So one of my most hated emergencies second only to HBCs is anything involving a horse. And recently, I've decided that I hate colics especially. Well, no, I hate any emergencies involving horses. They are all terrifying.
The more and more that I do colics the more and more I am less comfortable about them. Or at least the more and more terrified of them. And not even really terrified but just worried that I did something wrong, missed something, or didn't fix the horse at all.
Of course, there is a limit to what I can do. At some point, there are going to be those cases that I can't fix. And I've seen them. And I've given the poor prognosis. And I've gone home only to find out that the horses have died later. Those suck but have taught me an important lesson. If you think its going to die, don't be optimistic. Its okay to euthanize the horse. After three of those, I decided that when I see those horses that don't want to get up, that have high heart rates and just want to lay around and groan. Those horses I euthanize.
Colics just suck.
I mean even the yearling stud colt who was the best horse I've ever tried to tube caused me to panic. Sure he responded to banamine. Sure he liked his torb. Sure he let me tube him and got gut sounds right away. Sure even his rectal (that's right, I rectalled a yearling stud colt) was normal but it didn't stop me from freaking out about it. What if I missed something-especially on his rectal exam?
And Josh, poor, poor Josh. Maybe if I had been able to tube him on Thursday, he wouldn't have had to be euthanized on Sunday.
Sorry this one is sort of rambly. All I know is that I hate colicky horses, thinking about them makes my stomach tie in knots and seeing them has me question myself for days. No matter the outcome.
Monday, June 16, 2014
TMI: Diagnosis
Well, its time for another round of what's wrong with Leslie's body? And not that you asked. Its going to be TMI. Feel free to skip if you don't care. (I won't be hurt. Promise.)
So, let's see, where I was I?
At the mid/end of May, I went in for an ultrasound of my uterus and ovaries. Eventually, the doctor called me back with the results. The ultrasound was consistent with polycystic ovaries (PCOS). The doctor sounded sort of skeptical about that diagnosis and decided that we would see what the bloodwork looked like. I started my progesterone and then had a period as expected. My period was way shorter than expected.
Then on Day 4 (because of Memorial Day), I had blood drawn for a million tests. I don't do well with getting blood drawn and made the mistake of looking at the number of tubes that I was scheduled to have extracted from my arm. I made it through but my arm hurt the rest of the day. It might have been in my mind.
Joe also submitted his 'sample' and it ended up being all okay. He might have been proud of that. LOL.
So I was waiting on my bloodwork results and the doctor called while I was in STL. I missed her phone call but called the nurse back and she gave me some results and let me know that my doctor was going to be out of town. Then on Sunday, we were waiting in the airport when my doctor called me! I love my doctor for this reason. It might take her a while to get to me but she routinely calls late on Fridays so I don't have to wait another weekend and here she is calling on a Sunday so that I don't have to wait for her to get back into town. Pretty sweet, I think. Of course, on the Fridays that she has called me I've been dealing with veterinary OB emergencies and unable to answer but that is beside the point.
I had my thyroid tested again (it was normal), my rubella titer checked (normal) and was screened for cystic fibrosis (okay). Then a bunch of hormones were tested too. My ratios of FSH and LH were abnormal and my testosterone was elevated. Both of these indicated that the ultrasound was accurate and that I have PCOS.
Friday, I had my progesterone level drawn. The doctor's office called today looking for some info before they will call me back with my results. I have a bruise in my elbowpit from getting blood drawn. It wasn't so bad as the last time because it was only one tube BUT I did look and it appeared that they were using an 18G needle to draw it! That's too big! Use a 22!
Anyway, I think the plan from here is that I continue on the progesterone and also start Clomid. The doctor is also planning more testing-for diabetes, insulin resistance/metabolic syndrome and cholesterol, etc for heart disease. PCOS predisposes you for all those things. It also explains my weight gain.
If by chance, I have insulin resistance I'll also probably get started on metformin.
I guess I still have a lot of questions about PICOs. Dr.Google here I come! Questions like-what are these cysts on my ovaries? Are they follicular? Little follicles that never progressed or regressed, follicles that were recruited but nothing ever came of them? Are you at more of a risk for diabetes if you have a family history of it? Why do I need a blood test? Can't I just pee on a stick like I make a dog do?
Of course, there is one other part of this getting pregnant plan that needs to come around...you know what I'm talking about...
So, let's see, where I was I?
At the mid/end of May, I went in for an ultrasound of my uterus and ovaries. Eventually, the doctor called me back with the results. The ultrasound was consistent with polycystic ovaries (PCOS). The doctor sounded sort of skeptical about that diagnosis and decided that we would see what the bloodwork looked like. I started my progesterone and then had a period as expected. My period was way shorter than expected.
Then on Day 4 (because of Memorial Day), I had blood drawn for a million tests. I don't do well with getting blood drawn and made the mistake of looking at the number of tubes that I was scheduled to have extracted from my arm. I made it through but my arm hurt the rest of the day. It might have been in my mind.
Joe also submitted his 'sample' and it ended up being all okay. He might have been proud of that. LOL.
So I was waiting on my bloodwork results and the doctor called while I was in STL. I missed her phone call but called the nurse back and she gave me some results and let me know that my doctor was going to be out of town. Then on Sunday, we were waiting in the airport when my doctor called me! I love my doctor for this reason. It might take her a while to get to me but she routinely calls late on Fridays so I don't have to wait another weekend and here she is calling on a Sunday so that I don't have to wait for her to get back into town. Pretty sweet, I think. Of course, on the Fridays that she has called me I've been dealing with veterinary OB emergencies and unable to answer but that is beside the point.
I had my thyroid tested again (it was normal), my rubella titer checked (normal) and was screened for cystic fibrosis (okay). Then a bunch of hormones were tested too. My ratios of FSH and LH were abnormal and my testosterone was elevated. Both of these indicated that the ultrasound was accurate and that I have PCOS.
Friday, I had my progesterone level drawn. The doctor's office called today looking for some info before they will call me back with my results. I have a bruise in my elbowpit from getting blood drawn. It wasn't so bad as the last time because it was only one tube BUT I did look and it appeared that they were using an 18G needle to draw it! That's too big! Use a 22!
Anyway, I think the plan from here is that I continue on the progesterone and also start Clomid. The doctor is also planning more testing-for diabetes, insulin resistance/metabolic syndrome and cholesterol, etc for heart disease. PCOS predisposes you for all those things. It also explains my weight gain.
If by chance, I have insulin resistance I'll also probably get started on metformin.
I guess I still have a lot of questions about PICOs. Dr.Google here I come! Questions like-what are these cysts on my ovaries? Are they follicular? Little follicles that never progressed or regressed, follicles that were recruited but nothing ever came of them? Are you at more of a risk for diabetes if you have a family history of it? Why do I need a blood test? Can't I just pee on a stick like I make a dog do?
Of course, there is one other part of this getting pregnant plan that needs to come around...you know what I'm talking about...
Literature Review
I decided about a month ago to save some money by going to the library instead of purchasing books for my Nook. As I mentioned before, its difficult for me to get to the library while its open since its closed on my typical day off (Monday). Also, as I mentioned before, I want to take all the books with me!
I very reasonably (or so I thought) checked out three books for a two week period. And it took me three times of renewing them before I had them finished. Sigh. I know I was busy but I just don't read like I would like to.
The first book I read was Bones of The Lost by Kathy Reichs. Her books are the inspiration for the show Bones on Fox which you may remember I recently became obsessed with. Because of my obsession with the show, it was sort of hard to get into the book. The character of Temperance Brennan in the book was far different than the Temperance Brennan of the book. However, this book makes for a cheap thriller suitable for the beach or poolside. Anyway, in this book, Temperance is investigating the death of a girl found on the side of the road. She's also doing some work on the side for the feds involving some illegally imported dog mummies. And finally, she has to go to Afghanistan to investigate the death of some nationals that might have been killed by a US soldier. So yeah, there's a lot going on. I'll go ahead and give you a spoiler-all three events are related! But how? Well, that's for you to find out.
The next book I read was Chang and Eng by Darin Strauss. This book chronicles the life of the original Siamese twins, Chang and Eng. It is told by Eng. I stumbled across this book while looking for the one book I went to the library for. I decided to give it a try and if after 50 pages I didn't like it, I would quit. If it was still only okay, I would reevaluate at page 100. Well, at page 100, despite the book being a very, very slow read, I kept reading. Its a good book. Slow to get going but interesting.
The book I really went to the library for was An Irish Country Courtship by Patrick Taylor. This is the fifth book in the series and though it was a bit more dull than the previous books I still liked it. I may have mentioned this before but I these books are like the MDs of James Harriot. I recommended them to my mom who didn't like them though! I surely do. In this book, young Barry gets dumped by his girlfriend and in trying to forget it, throws himself into his work. Of course, there is a scheme that involves O'Reilly tricking Bertie Bishop. And finally, O'Reilly proposes to his nurse girlfriend.
I recently started reading The Goldfinch by Donna Tartt and it is a tome! Seven hundred and seventy pages! The book won a Pulitzer Prize so hopefully it will be worth the $23 price I paid for the book... There is something to be said for a crisp, clean fresh book. I've surpassed the 50 page mark and am willing to continue...
After I finish my huge undertaking, I am going back to the library. I'll be working on the Patrick Taylor books as well as starting my quest to 'read the library'. By this, I mean I plan on reading one book from every shelf in the library. I was considering allowing so many skips per letter if a particular shelf didn't seem to hold anything promising but instead I think I will make myself read 50 pages. Then if that seems okay, I'll read 50 more. If I've made it that far, I'll have to continue and forge through. I figure that I'll find some diamonds in the rough this way.
I very reasonably (or so I thought) checked out three books for a two week period. And it took me three times of renewing them before I had them finished. Sigh. I know I was busy but I just don't read like I would like to.
The first book I read was Bones of The Lost by Kathy Reichs. Her books are the inspiration for the show Bones on Fox which you may remember I recently became obsessed with. Because of my obsession with the show, it was sort of hard to get into the book. The character of Temperance Brennan in the book was far different than the Temperance Brennan of the book. However, this book makes for a cheap thriller suitable for the beach or poolside. Anyway, in this book, Temperance is investigating the death of a girl found on the side of the road. She's also doing some work on the side for the feds involving some illegally imported dog mummies. And finally, she has to go to Afghanistan to investigate the death of some nationals that might have been killed by a US soldier. So yeah, there's a lot going on. I'll go ahead and give you a spoiler-all three events are related! But how? Well, that's for you to find out.
The next book I read was Chang and Eng by Darin Strauss. This book chronicles the life of the original Siamese twins, Chang and Eng. It is told by Eng. I stumbled across this book while looking for the one book I went to the library for. I decided to give it a try and if after 50 pages I didn't like it, I would quit. If it was still only okay, I would reevaluate at page 100. Well, at page 100, despite the book being a very, very slow read, I kept reading. Its a good book. Slow to get going but interesting.
The book I really went to the library for was An Irish Country Courtship by Patrick Taylor. This is the fifth book in the series and though it was a bit more dull than the previous books I still liked it. I may have mentioned this before but I these books are like the MDs of James Harriot. I recommended them to my mom who didn't like them though! I surely do. In this book, young Barry gets dumped by his girlfriend and in trying to forget it, throws himself into his work. Of course, there is a scheme that involves O'Reilly tricking Bertie Bishop. And finally, O'Reilly proposes to his nurse girlfriend.
I recently started reading The Goldfinch by Donna Tartt and it is a tome! Seven hundred and seventy pages! The book won a Pulitzer Prize so hopefully it will be worth the $23 price I paid for the book... There is something to be said for a crisp, clean fresh book. I've surpassed the 50 page mark and am willing to continue...
After I finish my huge undertaking, I am going back to the library. I'll be working on the Patrick Taylor books as well as starting my quest to 'read the library'. By this, I mean I plan on reading one book from every shelf in the library. I was considering allowing so many skips per letter if a particular shelf didn't seem to hold anything promising but instead I think I will make myself read 50 pages. Then if that seems okay, I'll read 50 more. If I've made it that far, I'll have to continue and forge through. I figure that I'll find some diamonds in the rough this way.
Friday, June 13, 2014
Wedding Bells
Earlier this month, Joe and I celebrated our two year wedding anniversary. It was very low key. Apparently, we don't care much about wedding anniversaries. Joe was going to buy me some boots which were out of stock in my size. I got him a t-shirt that says 'driving my wife crazy one goat at a time' and a goat plate. The traditional and modern gifts are like cotton and china. If we did anything, it must of been very unexciting.
But our days of wedding bells past were not the only wedding bells this month! My BFF Martha got married in Missouri! She married long time friend, Brad! And I was in the wedding party which is good because when I found out about their engagement, I threatened to slit my wrists if I wasn't. (Maybe it wasn't that serious but I would have been terribly disappointed.)
Any who, proceeding the wedding there were some bridesmaids dress drama and some socialization drama as I perceived it but it was probably all in my easily to take offense mind.
Also the week before the wedding, I got food poisoning. Like seriously. Thursday night, I was on call and doing great. Ate dinner then started to feel bad. Then went in for a c-section and visited the bathroom like three times by the time the dog was on the table. At that point, the tech had called in TC. Which was good. I sat in the hall with Blaze the cat. I helped with puppies then ran to the bathroom and threw up. I literally never throw up. I felt a little better after that. I took some ondansetron that we had left over from a patient and felt really weird all night. I barely got any sleep. I considered the ER and for a brief minute having my boss place an IV. Friday, I soldered through calls then slept all night on the couch. I did loose four temporary pounds.
Then Saturday and Sunday, I decided I wasn't tan so wore tank tops outside all weekend. Saturday, I got a little burned but decided to follow it up on Sunday with the most painful of all sunburns. I peeled all during the wedding weekend leaving little shreds of DNA behind. Gross. I am now tan. I used a tanning lotion on my legs which looked pretty good.
Joe and I went into STL via plane (direct flight! Woo!) on Thursday and visited my parents and grandma. Then I went from the way far out county area to downtown for dinner and walking to Lacedes Landing for a beer. Twice I had to convince myself not to drive into Illinois from failed navigational skills.
Friday, we met up with Amberle for a clinic tour and lunch at an amazing Asian place. Seriously, missing Amy's Thai. Maybe some takeout from the place downtown this weekend? Then we had the rehearsal dinner. The wedding party hung out in a suite that night. I called it quits early.
Saturday (the big day!) was sort of rainy. Then as we got out of the car to get our hair done it was really rainy! Like I was soaked to my skin rainy! I hadn't anticipated doing my hair but was sat in a chair and had it done. I'm not saying I could have done it better but maybe...she did my makeup and while Joe thought it looked nice, it seemed a little bold for me. After that, we went to the winery to get dressed and then pictures. Of course, everything was soaked. Martha's dress hem was soaked and muddy. If it had been me, I would have cried. Like big hysterical tears.
As we were starting the wedding, we were literally lining up to walk down the aisle at this point, it started pouring. Mind you that the wedding is outdoors! We all huddled under a vine arbor and waited for it to pass. The ceremony was short and sweet. Dinner was good. No cake, but an ice cream bar which might be even better!
Both the maid of honor and best man had been friends of our group since undergrad so their speeches were really nostalgic which is great for me since I'm overly nostalgic to a fault. Also great, talking to Matt Ryan (best man) and Eric Lutzeier, an old friend, because it appears that they are also both tragically nostalgic. We laughed it up about Brad's failed pursuits of many a girl including myself and various other dorm fun events.
On a random note, it was pointed out that all the bridal party had advanced degrees with a Masters being the lowest one ! LOL
It was a beautiful wedding that was barely marred by the weather. I want another wedding (to Joe, of course!) but I'm still paying off the first one!
Best of luck to the happy couple!
PS-here are some pictures of me looking
fat and washed out in my bridesmaids dress.
But our days of wedding bells past were not the only wedding bells this month! My BFF Martha got married in Missouri! She married long time friend, Brad! And I was in the wedding party which is good because when I found out about their engagement, I threatened to slit my wrists if I wasn't. (Maybe it wasn't that serious but I would have been terribly disappointed.)
Any who, proceeding the wedding there were some bridesmaids dress drama and some socialization drama as I perceived it but it was probably all in my easily to take offense mind.
Also the week before the wedding, I got food poisoning. Like seriously. Thursday night, I was on call and doing great. Ate dinner then started to feel bad. Then went in for a c-section and visited the bathroom like three times by the time the dog was on the table. At that point, the tech had called in TC. Which was good. I sat in the hall with Blaze the cat. I helped with puppies then ran to the bathroom and threw up. I literally never throw up. I felt a little better after that. I took some ondansetron that we had left over from a patient and felt really weird all night. I barely got any sleep. I considered the ER and for a brief minute having my boss place an IV. Friday, I soldered through calls then slept all night on the couch. I did loose four temporary pounds.
Then Saturday and Sunday, I decided I wasn't tan so wore tank tops outside all weekend. Saturday, I got a little burned but decided to follow it up on Sunday with the most painful of all sunburns. I peeled all during the wedding weekend leaving little shreds of DNA behind. Gross. I am now tan. I used a tanning lotion on my legs which looked pretty good.
Joe and I went into STL via plane (direct flight! Woo!) on Thursday and visited my parents and grandma. Then I went from the way far out county area to downtown for dinner and walking to Lacedes Landing for a beer. Twice I had to convince myself not to drive into Illinois from failed navigational skills.
Friday, we met up with Amberle for a clinic tour and lunch at an amazing Asian place. Seriously, missing Amy's Thai. Maybe some takeout from the place downtown this weekend? Then we had the rehearsal dinner. The wedding party hung out in a suite that night. I called it quits early.
Saturday (the big day!) was sort of rainy. Then as we got out of the car to get our hair done it was really rainy! Like I was soaked to my skin rainy! I hadn't anticipated doing my hair but was sat in a chair and had it done. I'm not saying I could have done it better but maybe...she did my makeup and while Joe thought it looked nice, it seemed a little bold for me. After that, we went to the winery to get dressed and then pictures. Of course, everything was soaked. Martha's dress hem was soaked and muddy. If it had been me, I would have cried. Like big hysterical tears.
As we were starting the wedding, we were literally lining up to walk down the aisle at this point, it started pouring. Mind you that the wedding is outdoors! We all huddled under a vine arbor and waited for it to pass. The ceremony was short and sweet. Dinner was good. No cake, but an ice cream bar which might be even better!
Both the maid of honor and best man had been friends of our group since undergrad so their speeches were really nostalgic which is great for me since I'm overly nostalgic to a fault. Also great, talking to Matt Ryan (best man) and Eric Lutzeier, an old friend, because it appears that they are also both tragically nostalgic. We laughed it up about Brad's failed pursuits of many a girl including myself and various other dorm fun events.
On a random note, it was pointed out that all the bridal party had advanced degrees with a Masters being the lowest one ! LOL
It was a beautiful wedding that was barely marred by the weather. I want another wedding (to Joe, of course!) but I'm still paying off the first one!
Best of luck to the happy couple!
PS-here are some pictures of me looking
fat and washed out in my bridesmaids dress.
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