Evidence-Based Crunchy

“There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.”

― Hippocrates

This post has taken me a while to write, mostly because it’s incredibly near and dear to my heart, but also because I think it’s a subject that people potentially have strong ideas and opinions about, because I know I do. If you’re just reading for the first time, or haven’t read the ‘about me’ session, I’ll let you know I’m a physician. A western medicine physician. I went to a Canadian medical school and trained in both Obstetrics and Gynecology and Family Medicine in Canadian residency training programs. What does that mean? It means I spent ten years learning the ins and outs of the human body; about anatomy and physiology,; pathophysiology and pharmacology; about health, wellness and disease; about epidemiology and evidence based medicine.  I learned this in both the classroom and at the bedside and I firmly believe that practicing evidence based medicine provides our patients with the best possible care.   At the same time I consider myself crunchy; I am both politically and socially liberal, health conscious, spiritual and environmentally aware and I don’t believe these things have to be mutually exclusive

As a physician of western medicine who firmly believes in evidence-based practice but also dabbles in essential oils, eats a predominantly whole foods, plant based diet and loves a good tincture and potion, I often find myself frustrated. Frustrated at the division between what people perceive as western medicine and all other forms of complementary medicine out there. Because I don’t believe there has to be a division. I believe many forms of alternative medicine and allied health professions, whether that be Chinese medicine, naturopathic medicine, registered massage therapy, physiotherapy etc., are just that COMPLEMENTARY and can be integrated into the overall management and support of an individuals health and wellness.

And so, I consider myself evidence based crunchy (a term I wish I could say I coined, but I heard it from a fellow colleague and thought, hey that’s how I practice medicine!). So what does this mean? It means that if the evidence shows that there is a non-pharmacological treatment or remedy for something a patient is presenting with, I’m game to try it, and to be honest, often times recommend them. Kiddo has a cough? Try some honey. [Just not under the age of 1 for the theoretical risk of botulism in unpasteurized honey].  Struggling with mild to moderate depression? The first thing I suggest are lifestyle changes including exercise, meditation, mindfulness practice and yoga.  But want to try some herbal supplements or natural health products? Go for it. There is some evidence for St. John’s Wort, Omega 3’s and SAM-e’s.  Want to try to bring your cholesterol down with diet changes? Damn straight! But you got a kid with fever? I will advise against using your essential oils to bring the fever down and suggest you go with something we know works like good old fashioned acetaminophen  A pregnant woman with a UTI? You need more than cranberry juice, my friend.  If some evidence in a peer-reviewed scientific journal comes out saying differently I’ll pay attention and adjust my practice, but until then I use what I know is safe and effective and is based on the evidence.

So why am I sharing this with you? I guess it’s because I want people to realize that a lot of us in medicine see the grey between the black and white; we see the desire that many patients have to pursue what they believe to be more natural remedies; we understand your desire to take control in your health and actually DO want to support you in that. But we want to do it in a safe, evidence based manner. I think what is often misunderstood is that natural doesn’t necessarily mean safe. Plants are powerful. Many of our most potent drugs in medicine come from plants. Digoxin, a cardiac medication that needs to be monitored very closely for it’s narrow therapeutic window, comes from Foxglove.

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Many chemotherapeutic agents used to treat cancer come from plants. Tamoxifen, a drug that dramatically improved the treatment of breast cancer,  is derived from the bark of the pacific Yew tree.

I can’t speak for other physicians, though I suspect that many feel the same way that I do; we DO want you to be engaged, to take control of your health, to get engaged, to educate yourself, to make diet and lifestyle changes, but we want you to do it safely. By all means, go see a naturopath, use essential oils but please talk to us about it. We’re here to listen and support you on this journey because some of are quite crunchy ourselves.

xo

 

Time MGMT

a.k.a – How to make time to train when you have three children under the age of four

I think this is the skill that I’ve likely honed most since becoming a parent, and yet still need to work on it (based on how long it’s been since my last post :). It’s incredible how many balls in the air you have as a mother: managing your kids needs on what feels like a minute-to-minute basis, grocery shopping, meal planning/prep, laundry, cleaning, feeding the cat, paying the bills, signing your kids up for activities on time….the list goes on. And have you noticed I have neglected to include one VERY important component? SELF CARE.

I don’t know if it’s our biology or rather that we fall into the habit of putting ourselves last but most women and mothers I know are guilty of the same. We are all great at taking care of our children, our spouses, our furry friends but sadly not always ourselves.

Now that I’m on baby number three I’ve come to realize that a) I’m guilty of this and b) this needs to change. Fortunately I have a husband who is super supportive of me making/finding the time to still do the things that make me happy outside of being a mother and for me that is fitness, running/biking/yoga. Those are my happy places. But that still doesn’t make it easy. Our days are full. FULL full. They start somewhere in the 6:00 am hour when our darling boys scramble out of bed full of energy and ready to get the day started and they don’t wind down until 8:00 or 9:00 pm at night after the kids are in bed, the dishes are washed and the toys have been tidied. So how do I find time to train? I’ve learned to make time. It’s never going to be the right time to go for a run, or to get to that spin class. Someone is always going to be crying. There will always be laundry to be done, dishes to be washed, beds to be made, PlayDough drying out that needed to be put away hours ago. But you have to leave it behind and just GO.

It’s funny, for Hagen and I the more kids we have it’s almost easier for us to find time for ourselves. Partly because we are more aware of how important it is and how having that little bit of time makes you a better partner, parent and happier self; but also because we have gotten better at scheduling, prioritizing what makes us happy and realizing it’s something you absolutely have to do.

So what are my tricks to try to manage my time and get it all done?

  1. Make the time. You’re never going to get out for a run, a bike ride, a cup of tea with a friend if you don’t schedule it it. Make it a priority. Days are full but that doesn’t mean there isn’t room. Hagen sets his alarm for the wee hours of the morning to get to the gym or out for a run. Sometimes I’m not leaving for an exercise class until 8pm at night because that’s when there is finally peace in the house. And some days when I’ve got a meeting and a few groceries to pick up and a baby in tow I travel by jog stroller. I run/walk to my meeting, the grocery store, etc. When the car needs service, I drop it off first thing in the morning and run home. I remember one of the few winters in the past four that I wasn’t pregnant (ha!) I’d get up early to run and the kids would be awake and not wanting me to leave so into the Chariot they’d go and we’d run past the fire station and by the bagel shop. Get ‘er done.
  2. Ask for help. Or pay for it. Full stop. We don’t have much family nearby. Hagen’s father lives in the city but works full time as a professor so isn’t around much to lend a hand. My family is all on the mainland. We are lucky to have a fantastic network of friends but most have kids the same age so not a lot of people we can lean on for childcare. So we have a nanny. Full time. Yes, I’m on maternity leave. No, I’m not ashamed. I have a few people ask me if our lives are as happy/fun as they look on social media and I can honestly say yes, they are. Because we have help. We know we need it. It makes us happier people and better parents. It’s a big expense, but absolutely worth it for our happiness. Our lovely Nanny has quickly become part of our family. She helps me run our home, she is helping me raise my children and she is helping me keep my sanity. I can get out for a strength training class, a trail run, and leave the three kids for an hour and focus on myself. It feels so good and I return refreshed and re-energized to deal with the chaos of a three year old who has decided he no longer needs anyone to wipe his bum after he poops or a four year old whose love of numbers and incessant questioning could drive you to madness. But it doesn’t, because I prioritize my sanity.
  3. Be accountable and make the investment by whatever means you can. Commit to meeting a friend for a run, offer to pick them up on the way to your yoga class. Schedule it into you planner so it’s there staring you in the face. Or pay for a trainer. Register for a series of classes. If it’s important to you, it’s worth investing in. If it’s going to make you happier and healthier than make the time and spend the money. It’s probably going to work out to be less $$ that how much you spend on latte’s a month so budget and plan accordingly. Don’t buy that extra bottle of wine on the week-end and put that cash towards the pilates classes you’ve always wanted to do. Always wanted to run a 10k – make a plan to run with a friend every weekend, join the local Running Room ‘learn to run group’ beacuse I guarantee you’ll meet at least a handful of people in the same boat as you who you can be accountable to. And do it now. Why? Because there is never going to be a ‘good time’ now is as good as it’s going to get. Life only gets busier. We all know that by experience.
  4. Manage your expectations. A.K.A Embrace the chaos. In an ideal world I want our house to be clean, everything in it’s place, our kids fed and happy and clean. You get the picture. But we don’t live in an ideal/perfect world. We live in chaos, like most families with small children do. So it’s OK if the French Press sits with old coffee on the counter all day; if the Paw Patrol toys are strewn on the living room floor; if the pile of unfolded laundry sits for just one more day. Now don’t get my wrong, I’m NOT saying let chaos rule, I’m just saying let a little more chaos into your lives. You’d be surprised how much happier everyone will be for it 🙂

 

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I’ll finish by saying this. I am by no means an expert, if you have other tips on how to fit training and self care into your lives I’d love to hear about them! I plan on doing another post on the importance of self care in general as well because I think this is something we women need to get better at!!!!

Until then, stay well and train. Hard.

xo

Aspiring to endure

en·dur·ance
inˈd(y)o͝orəns,enˈd(y)o͝orəns/Submit
noun
1.
the fact or power of enduring an unpleasant or difficult process or situation without giving way.
“she was close to the limit of her endurance”
synonyms: toleration, tolerance, sufferance, forbearance, patience, acceptance, resignation, stoicism More
adjective
1.
denoting or relating to a race or other sporting event that takes place over a long distance or otherwise demands great physical stamina.
“the annual 24-hour endurance race”

 

Dare I say it? I do. I’m doing it. I’m going to call myself an aspiring endurance athlete. I’m declaring so for two reasons, really: 1) I’m a goal oriented/action oriented person; I can’t just run or work out, I need to train for something, aspire for something and 2) I hope to inspire/motivate/encourage you out there who have always thought about signing up for something, whether it be a 5k community run or the Canadian Death Race; I hope that after reading this you are inspired to sign up.

So why endurance, you might ask? I don’t know, really. It just attracts and inspires me. I like running (most of the time, though not so much these days). I really do. I was never super fit as a kid, not un-athletic, just average. I didn’t make any teams in junior high school. In Grade 10, I tried out for volleyball and didn’t make the team but was offered the manager position which allowed me to practice with the team then travel to the games to assist, which I was totally down with. I tried every sport under the sun, literally. Swim team, soccer, basketball, volleyball, softball, rhythmic gymnastics, ringette, synchronized swimming, figure skating….you get the picture. I had incredibly supportive parents who would let me sign up for/try whatever sport I wanted, encourage me to finish what I had started but never pushed me beyond what I wanted. Sometimes I wondered if they had ever pushed me to pursue one sport, instead of try the pot-pourri that was my childhood athletic experience, if I would have ever really gotten ‘good’ at something, but then I think of all the incredible experiences I had and how they have shaped me to be the person I am today, and am I grateful for the way they chose to raise me.

So back to endurance running. I was fortunate to attend Rothesday Netherwood School for  Grade 11 and 12 (my final years of high school). Every year, after spring break, the entire student body participated in ‘Spring Trots’. Sounds like an unfortuage GI event to me now, but it’s actually a school running series where the elementary, junior and senior school students (and teachers!) run daily after classes working up to a set distance. I had never really run any significant distance before this and as a senior school student we worked up to a 10k run. There were lunchtime awards for most improved runner, which I was awarded at one step along the way, and although I was by no means the fastest, I felt a huge sense of accomplishment. And after that, I always ran. I rowed competitively during my undergraduate studies and ran to keep fit in the off season.  Then, when I moved to Japan after my undergrad and experienced intense culture shock, running helped me stay grounded. So, for some reason that escapes me today, I signed up for my first 1/2 marathon in Japan. I suspect it was for the same reason that I’m now hoping to move into endurance distances: to motivate myself, to challenge myself and to stay fit. I made myself a training schedule and manage to follow it pretty religiously, and ran my first 1/2 marathon in Kashiwazaki, Japan. I was one of three non-Japanese people who entered and probably the first person who had never previously run any distance close to that. It wasn’t a huge race, maybe a few hundred people. It was tough: hot, lots of uphill and only one water station at the half way point. I think I was the third last person to finish (literally a few 80 something year old Japanese runners behind me). But you know what? I didn’t care. I DIDN’T CARE. Because I was running for me. I ran through the finish with tons of people cheering ‘Ganbari’ which translates to ‘tenacity, endurance’ and I shouted back ‘Ganbarimasu’ which translates to ‘I will do my best’. And I did.

After that, I was hooked. Despite literally being one of the last people to finish the race, I felt so good. I was so proud of myself to finish. Maybe I was lucky to do my first 1/2 marathon in Japan, so I didn’t have to prove anything to anyone but myself, and I think that was the point where I fell in love with running. I did a handful of other races that year, and actually got on the ‘podium’ for one race, coming third place in a ‘mountain’ race which literally had us running straight uphill for 5km then downhill 5km. So when I returned to Canada after my year abroad, I kept running. I signed up for local community runs like the Bluenose 10k and 1/2 marathon, Ottawa 1/2 Marathon, ‘races’ like that for fun and to give me something to motivate myself to get our there and train. I’m also  fortunate to have done a lot of traveling and have run road races not only in Japan but also in Tanzania and The Netherlands. I eventually got into triathalon and joined the Halifax Triathlon Club and started doing group training sessions.  During my first year of medical school I trained with the cross country club at Dal which was an incredible (albeit humbling) experience which hugely improved my running. Since then I’ve done a bunch of 5k and 10k road races, a few marathon’s and a handful of 1/2 marathons.

And then I got into trail running. At first, just casually and for fun/training to mix it up. And belive it or the the first and only significant endurance distance run I have ever done was ‘for fun’. My ex-boyfriend/training partner and I decided one Saturday for fun we would run Cape Chignecto in Nova Scotia..it’s somewhere around 50km. We started out late (I think we decided, or rather I decided, it was imperative that we go to the farmers market for Mary’s Cinnamon Buns before we headed out of town). But I loved it! We had a ton of fun, seriously. Except for the fact that we ran the last 10+ km in the dark….bad planning on our part.

Then I moved to B.C. for residency (and ended up staying…another story!) and found myself getting more and more into trail running. Then I meet this super cute resident in the same year as me who is also into trail running who tells me about some awesome trail runs in Victoria (spoiler alert: WE’RE NOW MARRIED WITH THREE ADORABLE BABIES!) So I started getting more and more into trail running and fell in love,  with trail running and also with said resident. I’ve done a few little trail races here and there. But now that we have three beautiful boys and our family is complete I’m excited to start training for some longer distance trail races.

 

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I’m fortunate to have a very enabling husband when it comes to fitness so I’ve already gotten the okay and even encouragement to sign up for some races this summer. I’m starting easy with a MEC 5km run at the end of march at Thetis Lake (start slow and build!) and then gradually building up with longer distances doing an 11km trail race at Royal Roads in April and a 7km trail race in Duncan in May. I’ll hopefully do a few more races throughout the summer and my hope is to finish the season off with the Finlayson Arm 28km race in September. I feel like that’s a reasonable distance to aspire to over the coming months. Then maybe next year I’ll tackle the 50km!

Diving back into running after three babies, and only a bit of running in between pregnancies has been challenging. I decided to make it easy on myself by following a training plan. For one thing, it forces me to take things gradually so I don’t go all in too quickly and end up injuring myself. The other thing it does is make me accountable. I’m following this beginner 10km training plan from Running Shoes Guru. Right now I’m on Week 4 of the plan and it’s going well. It’s easy to follow and gradual enough that it’s not overwhelming but definitely starting to challenge me. I’m trying to work on strength on off days through boot camp etc.

So race one is just over two weeks away and I’m excited. I know I won’t be fast, and even though it’s only 5km it will likely hurt. But it will feel so good to get back out there into that community. I love community races. You see people of all shapes and sizes and level of fitness ability. Everyone is so positive and supportive. I’m excited to get back into this world, and also to show it to my children. To show them how important it is to be fit and active and to challenge yourself. Wish me luck!!!

xo

Sarah

 

 

Traveling with tots…

“When traveling with someone, take large doses of patience and tolerance with your morning coffee.”
— Helen Hayes

This seems like a timely thing to post about as we settle into our new digs in La Quinta, California for 10 glorious days of rest, sun, and as much relaxation as is possible with three kids under the age of four.

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I mean, really, this photo says it all. Travelling with kids is a f*&k ton of work. From planning on where to go, when to go, what to pack to the actual travel itself. It’s an immense amount of work, completely worth it, but a lot of work. Though, if you had asked me this morning at 9am when we were running around like maniacs trying to get our van packed up, the children in the car with empty bladders and full stomachs and make sure we didn’t forget anything critical I would have likely had a different opinion.

We don’t travel extensively or to any exotic destinations (unless you consider California exotic, which you very well may if you’re from eastern Canada). Our big vacations these days consist mostly of heading back east to Prince Edward Island and Nova Scotia  (which is an epic journey from where we live) to visit family, and to Palm Springs, California to get some much needed sunshine. I personally find travelling by plane much more stress inducing and requiring more organization than when we travel by car (camping, or over to Whistler to visit my parents) because you basically have to carry what you pack and, as witnessed in the photo above, this literally means carry what you pack for your family of five.  We’ve been traveling with our kids since Henry was four weeks old and over the years have gotten it pretty dialed in. Despite this, it can still be an incredibly stressful undertaking.

Yesterday’s departure rated as one of the most stressful to date. We were leaving from Vancouver, as Hagen and I had been over attending a conference and we figured it was easier and cheaper to fly directly from Vancouver to Palm Springs than from Victoria. Our flight wasn’t leaving until 12:30pm, which is a very civil flight time, so we were feeling relaxed and like we had lots of time to get organized. I mean, we were already packed so we just had to re-pack what we had brought and throw it in the van. Ha! If only it were so easy. I mean, literally we did just need to re-pack. We had a handful of items we were leaving behind (winter boots, jackets etc.) but other than that we just had to pack up what we had brought. So why does it take so long? Scrounging the house for the beloved new train that Johann has somehow already lost, convincing Henry that yes, he does need to wear socks as it’s actually cold out in Vancouver this morning, making sure we have the chargers of our iPhones, iPads, apple watches etc. And whilst doing all of this keeping a baby happy, fed and toddlers in check.

Vancouver had an uncharacteristic dump of snow the night before we left so the back-yard of our AirBnB had a good 6 inches of snow in the back yard. We sent Henry and Johann out to play in the snow while we got packed up. They came back in in their boots and winter jackets and we got them changed into their running shoes to get ready to hop in the van and head to the airport. Hagen went out to get the van cleaned off and I was feeding Wil. Henry decided to open the front door and told me there we just going to ‘wait on the porch’ for Hagen. Minutes later they are knee deep in snow and soaking their feet – exactly what we were trying to avoid – in slush. Sigh. Deep breath. Keep calm and parent on.

We manage to load our wet-footed children into the van, get Wil fed and bundled up and check-out in time – well 30 minutes behind our desired departure time of 9am – but still lots of time to make our 12:30 flight, right? Then after driving two blocks, Johann announces he needs food. NEEDS FOOD. And everyone knows a hungry toddler is a hangry toddler. So I unwrap a Z-Bar and toss it back (they sit in the very back seat of our Odyssey). Of course it falls to the floor and neither Henry or Johann can reach it. Johann’s desperation for food escalates, and we decide to pull over so I can hop out and hand him a snack to end the hanger. So we pull over, I open my door and immediately step into ankle deep ice cold slush. I was NOT impressed. Immediately got back into the van and declared my attempt to feed Johann over. Hagen took over as I was in no shape to deal with any more hanger and toddler irrationality. I felt badly, but I just had zero patience: perhaps the fact that I hadn’t had a long stretch of sleep the past few nights, coupled in with the stress of travelling and my ice cold soaking feet. We’re lucky that we can often balance on another out; when Hagen is feeling on the edge, I can step in and take over and when I’m at the end of my rope, he can sense it and calm Dad takes over to let me catch my breath and regain my patience.

We navigated through the snow covered streets of Vancouver, passing by the snow-naive drivers going 30km/hour (who also likely didn’t have snow tires) and made it to the YVR Park’n’Fly. Then my darling husband made about 6 trips from our van to the Park’n’Fly building, loaded our five bags, three car seats and one travel crib onto the shuttle and then out of the shuttle, onto his back, shoulders and luggage cart to get to the West Jet counter. We had checked in the night before, but had been given seats apart (why do they do that when you are traveling with toddlers?!) but managed to get it sorted with the agent. But man, even just checking in is a lot of work! You have to print your own baggage tags, tag your bags, print your boarding passes and then carry your everything over to the belt to go through the xray machine etc. I mean, when you’re traveling solo with just a carry on, or even if you’re checking a bag, this is pretty efficient. But when you’re travelling as a family of five with three little ones who can basically do nothing for themselves, it’s an incredible amount of work. Fortunately once we had our bags checked they rushed us through security and we managed to get through pretty efficiently. There wasn’t much of a line up through customs so we made it through without a hitch. So despite numerous hiccups we made it through the snow and slush, onto the shuttle and through check in, baggage drops, security and customs with almost an hour to spare! We got ourselves some coffee and smoothies and then made it to the gate.

The flight itself was pretty unremarkable. It’s a quick flight (especially compared to flying across the country to PEI!). Wil slept on and off. Henry and Johann were promised iPADs which they only get when we fly so spent most of the time playing games and watching videos. We arrived on schedule, all bags, car seats and baby paraphenelia arrived with us! The only hitch – the rental cars were on hold status or something random like that – WTF? I was assured it didn’t happen often, which wasn’t really that reassuring to me, but we got a coupon and our van was ready to go about 40 minutes later so we loaded in, strapped in our three patient but exhausted boys and headed for In’N’Out burger for dinner. It was early to bed for H&J, I fed Wil then we headed out to Trader Joe’s to stock up on some food for breakfast, came home, watched the final olympic men’s hockey event and we called it a night.

So all that being said, we have learned a lot over our four years of traveling with children and we have learned a few tips and tricks to make even the most stressful travel days worth it. And waking up in California to sunshine, having fresh coffee and avocado toast and working out by the pool makes the long day of travel 110% worth it.

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Top Ten Fifteen Tips for Travelling with Tots 

  1. Scrap the overly ambitious departure times – This might work for some, but we’ve had one too many 6 am departure time (yes, departure time). We learned that kids, despite how exhausted they may be, don’t nap on demand. We flew to PEI for my bff’s wedding when Henry was 19 months and Johann was 5 1/2 and had a 6am departure. We left our house around 4:15am and were really hopeful that they boys would sleep for part/most of the flight. Johann slept most of the way, Henry LITERALLY cried half the way to Toronto. Bless Hagen who carried him up and down the aisles relentlessly.
  2. Cut the carry on – I used to pack SO many toys for our kids on the airplane and they would literally play with something for five minutes then ignore it the rest of the flight. I also used to buy new presents for the flight – a new school bus, race car etc. So now we pack one or two toys each (a train and a paw patrol character), a few books, water reveal colouring and a tablet/ipad.
  3. STOP JUDGING PARENTS FOR USING SCREENS – I agree that they need to be regulated and kept to a minimum, but travel trumps any rules we have. Travel is incredibly stressful, and we expect a huge amount from our kids. So for everyone’s sake, give them a screen. There are tons of great educational games out there now. Henry’s favourite game is Endless Numbers. Johann loves building car puzzles. I honestly have no qualms letting them play these games as much as they want, Keeps everyone happy: kids, parents and fellow passengers.
  4. Pack smart snacks – Our kids need to eat regularly, and although they are pretty good when it comes to eating they are actually pretty good, you won’t always find food that is healthy, that they’ll like and that will fill them up while you’re traveling. We pack fruit, nuts, granola bars (home made and z-bars), cookies, cut up veggies (cucumber, carrots, snow peas etc), seasme snacks, goldfish (kids love them!), fruit snacks etc. And bring water bottles! Kids are always thirsty (especially if you feed them goldfish) and guaranteed they will spill whatever drink gets served to them on the plane in those flimsy plastic cups. Plus packing your own stuff saves you $$!
  5. Prepare for the inevitable – Diaper blow out, potty accident, spilt apple juice etc. It’s going to happen. It just is. So pack extra clothes for everyone (shirt, pants) yourself included (at least a t-shirt). I won’t say who was the culprit, but poor Hagen was left covered in toddler urine on our flight back from Halifax last summer. He let it roll off his back (he’s a doctor, ‘urine is sterile’ was all he had to say and moved on). I don’t think I would have been as graceful about it.
  6. Gate check  what you can, when you can! – I mean, why not? We gate check our stroller and car seat for baby. Especially if you’re going to be doing lay-overs. Gives you a place to hang your bags/tuck your kids bags as they will inevitably not want to carry them, and a place for baby to snooze.
  7. Wear your baby! – Even though we gate check our stroller and car seat, I always bring a carrier. For infants I would bring my ring sling (easy to slip on and off) or Tula carrier, toddlers the Tula. Even now both Henry and Johann love being carried! So when baby needs a nap, toddler is melting down, or you have a 1km trek from one end of the airport to another – wear your babies!
  8. Baby wipes, baby wipes, baby wipes – Carry at least two packs of these, even if kids are out of diapers! They can be used to clean up the inevatable spills, clean hands before snacks, wipe down tale trays etc. Youll never regret packing wipes.
  9. Bring medicine! – The worst is when you’re traveling and someone gets struck with something nasty. Dear Henry gets motion sickness so we try to always have some Gravol on hand. Get migraine headaches? You’ll be miserable if you’ve packed your triptan on your carryon and one comes on mid-journey. I got hit with a terrible gastro in the middle of the night after my BFF’s wedding on PEI (picture me breastfeeding a five month old while my husband holds a bowl out for me to puke in). We hadn’t brought any Gravol, and there are no 24h pharmacies on the island so we had to phone my (incredible) father in the middle of the night who managed to go by the hospital ER and pick some up for me. Never again will I travel without Gravol.
  10. DO IT. HAVE FUN. LOWER YOUR EXPECTATIONS – Honestly, traveling is stressful, but just do it. It’s always worth it in the end. Remember a lot of what happens (flight delays, missed connections etc) is out of your control so sit back and go with the flow. Kids feed off our energy, so the more agitated you are, the more agitated your kids will be. Have fun. Remember you’re spending quality time with your kids even when you’re miserable, and watching you deal positively with stress will likely wear off on them. And the memories you create on vacation are priceless.

I could go on and on but I do think these are some of the key things we’ve learned (well that and get Nexus cards…..so worth it!!!!). I’d be happy to answer any questions you might have – I’m definitely not an expert but have earned lot over the past four years and more every time we travel! And have you children that are older, wiser and capable of carrying their own bags? I’d love any advice you have to send my way. Us mama’s got to stick together 🙂

Addendum

So we are actively on vacation and I thought of a few more key tips for travelling with tots/little people:

11. Don’t pack a ton of baby gear – rent it! Travelling with babies means travelling with a ton of gear. Car seat, stroller, travel crib/pack’n’play, etc. Fortunately most popular destinations have places that you can actually rent some of this gear from. When we are in La Quinta we rent from DesertBabyRentals. We’ve had great luck with them over the years renting bouncy chairs, baby bath tubs, high chairs, etc. It cuts down the stress and keeps you from having to lug a ton of gear from Point A to Point B. And when it comes to clothes just make sure to book a place with a washer/dryer and you can wash and rewash as much as needed!

12. Invest in a travel crib – So yes, I did just say don’t pack it, rent it but I say travel cribs are an exception. Henry was a terrible sleeper as an infant (and I blame myself for some of this as I had a ton of anxiety round sleep) so when I was planning on being away for 5 weeks with him on the road visiting family out east I decided to make the investment. I did quite a bit of research and settled on the Baby Bjorn Travel Crib Light  Not cheap, but so worth it. Great reviews, packs and unpack easily, comes in it’s own bag that you can easily check on an airplane (with a bit of room to stuff extra items) and super lightweight. I actually started napping him in the crib before we left to get him used to it (he was bout 8 months at the time) and he slept like a dream in it. When little Johann came along we started traveling when he was barely three months, and Henry was only 17 months so still sleeping in the Baby Bjorn (and did so until he was just over three years old!) so I started looking around to see what else was out there. I came upon the Guava Family Lotus Guava Family Lotus Basinette and Crib and decided upon that. It’s perfect if you start traveling with an infant as you can use the basinette, then once they start sitting up on their own transition them to the crib. We’re using it while we are on this vacation for little Wilhelm!

13. Stick to your routine – So obviously being on vacation requires flexibility, but in general I think toddlers really do best with routine and schedule. They are still learning how the world works and knowing what comes next gives them some form of comfort and sense of control. And please understand I mean ‘routine’ in the loosest sense of the word. For us this means reading/playing with the boys when they wake up then breakfast as a family, get organized and some sort of morning outing (which is heading across to the pool these days), back home for lunch as a family, the another outing, then home again for quiet time, family dinner, bath and bed.  This can involve some planning ahead, for example for us our kiddos still have a bath on most nights so we always make sure to book a place with a bath-tub. Keeping the routine consistent helps keep the days flowing as smoothly as they can with toddlers on vacation 🙂

14.  Spell each other off – When we first had kids, I am embarrassed to say I judged other parents who needed to take time away from their kids. HA WHAT A ROOKIE MOVE THAT WAS. We all need time to ourselves to recharge our batteries, remember who we are outside of being a parent and to unwind. For both Hagen and I that is exercising, so we make sure that we build in a little time each day for one another to get some exercise in. Plus, being on vacation it’s nice to do something special – for me that’s heading out to get a mani-pedi, for Hagen it’s doing an extra long run – so again, we make sure to make this happen for one another.

15. Plan your meals – when we travel we are usually gone for two weeks at a stretch. It’s such an effort to plan, pack, travel etc. that we want to make it worth our while but being away for two weeks with kids can be tough if you’re not organized ahead for food and end up eating out. It can get expensive and unhealthy. Hagen and I are transitioning to a plant based diet (more on that on another post) so it’s even more important for us to plan ahead. I do most of the planning and cooking these days so sat down, researched some healthy but simple meals to make and did a big grocery shop with Henry and Wil in tow to buy what we need for the week.

 

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Finding Patients

pa·tience ˈpāSHəns/ noun
– the capacity to accept or tolerate delay, trouble, or suffering without getting angry or upset.

If you read my ‘About Me’ you’ll know that this blog is about many things: being a mother/parent, a physician, and an *aspiring* endurance athlete (I say aspiring as I have only ran any signifiant ultra distances once…but I’ll get into that another time) but that they all share one thing in common and that is patience.

I can honestly say, I never knew how patient I was, or would learn to be, until I became a mother. Those of you who know me well know that I’m a doer. Before having kids I was constantly on the go. Being home doing nothing wasn’t something I did. People would watch movies or binge on Netflix during the day? That was crazy talk to me (though now sounds like a dream day….). I was out studying, running, hiking, working, involved with committees, socializing – you name it. Now with three young children my days are the opposite, mostly spent at home keeping the peace and trying to run our home. Getting out with just the baby, or alone, for that matter, is a feat for me these days.

Being a parent, patience is probably one of the most important traits you need to have, or learn. Holding your newborn as they cry for no reason for sometimes hours on end; dealing with the constant negotiation of toddlers as you try to get through a day without tantrums, getting out the door on time, getting healthy food into their mouths, getting into the bath, getting out of the bath, negotiating bedtime etc. And I can’t even imagine what the tween and teen years will bring!  The amount of negotiating, explaining and waiting that goes on in a day as a parent is unbelievable. I think of myself as patient person, but I have to say that at times I do lose my patience and I am constantly working on this. It’s SO hard as a parent to maintain composure when you’re at the end of your rope, you’ve been negotiating all day long with your brood and you just want them to go to sleep so you can have that coveted hour of two of uninterrupted adult time before you go to sleep to recharge and do it all again the next day. I’m currently reading a book called ‘Permission to Parent’ by Robin Berman who talks a lot about this and how hard it is as a parent to remove emotion from the equation. And this is something I think I do well most of the time, but that I also need to work on daily.

I also need to be more patient with my husband, who is incredibly patient with me (most of the time :). My mind works at a mile a minute and I’m constantly doing five tasks at once. I’m very organized in my own disorganized way. In my efforts to keep our family of five organized, I have piles around our house. Piles of children’s toys I want to take back up to their room, piles of toys to donate, piles of laundry to be folded, piles of clothes to donate, piles of paperwork to be filed, piles of magazines to sort through…you get the picture. And my husband, whose German heritage tends towards tidiness and order, is not into piles. His home has basically become over run with toys, baby paraphernalia and piles and piles and piles. His closet is his only sacred space left in the house.  So when I see his socks on the counter or his bike left out in our mudroom, instead of asking (dare I say nagging) him to move it, I have to take a breath and remember this is his home too. I may be the one at home these days and organizing our lives, but I need to be patient and remember it’s a shared space and he puts up with my piles so I need to relax a bit. I’m not perfect, so why should I expect him to be?

Being a family physician also requires an immense amount of patience. Gone are the days where a physician was put on a pedestal (which isn’t a bad thing) and we now are taught to practice ‘patient centred’ care where we put the patients needs, interests and wishes at the centre of our treatment. I think this model works most of the time and is a positive change in the practice of medicine. The problem comes when you are dealing with patients who doubt that you have their best interests at heart; when they don’t want to vaccinate their children because they believe the ‘research’ they have done on the internet reading testimonials and totally false information; when you disagree that the vitamins and supplements their naturopath has prescribed are indicated; when you disagree that cannabis oil is going to cure their cancer. You need an inordinate amount of patient to listen to their side, understand where they are coming from and to try to explain that you DO in fact have their best interests at heart and your goal is to optimize their health.

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And being a mother and physician while still trying/aspiring to be an endurance athlete requires a well of patience. Patience mostly with myself. I have had three children in four years. My body has changed incredibly, and I have to be kind and patient as I slowly work to get back to the level of fitness I once had. I have zero abdominal tone. I have bad PFP (patello-femoral pain syndrome) after my hips expanded to carry and deliver these beautiful babies. I am still carrying extra weight (how could I not be?! I gave birth to my third beautiful boy only three months ago!). But I have to remind myself of this almost daily, when I can barely do five push ups in a row (on my knees!), when I am out of breath after running just a few km, when I still can’t squeeze into half of my wardrobe, that I need to be patient and kind. It took 10 months for my body to change and to gain the weight, so I need to expect it will take the same amount of time to shed the weight and get my fitness back.

So that’s why I decided to name my blog finding patients. I wanted to be a bit clever 🙂 And because on a daily basis,  I am trying to remind myself to be patient; patient with my children, patient with my patients and patient with myself.

This wasn’t my plan.

From there to here.

If you asked me 10 years ago, even 5 or 6 years ago, this wasn’t where I saw myself: living on Vancouver Island, the exact opposite end of the country from where I grew up, working as a family physician and married to another family physician, mother to three beautiful boys.

Ten years ago I was in my second year of medical school, still just figuring out what the whole medical education system was all about and sorting out where I saw myself fitting in. I knew I loved women’s health. In fact, I spent a month after my first year of medical school doing an OBGYN elective at Komfi Anoche teaching hospital in Ghana.

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Evans, a third year medical student at Komfe Anoche Teaching Hospital who showed me the ropes during my elective.

By the time I reached my last year of medical school and began the CaRMS matching process (that’s a whole blog post on it’s own!) I was torn between OBGYN and doing a Family Medicine residency with a focus on Women’s Health and Maternity. OBGYN offers a huge variety, from managing medically complex patients during pregnancy, doing on-call obstetrics, and gynecologic surgery. Family Medicine offered it’s own variety in a different way; managing people across their lifetimes, developing unique relationships as a primary care provider, with the added bonus of being able to shift your focus as your interests change throughout your career.

In the end, I went for OBGYN and matched to UBC for my training which was my first choice. They had a great program, strong in obstetrics, and I wanted to be closer to my brother and his family while I did my residency training. I was truly passionate about women’s health (and still am!) and at the time didn’t see myself settling down and having a family. I wasn’t against the idea of children, but thought it might not happen for me. I was 30 years old graduating medical school looking ahead at a 5 year residency training program at a minimum, seven years if I wanted to do an MFM fellowship.

It was at the end of my PGY-2 year (post-graduate year) of my OGBYN residency program in Vancouver, B.C. working crazy hours on call at BCWH, VGH and St. Paul’s Hospital when everything changed for me. My plan, up until that point, was to finish my residency and take it from there. I wasn’t certain what I wanted to do when I finished, but I had often dreamed of returning to Halifax and maybe doing a fellowship in MFM (Maternal Fetal Medicine).

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And then it all changed. I started dating Hagen, my now husband, who was just finishing his family medicine residency. We had started our training together; he was a first year family medicine resident in Victoria where I had been placed to do my intern year as a Royal College resident. We were friends first and didn’t actually start dating until almost two years after we first met. And as soon as we started dating, I started looking at life much differently. Suddenly regularly working 80 to 100 hour weeks wasn’t my jam. Working 24 hour in-house call every other weekend? Not so much fun. I loved (and still do love) OB but realized I wanted to spend more time outside the hospital than inside. And I also realized that that was an ok thing to want. I mean, some people LOVE surgery and being a surgeon IS an amazing career, but I didn’t love it enough to make it worth the sacrifices you (and your family) have to make as a female surgeon. So I took the leap, jumped through the hoops and made the switch from OBGYN into Family Medicine. Despite having completed a general intern year and 18 months of specific OBGYN training I was only credited 6 months for that training so had to complete an additional 18 months in the Family Medicine program to obtain my certification (it’s officially a 24 month training program). In that 18 months, Hagen and I managed to produce two little boys and I was fortunate to take two 10 month maternity leaves.

So…after graduating from medical school in 2010, doing 2.5 years in the OBGYN training program, switching into Family Medicine and taking two 10 month maternity leaves I completed my training as a Family Physician in June of 2016. I’m currently on my third (and final!) maternity leave and prior to taking this leave was working as a locum physician doing general family practice, hospitalist medicine and maternity. When I return to work from this mat leave I am fortunate to be joining a group of amazing female GP maternity physicians at GROW Health here in Victoria and will primarily work there. I’m also doing some fellowship training in addictions and specifically perinatal addictions medicine so I plan to incorporate some of that into my work here in Victoria as well.

Do I miss OBGYN? Absolutely. Do I wish I were the one holding the scalpel when I scrub in to assist in a C/S? Definitely. Do I occasionally dream about going back and completing my residency training as an OBGYN when my kiddos are a bit older? Sure I do. And I’m lucky enough to have a husband who assures me if this is something I decide I want to do he would support me.

But for now, I’m happy. I have a satisfying career working with incredible colleagues and I and still get to focus on maternity and womens health. Additionally, there is fantastic opportunity for growth in my area of interest, perinatal addictions. I have an amazing husband who is also an incredible father and my best friend who not only supports but encourages me to do make time for myself whether that be going for a trail run or getting a pedicure. We have the time to focus on wellness and nutrition; to spend our time researching nutrition and creating healthy meal plans for our family. We have the time to travel, nothing extensive or exotic at this point, but we find the time to go away as a family camping, biking and hiking in Whistler and enjoying some sun in California.  And then there is the family that we have created together.

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I mean, look at those faces – who wouldn’t feel incredibly blessed to have brought those three amazing, funny, sweet, smart and wild boys into the world?  So no, this absolutely wasn’t my plan but I can say I have never experienced love and happiness like this since my I made the leap and I wouldn’t change a thing.