Monday, September 26, 2011

I think I expect too much...

It suddenly became clear to me today that one of my major problems is that I expect too much. From myself, from my family, from my friends, from my colleagues, from my employees, etc. Really the only ones who don't let me down are the 4-legged furry kids.

Friday was extremely busy and, as the day after the, dum dum dum dum, big office meeting, the kids at work really busted behind and worked hard. Today, it was showing signs of already wearing thin. I think I mostly wasted my breath during the meeting, especially on the "older employees" who are entrenched and that I have known for eons. Things are never their fault, you know. Plus, what am I supposed to do about the wife?

This week, my schedule is really different than usual because, as things will work out, I have an appointment to take Scout to have his recheck echo done plus I'm driving the foster puppy halfway up to her new home therefore my usual working times had to be rearranged pretty significantly. Typically, Wednesday afternoon is the boss's time off to go do whatever he wants, usually involving hitting a little white ball somewhere in the direction of a tiny hole way far away. I have to leave early on Wednesday therefore he will either need to cover the afternoon or not take appointments. I arranged this well in advance and asked several times if he wanted to take a different afternoon off. Finally, after I spelled it out in grave detail today, he realized why I kept bringing it up and gave me a straight answer. I would have thought he could put two and two together to figure it out...

Then there is my mother. She is finally going through the process of retirement. I told her more than once I'd be glad to go with her to help sort out the business / information part and she says she wants me to but then won't set an appointment when I can go. Or, the other day, I suggested a time and when I asked if she had set it, she said she didn't know when I would be available... We had a planned time although she wouldn't schedule an appointment last Thursday but she found a reason not to go even though I told her the next chance I would have would be Monday, Oct. 3. Now she wants me to make time this week when my schedule is super, ultra hectic and is annoyed / angry with me that I told her no. (I may have mentioned this before while whining and griping but my family works on the system of manipulation by guilt. My personality type is extremely susceptible to this and it has taken me years to recognize it for what it truly is. I still have difficulty dealing with it but at least I can rationally recognize it and try to make better decisions.)

Of course we can't forget the prodigal brother of mine. He still has his sights set on the place that I still own and need to sell if I can ever get some things settled here long enough to deal with it. Basically, he sees himself getting something for nothing. And, of course, the rest of the family think I'm horrible in not being willing to comply. Plus they still refuse to face facts that he and his wife are still on something. I was reading some of the Crass Pollination blog entries regarding drug-seeking people, excuses, habits and could see him and her in almost every one. It's hard to be truthful with yourself about people you care about but there is just no denying what I'm seeing and hearing; unless you are one of my family talking about my brother.

I also love the fact that no one listens to things I say about medicine but they run to my cousin who is training to be a nurse and take all things from her mouth as gospel. My other cousin, who is in her 50's and diabetic has developed cirrhosis of the liver secondary to her diabetes and poor control. Unfortunately, there is not much to be done at this point unless she could have a liver transplant and I don't think she's a very good candidate. Explained all of that but it took my nurse-in-training cousin saying that high cholesterol can cause cirrhosis for anyone to listen. I don't care so much except that I wish if they don't want to listen to me they would cease to ask thereby wasting my time. Or maybe I do care. I've always been overshadowed by someone or something and maybe there is a deep dark part of me that craves someone to listen and pay attention to me. Hmmm. Haven't thought about that until now when I asked myself why it really annoys me. The longer I know me the more convinced I become that I'm really messed up in far too many ways.

As a side note, I don't really know what is happening since this is usually the time of the year when we begin to slow down a little but all last week and starting already this week I've been at work really late because we've been so busy. Maybe there is some kind of strange time shift happening or there is a full moon or something.

Going along with my usual poor record with employee pets, I diagnosed a probable FIP in one of the kids' cats. If anyone else has a better suggestion I'd love to hear it. Nearly 2 year old, NM, always been thin and now losing weight, lethargic. Temperature today was 106. No lovely fight wounds to blame it on (I was hoping!!), FeLV / FIV negative, low white count, mild elevation of ALT, nothing else abnormal on bloodwork. No palpable fluid or masses in abdomen, kidneys of normal size and non-painful. Mentation not just right and menace was decreased, I think, although y'all know cats can be hard to assess, no retinal lesions that I could see.

Had a weird case come in Friday, too, that I still haven't an answer to explain. This was a robust 5 year old, NM cat who presented for severe vomiting and acting more needy than usual. His exam was boring, absolutely nothing I could pinpoint. Owner opted to allow bloodwork that showed everything completely normal except an ALT of 531! I was thinking neoplasia or toxins but could find nothing to aim at therefore I kept him hospitalized on fluids. Today, he's eating some (still a little picky) and the ALT is down to a mere 144 (high end normal 100 on our machine).

And I need to do some research into cat skin problems. Saw this weird lesion today on an upper and lower eyelid. Very crusty, dried, flaking skin but non-pruritic. No other lesions, did have a few fleas. I opted to start the cat on Advantage Multi in case it is a weird demodex case although the scrape was negative. Figured it would at least serve to treat the fleas while I do a little digging, anyhow.

I euthanized a 10 year old Saint Bernard Friday whose little boy brought him 2 dandelions and insisted on sitting beside him hugging his great big hairy neck as I did the dirty deed. It was a day for euthanasias including the technician's mom's ancient old dog reminding me once again of the frailty of my geriatric crew and how short a time we get to enjoy our furry family.

We also had a catastrophe at work today just to add to the excitement. There was a little old poodle boarding with us while his owner, an elderly lady, was in the nursing home for rehabilitation. One of the kids took him over to visit his mom on Sunday. The little dog has seemed fine although he had a little diarrhea one day last week and has some arthritis problems. I even did an exam one day although he was not completely cooperative because his legs were hurting, he kept wiggling and fighting. Over the weekend, he started to decline and bloodwork today showed significant hypoglycemia and a very high white count. The boss had placed an IV catheter after his visit Sunday because he seemed to be worsening and as he added a little glucose to the fluids, the dog sat up, urinated, then became agonal. We administered CPR but were unable to bring him back. After he was gone and relaxed, I could palpate a small mass in the cranial abdomen. In a mix-up of communication, the girl who took him to see mom went to her with flowers and sympathy before she knew of the dog's death. As it turned out, the boss had been instructed to filter all communication through the daughter who had not yet returned his call and our employee thought she had already been told. Bad scenario all the way around because she certainly meant well but it fell to pieces.

It's definitely been interesting around here lately. The puppy is doing great and is up to 11 pounds today. She is becoming stronger and stronger with mucho puppy energy. She still has some carpal and tarsal hyperextension if she overdoes her play but she can do so much more before it manifests now and daily the time grows longer that she can play without problems. Her little front legs also curve on occasion but this, too, is improving daily. Since her calcium was within reference range rather than higher as a puppy of her age should be, I did opt to supplement for now but will watch the levels as she grows. There have been no more seizures and she is eating like a champ. I'm really glad she goes to her new home this week because the longer she stays with me the harder it will be for her to transition to yet another home as well as for me to let go. That's the worst part about fostering. I would post some pictures but I can't get any good ones these days because she is so busy! Yesterday, we had her out to let her run around and she discovered the boys cot, took it over, and proceeded to destroy 2 pine cones, several pieces of pine straw, and played with her tennis ball. Suddenly, she simply crashed and fell over into a deep puppy sleep only to be disturbed when one of the dogs came near enough to stimulate her desire to aggravate. She is growing into a really cute puppy and looks much better. I think she is 2-3 weeks younger than the first owners thought she was judging from teeth progress but the teeth could also be off due to the starvation. Not sure.

My overgrown horse puppies are still lots of fun. They all got chew treats over the weekend and Guess was having a blast playing keep away. It upset Maybe, however, so she ran off and buried her treat while Tag set about the serious business of chewing on his. They are becoming very graceful as they move and I cannot get over how big they are. They are really neat and pretty dogs although unusual in their markings and very, very laid back and gentle. Once again, pictures would be great but they won't be still! Maybe likes to hold your hand but sometimes gets overenthusiastic and grabs a little too hard. They really need some harness made for them and a little goat cart to pull. I'll bet they would love it. They always have some secret mission going on and I often wonder what plans they have for all the holes they dig, large limbs they find and bring up, and, especially, trying to move the water buckets. I'm sure it's all part of the plan.

I discovered that my other young dog, a Border collie named Indiana Jones, knows how to sit and stand up on his hind legs on command. Since I didn't actually teach him either trick it surprised me a little. He's pretty smart, though, and very intense, true to his breed. He may be mixed but definitely has the instinct; I just wish I had someone to train him and a flock for him to work. He came my way while I was in my first job. A local rescue group brought him in after finding him. He had been shot in the head with the bullet miraculously traveling beneath the skin from behind his ear and exiting through his lip, shattering the upper fourth premolar and first molar on that side. His hearing was damaged as well. After removing the maggots, cleaning the wound, removing tooth fragments, and putting his lip back together he came home with me. Today, unless you look at his teeth, notice the subtle tightness of his lip on that side or the slight droop of that ear compared to the other, you would never know of his rough beginning. I'd bet that he was out in a pasture herding someone's cows and they shot him. He was only 5 of 6 months old. He was also my first ever cryptorchid neuter.

The old folks and in-betweeners are doing well for now. Sam's neurologic problems are progressing although the laryngeal paralysis seems static and is causing him no problems right now. He has a hypermetric gait and is weak in his rear added to his old orthopedic injuries (pelvic fracture, tarsal shear fracture). He also is losing his voice sounding hoarse when he barks and has some degree of fecal and urinary incontinence. On really hot days, he has some roaring and exercise intolerance because of the lar par but, for now, I have no plans for surgical intervention. I don't know if his other problems are degenerative myelopathy, peripheral neuropathy associated with lar par, lumbosacral stenosis, or something else, but I can't quite see doing an MRI when it won't really change what I'm doing. I may invest in a cart but am hesitant because Sam refuses to be an inside dog (he hates confinement and boundaries much like his mom) and I'm worried that he might tip himself, become trapped or entangled, or something outside that would result in his getting hurt.

Over the past several days I've gotten back to drawng more cartoons. I'm not particularly talented but do enjoy them for my own fun. They are in many ways a barometer of how things are going in my life. My brother and I drew together as children, he was very talented, then I ceased to draw at all after his death for years. I find that I turn to drawing the cartoons now either when I'm happy or very stressed. If somewhere between, my production falls off. When extremely depressed, I also don't draw. Right now, stressed would be the impetus. I've done several lately about how to avoid matching for a residency centered on some of the things that I'm sure hurt my chances. So far I've barely scratched the surface and haven't even touched the first internship. There are always ideas floating around inside my crazy little head but I have to be in the mood to put them on paper. Plus with my cynical, dry and odd sense of humor outlook, you never know what will trigger an idea. At the moment, however, I'm also in that mood where I don't really feel like sharing them too much.

The storms are wreaking havoc with my messed up vestibular system. After a while, one becomes accustomed to being constantly slightly dizzy and it's only hard on the rare occasions when one is not dizzy or on the frequent occasions when the dizziness worsens and is accompanied by nausea. Unfortunately, I'm a really cheap drunk and most, if not all, drugs completely knock me out. Meclizine helps with the dizziness and nausea but I also have a hard time functioning and doing my job when I'm fighting sleep. Also makes for some interesting conversations with clients when the speech starts to get slurred on top of my heavy Southern accent. (No, occifer, I've not been drinking!) The other fun effect is that on certain medications, I find it impossible to lie. Those would be the days when, if asked how I am doing I would burst out with a full report, no glossing over or omitting things. Or would tell you that your shirt was ugly or your haircut looked bad, etc. Scary for a person like me who is really reserved and controlled, especially in speaking.

Probably partially because of that, I did another classic fall over the weekend. Had my house shoes on outside and tripped coming up the porch stairs. Instead of bamming my head into the door, this time I thought it would be more interesting to slam the fingers of my left hand in the door. Surgery tomorrow may be challenging although the swelling has mostly resolved. I really missed having my Rusty-dog as a perfect heating pad to lay on / against me. He always found the spots that were sore and was much better than an electric heating pad. The others are not that generous. I guess I'm slowly coming to grips with no longer having the boy but there are times it still hits suddenly just how empty that spot in my heart remains.

I think that's about all that I have to complain about, update on, or whine about for now. So enough of my rambling and I should probably go to bed...


haldol said...

Damn it May B, stop being so insanely hard on yourself. Why is it that "you expect too much from others" instead of "some of the people around me (especially in my family) are lazy a-holes"? That kind of self-blaming for everything is the fast track to depression. You're an excellent vet and an amazing human being. Give yourself some credit.

Amanda said...

The comment on the geriatrics reminded me that, with four animals ranging in age from 2 - 5 years old (1 tiny dog and 3 cats) I'm going to be hurting in about 10 - 15 years.


Anonymous said...

Gee Dear, sounds like you took some of those "truth drugs" before you wrote that post! ;) You know what I'm going to say, I'll call you later to yell at you.