Making Lemonade from Lemons....

So, it's been a busy past couple of weeks and just when it feels like we are getting control of things, something comes out of the blue to remind you you're not in control..  I guess that's life.  I will look at it though not as the world spinning out of control and anxiety, but as a reminder of the blessings we do have.  There are several stories from the past couple of weeks I could share, but I'll focus on this past week.

I was working at a place that was super busy, but I was fortunate to work with a new graduate veterinarian.  In my line of work, it is fairly rare that I get to work with another veterinarian, because most of the time I am the only veterinarian.  This isn't my first rodeo, so to speak so I can survive ok on my own, but I sometimes find myself longing for a colleague to run my case by, or pick their brain, or just lament with.  The new veterinarian was refreshing for me to work with and reminded me that if it wasn't for the prospect of going back to school, I'd have loved to teach other veterinarians (I got to do this briefly when I was on a Mission trip).  It reminds me of how much I know, how much I have learned and that I've grown in more ways than just my cynicism in the past 10 years.

It's great to work with a new veterinarian because they are fresh out of school and they want to do everything "the right way".  They haven't been jaded by years of dealing with difficult people, too many long days and nights and they still feel like they can change the world and save everyone.  It's refreshing, but it also reminds me of how much I have forgotten since veterinary school.  As the new veterinarian was about to deal with some difficult clients, one of the technicians said, "Talk to Dr. Meg- She's good at dealing with pain in the butt people."  While I think that was a compliment, I told the new vet, "I'm happy to come in with you, but I know you can handle this on your own."  She seemed happy that I had confidence in her.

Ok, now to the lemonade from lemons moment.  The new veterinarian came back to see me to go over a case.  She presented it to me and then asked for validation.  "So, the next step would be a fine needle aspirate and bloodwork right?"  I look at her and say, "yes, ideally, but what does the client want to do?"  I told her I've seen and been involved in many cases where you do diagnostics and then there's no money left for treatment.  The patient was sick and had been sick with possibly cancer for a little bit.  I told the veterinarian, "I know it's not what they teach you in veterinary school, but it's ok to offer her to try to make the patient feel better for a little bit, knowing that won't be a cure.  If the diagnostics aren't going to change what the owner does, it can be better to skip those and just focus on what you can do."  A technician was in the office with us and told the veterinarian, "oh, I remember that client, when she called she expressed that money was a concern".  The veterinarian looked at me and said, "Ok, I'll go talk with her again and present that option."  She came back in and said with a look of enlightenment, "She seemed relieved when I presented the option to just focus on treatment, she was kind of embarrassed that she couldn't pay for the diagnostics and was glad I brought it up."  The new doctor learned just like I had in the past that the things you do in veterinary skill and the things they drill into your head that need to be done in every situation do not really apply to real life all the time.  Sometimes you have to realize you can't cure everything, but you can try to make everyone feel better, at least for a little bit.  You can make lemonade from lemons or at least you can try to.

Starry Night

I love that my four year old lectured me the other night about "staying up too late". We broke his bedtime and took him to the see the starry night in the mountains at a National Park a couple hours away.   He loved it, but said it was "too late" for him to stay up.  Last year, we kept him "out late" to go play mini golf and this year it was taking a drive a couple hours away, waiting for the sun to set (even though the earth rotates away at about 850 miles an hour it feels like it takes forever with an impatient four year old).  As the sun set, there were some astronomers nearby who had telescopes (which I wanted to keep calling microscopes because I look into microscopes on a daily basis to see a different kind of "majesty".

My son got to look through the telescope for the first time and the astronomers even had a step stool for him!  We also all thought it was awesome to be able to see Saturn, complete with rings.  Staring up at the starry sky, something that is not easily done in our urban setting (If you look into the sky you see planes and helicopters).  Initially, my son was reluctant to lean back and look at the sky, he was more fascinated with the flashlight.  I think the telescope kind of roped him in (and his mom and dad as well).  To think that each light that we saw in the sky was another star or celestial feature that could hold even more planets, and even more galaxies outside our galaxy- it was magical.  My son began talking about light years and rockets and all sorts of things from his imagination  Once my son decided to lay down (I think he was worried about getting his hair wet or dirty in the grass) he snuggled up against me and we just whispered and stared at the sky.  I could tell he was getting tired, over two hours past his bedtime after a very busy day with no nap.  I whispered to him, "It's ok to close your eyes and go to sleep beneath the stars".  It was not long after that I heard the snoring begin.  I kind of laughed to myself.  There's this infinite possibility and magical-ness in the universe.  Yet, I think there was also an infinite possibility and magical-ness of the little guy snoring next to me.  I had been tripping up on the words "telescope" and "microscope" the whole night and I realized, one is the forest and one is the trees and both the macrocosm and microcosm are such blessings and fill us with such awe.  All we have to do is step aside from our busy lives and fall asleep beneath the stars occasionally.

When you're going through H--l

That is the title of what we deemed our theme song during my internship year.  My intern-mates and I learned to just keep plugging away doing our 15-20 hour days of learning how to be veterinarians.  Part of the song says, "keep on trying, you might get out before the devil even knows you're there".  I thought when my son was an infant, it was a suiting theme song for the sleepless nights (and days).  I might just make it the theme of early parenthood though.  Last night was a particularly harsh night in our household.  My skills as a veterinarian actually somewhat interplayed with my motherly skills.

Yesterday during the day, for some strange reason we don't know why, my son had a nosebleed.  He came home with his shirt to be laundered but otherwise no worse for the wear.  My husband and I have been burning the candles at both ends in both our professional and home lives currently so we went to bed early, in an effort to take care of ourselves.  We even were disciplined enough to stop the TV show we were watching so we could get into bed by 10 pm.

At around 12:45, we heard a small, plaintive cry.  I got up and asked my son to stand up and come to his door (I don't like moving around any more than I have to in the middle of the night).  As I approached his room, I could not believe that he had a small cry, his room looked like a scene out of CSI.  When a veterinarian almost feels like passing out from a massive bloody scene, you know it's bad.  I came into hug my son and felt fortunately I was wearing a T-shirt that was circa 1980 (it actually was an old T-shirt of my father's that I love to wear and fortunately, it's color was blue).  My efforts to try to get my son to lay down to help stop the bleeding (using gravity, his favorite physics concept) or to try to put pressure on his nose.  Failed.  Failed miserably.  I then just focused on calming him down and consoling him.  Ok, nosebleeds, in dogs or cats are always horrible and they always appear 100 times more horrible than they actually are.  As I was trying to assess the situation, I must have said something that let my husband know the severity of the situation, so he started asking me questions.  He asked me if I needed gauze.  Gauze?  I need a Costco supply of paper towel I may have exclaimed.  Please, please don't come in here, I told my husband.  He is rather squeamish and I did not want to have two medical cases to attend to.  Apparently being married to a veterinarian has helped my husband get a stronger constitution.  He basically just said, "Tell me whatever I need to do!"  Ice pack!  Paper Towel!  I think I may have even said, "Stat" which is a medical term for "I needed it two minutes ago!"

My son was still not receptive to the icepack or pressure on his nose.  He didn't want to lay down either because he said it would go down his throat.  He was also concerned that he was going to get blood on me, (apparently he takes after his father in this department).  I told him I didn't care and I just needed him to relax.  I had my husband call the pediatrician's emergency hotline because I was really at a loss as to how I was going to stop the spigot, so too speak.

I thought, "if he was a cat or dog, what would I do?"  Darn, I don't have medical supplies in my house, I'd squirt a little epinephrine up his nose.  Baking soda can help sometimes, but I'm pretty sure up the nose is just a recipe for a disaster sneezed all over the place.  No- I can't break open his epi-pen and no, I can't sedate my child.  I just needed to lower his blood pressure.  I snuggled him and though things did not stop, they were slowing down.  I spoke with the pediatrician and she told me to be concerned about the amount of blood loss.  I know that it takes a lot to bleed out the nose- it looks horrible and it goes everywhere but be it a 10 pound cat or a 30 pound human, a nose bleed is typically not fatal.  She also told me I needed to hold him down and apply pressure.  Well, as I said previously, the only thing that did was raise my son's blood pressure and make everyone more of a mess.  I felt bad ignoring the advice of a doctor who I had just woke up in the middle of the night, but I thought clearly this person has not tried to reason with a four year old at 1:00 in the morning....

In order for a blood clot to form, there has to be slow movement of blood.  That's why sometimes blood clots form in places where you don't want them to (the brain, heart, the leg) when people aren't moving around or getting good blood flow.  Try keeping up with a four year old, it's difficult for a blood clot to do.  If an animal (or person) has a wound, pressure needs to be applied or something needs to happen to "plug the flow".  Pressure is normally the best thing to do, but when you're not able to apply pressure, slowing down the movement of the blood helps.  It's kind of like if you have a dam that is about to break, having a spillway helps take the pressure off the dam, thus lowering the blood pressure, slowing the flow, allows more time for the "construction crew" or the blood clot to come in and repair.  Fortunately, mothers have an innate calming effect and can help lower their offspring's blood pressure.

I asked my son if he wanted ice cream.  Ice cream?  Yes, ice cream at 1:30 in the morning.  My husband happily obliged (I think he may have been excited I was sending him away off the battlefield).  My son happily ate ice-cream and the coldness in his mouth was in close enough proximity to his nose that it did help to constrict the vessels and slow the bleeding.  As things were looking better and I was thinking a trip to the hospital may not be imminent, my husband asked what should be done next.  The laundry and crime scene I told him could wait for tomorrow, but I wanted our son to sleep in bed with us so that we could keep a close eye on him and make sure the dam didn't break again.  I don't know why I thought about it at 1:30 AM, but I told my husband, "Don't worry about the laundry, I will do it in the morning, but can you please change our sheets?"  I think initially he wasn't exactly sure where my priorities were, but you have to understand, we just got these wonderful, luxurious sheets for our 5th anniversary, I didn't want them wrecked.

As my son improved and was even starting to reach the Land of Nod.  My husband, the man who couldn't even stand thinking about blood when we were dating had put nice dark blue sheets on our bed.  Even though I told him he could sleep in another room, so he wouldn't be put at risk or a recurrence, we all slept a blissful 4 hours of sleep.  When you're going through H--l, remember principles of physics, and that you might get out before the devil even knows you're there.  Oh and I do now have some epinephrine on hand....

Anger Management

The other day after my son and I were coming back from an enjoyable adventure at "Book Park" in a part of town we only get to maybe once a year (it's full of bakeries, coffee shops and over-priced stores) my son decided to have a meltdown.  I'm not exactly sure why.  He wanted me to make a left turn onto a bridge that would require me to go the wrong way on a one way street.  Obviously, I couldn't oblige.

As I tried to settle him down, I can't remember exactly how I said it but I said something along the lines of, "I think you have anger management issues".  He then somehow connected that to one of his favorite baseball players.  About a month ago, this player got in a argument with another player (and rightly so, as the other player hurt him) and hit him.  He got thrown out of the next 4 games.  We used the fact that my son heard this on the radio to teach my son that hitting is never ok.  We hadn't talked about it in over a month.  My son told me that he got in trouble like his favorite baseball player did and he didn't use his words.  He made this connection from so long ago.  I kind of laughed to myself thinking that I'm sure that baseball player did use some words, but fortunately not words that my son heard.  He amazes me sometimes how he does actually learn lessons and consequences (anyone who has an active pre-schooler can probably relate that sometimes it feels like you're talking to a brick wall, or to an energetic ball that never stops long enough to actually listen).

Intervention

This is a plea.

Please, please don't wait to talk to your veterinarian about a behavioral problem until you are so upset about it the only thing you want to do is relinquish your pet.

There are so many resources we have in today's medical world and also in our understanding of behavior.  Inappropriate house soiling in cats is a disease that can be managed and in some cases simply cured.

Kicking the can down the road and thinking a rescue is going to take a cat who has a house soiling problem is unrealistic.  It's cruel to the cat and it's difficult for the veterinarian.  I have actually been in situations where I or a colleague have been asked to euthanize a patient for a problem that could have been treated if the owner had asked for help years or even just months ago.  Trying to "fix" the problem by dumping your cat with a behavioral problem on an already overcrowded shelter is sentencing the cat to death.  I'm sorry I'm being blunt- no- I'm not sorry.  People need to know there isn't an island where abandoned pets go.  No one (or VERY, VERY FEW special people) are going to adopt a cat from a shelter where "reason for relinquishment" is cited as house soiling.

Sometimes, the willingness to add an extra litter box, to change the litter more frequently or limit the cat's access to certain areas are the only things that need to be done.  There is kitty "prozac" that can be used in more severe cases, but most of the time I don't even need to resort to that.  Most of the time it just involves a conversation.  Sometimes, in difficult cases, you can even consider making the cat an outdoor cat.  If that's what it's going to take to keep the cat from being dumped, the risk of a cat outdoors if it's properly vaccinated and cared for is a lot better than a cat with a death sentence.

Please- whether it's a dog or cat, call up your veterinarian and talk, or schedule an appointment.  We have no problem troubleshooting these situations with owners.  We do have a problem with people having a callous view of pets as property.

In some extreme situations, we do exhaust all options and these are special situations where maybe that cat has a severe anxiety disorder or mental illness, but these cases are really rare, but when both the vet and owner know they did literally everything they could, everyone can sleep ok at night.   Asking a vet to sentence your cat to death because you don't want to add a litterbox?  I will restrain from my vitriol on that one.

Pink Guy and Gravity

So a while back, my husband had pink eye.  It was a horrible experience and my husband found out that I'm way more afraid of and grossed out by pink eye than I am of any blood and guts disease.

My son went to a birthday party at a gym place (the same type of place my husband thought he caught the Pink Eye from).  The next day, Sunday he started rubbing at his eye.  I flipped out and started trying to make plans for who could watch him the next day, because there was no way I was going to send my son to school to pass pink eye around.

As sanity returned to me, I took a closer look at his eye and realized, no, it was not pink eye.  His conjunctiva (the inner tissue of the eye) was totally fine, it was just his eyelid he kept rubbing at.  Whew!  I was relieved, but then started talking with my husband, saying that we hoped that when he went to school the next day, they wouldn't think that he had pink eye and try to send him home.  At this point, my son's ear perked up and he said, "Pink Eye".  My husband's look could have killed me.  "Nice job," he said.

I suavely said, "yeah, do you remember the pink guy at the pool?  My son looked at me questioning and then I went on to talk about a guy who was pink at the pool and the conversation flowed on.  He thought he heard pink eye, I clarified it was a pink guy.  The last thing I needed was him to go to school and say, "I have pink eye" or put it in someone's head, so we talked quite a bit about a pink guy.  It all actually brought back some memories from vet school for me- Cattle actually have a form of infectious conjunctivitis.  It was called (they change bacteria names on a frequent basis) Moraxella bovis-  the little thing that helped me remember this was saying, "Max Bovis, Private Eye" that is how I remembered the name of the bacteria and the disease that it caused.  Maybe I should have included Max Bovis in my son's Pink Guy story....  Let's just say I'm relieved his eye looks totally better today so no misunderstandings to worry about.

My son had an interesting comment last night- he told me he wanted to be an astronaut who doesn't go into space.  "Why don't you want to go into space?" his response was, "I like gravity."  "Why do you like gravity?" was my response and then he said, "because I don't want to float- I want to walk on my two feet."  I wonder if he will think the same in another ten years.

My old kitty....

My cat Duchess is getting older.  Whenever I am feeling sorry for her and she is looking particularly decrepit, she manages to get into some type of trouble- knocking a trash can down, getting into a bag of rolls on the counter.  She has a long list of ailments, but nothing that really knocks her down.  As I hear about and witness senile, old arthritic animals on a regular basis, I remember how lucky I am that she has been fairly healthy for as long as she has, and lucky that my biggest gripes with her are her naughtiness.

There are some changes that come with her age- she sleeps all the time and she has an obnoxious "Meoww".  I'm pretty sure she's deaf (the only way to confirm would be taking her to a neurologist for advanced testing, but her diagnosis wouldn't change anything.)  Her "Meoww" is of such a large volume that it could wake the dead.  I'm sure if she heard it, she'd be annoyed at herself.

Duchess still has attitude and if she was a person, I'd imagine she'd be like Sophia on "Golden Girls" or the cranky Hallmark lady.  She's got "Tortitude" which means a Tortie with attitude.  As I was getting frustrated by her losing weight, (she's faked diabetes for me as well as many other diseases that get me stressed out because her initial testing will come back positive and her follow-up will be ok) I called her a "Brat" in front of my son when casually talking to a veterinary staff member.  My four year old immediately said, "but I love Duchess mommy, Duchess is a good girl!"  He then went on insisting that he wanted to carry her carrier out to the car and that he wanted to be the one who let her out of the kennel when we got home.  He showed me just how much he loved her.  Though he is not aware of her many annoying habits and her impact on our pocketbook, he reminded me what a sweet, wonderful kitty she can be and that at this time, she's the only pet my son actually likes (He's not a fan of the large dog because he knocks his toys down).  Sometimes, looking at the world through a four-year old's eyes is
helpful...

He's already old enough...

This weekend, as we were getting ready to go to Mass, the inevitable fight over wardrobe ensued.  My son probably fights just as much as any fashionista over what to wear.  He's not arguing about dresses or princess costumes, but over which jersey and sports paraphernalia he can wear.  I let him wear sports outfits to pretty much everything, and I even let him wear his astronaut outfit in public (he's cute and it's a functional one-piece).  My husband and I draw the line at Mass.  He doesn't wear exactly what we want him to wear, but we typically give him a choice of 2-3 shirts and 2-3 shorts or pants that we deem appropriate.  This time though, my son screamed "Well, when we were at Mass last week there was a boy who had a nice orange t-shirt with a baseball player on it, if he can wear that, why can't I wear my sports clothes."  Oh no, I thought, it can't be starting already- comparing parenting to others and trying to rationalize why some parents do some things and some parents do others.  Before I launched into, "Well some parents would let their kids run around naked in the streets or run off a cliff."  Fortunately, I caught myself and said, "Well you know how we are going to have a fun day today and go to soccer class and the pool?  Some kids don't get to do that with their parents because every family is different and just as we are able to do some fun things others can't, we have some rules that others don't and that's what makes our family special!"  I'm not sure how well that reasoning worked for him, as he tried to undress himself in multiple ways, but we made it to church and had a good rest of the day.

My son has probably had dreams for a while but just recently started sharing them with us.  I had and still have quite an active dream life that my husband makes fun of (apparently during my pregnancy I woke up in the middle of the night with what I thought was an epiphany of building a "Kitty Superhighway for bad kitties."  I guess this was supposed to be my solution to bad cats was to give them an expressway, not exactly sure of the logic.  Well my son informed us that he had a dream about a shark.  I was concerned that talking about this was going to give him a nightmare, but he told me it was a "fun" dream.  He then told me he reached down to pet the shark (obviously cuing Jaws in my mind) and then when he felt the nose, it felt like Dewey's soft nose (our dog).  Apparently this was really amazing and funny to my son and he keeps talking about it and I'm reluctant to give him a lesson about sharks as if this is going to be a recurring dream, I'd rather have him think it's funny and not scary.  And.... I will plan on letting him watch Jaws before he ever goes swimming in the ocean alone so he doesn't think that petting a shark is a "fun" idea...

89 bottles of beer and are we there yet?

We took a long trip to see my in-laws over the holiday week.  We are talking 12 hours in the car.  Within the first 5 minutes of the trip, my son started asking, "are we there yet?".  He was actually a really good sport for the trip and thanks to the DVD player from my parents, we all made it through the drive in relatively good shape.

We then drove another 4 hours to go to my husband's alma mater for the first time for my son and myself.  Toward the end of that day, my son asked, "Can we please stop driving, I don't want to just drive around in the car."  After getting out and walking (and him falling asleep in the stroller on the trip after he visited all the sports stadiums) we were back in the car.  I was trying to distract him from the fact that we had thrown out his milk from lunch.  "I want my morning milk," he kept repeating.  "Well, your morning milk is now yogurt, or cheese curds or something gross in the trash can."  My logic didn't help.  Instead, I resorted to trying to get him to sing my husband's alma mater fight song.  He did this for a while and then a little later in the trip, he randomly said, "89 bottles of beer on the wall."  I did a 180 with my head.  Where on earth did he learn that song from?  Oh no, with his fascination with numbers, my husband and I could be in for a VERY long ride back home.  Fortunately, he explained to us exactly where he heard it from, Linus and Lucy's brother Rerun on one of his Charlie Brown shows.  Our son also likes rockets and space ships and numbers so much currently that we get him to eat his food by counting backwards from 10.  10-9-8-7-6-5-4-3-2-1 LIFTOFF!  Who knew eating 10 bites of something could be so exciting!

His other favorite song right now is one he learned at school-  "Mercury, Venus, Earth and Mars.  Mercury, Venus, Earth and Mars.  Mercury, Venus, Earth and Mars- Going around the Sun.  Jupiter, Saturn, Uranus and Neptune, Jupiter, Saturn, Uranus and Neptune, Jupiter, Saturn, Uranus and Neptune- Going around the Sun.  And don't forget, little baby blue toad.  Don't forget, little baby blue toad- don't forget, little baby blue toad- Going around the Sun!!!"  This is sung over and over with much energy.  My son must have initially thought that "Pluto" was little baby blue toad and now we repeat this because it's cute and it makes us laugh.  Also- Pluto is no longer considered a planet, so why not Little Baby Blue Toad?