Tuesday, January 31, 2017

Behavior Issues

One thing I've learned from being a parent and being a veterinarian is the Winter Time Blues.  Whether it's an obnoxious dog or an obnoxious toddler, if you find yourself with an annoying, rambunctious mammal, it's probably because they haven't been getting enough exercise or time outdoors.  This is the time of year when dogs come in (and some cats that are used to being outdoors) with cabin fever.  They've had so much pent up energy they haven't been able to release that they release it on you- by jumping, knocking you over, or just shaking their bodies uncontrollably.  My three year old takes it to a different level and has been known to slide along the hardwood floor in his socks and throw baseballs violently.  I will tell owners- you need to give your dog more exercise, as they talk about how annoying their dog is.

One of the first things I've taught my husband about dog ownership is if the dog is being annoying, it's most often not the dogs fault, it's your fault for not giving it enough exercise.  This could apply to kids too.  A couple of days ago, we had a beautiful day and I took my son to the park.  He then decided he wanted to go to another park and he practically ran the whole way there.  At Mass the other day, he used me for a jungle gym for half of Mass and the older women behind us remarked that they would like half the amount of energy that he had.  Yes- I think we are getting to that time of year where I need to watch my patience.  It's that time of year when it seems like my son is driving me nuts and I take him out- either to Chick Fil A or McDonalds or pretty much anywhere that has an indoor playground (or maybe the trampoline park again?)  Unfortunately they don't have those indoor playgrounds for dogs- so maybe my dog needs a trip to doggie daycare.  Anywhere would be helpful, to get out that wintertime blues and to have fun, instead of being annoyed with Cabin Fever.

Thursday, January 26, 2017

Crazy night...

I have had a couple of recent conversations with veterinarians about how we sometimes interact with others and just can't understand how they aren't very adaptable.   You mean you can't deal with sudden change?  With a problem that suddenly comes up and changes what you are doing, how you are doing it and the time you have to do it?  Yes, all of us vets have agreed, we have learned to be adaptable.

You can be in the middle of a wonderful sweet puppy exam and you have a dog that comes in unexpectedly in heart failure, or more dramatic, a dog that has been hit by a car with traumatic injuries.  Your brain goes from talking about brushing teeth and vaccines to dosing pain meds and assessing if the pet needs CPR.  There's nothing like going from 0 to 60 mph in your brain.

Yes, as I congratulate my profession at our adaptability, I sometimes come home and have to remind myself to be adaptable.  It's a good characteristic to have with a toddler, and I think I am fairly adaptable to his moods, desires and 0 to 60 personality.

The other night, I had to remind myself to be adaptable.  I wasn't treating a dog in trauma, there was no life or death incident, it just wasn't how my husband and I wanted our evening to go.

After a pretty nice "hang out day" with my son, my husband got home late from work and we were starving, it was close to 8pm.  We had a good dinner although it was fairly rushed.  Due to how late dinner was, we decided our son could forgo the bath we had planned.  As we were trying to get him ready for bed, the dog needed to go out.  As I was trying to get my son ready, I hear my husband calling that there is something wrong with the dog.  All I heard was "He's stuck in the raspberry bush".  I come down stairs and see my dog circling around under a low-lying tree with grapevine growing over it.  Apparently he was refusing to come inside for my husband.  I tell my husband to attend to our son and I'll try to figure out what's going on.  I find an old pair of shoes and go outside and also experience I have difficulty getting the dog inside.  He's circling around and acting like he wanted us to see something.  "Oh great", I say to myself, "I hope it's a kitten he's found and not some other form of wildlife."  As I search for a flashlight and realize the first two I picked up don't have batteries, I hear some type of smoke detector/alarm going off (like it ran out of a battery).  My husband's looking for batteries and I'm trudging out into the yard in the mud to some unknown discovery.  "Yep, this is definitely not how I wanted to spend this evening.  Be adaptable," I remind myself.

I go outside search the area my dog is interested in and to my relief do not see anything gross or really anything at all.  It's pitch black.  I decide maybe my dog is interested in something on the other side of the fence and if he still wants to show it to me tomorrow in daylight, I will go beyond the fence to investigate.  Rather than wrestling with a dog in the mud (we all know where that was headed), I quickly ran upstairs and got a buffet of different treats to bribe my dog with.  It worked.  He came inside.  My husband and I went through the house looking for the affected smoke detector (It wasn't easily obvious and reminded me of why firefighters always say to change ALL your detectors each daylight savings time).  I think I will take an abdominocentesis over a smoke detector hunt anyway...

Tuesday, January 24, 2017

Helpful for a little one at Mass

Just as I was worrying about my son's spiritual health in a previous post, I got the news from my son's teachers, "You must take him to church regularly, he had a quite a lengthy conversation with a couple of teachers about Mass, genuflecting and lifting the wine cup.   Just in case you think he's not paying attention, he actually is!"

That statement was encouraging.  I almost think my son used to pay more attention at Mass a while ago and now has just become so antsy it's hard to keep him still.  For Christmas, my son got the "Missal for Little Ones" from Ignatius Press from my mother-in-law.  Two weeks ago, he used it and had us follow along with him.  He was very engaged and was trying to kneel, stand and move around along with the appropriate parts of Mass.  Prior to Mass this week, he asked for a cup and a napkin and on his own asked to re-enact some parts of Mass.  Of course this week was a little harder at Mass and I had to tell him he needed to be quiet or else I would take a toy away if I had to haul him to the back of the Church.  In his defense, we went to Mass at a later time and he was tired and hungry.  It was a last resort for me to use a "stick", but all the "carrots" I had offered were just not enticing enough to keep him from screaming.  Oh well.  We are a work in progress, I'll take the victories and small moments I can get and I will keep bringing the Missal to Mass with us.

Friday, January 20, 2017

Busy and Historic Day

Busy and historic day for our country.  Sorry I didn't blog sooner, but I was too busy driving 9 hours in a car with a toddler.  Yes- I am certifiably crazy.  May fill you in more later on that one, but for now, let's just say a prayer of peace and hope for our nation during these historic times.

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:

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?