Friday, October 31, 2008

Goodbye October!

Where did this month go? It was far too busy. Yesterday I drove to Texas A&M and spent the day with my dental mentor at the vet school.

I had not been to the vet school since I graduated 13 years ago. I got a little thrill pulling into town and seeing all the big familiar buildings. Inside the vet school so much was the same, for example the art and posters on the walls were exactly the same that were hanging when I was in school. Back then I hardly noticed them. Also, it smelled exactly the same. However, I think they moved every single department in the small animal clinic, and now have expanded with a big ICU. Also new: there is a small room totally dedicated to dentistry. This is a great improvement, since when I was in vet school, we had about two hours TOTAL in dentistry education, and there was no dentist on staff.

It was a very educational day for me. I got to see a root canal, a mandibular fracture repair, and this little ferret, who had fractured a tooth extracted:
He's getting a dental X-ray.

Some fun pictures from the clinic today:
A flying monkey, a la Wizard of Oz.

She's a turtle!

Uh, self-explanatory.

Monday, October 27, 2008

Photos for You

For Lisa, my Farmers' Market haul:
OK, the pumpkins were previously purchased and are there just for decoration. There is a small watermelon, that Colin picked out but was a total DUD, completely unripe. The ugly pears, just 75 cents each, are delicious, and there were 5 but Colin totally consumed on while we walked, leaving only a small marble-sized core which contained the seeds. The fresh green beans were steamed and tossed with leftover pomodoro sauce, and eaten with a yummy risotto ai fungi made from just one of those huge portobellos. The yellow tomatoes tasted better than the red. Not pictured: Berkshire pork, used to make potstickers (see the food blog).

For Melissa, my new purse:

It is beautiful and I love it. I just wish it was a smidgen bigger.

And now, some early Halloween pictures!
Anna is the Lilac Fairy (from Sleeping Beauty -she's the one who changed the curse from Aurora dying at the needle prick to sleeping until a prince kissed her). Repurposed ballet costume with perfectly matching $6 fairy wings.

And Colin as Peter Pan. He is as thrilled with his homemade costume as I am. Is Peter's sword supposed to be a Light Saber? Oh well!

Friday, October 24, 2008

Not the way I would write the ending

Last week a long time patient of ours was finally euthanized. It was time - past time - but unfortunately when he crashed his usual doctor was out. When his kidney values reached astronomic levels, another doctor had to tell his owners it was time. "But you don't know what he's been through! You don't know what he's come back from!" they countered. True, but when the kidney levels are that high, there is no recovery. Of course, you could tell that from looking at the poor cat, but the owners, blinded by love (in this case, literally), could not see how dire it was. Finally, they permitted a swift, peaceful death, even though it was about a week too late.

A dachsund is on my schedule; "dragging back legs," is the complaint. It's an eleven year old dog who hasn't received any veterinary care in over two years. Even worse: he has a history of back problems, and hasn't been walking since the day before. And had been wobbly on his feet a few days before.

Here's how spinal injury in dogs works: a disk from between the vertebrae protrudes and puts pressure on the spinal cord. The disks of a dachsund are more brittle so it happens frequently in this breed. The resulting pressure and inflammation makes the cord swell. Since the cord is in a confined space (the vertebral column), it cuts off its own blood supply. No blood = no oxygen = cord death. Time is of the essence. When they're wobbly, you can reverse the swelling with steroids and rest. The longer they are down, the more likely they are to need surgery, and the worse the prognosis.

With a history of previous episodes, this owner knew time was an issue. And despite her elaborate show of tears, it was obvious to me and the staff that she had long given up on this dog. I mentioned surgery ("I can't do that!") and medical management (he still had a chance), but she sobbed and said, "I think we're just going to have to let him go."

Poor dog. He had periodontal disease, large fleas trucking across his body, and now back pain and paralysis. A fast painless death wasn't the worst outcome, I supposed. She signed the paperwork like a heartbroken soap star, then handed him to me, saying, "We're doing the right thing..."

I couldn't tell if it was a statement or a question. I didn't reply. As she gathered her purse, dabbing her eyes, she spotted a folded newspaper on the bench. "Can I take this?" she asked, clear voiced, indicating the crossword. Sure. Could you work a crossword the same day your dog died? I couldn't.

Later the same day, I heard the distraught voice of a client, bringing a limp animal into the clinic. I quickly ended my appointment and helped carry the patient to the back. I saw a beautiful bird dog, blue mucus membranes, warm and robust but unresponsive. We intubated, administered CPR, oxygen, epinephrine -- it was too late. Her body temp was 96 - whatever had happened was too far gone; her brain was dead. She looked familiar, then I realized I'd seen her for a simple ear infection two weeks before. I remember how sweet she'd been, lifting her muzzle up to me, her hindend wiggling. Her distraught owner said she'd been normal all day when she left for an errand. Two hours later, she found her unresponsive, curled up on the bed.

There was no outward reason for her to die. She'd had a normal exam (except for a minor ear malady) two weeks prior. It was beyond explanation. Although I wish I knew why she died, I was relieved the owner declined autopsy -- I'm no pathologist, my schedule was full, and it doesn't change the outcome. A beautiful, beloved companion was gone.

Sometimes people hear of my job and think that caring for my patients at the end of their lives is the worst part. They are wrong. Helping my patients have a calm, peaceful end to their suffering can be very rewarding, although it is always gut-wrenching. When the end comes too late, or too soon, with contrived emotions or lack of caring, then it is unsettling. Losing a pet always feels painful, but these three in the same week all seemed so wrong, in so many ways.

Tuesday, October 21, 2008

Actually, I've done a lot of stuff since these pictures...

But the pictures of my NYC trip still need posting. Meanwhile, I've been working, driving to ballet, and visiting my other sister, parents, and family in Houston. Let's take a trip down memory lane...

Here's the boatload of beautiful appetizers we ordered at Buddha Bar...

The sisters' brunch! Erin, me, Emily, and Liesel.

At the farmers' market: lots of apples and heirlooms.

Amazing crepes made on the street while you wait!

After the thrilling performance of Wicked. Note how I coordinated my sweater to my musical...

Beautiful sunset on the last night from Emily's apartment. In the background is the Hudson River, in the foreground is Ground Zero.

Last night! What a wonderful trip! Salute!

View all my NY pictures here

Monday, October 13, 2008

New York State of Mind

My last day in New York was also fabulous. We talked to the kids on iChat, went to Emily's quaint church, then had an amazing and cheap lunch at a street fair - crepes with goat cheese, arugula, tomatoes, garlic, and turkey. Also could not resist some Thai food - $3 for stirfry or pad thai! We went to MOMA but unfortunately were too late to get in to see the Van Gogh exhibit that day. It was the only disappointing moment of the trip. So, what's a girl to do? Might as well shop.

Macy's gives out discount shopping cards to out of state guests, and I found 2 skirts and a pair of pants, especially after Emily graciously accompanied me to the petites department (nearly an entire floor!). One of the cashiers that helped us at the end was like a miniature Gilda Radner (her name was, no joke, Aswilda). I found a great pair of pants with a tiny hole in them. She tried to find me a replacement in my size in the back storeroom, and I could see her looking demonstrably sad and shaking her head from across the floor. "You've waited a lowng time," she said on her return, "So I'm just going to discownt it. I'm not even gonna ask. I'm just gonna do it. Let them come ask me!" She was hilarious.

We made it back to the apartment just in time to catch the brilliant end of the sunset from Emily's apartment windows. Then we had dinner at Patsy's, an established Italian place "Frank Sinatra made famous." I was a little worried when Emily pointed out the old career waitstaff and I noticed the established clientele, but after my first bite of salad, I knew we'd be OK. Rustically torn arugula, endive, and radicchio in a perfect vinaigrette -- mmm. I swooned when I tasted the Penne alla Vodka - perfectly al dente pasta, delicately creamy tomato sauce. Our waiter murmured his approval of everything we ordered. For entrees, Emily got stuffed chicken breast, and I had rack of lamb. It was heavenly. I sucked every little bone dry, then mopped up every bit of sauce.

We took a slice of cheesecake home (so tall! so eggy!) and shared it with another friend of Emily's who met us for a last glass of wine. We were very sad to see our fun weekend end. Our adventures were as perfect as the sunny, cool weather. Still, this morning I was up early, catching a cab back to JFK while Emily got ready for work.

I picked the kids up at school, and they were so excited to see me. Anna noticed my new purse immediately. We talked about how she missed me SO MUCH MORE than the week she spent in Houston. Now its back to work, school, routine, and they all seem to appreciate my role a little extra now, and I certainly appreciate them letting me go have this little adventure in the big city.

Sunday, October 12, 2008

New York, New York, Is Everything They Say, and No Place that I'd rather be. Where else can you do a half a million things, all in a quarter to 3?

After an amazing morning in surgery Friday, I took the afternoon off and flew to NYC, FINALLY, to see my sister who moved there over a year ago. My family, driving me to the airport, was demonstrably sad about my departure mostly because they all wanted to go with me. I understand; it's hard to be the one left behind.

Emily took the train out to meet me at JFK, then we took a taxi into the city. We went directly to our restaurant in the trendy Meatpacking District. Although it was after 10 pm, fashionably dressed hipsters were just starting their night. I felt a little shabby in my tired makeup applied 13 hours earlier with flat airplane hair, pulling my rollaway suitcase, but I was very happy to be there. Emily had called earlier to make a reservation and was told that she didn't need one. Now there was a roped off entrance with a guy at the door and a list; anyone not on the list had to wait in the line.

Emily said she'd called and gave her name. He couldn't find her name on the list (of course) so sent his buddy inside to check the master list. He came back out and said nothing and kept working the line. I caught his eye and said, "Did you find us on the list?" He nodded silently and let us through the ropes.

Inside we checked my bag and waited again at the hostess stand. Emily was annoyed because although the place was hopping, there were available tables. "It's just this New York game they play," she said. "They make you wait so it seems like they are more important and in demand." But soon we were led to our table.

The Buddha Bar is this cavernous dark space, huge by NY standards, with a 17 foot Buddha statue at the end. The walls are painted black, the lights are low and most of them red, and Bollywood techno was blaring. Behind the long bar were tanks of illuminated live jellyfish. It was so dark we had to move our one table candle closer to read the menu. I loved it.

Emily suggested we just order a bunch of appetizers, since it was late and that was the best thing on the menu anyway. So we ordered fillo wrapped shrimp, spring rolls, and sushi. Also a bottle of wine. "And for your entrees?" said our waiter. "Oh no, we're just having appetizers." The waiter, shocked, pulled back with his hand on his chest. "I don't know if I can do that! Let me go check!" Emily was fuming. "Seriously?!? He thinks after all that we ordered we are going to eat entrees, too?"

The waiter returned and said if the chef, very serious about his cuisine, had seen the ticket with just appetizers he would have torn it up. But! he assured him that we were very nice ladies, and he granted an exception since we were ladies. Then he brought the bottle of wine, showed it to Emily, then ran off with it. "Now you see it, now you don't," I told Emily. When our waiter finally returned with the wine, Emily teased him that she thought he wasn't going to let her have it. "Well, this is a nightclub," he said. "I don't want to be opening it in the aisle and jostle someone." Some nightclub - almost no bar, no dancing, just tons of tables with people eating dinner. In Texas we call that a restaurant.

The food arrived, and it was beautiful and everything tasted exquisite. We agreed the best was a yellowfin-jalepeno roll. Finally we got a cab and went to Emily's apartment. It is beautiful, with parquet floors, marble in the kitchen and bath, and huge windows overlooking Ground Zero. Just past the financial district, you can see the Hudson River. It is amazing. Emily made me play Dance Dance Revolution before we went to bed.

After a lazy morning we met some of Emily's coworkers, another pair of sisters, for brunch. These girls were so nice, and they obviously thought a lot of Emily. The food, again, was so good. I got a mushroom omelette with a mixed greens salad. The salad was so fresh and tasty, but then I found a paper towel mixed in with the leaves, wilted in the vinaigrette. I told the waittress, and she promptly apologized, removed it, and brought us a free creme brulee french toast! My meal was free and at least 3 people apologized.

It was a gorgeous day, sunny and in the 60s. We went to Emily's office and to the farmers' market. There were bushels of apples and lots of grapes, unlike the current market in Texas. Also, TONS of heirloom tomatoes. Don't worry, I took lots of pictures. We each got a cup of apple cider, and it made you weak in the knees. It wasn't too sweet or too cinnamon-y, just concentrated appley goodness.

We changed into bike shorts and Tshirts, walked past Ground Zero (nothing to see but a fence around a huge construction zone) to the Hudson River Park, where we walked along the river. Many families were out, enjoying the green space and sunshine. At the pier, the parks department was offering free kayaking on the river. We put on lifejackets and scooted barefoot on to kayaks. The river was a little choppy and it was only about 0.25 seconds before our butts were wet. However, it was so nice to paddle around in the very protected area between the piers, I could see why Emily often does the kayaking. Also, in a city that sucks you of money at every turn, it was FREE!

We had to hustle our cold wet butts back to get ready for our evening out. We had dinner at an Italian restaurant, Ciro, which was great and I would have liked to linger and order more courses, but we had to get to our show. Emily got tickets to Wicked, a musical about the Wicked Witch of the West (as in Oz), and it did not disappoint. The singing was so good, but also the costumes! The dancing! The set! Really worth it.

After walking around absurdly bright and crowded Times Square, we hailed a cab to take our tired feet home. Today shouldn't be as busy, but should be just as fun. I'll let you know...

Wednesday, October 08, 2008

Too busy to blog

I haven't even sat at my computer since Monday night. Tuesday was a marathon - busy work day with just 2 doctors and a in-house seminar, then rush home to Open House at the school, brief stop at our neighborhood National Night Out. Then it was a late dinner watching the debate; I fell asleep on the couch as soon as the analysis started.

Above, Colin shows me with a magnifying glass a cool glycerin bubble thingy. Below, Anna shows me a puzzle in her classroom. Obviously, I met them there in my blue scrubs.

Anna's beautiful artwork. I am so glad that my children really love each other.

Today they had an early out, so we went shoe shopping, shopping at Central Market, feeding the ducks, playing on the playscape - beautiful, crisp, sunny, fall day!

Monday, October 06, 2008

Small but significant

I worked Saturday, and had a pleasant morning of nearly all wellness appointments. The one exception was an easy eye case.

A new client brought in her terrier with a squinty red eye. I could see that the edge of the cornea had a bluish haze from swelling, and it certainly was red. But there also was a brown foreign object stuck in her cornea at about 10 o'clock. It was tiny but causing a large problem.

"I don't know how she did it, but she's always tearing around the yard," her owner told me. "When we lived in California she inhaled a foxtail and required general anesthesia. I still have that burr in a baggie at home. It cost me $600."

This terrier was sweet but wiggly. I recommended a reversable sedative before I went poking in her eye with sharp forceps. After she went from perky to limp, the small piece of mulch came out easily. It was about this big: 0

I debrided the small ulcer it made and flushed with lots of saline, and sent her home with antibiotic and antiinflammatory drops. I put the tiny offender on a gauze in a ziplock baggie. "Here's your $200 piece of mulch!"

Wednesday, October 01, 2008

I am so playing this Thursday night...

Also note, new food blog entry (finally)