Tuesday, April 21, 2015

Fluorinated Water and Coconut Oil

So these people call because their mean outdoor cat got in another fight and has an abscess again. They were just here! Oh wait, that was a year ago. For the same problem. They come in stinking of cigarette smoke and unwashed clothes and the cat is already hissing.

My nurse goes into the room. "Hi, How's Fluffy doing today?"

"Well, he's okay, but see I can't pet the cat, only he can pet the cat." "Yeah, only I can pet the cat but only when he wants to be pet. You see, he is outdoor mostly, he came to us as a stray and only lets me pet him. Sometimes."  "Yes, I'm the only one that..."  A further 10 minutes of this conversation ensues while my nurse walks out of the room without having any of her questions answered.

I walk in. "Hi I'm Dr. M. So, he got in a fight again? How long ago was it?"

"Oh, a week maybe. But it just closed," the woman says, "because I put coconut oil on it!" She looks like a washed up hooker from the 80s. "Have you ever tried coconut oil?"

"Um no. So we need to drain the abscess, and we are going to have to sedate him. I'm also going to give him an antibiotic injection."

The husband says, "Ok."  The wife says."Ok. Will he get a cone? Because he got one last time, I remember. You know, I stopped drinking fluorinated water 20 years ago, and my memory is better than ever." She then gives me a knowing smile and nods.

"I've been drinking fluorinated water my whole life." ::and I think to myself, 'and which one of us is the doctor in this room?'::

She says, "Oh, well have you seen the latest research out of Europe?"

"Um, no I haven't. So-"

"Well you should look, very interesting stuff, fluorinated water is very bad for you, you should stop drinking it. Your memory will improve."

"Ok, I'll think about it. Meanwhile, let's fix this abscess."

I have to leave the room while she is still talking because she just won't stop no matter what signals I try to give her, such as changing the subject, standing up, opening the door, and walking out.

We sedate the cat and lance the abscess. He wakes up. I go out to the lobby to tell the owners that he is awake and all went fine. "So," I say, "you're going to need to keep the hole open for the next day or two so it keeps draining."

The husband begins nodding his head in understanding. The wife says, "Ok, so should I put coconut oil on it?"

I start to shake my head and say no when she immediately asks "How about hydrogen peroxide?"

I say no, and that H2O2 kills healthy cells plus it burns. The husband says, "Yeah, you don't use hydrogen peroxide," whereby the wife interrupts immediately and says "Let her talk!"

I continue explaining that they will need to allow the abscess to drain and the husband nods in understanding. The wife stares at me confusedly and asks me if he's going to have an e-collar. I tell her no, he doesn't need one this time. She says, "But he had one last time! I remember!"

"Last time," I say, my patience running thin by this point, "he had a drain which he could have pulled out. He didn't need a drain this time, I just need you to keep the area clean and keep it open to drain." (Admittedly, too many uses of the word 'drain' for her addled brain).

Then she says, "Oh! I know! I'll put coconut oil on it, that'll close it right up!"

I sigh as the husband tells her that no, we want to leave it open and she tells him to Let me Speak! again. I just look at her for a moment resignedly. "Ok, what are we supposed to do again?" She asks.

"Would you like me to write it down for you?" I ask. She nods, apparently forgetting that her memory is killer now that she stopped drinking the fluorinated water.

I go sit down at a computer and type instructions, while drinking a glass of [fluorinated] water.





Tuesday, March 31, 2015

Strong Women

Dear Sugar, the advice column, is back. Only now it is a most excellent Podcast by the two Sugars, Cheryl Strayed and Steve Almond. If you've never read Dear Sugar, it's not your typical advice column. You'll find no Miss Manners here, as Sugar deals with everything from sexuality to drug addiction to family dynamics. At the core of most of Sugar's advice is that it's okay to be your true self, whatever that may be. It really resonates. I read the column for a few years, then Sugar was revealed to be Cheryl Strayed, who had just released her book Wild, and a collection of Dear Sugar columns, called Tiny Beautiful Things. Dear Sugar went on hiatus while Cheryl promoted her books and the Wild movie.

I was excited to learn Dear Sugar was back, and subscribed to the podcasts. (I finally found something I can do with that 50 minute commute!) The second Podcast episode  deals with a letter from a woman who suffered extreme emotional degradation at the hands of the man she loved, and she questions if all men are like that, and if there are any men out there who really respect and love women. The Sugars discuss feminism and how deeply ingrained in our culture it is for men to degrade women as a means of controlling them.

Last week I was talking to a man who I know, not personally but in a professional manner. Although I'm not going to disclose the nature of the conversation, I will say that it was not my boss, or a client or anyone close to me. During our discussion, there came a point where he actually was making a case for me to NOT go for the thing I wanted to go for, and his justification was that I already had a pretty good thing to begin with, and I should just be grateful for what I had and not have higher ambitions.  (I know this would make more sense if I actually told you the details, but you'll just have to trust me).

He was telling me what men have been telling women for decades, if not centuries. You're lucky you have this much! You're lucky we gave this to you. You don't deserve more.

I wasn't going to just sit back and listen to that load of codswallop, so I called him on it. He said he didn't mean it that way, and the truth was, he didn't really mean to say that I didn't deserve more. And that is what is so frightening. Pushing women down, "keeping them in their place," is so ingrained in our culture that men often don't recognize it in their own behavior. It's how they were raised.  Boys are taught that women are the weaker sex. Male body parts are used to describe bold, confident behavior. Female body parts are used to describe weakness and cowardice.


It is common knowledge that women are paid less than men for the same work, across all disciplines. It's still happening today, despite being known. Women are still portrayed in movies as being only concerned with relationships and their worth determined by their appearance or the status of the man they are with.

Well, it's time for that to change. Now. With our generation. If there's anything true about GenY, it's that we aren't afraid to speak our minds.

I started writing this post a few months ago, but never finished because I couldn't find this article that I had read about this subject, and I really wanted to reference it in this blog. Then, finally, one of my friends shared the article. It's called 10 Words Every Girl Should Learn and is written by Soraya Chemaly.  The author definitely better articulates what I am trying to say.

            "We socialize girls to take turns, listen more carefully, not curse and resist interrupting in ways we do not expect boys to. Put another way, we generally teach girls subservient habits and boys to exercise dominance."

It's time for that to change. Ladies, don't be afraid to take charge of your own conversations, and lives. Speak up, teach your daughters to speak up. Teach your sons to respect women as equals and listen to women's voices. Because we deserve it. We do deserve more.




Friday, February 13, 2015

February is the Worst Month

I plucked a new WHITE hair from the top of my head this morning at 5:55 am, after having gotten up to feed the baby at 5:40, and just before heading off to work. I would chalk this one up to the Almighty Baby, except for the fact that the last two weeks at work have sucked. There is no other word for it.

No offense to my February birthday pals, but February is the worst month. Feb and I have never gotten along, and I know plenty of people who have broken up with significant others, lost jobs, slipped on the ice, ate a bad donut or worse in February. Back when I lived on the east coast, I thought it was because Winter was dragging on and it was still dark and cold and yet again the groundhog saw his shadow and when is it gonna be Spring already?!?!? But now that I live on the West Coast, where February still sucks, I can say, without a doubt, it's just the month itself.

Last week, nearly every case I saw seemed to have a bad prognosis. I don't recall a week where I saw so many sick or dying pets, although so far this week isn't shaping up to be any better. When you hear a veterinarian say, "It isn't all puppies and kittens," we aren't lying. In fact, when we do see a puppy or kitten it makes our hearts soar, because 9 times out of 10, that puppy or kitten is healthy.

First there was the cat whose vomiting had progressed from a few times per week to 2-3 times per day. FYI, that is bad. Cancer! Then a new diabetic (that one actually turned out okay but it is always a difficult conversation because diabetics require a significant time and financial commitment. If the owner can't commit, I recommend euthanasia). Next was a cat with a fluid filled abdomen, cancer. A cat with a fever of unknown origin, who is now doing better but it was touch and go for a few days. Then, a dog who came in for a skin tag and had a giant mass in the abdomen. The owner chose to ignore this piece of information and took her home after discussing the skin tag was the least of her worries. When I called a few days later, he was still blissfully thinking his dog was fine.

Then there was the dog who had lost 30% of its body weight in the previous 2 weeks. This one was an undiagnosed diabetic in ketoacidosis, which is a state of severe disarray that precedes diabetic coma and death. Oh and she had a liver mass and a raging new heart murmur. That was followed immediately by a cat whose jaw was hanging open and had a firm swelling on the chin which was cancer.

Add to the list a bird with hepatic lipidosis, ascites and pneumonia, a cat with a mass in its abdomen and likely peritonitis, a FIP kitten, which I can't even talk about because I HATE that disease, and a couple more cats with likely cancer, two dogs in congestive heart failure, and kidney failure cats destabilizing, I have had enough.

The absolute worst is giving the horrible news when people came in expecting only something minor to be going on with their pet. Hearing that their pet has a terminal illness is devastating, and it's no picnic for me either. :(

By the way, it's Friday, February 13th. I am skipping the rest of February.


Saturday, January 24, 2015

Entitled

I've been neglecting this blog, and not because I'm super busy (although I am), and not because I now have a kid (although I do), but because I haven't been feeling the creative drive to write. I've had a few false starts, and everything just seemed too trite to write about, or a rehash. Tonight I'm sitting on my couch in a rare moment of relaxing before bed, trying to think of ways to get some yoga into my already crammed schedule, and feeling only slightly guilty about the housework that didn't get finished today.

I've been back to working full time for the past five months, and have been seeing all manner of crazies. I've seen a lot of great clients as well, some who ask me about my kid every time I see them or ask me how the commute is going. People really do care. Some of them. 

I hate to admit it, but my generation is the worst with entitlement. I saw a little puppy today owned by a girl about my age, maybe a few years younger. The puppy had a few issues that are common to puppies, but still need treatment. The puppy was on one of our "puppy plans," which is a comprehensive plan for all the normal first year things, exams, vaccines, dewormings, pedicures, flea and heartworm treatment, spay/neuter surgery, microchip, fecals, etc. It is a discounted wellness plan designed to get people in the habit of bringing their puppies to the vet, and doesn't include sick diagnostics or treatment.

When the owner saw the estimate, she told us she didn't have any money. She then proceeded to tell us how she already gave us $300 for the puppy plan last week, and even more is due the following week. And, the last time she was here, um, her boyfriend had to pay for the dog, and she can't ask him again so soon. Oh, and she doesn't have a job, but she has an interview Tuesday and if she gets the job, then of course she can pay. But until then, well. We are being completely unreasonable by expecting her to pay for the care HER dog requires. She deserves to have a dog, but we don't deserve to be paid for keeping it healthy. 

I smiled. She declined everything.

What I wanted to say was this: YOU chose to get a puppy (while not having a job). YOU chose to buy the puppy plan, of which you were clearly aware required payments. It is YOUR responsibility to pay for this dog, not mine. Figure it out, or don't have a dog. 

But we can't say that to people. I want to say it, multiple times a day, sometimes. But I don't. So I say it here, into the nothingness and everythingness of the internet. 

The saddest thing (besides the dog not getting the treatment it needed), is that is the interaction that stood out the most today, among all of the nicer clients and appointments I had. No wonder burn-out is so common. 


Tuesday, October 7, 2014

Client Relations

To all of the people who think I should be available to them 24/7: We live in a big city with a hundred and one great emergency clinics. They exist so I don't have to be on-call all the time. I deserve to have a weekend with my family without thinking about or talking to you crazy people.

To all of the people who think I am just trying to sell you flea meds to make a buck: Your dog/cat has fleas, and/or flea allergy. Taking one pill is not going to solve your problem. Don't get mad at me when in 2 months you are back in here with skin infections having to pay me $300 all over again. I tried to help you stay away.

To all of the people who think that it is their right to own a pet, but not their responsibility to pay for it: You are what is wrong in this country. Stop blaming everyone else for your problems and asking everyone else to pay for your mistakes. Take responsibility for your pets, children, bills, house, car, whatever. You will be happier for it.

To all of the people who have somewhere else to be: It is not my fault nor my responsibility to get you to your next appointment on time. You are lucky we squeezed you in on a busy Saturday. If you don't want to wait, come in during the week. You might get out of here a little sooner if you put down your phone and listened to what I had to say the first time, instead of making me repeat it because you weren't paying attention.

To all of the people who just can't afford it right now, but will come back next month: You're not fooling anybody. We've been talking about that dental for 2 years. Do you really think I believe you're going to schedule it next month?

To all of the people who have a mean dog but refuse to acknowledge or curb it's bad behavior and tell her Good Girl as she's trying to bite my face off, or say She never bites! or get offended when I muzzle her: Fuck you. You're an asshole, and its clear where your dog got it from.



Now,
To all of the people who take care of their pets' needs and without holding a grudge about the cost: Thank you, you make my job a little easier.

To all of the people who listen to what I tell them and try to follow instructions: Thank you, you make me feel like something is going right.

To all of the people who ask me before asking Dr. Google: Thank you, you just saved both of us a big headache.

To all of the people who thank me for saving their pet's life or helping them to the next: Thank you, thank you, thank you.

Friday, June 20, 2014

Throwback, err, Friday - Vet School Blogs

I have only written 4 posts this year and we are six months in! Sorry ... but I have an excuse at least. I created a human being. From scratch.

I was looking through some old emails and came across a few monster emails I wrote during vet school. Here is one from my very early days as a freshman ... I can't believe how ecstatic I was.

---------------

_SU won the game today

Well, it was against northwestern, so i don't really count that a huge victory, but whatever. game day here is just like it was at ____ state. btw, i dont feel like using punctuation right now or capitalizing everything, because i was just typing up an outline of our dissection of the dog, which i am planning on giving to my group, so i carefully capitalized everything that need to be etc. 


***warning for people who arent in the veterinary field...there are some gross details in this email.********

classes started wednesday and are going well. i am so tired though. wednesday and thursday we had orientation to everything, but we still started the material. since they are on a quarter system everything is condensed into 10 weeks, so we had to get started right away. the first day of anatomy we got our cadavers and started dissecting. our dog is a really really fat blue heeler and it has been a bitch to clean all the fat away from her muscles. we named her hyena fatty, because she kind of looks like a hyena. its been fun though. my group is a little uptight, and they are all worried about grades and cutting in the wrong place and i am ust like, cut that sucker. monday i am going to just take over because at the rate they are going, we will never get her arm off. that is the first thing we are doing, learning the thoracic limb, and we have to know all the muscles and their actions and innervations, and the bones and some of the structures on the bones. we have been spending alot of time digging around in her fattiness. she is gross. we separated the latissimus dorsi from the obliques and a pocket of liquid fat cam oozing out of her. it was gross, but we were all cracking up. monday we have to deglove the rest of her arm and then take the whole thing off of her body. wednesday we start learning nerves. 

i also have radiology, which is only on wednesdays and i think its going to be a peice of cake. the first day he showed a film of a bloat, and i was like seen it. i have epidemiology every morning, and then cell biology at the end of the day and tuesdays and thursdays i have histology. histology we havent really started yet bc we only had one day of it so far and it was spent learning how to use a microscope. thursday on my time in btw orientations i went and gave blood, yay!! then friday we dissected again, and thats when i decided that it was time to take charge of the whole thing.  and we had two hours of cell bio, i think that is going to be my worst class. for some reason i just have trouble remembering that stuff. 

right now all the clubs are trying to get first years to join, so we keep getting free lunch which is great. i feel like i am in grade school again. we have lockers in the basement where we can keep our scrubs for anatomy. i carry colored pencils around with me all the time, pack my lunch in a dorky lunch box, bring clothes to school, work in groups, and sit in the same seat every day. people are really possesive of their seats. its pretty funny actually. i just bought a backpack because my trapezius muscle was getting very sore from carrying 30 pounds of stuff a mile there and back every day. i should haev mentioned that our class notes are excessive and consist of about 900 pages all together. i dont have to bring them all every day, but still. thats a lot of paper. i also bring my dissection guide every day. and notecards.

i am really tired and its only the first week. im sure i am going to be a zombie pretty soon. then i will write emails that are all the same sentence---whydididothistomyself. 

talk to you soon...sendme funny emails so i don't lose my mind!!!! if i go crazy, its all your faults. 

ps. to the doctors on this list...what is a really good brand of stethoscope? 

loves


-----------

I just want to point out there were people who were the same way in necropsy rotation. Fourth year.  I mean grow a pair.*

*I must amend that last statement. Grow a VAGINA. Much stronger than balls.  

Wednesday, May 7, 2014

Blue Buffalo Sued for False Advertising

When clients ask me what food they should feed their pet, I tend to mention the same few companies, who have proved through time and science that their products are wholesome and balanced. There is one company I never recommend to clients, Blue Buffalo, and my reasons really have nothing to do with the food itself. My main complaint, in addition to a few other things that have come to light about Blue, is the way the company markets it's products. Ever since Blue commercials began airing, I have had many discussions with clients about by-products and the true definition of the term, and so-called "bad companies."Apparently Purina has had enough of it, as well.

I find it wholly unethical to a) Vilify other companies in your own industry in your marketing materials and b) Imply that certain pet food ingredients like by-products and corn are evil, cheap fillers that harm your pet. (See this post). That is why I was ecstatic to read that Purina has filed a lawsuit against Blue Buffalo for false advertising.  You can read about it directly from Purina at their website, http://www.petfoodhonesty.com/.  In further research, it appears that Hill's has also come up against Blue for their advertising claims.

Purina states that they used an independent laboratory to find that Blue foods do contain by-products and by-product meals, despite their claims. This is unsurprising, as the term by-product only means material not used as human food, and encompasses quite a few things that commonly find their way into pet food. As I have said in previous posts, by-products are not bad. It is only the term that has a bad connotation. Highly nutritious organ meats like liver and spleen are included, as is bonemeal which is a great source of calcium. Feathers, hair, hooves and teeth are not included.

Marketing for pet food is obviously directed towards the owner, as s/he is the one with the wallet. This is true of ALL pet product companies. The shiny bag with the pretty picture on it, the logo, the fun colors and different size fonts all appeal to the owner. If we were going to let the dog decide, a plain bag that the scent could travel through would be plenty. It is difficult to remember this when confronted with an aisle full of gorgeous labels. I understand why companies make their bags so pretty, I really do. The same goes for the advertisements. TV is a great way to get your message out there. But it is possible to promote your own product without putting down the products of others, which I really believe hurts the entire industry in the end.

Blue has responded with a letter that tries to appeal to it's customers emotions, just like their advertising.  You can find it on the Dogington Post website, linked above. They continue to vilify their competition, accusing multibillion dollar company Purina of attacking a "family run company" and using emotional descriptive terms like outrageous, voodoo science, pet parents, and frivolous. Meanwhile, according to this article, Blue made over 600 million dollars in profits in 2013 and may be sold this year.

It will be interesting to see the outcome of this lawsuit as well as the many other things that could be changed in the pet food industry as a result.  A great article on evaluating pet food companies can be found here.