MacGyver Style

My husband has just recently started re-watching old MacGyver reruns.  I think the combination of the remake being on and just enjoying them has rekindled his interest.  He was a little surprised when he found out how familiar I was with them.  I told him, as veterinarians, we all have a little "MacGyver" in us.  Between finances not being what they are in human medicine and making do with what you have, we also have to adapt and make do with medical devices, equipment and medicine that is primarily produced for humans.  

I also have a special link to MacGyver in that when I was in college, in order to get away from a crazy roommate, I would go to my teammate's dorm room and hang out, while she watched MacGyver.  Little did I know that this was how I would meet one of my best friends for life.  My teammate's roommate actually became a great friend who I've taken road trips with, was a bridesmaid and more.  The person (my teammate) who introduced us long ago, we have both fallen out of touch with, but we are grateful for her introduction.

There are not a whole lot of drugs and devices that are developed primarily for veterinary medicine.  There just isn't enough money to warrant the research money and production costs for a market in which some owners don't even see the importance of vaccination, let alone advancing medical procedures.

Some of our equipment and drugs are a result of things that were initially developed for humans and then just didn't work out- either because of safety concerns in humans or another reason.  Then these companies try to recoup their cost by marketing and developing it as a veterinary product.  Probably about 60-70% of the medicines we use are "off-label" in veterinary patients and are primarily human drugs.  My husband was shocked to find that out.  The FDA doesn't do studies on these drugs for animal use, they are studied for human use and then us veterinarians fiddle around with them and learn how we can use them to benefit animals.  Even medications like Viagra can have a veterinary use.  (In this case, we use it for pulmonary hypertension).  It's kind of funny to see the reactions on peoples faces when you tell them you are prescribing Viagra.

Not only do we do things "MacGyver style" with the drugs and devices we use, sometimes with surgery or bandaging or other problem solving we have to just kind of wing it.  Did you know you can put boxer shorts on a dog by putting their tail through the fly and you can use this to prevent them  from causing sores on their hind end.  Or, besides being cute, an infant's size 6-9 months onesie can help prevent that cat from licking its abscess?  Canned pumpkin and epsom salts have been friends of mine in multiple situations.  I can also get pretty creative with taping and using plastic splints.  We actually keep saws and drills at the clinic to help finagle and mold things to our individual patients.  Veterinary medicine keeps you on your toes and does require creativity, because many pets have different needs, different problems, different sizes and different tolerances.  Throw in financial concerns, and you have a recipe for coming up with some pretty interesting problem solving.  In case you were wondering, my Swiss Army Knife was a staple along with my stethoscope during my school years.

So the next time you watch MacGyver, think about your veterinarian!

Happy Galentines Day?

Apparently, I was told that Monday was "Happy Galentines Day".  Whether that's legit or not, I won't get started on it.  Friendships, particularly female friendships, are so important!  I realized a couple of things about friendship this past week.

One realization was I had gotten a spa gift card from a wonderful client last year and I haven't made time for myself to use it yet.  But when I found out one of my best friends was coming to town, I decided that rather than spend the wad on myself, I'd have so much more fun going with my friend!  My husband was a little puzzled by this decision, but I told him it's so much more fun to feel spoiled when you do it with your friend and I'd rather have fun with my friend than feel responsible for making awkward conversation...  This little trip is now something I'm really looking forward to.  It's so much more fun to do things when you do them with others.

Another realization I had is that, those friends that you have who tell you the truth no matter what, could just be gifts from God getting you back in line.  I had been procrastinating a while about doing something, I wanted to be "perfect" before I did it and my friend just blatantly called, "well if you wait for that, it's never going to happen!  Why don't you go for it and hope you improve because of it."  The statement that she made a while back was validated by someone else and they were glad I had a friend to keep me from shirking away from potential.

Lastly ,was something that happened last week that I was really touched by.  It was something I didn't share last week because it was still a little raw.  A good friend and former client of mine called me when I was coming home from working a long way away.  She called because she came home to find her pet in the process of dying.  She called me because she needed a ride to get to the emergency center.  I found myself in a lot of traffic.  You know that type of traffic that is the worst its been all week because it's the one time you need it to be not so bad?  That was the traffic I was in.  I felt bad for my friend, bad for the pet, and bad for not being able to just fly over traffic.  As I tried to console her and talk her through ways to make her pet more comfortable, I tried to ask if there was someone closer to her who could give her a ride, and I would meet her at the ER.  She went through everyone she could come up with and I was the only possibility.  I was about a half hour away and it didn't sound like I would make it to her.

As I thought, and prayed for a way to console both my four-legged friend and her, I thought of another client/friend.  She lived close to this one.  They had never met, as far as I knew.  I live in an area that is fast-paced and transient, where many people don't know their neighbors and many people are too busy with their lives to help others in simple ways.  I thought, "Well, maybe I will give her a call, she lives nearby and I know she would not want a pet to suffer."  I hadn't talked to this friend in a while and here I am, calling her to go pick up a random woman and her dying pet.  She had no qualms, she was ready to go and ready to help.  Her generosity of heart and of friendship to me and a person she had never met really made me feel that the world is a smaller place and there are plenty of us who really do care about each other.  Unfortunately the pet did not make it, but there was definitely consolation that no one was alone and everyone tried their hardest.  Sometimes that type of love is the best we can do.  Sometimes that type of love runs deeper than the valentines cookies and candies and flowers that we get sold.  Friendship is one of the deepest loves and for that I am grateful.  Happy Valentines Day!

Penny wise or pound foolish?

Penny wise or pound foolish?

My husband and I work hard to get the most for our money.  As I have blogged about before, we coupon, go for rebates and sales and do our best to make our money do the most we can.  I've even spent time talking to customer service trying to get money back or a new item for things that break (learned many of these things from my mom, that simply asking customer service for assistance can sometimes lead to great results).  We are also fortunate to have family that are generous to us (thanks grandmas for clothing our son in great fashion!)

So while we work hard to be frugal, it's easy to sometimes fall and make mistakes.  To have a rough day and think a fancy coffee will make it better, or through a lack of planning make an expensive choice out of convenience or necessity.

As my husband and I did a budget evaluation and tried to reign things in, I realized some decisions we make, we would not be able to make if we didn't have some wiggle room in our budget.  Our wiggle room mostly comes from being frugal and trying to make good choices.  While I would love to be able to buy my family's food from Whole Foods and Trader Joe's every week, I find myself shopping at Aldi and that's ok.  I would prefer to have that wiggle room for other things.  I am grateful that our frugality helps give us the wiggle room to be "extravagant" in small ways.

Earlier this week, I took my son to the doctor and when they mentioned he needed bloodwork again this year, my face showed my total terror.  Last year, we had an awful experience that involved my husband having to hold my son down, several pokes, and ultimately a technician telling us she didn't think she could draw his blood and we would  have to go to another lab anyways.  It was a horrible experience for everyone that even a cheeseburger and Kristy Kreme did not erase from our memory.  Last year ,we had been told our insurance was not accepted by the children's hospital, so our insurance wouldn't cover the bloodwork, so we went to a regular lab.  This year I asked, "how much is it if we pay for it out of pocket?"  The tech looked sheepishly at me and said, "you want to do that?"  I told her, "maybe, our insurance isn't very good so we will have to pay our deductible anyway."  As we were taking, I observed how they expertly obtained blood on a 2 day old baby.  I was convinced by their skill set.  Though it cost us a couple hundred dollars and I thought, "that's a couple extra hours at work for me," it was worth every penny.  I didn't have to restrain my child and it was just one well placed poke.  He even referred to it later in the day as, "I was scared but then I was brave and I got poked".  None of the trauma from last year, worth every cent.

On a very warm evening this week we got to go to our favorite taco place.  There is a older homeless man who normally resides on a bench on our walk there.  We try to pray for him every night and it is not hard as he shares his name with my son.  We went to eat dinner and we were happy to get 3 free tacos because we do punch cards (we use loyalty cards quite often).  As we were enjoying our tacos,  I thought of the man we were sure to pass on our way back.  I have given him warm winter socks and a McDonalds gift card previously and on this warm, blessed summer night, I told my husband I wanted to buy him a hot meal.  I went ahead and got him a kids quesadilla, not knowing his taco preferences and thinking the kids meal was actually one of the more balanced meals on the menu, my husband and I agreed.  I purchased it and when they asked me for a juice choice I automatically chose what my son likes- orange juice.  As I walked back to the table my son got all excited.  He thought the orange juice was for him, we explained to him that it was for a man with his same name, but not him, it was for the nice man on the bench.  My son processed this, got a smile and then told us how he wanted to hide it behind his back, give it to the man and he would smile.  He was excited by this thought and followed through.  Even though it was an orange juice he wanted, he was happy to give it to the man.  Later, when we got home, we gave him a special treat of orange juice (normally before bed he can only have water) and I think he was a little more grateful for that juice than what he would have been otherwise.  I was happy to spend that extra money, that was in our "wiggle room" budget to know that my son was learning a "priceless" lesson.

We will keep nickel and diming where we can as a family, but I like to think it's not "pound foolish" to spend money on those you love- protecting them from pain and discomfort or teaching them there's more to the world than themselves.  For the opportunity to do this, I'm grateful.

Veterinary Acronyms

The other night my husband asked if I was going to make it home on time.  My response, "They scheduled an ADR for my last appointment : (

A what? he asked.  An ADR stands for aint doing right; this can mean anything from the pet looked at the owner funny to it's wobbling around and on death's door.  An aint doing right or ADR is kind of like the card that you pick up in a board game that could mean you won $1,000 but most likely is going to mean you miss a turn or go to jail....

A HBC is a hit by car.  A FUO is a fever of unknown origin.  For the average layperson- a FUO means a large bill because you basically have to rule out the presence of an infection or cancer anywhere in the body.  Oftentimes, an ADR in a cat becomes a FUO once you take the cat's temperature and then it is basically a bite wound or abscess unless you can prove otherwise.

A DOA- dead on arrival.  Not a happy one.  Neither is a TTJ (Transfer to Jesus).  A GTL is similar "Going Towards the Light" or a CTD "Circling The Drain."

We have comments for temperament too, of both the patients and the clients.  DTH is Difficult To Handle (which could apply to the owner or their pet).

PITA and PIA, I'm sure you can figure those acronyms out.  Apparently our human medicine colleagues use some of the same codes, but they also use numbers and colors.  One late night I found myself in a hospital waiting to get a rabies vaccine- long story.  I kept hearing a Code 51 or some other code called out over the intercom.  One of our veterinary technicians used to be a paramedic, so she clued me in that the two codes I heard most frequently meant, "drug overdose" and "psych case". I could understand why you would call that as a vague code instead of an obvious announcement.  So now consider the above part of your "veterinary education".

Short Post Today

Sorry for the shortened post today, I've seemed to have succumbed to whatever winter virus is pretty miserable out there.  I do have my sweet little toddler to say, "Mommy I want to cough with you : )"  He sees it as a way to try to snuggle in bed (even though this is the time I feel the least snuggly).  I'll be grateful for the love and concern he does show.  See you next Tuesday (hopefully I'll be better then...)

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.

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...