Tuesday, January 17, 2017

The Drug Epidemic

Everyone seems to be talking about it, even this recent election, it was an important topic in states like New Hampshire.  When most people think about drugs, they think about marijuana, or heroin.  What is really becoming a problem though is prescription pain killers.

Some veterinary clinics have actually been held up at gunpoint, so that people can steal controlled substances, including ketamine, from clinics.  Clinics and hospitals follow policies set out by the DEA, or drug enforcement administration.  Every drug that comes into a clinic is accounted for and every drug that goes out is also accounted for.  Some clinics have chosen not even to carry the drugs that are more likely to be abused, seeking instead to write prescriptions so that clients can purchase them from a drug store and take them out of the paperwork (and risk) of having such drugs in stock.  It's unfortunate, because sometimes these drugs can be very helpful for pain injections and not having them in a clinic can make it difficult to treat extremely painful patients, such as those hit by a car or spinal traumas.  If the clinics don't have adequate pain medication, the patient will be referred to a place where they do.  There is a certain amount of security risk, and risk to the staff with having controlled substances.  Like any profession, there can be people who abuse controlled substances and that is why people get background checks and even random drug testing when they work with them.

The more difficult aspect of veterinary medicine and controlled substances is the policing of people who might be abusers.  Every time I get a prescription request or a refill request for a controlled substance or substance that can be addictive, I have to meticulously go through the file and do calculations and math to make sure that we aren't giving extra refills.  I have actually had people say they need Xanax (an anti-anxiety medication) for their dogs for thunderstorm anxiety and have calculated out that from the time it was dispensed last to the time they need a refill there would have been a thunderstorm on a daily basis.  There are other pain medications we have to be careful of too.  Sometimes it's just a simple matter of doing math and sometimes it just requires you to have an extra "sense" and see how people respond when you suggest alternatives for their pet rather than controlled substances.  I have to say that these conversations are about as difficult as talking to an overweight person about their overweight pet (AWKWARD).  Sometimes pharmacists and veterinarians work together to do the math and there are now new laws that require new prescriptions for any controlled substance, rather than just being able to call it in.  I've worked at places where they have worked in conjunction with police for people who are nefarious and actually steal prescription pads or falsify information in order to get a hold of drugs.  It's really rather sad and it's a side of being a veterinarian I did not think I signed up for when I graduated.  Hopefully, as a culture we can get a handle on the drug problem and help those who have been hurt by this addiction and who hurt others, including their pets who don't always get the pain meds they deserve.

Friday, January 13, 2017

Service and Working Dogs

I have written previously about service and working dogs and what a wonderful job they do and also about some of the abusers.  Sometimes people think its "easy" to spot people who have "fake" working dogs.  Just remember, working dogs can do several different things other than leading the blind and helping the physically disabled.  They can help military veterans with PTSD, help anticipate diabetic and epileptic crises and so much more.  I once treated a dog who was a bed bug detector.  She was a rescue from a shelter in the south (shelters in the south of the US have the highest number of dogs killed for lack of homes) and she was worth over $40,000 because of her bed bug detection skills.  I also have met a dog who did four tours in Afghanistan and saved an entire Ranger Battalion from dying from an IED, thankfully due to his nose and sense of detection.  It's amazing what dogs can do!

Dogs have the capacity for loyalty that I think most humans are not capable of, they can persevere in situations along with our most hardened soldiers and come back home to retire as the most humble house dogs.

Even dogs with very little training can help their owners when they come back from situations they don't want to talk about.  Dogs don't ask 50 questions- they are just present and they always seem to know when to offer a paw or a shoulder.  There are several organizations that help military personnel when they are away on duty to all parts of this world and can't take their dog with them.  Many personnel have family members or friends take care of their dogs, but sometimes they don't have these resources available.  If you are considering not having a dog because of the commitment, etc, consider fostering a dog through one of these organizations.  You could truly help someone have peace of mind about their best friend when they are away and provide them with comfort when they return.

I have no preference between the following organizations, please look into them and their references before considering:

dogsondeployment.org
4 Nonprofits
List of a variety of nationwide and local groups
Guardian Angels

Tuesday, January 10, 2017

Post-Christmas Examination

I listened to a good podcast earlier this week, a Podcast called "Homemakers By Choice".  The title of this episode was called, "Feelings After Christmas".  I have to admit even though my family stretches out Christmas to Epiphany, it felt like it went by too fast and I had a sadness in taking the tree down and putting the decorations away.  There is a certain amount of "letdown" the day after Christmas.  The point of the podcaster was the focus of our Christmas and focusing on that little baby Jesus for more than a day.

Earlier this week, I had one of those uncomfortable moments in the car with my son- one of those moments that I had anticipated would happen more in his teenage years, than at the age of three.  I'm not sure exactly how it came up on our commute home.  We had about an hour in the car and I normally like to keep the conversation light and talk about the number of airplanes we see, or boats in the river, or other things like that.  He blurted out, "Jesus isn't my friend."  I tried not to slam on the brakes, or go into immediate crisis mode that my three year old was battling with atheism.

Whoa.  I think I may have said that.  I then tried to go into everything my husband and I taught him, "Jesus loves you, he cares for you, etc."  Nope.  He was certain.  Jesus was not his friend.  I questioned further.  "He doesn't like that I got so many presents at Christmas.  He told me I should give some presents away."  I tried to decipher how he had this conversation with Jesus.  Apparently he talked with Him before Christmas, in our house.  I tried not to get wrapped up in the details.  My son then told me that the "big boy baseball mitt" he had for asked for (and gotten) from Santa should be given away to another boy.

Apparently the giving tree at Church had left an impression on him, and I'm not sure exactly how, but he thought he had gotten too many things for Christmas and that Jesus was disappointed in him and he should give more to others.  I treaded lightly, but was impressed by his thinking.  He went on to say if Jesus loved him, "Mommy would sleep in my room at night."  I went on to tell him that Jesus loved him and that is why Mommy would NOT sleep in his room overnight.  Jesus loved him so much, he wanted him to be safe and grow into a big, strong, courageous man, which means sleeping in your room with Jesus looking on.  That's about where that conversation stopped.

This weekend, my husband and I went on a great date to a theater to see a comedian.  The theater was part of a new entertainment complex that was built in our area, everyone was dressed up fancy and there were a lot of wonderful new restaurants and sparkly decorations and glamour and glitter that comes from a brand new mega-complex.  We had a great time, and it was a lot of fun, but people weren't "joyful".  They were happy and having fun- but I did not find joy.

The juxtaposition to that trip was the next day when we went as a group, Lay Dominicans and their spouses (and my 3 year old) to a Hospice House.  We came bringing some goodies and someone brought music and we took all of our 3 year old's musical instruments and dispersed it throughout the crowd.  We sang several Christmas Carols, ending with "We Three Kings" as it was Epiphany Sunday.  Those people were joyful.

But most of all was the older woman who we went down to where she was, bedridden.  Initially, I couldn't tell if she was happy or annoyed by our presence, but when my son went over to her and shook her hand, I could tell she was smiling and watching her try to belt out, "Silent Night" with us showed me such joy.  Joy that doesn't come from sparkles, glitter and Christmas decorations.  Joy that comes from knowing our Savior Jesus Christ was born for us from Mary on that Holy Night.

That night, my son said singing at that House was his favorite part of that day and that was a fitting end.  I no longer felt "cheated" out of Christmas.  That was the Joy I had been looking for.

Friday, January 6, 2017

The Importance of Regular Exams- for your pet's health- and your wallet

I see a lot of patients who only come in for vaccines and in dogs, if they are only get Rabies and Distemper Vaccine (not Lyme, Lepto, Bordatella and Flu which are also recommended vaccines dependent on your dogs lifestyle).  Or people who only bring their cats in for Rabies vaccines every 3 years.  Sometimes these people think the only thing veterinarians are for is for vaccinating their pet and euthanizing at the end of their life.  They really don't understand that just like regular tune-ups for your car, or taking good care of your health, an ounce of prevention is worth a pound of cure.

I have seen patients that come in to get vaccines, but I end up diagnosing serious illness, such as cancer or immune mediated disease that the owner had no idea about.  When we diagnose these diseases BEFORE they have to go to the Emergency Room, we could help them save thousands of dollars, or give them extra time with their owners instead of "suddenly" dying at home.  Every exam I go into, I go into with an open mind.  I do not vaccinate until I examine the eyes, ears, joints, abdomen, heart and lungs.  I sometimes will go into an exam for vaccines and inform an owner that their dog is blind, has a serious ear infection, or could benefit from a change in diet or an over the counter medication for allergies or another disorder the owner wasn't even aware of.  If we diagnose these problems early, it can not only improve the pet's quality of life, but also the owner's pocketbook.  If 1 year of a dog's life is equivalent to about 3 years of a humans, it's not unreasonable as they get older that we perform exams and bloodwork annually or semi-annually.  One of the things I appreciate about being a veterinarian is it is not cookie-cutter.  I could go in to vaccinate a dog and instead end up having a wide variety of conversations, putting on my oncologist, dermatologist or cardiologist hat and changing from a general practitioner who vaccinates to a diagnostician that investigates.  In someways, with people not being aware of what is going on with their pet, I can amaze them by saying, "I bet your dog chews its paws a lot, right?" or picking up on other signs that there is something going on, "does your dog stumble" and then telling them, "No, your dog hasn't become klutzy, she's lost her eyesight."  Keeps every day interesting.  So please, consider taking your pet in regularly, it's not for us to earn more money, it's for your pet to stay healthy in the long-run.

Tuesday, January 3, 2017

My New Year's Resolution

So it's that time of year and everyone's making resolutions.  I had pretty much came up with "Live healthier and eat better."  Lent is kind of when I make the more "spiritual" types of resolutions.  This year though, I will be making a more spiritual type of resolution at this time of year.  My resolution is to stop focusing on efficiency and start focusing on randomness.

That probably seems very counter-cultural, so please let me explain.  I want to be more open to those life-changing moments that don't change my life.  Yes, you read that right.  I want to be open to those moments in my life that may seem mundane but that could completely change someone else's life.  We have just passed through the time of the year when, "It's a Wonderful Life" is constantly on TV.  I'm sure I'm not the only one who wonders after watching that movie what would happen if God (or an angel as in the movie) went through replays of our life.

I'll be honest- for every one person I've helped, maybe there's been 3 people I've annoyed?  Hopefully the 3 will forgive me and move on and as I become more wise and self-aware it will be less....  But it's kind of like that Starfish analogy-


A man was walking along a deserted beach at sunset. As he walked he could see a young boy in the distance, as he drew nearer he noticed that the boy kept bending down, picking something up and throwing it into the water. Time and again he kept hurling things into the ocean. As the man approached even closer, he was able to see that the boy was picking up starfish that had been washed up on the beach and, one at a time he was throwing them back into the water. The man asked the boy what he was doing, the boy replied," I am throwing these washed up starfish back into the ocean, or else they will die through lack of oxygen. "But", said the man, "You can't possibly save them all, there are thousands on this beach, and this must be happening on hundreds of beaches along the coast. You can't possibly make a difference." The boy smiled, bent down and picked up another starfish, and as he threw it back into the sea, he replied 

"Made a difference to that one"
There have been a couple of circumstances in my life and even some this year- where I have had the privilege of finding out something I did or said actually had life-changing consequences for someone else.  In the interest of privacy, I won't share all the specifics, but just some things to trigger a memory and awareness of your own- what a difference you can make.
I convinced someone long ago with a late night conversation in a language that wasn't even my own to stay in veterinary school.  After she graduated, she wrote me and said, "Thanks for talking to me and telling me to hang in there."
Providing reference letters and mentorship to other people, just like others have done for me and even providing a reference for someone to retain custody of their child.
Instead of hurrying through a transaction, stopping to answer someone's question about enrolling in school and sending them to a place where they could have a job that would not only give them experience but would pay for school.  This was an interaction I didn't think much of until later when their new employer thanked me for sending them a great candidate.
More often than I admit to myself, I sometimes feel an inner pull to do something or say something- sometimes I'm off on my intuition, but sometimes it is exactly the right moment and  both myself and the other person believe it's a "God-incidence" instead of "coincidence".  So this year, I vow to listen to my inner voice, take more time to slow down and reach out to others and be less efficient for my needs and more giving to others.
Hello- 2017, Goodbye "efficiency" and maybe someday I'll get to see some other consequences of my actions and I will continue to pray that I will bear fruit for "Him who strengthens me".
If God replayed your life and the consequences of your actions, what would you see?

Friday, December 30, 2016

Three Kings

One of my favorite traditions passed down from my family has been keeping the Christmas decorations (and tree) up through Epiphany.  Who wouldn't like Christmas being a little bit longer,  especially when there's not really anything exciting going on in January?

The celebration of Epiphany is when the Christmas season ends and we celebrate the arrival of the Three Kings arriving to adore Jesus.

Many people would be able to tell you about the gifts they brought, can you?  Gold, Frankincense and Myrh.  I just recently found out the significance of Myrh.  Gold and Frankincense I think are easy things to think of as Kingly gifts, but Myrh?

Myrh was present at the beginning and end of Jesus' life.  I'm certainly not a Bible scholar, but the more I learn, read and actually absorb, the more intriguing it is that parts of the Christmas Story are precursors for the Easter Story.  Myrh gum comes from the resin of trees and like the gift Frankincense could be used as a perfume.  At the beginning of our Lord's life, Myrh was a gift, at the end, it was present at his Crucifixion, death and burial.  These characteristics of Myrh I was aware of previously, the characteristic I learned of recently is one that piqued my interest as a veterinarian.

Myrh was used as treatment for intestinal parasites.  Wow!  That's kind of cool for this nerdy veterinarian and it also makes sense that this would be a gift for a baby, to help protect and keep a baby healthy.  There are other items in the Bible that refer to intestinal parasites, such as the reason pork was not allowed for the Jewish people to eat.  There was actually human health and infectious disease logic behind some of these Biblical directives.

Sorry if the above grosses you out, but it's definitely a different factoid about Epiphany than what you will find in most places, so consider yourself prepared for Jeopardy!

Tuesday, December 27, 2016

The Three Year Old's Mind...

That's a loaded topic.

My son varies from humoring me to making me feel guilty just by sharing his perceptions of things.

He asked my husband over and over in different ways at Mass why Joseph and Mary were Jesus' mommy and daddy and why he was born in a manger.  My husband's response- "Because God wanted it that way."  That was a final word that didn't get questioned, I wish I could use that on his many, "But Why's"

After Mass, as we were sitting in the living room after my son had put the baby Jesus in all the nativity scenes, he started playing with his Fisher Price Nativity Scene.  Oblivious to us, he started doing dialogue that we tried to follow along.  At one point, the Virgin Mary was on top of the Manger, in the spot where the Angel was supposed to be.  My son, pretending to be Baby Jesus, (yes, this is sacrilegious, but take it with the mind of a three year old) was waahing and crying, "Mommy, please come down,"  apparently Mary was saying, "I want to sing and be an angel".  Baby Jesus informed Mary several times that she was not an angel, she was a mommy and she needed to stop singing and get down and be with him.  A little later, as the shepherds, Three Kings and Holy Family all crowded around to see the Baby Jesus, Baby Jesus asked them all to leave because he needed to be alone...  Historically inaccurate, but still a cute scene and if playing this scene makes my son realize that Jesus came down to Earth to be one of us, mission accomplished.

Now for the guilty part.... I periodically multitask to the detriment of getting things done (and to letting the dog back in).  This doesn't work well with a dog who doesn't bark.  While it's wonderful that I don't have an obnoxious, barking dog, sometimes I wished he barked as a form of self-preservation.  Over a month ago I left Dewey in the rain during the afternoon, got distracted and moved onto something else.  My husband came home, he eventually asked, "Where's Dewey?"  I realized I had left him outside and at this time, it was dark.  My husband asked, "Why did you leave Dewey outside in the dark?"  Apparently over a month later it left an impression on my son since he asked, "Why did you leave Dewey outside in the rain in the dark?"  I was adequately guilted again and my husband defended me with, "sometimes people get busy and they forgot things, but don't worry, mommy won't leave you outside in the dark with the lights out."