Grandpa

Last week, I was preparing to travel back to Missouri to say goodbye to my grandpa. He had been sick for a decade battling chronic leukemia and then congestive heart failure. His age and diseases were taking a toll on him and when I last saw him (Christmas), he wasn't looking like himself.
The week before last, they found some spots on his liver. The onco nurse didn't think it looked good. My grandpa was dying. I was called home.
Sadly, before I got there, he passed away.

We hung out at my Grandma's house a lot over the weekend. I know that his death was hard on her but I'm pretty sure she had come to terms with it long before it actually happened.
Grandma encouraged us to take whatever we wanted as she knew the house would have to be packed up. Its hard to do that. Its hard to know what means so much to you when put on the spot like that.
I knew more than anything else what I wanted.
A grocery list.

Grandpa was legendary in his grocery shopping ways. As kids, he rarely let us go with him lest we distract him from watching every item being ran up so he could argue the sale price where needed. Grandpa didn't hesitate to go to multiple grocery stores to save some money. (Product of the Depression I guess.)

His sale ads were always circled in red magic marker.

He had his grocery lists for each store. I like the first list because Grandpa made it and Grandma put specifically what she wanted on it. That was actually pretty rare. 

When he could buy things on sale, he would store extra in the basement. 

Other things I remember about my Grandpa-
When I was between my senior and junior years of high school, he took me to Columbia with Grandma for a summer camp type program. He got pulled over for speeding when passing and got a ticket.

He called me by my aunt's name with regular frequency.

When we ate lunch, Grandma would make his salad and hide a single pea at the bottom. Grandpa hated peas. 

When they moved to TDL, Grandpa would wake us up and take us to the beach to swim in one of the lakes. We didn't know how to swim so we could only go in to our waists. 

Losing a grandparent as a kid is sad. Its confusing and abstract. Losing them as an adult is harder I think because you know what a good person they are...

Well, That's Something Different...

[WARNING!!! BELOW CONTAINS GRAPHIC PHOTOS OF MY JOB. YES, SERIOUSLY, I HAVE TO DEAL WITH THIS! And honestly, this isn't even the grossest thing I typically see...]

So today, I didn't have any farm calls. I was just hanging out, contemplating if I should look at the two boarding dogs that need to be looked at each time they board (which is often), when we got a phone call for a horse with a laceration. It was like 10:15.
The owner was hesitant to tell the receptionist where this horse had lacerated itself and for good reason. This horse had managed to lacerate its vulva. Well, near its vulva was what I was told. I wasn't doing anything so I packed it up and headed out. Luckily, it was close by.

When I got there the woman assured me that this horse was a recent rescue and that her horses typically didn't look like this. This horse was found tangled in some fencing this morning and was happily eating in a stall since then.
The mare was thin with a rough hair coat. She seemed calm enough as we lifted her tail up so I could get a look and cover the top of the tail with some vetwrap.
Behold what I saw beneath the tail:

On the mare's best day, she had poor vulvar conformation. She probably was a windsucker by way of her age, body condition or just bad luck. Today though, her luck ran out. This mare had literally, tore her entire vulva off! It started about two inches below her rectum. There was just a thin strip hanging on on one side and the other had about half an inch. The clitoris at the bottom was ripped clean off. Surprisingly, she wasn't bleeding much and didn't mind us looking and touching.

After some consultation (always calling CB!), it was decided that this wasn't going to be reattached. The inch long strip holding the vulva on would likely die and take the whole big wad with it. My worry was that she would scar too much and end up having trouble urinating. 

I gave her a mild sedative-it was really not enough to do anything. I should have went way higher! I sprayed some lidocaine onto the area-which she hated! And then in a very quick fashion, cut the sucker off! It bled only a small amount. I tried to clean it the best I could afterwards but the mare was having none of it. She tried to double barrel kick me!

I left the owner with some antibiotics, banamine (an NSAID) and the instructions to keep the tail wrapped, keep it free from flies, and hose the area off a couple of times a day. I'm going to recheck it in a week. If by chance she's having difficulty urinating, I suppose we'll have to catheterize her and hope that we can get it to heal and that we don't give her the worst ascending infection ever.

Short of referral for cosmetic surgery, I'm not sure what I could have done differently. Fingers crossed!

Traveling

I recently had to do some traveling. I will blog about the reasons later this blog is about traveling in general.

I have decided that traveling, especially flying, alone is a double edged sword. For the most part, it has its advantages. The main one being that you can move at your own pace. Meaning that I can stand on the moving sidewalks and don't have to hurriedly run through the airport because my husband can't take five minutes for me to go to the bathroom.
Flying with someone has more advantages that I was prepared to realize. One, you have somebody watch your luggage meaning that you can go to the bathroom whenever you want and come back to a good seat. Two, you have someone to go get you things since you can watch their seat. Three, you have somebody to talk to. Those might be the the main things.

When I was traveling, because it was the summer time, I really was very jealous of people that got to actually take vacations. Joe and I have not had a vacation for two years. It's because is a combination of working too much and lack of fundage. Joe is threatening to put 'vacation' on the list of banned words. I might complain a lot about not getting to vacation.

I really can't remember the remainder of the reasons that travelling sucks. Other than waiting. And its expensive. Seriously, did I just pay almost three dollars for a bottle of water? Yes, yes, I did.

My pumpkin is making good progress. And I have two more little ones coming on.

ADR

Sometimes no matter what you do, you'll have clients that nothing goes right for. You try and try to save an animal and that animal does poorly or worse yet, dies.
Where I used to work, I had an old world Mennonite farmer like that. He had a grazing dairy of Jerseys and a pretty nice set up. I can think of FOUR instances where everything I touched turned to shit.
Instance 1-My boss sent me out to cut an LDA on a little cow that had been seen the day before but had a temperature and thus surgery was not performed. Now unfortunately, while this farmer had a great set up for calving out cows, he did not for cutting a DA. I tied up the cow, gave her a touch of sedation, clipped and prepped and go to work. And as I was sorting things out, the cow tried to lay, then laid down. :( I frantically closed her side up with towel clamps before intestines and the like could spill out. We got her up, resterlized the surgery site, opened another surgery kit and tried again. And she tried to lay down...AGAIN. So I closed her up, forced her to lay down and opened her up on the bottom of her stomach. In between the not standing and the forcible laying down, I called my boss in a panic (actually, I called both bosses for different forms of advice). I was mostly finished with the DA when my boss finally arrived and I wondered why I didn't do cows on their backs in the first place. I'm not sure how the cow did but I'm guessing well.
Instance 2-Thanksgiving Day, near dusk, my turkey is coming out of the oven. I get a call from this guy that his buggy horse had cut its leg but they are at a wedding. I procure directions and when I arrive, the horse has a blood soaked bandage around its leg held on with duct tape. The horse had managed to cut the giant blood vessel on the inside of its leg. (I think its medial saphanous?) Its a huge vessel. I've used it to euthanize horses. Oddly enough, it wasn't bleeding too much any more and the horse with some sedation allowed me to nerve block the area and cut off a chunk of flesh. Then I started stitching. Then all hell broke loose. I gave every bit of sedation I felt comfortable with, plus a twitch, plus a couple Amish guys holding up various legs. I got enough stitches in the upper cut to stop the bleeding and felt okay about it. The lower cut got one on top of the big spurting artery. I bandaged the leg and left.
Instance 3-A few days later after the Thanksgiving fiasco (or maybe the next week), I get called out on a Saturday afternoon, the horse that this guy borrowed had cut his shoulder. It was pretty old so he had an  ugly wound that had to heal by second intention.
Instance 4-This was by far the worst but I learned a valuable lesson. NEVER AMPUTATE A COW'S UTERUS. No matter how much you think its a good idea its not. Especially when you call your boss and he's like, 'I did it once'. Especially if he's been practicing longer than you've been alive. NEVER AMPUTATE A COW'S UTERUS. But if you do, you better have a good, well thought out game plan. The first six inches when really, really well. Then I realized that the uterus is very vascular. I told the farmer that the cow would be dead by the morning. She was. Bleed to death.

Anyway, at this new practice, I have a similar farm. Its not so much that whatever I do is bad but more that I get to give them the bad news. This farm has provided me with some interesting cases though. This farm is also a notorious 'while you're here' client. Which is fine when time allows it. They also have to pay me when I'm there so they want to get their money's worth of the $45 farm call fee. I understand it. I can think of two pretty remarkable things. 1) I finished cutting a DA when they wanted me to look at a cow with pneumonia. The cow had a fever and was open mouth breathing. However, when I listened to her chest, I heard not a sound. With this level of respiratory distress and fever, if it was pneumonia, she should have all sorts of badness to her lungs. After some consultation, my conclusion was a pnumothorax. Air loose in her chest. I actually did a chest tap and got some suspicious air (I can't vouch that I did it right though). My guess is that in the process of calving, she ruptured a bulla (big fat pocket of air) or a lung lobe off of its attachment. She was drowning in oxygen. Unfortunately, being attentive farmers that had noticed her respiratory distress and fever, they had given her penicillin. Needless to say, she wasn't being slaughtered anytime soon. Also, it was Friday. (Of course!)
The next interested things I saw were pretty recently. I went out to see a cow with a swelling under her jaw. The cow was pretty pathetic looking but the swelling was impressive. She also had a fever so I put her on steroids and penicillin. Then I did a couple of other things that were thrown on at the last minute. So today, I get a call from the same farm for a cow with a swollen jaw. I ask if it was the same cow and it wasn't. (Whew.) She thankfully still looked pathetic but the swelling was almost entirely resolved. This cow had saliva and blood hanging out of her mouth. She also had a fever. On my oral examination though, she had quite the different presentation. Attaching to the base of her tongue was a huge mass. It went as far back as I felt I could comfortably put my hand. It looked like a melanoma. While she hadn't been given penicillin, she was still testing positive for it in her milk from her dry treatment so I suggested not shipping her until she was clear. She wasn't doing too great so I suggested to shoot her in a few days if some steroids didn't rally her. I don't hold out much hope because her tongue seemed paralyzed.

So in a fit of 'my doctor told me that I was fat so I better exercise', I walked two nights last week. Nothing far. The first night, Riley and I walked for about half an hour. Riley is the fat old corgi. She needs the exercise too despite having her lady bits removed. Mine work just about as well. :( The next night we walked for only one lap but I gave Riley her vaccines and we sprinted a tiny bit too. I am determining if Riley will make a jogging partner in my upcoming bid for couch to 5K. The answer is probably not. I haven't walked since. Tonight, I was feeling like I needed a pity party so showered when I got home from work and here I am.

Also last week, my shoulder and neck really hurt. Wednesday, I was about paralyzed from the pain. I had one of the techs laser my neck. It helped some. The next day, I had it repeated. I've found that on a regular basis, my shoulder on that side (right) hurts so much it wakes me up at night. Which sucks because I like sleeping on that side. It also hurts to lay on the couch-partly my neck, partly my shoulder. I'm thinking that a doctor might be a good idea-maybe I tore my rotator cuff?- or a chiropractor. But honestly, maybe I should just take more Advil.

Finally, I'm flying home to Missouri this weekend. I really don't want to but I have to. My grandpa isn't doing very well health wise and we think it might be close to his time to pass. Its not something that I want to face. I've been dreading such a phone call for a while now.

So this is a picture of the snapping turtle that I helped across the highway.
I learned that snapping turtles are really assholes. And not just a little. I mean I think everyone knows they they are jerks but seeing as that I had never seen one in person I just wasn't sure of this fact. I now understand why some people might want to run them over on purpose.

Anyway, I pulled the vet truck over, and trotted down to where the turtle was on the side of the highway. I took this pic then I reached to pick him up. I knew that you could grab a turtle by the back of his shell and that he wouldn't be able to reach you with his neck so that's what I tried. But as I reached for him he snapped at me instantly. He wasn't more than about the size of a dinner plate but he meant business.

Still not wanting him to get ran over, I did what any good citizen would do. I kicked him across the highway. He spun and flipped over and every time I reached for him again with my foot he tried to bite at me.

I successfully got him to the other side of the highway, but now I know that I will never stop for a snapping turtle again!

Over three days, I harvested black raspberries and made a crumble. It was really good but my desire to wait for enough berries to ripen to make another one isn't there.

My pumpkin plants have produced one very loved pumpkin!

TMI

This post isn't about veterinary medicine. 

In a few posts, I've mentioned some things about trying to start a family and where that is going. Unfortunately, it still is going no where.

Joe and I have been together for over 7 1/2 years and married for one. We're ready for a family. Add in the fact that I'm 30 and starting to freak out about the fact that I don't have kids. Everything else (almost, I'd still like a house of my own) has come together-husband, career. So yeah, we're ready.

I stopped taking birth control like last August or September and thought that I would just let things happen as they will. Nothing happened. In fact, I didn't even have a period after stopping birth control. I wasn't too worried. For several years prior to starting birth control, I didn't have a period through the fall or winter. It was actually very convenient. In February, I went to the OB/GYN for just a yearly exam and mentioned this fact to her. She wasn't too worried because I told her that normally by the end of February or March, I normally started again. She also assured me not to worry about getting pregnant. That for most people, it took a year of trying and not to be too worried. 

By April, I hadn't started yet. So I called the doctor (actually a nurse practitioner-a google search told me I should just call her by her first name unless they introduced themselves as something else) (On an vaguely related topic, everytime I introduce myself as Dr.Leslie, I die a little inside. But it doesn't stop me from doing it.), and told her. I went back down and had a thyroid level and prolactin level checked, I peed in a cup for a pregnancy test and was put on progestrone (provera) for five days. 

I took the progesterone, blamed it for some weight gain and started a period like a good little normal woman. After about ten days, it was done and I thought/hoped all would be good. Then a month went by, then five weeks, then six weeks and then I went back to the doctor...um...nurse practitioner. 

NOW...I am to take progesterone for 12 days a month for the next five months give or take some. The idea is to hopefully trick my body into cycling normally once I stop the progesterone. I can stop it whenever. If from there I don't get a period, I'm to see an actual gynecologist or go to a fertility specialist. 

So this is my plan: August, September, October, November and December (December being optional)-take progesterone. January and February let my body do its thing. (Hopefully do its thing.) March, April, May, and June try to get pregnant. Have baby following winter-this works best for me (i.e. no farm calls in the icy cold) and for my boss (she told me so...I'm pretty sure she was serious). Of course, if I would get pregnant before that...well, that's fine too. If I don't get pregnant in that time frame, as long as I have my period, that's not great but acceptable. I'll probably start calculating my ovulation and things like that but won't get to excited. If by some stroke of bad luck, I don't have my period in January/February, then I'll go to the doctor. Probably not jumping into the whole fertility specialist thing just yet. 

I'll be honest. I'm not liking where this is going. I'm not liking the idea that my body can't get its shit together long enough to fulfill its one most basic urge. I'm not liking the idea that I might have to do fertility treatments of any kind no matter how basic. I'm not declaring myself infertile just yet. Its probably just some sort of flukey thing and everything will work out. I feel bad for women that really are infertile. I'm not ready to lump myself into that group because I know there are people that are having much more problems than I am having right now. Eventually, I might be there but right now, I just have messed up hormones. And I need to lose some weight. (This came from my nurse practitioner as something that might help.) 

Also, across the street from the doctor's office which is really a doctors' complex in front of the hospital, there are several cemeteries. However, this time some pro-life group chose to put a thousand plus little blue and little pink crosses in the lawn representing a day's worth of aborted babies. I find this in extremely poor taste. While I don't think that this office performs abortions (at least not when they are elective), I still think that its in poor taste...what about all the women that can't have a baby that see that? What about all those women that miscarry that see those crosses? What about all those women that have their babies die and have to continue to carry them for days? Did anyone think about that? I'm normally not a politically correct person, I'm normally all for free speech and think people are too sensitive. But seriously, use your heads sometimes and be sensitive.