5 years ago
Monday, October 31, 2011
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...
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.
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.
Saturday, October 22, 2011
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.
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.
Thursday, October 20, 2011
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."
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."
Tuesday, October 18, 2011
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"...
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"...
Monday, October 17, 2011
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.
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."
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."
Friday, October 14, 2011
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!!
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!!
Tuesday, October 11, 2011
Loss of Subtlety
Although I'm quite zonked on meclizine right now in an effort to maintain balance and an upright position, I've not had quite enough to write the entry I was considering therefore y'all will have to do without more of my deep dark secrets for now and just hear my Halloween complaint...
I'm sure that my viewpoint on the matter is influenced by my English literature background and love of classic books. The whole Halloween scene such as it has become is simply vulgar and disgusting to me. What set this off was the sign that I noted on my way to work advertising "Murder on Meighan" (a local road name) then describing "haunted" things consisting of chainsaw massacres and such.
What ever happened to the subtleties of haunting and fright? I am not a fan at all of the vulgar displays of torture and terror. For me, the suggestion of fear is much more tantalizing. Think classic Dracula or some of the great old ghost stories from back when like The Legend of Sleepy Hollow. There are many, many excellent books that involve ghosts and hauntings but fail to describe in all its gory detail the blood and guts. (And, no, I'm not at all squeamish about blood and guts for the record; I just don't find that particular brand of horror appealing.) For me, leaving much to the imagination, hints and suggestions rather than detailed description, leaving that echoing question about what was real and what not is much more entertaining. On a slightly related note, I think we have this problem with clothing as well. Call me old-fashioned if you want but I think it was better when some things were left to the imagination rather than everything left to hang out in full view.
Tell me, what does a huge chainsaw covered in blood and gore have to do with a "haunted" house? What self-respecting ghost really needs a chainsaw? Has the world gotten so jaded and lost so much imagination that only more extreme horrors can move anyone? If I wanted to visit a haunted house, I wouldn't be satisfied with less than the classic old mansion on the hill with spiderwebs and creaky hinges, etc. A ghoul armed with chainsaw would be anti-climatic. So there's my opinion on the matter.
I'm sure that my viewpoint on the matter is influenced by my English literature background and love of classic books. The whole Halloween scene such as it has become is simply vulgar and disgusting to me. What set this off was the sign that I noted on my way to work advertising "Murder on Meighan" (a local road name) then describing "haunted" things consisting of chainsaw massacres and such.
What ever happened to the subtleties of haunting and fright? I am not a fan at all of the vulgar displays of torture and terror. For me, the suggestion of fear is much more tantalizing. Think classic Dracula or some of the great old ghost stories from back when like The Legend of Sleepy Hollow. There are many, many excellent books that involve ghosts and hauntings but fail to describe in all its gory detail the blood and guts. (And, no, I'm not at all squeamish about blood and guts for the record; I just don't find that particular brand of horror appealing.) For me, leaving much to the imagination, hints and suggestions rather than detailed description, leaving that echoing question about what was real and what not is much more entertaining. On a slightly related note, I think we have this problem with clothing as well. Call me old-fashioned if you want but I think it was better when some things were left to the imagination rather than everything left to hang out in full view.
Tell me, what does a huge chainsaw covered in blood and gore have to do with a "haunted" house? What self-respecting ghost really needs a chainsaw? Has the world gotten so jaded and lost so much imagination that only more extreme horrors can move anyone? If I wanted to visit a haunted house, I wouldn't be satisfied with less than the classic old mansion on the hill with spiderwebs and creaky hinges, etc. A ghoul armed with chainsaw would be anti-climatic. So there's my opinion on the matter.
Saturday, October 8, 2011
I Guess Maybe
I've been promising a post about the "new kids" for a while now and the fact that I ran across some pictures from when I first found them and was amazed at how little and cute they were prompted me to finally come through.
Mom and I were driving to town, innocently minding our own business when I started to pull out from the old bridge and saw 2 pups chasing after a car. They were close to being hit and I tried my best to ignore them, even rationalizing that we could go ahead with our errands. I really DID NOT need any more dogs. I mean, for heaven's sake, I'm overloaded already!!
OK, so I guess it's obvious, my rationalization failed and I stopped and picked up the pups, tossing them into the back seat. They reeked of fish. People are terrible about tossing dogs in that area. It is not close to any houses but there is a creek so I guess they think they will survive on water and fish. I've personally found 6 dogs there and my mom picked up one way back before my brother and I were even conceived.
The pups on the day we found them, approx 3 months old.
The little male approached us very quickly and easily, wagging his tail while the female hung back a little, more timid and definitely contemplating the situation. This has proven true of their dispositions. She thinks about things a lot more than he does. He tends to just burst right in with little trepidation. She's the brains, he's the brawn. Together, they come up with many nefarious deeds and are always into mischief.
Guess at 4 months
Maybe at about 6 months
I tried to find them homes but there were just no suckers available at the time and it didn't help that the girl developed hemorrhagic diarrhea just a few days after I found them then the boy had tooth issues and had to have that corrected. Additionally, they fell in love with Tag, my older Border collie mix who was found in the same place and he really enjoyed having them as well since he was missing his hero and companion, Bogie, who died last year.
It took quite some time for me to settle on suitable names and they came about partially because I found myself saying, "I guess maybe I'll just keep them" so often. The male became Guess and the female Maybe. It has been a lot of fun messing with people and the names plus the pups themselves make me laugh; something I really need right now.
They have the most fun hiding their toys from each other, jumping in the swimming pool, dragging off the huge water buckets, digging holes in various and sundry places, and just running around. They are very large dogs, I never expected them to grow quite that much! At 8 months, he is 92 pounds and she is 74 pounds. Here is a picture of his paw in comparison to my hand when he was only 4 months old. The next one is my ~50 pound dog and my 15 pound dog. It'll be interesting to see where he stops!
I was amazed at how much they have changed from the first pictures. I still don't have any really good pictures of them because they won't be still. Although they were definitely not a planned addition to the family, I am not at all sorry that they came. They have been far too much fun to have around.
Surprise
I want to start with a comment on irony. I appreciate the comments on the last post and just thought y'all might be amused to learn this about me. The first job offer I had came from the man where I did my terminal preceptor. I turned it down for several reasons but probably the biggest was that his wife did the grooming / was office manager, his sister-in-law was the receptionist, and his niece worked in the kennel. I've always had worries about such strong family oriented businesses. You know, you feel like you may become part of THE FAMILY from which there is no escape... My first job turned out to have similar issues since the stepdaughter was the office manager unbeknown to me at the time of accepting the position. The wife in that situation was the ultimate boss, too, even though she didn't work there physically. I have known the people where I work now for years and never would've guessed that this would happen. I do, however, have a very current resume and am keeping my eyes / ears open. Unfortunately, I won't be able to do much in the immediacy due to the necessity of being home but.....
Thought I would share a fun surgery story. We inherited a client who has a young Yorki that was diagnosed with a cruciate rupture at another local veterinarian's office. The owner took time off work then found that the other vet wouldn't be able to do the surgery during that time so she called my boss who told her that we could take care of it. I examined the dog who did have a beautiful cranial drawer on the right leg then anesthetized it. All I can say is that it is a good thing I'm comfortable with improvisation.
I approached the leg as I would to perform a lateral suture but stopped because with the leg completely relaxed I could actually feel the patella (kneecap) and it was sitting on the medial aspect of the leg with the tibia rotated medially and neither would move to the correct position. I then altered my approach slightly and found that the cruciate ligaments were intact and there was absolutely no patellar groove in the femur. Instead, there was a mound of bone and the tendons were so contracted that the patella couldn't even be moved into an appropriate alignment.
Instead of a CCL repair, I got to create a new groove for the patella, transpose the ligament to a correct position thereby straightening the tibia, and then tighten the joint capsule so that it would all stay put. It was rather fun for a change although I prefer soft tissue surgery over orthopedics, hands down. My reason? Probably partially because I'm more comfortable with it but also because I find that no matter what I do, orthopedic surgery turns into hamburger and I can make soft tissue procedures look really pretty... And in this case, it's not just me. My orthopedic procedures actually look a little less like hamburger than the boarded orthopedic surgeons I've worked with thus far.
I also had a lot of fun explaining all of this to the owner. I even pulled out a great knee model and was about to take her to the chalkboard painted door to draw but she stopped me... :(
The only worry I have is that the owner won't do his PT like I demonstrated because she may be afraid it hurts too much. Then I'll have another like the last FHO that has a habit of holding the leg and has now built up scar tissue. That one has been frustrating. The dog had a traumatic coxofemoral luxation that was reduced closed then failed to stay in. I was trained that if it didn't stay in well during reduction, go on to an FHO rather than waiting. In this case, it was replaced multiple times and had cross pins placed through the femoral head once but still fell apart. I then did an FHO that I wasn't 100% happy with because there was a small piece of bone I would have preferred to have removed. When I discovered this, however, it was at the post-op radiographs and the dog had great range of motion with no bone interference therefore I opted not to re-open the site. Since then, the owner failed to do the PT and now the dog has such severe scar tissue formation I don't know if we'll ever get her to use the leg properly. At this point, we are sedating her periodically to stretch the leg and break down the scarring and she is wearing ankle weights to strengthen as well as fatigue the muscles in hopes it will help. Still waiting to see what will be the final result. We almost re-operated but when we anesthetized her and took more films the bone is remodeling perfectly and with a lot of pressure we could still make the leg go full range of motion after forcing the scar tissue to give; still no bone interference.
I wish I had the capability to bring them into the office (and owners would cooperate) to do some PT myself. Time is the major factor because I would be complained at about taking so much time for what would be perceived as too little income. Especially since I think we should increase our surgery price but let it include x number of PT sessions. Oh well. No one wants to listen to the new kid especially when it involves change!
Thought I would share a fun surgery story. We inherited a client who has a young Yorki that was diagnosed with a cruciate rupture at another local veterinarian's office. The owner took time off work then found that the other vet wouldn't be able to do the surgery during that time so she called my boss who told her that we could take care of it. I examined the dog who did have a beautiful cranial drawer on the right leg then anesthetized it. All I can say is that it is a good thing I'm comfortable with improvisation.
I approached the leg as I would to perform a lateral suture but stopped because with the leg completely relaxed I could actually feel the patella (kneecap) and it was sitting on the medial aspect of the leg with the tibia rotated medially and neither would move to the correct position. I then altered my approach slightly and found that the cruciate ligaments were intact and there was absolutely no patellar groove in the femur. Instead, there was a mound of bone and the tendons were so contracted that the patella couldn't even be moved into an appropriate alignment.
Instead of a CCL repair, I got to create a new groove for the patella, transpose the ligament to a correct position thereby straightening the tibia, and then tighten the joint capsule so that it would all stay put. It was rather fun for a change although I prefer soft tissue surgery over orthopedics, hands down. My reason? Probably partially because I'm more comfortable with it but also because I find that no matter what I do, orthopedic surgery turns into hamburger and I can make soft tissue procedures look really pretty... And in this case, it's not just me. My orthopedic procedures actually look a little less like hamburger than the boarded orthopedic surgeons I've worked with thus far.
I also had a lot of fun explaining all of this to the owner. I even pulled out a great knee model and was about to take her to the chalkboard painted door to draw but she stopped me... :(
The only worry I have is that the owner won't do his PT like I demonstrated because she may be afraid it hurts too much. Then I'll have another like the last FHO that has a habit of holding the leg and has now built up scar tissue. That one has been frustrating. The dog had a traumatic coxofemoral luxation that was reduced closed then failed to stay in. I was trained that if it didn't stay in well during reduction, go on to an FHO rather than waiting. In this case, it was replaced multiple times and had cross pins placed through the femoral head once but still fell apart. I then did an FHO that I wasn't 100% happy with because there was a small piece of bone I would have preferred to have removed. When I discovered this, however, it was at the post-op radiographs and the dog had great range of motion with no bone interference therefore I opted not to re-open the site. Since then, the owner failed to do the PT and now the dog has such severe scar tissue formation I don't know if we'll ever get her to use the leg properly. At this point, we are sedating her periodically to stretch the leg and break down the scarring and she is wearing ankle weights to strengthen as well as fatigue the muscles in hopes it will help. Still waiting to see what will be the final result. We almost re-operated but when we anesthetized her and took more films the bone is remodeling perfectly and with a lot of pressure we could still make the leg go full range of motion after forcing the scar tissue to give; still no bone interference.
I wish I had the capability to bring them into the office (and owners would cooperate) to do some PT myself. Time is the major factor because I would be complained at about taking so much time for what would be perceived as too little income. Especially since I think we should increase our surgery price but let it include x number of PT sessions. Oh well. No one wants to listen to the new kid especially when it involves change!
Friday, October 7, 2011
Work Grumps, Case Themes, and a Little Whimsey
A little grump, a little whimsical; just a mishmash of goo this morning...
I'm sure I've mentioned that the boss now has his wife working as receptionist. It started as a temporary measure while the kids' class schedule prevented having someone there in the morning for a couple of hours. Because none of the kids were working out well up front and they failed to alter their schedules, it became a full time problem. Now, we have hired another person, who I like so far, to work part-time receptionist and part-time in the "middle."
The whole situation has exploded in a way. This will probably be confusing, but I'll try to explain what is happening. One of the kids is the cousin of the licensed tech who is currently out on maternity leave (second daughter born via C-section last Monday, 10-3, healthy and everyone doing well). Originally, she wanted to be a veterinarian. She has failed to work out well in any position and has already decided she doesn't want to be a veterinarian but a vet tech. She started out as a receptionist and, not only were we frustrated constantly but we were also getting constant complaints from the clients. Her kennel weekends stink; animals aren't properly taken care of and she just doesn't seem to care. We've moved her to kennel in the afternoons, thinking it might help but she also doesn't seem to care in that position either. I guess I should add that she's terribly inconsistent. On rare days, she does well but those are few and far between. Her cousin, just before going on maternity leave, told her she would be taking over the "middle" position. This tends to be the coveted post because it is viewed as getting to do more cool stuff. First, her cousin spoke completely out of turn, not even consulting us. Second, supposedly her cousin understood that her performance was not acceptable but chose to tell her that anyway. Third, she is definitely not the person we would place in that position.
At our recent office meeting, I spoke of many of these problems then intended to pull all 3 of the kids aside to speak in private but haven't been able to for multiple reasons. This child is one of those personality types that I really fail to comprehend (it's going to be very difficult for me to talk to her) because they seem to never recognize when they do something wrong and blame it all on others. In my opinion, she needs to go but I've also said that since her first weekend when she left the hard to handle dog in a cage with no care and never called anyone about it all weekend. Unfortunately, I don't have this authority. In lieu of that, I can and have significantly cut her hours. If there is failure to improve they will drop more.
Of the other 2 kids, one does a decent job up front but gets overwhelmed rather easily. Besides, she's the best in the kennel and to pitch in for pretty much any job. The third was banned from the front quickly. She does okay in the kennel but isn't great at pitching in to help with other things. When I need another set of hands, I can never find them when she's working.
Our new person is doing well up front, picking up quickly, and I have no major complaints yet. She seems to care and looks for ways to help and make things run better. She has had some experience in the past and helps in the "middle" as well. Which brings me back to the wife. She's still hanging on and won't go to the planned schedule or ever let us know things in advance like when she needs a day off so that we can plan for coverage. I've inherited planning the schedule but yet certain people are off limits.
Having the wife there is like having Dianne reincarnated but 1000 times worse because she is the wife so what do you say about it? Dianne was a close personal friend of the boss, which was bad enough, but now it's family... She takes messages and we never get them, doesn't pull charts, doesn't let us know things, etc. etc. etc. The other recurrent theme is appointments being set during the 12-2 period that is "lunch." The boss is almost always out for the full 2 hours. I rarely leave the building but use the time to catch up. Charts, phone calls, client instructions, dropped off patients that haven't been checked yet, surgery that ran over, etc. It's also the time I typically use to see employee pets if needed as well as anything that may be needed on my herd. Lunch for me usually doesn't happen or consists of nibbling cheddar cheese while doing one of the above tasks. Every once in a while I'll run out and grab something or take recycling or deposit my check but it's just not the norm. Because of this, suddenly there are routine appointments being taken during that time. (Don't misunderstand, emergencies are always accepted but routine stuff is usually set around that opening or told to drop off.) The end result is that I'm now staying late on an almost daily basis to finish what I couldn't finish during lunch.
I'm going to relate a conversation that occurred last week between myself and the wife (there's a cartoon version of it...) I was examining a dog before anesthesia for surgery. Wife: Scooby ---'s mom called, he has tapeworms and she wants to pick up medicine. Me: That's fine, just pull the chart for me. Wife: The groomer saw the tapeworms. Do you still need the chart? Me: Yes, please pull it. Wife: He is seen here routinely. Do you still need the chart? Me: Yes. I need the chart! (Inside my head I'm saying "JUST PULL THE DAMNED CHART!!!!!") Bear in mind, too, that this was also after the office meeting in which I enumerated "pull the chart" to the point of redundancy. That's what I mean; we have rules and ways the clinic is run but they apparently fail to apply to the wife.
The other major aggravation with work is that I do not feel that I can trust anyone (including the boss) to actually properly care for the patients. The only problem is that I can't be there 24/7 myself. So what am I to do? I hate leaving critical patients on my day off because they typically are worse when I go back and usually because of something that was done with which I don't agree or because something that was instructed was not done... Not only can I physically not be there and control the situation but it is also unfair to my kids. Plus there is all the stuff at home that I have to do. I went to a meeting at AVMA about managing your time and the top recommendation was to delegate. How do you delegate when there is no one you can really trust to do what you ask and do it right? (By the way, I also feel that I should state that although I have perfectionist tendencies and am very hard on myself I am not nearly that hard on others.)
The other fun part about having the wife around is that their son-in-law has started vet school this year. I've determined that she must be a very insecure person because she takes everything poorly and gets really defensive and seems determined that she has to outdo on everything. The son-in-law failed to obtain admission to the school where I went which was "his dream" per mother-in-law. I'm probably being judgmental but what I've known of the young man was not impressive. He seemed very lazy to me and I find it frightening that he suddenly decided to become a vet after his fiance said she wanted to be just like her mom (i.e. get a college degree, marry a vet, and live as a kept housewife.) It affected me much like the 2 students I knew as an intern who said the reason they went to vet school was that it seemed like "something they could do." When asked if they were glad I was told no that it had been too much work but that now they were in debt too far to change their minds. (Maybe I'm wrong to have issues with these viewpoints. I just know how hard of a time I'm having when I have such a passion for what I'm doing. Maybe it's easier when you don't...) Anyway, sorry about the rabbit trail, back to the story. Apparently the fellow made the highest grade on the first anatomy exam and was one of only 2 A's on some other exam therefore the wife has been compelled to tell me all about how wonderful he is doing, etc. and how sorry the other school should be that they failed to accept him. Although they keep saying that they do not intend to return home, I have a hard time seeing through my cynical viewpoint that someone who has not had to work for anything (dad-in-law, my boss, paid for his undergrad after he forfeited a scholarship elsewhere and is paying for his vet school) will want to actually work for a living when he could come sponge, oops, I mean work for, his dad-in-law. Sorry, the whole situation tends to annoy me. Maybe I'm jealous because I had to work so hard for it all.
The summary of all of the above is that work right now is driving me out of what little mind I have left.
As usual for me, I am working on themes with my patients. I've never been sure but I've often wondered if this happens so that I can really, really get the hang of something. Lately it has been penis / preputial issues and cats with high liver enzymes for no apparent reason. First there was a youngish dog whose penis was constantly protruding. I determined that the preputial orifice was too large allowing the skin to roll and entrap the penis. The second was a 7.5 week old puppy with the opposite problem. The end result on him was that his urine was collecting within the prepuce causing constant irritation, inflammation, and intermittent infection. A little plastic surgery on both resulted in cessation of their clinical signs. I know that I mentioned the first cat with the huge ALT. He went home eating, no more vomiting, value back to normal, and hasn't looked back. I now have a cat in the hospital who presented for decreased appetite and vomiting also. He is a little icteric. Total bili was 4.5, ALP=715, ALT not readable. No history of toxins, etc. Nothing I have found yet to aim at but started him on IV fluids and, ironically, he ate voluntarily shortly after being left in the hospital... Cats. Go figure. Still don't know what his outcome will be but I was encouraged by his eating. It was really funny because the good kid was going to syringe feed him just to see if he'd take it and not vomit. She accidentally shot the food out into the cage and he promptly set about eating it. Maybe he was afraid she'd shoot him next if he didn't. I may make a cartoon out of that, too...
On a whimsical note, I was reading the funny named pets commentary in the DVM magazine and it prompted me to share a few of my own. I tend to name things fairly regular names then give funny nicknames. I also have several really boring names but they came that way. My poodle Buddy came named. He has picked up the nicknames Budda Boo (his belly is chubby and reminds me of a Budda belly), Cujo (he tried to eat Can't Spell way back when), and Einstein (he's incredibly smart and has the wild hair to go with it.) Sam is a Shepherd / Collie mix who gets called Sam Bones, Sam Baloney (private eye), and J.P. O'Hairy (after J.P. O'Hara the sheriff who struts a lot in the John Wayne movie El Dorado). I have a Border collie named Indiana Jones who is usually called Indy. He lives with an ancient Chow / Rottie mix who is red and came to me with the name of Chief. Often the pun is made "Indy & Chief" which sounds like Indian Chief. We also often say Chief Red Dog. My flat coat retriever cross that died a couple of years ago was named Flash after the Basset hound in The Dukes of Hazzard. We called her Flash LaRue most often but also Flashley (silly joke based on Gone with the Wind in which we thought it funny if Melanie and Ashley had ran past each other in the post-war reunion scene). Scout is a Jack Russell terrier cross. He answers to Squirt and I call him the Da-Chi Terror, which he loves, because he looks like a Dachshund, Chihuahua, Jack Russell mix. Mollie, my Border collie who died, always prompted me to burst into song with one of the "Molly" songs. Yoda gets called "Yoda-man" quite often and Thumper is "Thump-Thump" with referral to Pirates of the Caribbean when Jack asks where is the thump-thump. Probably more ironic since he was named for the rabbit in Bambi. I know I'm leaving many out but those are the ones that came to mind at the moment.
With the constant frustration right now, I find that turning to silliness allows me to cope a little better. It has resulted in lots of new cartoons, plenty of sarcastic comments at work, and just some plain old goofiness. We have painted the kennel door with chalkboard paint which has been a fun outlet at times. I also saw a great T-shirt that I want. It said something to this effect, "Text messaging in the 1800's, . _ . . _ _ _ . _ . ." That is Morse code for "LOL." And, yes, I did look it up to make sure it was correct:)
I'm sure I've mentioned that the boss now has his wife working as receptionist. It started as a temporary measure while the kids' class schedule prevented having someone there in the morning for a couple of hours. Because none of the kids were working out well up front and they failed to alter their schedules, it became a full time problem. Now, we have hired another person, who I like so far, to work part-time receptionist and part-time in the "middle."
The whole situation has exploded in a way. This will probably be confusing, but I'll try to explain what is happening. One of the kids is the cousin of the licensed tech who is currently out on maternity leave (second daughter born via C-section last Monday, 10-3, healthy and everyone doing well). Originally, she wanted to be a veterinarian. She has failed to work out well in any position and has already decided she doesn't want to be a veterinarian but a vet tech. She started out as a receptionist and, not only were we frustrated constantly but we were also getting constant complaints from the clients. Her kennel weekends stink; animals aren't properly taken care of and she just doesn't seem to care. We've moved her to kennel in the afternoons, thinking it might help but she also doesn't seem to care in that position either. I guess I should add that she's terribly inconsistent. On rare days, she does well but those are few and far between. Her cousin, just before going on maternity leave, told her she would be taking over the "middle" position. This tends to be the coveted post because it is viewed as getting to do more cool stuff. First, her cousin spoke completely out of turn, not even consulting us. Second, supposedly her cousin understood that her performance was not acceptable but chose to tell her that anyway. Third, she is definitely not the person we would place in that position.
At our recent office meeting, I spoke of many of these problems then intended to pull all 3 of the kids aside to speak in private but haven't been able to for multiple reasons. This child is one of those personality types that I really fail to comprehend (it's going to be very difficult for me to talk to her) because they seem to never recognize when they do something wrong and blame it all on others. In my opinion, she needs to go but I've also said that since her first weekend when she left the hard to handle dog in a cage with no care and never called anyone about it all weekend. Unfortunately, I don't have this authority. In lieu of that, I can and have significantly cut her hours. If there is failure to improve they will drop more.
Of the other 2 kids, one does a decent job up front but gets overwhelmed rather easily. Besides, she's the best in the kennel and to pitch in for pretty much any job. The third was banned from the front quickly. She does okay in the kennel but isn't great at pitching in to help with other things. When I need another set of hands, I can never find them when she's working.
Our new person is doing well up front, picking up quickly, and I have no major complaints yet. She seems to care and looks for ways to help and make things run better. She has had some experience in the past and helps in the "middle" as well. Which brings me back to the wife. She's still hanging on and won't go to the planned schedule or ever let us know things in advance like when she needs a day off so that we can plan for coverage. I've inherited planning the schedule but yet certain people are off limits.
Having the wife there is like having Dianne reincarnated but 1000 times worse because she is the wife so what do you say about it? Dianne was a close personal friend of the boss, which was bad enough, but now it's family... She takes messages and we never get them, doesn't pull charts, doesn't let us know things, etc. etc. etc. The other recurrent theme is appointments being set during the 12-2 period that is "lunch." The boss is almost always out for the full 2 hours. I rarely leave the building but use the time to catch up. Charts, phone calls, client instructions, dropped off patients that haven't been checked yet, surgery that ran over, etc. It's also the time I typically use to see employee pets if needed as well as anything that may be needed on my herd. Lunch for me usually doesn't happen or consists of nibbling cheddar cheese while doing one of the above tasks. Every once in a while I'll run out and grab something or take recycling or deposit my check but it's just not the norm. Because of this, suddenly there are routine appointments being taken during that time. (Don't misunderstand, emergencies are always accepted but routine stuff is usually set around that opening or told to drop off.) The end result is that I'm now staying late on an almost daily basis to finish what I couldn't finish during lunch.
I'm going to relate a conversation that occurred last week between myself and the wife (there's a cartoon version of it...) I was examining a dog before anesthesia for surgery. Wife: Scooby ---'s mom called, he has tapeworms and she wants to pick up medicine. Me: That's fine, just pull the chart for me. Wife: The groomer saw the tapeworms. Do you still need the chart? Me: Yes, please pull it. Wife: He is seen here routinely. Do you still need the chart? Me: Yes. I need the chart! (Inside my head I'm saying "JUST PULL THE DAMNED CHART!!!!!") Bear in mind, too, that this was also after the office meeting in which I enumerated "pull the chart" to the point of redundancy. That's what I mean; we have rules and ways the clinic is run but they apparently fail to apply to the wife.
The other major aggravation with work is that I do not feel that I can trust anyone (including the boss) to actually properly care for the patients. The only problem is that I can't be there 24/7 myself. So what am I to do? I hate leaving critical patients on my day off because they typically are worse when I go back and usually because of something that was done with which I don't agree or because something that was instructed was not done... Not only can I physically not be there and control the situation but it is also unfair to my kids. Plus there is all the stuff at home that I have to do. I went to a meeting at AVMA about managing your time and the top recommendation was to delegate. How do you delegate when there is no one you can really trust to do what you ask and do it right? (By the way, I also feel that I should state that although I have perfectionist tendencies and am very hard on myself I am not nearly that hard on others.)
The other fun part about having the wife around is that their son-in-law has started vet school this year. I've determined that she must be a very insecure person because she takes everything poorly and gets really defensive and seems determined that she has to outdo on everything. The son-in-law failed to obtain admission to the school where I went which was "his dream" per mother-in-law. I'm probably being judgmental but what I've known of the young man was not impressive. He seemed very lazy to me and I find it frightening that he suddenly decided to become a vet after his fiance said she wanted to be just like her mom (i.e. get a college degree, marry a vet, and live as a kept housewife.) It affected me much like the 2 students I knew as an intern who said the reason they went to vet school was that it seemed like "something they could do." When asked if they were glad I was told no that it had been too much work but that now they were in debt too far to change their minds. (Maybe I'm wrong to have issues with these viewpoints. I just know how hard of a time I'm having when I have such a passion for what I'm doing. Maybe it's easier when you don't...) Anyway, sorry about the rabbit trail, back to the story. Apparently the fellow made the highest grade on the first anatomy exam and was one of only 2 A's on some other exam therefore the wife has been compelled to tell me all about how wonderful he is doing, etc. and how sorry the other school should be that they failed to accept him. Although they keep saying that they do not intend to return home, I have a hard time seeing through my cynical viewpoint that someone who has not had to work for anything (dad-in-law, my boss, paid for his undergrad after he forfeited a scholarship elsewhere and is paying for his vet school) will want to actually work for a living when he could come sponge, oops, I mean work for, his dad-in-law. Sorry, the whole situation tends to annoy me. Maybe I'm jealous because I had to work so hard for it all.
The summary of all of the above is that work right now is driving me out of what little mind I have left.
As usual for me, I am working on themes with my patients. I've never been sure but I've often wondered if this happens so that I can really, really get the hang of something. Lately it has been penis / preputial issues and cats with high liver enzymes for no apparent reason. First there was a youngish dog whose penis was constantly protruding. I determined that the preputial orifice was too large allowing the skin to roll and entrap the penis. The second was a 7.5 week old puppy with the opposite problem. The end result on him was that his urine was collecting within the prepuce causing constant irritation, inflammation, and intermittent infection. A little plastic surgery on both resulted in cessation of their clinical signs. I know that I mentioned the first cat with the huge ALT. He went home eating, no more vomiting, value back to normal, and hasn't looked back. I now have a cat in the hospital who presented for decreased appetite and vomiting also. He is a little icteric. Total bili was 4.5, ALP=715, ALT not readable. No history of toxins, etc. Nothing I have found yet to aim at but started him on IV fluids and, ironically, he ate voluntarily shortly after being left in the hospital... Cats. Go figure. Still don't know what his outcome will be but I was encouraged by his eating. It was really funny because the good kid was going to syringe feed him just to see if he'd take it and not vomit. She accidentally shot the food out into the cage and he promptly set about eating it. Maybe he was afraid she'd shoot him next if he didn't. I may make a cartoon out of that, too...
On a whimsical note, I was reading the funny named pets commentary in the DVM magazine and it prompted me to share a few of my own. I tend to name things fairly regular names then give funny nicknames. I also have several really boring names but they came that way. My poodle Buddy came named. He has picked up the nicknames Budda Boo (his belly is chubby and reminds me of a Budda belly), Cujo (he tried to eat Can't Spell way back when), and Einstein (he's incredibly smart and has the wild hair to go with it.) Sam is a Shepherd / Collie mix who gets called Sam Bones, Sam Baloney (private eye), and J.P. O'Hairy (after J.P. O'Hara the sheriff who struts a lot in the John Wayne movie El Dorado). I have a Border collie named Indiana Jones who is usually called Indy. He lives with an ancient Chow / Rottie mix who is red and came to me with the name of Chief. Often the pun is made "Indy & Chief" which sounds like Indian Chief. We also often say Chief Red Dog. My flat coat retriever cross that died a couple of years ago was named Flash after the Basset hound in The Dukes of Hazzard. We called her Flash LaRue most often but also Flashley (silly joke based on Gone with the Wind in which we thought it funny if Melanie and Ashley had ran past each other in the post-war reunion scene). Scout is a Jack Russell terrier cross. He answers to Squirt and I call him the Da-Chi Terror, which he loves, because he looks like a Dachshund, Chihuahua, Jack Russell mix. Mollie, my Border collie who died, always prompted me to burst into song with one of the "Molly" songs. Yoda gets called "Yoda-man" quite often and Thumper is "Thump-Thump" with referral to Pirates of the Caribbean when Jack asks where is the thump-thump. Probably more ironic since he was named for the rabbit in Bambi. I know I'm leaving many out but those are the ones that came to mind at the moment.
With the constant frustration right now, I find that turning to silliness allows me to cope a little better. It has resulted in lots of new cartoons, plenty of sarcastic comments at work, and just some plain old goofiness. We have painted the kennel door with chalkboard paint which has been a fun outlet at times. I also saw a great T-shirt that I want. It said something to this effect, "Text messaging in the 1800's, . _ . . _ _ _ . _ . ." That is Morse code for "LOL." And, yes, I did look it up to make sure it was correct:)
Tuesday, October 4, 2011
Coda
I loved reading May B. Insane's previous post- it was a lot of fun bringing these wonderful dogs to their new sucker, er, person. I see both of them almost every day and continue to be amazed at the personality Maddie displays- hers is truly a complex psyche.
So Insane has been bugging me to blog recently. Since I now work in The Most Boring Job a Vet Can Have I don't really have much good blog fodder. I'm sorry, what can I blog? "Today I saw a few thousand dead pigs..." But as Insane's previous post relates, sometimes we do see or hear of good stories.
On a previous weekend I was in the town I used to practice in and ran into an old client. I had seen her old, geriatric Min Pin named Layla a few months after I started working at that practice in 2008. At that time Layla was about 12, diabetic, and was in end stage congestive heart failure. She had marked ascities, crackles, and exercise intolerance despite being on a high lasix dose, enalapril, and spironolactone. She would hardly lift up her head as I examined her one afternoon.
Now "The Book" calls for an echo to evaluate heart function before placing any animal on any kind of positive ionotropic medicine, and I agree with this. However, as so often in private practice, "The Book" comes up against "The Client Has No Money" and the client with a sick pet will always win. So, while warning Layla's owner about the dangers, I started her on Vetmedin, a veterinary only heart drug that is kind of a mixture of a positive ionotrope and something else I forget right now... (this is what happens when you don't use information- it floats away).
Two months later this dog was eating and barking again. Against all odds she had improved that much. Now, three years later she is 15 years old and on a cornucopia of medications daily but runs, barks, eats, plays with her sisters, and is a happy dog. I have Layla's owner much more time than she could ever hope for. Sometimes that's a nice feeling.
So Insane has been bugging me to blog recently. Since I now work in The Most Boring Job a Vet Can Have I don't really have much good blog fodder. I'm sorry, what can I blog? "Today I saw a few thousand dead pigs..." But as Insane's previous post relates, sometimes we do see or hear of good stories.
On a previous weekend I was in the town I used to practice in and ran into an old client. I had seen her old, geriatric Min Pin named Layla a few months after I started working at that practice in 2008. At that time Layla was about 12, diabetic, and was in end stage congestive heart failure. She had marked ascities, crackles, and exercise intolerance despite being on a high lasix dose, enalapril, and spironolactone. She would hardly lift up her head as I examined her one afternoon.
Now "The Book" calls for an echo to evaluate heart function before placing any animal on any kind of positive ionotropic medicine, and I agree with this. However, as so often in private practice, "The Book" comes up against "The Client Has No Money" and the client with a sick pet will always win. So, while warning Layla's owner about the dangers, I started her on Vetmedin, a veterinary only heart drug that is kind of a mixture of a positive ionotrope and something else I forget right now... (this is what happens when you don't use information- it floats away).
Two months later this dog was eating and barking again. Against all odds she had improved that much. Now, three years later she is 15 years old and on a cornucopia of medications daily but runs, barks, eats, plays with her sisters, and is a happy dog. I have Layla's owner much more time than she could ever hope for. Sometimes that's a nice feeling.
Monday, October 3, 2011
Happy Endings; New Beginnings
I thought that I would give y'all an upbeat post as a relief from my gripes and whines of late and before I start on the next bunch...
This past weekend, my friend Can't Spell and I arranged a half way meeting to bring to conclusion the great puppy exchange. At this point I think we have saturated with pets the poor sucker who is Can't Spell's friend that lives near her. I must say I cannot complain at all about the home; these babies are loved and spoiled, what more could I ask?
First was Maddie, the flea allergy dermatitis hound whose story I related recently. Here is a picture of her at the clinic the day she was brought in to be euthanized.
Maddie was taken to her new home in July as I went to AVMA. Her new owner had casually mentioned that she might be in the market for a puppy as a companion for Maddie recently therefore when Lilly came through the front door, I asked if she would be interested. To my surprise, she said yes. As you can appreciate from the picture, Lilly was in pretty bad shape. As I mentioned previously, she had gone from a bouncing healthy 5 pound puppy a month before to a malnourished 6 pounds with severe sarcoptic mange. She was dehydrated, not eating, and her eyes were matted closed because of the oozing from her skin.
So on Saturday, October 1, the girls met for the first time. Here they are in the parking lot at PetSmart. Look how good Maddie looks!! She has a healthy and full coat of hair. She seemed so happy and, while acknowledging she knew me, did not seem overly excited to see me. If anything, she seemed a little nervous that I might take her away again. The puppy was thrilled to meet a new dog and new people. She was particularly thrilled that Maddie allowed her to chew on her tail and legs and feet...
Don't they look happy?
This past weekend, my friend Can't Spell and I arranged a half way meeting to bring to conclusion the great puppy exchange. At this point I think we have saturated with pets the poor sucker who is Can't Spell's friend that lives near her. I must say I cannot complain at all about the home; these babies are loved and spoiled, what more could I ask?
First was Maddie, the flea allergy dermatitis hound whose story I related recently. Here is a picture of her at the clinic the day she was brought in to be euthanized.
Maddie was taken to her new home in July as I went to AVMA. Her new owner had casually mentioned that she might be in the market for a puppy as a companion for Maddie recently therefore when Lilly came through the front door, I asked if she would be interested. To my surprise, she said yes. As you can appreciate from the picture, Lilly was in pretty bad shape. As I mentioned previously, she had gone from a bouncing healthy 5 pound puppy a month before to a malnourished 6 pounds with severe sarcoptic mange. She was dehydrated, not eating, and her eyes were matted closed because of the oozing from her skin.
So on Saturday, October 1, the girls met for the first time. Here they are in the parking lot at PetSmart. Look how good Maddie looks!! She has a healthy and full coat of hair. She seemed so happy and, while acknowledging she knew me, did not seem overly excited to see me. If anything, she seemed a little nervous that I might take her away again. The puppy was thrilled to meet a new dog and new people. She was particularly thrilled that Maddie allowed her to chew on her tail and legs and feet...
Don't they look happy?
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