Judge less you be judged...

So I found myself having a hard time recently with trying my best not to judge a client.

It's kind of hard when the information you have is the following: bought an expensive purebred dog- didn't want to pay for spaying and taking care of said dog and allowed dog to become neglected to the point that the lack of grooming was causing the dog to be deaf and have an infection and by the way, because she's not spayed, I will probably be seeing her again in a few months because the owner doesn't want to pay to spay her.  Ugh!

This does not break client confidentiality, as the above is a case I've seen play out multiple times, with multiple different people of different backgrounds.  The only reason we sometimes see these cases is because the holidays are coming up (Such as Christmas and even Super Bowl Sunday).  People don't always directly say it, but I think they are embarrassed to have guests come over to the house and see what condition they are in.  This is a sad circumstance.  I'm sure there are lots of pieces of information I don't know about circumstances and mitigating factors, but it still gets to me.  I try to educate people and I try to do it with charity, but when at the end of telling them how to take care of their dog, they just look at me blankly, it gets frustrating.

On the other end of the spectrum, there have been people sometimes that pleasantly surprise me.  One young mother I remember ,who after finding out the family dog had diabetes, turned to her son and said, "Well, it looks like we won't be able to go to Disney this year after all."  Not only did she make the decision to give up the trip to Disney to pay for the care of her "family member", she made sure her son knew that it wasn't a choice.  You take care of your responsibilities and you take care of the pets that you choose to welcome into your life, even if it means you give up a much wished for vacation.  I made sure I let her know I admired her parenting.

There was another person today who I commented how nice it was to see a parent teaching the right message.  I've had people ask me to be quiet in an exam room so they can answer their phone, or leave the room to answer the phone or to mindlessly look at their phone and play games while I am trying to explain something.  Today, I had a woman and a little girl and the little girl interrupted when I was talking with her to tell her she had several text messages on her phone.  The woman looked at her daughter and said, "We are at the doctors, we are listening to the doctor and those people can wait, put the phone away."  Wow!  I need to hear that myself sometimes, it was great seeing someone teaching her daughter to respect others time.

I will try not judge and try not to get angry with people.  During a time after I dealt with the first situation described, my husband asked how my day was going, I responded with, "I wish some people could be re-incarnated as a neglected pet."  I do not wish that truly, but I wish people would think more about neglect and that it isn't just starving your dog, there are many other forms.  That said, my dog could use a few extra back rubs and my husband reminded me that my dog could also get bathed more frequently as well...

Like A Refreshing Spring

We had a great vacation.  You may have noticed I was on vacation because of the technical glitch on my last post.  We had a great time with my family at our  cottage in Michigan.  We also had a great time with friends I don't get to see very often and both of their babies.  One of my friends had a 1 1/2 year old I hadn't met yet and the other one had a 9 month old I had not met yet.

These friends are both very special to me in different ways.  One is a devout Catholic ,while the other family's members are devout non-denominationals.  Both of them are the type of friends that when you leave you feel better about yourself and about the world.  This is important in times like these.  In times when all of us aren't really thrilled about our political choices or the direction our world may be going.  It was also refreshing to get to a place in the country where churches are common and it's ok to leave your doors unlocked in the driveway, run around in your bare feet and hold opinions that are proudly displaced on billboards that would not be seen in more politically correct areas.

It's also refreshing to be with parents who are going through the same struggles- getting your toddler to eat, potty training, manners and balancing work and family.  As one of my friends said, "it's not healthy to be isolated, but sometimes it's too easy to become isolated."  I yearn for a time when my friends and I may live close enough together I could go over to their house and enjoy a glass of wine on the porch every night and discuss our problems, joys and hopes.  For now, I will settle for every so often, but perhaps someday, our paths will be closer.  Until then, I hope to be a better friend and enjoy the refreshing spring of friendship whenever my path can lead back to it.

I also found myself praying easily with both friends- I think I kind of surprised my husband when I went into spontaneous prayer with my non-deonominational friends (still beginning and closing with the sign of the Cross) and ending with "In Jesus' name, Amen".  I guess I've picked up the different languages of different forms of prayer and the different vocabulary we all use to say, "Please and Thank you" to our Lord.  Even as grown-ups we need to still remember to do this and I'm ever so grateful for wonderful friends who make this journey a little more interesting and a little lighter load.

Multitasking

Multitasking

I've been told Moms are good at it.  I'm not really sure that's true.  I think the only reason people say that is we are forced to attempt it.  The results don't always equal success.

As a veterinarian, I have to multitask.  I have to triage- A medical term derived from French where you divvy up your responsibilities into; going to die if I don't help, going to live for at least a while if I don't help or going to die no matter what I do.  In an emergency situation this skill is important to prioritize what you address first.   I found myself once getting screamed at by an irate person because her precious bulldog who ate a large steak bone (which she gave it) was going to have to wait because I was in the midst of chest compressions on a dog that a team of five of us were doing CPR on.  Her response to my, "ma'am, please wait so we can save this dog's life," was, "But I was here first!".  Hopefully, her dog never needed CPR even though it might of made her understand the absurdity of her statement.

I often have to multitask professionally- the dog or cat comes in for vaccines and I find it has anemia, and an ear infection, and most importantly to some, needs its nails clipped.

Medical priorities and priorities of pet owners don't always go in-sync.  I don't know how many times I have talked with owners, told them there dog only has a few more days to live and they jump on getting their dogs nails clipped because they are already at the clinic and it's convenient.   I do try to treat the whole dog and all the problems though, even if that means doing a little extra work so that dog or cat with terminal cancer or kidney disease doesn't have to deal with the additional discomfort of a urinary tract infection or ear infection.  It's just hard sometimes as we often have many balls in the air.  Often people come in as "emergencies" or "walk ins" and we have to juggle those patients with those we already have on the schedule or find extra time (often during lunch) to do procedures that have to be done for the animals health and comfort and can't be put off another day.

Okay, so professionally I don't have much control over multi-tasking, but personally I do.  I would like to take a journey to do less multi-tasking and more "focused sprints", meaning small periods of focus to get the job done.  I will try to report back on how this journey goes.  What might have been my epiphany, you might ask?  I found myself walking my dog back to our hotel room not remembering what I did to the hotel key.  While I was walking my dog I was simultaneously thinking about everything I had to do and trying to figure out how to get my phone back in the Internet to publish this blog and at least two other things.  I left the key on the grass when I picked up my dogs waste, apparently.  Luckily I found it and all is well but it made me think about how ridiculous and truly non-helpful multitasking can be.

Then as I was chastising myself I was thinking about multitasking being similar to how us Moms overload our purses.  I try to clean mine out regularly but my husband still makes fun of it...that is... Until we found ourselves in the airport and my son was insisting we purchase orange juice and the only bottle they had was a ridiculously tall one that would have ended up spilling all over my son and my husband looks at me like I'm crazy.  Then I pull out a straw from my purse. "You carry a straw in your purse?" He asked.  "Yep, for moments like these".  An orange juice and toddler crisis averted, I think my husband had slightly more respect for my purse that day.  Maybe I shouldn't beat up on the multitasking mommy bag traits I have after all.

Lights Out

I read a book a little bit ago  called "Lights Out: A Cyberattack A Nation Unprepared Surviving the Aftermath" by Ted Koppel.  For anyone with a little extra time on their hands or who likes to read about disaster preparedness or who thinks our country is heading to a cataclysmic event, I would recommend it.

I was intrigued by it because I have often thought how our society has become so dependent on the internet and electricity.  Between staying in third world countries, a early history with camping and even staying a brief time on a farm that operated without modern conveniences as a child, I have come to appreciate electricity, but also understand that one doesn't have to be entirely dependent on it as an individual.

As a society, we are incredibly dependent on it.  From banking to communication and healthcare and more, we cannot exist as a society without it.  Ted Koppel's book is quite fascinating and a little bit alarming too.  The ease with which hackers, especially foreign-government associated hackers could take out our power system, and the lack of protective policy or support from our government that he lays out, is frightening.  I try to block that from my mind.   He stated that, in the event of a catastrophic shutdown of our power grid, it could take two years to get it back online and probably only 2 in 10 Americans would be able to survive a year.   There are just too many things in this world we can't control.

Some of my respect for rugged individualism also was reignited.  Only 2 in 10 of us could survive what our countrymen's lifestyle was just a little over a 100 years ago.  My fear and anxiety over a power shutdown then made me put energy into a disaster preparedness kit and thoughts of what my family would be able to do.  I think my husband thought I was going crazy as I read this book and came up with ideas for survival.  It doesn't hurt to have a plan, right?  I talked with my fellow garden partner about the scenario.  I informed her that both of us would be a desired commodity in this scenario, we both had medical skills, knew how to garden and enjoyed eating vegetables.  Our husbands, in the real estate field and public policy field who were meat eaters might have a hard time.  She joked that we wouldn't have to nag them about eating junk food anymore.

Reading the book made me think a little about disaster preparedness, followed by don't worry too much our fate is in God's hands followed by I look at my every day life and imagine how I would do things without electricity.  I think overall it was a good read for the summer and something we might all benefit from reading and pondering.  Let's hope that it stays theoretical.

Perspective

Here in the Mid-Atlantic, the heat index was approaching what I used to experience in Arizona.  My husband had been complaining about "Big Blue's" (our Subaru) air conditioner not working like it should.  I guess I didn't fully grasp it until I drove it yesterday and was HOT.  Our heat index today was supposed to be in the weather alert range.  I told my husband that, because he was driving with the toddler, he got the air conditioner today and I got the hot commute over an hour away in a car with a malfunctioning air conditioner.  Knowing that it was going to be an uber hot day, I also needed to get to the garden to water it because my garden buddy was out of town.  I got the skimpiest outfit I could find and that is what I was planning to get through my drive in and then change into professional clothes at the clinic.

My cat has been kind of finicky with her food the past couple of days, so my husband and I have been monitoring her.  Literally as we were leaving the house for work she profusely vomited all over the dog's favorite dog bed, multiple times.  While I whisked her up and isolated her and the dog in the basement for the day, my husband dealt with the bedding and then I realized that I had vomit on my shirt.  I changed my clothes, rushed to get to the garden, lugged around 50 feet of hose and watered it as much as I could for 15 minutes and then rushed into an hour of traffic jam.  If I was working at a clinic closer, or had a car that had working air conditioning, I would have brought her with me and ran tests, but I made the difficult decision that I thought the risk of her getting sick from the driving conditions was worse than the risk of her being sick all of today.

I got to my workplace and the parking lot was full.  I knew something was going on.  I ran to the back to change my clothes and noticed a surgery was going on.  The clinic cat, who looks strangely like my cat (just 10 pounds bigger) was getting emergency surgery for an abdominal mass.  She's two years younger than my kitty.  I kind of had a moment of freaking out about my cat back home.  Just like my kitty, her symptoms started with being finicky and a little bit of vomit.

I went to the bathroom and went to change my clothes and let's just say someone had left it a mess.  I won't get into details.  I then rushed to see my first appointment, which had fleas all over.  The day went on with me just not catching a break.  It ended in a cute puppy visit.  I even remarked to someone "yay, I get to end the day on a happy note," but then I found out that the other puppy in the family was deathly ill from parasites and may not make it.  So much for the happy note.  Earlier during the day, I found out my favorite gelato was on sale at CVS.  I bought a pint.  I cajoled my fellow workers into finishing off the top 1/4, so it wouldn't melt all over the car.  I figured, yes, I probably shouldn't eat a 1/2 pint of gelato- but in weather that feels like 110 degrees, the laws of nutrition don't apply and I wasn't doing it in front of my son so I didn't need to worry about the example I was setting.

Just as I was thinking about how rough my day was, (alternating with appreciation of my pseudo air conditioning of gelato) I come home and hear on the radio what happened in France.  At the writing of this, there are not many details known.  I feel great sadness, once more for the French people.  But I know I am grateful for the fleas, anal gland and other grimy aspects of my job because I am fortunate, fortunate to have a job, a family and a country that will hopefully continue to fight evil.

Thank you to our Men and Women in Blue

I am grateful for our police.  Now that's not to say that every police officer is perfect, free of racism and doesn't abuse power.  I have run into a few who have not stood up to the standards we expect of them.  But that can be said of everyone.  I am not a minority and so I can't speak to all the politicization of stuff out there and I don't want to.  I do want to be grateful for the people who keep us safe and prevent all of the people with bad intentions from causing us harm.

When I was younger, I did not have as many favorable interactions with police, but now that I'm older (and wiser), I see that the biggest way their work effects us is in the way we DON'T see what they do.  Being blessed to live in a neighborhood where I've only had to call the police for graffiti and a scammer, I don't see crime, I don't live in fear (my large dog also helps with that I admit.  I think he's more effective than most security systems).  The absence of it though is something that can be taken for granted.  If I lived in a different community, I would see more what the police were and were not doing, it would probably be more obvious.  But rest assured, if there were no police, we would all be living in anarchy.

I don't want to get into the politics, I don't have the energy for fighting and I can see truths on both sides of the equation, but I have been blessed to know that, overall, police officers are good and when they are not, they are people who are imperfect, just like all of us.  I have tried not to watch the news too much.  From being a girl who was once a complete news junkie, I am trying to back away little by little and protect my son from learning too early about the imperfect world he lives in.  We let him have glimpses of sadness and people making the wrong decisions, but I'm fine with him for now thinking that a gun is a toy in Colonial Williamsburg and not an instrument of something more finite. At least for now.

This weekend, as I felt overwhelmed by the news and the politics I too my son for his first trip over to the police station.  We took cinnamon rolls and cupcakes and we said, "Thank you".  When everything is overwhelming, sad and despairing, it's time to step back and be grateful for those who do their part to make our world a safer place.

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Garden Update

This is going to be a fairly brief post as we've been busy, busy, busy with travel.  With a journey to Atlanta for my in-laws and then another one to Michigan next week, we are either in the process of packing or unpacking at any given time.  Thankfully, I have an awesome garden partner who apparently isn't taking much vacation this summer.  I'm also on my way to the DMV next for a much unwanted wait in line.  Aah, government bureaucracy....

I took some pictures of our awesome jalapeño plants that are already producing ample jalapeños.  This is the first time I have grown them and they are awesome, either in a homemade salsa or in eggs for breakfast.

Our potatoes look like they might be petering out, so I think we are going to pull them and eat them before they all die and maybe try to do another round.  I'm looking forward to the tomatoes and tomatillos and am disappointed that all of my cilantro has perished in this heat, but I can't blame it.  It has been hot!  My garden buddy actually said she thinks our tomatoes are getting too much nitrogen from the thunderstorms, they are practically bionic : )

Enjoy the pictures and I will take a picture when I can make fresh salsa from garden-grown tomatoes, tomatillos, jalapeños (sadly not garlic and cilantro as planned).  Better luck next year with those, or maybe they just don't do well around here in July...

Our First Crop of Jalapeños

4th of July and Dogs

When we think of 4th of July, we think of Independence, Fireworks, hot dogs and family and friends.  Veterinarians add on anxiety and fireworks injuries to the mix.  Whether it's a dog biting some homemade fireworks (because it can be a fear response to go after something so loud and exciting like that) or a dog eating drywall, 4th of July can present some health challenges.  Add on the fact that it's a holiday weekend, and I'm just happy I'm not working in the emergency room anymore.


The following link shares some information regarding throwing balls in the park.  
CBS Story on Tennis Ball Bombs
You also want to be careful with sparklers and  "Bang Snaps"  with young dogs.  Young dogs are often adventurous and don't know better than to chase after things that make noises and put them in their mouth.

Regarding Firework/Thunderstorm Anxiety:

This is the time of year when it feels like we are writing prescriptions for dozens of anti-anxiety medications for dogs whose fear of fireworks varies from trembling and whining to breaking through drywall and escaping...  Sometimes dogs only have thunderstorm anxiety, but often dogs are afraid of loud noises in general.

Please talk with your veterinarian whether your dog's case is severe or not.  It's a good thing to have this conversation.

There are some homeopathic remedies that can help.  Rescue remedy is one I have heard of some people having success with, as well as Zylkene and Solliquin.  These are over-the-counter medications.  We also have the ability to use prescription medications (such as doggy/kitty valium) and even doggy prozac.  Signs of anxiety include drooling, inability to rest, panting heavily, as well as whining.  If this is something that can be of help to your dog/cat, please let your veterinarian know.

There are also behavioral modification techniques that can be used when there are no thunderstorms or fireworks in the immediate future.  These involve playing music/CDs with the offending noise and while continuously keeping your dog calm, slowly increasing the volume and reassuring your pet.  Sometimes you can also train your dog to go to a "safe spot" either a kennel or interior bathroom where they will feel safe and confident.

Have a safe and happy 4th of July, from my four-legged and two-legged family to yours : )

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My recent encounter with human healthcare

I have joked with my husband that there must be an alert on my file with doctors.  Sometimes, some places I've worked at have put a special indicator on files, either because the dog bites or the person is "an acquired taste" or sometimes it will be bluntly posted "PITA" or "don't bend over backwards for this person."  I have a lengthy history with the human medical field and misdiagnosis.  I kind of learned some, "what not to do with bedside manners" and "it's better to not know an answer than to make one up."

Most of the time being high maintenance is a good thing, you get answers from people and you protect yourself.  There have been multiple times where I have caught mistakes and I know that when someone is asking questions and being proactive it can help in the ultimate outcome.  The third leading cause of death in the US is medical error.  That's rather sad, but for a variety of reasons it happens.  That's why if you ever have concerns, don't be afraid to speak up.  Caring doctors, nurses and veterinarians don't have a problem talking through things and making sure all their i's are dotted and t's are crossed.

I've been having some issues lately and thought (as well as my doctor, my friend who is a doctor  and a specialist) that I could have had kidney stones.  I was in immense pain, but did I go to the ER?  No, my experience with ERs kind of scared me away.  From medical mishaps, to waiting for hours, I will try to avoid the ER.  I was almost wishing today though that I was a dog.  As I told my husband, if I was a dog, I would have received more prompt, efficient treatment.  Instead, I'm a human, navigating a bureaucracy.  My doctor last night told me I needed a scan to rule out kidney stones.  I called first thing this morning and got an appointment with a physicians assistant.  She said, no, I don't think you have kidney stones, but I'd like you to see the urologist, and if you can't, let me give you a big shot of something because you look like you're really sick.  Comforting.  I then waited and felt like junk in the waiting room of the urologist, feeling fortunate they could squeeze me in.  The urologist went back to the original, "I think it's a kidney stone but you should probably go to the ER because you will get everything taken care of a lot faster."  In my experience, ER and fast are not two things that go together.

Anyways, I got to thinking of how veterinary medicine is more efficient.  Of course, we don't have human health insurance and all the paperwork that goes with it, but we also are trained as doctors to not punt everything to someone else.  Unfortunately, veterinary medicine is changing away from this "general practitioner" model and into a "punt to the next person model."  Sure, I like punting my surgery cases and really frustrating cases to specialists.  There is a role for specialists, but there is also something to say about efficiently managing a case and not making people go to the ER to not have to wait in a waiting room (Newsflash: they will still wait in a waiting room).

So, while I will wish I was a dog and could get efficient healthcare from a veterinarian, I also recall times where I run late because of a difficult case or trying to squeeze someone in and my patients and clients have to wait.  I will also try to remember quite often I don't know and can't find out the answer and that's why medicine is an art and not a science.  Hopefully, like 30% of my patients who don't have a diagnosis, I will just go ahead and get better on my own, independent of having an "answer".