Our Birth Story

I meant to get this posted near her birth! But the 4th trimester has been wild! … more on that another day. Alas, here we are, and it is finally time for a catch up! If you had been following along you know pregnancy was going well. (And I’ll share my 3rd trimester update eventually…) Due to my age we were candidates for induction at 39 weeks. My doctor and I had made this the tentative plan. I wasn’t super into a ‘birth plan’ per se, but I am type A and like to have some semblance of a strategy in place! But baby girl evidently did not feel this was a good plan… we discovered she was breech, and for a first pregnancy this would mean you cannot have a vaginal delivery due to safety reasons.  If she did not flip to the appropriate direction (ie: head down versus up), I would need a caesarean.  Spoiler alert: she stayed breech. Google “spinning babies” if you want a laugh thinking of me laying upside down while very, very pregnant in a feeble attempt to turn this strong-willed little lady.  We also tried an external cephalic version (ECV) where my doctor attempted to rotate by pushing on my belly.  Yes, it looks as barbaric as it sounds.  It was tolerable pain (nothing compared to what was to come…) but, sadly not successful. Baby girl was showing her stubborn streak. I blame her dad.

Speaking of the hubs… he had a work trip leaving 4 days before our planned induction/now possible c-section. The day before his departure his parents were flying in to stay with me while he was away and help once baby arrived. They were somewhere mid-flight when I went in for one last OB visit before he heads out of town. You know, just in case…

At the doctor I reported the standard late pregnancy symptoms of feeling tired and uncomfortable but overall, feeling well. I had been having mild intermittent belly tightening, and a few episodes of tightening that were more intense but random and rare, nothing too crazy to me or that would signify labor was near. My doctor checked me, and we found out those pains were actually contractions! I was dilated in early labor. The best laid plans, am I right? Since baby girl was breech, suddenly time was not on our side. If we waited I could further into labor and need an emergency c-section. Not ideal. Instead, we opted for a more controlled urgent one. This meant… we were having our baby that day. What! We left the doctor’s office at 10 am. Drove home. Francis got a potty break (of course) and I grabbed my hospital bag. (I almost took it to the doctor appointment that day but was thinking what a rookie move that would be… go figure!) We were back at the hospital and in the operating room by noon. We attempted one last ECV after my spinal (numbing me from the waist down for surgery) … but again she wasn’t willing to flip. 

There was such a mix of emotions this day. I felt like I had done everything the best I could during pregnancy and still ended up having a c-section which I really did not want. I was scared. I know too much medical stuff. But not enough at the same time, if that makes sense? The nurse with me saw my fear. While wheeling me back to the operating room she paused the bed and told me a story about my baby girl. She gave me breathing techniques and promised to stay with me throughout. And then we were on our way again. At this point it all happened so fast. There was a mirror overhead and I watched my doctor working. I remember squeezing my husband’s hand in pulses to focus on something other than the fear. I watched as baby girl arrived and heard her little cries. My fear now mixed with a whirlwind of other emotions. It was one of the most overwhelming moments in my life. As they brought her over and placed her on my chest, I knew nothing would ever be the same.  Welcome to the world Everette Hazel. You represent the hope and dream of your parents. And we can’t wait to get to know you.

Photo: Stephanie Honikel Photography

2nd Trimester Recap.

Ah, the second trimester. The time when you (usually) start to feel a little more normal. For me, this rang true. At about 14 weeks the fog finally started to clear. It wasn’t a quick process. I did not wake up one morning and say “whew I made it.” But over a few days to a few weeks, I noticed improvement. And wow after the first trimester it was great to break through. 

To start, my fatigue dissipated, and my daily nap was no longer required to survive the day. I also felt like getting back to my ‘normal’ foods again including salads and smoothies. Although, my craving for avocado toast certainly did remain… My motivation to exercise also improved, as did my ability to make it happen. This was a welcome gift! It felt great to finally be able to move my body to keep myself and baby healthy knowing how important it is to get regular exercise in pregnancy. (SEE my post here) I changed my walks to my usual jogging and I was able to get back to 2 miles at a comfortable pace.  I started to take longer hikes with my husband, but still could not keep up with him… I also restarted a strength program focusing on short full body circuits to get my muscles going again. 

With my overall renewed energy, I made it a priority to break some of my first trimester habits and remove the crutches I no longer needed. Sadly yes, this meant I said goodbye to my daily bagel and purse stash of crackers. Feeling better overall allowed me to eat and move better, and in doing so (you guessed it) that I felt even better making these healthy choices. 

The biggest surprise of this trimester was my crazy dreams and insomnia. Some nights I would wake up in a full panic over a dream. I also would wake up with full on tears streaming down my face over something that happened in the dream! This was so wild. The insomnia nights were equally crazy.  I could be wide awake for no reason until 3-4 am or fall asleep normally then wake up at 3 am ready for the day. There was no use fighting it. I had the urge to do something productive during these times, (3am laundry anyone?), but instead finished a book on my iPad. The night feels very long when you are awake! Something tells me I will learn this more after baby is here… maybe this was just preparation.

I had hoped my renewed sense of energy would mean more normalcy in my day-to-day life. Unfortunately, this trimester coincided with a peak in COVID-19 in our area. Given pregnancy is a high-risk condition, I continued my time staying safer at home. It was a huge bummer to think I was wasting some of my best days of the pregnancy stuck at home. The emotional toll of being pregnant during this pandemic is something I will write on another day. Bottom line, it is really sad, and I know I am not along in feeling that it has made this already crazy adventure very tough for pregnant women. I feel a lonely and fearful and grieve the ‘normal’ experiences I should be having like registry shopping and babymoons and baby showers. I know most importantly I am safe and healthy, but still sad for losing the first-time mom pregnancy experiences.  

Physically I started to have a very tiny bump and at 16.5 weeks felt my first flutters of movements. It honestly gave me butterflies.  Such a strange sensation! And although I don’t automatically feel attached to them in a ‘oh hi there’s a human in there’ sort of way, (I am way too practical for that) it definitely hits on the mystical magical spiritual process that is occurring on a deep level. 

Logistically we hit our regular appointments with our OB, had our anatomy scan and the glucose tolerance test. I added in a visit to the dentist for a much overdue cleaning- dental care is super important during pregnancy! Poor dental health can lead to worse outcomes including things like preterm labor. I started my registry- if anyone is interested in what I picked and what I passed on a future post could be devoted to that as well.  I read every website known to womankind as I prepared it, and often went down unnecessary hour-long rabbit holes to learn more about all the things… I guess that is how my Type A pregnancy brain + staying at home passed the time and rationalized what might be ahead in this grand adventure. 

Overall, this trimester has been pretty good. I hate to complain with any negatives as I know how lucky I am, but the reality is everyday still isn’t roses. I still did have days when fatigue would hit or dinner wasn’t happening due to my stomach discomfort. The fullness in my stomach has been one consistency throughout and it is still wild to me that so much more growth still has to happen.  I can’t decide if everything is flying by our creeping along… Even though I am a doctor somedays I just feel in the dark about what is going on with my body and realize my control is gone. Again, likely preparing me for the future with a baby, I guess!  Nothing to do but wait it out, stay as healthy as I can, and allow nature to do its magic.  

See you in the 3rd Trimester! Ah!

My Starting 5 – April 2021

I was supposed to have this published on the fifth of the month, but instead of working over the weekend we took some much needed time off! A mini babymoon night was just what the doctor ordered. It was great to be able to just relax and spend a few moments away to ourselves after such a hectic year. Just wish it was a longer trip!

I am back on my game plan and writing in real time so that I can get you my Starting 5 for the month of April.  As a reminder, the Starting 5 is my list of the top of items or tips/tricks that I am loving and would share with you over the water cooler at work or over wine with my BFFs. There was a great response to last month’s list… (Here!) hoping you find some gems in this one as well. 

Without further ado… the April Starting 5. 

Hypervolt

Hpyerice Hypervolt in gray and black shown zoomed in
Hypervolt with Bluetooth Percussion
  • 2 words: Game Changer. I have experience with these devices as a team doctor and know they can be great. I was trying to come up with a fun Christmas gift for my husband this year and came across an advertisement. I thought he might love it as he gets a little stiff from his workouts mixed with long days standing over the operating room table. So yes, this was actually a gift I bought for him knowing full well I might use it too… #marriage Come to find out, it is a total game changer for me in this pregnancy! I have been using it daily on my hips, low back, glutes etc. My SI joints have been a hot mess since the second trimester and this little nugget has been worth every penny. Note that I did get it on sale for the holiday… so keep an eye out for a deal but knowing how much we both use it I would absolutely pay full price. 

Be Well By Kelly Protein Powder

Be Well By Kelly Protein Powder
  • If you follow me on Instagram (which I hope you do! @sportsdrmorgan) it is no secret I love Kelly Leveque and her nutrition concepts. When she launched her brand of protein powder I needed to test it out. Prior to this, I have used several whey and plant-based powders. Some I still love (Tone it up Peanut Butter is delicious!) but wanted something less processed to use during pregnancy. Enter BWBK Protein. It is extracted in a chemical free manner, is made from grass-fed beef and contains collagen. I choose the vanilla flavor and have been loving it in my morning smoothie. Also, hot tip- you can mix a small amount in almost anything to up the protein. Another current go to: mix a half scoop in all natural PB and spread on an apple as a balanced snack. 

Hatch Belly Oil

Hatch Belly Oil
  • Staying with the pregnancy theme I splurged on the luxurious Hatch Belly Oil. I have been slathering on all the balms and oils and creams I can find to aid in the stretch as my belly grows. Nothing truly prevents stretch marks according to the science, but it sure doesn’t hurt to keep the skin hydrated. The Hatch Belly Oil is pricey, but it lives up to the hype! The smell is soft and pleasant and it dries super fast. I also love applying it because it feels like a little dose of luxury. And in the times of COVID, while pregnant, staying home all the time… there is something to be said for feeling a little luxury in my post-shower routine. 

Getting Dressed

  • Speaking of little luxuries… getting dressed while pregnant isn’t one of them. Nor is getting dressed during a pandemic! Anyone else switched to a 100% sweats and yoga pant wardrobe? Then one day I got dressed. Nothing fancy, just something that made me feel good to wear. I also put on my engagement ring and a splash of makeup. I don’t usually wear my ring when I am home since the majority of the day I find myself doing chores like laundry or washing dishes. That day I noticed immediately I felt better. Putting a small amount of effort can make a huge improvement in your mental wellbeing. Hopefully this is something I can remember to do postpartum as well!  Funny story one day I did ‘full makeup’ for a photo I was taking and when I walked into the bathroom I caught my own reflection in the mirror and literally jumped. I scared myself because I didn’t recognize my own reflection. Haha. Definitely time to step up my day-to-day game for no one except me and my own mental wellbeing. 

Outlet Shopping

  • It is no secret I love a bargain. I needed new bedding for our a new California King size bed. (bed linked here  … I love it!) But I also didn’t want to spend a fortune on the linens. Bedding is important for sleep yes, but my 28lb Frenchie sheds on it. I also needed a few furniture items for our nursey but didn’t want to break the bank.  Baby stuff adds up and is expensive! I will do another post on what we bought for the babe, spoiler alert, you don’t need as much as the registry folks want you to think you do. 
  • After ogling a few of the duvets online from Restoration Hardware I serendipitously found an RH outlet nearby. I did the same for Pottery Barn when hunting for a glider and crib. Here’s the tip. Look for an outlet version of these stores. They sometimes carry ‘scratch and dent’ products, but they also sometimes have perfect returns that cannot be resold. 
  • While in the RH Outlet I stumbled across a pair of Cal king sheets that matched my aesthetic, but no duvets.  I didn’t go to buy sheets. Ugh. I decided to pull them out of the packaging to be sure I didn’t also ‘need’ to buy sheets even though we had just bought two sets… and low and behold it was a DUVET! I was ecstatic. I continued my hunt by searching for shams… but couldn’t find 2 that matched and were the appropriate size. That is until I again opened a package that had been mislabeled. No way, right!  The sales lady was laughing with me by the time I finished. She said the product comes in on large pallets and they cannot look through each in detail. So, if you do venture to find a bargain don’t be afraid to ask to look inside the packaging!
  • While on my Pottery Barn Outlet shopping trip I had another great experience. I had started my search for nursery furniture online, but to my dismay every glider that I did not find hideous was backordered or special order and wouldn’t arrive until months after our due date. Did you know some of these chairs take like 10-20 weeks to produce, let alone ship? The gestation on the chair is as long as on the actual baby. A friend told me to try the PB Outlet as I could take the pieces home the day I purchased. I found the perfect glider in a neutral gray fabric… and while there saw a crib that would work too. We had initially intended on the cheapest crib possible and had considered one from Ikea. But those looked flimsy in person and I was concerned about function.  I also did a deep dive into crib and nursery safety one afternoon (working from home = lots of deep dives into the internet baby space) and I found out about Greengold Certification and the chemical free nature of the products from PB. This was a win win. We got our glider and crib, and I grabbed a stuffed lamb toy to add to the mix. All in all, we saved money and were able to get them set up in the nursery in plenty of time. 

Orthopaedic Injuries of Pregnancy

It is no secret that pregnancy comes with a host of changes for your body. These changes allow you to accommodate making a new life but also can put you at risk for musculoskeletal issues along the way.  This is often because of some combination of loosening of ligaments due to hormones, changes in the center of gravity due to your new “bump”, added weight in general, and increases in overall body stress.

Most common Issues I see in practice:

#1 Injuries from a Fall:

As a specialist, I usually see a patient when they hurt something that needs further investigation.  Injuries happen to even the healthiest of pregnant patients.  One of the most common I see is an ankle sprain (see my full post here on all things ankle sprains) Pregnant patients often feel unbalanced.  A movement as simple as stepping off a curb awkwardly can lead to an ankle injury. The great news is the treatment for ankle sprains during pregnancy is very similar to the average patient, and most do very well without long term issues. 

Another common injury from a fall is a broken kneecap (patella).  Again, these tend to happen because of being a little off balance.  With a slip or fall, you can land directly on the knee causing the patella to break. This is painful! The injury is not usually subtle and makes it difficult to stand or walk.  X-rays will show us the problem, and sometimes the problem needs to have surgery to fix, but often you can get better with a period of resting your leg in a straight position. Though keeping your leg fully straight for weeks is not easy while pregnant… something I appreciate even more now that I am pregnant! But my patients have made it through, and you will too! 

Other broken bones can also happen during pregnancy from falls. The second most common fracture in my practice is a broken wrist. When you start to fall you naturally reach for the ground to brace yourself. Unfortunately with this motion, you can land on your outstretched hand break a bone in your wrist called the distal radius. Again, sometimes these need to be fixed with surgery. The ones that do not are treated in a cast for several weeks. Being in a wrist cast while pregnant also seems absolutely no fun, but it is achievable and safe.  Keep in mind these things can happen in pregnancy (just like outside of it), and orthopedic doctors are trained to do what is best to make sure your bones heal well, and your pregnancy stays safe. It is key to let your OB know if you have had a fall or are seeking care with another doctor. This allows us to all work together to be sure we are optimally treating you and keeping everything as pregnancy safe as possible.

#2 Aches and Pains

Ah yes, the joys of pregnancy…  Sometimes if feels like everything hurts whether you move or sit still! Joint pains, achy muscles, and stiffness all over are very common.  Muscle imbalance mixed with a growing belly often leads to a very common complaint, back pain.  It is estimated that 50-80% of patients experience back pain during pregnancy (2). Other super common areas of pain are the hips/pelvic girdle, knee, and neck. Most of this can again be attributed to the normal changes that occur during pregnancy, and keeping active throughout is the absolute best way to keep these issues at bay.  

#3 Wrist and Hand issues

Again attributed to the changes of pregnancy, wrist and hand pain is also very common. One specific condition that plagues pregnant patients is carpal tunnel syndrome.  This condition usually experienced as hand numbness and tingling in the thumb, index and middle fingers and has been estimated to occur in up to 62% of women who are pregnant (1). Great news, this most often resolves on its own after delivery. Until then, stretches and braces for the wrist usually help relieve the symptoms. 

How to stay safe:

First and foremost, listen to your body! The changes of pregnancy alter so much about your function and physiology. You should avoid risky activities where falling could occur, be careful on wet ground and ice, and always be extra vigilant of where you are walking. Stepping off a curb requires attention as does hurrying across a street or walking on a dirt road/path. Be careful! 

Another great tool is a daily body “check in” to see how you are feeling. Is your back tighter today? How do those hips feel? If you can catch an ache or pain early before it becomes severe, you can likely fix it faster. Add in stretches or targeted exercises for your problem areas, and keep moving throughout pregnancy.  Another tip is to remember to take a break if you are sitting for a prolonged period. This helps keep your body from becoming stiff.  It is important to avoid heavy lifting, and be sure you are using proper techniques to lift with your legs (not your back) to stave off further back pains and injuries.  Avoid reaching far away from your body as much as possible to keep your center of gravity stable.  Sadly, since your balance is a little off, retiring your high heels short term is the safest thing to do. 

As always on this website I preach an overall healthy, active lifestyle. In pregnancy this doesn’t change! If anything, it means more focus on these techniques to keep you fit as everything changes. Daily stretching, strengthening, and cardiovascular exercise help keep your body healthy and strong all pregnancy long. This helps you avoid injuries, keeps a better mind-body connection to avoid falls, and keeps aches and pains away.

Finally, what to do if you have pain or get hurt:

First, think about the severity (how bad is it?). If on your daily body check you noticed some general soreness and aches and pains, start with easy-to-do changes at home. Sit in a more proper position while working, remember to take standing breaks, and be sure you are getting proper exercise and stretching.  Always keep in mind your daily routine and that you may need to change something if your body is aggravated by these activities. Also, as always, talk to your OB! Bring up these concerns at appointments or even before if you feel they are significant.  Many small aches and pains are common and not a big deal, but you should always discuss with your doctor to be sure something further doesn’t need to be evaluated. Also know that even for general aches and pains, sometimes braces or other supports can be used to ease the discomfort.  Sometimes your doctor may recommend a pregnancy-safe medication such as Tylenol or even refer you to physical therapy to aid in your recovery.

If you have a larger amount of pain related muscle or joints or if you have had a sudden injury, an urgent/emergency evaluation is the way to go. You should also absolutely reach out to your OB as they can work with your orthopedic team to be sure you are optimally treated as a whole by coordinating specific recommendations based on pregnancy. If you need an X-ray, don’t panic. You can use a shield, and the doctor will do everything possible to keep you safe by only taking x-rays that are necessary to treat you properly. Trust your doctor, and ask questions along the way. I never feel bad when a pregnant patient asks about the necessity of a test or treatment. 

Sources:

1. https://pubmed.ncbi.nlm.nih.gov/19753825/

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3306025/

3. https://www.cedars-sinai.org/health-library/diseases-and-conditions/b/back-pain-during-pregnancy.html

My Starting 5 – March 2021

I enjoy reading ‘Things I love’ posts from bloggers, but they sometimes feel overly sponsored and materialistic. That said, I love seeing the true gems others find. Enter: My Starting 5. These are the 5 things this month that I am totally into. They might be items I love, but I also want to focus on fun experiences or useful tips.   Think of it as the former chats about the latest gadget with a coworker or the tip your BFF gave you over dinner.

It also goes without saying none of this is sponsored because well, no one sponsors me. If that ever changes I will update accordingly. 

Without further ado, the March Starting 5!

Breville Smart Oven Air

Our new Toaster Oven
  • Let me back up… I contemplated adding a toaster to our wedding registry.  The one we used I swear my husband had in college! After reading some reviews I was drawn to the idea a toaster oven instead.  Basically, why have a toaster that literally is an appliance for 1 thing- toast bread?  The toaster oven which does all sorts of things. Right before we made the move to Phoenix I saw this little gem on sale. And when I thought about turning a real oven on to cook in the 115 degree desert heat it seemed worth trying. Let me say, it may be my favorite adult purchase EVER.  Seriously this thing is genius. It toasts, roasts, air fries, bakes and the convection feature makes it heat up so fast without heating the whole house. Literally almost zero preheat time. I think I lived here a month before I even had to turn the real oven on… and that was Thanksgiving when I was using BOTH the toaster oven and real oven.  Simply genius. 

Simple Modern Tumblers

Best Tumbler
  • I mentioned in my 1st trimester post (linked here) that I really had to focus on upping my hydration game during pregnancy. These cups made it happen. I love the neutral colors and size.  I filled it with extra cold water (which it keeps maintains temperature on very well) and thanks to the nifty straw I can chug it down easily. Bonus tip for staying hydrated- every time you take a drink think about 10 big gulps. Boom, you are on your way to hydration.  I use a free app on my phone to track the volume I drink (Water Llama) and know if by noon I am 2-3 fill-ups in I am on track.  I bought my first one at Target… and also they have them on Amazon. 

New Planner

My new 2021 Planner
  • Ah Amazon how I hate to love you so much.  At the start of 2021 I was looking for a simple monthly calendar to help keep this website and instagram on track. Everyone says you need a content calendar (still learning all these things…) but being a visual person I hoped it would help me see everything together.  Most calendars I used before were too busy and had too much space for things I didn’t need (birthdays and to-do’s, etc-  I keep those on my online calendar). Enter this planner from Amazon.  It is thin and simple has just enough space to layout my ideas for the weeks and months ahead.  I have never felt more organized in my content planning. Now time to execute! 

 Podcast Walks

  • That first trimester is a doozy! Nearly all my exercise came from walks in the neighborhood. I have always loved podcasts but found a new appreciation for them while on these walks, and also while working from home and needing a source of stimuli other than my computer screen. Or Francis snoring on the couch. I have been catching up on Oprah’s super soul, re-listening to old favorites from How I Built This, for a short burst I enjoy The angry therapist, and recently have following Be well by Kelly. 

Sunday Pizza Night

  • The Sunday pizza night tradition started in LA when I first moved in with my husband.   And it is one of my favorite easy traditions we have maintained.  It works for several reason.  First, who doesn’t love pizza?  Second, I love having one night a week I never have to think about what to make for dinner.  Our routine is to order a giant salad to split and pizza to share.  After relocating to Phoenix we found ourselves deep in the largest pizza scene I have ever seen (Thrillist Best Pizza Phoenix) . And although I miss my beloved Manhattan Beach Pizza in Southbay— the fact that we can find a wood fire/artisan/special pizza place on every corner certainly helps.  We have tried a new one almost each week! I don’t see this tradition ending any time soon. If you want to try one but don’t live locally… goodbelly.com actually delivers Pizza Bianco nationally. Crazy, right.  If you end up in Phoenix we also love Cibo, The Parlor, and Base Pizzeria. 

1st Trimester Recap

(secretly pregnant in these workout photos… just another day in the life!)

When my now husband and I first started seriously dating we had a talk over a diner breakfast one lazy Sunday morning that went something like, “hey I like you, this is going well and to get the life we both want we need to move quickly…” From engaged to married to expecting all during a crazy pandemic year that tipped everything sideways… I believe that is the definition of moving quickly! 2020 was the best and most insane year of my life. 

In August 2020 we pivoted away from our dream wedding and celebrated with an intimate micro-wedding that turned out more perfect than I could have hoped (still working on sharing those photos…)  Around this time we decided to let what would happen in the baby making department, well happen. Being 37 years old gave me doubts that this it be an easy road. To that end, my sincerest love to anyone struggling with infertility. I have a personal story to share another day that makes me extremely sensitive to this and the emotions of saying we were open to trying was enough to bring me to tears. After some soul searching I choose to focus on the word ‘surrender’ knowing none of what might happen was in my control.  People ask if we were trying and I have debated if that is TMI?… but if sharing helps anyone then it needs to be done. Making babies isn’t always as easy as they teach in high school!  There is a small window in a woman’s cycle when babies can happen called ovulation. This time varies for each woman and most don’t actually know exactly when this is. I wanted to approach this little journey as much like a doctor as possible. This meant using a basic drug store ovulation kit.  When the little guy flashes a smiley face that is go time. It doesn’t always work like magic but can be very helpful to learn your cycles and for us, that was it.

How did I find out? In a word, I KNEW. I am super aware of my body. There was something the tiniest bit off. Slight belly discomfort, a minuscule amount of something not even considered nausea but something. I took a very early test and voila – positive. I didn’t get too excited, knowing early tests aren’t always the outcome, but sure enough!!  I had an immediate mix of emotions from excitement to gratitude to fear to wow this is so weird! I was shocked. So shocked that even though I know some women take time to figure out a cute way to tell their husband… I instead choose to blurt it out on the next phone call.  I knew I needed his support immediately.

Everything that followed was new.  I kept telling every doctor how weird it was. I had treated many pregnant women before, but never imagined what it actually felt like to be pregnant. I also never realized how isolating it can be. It is crazy that in the time when hormones are all over the place and this huge life change is on the horizon there is taboo in telling others. There is something to be said for privacy if you choose, but this taught me it is important for everyone to tell as much or as little as they want whenever they decide to do it.

What I felt:

Tired. So tired. In weeks 3-13 I slept more than ever in my life. I am NOT a napper, but this fatigue was no joke.  I would sleep on the couch 2-3 hours in addition to going to bed early. And by early I mean at 8pm I was under the covers. I felt guilty but didn’t have a choice.  My body needed rest. Lucky for me my husband was super supportive and kept encouraging me to listen to my body. When he asked what I did that day and I said I ate a bagel and napped, I swear he said awesome great job.

Digestion changes. Many women have severe nausea or vomiting way worse than I.  But for me this was still terrible.  I was nauseous and my digestion slowed down like crazzzzy.  There was a 2 month period where dinner wasn’t something I could eat.  I would start the day with a little breakfast, do okay at lunch and at dinner couldn’t eat without being nauseous, overly full and very uncomfortable. In general carbs were my friend and a fancy dinner became saltines and a slice of cheese at 4pm.  Not wanting to fall totally off the healthy food train I tried my best to sneak in salad and protein when able. I loved eggs and avocados so much this kid is half avocado toast.

Body changes. Despite no actual bump my lower stomach became super sensitive very early. I couldn’t tolerate any seam across my belly.  Pants felt strange and uncomfortable. One of the silver linings of staying home during COVID was there was rare instance I actually needed to wear anything other than cozy sweatpants.  And then there are the boobs. People say they get bigger… and that is no lie.  Everything on the front half of my body felt swollen and hard to recognize. Contrary to most women instead of super luscious hair and nails, mine fell out and were brittle to the point of asking my doctor, but it was nothing of concern.

The usual suspects. Peeing all the time, sensitivity to odors, cramping legs at night and bleeding gums are super common issues and I experienced them all. 

Things that helped:

Listening to my body. It felt like the day after you have a bad flu… but for the whole trimester. Naps were on repeat. It was hard to feel so lazy but I didn’t have a choice. Hormones and the body changing rapidly, as well as growing an entire new organ (the placenta) means required rest.

Trying to make healthy food choices as much as my body allowed- although I ate more bagels than in years, I gave myself grace.  This wasn’t a free pass to follow every craving.  I was very aware it was easy to say I craved pizza… when honestly when do I not crave pizza? I also kept in mind the nutritional needs for this tiny addition are in fact tiny. If I could stomach a few pieces of broccoli those nutrients were enough!

Exercising as I could. I wanted to try to keep something from my normal routine even if it had to be very limited.  I prioritized daily walks to feel better physically and mentally. I went on slow bike rides while my husband ran alongside (running was out of the question with that weird stomach sensation). I stretched nightly to try to help with leg cramps. 

Hydrating. Normally I am terrible at drinking water. It is a job hazard. Seeing patients all day means no time to stop to drink or use the bathroom. But after I made hydration a priority – 80+ oz per day, tracking it on free app on my phone – I noticed a huge improvement.  I was worried about going to the bathroom a million times per day. But my sister in law said it best reminding me I was doing that already- at least this way I was hydrated. And it actually made bathroom trips better because I needed to go as opposed to just having the sensation. 

Preparing. Carry the big purse at all times. Trust me. I had citrus fruit, sparkling water, pretzels, crackers, and plain bread on hand anywhere I went. I’m not sure anything really helps during this phase, but having something to try gave me the sense of control I desperately desired.

Onto the next trimester…

The ACL Tear.

As we approach the end of football season, there is one injury that we have heard of several times throughout the year (and past years as well). The ACL tear.  Most sports fans have seen this listed on the injury report and heard the announcers talk about concerns for this when a player goes down on the field, but what is it? Why is it a big deal, how does it happen, and what is typically done about it?  

First, knowing a little anatomy of the knee is important. The ACL – or anterior cruciate ligament – is an important structure inside your knee joint.  We have 4 ligaments in and around that area, named for where they are located. Anterior (front) and posterior (back) cruciate ligaments, and medial (inside) and lateral (outside) collateral ligaments.  Today we focus on the ACL because it is usually the most ‘tragic’ when injured in sports. By tragic, I mean the one that is the most worrisome for an athlete because of the long treatment and recovery process that often alters one’s career short and long term. 

The ACL connects the bottom bone in the knee (tibia) to the top bone of the knee (femur) from front to back.  It plays a key role in stabilizing the knee. In medicine we would say it “resists anterior translation of the tibia on the femur.”  Stick with me here… this means in regular language that it stops the bottom bone of the knee from sliding forward in relation to the top bone during normal movement, aka inside the knee joint where it bends.  This bending is what allows us normal knee motion needed for walking, running, jumping, playing.  But we need something to help keep the bones attached to one another or else the knee may feel unstable (jelly-like) when we put stress on it.  [Think of the knee as a door hinge where the ACL is the pin that connects the two pieces of the “hinge”; without this the door can swing open and closed gently, but if it’s pushed too hard the hinge may not line up properly and may become damaged].  Not an ideal situation if one is interested in getting back to doing higher impact activities like playing football. 

If the ACL is torn the knee becomes unstable because the bottom bone can shift away from the top bone.  The cool thing the human body is that there are often redundant systems.  For the most part (although not always for every person) normal walking and low-impact day-to-day life can still be achieved without the ACL because the other ligaments and muscles around the knee can pick up the slack to provide stability.  This means even without an ACL, for daily life activities, many people move about fine.  The problem is with any sudden or shifty movements, such as cutting in sports or in high-impact jobs like law-enforcement or firefighting where folks are required to do movements that aren’t straight forward or backwards. These types of movements are more complex and require more stabilization, so without an ACL the knee can feel unstable and even give out.  For football and other sport athletes, one also would not get the control or explosive power she or he needs to play.   

An ACL tear most likely occurs when the leg is forced in a way that stretches the ligament too far.  Remember, the ACL blocks forward movement of the bottom part of the knee.  Consider a  a football player whose foot is planted to the ground when his knee gets pushed backwards, pushing the top bone away from the bottom bone. Pop!  The ACL is overstretched and gives way.  This is just one example, and there are of course other ways this happens.  Sometimes it involves a collision with another player (as described above) and sometimes it involves getting the leg in an awkward position when a person is running or jumping with the knee buckling inwards/backwards due to the force of the jump or a bad landing.  In this case, it is simply the lack of control and force of the jump landing or cut that causes the tear.  We tend to think of these “non-contact” tears occurring most frequently in young female athletes (maybe a teenage basketball player) that hasn’t developed full hip/knee control. 

The tearing of an ACL is an abrupt injury and not usually subtle.  Sometimes people hear a pop (but not always), feel a pop, have sudden onset of significant pain, and usually fall to the ground.  Most of the time the injured can’t walk easily (if at all) and don’t usually keep playing the game after.  The knee swells up from the inside due to the trauma (effusion).  I usually ask patients if it swelled up like a water balloon as an analogy.  A former mentor of mine taught me when I was learning about knee injuries that a young person running or cutting during sports with a sudden burst of pain with a pop in the knee and large swelling is an ACL injury until you prove otherwise.  This still rings true for my patients today.  #mentor

To diagnose the ACL tear we first talk about what happened when the injury occurred in great detail.  Then, we do an office examination of the knee, as well as the hips and lower legs.   Looking at the other nearby joints is important! Just because it seems that it might be an ACL tear it doesn’t always mean that is our answer.  We complete a few special maneuvers that help clue us in to what possible problem could be happening inside your knee. These maneuvers are helpful to distinguish other injuries that present in the office like an ACL tear.  This exam also helps us determine what next steps to take or if there is concern for other associated injuries (ACL tears often occur with other injures such as MCL tears, meniscus problems, and bone or cartilage injuries).

So you tore your ACL, what now?  Since it is such a crucial ligament for knee stability, most highly active people or athletes should discuss surgery to repair or reconstruct the ligament in the knee.  It does not grow back. It does not scar into place or heal. That said, it is important to note that older patients or people who are less involved in side-to-side/cutting sports or activities may not need surgery.  Be sure you have a discussion with your doctor about what the benefits of surgery are for you, the associated risks of the procedure, as well as the expected long term outcomes.  We practice medicine using the guide of high quality research, and if the studies show that you may do just as well without surgery, that may be the best way to treat your specific injury. Most important is to have these discussions with an orthopedic sports trained surgeon.  They will discuss options, the optimal timing to have surgery if it is thought to be best for you, and also very importantly your rehabilitation and expectations for recovery.  

Whether one has surgery or is treated without operation, he or she will need extensive physical therapy/rehab.  It takes many months for one to get back on the field!  One has to be patient.  For professional athletes that have dedicated athletic trainers and rehab specialists, these are season ending injuries. Often with great rehab, they can return in 6 months (at the earliest) though it can take 1 or more years to reach the prior level of sport.  But these are gifted individuals with many many resources.  For the average injury, it will be at least 1 year before one may feel 100%. And keep in mind, once a person has had an injury, and then had surgery, it is quite possible the knee will never feel 100%.  [Stay tuned for my article discussing preventing injuries like ACL tears.]

Stay healthy-

Don’t delay routine medical care, even during a pandemic!

Given the ongoing COVID-19 pandemic it is easy not to feel safe leaving our own homes, especially if our destination is a place we feel at higher risk.

One of the settings where you may feel more at risk is your doctors office. The reassuring news is since the pandemics onset hospitals and medical offices have instituted many protocols and policies which make it safer to visit. Protocals that you may notice include temperature checks upon arrival, questionnaires about possible COVID-19 symptoms and exposure, limited capacity waiting rooms, visitor regulations and mask requirements (I reviewed those in this post). These changes make coming to your appointment safer, but it is clear that patients are still avoiding the doctor. From the CDC, as of June it was estimated that 32% of Americans had delayed routine care due to COVID-19. (1)

Continuing to seek out routine medical care, preventative health screenings and other medical care is vital even during an event such as a global pandemic to prevent long term increases in morbidity and mortality for all medical conditions.  

The reason why we have routine medical screenings and preventive health appointments is exactly what it sounds like- these visits prevent future problems.  Unfortunately delaying these visits can delay diagnosis and treatment of conditions not only now, but also in your future. Delays in diagnosis means the disease can make you more sick, or worse, cause earlier death.

For the average adult there are a few routine maintenance visits to consider.  First, a visit with your primary care physician can get you on the right track.  These visits are a great way to evaluate any health changes you may have had in the last year, as well as check for early signs of issues to come. Getting your blood pressure checked and discussing what you may need for your age/lifestyle/risk factors may seem simple, but it is these parameters that give your doctor insight into your current and future health needs.  Some of these needs may include lab tests to evaluate your cholesterol levels, blood sugar, or referrals to other specialists for more specific care.  These routine visits, although seemingly simple for most people are very important.  

Another screening needed if you are female may be seeing your OB/GYN for a women’s health exam.  Depending on your age, marital status and sexual history this may include a pap smear and pelvic exam, lab screening and again further referrals if needed.  Both males and females need to consider seeing a dermatologist to evaluate for any skin concerns, and let’s not forget about routine visits with the eye doctor and dentist. 

Another area to consider in addition to these routine visits are those that are dedicated to prevention.  The main appointments focus on preventive health for age-related screenings for malignancies (cancer).  Your primary care doctor is a great start to determine if you need one of these type of visits based on your age, risks factors and family history.  For women, mammograms are an extremely important and we know that early detection of breast cancer is vital to survival. For men, you may consider an evaluation of your prostate health and have any appropriate screenings required. For both males and females of appropriate age, you need a colonoscopy.  There is great evidence that routine colonoscopy screening is vital to early detection and treatment.  Unfortunately if these screenings are missed or delayed due to the pandemic the delay could precipitate short and long term consequences.

The final area to focus on for routine medical care is vaccinations. Vaccines are becoming more of a hot topic with the push for pandemic mitigation and recent data release for the COVID-19 vaccinations awaiting emergent FDA approval for use. However, there are other vaccines that both children and adults need regularly. When you go for a visit, ask if there are any additional vaccinations that you need. This year more than ever the influenza vaccine is at the top of the list. (And I’ve had mine!) The concern here is this year’s flu season could be even more challenging given the current pandemic.  The fear of doubling the sick population (with flu patients on top of our already stretched hospital system trying to provide care for covid patients) could be insurmountable.

And since I try my best to practice what I preach in all areas of medicine and health… if you follow me on Instagram (@sportsdrmorgan) today you will see my experience at my doctor visit!

  1. Czeisler MÉ, Marynak K, Clarke KE, et al. Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020. MMWR Morb Mortal Wkly Rep 2020;69:1250–1257. DOI: http://dx.doi.org/10.15585/mmwr.mm6936a4