Clearly, I just don't understand people...

Following is a short excerpt from an email that I received forwarded from a friend of mine yesterday:

"Due to the time of their move, we are hoping to have Roses in a good home by this Friday.

Roses, a 2 yr old Jack Russell. She is house trained, fun, and playful. Unfortunately I am not able to keep her for a family member so she is looking to sell her for $100, obo. All shots and immunizations are up to date. Roses is a great dog and is house trained to the point of going to the door to let you know its that time. She does not jump on you unless you tell her it is ok. She knows some commands.. Now the leash thing is what is a little new for her. My cousin lives in an area where Roses did not have to be on a leash. She is familiar with it, just pulls you some.

She loves belly rubs. Not much of a barker, only when someone is a the door but once inside she does her "inspection" and then is fine."

They desperately need to find the dog a home, by Friday no less, but are asking $100 obo????? Pardon me if I'm being too critical but that makes no sense to me. Perhaps they are of the mistaken belief that making someone pay to take the dog insures that it will get a good and lasting home... Best of luck to them (sarcasm implied) but mostly I just feel sorry for the dog!

And in the latest drama from the children at work... We were closed Monday after Christmas as a novelty (have never done that before but what the boss's wife wants, the boss's wife gets) and Monday night I got a call that didn't come through because my phone is currently demon-possessed (i.e. I need a new phone because it is wearing out but just haven't bit the bullet to buy one) from one of the children wanting to swap shifts with one of the others. She found great initiative to call the boss since she didn't get through to me and finagled the swap in just a couple of minutes. Really annoyed me because I had scheduled the better worker to be there all day since the day after a holiday is always crazy. So we had to deal with her laziness all day Tuesday. Didn't matter what we said or did, she just lazed around and really didn't contribute at all to the work. Didn't even need her there for all that she did. And I still can't convince the boss to just get rid of her! I really don't know what is his problem.

Wednesday, I said something really inappropriate in front of the employees because of the frustration. See, we (I) made the boss Voodoo stress relief golf balls for Christmas (he's an avid - obsessed - golfer). I got an empty egg carton and put 12 golf balls in it. 10 of them I drew the faces of all the employees on and named; I named one of the others for him and the other "miscellaneous" so that he could make it anyone he wanted. Yesterday, I suggested that he take the one for the employee and hit it a few times for me... Guess I really shouldn't have said it but it was one time I just couldn't stop my tongue in time.

Today, I had accidentally scheduled 2 of the kids to be there because another employee was initially going to need to be off. When that changed, I guess I forgot to alter the rest of the schedule. As it turned out, the better employee unexpectedly needed to be off because her mom had to go to the doctor. The lazy employee immediately sent a text to the third employee to see if she could come in because there were "so many dogs in the kennel she couldn't do it by herself!" I had already discussed the matter with the other 2 employees the previous day and okayed the day off besides knowing that the other girl would not be available. We didn't need 2 people there anyway... If it were up to me, she'd already be gone. Clearly she is not cut out for the job.

I think I'm going to revise the schedule for next month tomorrow and cut her down to one day a week. I also think I'm going to cut the other 2 down to 2 days a week because they aren't exactly giving stellar performances at the moment either. They seem worse when they work together. Maybe cutting hours (again) more drastically will help. It's pretty much all that I have the power to do although there are days I've been tempted to tell her she's fired, get out, and just see what transpires. It'd probably only wind up eliminating what little authority I have, though.

Sigh.....

Injustice

I'm complaining a little and, for those in the medical field who practice good quality medicine, this is not directed at you. We had it pounded into our heads about the importance of not creating resistance in bacteria by overuse or injudicious use of antibiotics. There are several issues in veterinary medicine regarding whether we should be allowed to use particular antibiotics in specific instances or, sometimes, if we should have access to the medications at all. It scares me that the people who are attempting to make these decisions are often not even medically trained...

There I go on a bit of a tangent again but it is necessary for the story I'm about to relate so that y'all understand why I'm frustrated. It was thrown in our face (and continues to be) that veterinarians are the reason for bacterial resistance to antibiotics. Of course the human medical field has no hand in the problem; it is all our fault.

Yesterday, I had a dog come back in that I had performed an enucleation on last week due to a tumor of its globe. A portion of the lid had dehisced and I was concerned about lacrimal / secretory tissue maybe having been missed because that particular enucleation is currently in my chronicles as the bloodiest I have as yet performed (and I've done quite a few!) I'm sure it was because of the tumor but I was concerned at the time about remaining tissue simply because of the sheer volume of hemorrhage. I explored the socket and determined there was no remaining tissue that shouldn't be there but that the dog likely had an allergic reaction to the suture I had used, based on the tissue appearance. I re-sutured the eye with a different suture type and called the owner after the dog was awake to let them know what I had found. That was when the owner started complaining because "he had spoken with a human doctor friend who said that we should have put the dog on antibiotics because they always did."

Just to compare notes: when y'all go to the doctor for a mild cold, do they always run a CBC? How often do they perform a culture and sensitivity? And how often do you go home with a Z-pack regardless if it is really needed? Except in the case where the globe is abscessed or the animal has evidence of a systemic infection, why would you place an enucleation on antibiotics? For crying out loud, the eye (face) has such a wonderful blood supply it just begs to heal itself; almost as much as the mouth or the rear end or the bladder...

But, don't forget, veterinarians alone are responsible for multi-drug resistance in bacteria.

No, I did not put the dog on antibiotics. And yes, I do readily admit that some of our older colleagues who have not stayed on top of newer information do overuse antibiotics. I just find it frustrating that we get that bum rap then get advice from a human doctor on how to manage our cases. I don't even know if the human doctor he spoke with is an ophthalmologist. Maybe next time I go to the doctor I'll suggest how they should handle my case based on my experiences with multi-species...

Ruts

Have you ever gotten your car stuck in the mud or snow or ice or something? You know, stuck so bad that no matter what you do, all that happens is the wheels spin mindlessly digging a deeper rut. You can't move. You can't turn. You can't do anything. This has happened to me once, so far, in my life. Usually, you see, I'm more of a thinker and planner therefore I think it all out and see the potential dangers and figure out a way to avoid it. The time it happened, I tricked myself because I was in Wonder Woman mode and convinced I could do anything... But this post isn't about getting your car stuck although I've really tried to go off on that tangent. No, this post is about getting your life stuck.

I heard the comment on the radio recently that a rut is nothing more than a grave with both ends kicked out. I don't know to whom to attribute this quote but I thought it had some merit behind it. You know the old proverbial saying between a rock and a hard place? That's where I am.

I think that the polite psychobabble term is to say that I have issues. (As if y'all haven't figured that one out yet...) You know what I find the biggest problem to be? I need just a little time of quiet solitude to face some of these issues and make some decisions. I actually feel ready to deal with some of them (may have been long ago) but I can't seem to stop long enough to work out the problems. Life interferes. The herd needs to be fed, medicated, whatever. Mother needs to be fed, medicated, whatever. The work children need to be babysat. The work boss needs to be babysat. Oh, and I actually need to do my job and earn some money and pay the bills... I know I'm complaining about things that everyone faces on a daily basis but, tell me truly, don't y'all ever struggle with the need to just stop for a moment???

I wish that the world would stand still sometimes during really hard times to give one a chance to steady the equilibrium and face the situation. But it doesn't. So how does everyone else deal with it? Or do they? I feel as if I've been burying my "issues" for eons and they just grow and grow making it an even more overwhelming task to attempt to deal with them and put them to rest. Maybe in an unmarked grave.

Perhaps taking a real vacation would help but right now it is simply impossible. Between mom, the herd, work, and finances there is just no feasible method of taking time off. I keep searching for something closer where I could run away for just a little while but have as yet to come up with any good, affordable options. It has become really difficult to find any time of solitude lately, too, now that mom is fully retired. If I keep letting these things pile up, the size will be of such enormous proportions that I'll never manage to take care of things...

Addendum

I was thinking (obsessing) about my post from yesterday and realized that I should add a couple more adjectives. Hyper-responsible and guilt-driven. There, that should do it. Unless, of course, I think of something else...

Merely Human

It's awfully difficult many times to deal with everyday life. I'm an admitted control freak, OCD paranoid with perfectionist tendencies who is over and abundantly self-critical. I'm really beginning to think that I need to look into a more benign job option...

Reading Nurse K's recent post just brought the issue to mind yet again although it has been dwelling near the top of what is left of my mind for many weeks now. You know, I really love medicine. I love what I do and am constantly fascinated by the intricacies of the body and the things that we can attempt to do for it. I'm a questioner and spend a lot of time researching things; really too much because I tend to get sidetracked by something else interesting that has nothing to do with my original mission. In near constant battle with this side of my nature is the fatalistic side that wonders if anything I do really, truly makes a difference. Perhaps the kidney failure dog would have survived to live another day without my fluids or maybe the anesthetic reaction death would not have survived even without anesthesia... Who really knows the answers to these questions?

The first time that you make a mistake, no matter how minor, is brain-numbing, poo in your pants frightening. You live with the daily realization that you hold lives in your hands and a miscalculation or momentary lapse could be fatal (unless you are currently subscribing to the fatalistic point of view in which case nothing you do or don't do matters anyway). The first time that you make a mistake (or believe you've made a mistake) that resulted in death is 1,000,000 times worse. And, if you're dysfunctional like me, you beat yourself over it constantly unless you can 100% factually prove to yourself that you had not even a tiny little part in causing the death.

There is a rational side to my being that knows I (and everyone else on earth) am only human and that human beings will make mistakes; it's inevitable. The stronger side of my being always wins in that I blame myself and never let myself forget what an idiot I was (am). I was told recently by a good friend that I earned a DVM not a GOD degree and I know that is right and good advice but it really hasn't stopped me from being so critical.

I figure, logically, that I'm gonna have to find a better way of dealing with this problem soon or burnout will be the next step. That or I'm gonna have to find a benign job where I can still be happy with what I'm doing. I can picture it now, though; teaching English lit and screaming at the students when they're worried about a grade that it is not a life or death situation so grow up and deal with it. Or being a librarian and having a hard time coping with demands because I can't figure out why it's so bloody important. Besides, I don't think that my personality type (dysfunctional though it is) is cut out to be satisfied and complacent - with anything.

Darn. There's just no way to win, is there?

A Tale Of...

Being Late:

We had purchased concert tickets for a favorite group of mine for last Friday evening. I had told mom multiple times that we needed to leave the house no later than 4:30 due to the time difference (concert in Eastern time zone, I'm in Central). I took half of a day off work and left around 1:00.

When I got home, I discovered mom in a frantic tizzy over the car insurance payment, which was due that day. She often drops it by the local office but we had gotten a letter that the office was closing. Rather than go by there or call, she had let time slip away and it was now the due date. Again, rather than calling the other relatively near office to find out if it could be dropped after hours or wait until Monday, she decided it was necessary to go haring off on a minimum 1 hour round-trip to drop the payment at 3:00. With holiday traffic. Even though I told her we could leave a little early and drop it on the way out of town with only a slight detour. In the midst of her craziness, I went blank as to why we needed to leave that early.

We left at 5:00 and it wasn't until we were almost there that I remembered the time difference and realized we would be late. To add to that, the event was at a university and the directions they gave were really crappy although they sounded completely easy (I'm the type of person who doesn't give good directions but can find anything regardless of how bad the directions are.) If it hadn't been for the terrible directions, we would have only missed about 15 minutes of the show. As it were, we missed the entire first half (1 hour) and walked in during the intermission. The second half was wonderful but I'm still ticked about the whole thing both at my mom and at the crappy directions.

Not Fitting In:

Back to my former subject for a moment. There was another area upon which I meant to comment but got sidetracked and did not. In my profession, I don't fit in either.

The problem is I'm both over and under educated. Having done internships in preparation for a surgical residency hope, I'm way over educated for private practice. I want to pull out things about which my boss has never heard. Unfortunately, I'm under educated for specialty clinics not having matched for a residency. And while there might be some private clinics in-between, there certainly are not in the place I'm at right now.

Anonymous' comment about not fully trusting that other people find me interesting enough or non-annoying enough to continue remaining in contact really rang true for me. I find myself annoying all too often; it's difficult to believe others don't have a similar experience.

Frustration:

Kind of related to the previous tale, I was so extremely frustrated at work Friday. There was a young, intact male cat that presented for a fever and heavy breathing. He had pleural effusion that was hemorrhagic with tons of white blood cells. Certainly not the only possibility but, for me, a pyothorax until proven otherwise because he was a perfect clinical picture.

The problem, my boss took him in and decided it was likely FIP (certainly possible but...read the literature, I researched pyothorax in depth not so very long ago.) He wouldn't place a chest tube and do lavage. I couldn't really do much because I was leaving in such a short time. I did manage to do thoracocentesis and remove about 170ml of fluid so he could at least breathe better and do a cytology on that. I hate situations like that because they leave you feeling so helpless.

Granted, either way the prognosis is guarded at best but....

Old Friends:

A couple of my good friends from high school were unexpectedly in town this week and we all got together for a little impromptu party. It's the first time I've seen 3 of them in about 5 years. Thursday evening, it was a free for all with 7 kids ranging in ages from 2.5 to 12 plus the 5 of us, 2 husbands, and one grandpa. The kids had a blast and so did we except that the men, rather than playing babysitter like they were supposed to, kept wandering in where we were and butting in on our conversation.

Last night, I got together with two of them again (everyone else couldn't make it) and we had a really good time. This time was a little more like old times because we had more of a chance to catch up on things and the three of us hung out together more than the others.

One of the children has Asperger's syndrome, a form of autism. I found it difficult not to just watch him constantly in fascination. He's a very interesting child and I found myself relating to him in many ways. For instance, when he grows nervous, frightened, or overwhelmed, he will scream. Wouldn't it be nice in some ways if we could all do that? Instead of bottling things up and packing them deep inside, just scream out loud and let out some frustration. I also loved his lack of inhibition in that he would just burst into song or dance or whatever. True, some of this is just in being a child but some is also due to his disorder. Sometimes I do similar things but only in my head. How much more interesting life could be if I did it out loud!

The one friend leaves to go back home to Pennsylvania Tuesday. I don't envy her the drive. I told her that at least I was able to legally drug my dogs when I did the New York drive; you just can't do that to human children.

The other friend will be leaving in a month or two. She and her family are missionaries and are waiting for funding to be able to leave again. The other two live around here but I've just not taken the time to really get together before this.

Aggravation:

Time and time again, I have tried to train the kids how to properly restrain animals and they continue to refuse to listen. Every time I have to utilize one of them, I have to explain again and they still don't do it right. I'm looking so forward to the technician coming back from maternity leave because a) I'll have someone who can restrain and b) maybe she can get it through their thick heads!

Wednesday was dullsville. All afternoon was slow and I utilized the time to fill out an internship survey on VIN explaining how unhappy I was with my experiences and working on the controlled drug log doing my counts, etc. Around 4:30, everyone decided to come amongst them a lady who had started the online vet tech program volunteering through us then quit because she had not kept up (doing the program online really requires a lot of discipline and self-initiative) and didn't want to bust butt to catch up. The cat she brought in had a large, palpable cranial abdominal mass. I kept him for IV fluids, blood work, radiographs, etc.

First, I told the children what I was doing and that I needed a hand. They had been lazing around all afternoon and suddenly were frantically trying to finish their work so I wound up having to wait on them. Then, I instructed them how to hold the cat so that I could place an IV catheter and obtain blood. The cat was not extremely fractious, just a little nervous and he doesn't see well. Let's put it like this, with two people supposedly holding the cat, he managed to bite my hand and scratch my arm pretty good with his back legs.

I was always taught (back when I worked as the kennel help, vet assistant, receptionist and general jack of all trades) that if anyone got bitten or scratched, it was supposed to be the holder and that you protected your vet at all costs...

And, that's all folks!!

Just call me an ass

Perhaps I'm being too harsh but y'all can call me an ass if you want, I don't think it will change my mind on either of the two situations I'm about to relate.

Number one, brother dearest lost his driver's license and for some unexplainable reason needed one of us to call about getting a duplicate. My darling aunt called to ask me to do it since "it was my day off." Um, no. I am not getting sucked into it. I'm not getting involved in his crap, I'm not dancing as his slave just because he's the special male, and just because it's my day off does not mean I don't have things of my own to take care of, thank you.

Number two, see how hard this is to figure out. I had to go to the clinic Saturday to take care of a couple of things with Sam (my boss was on duty.) I got there around 2:15 and was there until about 5:15. During that time, the good kennel worker (who was not on duty) came by to check on the little stray that I've managed to finagle the finders into surrendering so that he can be properly taken care of rather than receiving poor attention. She mentioned that she came by again because she had been there in the morning and the kennel worker on duty aroused suspicions so she wanted to check back. What bothers you about this? The kennel worker was at the clinic between 10-11:30 and upon leaving had clocked herself in and out for 4:20-5:30 that evening. She did not show up while I was there. If she came, she had to have come between 11:30 and 2:15 (awfully short time between coming to walk the dogs, etc.) or after 5:30 when it is already dark. If it were up to me, she would have been fired long ago but if, for some unexplainable reason she was not, she would be gone now. My boss, on the other hand, asked her in some doofy way if she had come and she gave him a cock and bull story that made no sense and he seemed okay with it. Either he's a lot dumber than I thought or he hates conflict to the point of negligence. I would have asked her what time she came and gave her the chance to lie to me.

So there it is. Maybe I'm being mean but I just don't care in either case. If I ran the world, there would be a lot more people who were forced to step up and take responsibility...

Californy is the place you oughta be...

NOT!

So, Maybe has been pestering me to post something for, well, forever. I just don't have near as much good blog fodder as I used to have!

So, as many of you know, I left private practice a few years ago to work for the dark side. At the time I didn't realize that by doing this I would be opening myself up to one of my biggest fears- airplanes. However, with all the various trainings I've had to go to since then it's literally been a very easy choice- get on the darn plane or quit my job. I need my job right now- another one in this economy wouldn't be easy to come by where I want to live.

I have been relatively lucky with my four other trips (Holy crap- they actually got me on an airplane four other times?!?!?!) in that they were short flights- an hour and 20 minutes tops. However, last Monday I had to conquer my fears in a big way and hop on a FOUR HOUR PLANE TRIP to attend a training session held in California. Yuck, puke to quote a favorite aunt of mine... But that's not what makes this trip funny...

This training is for literally EVERY offline inspector in the country, and we are the 12th class of 200 USDA types to be cycled through this particular hotel. It's a nice hotel- I kinda like it. It has free breakfast (not something to be taken for granted among pricey hotels), free basic shuttle service, and some other nice things. However, 12 classes of rowdy USDA types have apparently taken it's toll on the poor hotel- I think it's literally falling apart.

The first day I was here one of my classmates told me his shower wall fell on him. Not a piece- the whole darn wall! He got a nice free room upgrade. The biggest windstorm to hit Southern California in 30 years descended the second day I was here and another classmate told me he had to use his iron to knock his window back into the frame. Granted, 60 mph winds are kinda extreme, but still...

However, something happened to me the third day that would have sent Maybe into a frothing fit of phobia induced insanity- I got stuck in the elevator on the way down.

I got on the packed elevator on my floor and it started descending towards the lobby. It's always a bad sign when the elevator starts to go down before the doors close... About 3 seconds into it I noticed we seemed to be going down awful fast... I literally opened my mouth to say that and we heard this awful noise and literally crashed to a halt! I swear, I think the elevator used it's emergency stop system. It took ten minutes for hotel maintiance to get us out. I was fine until I got out- then I took the stairs the rest of the way down and tried to stop my legs from shaking.

I'm a little phobic about going down now- it doesn't help that all the elevators are glass on the outside and you can see going up and down. I don't think I'd mind it so much if it was enclosed and you couldn't see how high up you were or how fast you were going.

I am now an amateur expert on elevator safety mechanisms.

I'll take testicles with that

Here's a novelty; I'm going to write a vet related post, something I've not done in a while. Soon, I'll post the case of the draino burn puppy but not until we've reached full resolution and I can include all the cool photos.

My boss has a horrible habit of handing me cases to do the surgery and saying, "Oh, this one should be really easy!" I love surgery so being handed the cases is usually not a source of irritation. The being easy comment is because inevitably when he says that it turns out to be way more complicated than he expects. Then he gets antsy because it takes longer than he thinks it should. Then he gets guilty for dumping it on me and tries to help, thus only getting in the way. It's all so predictable I could choreograph a movie beforehand.

The most recent of these was a bilateral perineal hernia on a 12 year old Chihuahua with horrible dental disease, mild azotemia, and a single descended testicle. The azotemia resolved with 24 hours of fluid therapy and I then took him to surgery. My boss said that the hernias were small and only contained a little fat so they should be no problem to repair. As an aside, with my aggressive dental techniques (at least that's how my boss and staff view them), the dog had one lonely tooth left at the end of the day. Tell me what I should have done differently? The teeth were abscessed with horrible periodontal disease and most of them fell out in my hands not even qualifying as true extractions in my book...

When I opened the herniated areas, the dog's guts were hanging out his rear through the incisions I created. There was also another, initially unidentified object encased in fascia and not directly connected to the intestines on the right side. The intestines appeared healthy with no evidence of damage therefore I reduced the left side and closed the hernia then moved to the right. I reduced the intestinal loops then began to carefully explore the unknown mass in an effort to identify it. If it wasn't a testicle, I really don't know what it was. The anatomy was perfect for a retained testicle although the "testicle" itself was inflamed and engorged as if it had been strangulated. I ligated the blood supply and removed the presumed testicle then finished repairing the hernia. I then proceeded to castrate the dog only to discover that he had a descended testicle and a subcutaneous testicle.

OK. I can still do routine math. One plus one plus one equals three. Wait a second!!! Three??? Three testicles? There are only supposed to be two. I'm thoroughly confused now. I dissected the "mass" and still came to the conclusion that it was a testicle. I did a touch prep that was totally useless with its ambiguity.

Yes, I have submitted it for histopath. I'll let you know what I find out..... Three?????

Misfits, Unemployables, & Misconceptions...

I'm 99.9% positive I've referred to this quote before but I'm going to reiterate it here. Great movie if you appreciate sarcastic / ironic type of humor, Cat Ballou, in which occurs the quote "I'm not running a dude ranch for misfits and unemployables!" Most of the time I feel as if that's exactly what I'm running with myself included in the category...

Lately it has struck me with great force how little I fit in - anywhere. See if some of you nerdy types out there feel a chord struck on this one. Or maybe some of you not so nerdy types with different issues. I cannot think of a single time or place that I have really fit in. I have a couple of really good friends that are the closest to me and with whom I feel most comfortable but there's even a disconnect with them. When I recently examined my friends I was also struck with intense irony. I think that most people surround themselves with people that are similar to them. My friends are extremely varied and many are not at all like me. We usually have some area in common that served as our meeting ground but then we diverge in the extreme. (Or maybe I truly do have multiple personalities and each friend represents a facet of me. Now there's a scary thought...)

In my quest for honesty, I'm gonna bluntly say some things that I usually wouldn't say. My IQ is a great deal higher than my family's. I've always had a difficult time communicating with the family because we view things so differently. They are generally prejudiced against new ideas; I like new ideas. I like to explore things and view new ideas as a challenge to be questioned and explored while they look on new ideas (or things) with fear and reject them out of hand. I also have always had a hard time finding common ground to spend time with the family. They like senseless, non-stimulating entertainment. Mindless television shows and such. I like intellectual, quiet pursuits such as reading or challenging board games (Scrabble or Trivial Pursuit for example) and have no problem with spending time together with people I like in utter silence, just enjoying the company. My family gets nervous in silence. They then use their super-sensitive feelings and ability to hold grudges and begin to formulate theories as to who is mad and why, all because one is not speaking. It can't be normal; the silent person must be angry. I like to try new things; they condemn new things without trial. It's like a lynch mob performing a hanging without the benefit of a just trial by jury.

As a child, I grew up quickly and started taking on adult responsibilities at a very young age. One result of this is that I've never really gotten along well with people of the same age / peer group. It was difficult to relate to people worrying over whether Joe wrote "I love you" on a note passed around class when you were thinking about the financial situation of your family and whether the bills would be paid this month or not. It was also extremely difficult for me to understand the lack of interest in learning. Kids trying to get out of class and not doing assignments puzzled the stew out of me. I loved to learn and was reading books well beyond my age group even as early as first grade. I know I was a challenge for teachers with my endless questions and boredom with the age appropriate material.

This didn't improve with age. While I have a couple of close friends that I made in high school, there was still always such a disconnect. I had a hard time understanding their struggles with classwork that bored me. It was also difficult because they were intimidated by my grades. Being shy, introverted, and smart made friends hard to come by and considering I had an entirely different area of interests than having boyfriends and going to parties, etc. only complicated the matter further. Undergrad years were spent mostly in my own little world. I made a few "acquaintances" with whom I worked on some group projects but no real close friends although I met Can't Spell during that time. I lived at home and commuted to class (a 10-15 minute drive.) I scheduled my classes at unfashionable hours like 7:30 a.m. and worked 30-35 hours a week in addition to taking care of the herd and the house and cooking, etc. I'm not real sure how I stretched the time so now; must have had more energy being younger. As you can see, the schedule was not conducive to relationship building.

Vet school was much the same. I'm just not a joiner or a partier; not my cup of tea. I find myself still in the same boat. There are just so few people with whom I really want to connect. Oh, I have friends, it's just that they are friends at a distance. Not really people to whom I'm inclined to open up and invite into the deep dark recesses of my mind. And even if I were, not people who would understand or be comfortable there. Sometimes I'm not so sure that my closest friends are comfortable with delving into that region. Sometimes, I find it a little scary myself!

It also struck me while listening to a comedian play up the stereotypical differences in male and female thinking that I don't even fit in there. He said that men compartmentalize everything in boxes that aren't allowed to touch or interact while women have an information superhighway made of a wire that connects everything. I'm neither but both. I tend to compartmentalize but connect. And when he was making fun of the way women continue talking even when it would be impossible to be heard yet expect their mate to hear (i.e. head inside dryer or in another room), I related to the male rather than the female. I think I have a general tendency to think more in a stereotypical male fashion but understand female-ese fairly well. This is probably the reason I generally learn better from male teachers. I've never understood the hothouse of female emotionalism and stabbing in the back. Honestly, if I have a problem with you, I'd rather take it out back and just fight it out then be done with it.

While I'm discussing my dysfunctional self, I'm also going to share another aspect. I have always thought that I was so extremely fat until recently. It was perpetrated by the fact that most of the women in my family are tall and very thin. You know the type, not too many curves and rarely have to worry about gaining. My mother looked like Linda Carter of Wonder Woman fame with a bit less curve in her younger days. I'm an oddball. I'm shorter than most of my family and came with curves. Because I wasn't built like them, I thought I was fat and they added to my poor self-image by talking about how "heavy" I was. I was looking at some old photos and it suddenly struck me; I wasn't fat at all back then, I was just built different. Yes, I've always struggled to keep my weight in check but I wasn't fat. Wish someone had told me that back when... Now I am in part because I thought I already was.

So there. I've told many deep dark secrets about myself all started because of delving into old photos, listening to a comedian, thinking about some old friends, and talking to a family member who I've not talked to in a while. Scary what little, unrelated events can set into motion isn't it?

More Nicknames...

You know how many people have the habit of calling people "Big" and "Little" whatever their name is when referring to a father and son or something of the sort? It struck me this weekend that I have a couple of Big-Little pairs in my household.

First is Big Stubborn, aka Sam.


Then Little Stubborn, aka Peanut.


And we have Big Chicken, aka Flower.


And Little Chicken, aka Scout.


Fits all too well...

Complaints Again

Apologies, folks. I've had plenty of good fodder for the blog but have been kinda blah and just a bit stressed so have not taken the time to write lately. Can't Spell has been properly threatened but has failed to respond. Alas, I guess I'll have to pull out the good ol' super glue, vaseline, balloons, etc. next time we're in contact and come up with some horrid practical joke for her...

What to talk about amongst the craziness that has been life lately? First I think I'll tell about my funnest ever surgery from last week. I love reconstructive stuff. That and exploratories are my all-time favorites. We had a young pit bull puppy that was brought in by a local rescue group for a wound on his leg that they had been told was caused by accidentally spilling liquid Draino on the leg. The wound was about the size of my hand (6.5 surgery glove) on the lateral aspect of the thigh. It was actually granulating in nicely at the first visit then the scar tissue contracted to a point that it was significantly restricting the range of motion. I started out with hopes of doing a simple Z-plasty on the caudal stifle area to free up the motion then discovered that the scar tissue was so extensive that it involved all of the underlying fascia and much of the muscle bellies. I wound up resecting the entire wound and approximately 3/4 inch thick scar tissue beneath it in order to restore range of motion to near normal. Then I used multiple flap grafts and relaxing incisions to close the defect. It turned out so pretty and I had a blast. Not surprisingly, a small portion in the middle has dehisced but the range of motion is great and I would rather maintain that and sacrifice the skin. I've had them working him pretty hard already and will see him back in one more week for a second surgery to repair the remaining defect. I can't wait!! That's the fun part...

Today, Dr. C struck again. Ancient old poodle with an abscessed upper fourth pre-molar. I anesthetized her and did an almost full mouth extraction only to discover a disturbing black mass associated with the abscessed tooth. Ten to one it's melanoma. Bad, bad, bad.

And there was the depressing dog fight. Two dogs jumped the third dog and chewed her up pretty good although the wounds were all relatively superficial. We first saw her a week ago from last Friday. She was shocky and we treated her with IV fluids, antibiotics, debrided the wounds and partially closed the worst / deepest one. By Tuesday, she was doing great, eating, drinking, wagging her tail and all perky. By Friday, she was kinda dumpy and not eating well. Saw her back and performed blood work which showed that she was moderately dehydrated and had a low protein level. Big shocker there with those wounds. Debrided some more dead tissue, gave her some fluids and something for nausea (in case antibiotics were bothering her stomach) then allowed her to go home. The owner's husband had a prostatic biopsy that day then subsequently had to return to the hospital after collapsing. He required a blood transfusion and an ICU stay through the night... Spoke to the owner repeatedly on Saturday; dog was still kinda dumpy and not eating but hadn't really changed much. Offered hospitalization or to continue at home; they opted to wait and bring her on Sunday due to some difficulties with the husband, etc. I advised that I was on my way out of town and they needed to talk to my boss. Later the dog suddenly started breathing heavily then collapsed with clear fluid coming from her mouth. My guess is that she must have thrown a clot to her lungs. It happened very quickly. Even if she had been in the hospital, really nothing I could have done. It doesn't stop me from being self-critical about the situation, though.

Mom is up to the usual mess right now. We heard from my crazy druggie brother and sister-in-law the other day. I'm constantly amazed that someone can be nearly 70 years old and still so naive. Mom listens to his story and immediately realizes the sister-in-law is back on something but fails to spot it in my brother although to me it was equally obvious. They, of course, wanted money. Like that's a new thing. And they, of course, are still unwilling to go into a rehab program. And mom is still adamantly refusing to go to the doctor for her issues. She gets angry when I suggest it for any reason and believes that any medication that might be available would cause worse side-effects than any help it could provide.

She was particularly challenging over the past couple of weeks. She's in the process of finally retiring at the end of the month and most of her sick leave has been rolled over to add to retirement time. The few remaining days she has been trying to use up. We had been planning for months to go to Huntsville and hear David Jeremiah speak so I had suggested she take that day off which she agreed was a good idea. She then randomly took a different day off and worked on that one. The following week, I had suggested taking a Thursday off for a day trip which she agreed to do then did not then got mad that I did not want to leave at noon for a 2.5 hour one way trip... That was also the day that she got mad because I didn't immediately fix tuna salad for her to eat and went to bed without eating like a pouting child. I ask you this, how hard is it to open a can of tuna? Lately, though, if I don't cook or fix something healthy, all she will eat is sweets and candy.

I visited a friend of mine this past weekend that I've not seen in a long time and she pointed out something that I've lost sight of (you know, can't see the forest for the trees). If I want to do something more with my career, I probably should try to figure out which direction to take now rather than waiting because mom's only going to get worse with time and it's only going to get harder to go further. Now I just need to assess things a little more objectively and decide what I want to do because I'm really not happy with where I am at right now.

That's a hard thing to say. I really like my boss as a person but I hate the quality of medicine I'm stuck practicing. He refuses to move out of the dark ages although I have managed to get him to think a little more about things. He has become really money motivated; he wasn't that bad when I knew him previously. I got really PO'd at him about the stray animals he took in then wouldn't discount much at all for the spays / neuters. My confession is that I spayed and neutered all of them over the weekend while he was out of town. Ever since I feel somewhat guilty because I hate lies and am always criticizing him for his untruths and now I've been untruthful and deceived him... Do I have the right to continue to criticize when I've also not been honest?

And I really wish he would at least listen! I never realized quite how controlling he is until now. I guess the different capacity has changed my perspective. For instance, the fun surgery I told about while ago came in Monday and he saw it for the dehiscence. He told them that the wound had so much tension that it was not surprising it dehisced. No, it was not surprising but it was not under tension; it was because we chose to exercise and preserve range of motion. Or the other day he told an owner that tramadol would do nothing for arthritis pain (I had started the dog on tramadol for its arthritis and avoided NSAID's because of age and the fact that the owner had been giving Motrin (!) so I figured a good washout would be indicated before adding a different (safer!) NSAID.) Since I'm managing no less than 5 of my personal dogs' arthritis issues on a daily basis primarily with tramadol I think I probably have a greater grasp of its capabilities. And further, since he comes from the generation of "let them hurt a little so they don't move too much" I think I have a greater grasp of pain control in general. He scares me with the way he'll randomly give steroids and NSAID's, especially to older patients with no blood work. Or just pop a little dose of gentamicin here and there... The sad thing is that he doesn't really mean to throw me under the bus or do bad medicine; he just hasn't bothered to stay updated or to think about the fact that he is no longer the only doctor in the practice.

I have to admit that there is a part of me that still longs for the residency but I don't think it is really feasible. So, time to try to be really objective and make some decisions about life. For now, I think I'll end my complaint session because I'm bushed. Hope everyone has a wonderful Thanksgiving. Will try to post again sooner and will definitely work on Can't Spell. Hope she's prepared for our next visit even if it doesn't happen until April...

Still Alive, Not in Jail - But it was a close call...

Oh my. What a day was yesterday. I'm not sure if I can tell everything without this becoming a book but I'm gonna try...

I woke up all dizzy and vestibular because of the weather changes and had not slept well due to fever and chills related to my recurrent ear issues. Needless to say, this started the day out wrong. Had to take some Meclizine to function thus adding another factor for less than normal function of the brain which feels as if it is already deteriorating. I walked in to a patient of mine having arrested. It was an older dog that I had seen recently who seemed to be doing well other than having a urinary tract infection. Because of her age, I had recommended routine blood work be performed. It came back with moderately elevated liver enzymes and total bilirubin therefore I recommended an ultrasound to look for tumors, etc. The owner had planned to schedule that next week. The dog then developed respiratory distress early Wednesday morning and arrested shortly after arriving at the clinic while the boss was working on her. She had severe pleural effusion and on necropsy I'd bet it was lymphoma in the liver that metastasized to the lungs. Not a good way to start the day at work.

There wasn't all that much scheduled in the surgery area, only 5, and mostly "routine stuff."
That being said, y'all know how non-routine routine stuff can go on a bad day. The cat spay, which I can usually be done with in 10-15 minutes was like trying to bleed a turnip for pre-anesthetic blood work as well as induction plus the cat was freaking out and hard to hold. One of my talents is that I'm really good at handling cats. Unfortunately, I'm the only person in the clinic who is. Had there been someone else available to do the venipuncture, I would have readily swapped places and restrained the cat. The spay, of course, did not go smoothly either. The hemostat holding the ovarian pedicle was crap and almost caused a dropped pedicle, the uterine body tried to tear, the needle pulled off the suture, etc. You get the picture. The two dog spays kind of went in the same direction. I really want to perform a scientific study to prove that white dogs truly bleed more. The white Boxer was a bloody mess and there was no logical reason that I could offer; no dropped pedicles, no torn vessels other than normal, nothing, but she looked as if I bathed her abdomen in blood.

Then there was the preputial surgery. Little dog whose penis protrudes and gets stuck to the haired skin causing it to roll inward and trap the penis. This is the second time I've worked on it with the first procedure helping but not quite eliminating the problem. Relatively speaking, this one went smoothly but with the number of penis / preputial procedures I've been doing lately I'm thinking I should "specialize." The other procedure was to removed a wire from the mandible of a dog who had an old fracture and the wire had developed a draining tract. Unfortunately, the bone had not fused but it was already unstable with the wire in place. Of course, that turned into a lengthy, bloody mess because the wire had apparently broken at some point. I'm pretty positive I did not break it since it pulled easily but there was a piece left that I had to dig out. I don't like wiring mandibles; I like using acrylic much better. It's probably very expensive though, which is likely one reason most private practitioners don't use it.

I put off the last surgery for just a little bit and ran over the hill to the grocery store and to pick up lunch for a change. Wish I hadn't. I know to be really careful about eating out with all of my crazy food allergies and thought I had picked something safe. Didn't turn out that way. Unfortunately, I had not brought lunch because I was feeling yuck and running late; I didn't even have cheese to nibble...

I had planned to do the last sneak in procedure during lunch. I say sneak procedure because it is a little dog that we have inherited and one of the kids fell in love with, planning to adopt. Maybe I'm wrong in my views, but I do not think that it is right to charge employees for our time. For drugs used, food, materials, etc. at a discount, sure, but not for our time. There should be some perks to working at a vet clinic; especially where the pay is not good. Because my boss does not agree, I admit that I'm deceptive and sometimes slip things like that in while he's out of the office. With my craziness, I feel guilty about it all at the same time of being convinced it's important. Problem is that I criticize him all the time for "little white lies" that I disagree with so I have to self-criticize that I'm doing the same thing. Rabbit trail alert! Am I expecting too much from him to be more truthful? I hate the way he (like many others) goes to CE meetings, takes full credit, but didn't actually attend all the lectures he claims. Or his willingness to alter numbers on the drug log when there is an entry that he forgot to write down. Or the way he sometimes just lets things slide when talking to clients; not an outright lie but a lie of omission. But I'm doing the same thing to him, aren't I? It's hard having a strict conscience.

Back to the sneak procedure. We weren't sure if the dog was spayed and she really needed a dental. Unfortunately, the crazies started showing up early and it was one demand on my time after another. People who the boss had talked to or left phone messages for came to pick up their pets but, of course, had 1001 questions that needed to be answered by me. Decided to pre-med since there was a break that should be long enough to get things done. Saw the first afternoon appointment. I felt like I was back in New York. The first thing out of the lady's mouth was where is Dr. --? I explained that he was out and who I was. She barely consented to allow me to cut her dog's nails. After that, I quickly explored the other little dog; she was spayed (thanks to one of my teachers for showing me how to find out fast without a lot of mucking around as I've seen some vets do which makes determining a dog is already spayed take longer than actually spaying it) and we did her dental. I also pushed the new owner into a microchip while she was snoozing since the dog hates needles so much.

After that, the one appointment on the books became something like 15. It was a day characterized by minor crap that took 5 times as long as it should. Cat with miliary eczema; owner was nice but full of questions and was the second most sane person I saw all afternoon. A dog who might need a nail trim but, oh by the way, if you want to listen to his heart feel free. A chicken rushed in as an emergency broken leg; I had talked to the pseudo-owner ("It's my neighbor's chicken!") the day before. The lady who I've known for years with 45 minutes plus of conversation trying to decide if it is time to euthanize her dog. Please don't misunderstand on this one; I have no problem taking that much time to discuss an important decision but the problem with this lady is that she cannot decide anything for herself. My interpretation is that she is tired of the care needed for a geriatric pet but feels guilty euthanizing for that reason alone therefore wants me to decide for her that it is the best thing for the pet (not her, mind you.) I can't make that decision for her and, knowing how I feel about geriatrics, I'm sure y'all understand why I'm not going to advise her to euthanize unless the dog really deteriorates.

Then there was the cat who needed sutures removed from her entropion repair. That would have been quick and easy and I like her owners, they are very nice. What made it time consuming was that they are the same people who owned the dog that started the day... Needless to say, they had questions.

Even a simple rabies only with exam took way longer than it should have. The owners all wanted to chit chat yesterday. I felt like the psychiatrist role that we often have to play was taken to the extreme, all the while I was walking in a daze myself with the medications, allergic reaction, and already feeling yuck.

Between appointments, I talked to a lady who couldn't understand that her account ages the unpaid balance and applies any payment to the oldest charges. She sees it as picking up medication, paying for it that day, and it should not show up on her bill. I tried explaining every way I could and she only got more upset. Then when I had to excuse myself to see patients, she got more upset. Guess the boss will enjoy that one today...

I have yet another febrile cat with elevated liver enzymes. What is up with that?? It's like a rash outbreak and I still have had no one willing to let me go far enough for an actual diagnosis. That owner called over and over during the craziness and, of course, my help can't seem to handle telling her that I'll call her back after-hours because we were so busy. And the help contributed to the stress level. The one worker who usually does the best job made me crazy yesterday. She wouldn't restrain appropriately no matter what I said. The aforementioned cat was dehydrated and trying to place an IV catheter plus pull blood turned into a joke. The catheter happened; blood was very difficult to obtain and I only got a tiny sample. I handed it off to her and she promptly used all that was there to run the wrong test; not what I had asked for at all. At the end of the day, I tried one more time to get blood with the same results. Hopefully, the boss can get some more today for the rest of the testing. The girl also spent most of her time going into the rooms ahead of me on things that she really couldn't do much with then chatting with the owners. Every time I needed a set of hands, they were nowhere to be found. I wasted so much time looking for someone to restrain or take pets to the front, etc. yesterday it's not even funny.

Still I have not managed to get the girl up front to understand that I need a chart, a patient record for each individual, and something actually written on the chart to tell me who I'm seeing and why on EVERY SINGLE PATIENT. I'm about ready to strangle her. At the end of the day, I discovered (this was not the only one, just the final straw) that there was no chart pulled for the chicken. I guess since it's only a chicken it doesn't count.

The last appointment was a very large German Shepherd who has had infrequent, mild seizures for a couple of years. He has not been on medication and, like most of our clients, had no desire to go for an MRI to confirm there was nothing else present. He had a long, severe seizure overnight and was still showing significant post-ictal signs including blindness and the inability to ambulate, eat, or drink. I hospitalized the dog and was attempting to place and IV catheter and get blood. With two people holding, he still managed to kick and go crazy with us winding up with blood all over us, the room, and the dog. At least I also got some in the tube. I also got an IV catheter in place. Then I discovered we had no more fluids and our order had not arrived. It was too late to arrange a loan from another clinic. Wonderful.

By that time, I was so frustrated and aggravated with the whole day and with my help that when they wanted to know if there was anything else they should do and could they go home I just felt like yelling "Get the hell out of my hair NOW!!!" They left and did not do some of the things that they should have but I just didn't have the ability to calmly find and point out what they could do. Good grief; they are adults, can't they look around and figure out what is left to do?

I wound up being at the clinic until almost 8 finishing up all the stuff that was left over both by me and them. While I realize it's not necessarily a good thing, it was easier to just do it myself. Yet another reason I don't need kids. That I did not yell at anyone or pull out some weapon and just go ballistic is a miracle in and of itself. I have rarely been so happy to leave a place at the end of the day and so glad to have a day off. Hopefully I can recuperate enough to face it again tomorrow.

Happy Halloween

Instructional Essay

Per request, I am posting one of my undergrad essays that I mentioned previously. It took me a little time to find it because I've packed and moved so much I don't know where half my junk is anymore.

Sadly, in reading this and many of the other essays, I'm convinced that I had it more together and was a wiser person back then. Maybe I'm digressing with age. That is frightening; if I'm that bad already, where will I be in 20-30 years - yikes!! In any case, hope y'all enjoy the following piece; I still like it as much as I did when I first wrote it. Did I ever use any of the tactics described? I'll let y'all wonder about that one with the hint that my brother and I were very close and just consider what kind of mind thought up the essay...

Keeping Momma Single

Children often have more wisdom and judgment in dealing with people than adults; especially their single mom, who has the latest marketable goods (men) constantly thrust under her nose by “Sister Helpful,” and her crew of well-meaning family and friends. Because mom is lonely, probably does need help, and often feels frustrated and deserted, she tends to be susceptible to these men, and fails to use proper judgment. Often, her protective children must step in, judge the merchandise as suitable or not, and take the appropriate steps to help or hinder the relationship. Since “Sister Helpful” and crew are usually not exceptionally careful about whom they choose (any single male is considered suitable), it frequently falls to the children to rescue mom from uncomfortable situations.

A weak-kneed individual is usually easily dissuaded by a couple of bright, innocent children. A simple finger up the nose is frequently sufficient, but, if a little extra persuasion is necessary, ingesting the available “boogers” adds a more convincing note to the situation. This is the first step towards eliminating the latest unacceptable selection from pursuit of mom.

The second step, simple rudeness, is easily carried out as well. By refusing to carry on polite conversation, ignoring all attempts to “be friends,” and loudly interrupting each time he and mom attempt to converse, a child can often halt a disastrous romance in its tracks. Yelling and screaming like a banshee or wild Indian while mom is on the telephone also tends to be effective and quickly extinguishes the spark he is trying to kindle.

For the more stubborn suitor, firmer methods must be pursued. The “Clinging Child Routine” is probably the most effective in removing the unwanted male figure. By causing all appendages to act as velcro, clinging to mom’s leg, a child cannot be removed, even if force is exerted. This should be employed anytime it is suggested that mom spend time alone with the latest goods, or, it can be used as a constant. The suitor will find it difficult to spend “quality time” with mom when at least one child is constantly attached to her. For dramatic effect, a few tears and screams or sobs can be added, thereby doubling the effectiveness.

Eavesdropping on plans is highly recommended, since it allows advance planning and a more concerted team effort to be invoked. This is especially essential to the fourth and final stage of the sabotage, because needed props must be correctly placed, and memory must be refreshed on specific lines. The few brave souls who reach this point quickly realized that no one wants to harbor a dangerously insane child in their home. By simply talking to oneself constantly and allowing pertinent pieces of conversation to be overheard, the stage can be set for the final blow. At the table, the largest butcher knife should be placed readily at hand. It should then be picked up, fondled and stroked lovingly, while phrases from Shakespeare (Hamlet and Macbeth offer particularly suitable soliloquies) are employed in a barely audible tone. With practice, a glazed appearance of the eyes can be assumed at will and an evil, cunning smile should be rehearsed. A conversation based on methods of murder, particularly poisons, and undetectable crime, will soon cause reconsideration on the part of the guest of honor.

This infallible process should be used with care and responsibility, only against unsuitable suitors. The exception, “Mr. Right,” should not be made a victim, but encouraged for the sake of mom. By carefully following each step, any child of a single mom can protect her from “Sister Helpful’s” dire plot, and see her safely through her years of being alone.

Miscellany

Few things to say tonight and none of them really go together...

First, to answer the comment about my weird case. The cat was gone for less than 48 hours, closer actually to only 24. The entrance wound on the leg was still bleeding a little although the edges were dried and contracted enough that it had to be several hours old - but definitely not days. Although you are correct that the bladder heals very quickly, I can't buy that fast or if that were the case there was no uroabdomen. Can't Spell suggested that maybe by point of impact at the bladder the velocity had decreased such that it only spread the transitional epithelial cells that then sealed over almost immediately like when we do cystocentesis. Maybe??? The thing that bothers me about that scenario is that we all know how hard it can be to get the stupid needle to poke through the wall; how many times have y'all been watching yourself on ultrasound as the needle slides repeatedly off the bladder wall or gets stuck within the wall with incomplete penetrance? I'm still puzzled by the whole thing but the cat is doing great.

Second, I had a first time ever experience yesterday. Someone sent me flowers! The lady whose dog I euthanized last Sunday sent me a pot of rust colored 'mums with a thank you card. It was awfully nice of her but I feel a little bad because it seems as if it should have been the other way around. Here's a picture:



Third, I have to report that my little boy is growing up. Sniff. Guess, who has only ever acted like an overgrown puppy / baby did something completely non-babyish. Thumper and Yoda share the fenced area next door to Guess, Maybe, and Tag. Typically they get along great and play a lot together but Yoda did something and hurt his leg. He was crying and being pitiful and Thumper approached him wanting to play. Thumper can, on occasion, be a bit of an ass. He is a very fearful dog and approaches life as a bully to keep from getting hurt. He started trying to bully Yoda into playing while Yoda crouched, whining. Guess and Maybe ran over, very puppyishly to begin with, then realized there was a problem. In front of my eyes I saw the gangly puppy straighten up and seem to get very tall and big then he let out a woof at Thumper that sounded very grown-up indeed. Thumper backed off and stopped aggravating Yoda. It was funny to watch and very cute. Immediately afterward, Guess went back to his puppy persona. I'm happy to report that Yoda's problem was just a little strain and he is doing well with some pain control. They were playing near full force this morning.

At work, all and sundry survived because they didn't upset my routine (satisfied with my admission, Can't Spell?) and I have the weekend off - hallelujah! Was a lovely day today and I wanted to go somewhere but woke up with a nasty sinus headache and the accompanying dizziness that makes driving unsafe. I settled for spending a relaxing day with the kids instead.

Tried to keep the Sam monster in again last night. He has cooperated some on the worst cold and rainy nights but proved to have a superior stubbornness last night. He got up and wandered around then urinated in the floor. OK, give him benefit of the doubt, maybe he was trying to tell me he had to go and I missed it because I was so groggy. Then he glared at me, did it again and pooped then turned around to try to eat it. It was at that point that I gave up and sent him outside. He practically dragged me down the few stairs then took off to get water (as if he had none inside!!) Then he refused to come back inside. I was overcome by a superior force. And I thought that I was stubborn!

I'm still eagerly awaiting the arrival of his new wheelchair; actually I thought it would come yesterday. I'd like to put him in it a few times while he is moving well so that the first time is not during a bad episode. I hope his royal stubbornness will tolerate it okay.

That's about all I have to say for now. Today, mom was blessedly peaceful and things went well for a change. Except that I forgot to call the heating / air conditioning guy to come fix our heater. Oops. I won't get cold but mom, Flower, and the Da-Chi Terror otherwise known as Scout will. Guess I'll try to remember to do that Monday, before it gets really cold.

Hands, Eyes, and Other Things

Everyone has things about themselves that they don't like. I have always admired hands and eyes. When I notice a guy, the first two things I notice are his hands and eyes then his sense of humor or lack thereof. The hands and eyes are not necessarily deal breakers but the sense of humor definitely is... Maybe my obsession is partially due to the fact that my mother has beautiful eyes and hands and my brother had wonderful hands as well. Dunno. Point is, I notice.

Tonight, we were watching an old favorite movie and I found myself captivated by the lovely hands of the female leading lady. Then I thought about my own hands. I really hate my hands. They are just not pretty at all. I have chubby hands with short, fat little fingers and, even when I was not overweight as I am now, they were still that way. I'm not particularly fond of jewelry but, even if I were, I wouldn't wear rings because they just accentuate how chubby my fingers are. In addition to that, my hands sweat a lot. I remember my friends in school always complaining when we had to join hands for prayer or something and they couldn't wait to let go and wipe their palm dry. It's also kind of embarrassing that I always leave a handprint if I lay my hand on any surface.

There are many other things I don't like about myself but I really wish I had pretty hands. I'm honest enough without meaning to be boastful to acknowledge that I have nice eyes but my hands - yuck!

I know, weird little interlude of commentary but I just realized again how obsessed I am with hands and eyes because of the movie.

In other news, when I was complaining about the childish behavior of my mother I neglected to mention the bids for attention. I really can't do anything while she is home without her immediately needing me. I reckon it's payback time for when I was a child. I must admit I do remember our trying to get her attention when we were little anytime she got on the phone or whatever. I also remember our behaving rather badly when my aunt introduced her to men in an attempt to fix her up with a new husband after my dad's death. To give credit where it is due, we didn't behave poorly when the man was nice, it was just the idiots that my aunt dug up from under some rock. In fact, I wrote a rather nice little piece (I'm actually quite proud of it) as an undergrad for my instructional essay assignment called "Keeping Momma Single" that explained in detail steps for children to follow to eliminate the poor inappropriate guys from their single mom's life.

Mom is not at the point where she can't be left alone yet but I do fully remember my grandmother's tendency to wander. I had to put a lock at the top of the door where she couldn't reach for anytime I was out of the room, i.e. to go to the bathroom or anything. Then my aunt got mad because she couldn't just walk in whenever she pleased. Fun times.

I'm strongly contemplating investing in another horse. I know it makes no sense whatsoever but I think I need to do something for my own sanity in an effort to protect what little I have left. I also need to do some more research on Alzheimer's for myself. I know a lot of what is out there regarding prevention or slowing the process but I'm very thorough when it comes to research. I'm about to start myself on a few supplements since my chances of developing the disease are pretty high given grandmother and mom and the tendency to be familial and attack females.

One of the biggest problems with the situation is me. As I mentioned before, I grew up in a manipulation by guilt situation dating back generations. Probably in part because of the early death of my dad as well as the serious health problems with which my brother was born, I am extremely hyper-responsible and probably take way too much on myself. This combination plus the fact that my family is either too old or too idiotic to help is going to make it hard for me to not try to take this world completely on my shoulders. At least I have recognized and given a name to the problem. That's the first step in defeating it.

I'm not looking forward to work tomorrow. I accomplished almost nothing today, on my day off, due to extreme exhaustion primarily prompted by stress. The boss's wife was supposed to be off Wednesday but was out sick on Tuesday therefore felt compelled to work Wednesday. She is the type of person that can take any situation and make it chaotic. To add to that, Wednesday was rather slow and we wound up with too many people there because of her. I typically schedule the kids such that we have two of them there on Monday, Wednesday, and Friday because Monday and Friday are pretty consistently busy and Wednesday I have the afternoon alone and the boss's wife is off. As it turned out, we were slammed Monday and Tuesday but had people out sick then were slow Wednesday with everyone bumping into each other and twiddling their thumbs. I guess I could have sent one of the kids home but that didn't seem very fair to me. Plus the boss decided he needed to work even though he usually takes the afternoon off. Probably some misplaced sense of guilt because his wife was there. It didn't help either that my appointment schedule for the afternoon was fairly full but my help kept telling me they knew how to do things then did not. Like centrifuging a blood sample. I told them 3 times to make sure it clotted first but they still didn't. Then they didn't know how to balance the machine although they said they did. I had to leave the room to stop the machine and give a lecture on balancing. I don't like being lied to in any way, shape, or form. For me, if you don't know how to do something, just say so and I'm more than happy to teach you!

And lastly, the Sunday of euthanasias was apparently just the beginning for the week. Not just for me this time either. Between the two of us, we've had minimally two per day. Here's hoping tomorrow is better and looking forward to the weekend off. Now if he tells me tomorrow he's going to be out of town after all and needs me to cover, I may shoot him! Just watch the news. "Veterinarian goes crazy and shoots boss and all employees over weekend duty. Details to follow."

Weird Stuff

Note: This post was intended for Tuesday evening but weather interfered with it being posted.

There were a couple of interesting things that happened at work today that I thought y'all might enjoy hearing about. It was a very, very busy day; I overslept and was 30 minutes late then hit the ground running as soon as I arrived with only a pause for "Boss's Day" lunch ( a day late, methinks but it's the thought that counts and they wanted me to be there. Awww, how sweet.) and left about 45 minutes after closing time which isn't too bad for me.

The most interesting cases of the day are as follows:
Approximately 4 month old male "stray" kitten that the new owner had only managed to catch about 5 days ago. The kitten was reportedly normal until early in the weekend when he began to lay around and just not act right while his 2 littermates were playing like crazy. On examination, he was pale and icteric with increased lung sounds. FeLV / FIV negative, CBC within normal ranges, Chemistry showed an elevated total bilirubin (2.8), low albumin and total protein, and a whopping ALT at 1536!! I think that is the highest ALT I've seen thus far in my career. Differentials such as FIP or toxins were floating through my mind. During the exam and bloodletting, the kitten got upset then started to breathe very hard and never really slowed back to a normal respiration rate. The owner opted to euthanize and send him in for a necropsy at the state diagnostic lab. The owner is very concerned about toxins since they have a crazy neighbor just down the street with a history of suspected poisonings. I encouraged him to try to do something and told him the necropsy would be the best bet for proof although we may strike out. I also told him not to get his hopes too high since I remember the case during my first year where we tested a cat and a food dish that was sitting just outside a neighbor's door and found both to be positive for antifreeze. Nothing ever came of it. Of course it was a different state...

The other case was a first for me and should go in the record books I think. Had I not been there, I would have thought it was made up. A 1.5 year old spayed female Himalayan got out of her house and returned home lame on the left hind leg with a wound on her hip area and blood in her urine. On examination of the wound, it appeared to be a pellet entrance wound. The bones were palpably fine and the muscle beneath was noticeably swollen and tender. I couldn't locate an exit wound. At the time I was thinking of bruising of the bladder or perhaps an unrelated infection or stone. For all of the above reasons, I recommended a radiograph to include both the abdomen and the leg. The results are below.



After this shot, I still was trying to convince myself that I was seeing things and the pellet might actually be lodged in the leg muscle so I took a second lateral.



Then, like a good little veterinarian, I took a VD (orthogonal view) just to finally prove to myself I wasn't insane.



An exploratory surgery followed during which I was expecting to find a uroabdomen or a loose BB pellet. Nope. The pellet was truly inside the urinary bladder and there was no leakage that I could appreciate. I performed a cystotomy, removed the pellet, explored the lumen of the bladder for obvious defects looking for an entrance wound and could find none. I closed my cystotomy site then obsessively examined the outer surface of the bladder for that entrance wound. Nada. I found a bruised area with some hemorrhage but no hole that I could close. Puzzled, I had my assistant inject saline into the bladder while I leak checked both my incision site as well as the rest of the bladder; no leaks. Hmmmmmm...... I'm still puzzled by that one especially since I could trace the path of the pellet past the inguinal ring and through the body wall. Not sure how to explain that one but even I am satisfied that the bladder wasn't leaking when I closed the body wall.

That certainly puts a new twist on "cystic calculi"...

Children

I'm back to vent a little. There aren't any good people to really say these things to because then they somehow get back where they don't need to go therefore it is easier to vent here where very few people that actually know me and my family personally can hear...

I'll start by saying that I'm not a fan of children. I don't hate them, I just don't like them a lot because they are usually loud and busy and make me tired. Rusty and I pretty much have always had the same attitude about children i.e. they should be on a leash or in a carrier at all times. I'm not the most patient person in dealing with children and long, long ago made the decision that I have no plans of having any of my own other than the four-legged furry kind.

That said, I think anyone out there who has acted as a caregiver for an Alzheimer's patient will understand where I'm going. In taking care of my grandmother years ago, I started somewhere in the middle and knew very little about the disease. We had not recognized the early symptoms but I remember dealing with the childish behavior, temper tantrums, throwing food, refusing to eat, crying easily, etc. that progressed into anger and sometimes violent behavior. Fortunately, my grandmother was a very small woman therefore she couldn't really hurt anyone too easily.

Knowing more now, I'm really recognizing early symptoms and stages of the disease in my mother. She refuses to go to the doctor so far so I'm working off a "self-diagnosis," if you will but it is there. Before I came home, there were often times she adamantly stated that I had not told her things that I would have sworn I had but I wrote it off to my own mistake since I was working such long ER shifts and so many overnights. I also noticed that she seemed to get upset more easily than I remembered but I thought she was just under stress because things had already started somewhat with my brother at the time. When I came home I was rather shocked at the difference in her.

It did not take long to reach the conclusion that further career pursuit was out of the question and I needed a job to allow me to stay at home. Working with her right now is extremely trying because she is in that stage where she shifts gears, often within minutes, from being mom to acting like a child. Today she got upset and had a first class temper tantrum because she couldn't find a phone book. When I got one for her and looked up the number she was suddenly all smiles again. Unless I cook for her daily all she wants to eat are sweets and that is almost all she will buy at the grocery store unless I send a list or go myself. Things that she used to do and that one would expect a mother to know how to do she cops out on saying she doesn't know how. It would almost be easier if she were constantly like that because I wouldn't have to shift modes so much going from caregiver to daughter and back again over and over. It's also hard to make myself be the caregiver; I've always taken a lot of responsibility in the family and have taken care of finances, big decisions, etc. for years now but this is a step further and a difficult transition.

Because of the time needed for mom, I've made the decision to only work part-time for now. This adds to the stress because it really stretches my finances with student loans to pay, increasingly expensive geriatric pets to care for, and the usual stuff like health insurance, etc. To add to all of that, I feel as if I have a huge mountain of stuff that has been put off and that needs attention but that I can never find time to do. Getting to the lawyer for the will revision, for instance. I really need to get this done before she gets worse... If it weren't for the situation with mom, I would be looking for a different job in a heartbeat although I'm so tired right now I don't know if I have the energy to face new people and new places again. It was suggested to me that I should look into assisted living for my mom but I don't think I can do that, certainly not right now. Mom is an introvert and has always been independent. We live on a large wooded acreage and like our privacy. I don't think she would adapt well to an assisted living type of atmosphere.

A good friend of mine recently advised me that I need to find some hobbies that are unrelated to work to help release some stress and help me to leave work at work. I know these options are stupid and not viable at the moment but I would like to get another horse (I REALLY miss my horses) and go back to school to get a master's in English literature. The obvious problem is that it will further stretch my bursting budget and add yet more responsibility to my load. I doubt that's what he had in mind when he made the suggestion. Another friend and I were talking about the fact that his doctor has placed him on Ambien and an anti-anxiety medication to allow him to actually rest while he sleeps. As he described it, he took work home and worked all night while he was sleeping therefore did not really rest. Sounds familiar but with my susceptibility to the mildest medications can you imagine what that combination would produce?? I had a dream the other night that I was 15 minutes late for work, my boss was mad when I got there even though I had an excellent reason then we had a really busy day and everyone but me left at 5:30 sharp while I stayed to finish what was left. It was very vivid down to the details of facial expressions and what was said. No need to say it; I know I ain't right. Which, by the way, is what I plan to name the next dog that I acquire, "Ya Ain't Right!" 'cause I say that so often to most of the herd. There has to be a touch of insanity to live with me, you know.

Last anecdote that I'm going to share tonight. I have a white long-haired cat with a bobbed tail that I named Katrina. I also call her the white witch with good reason. Mom thought it was wrong to name her Katrina so soon after the hurricane hit but it seemed appropriate for this cat. She is one of the sweetest and most lovable cats I've ever met; she loves to sit in your lap and just be loved. Until something sets her off. Like the day that I tried to catch Sprite, my feral cat, and she leaped through the air to attack Sprite who I had in my hands. I got the raw end of the deal that day although Sprite was so frightened that she hid for 2 weeks straight. Today, Katrina attacked Solitaire and bit his ear so that it was bleeding like crazy then would not leave him alone. I think she got mad because the food bowl was near empty... Crazy cat. The NurtureCALM collar has helped but not eliminated the problem behavior for her.

OK, I've complained enough for now and should probably go to bed since I have to work in the morning.

Yucky Sunday

I hope that Sunday can be considered an end to the week rather than a beginning this time because if this Sunday is the beginning then this week will be a doozy...

My boss went out of town Friday afternoon and through the weekend as he often does during the fall college football season. We had a cat in the hospital who had pyometra; emergency spay performed Friday, and a dog that I intended to discharge Saturday when I was at the clinic taking care of the cat. Fortunately for me, the kennel schedule got abruptly changed at the last minute putting the best worker who can actually be depended upon on this weekend rather than the worst one who was scheduled.

The reason I say fortunately for me is Sam. The last few days have been really bad for the old fellow. I'm pretty positive it has to do with barometric pressure. We've had a low pressure system which, by the by also affects my vestibular system like crazy, seems to make his walking worse. Since Wednesday evening when he got himself stuck partially in the dog house where his food was, he has not been able to rise unassisted. Once I get him up, he is typically able to ambulate although he loses his balance easily and cannot go far therefore I'm using a sling then his tail when he urinates and / or gets a little more steady / strong on his feet. Quite remarkably, he actually cooperated to being inside the house during the night and part of the day until Saturday night.

Saturday, I felt as if someone had drugged me unawares. After going to the clinic and taking care of the cat (who is doing quite well although not eating great voluntarily yet), I came home with the intention of cooking us a good meal. After taking Sam out, I was out of energy and fell asleep; it was like I seriously couldn't keep my eyes open. We decided on a light snack and early bed, as in 7:30 or 8:00. I had just laid down and was drifting off when Sam started trying to get up and got very agitated. I got up, took him out, and he tried to wander off into the woods. Refused to use the bathroom and acted annoyed that I wouldn't let him go. I took him back in and we repeated the process with my taking him out, offering him water, offering him food, laying in the floor on his cushion with him and petting him, etc. until finally, I took him out and he deliberately laid down in one of his favorite spots and refused to budge. I gave in to his superior stubbornness and let him remain outside.

Finally, I thought I might be able to sleep but then I was assaulted by Peanut barking demandingly at me. Usually she does this when she wants to play and not in the middle of the night. This time, she actually wanted to be held and petted, a new behavior for her since up until now she has let us approach her for any loving. After that, I kept waking, worrying about Sam, getting the flashlight and going outside to make sure he was okay and not too cold. Sunday morning, I went out early, got him up and moving then brought him in for a couple of hours to warm up. At that point, he demanded to go back outside and started walking around as good as he was before this whole episode started, including rising on his own. The only bad thing is that there is another system coming mid-week... I anxiously await his doggie wheelchair since I think I'm getting too old for this. I keep thinking how old I'll be when the horse puppies get old. Yikes! Better find myself some strong help by then.

On Saturday, I got two messages. The first was from my technician / friend who is out on maternity leave. Her dog was diagnosed with a kidney tumor that had already metastasized to the lungs and had caused hypertrophic osteopathy several months ago. She suddenly started going downhill over the past few days and had reached the point that it was time to let her go. The second was from a long-time client who has become a friend. Her dog had a mammary tumor that I removed last year but it had lymphatic invasion already and has recurred and metastasized to the lungs recently. She also has gone downhill over the past few days (I had seen her on Wednesday and we talked about knowing when it was time) and was ready to go. I arranged to meet both of them Sunday because it is such a hard decision to reach, when it is time and someone is ready, I don't like to make them wait since I feel it makes things even harder than they will already be.

My tech met me first and Vidalia, a.k.a. "The Onion," a basset hound that I have known since she was a puppy and her ears were longer than she was, went peacefully to doggie heaven. 'Dale was the puppy that my friend and her now husband got together shortly after they met. She has grown up with them and with their little girl who said, "Goodbye Onion. I'm going to be very sad." I think that the time was right, though, because she was a great deal worse but not to the point of such needless suffering that it will be regretted later.

The other lady met me a little bit later. Elsie was a 15 year old black and white Cocker spaniel. She was also one of the Rust-bucket's girlfriends in his and her younger days (he used to be a real Casanova.) Her mom let her walk around to use the bathroom outside and since it was such a pretty and peaceful day, we sat in the grass for the euthanasia. It was not the smoothest ever since she's always had crappy veins and her legs were all swollen and the veins kept blowing but since she had sedation prior, it wasn't as bad as it could have been. Elsie went to doggie heaven with her mom holding her and hugging her in the grass (and hopefully not sitting in any poop...)

So Sunday was kinda yucky which is why I hope it's not the start of a yucky week. Things do have a great tendency to go in themes although these were my only two really sick cancer patients out there at the moment. I have others but, as of last check, they are doing well and, I hope, continue to do so for a while!!

Otherwise at work, I probably will cause a ruckus tomorrow by my posted notes including a job description indicating that answering the phone is the receptionist's duty (i.e. pointed at the boss's wife who just lets it ring and assumes someone else will answer) and that the middle / floater position is not so glamorous as the kids seem to think, and that the kennel person is responsible for completely cleaning the kennel, etc. and this week's schedule. Should be interesting to see how it all plays out over the next few days. I'm thinking of posting another sign stating "Office Meeting, whatever date, no need to attend since Dr. Insane will be talking to herself with no one listening anyway."

Ultimate Scream

Way back in those long gone by days of vet school, I used to draw screams during class. If you look through my class notes, you can get a quick idea of how bored or aggravated I was at any one time. The classes that didn't lose my attention had few or no screams; the classes that were the ultimate in boredom were littered with screams; and the classes where my classmates were driving me crazy were littered with screams. There are a wide variety of them including just plain ol' circular face screams, various animal screams, hair added, block faces, different shapes, etc. There is also one that went a little further and became the wicked witch getting blown away in the tornado in Oz... How they turned out depended on my mood. Probably my favorite was the cat with fangs bared screaming.

Not too long ago (relatively speaking), Can't Spell sent me a text requesting that I draw a scream for old times' sake. I did and titled it the ultimate scream. At the moment, I feel the need to resurrect the harmless method of stress relief.

Somehow at work, I've inherited the job of making the schedule but the boss's wife is exempt somehow although she says she is not. The problem with her, though, is that she is in the habit of going to visit her mom at least once a week. I've asked repeatedly which day or days or rotation of days she would like for me to plan for her to be out on so that I can rearrange the others to cover. She will not give me a straight answer.

The other problem is that the 3 kids are all wanting to go to tech school. At my clinic, there is a receptionist, a kennel worker, a groomer, and a floater. The floater, or middle position, is the coveted spot because everyone sees it as being more fun and where you get to do more cool stuff. I don't necessarily agree, especially since when the boss's wife is working as receptionist it means that she wants the floater stuck under her rear to answer the phone, etc. (You know, the things that she should be doing...) I try to be a fair person and reward those who deserve it but it is getting pretty hairy. Although I have had a private meeting with all 3 kids, they still don't seem to understand the concept of needing to earn the right to do more. If I can't trust them to walk the dogs and clean the cages how am I going to trust them to count medications appropriately, get the right medication, etc.??? I'm about to the point of relegating all 3 to the kennel but that leaves me with no hands available at all on days that the boss's wife takes off unexpectedly.

I've further decided that I stink as a boss. Not that my boss does much better but I'm just not so sure I ever want to be a practice owner. I'm not very good at remembering to praise people; I expect them to do a good job and I guess I grew up without it so I don't exactly know how to incorporate it. I'm also not very good at criticism and I hate confrontation. And, as always, I really don't know how I got myself into this mess. I mean, 3 kids (not all that fond of kids, never wanted to be a parent), boss's wife, the go-to for everyone, in charge of the controlled substance log and inventory, in charge of the schedule...and this doesn't even count what goes on at home.

Maybe I'll strike oil, become a multi-millionaire and can retire from actual work then open a rescue clinic or go work for Best Friends in Utah...

On a side note, I must admit I found a twinge of jealousy in my heart when I read that the cartoon doctor lady published her work. I'm always torn with mine. I want to but then I get hesitant about whether they are good enough and whether I want to share them with a real public rather than a few close friends. I was working on scanning in some new ones tonight and found it funny that me, an English grammar OCD freak, spotted a couple of mistakes on some of the older cartoons that I haven't caught before; why it was funny is that I'm excessively tired and took some anti-dizzy medicine a little earlier. Maybe it takes my mind in an altered state to function appropriately these days. After all, I was advised by a good friend recently that I needed both drugs and therapy. I'm thinking of starting group sessions at work because I think they need help worse than I do.

Last comment for now is that I think I'm going to put Sam in a doggie wheelchair. It's been a hard decision to make and I still don't know if it will work but I'm at the end of my rope on options. Sam is at least 15, a shepherd / collie mix, around 65 pounds. When he was very young, he had a pelvic fracture and tarsal shearing fracture of his left leg. He developed laryngeal paralysis about 1.5 years ago but it has been very static therefore I have not surgically intervened. His voice is gone, he has mild fecal incontinence, and he has been progressively weakening neurologically. I don't know if it is the peripheral neuropathy associated with laryngeal paralysis, degenerative myelopathy, lumbosacral stenosis, or something else. The big problem is that he is an outdoors only dog by his choice. He hates being confined in any way, shape, or form. I'm just not sure how a wheelchair will work for an outside dog with rough terrain but have spoken to some people that have tried it with good success. With the change in the weather, he had a rough couple of days and got stuck down twice. The longer he lays, the weaker his legs get then he can't rise. After I get him up and massage his legs he's okay for a while. At this point I'm pretty comfortable with my pain control protocol and it seems to be the neurologic issue that is worsening. He's getting measured tomorrow and we'll have the cart in a few days. Guess we'll see how it goes from there. I really hate to be forced into euthanasia because of impaired mobility; he is otherwise a healthy and happy dog.

That's about it for now. I feel as if there was one other thing I meant to say but my little mind is rather muddled at the moment so I'm just not sure. That's why I hate taking medicine; I'll have something to do, say, or write and in the time it takes me to start I'll have forgotten it. Scary!!