What a week! (Warning, super long post)

It's been a rough week, hence the delayed update.
On Sunday, my department chief phoned to say that our proposed suggestion of me stepping outside the OR to put on or take off the breast pump flanges had been accepted. Monday morning as I was about to start working for the day, he came in and said that they had just phoned him as he was driving in to work to say that I absolutely could not use the pump in a patient care area until further discussions had been had. Then they called the endoscopy suite I was working in for the day to tell them that the endoscopy room I was in was going to run late, and they were to break in between patients to accomodate my pumping needs. Like that was going to happen - the list was busy, and there was no time for a break. Plus they could continue without me.
Shortly thereafter, I spoke with the same woman from Friday again, who again told me about the restriction. Then she asked if I would be willing to see the hospital's one lactation consultant in order to see if she could help me pump more effectively or come up with any other solutions. I said sure, send her along to the endoscopy suite. And then a couple hours later proceeded to have discussions about breastfeeding with her while going about my work in front of two nurses and the doctor. She suggested that I had to pump at least 8 times a day to maintain my supply, but that I could occasionally go 4 hours without pumping without having an effect. I don't think she'd seen the Free.style pump before, so she was intrigued by it. She was also entirely supportive of what I was doing, and said that she'd only recently been hired by the hospital because their breastfeeding practices were so abysmal. She really couldn't understand what the big fuss was about either.
The GI doctor in the morning was incensed on my behalf, and said that if that had happened to his daughter, he'd have immediately been on the phone to two lawyers. He suggested getting in touch with my malpractice insurance provider to see what advice they could give me, as they could get their lawyers involved if what the hospital was doing would potentially affect my right to practice or the scope of my privileges. The doctor I spoke with there agreed that my practice would be affected by their imposed limitations, and said he'd have a lawyer contact me by the end of the day. The GI doc also told me I should get in touch with the Medical Staff Association, which apparently helps to represent the physicians in dealings with the hospital administration.
As it turned out, the GI doc I worked with in the afternoon happens to be a member of that association's committee, and he was also very upset that they would be doing this to me. He even said he'd been at his cottage over the weekend, and had been telling friends about how this anesthesiologist at work was pumping during work, and how he wouldn't even have noticed it much except that he'd occasionally see the glow of the pump display under my scrubs top. He said he was impressed with my dedication.
It ended up being a very stressful day. I sort of cheated - though I put the pump on and took it off outside of the room, and tried to stay out of the patient care area as much as possible while pumping, the GI docs were on my back to keep things going and everyone basically said they wouldn't tell on me if I proceeded as usual. I felt bad about that though. I ended up choosing to go to a private office for the first time (well, the first real aesthetics at a private office that I've done) on Tuesday, since the oral surgeon had invited me and my pump to join him if I could swing it.
We interviewed our second potential nanny on Monday night after I got home, and she wasn't as good as the one we'd interviewed on Sunday, who really impressed us with her preparation for the interview, her answers to the questions, and her excellent questions about what we had to offer her. A seemed like a great candidate. We had one other interview coming up on the Thurs, and one other potential interviewee, so after a somewhat disappointing interview with our second favourite candidate Monday night, we tried to set up a fourth meeting. As it turned out, that nanny had already taken another position, and I started to panic that the good nannies were all going to be taken by other families if we took too long with the search.
I also spoke with the lawyer after work on Monday, who listened to my story and said that she couldn't imagine the hospital had valid grounds for placing those restrictions on me. The no fluids in the OR thing she could understand (as could I), but the rest of it seemed unreasonable. She said she wanted to sleep on it before deciding what to do, ie should she get involved at that point or not.
After the interview and discussion with the lawyer, my department chief called again to say that they had new concerns. Two related to patient care: the pump might malfunction, causing me pain and distracting me, and that the pumping might distract the nurses. He said the program director of surgical affairs also had been told by the lactation consultant that I only needed to pump once every 4 hours, and that I would thus not be able to delay the OR more than once a day to pump.
Then DH and I were pretty distraught. I thought maybe I should let the lawyer get involved, and he was really scared to let me do that, since I'm pretty junior, still don't have full active privileges (you need to be working at the hospital for over a year before the privileges become regular active ones), and don't want to make myself totally unloved at the start of my career. He also said he was getting tired of seeing me kill myself to keep feeding our baby breastmilk instead of formula. Pumping every 2 hours during the day does get pretty old pretty fast. It means I can't fully enjoy my time with K in the evening because I have to pump at times when I could play with her or feed her.
I ended up calling my department chief back to see how much of a risk he thought I'd take if I let the lawyer get in touch with the hospital, and he said he wasn't too sure. I asked if maybe I should contact the program director myself to see if we could talk about the issues together, since at that point no one involved in the discussions had bothered to talk to me. He thought that might be a good idea, and the lawyer agreed.
I had a pretty insomniac night Monday, for the first time since the times during pregnancy when I had to take a sleeping pill because I was so worried about losing the baby and then worried that not sleeping would make the contractions worse, making me lose the baby. By the time I thought about taking a sleeping pill, it was nearly 2am and I was too scared to take one for fear I wouldn't be able to go to work properly in the morning. I was worried about not getting a good nanny, not being able to continue breastfeeding/exclusively pumping, and about being on my own in the dental office the next day for work. I finally drifted off around 4am, only to wake up at 6:15am.
The first couple cases of the day were a little nerve-wracking, as they were kids having dental procedures done. After that, things settled down a little more, and it turned out to be a nice day. Fast-paced, but I managed to squeeze the pumping in. The oral surgeon and his staff were super nice, and though they had to laugh at the pump under my shirt, they were very supportive. At lunchtime I called and set up an early morning meeting with the program director for Wed before the OR day started. While I had her on the phone (and she sounded much nicer than I thought she'd be), the Chief of Staff walked in and said that the GI doc from Mon afternoon had contacted him that morning to discuss the issue. They both agreed with me that we needed to work together to find a mutually acceptable solution. I felt a little better, and actually slept on Tues night.
Wed am I met with her. I slept through my 4-5am BF baby and pump alarm, so I was out of my usual pumping rhythm. I decided to squeeze in an extra quick session while talking with her so that she could see what the fuss about nothing was about. She had me lift my shirt to show how the apparatus attached hands-free, and was amazed that such a pump existed, since it was much different from the ones in her day. We discussed my supply issues, and how I had been doing this for 8 weeks already without impacting on patient care. I reassured her I timed my pumping for when the patients are asleep and stable (for the most part), that I could wait to put on/take off the pump if necessary, and that I was obsessive about hand-washing around pumping. By the end of the discussion, she agreed that she didn't have any further concerns, and as long as I put on and remove the equipment outside of the OR, I could go back to business as usual.
Victory!
Wed evening, our favourite nanny of the first two interviews came for a trial run. She gave K a bath, put her down for a nap, struggled to get her to take a bottle when she got very hungry very fast after waking up (it was a challenge for us too), and did a great job feeding her some sweet potato I'd frozen a couple weeks back. K did manage to be pretty high maintenance though, as she sometimes is in the evenings. She threw a really good hissy fit for a while, and was very hard for DH and I to calm down as well. At least A didn't give up on trying to calm her too quickly, and didn't seem to panic. I was really worried K had scared her off.
Thurs morning, we had our third nanny interview, and quickly figured out that she was really not the right fit for us. We quickly scanned the list of other nannies we'd spoken to on the phone, and realized there weren't any others who'd seemed as good as A. We called her references, left messages for two, and managed to speak with one who said she'd used many nannys from a temp agency, and A had been by far the best. With that praise, we decided to phone and offer A the job right away, so that someone else wouldn't get her first. Then I spent the afternoon worrying she might have taken another job already.
DH called while I was on my way to work for the night to say that A was excited to accept the position and become our nanny. What a weight off my mind!
So now I'm hoping my milk output will pick back up again after the stress of the week. And I'm definitely ready for bed!