnant with my second child and I just had him a couple days ago. The labor and delivery took 12 hours from when my water broke and I had such a wonderful team of midwives and nurses to help me through the process.

From my first birth, I wanted to write about my first month’s postpartum recovery period where my mom prepared intentionally selected foods to help with recovery. A lot of things I never knew and thought it would be interesting to share. I plan to show pictures and the rationale for the foods I eat throughout this important recovery period.

Today was my first full day home with my newborn. For breakfast, I had oatmeal, eggs and zucchini. Oatmeal is a good source of iron and help with red blood cell production. It is also good for increasing milk production. My mom added in some nuts (almonds, cashews), dried fruits, banana, and blueberries.

For lunch, I had sea bass soup. My mom went to the Asian grocery store and bought a pound of live sea bass. Sea bass is good for healing wounds. For me, I had a first degree tear and received 3 stitches. This will help heal my wound faster.

Also, there’s tofu for protein and goji berries. Goji berries have several benefits including it is high in antioxidants, improved vision, more energy, lowering of bad cholesterol, increased energy, better sleep, weight loss, improved hair thickness and luster, and less dryness. Goji berries also may help fight depression. It is also great to put goji berries into some hot water to let it open up and drink it like a tea. It is slightly sweet.

My mom also added white cabbage for vegetables and less “flavorful” so it does not taint the taste of the breast milk. It is also advised to not add too much spices (including pepper).

For dinner, we continued to use the same fish soup base and added lamb. Lamb has heme iron, which is easier to absorb and help with the anemia associated with childbirth. Lamb also has zinc, which is vital to maintain an optical immune system, wound healing, DNA and protein synthesis.

If you noticed, everything is soup based. Hydration is incredibly important to maintaining breast milk, which is the primary food for the newborn.

Today I felt great. I’m not sure if it’s because I got stitches this time for a first degree tear so I’m not nearly as painful in my perineum area. Or maybe it’s because I’ve had experience and systems in place at home already. Or if it’s because I’m so glad that my newborn is able to latch well today (and not cause a bleeding nipple). Anyways, see you tomorrow.

Posted on by

This last 8 months of 2021 has been difficult, polarizing, and changing. At the beginning of this year, I got the Pfizer COVID-19 vaccine and thought everyone would eventually get on board with getting the vaccine and ready to cull the pandemic to its end.

People were going across state lines where less people were getting the vaccine. The rush to vaccinate began in the USA.

Then I heard chatter amongst my colleagues. People were scared to get the vaccine. A lot of misinformation was and is still out there. They hear about the cases where people got bad side effects. They weren’t going to chance getting the vaccine. They would rather get the virus and brave the disease process and treatment. While many survive, many also maintain “long covid” symptoms such as the loss or reduced smell or taste.

Finally, the rush to vaccinate had subsided and those hesitant to get vaccinated began to say “how could you want an experimental drug, I’m not a guinea pig.” The institutions were not to be trusted— only their “sources” would reveal the “actual truth”.

At the end of June, my hospital decided to implement a vaccine mandate by September 10th, based on the belief that the vaccine would pass FDA approval (and no longer under emergency use authorization). Of course there are medical and religious exemptions.

Since then, protests occurred in the name of freedom. People quitting, going into a different field away from healthcare. Others quit to become a “traveler” where in healthcare you could make 2-3x your regular wages. Nurses becoming jealous of those with big sign on bonuses and thinking of wanting some of that too.

Many religious exemptions were made. Personally, I’m not sure if it is to keep the staff or if there are truly that many religions that are against vaccines. What religion promotes transfer of diseases? When you know a way to protect yourself, adding a layer of armor against something, wouldn’t you want it to help yourself fight?

About a week ago, the FDA approved the Pfizer vaccine. The excuse to not get the vaccine changed again. Did it really encourage those people who were hesitant to get the vaccine to get the vaccine? I hear many say the government pushed them too fast to get it approved. Basically, why trust the government.

Right now in Michigan we are lucky to not have a big surge, unlike in Florida. We are lucky to be “business as usual” without delaying surgical care to patients. We don’t have a huge influx of covid patients and for that I am thankful. We are starting to get a few more covid positive cases compared to the last few months. I sincerely hope with the start of the new school year that everything stays the same. But I highly doubt that. More people will get sick. Sure there’s treatment for it but isn’t it better to take measures to prevent getting a disease?

Starting in September, we will see what will happen. Until then…

As for my little one, I feel fortunate to have pumped /breastfeed for one year. But I am also happy that he readily accepts whole milk and doesn’t mind (too much anyways) that it’s only bottles now.

I can’t believe he’s already 15 months old. He’s running around, bounces up and down to music, climbs furniture more readily, goes up and down the stairs, understands quite a bit of what I say to him (even in Chinese!), points where he wants to go or do or eat, and says a few words. He loves the water and can’t wait to jump back in the water again. It is such an amazing journey.

The storms are getting bad, with my parents losing power for 5 days. I am seriously considering getting solar with a battery backup.

That’s it for now.

Happy New Year 2021

Posted on by

I’m so glad that it is the new year and that 2020 is over. We have two approved, highly effective COVID-19 vaccines and vaccinations are on their way.

Next week I’m getting the second of two vaccine shots. I felt fine the first day besides a little arm soreness. The second day I felt fatigue, a slight headache and my arm was still sore. By the third day I felt much better. Since then (2 weeks now), I’ve felt fine.

It was a tough decision especially since I’m still breastfeeding and there were no clinical studies on that population yet. While there is unknown data for nursing women for this vaccine, there is plenty of data for providing immunity for our babies through our breast milk and it’s partially due to vaccines. Currently my baby is still doing just fine and progressively developing.

After weighing the risk vs benefits, I believe that the benefits of getting the vaccine outweigh the risks of getting COVID-19.

After speaking with some skeptics, I’ve countered some of their arguments below.

While we may not know the long term consequences of the vaccine, I do know possible long term consequences of COVID-19– neurological changes, difficulty breathing, and death for already over 330,000 Americans. I’m ready to have a 95% effective vaccine protect me from getting COVID-19.

While we may not know how long the immunity will last, I’m ready to take another booster shot if it means protecting my loved ones and anyone I come in contact with.

While we may experience worse side effects from this vaccine compared to other vaccines, I’d rather get known side effects than the potential unknown of how COVID-19 would affect me or others around me.

While this new vaccine development seemed rush, I also know scientists have been studying mRNA vaccines for YEARS, this vaccine has gone through rigorous testing, and the mRNA does not enter the nucleus of a cell and change the DNA. The mRNA provides the blueprint to make the spike protein found on the virus so our body can start making antibodies against this virus.

While there is currently no data due to a lack of studies to suggest a reduction in transmission of COVID-19, most vaccines do reduce the viral load buildup since you are much less likely to get sick. With a decreased viral load it would ideally be more difficult to pass the coronavirus. To suggest that getting the vaccine still would not protect those who haven’t or can’t get the vaccine is just unfounded.

I feel so relieved to be at the beginning of the end. I can’t wait for the pandemic to be over. I can’t wait to experience freedom from masks again. To go back to seeing friends and family, to traveling, and to eating at an indoor restaurant again.

While I know getting the vaccine seems scary, for me, NOT getting the vaccine is even scarier. If you’re ready to go back to any resemblance of normal again:

Be part of the solution, not the problem.

Protect those who cannot get vaccinated by getting vaccinated when the vaccine is available to you.

So here I am. I decided to borrow a book called “Dare to Lead” by Brene Brown. In there, the author discusses how on the flip side of courage is fear. And I definitely feel that. Fear that other people will judge me or think negatively towards me due to me speaking out. Sometimes it just feels easier to stay quiet and not make any waves.

But while we can’t be right 100% of the time, we can try. And we can keep trying to do the right thing. Just like in Frozen 2, when you’re feeling sad, you just have to do the next right thing.

The next right thing is to make a plan to get vaccinated when the vaccine becomes available to you. Let’s end this pandemic.

My First Labor and Delivery

Posted on by

I can’t believe it’s been twelve weeks since I had my baby. My entire life has completely changed in so many ways. I’ve become a first-time Asian American mother during a pandemic as a CRNA. Because it has completely changed my mind and body, I’d like to share my labor and delivery story, and later on, I’d like to share some products that made my life easier as a first-time mom.

As a first-time mom throughout the entire third trimester, the body is getting ready for labor by widening the hips. About 1.5 weeks before I went into labor, I lost my mucous plug. For me, it was a yellowish sticky blob.

First Stage

Early Labor

I was exactly 38 weeks along and wished my baby would come that weekend due to my work situation. On an early Saturday morning, my water broke while I was sleeping 3:20 am. A sudden wet gush woke me up! The water breaks before labor in about 15% of women. I called the midwife to let her know. We agreed that since my water was clear and GBS was negative, I could stay at home during my early labor. FYI, a GBS test checks if you have this common bacteria. If you are positive for GBS, you will get an antibiotic through an IV at the hospital during labor.

My goal was to rest and relax as much as possible. I went for a walk, ate breakfast, lunch, and dinner, watched a movie, and took a nap. Around 6:10 pm, my contractions became more regular, and by 8:15 pm, my contractions were 2-4 minutes apart, 45 sec to 1:15 min long, for at least an hour. They wanted me to go to the hospital when it’s about 4-1-1 (4 minutes apart, 1 min long, for an hour) so that they know you’re in active labor. 

Active Labor 

Triage

I got to the hospital around 9:15 pm and went to the OB triage with my husband (I could only have one support person, so I trained my husband to be there for me!). My primary midwife happened to be on that night, which was awesome!! They checked fetal heart tones (FHT) and external contraction pressure. Normally, I think they would do a cervical exam in the triage area, but I asked to have it done once I was admitted to a room, and my midwife made that happen. 

Hospital Admission

They used a soft belly band to hold the two monitors in place and drew a CBC and type and screen (they draw blood just in case you need a blood transfusion). They asked if I wanted an IV, and I agreed to it since I know it sometimes may be more difficult to place one later. 

My midwife did a cervical exam and found that I was already 5 cm dilated, 100% effaced, and -1 station. 

Later on, my nurse Emily was able to find wireless monitors, so I didn’t have to be attached to the wall. Since I already had regular contractions, and my baby had accelerations during the contractions throughout the admission time, my midwife was comfortable with just periodic checks every 30 minutes. I was monitor free for a few hours and free to move around the room.

For the next 4-5 hours, I used a birthing ball and bounced on it. I breathed through my contractions, mindfully thinking about the pressure I felt.  I tried out different positions: “slow danced” with my husband, had my husband pull up on my belly from behind (or I called it a penguin pull). I even got into the water tub. The water distracted and dulled the immense contraction pressure. But at 3 am, I couldn’t take it anymore and asked for an epidural. As a first-time mother, I wanted to labor as long as possible without an epidural, because once an epidural is in, the laboring process slows down.

A Combined Spinal and Epidural (CSE)

I got out of the tub, and my midwife did another cervical exam and found I had dilated to 8cm. There was only another 2 cm left, but I knew that the transition phase was coming, and through my readings, I learned that the transition phase is the most painful part, and I just couldn’t take it anymore. Also, I had attended the AANA Annual Congress last year. I learned that the latest literature indicated that a combined spinal and epidural was a great anesthetic choice for a laboring mother. I couldn’t wait to get relief.

At 3:30 am, the anesthesia resident got the CSE quickly, and I immediately felt relief through the spinal. In case you don’t know, a spinal numbs you quickly, and an epidural keeps you numb. They used a 0.1% bupivacaine with 3 mcg fentanyl concentration solution, and I loved that it was a bolus every 30 minutes rather than a continuous infusion. I felt little light pins from my chest down and slight itchiness from the fentanyl. But it was much easier to tolerate a little itchiness all over than the pain, especially as it neared the transition phase. Once the epidural was in, I did have to be on continuous monitoring, but I had to be in bed anyway. The nurse placed a foley catheter, which drains the urine. Shortly after pain relief, I fell asleep for a few hours until the morning.

Second Stage

In the morning, the nursing staff helped me move into different positions in the bed. Moving into different positions encourages the baby to move down into the canal on his own. At 11 am, the midwife broke the forebag, which prevented the baby from moving into the canal. My body continued contractions, but with the epidural, I didn’t feel any of them. The nursing staff continued to monitor the baby’s heart rate. The baby had accelerations with every contraction that came every 2-3 minutes. The accelerations indicate that the baby was tolerating the contractions perfectly. Finally, after I felt rectal pressure, the midwife came to assist with the delivery. I pushed for about 1 hour lying on my side, and he was born at 3:46 pm!

Third Stage

My baby immediately went on my chest for an hour of skin to skin time. He looked healthy (a APGAR score of 9 at 1 minute and 9 at 5 minutes. The APGAR score was created in 1952 by Dr. Virginia Apgar MD, an obstetrical anesthesiologist, to determine how well the newborn tolerated birth in the first minute and five minutes of his life). so they were happy to wait to do the height, weight, and give 3 medications. He was calm and quiet, having gone through such a traumatic experience! The midwife delayed the cord clamping until it stopped pulsating so that majority of the blood went back to the baby. My husband then clamped the cord. Shortly after, I delivered the placenta as well.

Placenta and Umbilical Cord Blood Donation

The midwife and nurse then gathered the placenta and umbilical cord tissue to prepare it for donation. I decided to donate the cord blood and placental tissue to research and some went to storage to help others cure diseases. I picked Cellsure because it was free to donate the tissue that would’ve otherwise went in the trash. I also checked my hospital to see if they routinely donated tissue but they did not. Around 28 weeks, I spoke to my midwife about donating my tissue. I found Cellsure online that accepted donations. About a month before my due date, I filled out an online questionnaire to qualify. Once I was done, Cellsure sent me a box for me to bring to the hospital when I was in active labor (4-1-1). I let my midwife and nurse know about the donation and they took care of everything. After delivering the baby, the nurse did draw one more set of blood for the Cellsure. They called Cellsure and someone came around 4 hours after the baby’s birth.

During the first hour, my baby tried to nurse but was just figuring out how to latch on. Latching is probably the most important part about breastfeeding!

The next day, I was super sore all over. I had the first-degree tear, so the midwife didn’t think I needed stitches. For pain relief, I used lidocaine spray and cooled witch hazel pads provided at the hospital. When I ran out, I used benzocaine spray.  I took ibuprofen and acetaminophen whenever offered (every 6 hours in the hospital, and I slowly cut back over the following two weeks). I also took Miralax once a day for the first four days after birth to help with bowel movements. My first few poops were all nice and soft so, I was happy about that. 🙂

Michigan vs MSU

Posted on by

All this week, there’s been so much hype about the Michigan vs MSU. With Coach Jim Harbargh at Michigan, Michigan football is doing better than ever. Usually, I don’t really follow but my fiancé is a huge fan (he listens to podcasts and even submits questions via Twitter, haha) and now I’m a student!!

Anyways, Michigan has been dominating the last 4 games although MSU has won all five games undefeated thus far.

Apparently people all over the country are driving or flying in, staying in the cheapest hotel almost 30 minutes area at $250, with the cheapest tickets going at $175 this year (unless you’re a student who got season tickets).

Guy Fiori is going to be at Meijers this morning. “Game Day” is happening at the Diag. Somehow my friend talked me into going so I woke up early to get some studying done before I take a morning break and start back up in the afternoon.

It’s gonna be a lot of fun.

Speaking of studying, there’s a lot of new material. There’s a final exam in physical assessment and a principles exam coming up on pediatrics, fluid and electrolytes, blood products, and part I of the anesthesia workstation (yes, I can draw the oxygen molecule from the hospital outside, through the entire machine, and to the patient circuit— wow!).

I definitely feel on edge at a much higher rate than ever before. I’m usually a pretty calm person but now more than ever, I can feel my heart racing and getting anxious. And that’s almost everyday. I try to calm my nerves by either studying more, or setting time aside to go for a walk or watch some funny TV. Taking care of myself is probably one of the most important things I can do to endure through the program.

I learned this week (amongst other things), that a “sugar high” isn’t really a sugar high. As a tasty candy bar, full of “simple sugars” or glucose or monosaccharides readily available for insulin to act on, glucose is too quickly shoved into cells, causing a hypoglycemic effect. The alpha cells in the pancreas senses the hypoglycemia and releases glucagon. Epinephrine is also released from nerve endings and adrenals. Both glucagon and epinephrine go to the liver, which then undergoes glycogenolysis, breaking down glucagon into glucose and releasing it back to the bloodstream.

However, image the little kid full of epinephrine, setting off the sympathetic nervous system, causing him to run around like crazy during recess or banging his head against the wall. So a “sugar high” is really caused by “hypoglycemia” that’s induced by our more primitive insulin that floods our bloodstream when sensing a huge amount of glucose. If instead the ingested glucose was complex such as a starch, then our insulin is a much better match, releasing the appropriate amount of insulin without going overboard.

I did a few spinals this week (how cool and amazing it is!!) but next week I will try to do more general cases. All right, enough updating. Until next time.

Jessica

PS. I know the first round of interviews is coming up so I just want to say good luck to anyone who’s interviewing at UM.

PSS. The double rainbow outside my window on Thursday is the featured photo. Nature is beautiful.

First time jumpstart a Prius

Posted on by

My remote stopped unlocking the 2009 Prius. The remote light lit up red every time I pushed it but the car didn’t respond. 

I went on Google to try to figure it out. I hadn’t driven my car in 5 days. I found out there are 2 batteries in a Prius– one in the front hood to start the engine and the other in back for the hybrid use portion. I was pretty sure the front one was the one with a problem. I looked up how to jumpstart a Prius because I’ve never jumpstarted any car before. 

Thank goodness for YouTube videos. And I parked in a garage. I asked one of the attendants to help me although once he heard it was a Prius, he became skeptical since in the past, he was unable to help another patron. 

First I couldn’t open the door, so I found out that there’s actually a key inside of the remote. After I took it out, I read that it may be difficult to insert the key to open the door on the driver’s side. Thankfully it was easy. 

Next, the attendant drove over a van, left the van on, popped open the hood, and attached the red positive jumper cable to the red, and black negative to the battery. 

Using the other end, he connected the red cable to my Prius (under the fuse V12 battery box on the drivers side, flip the red little box), and connected the black on the hood’s metal latch (it sparked!). We tried turning it on several times by placing my foot the brake and pushing the on button. It didn’t work. 

We sat a little longer– and took the black one on and off the metal connection several times before I saw my car lights go on, and then start emergency honking. The car turned on!

From the Prius? We took the jumper cables off — black then red. Then from the van, black then red. 

Of course, concerned about the health of the battery, we searched up how to check. It was fine. 

Anyways, that’s it. 

It’s getting real

Posted on by

Since I got accepted into the nurse anesthesia program at UM Flint, it’s been an exciting time in my life. I went on my first cruise, got engaged, joined a Community-Supported Agriculture (CSA) and started to really think about what this program will entail. Recently, the previous class invited the Class of 2017 to a BBQ before school starts. For me, it means it’s going to start soon. The program director sent information about what to expect (school = your life for 2 years and don’t let anyone expect you to help around the house but still have at least one evening off to decompress and hang out with loved ones), review material especially in math calculations, the autonomic nervous system and some medications we’re already familar with, and the people I’ll be with for the next couple years. 

Speaking of which, I didn’t expect my picture from the interview to go up. I wished I straightened out my hair a little better but hey, it is just a picture (see above). 

I appreciate that we’re paired up with a mentor from the Class of 2016. It makes it easier to ask questions since they just went through it first (or junior) year themselves.

Sometimes I’ll wake up nervous — but I haven’t even started yet. Then I’ll remember that it’s such a privilege to even have this opportunity. I’m not sure if anyone is ever ready for the massive amount of information that’s expected to be memorized and applied, but here it goes.

One thing I really don’t like doing is writing scholarship essays, or really any essay that involves describing ‘how amazing I am based on the criteria that you’re looking for.’ But it’s a necessary evil. One thing I don’t understand is that if we’ve already submitted our application with letters of recommendation to get into the program, why do we need to duplicate the process of submitting additional letters of recommendation when applying for scholarships? Regardless, I’m thankful to have a NYU faculty member who is not only super supportive of me but also fast in response. 

I’m thankful for everyone who’s supported me. Because life isn’t an individual event. It’s comprised of many people. So thanks.

I’m excited to start this new chapter in my life. There’s 2 and a half months left before school starts. Two more months to save money before I’ll have zero income. But it’ll be worth it.