While I was gone

I was gone most of last week, at the annual Veterinary Dental Forum.  Its my conference, my people, all teeth, all the time.  The week before Anthony was gone all week; he left again this morning, back on Friday.  It's the new normal.

While I was gone he sent me this great group of pictures.  Colin, after sticking to his scooter far too long, finally learned to bike on his tiny heavy beginner bike.  Once he had that down, he soon took to stealing Anna's 5-speed.  Even though it is pink, it was far superior to what he'd been using.  Anthony got him his own bike -- in blue, much better -- and left it for him in the garage with a note saying "To Colin, Love Mom and Dad."

After Colin got home on Friday, a beautiful Texas fall day, he ditched his school things and went out to the garage.  He started wheeling Anna's pink bike out when something caught his eye.

 Now he's jumping up and down and squealing.

 He's a pro already!


Can't you feel his joy?

Chewy the Hamster

On Sunday Anna asked me to look at her little hamster, Chewy, because her eye was tearing.  There was a swelling on the right side of her face/neck causing the problem.  The swelling was pretty soft and movable.  I figured she had an abcess or a cheek pouch impaction - that hamster is always shoving huge things in her cheek pouch.  I promised to take her to work the next day to lance the abcess.

When I got there the next day, the hamster's swelling was worse.   I gassed her down, then explored her cheek pouch with an otoscope.  It was empty and otherwise normal.  I felt this swelling, which felt much firmer now, not so fluidy.  I aspirated it with a needle and no pus.  Clearly this wasn't an abcess; it was a tumor.

This was going to be a big task, so I decided I needed to bring Chewy home and talk to Anna about it first, and also let her see her hamster before the big procedure.  "Yes, do it, if it will keep her from dying!" Anna said earnestly.  Well, maybe it will keep her from dying, and maybe not.  She might die under anesthesia.  Anna was tearful but still gave consent.

The next day after all my regular surgeries were done, and during my lunch hour, I sedated Chewy again.  The tumor had grown significantly again overnight.  Now it was pushing her mouth to the side.  With one technician holding a miniscule mask to her face, and another monitoring her heart and respiratory rates, I cut the skin over the tumor.

Sometimes there are benign, well-encapsulated tumors that peel right out.  A few times, when people are willing to spend money on their pocket pets, I have done these surgeries with great success.  This was not going to be one of those surgeries.  This massive tumor was irregular and had adhesions to everything.  It was extending under her eye and ear, into her oral cavity, down to her shoulder, shoving her trachea up and over like a snaking river.

Delicately I teased the tumor away from the vital structures.  I feared that if I hit a big vessel beneath (the carotid or jugular) she would rapidly bleed out.  My technician noted her heart rate slowing.  We added heat support and adjusted her gas.  It was frustrating that I could not intubate her and ensure her airway, or give her IV fluids, but of course that would be impossible with such a small creature.  After 45 minutes I had the mass about 3/4 of the way free, but Chewy developed a lot of edema (swelling) around her contorted trachea, and she expired.

The whole clinic was sad, for the little hamster and the girl who loved her.  When I got home, Anna burst out of the house, and I gave her the bad news.  She cried, hard, for about an hour.  When she had regained some composure, she said, "I know its not your fault, Mommy, I know you tried.  I'm glad she died while she was under anesthesia, so she wouldn't be in pain." Anna never ceases to amaze me. She also asked me to thank the technicians who assisted me and helped Chewy, and for the coworker who had made a precious clay momento with Chewy's pawprints.  She held her pawprint clay to her heart, and asked me if I would have her cremated ("I want to have her burned.").

Poor Chewy certainly couldn't have lived more than a few more days before that tumor would have choked her.  I was surprised how well Anna understood that.  Chewy was a "rescue" hamster that we got from a girl who basically ignored her once she became a teenager.  Skittish at first, she became quite friendly and curious, and let all kinds of children hold her.  She was in our home for only 4 months, but I think they were good ones.

My passion, my pup

Sunday Francesca was chewing her nightly "boney," her rawhide chew, when she suddenly stopped.  She kept bringing it to me, which was annoying.  "Go eat your boney, I'm watching a movie," I told her.  But she wouldn't eat it, and kept nudging me for attention.

She went to bed with her boney.  And carried it around the next morning.  "What is wrong with you?" I said as I lifted her lip.  Then I saw that she had broken her big molar, and there was a large red spot where the nerve was exposed.

AAAAaaaahhhh!

I am collecting cases as I work on my dental fellowship, but I did NOT want to practice on MY dog!  Poor Francesquita, no wonder she couldn't eat her boney.

Fractured teeth are very common in dogs, and this tooth is the most commonly fractured.  If the fracture exposes the pulp, or nerve, of the tooth, there are only two choices:  extraction, or root canal.  Do nothing, and eventually the pulp will die and fill with bacteria, and the tooth will abcess.  Meanwhile, its painful and unhealthy.

I got myself mentally prepared to perform the root canal.  Its a complicated, 3 rooted tooth, and I don't have as much experience with fixing it as I do single rooted teeth (like the fang).   Also, it is awkward working on your own dog, if you think about it too much.  Anthony put it in perspective for me, though, when he said, "What is the worst that could happen?  She could lose a tooth?"  Right.

So today, I fixed it, and it was the best I've ever done.  Just like in a human root canal, fils are introduced into the pulp chambers in each root:

Then, using progressively larger files, all the organic material/pulp is removed.  Once its cleaned, the pulp chambers are filled with an inert material called gutta percha:

Then the holes you made in the tooth and the rest of the crown is restored with composite.  The tooth is dead but functional.  Once it fractured, it would have died anyway.

Francesca is woozy and drunk from the morphine, but she is painfree tonight.  That is my gift to her; she gave me a great case to work on and a little more self confidence.

Treasure

Lots of good bloggy ideas in my head.  Little time or energy to get them out.

But look at this gift I got today!  I have a wonderful client who has gifted me with some of her gently used things, like a Waterford crystal bowl, Italian table linens, and a Lladro figurine.  (Can you tell she doesn't have a daughter?)  But today she gave me a gift I will really treasure:

Those are hand knit socks! Merino wool with just a touch of cashmere! Such beautiful tiny stitches!

I can't wait for chilly weather!

(PS these are NOT gently used.  They are brand new, never worn, knit just for me!)

The Next Installment

In Chile, we met another vet friend of Fran's, Catalina.  She was vivacious and friendly, and when she heard we were interested in going skiing, instantly volunteered to take us -- any excuse to hit the slopes.  She also had two daughters very close in age to our kids, and could loan us clothes and equipment.  She made it hard to say no.  So we made plans, and pre-bought lift tickets to get a discount.

Then, Colin started vomiting at around 3 am and continued every 45-60 minutes thereafter.  Anthony took one for the team, and stayed home with the sick boy while Anna and I went up the mountain.  Here's Anna in the car:

It takes about an hour to get up to the slopes.  We were so high!  Above the tree line!  Los Andes were SOOOO beautiful.  Here's Anna and I, just before her lesson.

Anna did not get taught very much in her lesson.  However, it did give Cata and I some time alone on the slopes.  I hadn't been skiing in nearly 15 years, but was pleased to learn it was like the proverbial bicycle.  I forgot how FUN skiing is!

And this resort was incredible.  Efficient, modern lifts, and so many runs!  We had access to 4 large areas of trails.  And no one was out there -- usually I skied right onto the lift.  The longest line I encountered was 4 people long.

Look at those beautiful mountains!  No trees makes for safe, wide runs, but it was so very bright.  I was grateful for the goggles Cata loaned me.  After lunch we had a few slow runs down the bunny slopes with Anna, and Cata tried out her snowboard.  Here's the only picture I have of her that day, my ski angel, taken by Anna after our last run.

I also forgot how very uncomfortable ski boots are, and how great it is when you take them off at the end of the day.  Skiing in July!  Incredible!

The next day Colin was BTN (back to normal).  He wasn't sad about missing skiing, just sad that he missed the snow.  Fortunately, Fran's mom, Carmen, and her uncle, Felipe, planned to take us to his rustic little cabin in Cajon de Maipo.  There was snow!!!

I love this view of his adorable cabin, with the mountains reflected in the windows.

Felipe lit the gas for his oven, and we heated up the empanadas we'd brought and opened the wine.  Felipe and Carmen speak about as much English as we do Spanish, but we had a lovely meal together, and a lively conversation.  Colin and Anna went outside to have a snowball fight, then we all went on a hike around the area.  It was a beautiful day.

We were also invited to be the guest speakers at Fran's niece, Elisa's kindergarten class.  The kids were supposed to ask questions in English, but they asked in Spanish.  They loved Anna, and asked her what her school was called, and what her friends were called.

Anna said, "Heather... Katherine...Benjamin...Vannida...Christina... umm..." A little boy said, "Tienes solo cinco amigos?"  (you only have 5 friends?)  It was hilarious.  We also sang them a little song we knew from her school in English and Spanish. 

What else did we do?  We ate out a lot.  One of Fran's favorite restaurants is Tip y Tap, a little Chilean restaurant that we loved for its dining room with windows that overlooked a play ground.  One wall had a forest scene, so here's Fran and I, correr en el bosco!

Here's what Fran liked to order:  tartar.   Fran! Someone forgot to cook your hamburger!

Here we are eating in a Patagonian restaurant with Catalinda.

This is from a high-end steak house where we ate with Fran and her brothers.  Oh man! that grass fed beef is good!  We started with Pisco Sours, then had wine, steak, and salads.  At the end of the meal, every table got a complimentary plate of cotton candy.  It seemed hilarious to us to get circus food at such a fancy place.  Good thing the kids weren't there to get so silly on all that sugar!

There is one last thing I have to post about, the amazing tiny winery we visited.  Until next time...

They're back from the wild West

Ok, I hear ya, clamoring for a post.  Our children returned from their 2 week visit in New Mexico with my parents.  They had a great time, going horseback riding, hiking, visiting Carlsbad Caverns, the El Paso zoo, and Peter Piper Pizza four times.  They also brought back this gem of a picture, which we LOVE!  There are more great photos and videos on Grandad's blog.

My kids had a great summer:  swim team, choir camp, and ballet camp in June, South America in July, and New Mexico in August.  I can't believe its over; school starts tomorrow.  Summer's over, but the heat goes on....

As we return to the school routine, hopefully I will get that post finished.

Hopefully this post was worth the wait!

We have returned from our long adventure in South America, leaving Santiago at 38 degrees, flying to DFW at 102 degrees, bringing many happy memories of a beautiful place with kind, polite people, amazing food and wines, and striking scenery:

However, the coffee in Chile was really terrible.  I can survive fine with my tea, but Anthony is seriously addicted devoted to good coffee.  Starbucks are ubiquitous, but they don't even make drip coffee there, and what they do put out is awful.  Apparently franchises in Chile don't have to follow any rules or standards from the franchisee.  Don't worry, we didn't try any of the other American chains we saw (KFC, McD's, Burger King, Domino's, etc).  We also did not try Starbucks ever again.  Look, they can't even get Anthony's name right!

On our first weekend, we traveled to the coast, Valparaiso, with Fran and spent a few great days there.  It was cold, but my kids are suckers for the ocean and a beach.  OK, me, too -- although I was cold I could not resist taking my socks and shoes off and walking in the lindo Pacifico.

The light and views at sunset were amazing.

The next day we back tracked a little into the Casablanca valley, where large wine producer Veramonte is located.  Fran's sister got us a special tour of the winery.  Wine touring and tasting is a relatively new concept in Chile, but they are quickly coming up to speed.  You do have to make an appointment for it, and although I've done the tour thing before, this one was superb.  An animated local girl with excellent English skills enthusiastically described their wine making process and what makes their terroir special.  Even Anna and Colin were engaged.  THEN she let us taste some of the recently fermented wines directly from the enormous stainless steel barrels.

It tasted great, but had not yet been aged in oak barrels.  It was exciting to taste the future potential.  Then she invited us to go inside one of the empty tanks - a big hit for the kids.

Then it was time to taste some final product.  Also known as time for Anna and Colin to watch videos on their iPods.  They don't enjoy wine tasting as much as we do.

This was a great tasting.  As we talked appreciatively about the wines, our host opened a special bottle for us to taste, not usually part of the tour (Ritual - a pinot noir).  Then a special cabernet, too.  Neither is available in the US, so we made our purchases, then we went to the place they recommended for lunch - Botha's.  This was a gorgeous restaurant where the chef/owner (a retired South African who fell in love with Chile selling mining equipment) greeted us, went over his oral menu (mostly Italian), then figured out what to fix us based on our conversation.  We started out with this lovely antipasto:

and what he promised would be the "best tuna you'll eat in Chile," and it really was.  He also matched it with a fabulous local pinot from a local vineyard.  Unfortunately, no pictures of the trio of pastas he put on each of our plates, but there is this stunning picture of Colin tucking into his spaghetti bolognese.

As we prepared to leave Valparaiso, the owner of our hotel gave us the idea to go to the beach and into the mountains to see the snow on the same day.  It was hard to talk the kids into this plan (not).

We took a different route back into Santiago, aiming for a place where our friend told us he'd hiked in fresh snow a few days before.  We got a little lost approaching the mountains, but got to see the beautiful agricultural lands that send us so much summer fruit during our winter months.  This time of year is their winter, and we stopped at a little farm stand and got 8 lbs of oranges for $4, plus inexpensive walnuts, almonds, and palta (avocados).  Finally we started our ascent into the mountains, and the roads got windier and tiny.  Unfortunately, most of the snow was melted.  We did manage to find a little bit of icy pelleted snow in the shadows, and the kids made the most of throwing it at each other.

As we paused here, a guy came out of a gate in a pickup truck, and rolled down his window to talk to Fran.  "They have great eggs at that farm," he said, showing us duck-sized chicken eggs.  "You should go get some.  Ask for Don Alfonso."  So we walked up the little dirt road, and asked three little girls who stared at us like we were aliens where Don Alfonso lived.  They pointed up the hill, and eventually Don Alfonso's wife came out and sold us some eggs, then invited us to see her little farm, with many chickens, cherry trees, and olives on a steep hill.  Don Alfonso himself came out to wish us goodbye.  Back in Santiago, we ate those oranges and eggs for days.

Eventually, Fran's brother Paolo needed his apartment again for a few days, and we heard about a sale on last minute airfare to Buenos Aires, Argentina.  Everyone said it was a beautiful city, and much cheaper than Chile due to the exchange rate, so we booked our tickets and said goodbye but see you soon to our Chilean friends.

We arrived in Argentina, and had to pay a hefty "reciprocal fee," just to get in the country.  Apparently, since our country makes citizens from South America apply for a visa just to visit the US, and you even have to pay to make an appointment to ask for this visa, they return the favor to US citizens and require payment when you arrive, before you can pass through customs.  Then you get a certificate in your passport that is valid for the lifetime of the passport.  We knew we'd have to pay it to get into Chile ($130 each of us, even the kids).  We did not realize we'd have to pay even more to go to Argentina ($150 each).  Man, what a terrible way to start your visit to a new country.  I renewed my passport this year, so now I can enter for free for the next 10 years, but Anthony and the kids have less than 2 years left on theirs.

Anyway, with that horrible just-been-violated feeling, we finally found a taxi to take us into Buenos Aires and to our hotel.  The ride takes about an hour, and the sun was setting.  It got darker, and more crowded, and the traffic in the center of the city slowed to a crawl.  Finally our taxi driver halted in front of our hotel, in the "Microcentro," on a crowded one-way street with two lanes of angry traffic, narrow sidewalks with rapid foot traffic, and it was a little treacherous getting our kids and our bags into the hotel.  The hotel was rather crummy, too, but was all we could find the first two nights of our stay after we'd booked the airfare.  For example, we had a room on the 6th floor, but the elevator only went up to the 5th floor.  We dropped our bags and headed back on the streets to find dinner.  The sidewalks were very narrow, grimey, occasionally the sidewalk was broken up, and crowded with many smokers.  We tightly gripped our children's hands as large buses barrelled down the lane next to us.  This was supposed to be a good area of tourists, and I didn't feel unsafe like I'd be robbed, but I did wonder why we left beautiful Santiago for this dirty, smokey, crowded city.  It didn't look anything like Paris, as was promised.

Fortunately we were just a few blocks from a great steak house.  Argentina, with its vast plains, is known for its grass-fed beef.  The place we went had an inground charcoal barbecue up front, with a few lambs and goats "crucified" and roasting in front of the coals.  In the dining room were many professional waiters, all male and over 50.  Some good Argentine beef and Cabernet did wonders for our psyche.  Colin had an omelette with queso y jamon, and Anna had a big skillet of eggs, jamon, and fries.  Also helpful was the considerate demeanor of our waiters.  Although we are very slow to order (since it takes a while for us to navigate a menu all in Spanish) and then we order in our marginal Spanish, we might be a server's worst nightmare.  However, the waiters were kind and helpful, never rushed us or even seemed impatient.  This actually was our experience throughout Buenos Aires and Chile.  Americans, not even in the South, are this friendly or kind.

The next day we explored the city, stopping in the Plazas to enjoy the sunshine.  Here the kids fed the pigeons, and maintained this still position for about 20 minutes, trying to get the pigeons to eat directly from their hands. 

I didn't know they could be this patient or this still.  Finally Anna had success!  You can't see her face but she was beaming.  A few moments later, they ate from Colin's hand, too.

Here they are in front of the Casa Rosa (pink house, like our White House) where the President still works, and where Evita gave her famous speeches to the people, and where Madonna filmed the reenactment of that scene.

We had lunch in a great little cafe overlooking Plaza Martin, and Anthony finally had a good cup of coffee, thanks to the Italian influence on Buenos Aires.  The next day we moved to a better hotel in a much nicer neighborhood (the Recoleta), and finally I could see why people said it was like Paris.  This area was filled with shopping and residential buildings with tiny but ornate iron work.  You could actually walk the sidewalks safely.

We visited the Cemetery, filled with amazing and ornate mausoleums.  It is a tourist destination, like the cemeteries in New Orleans or London.  Evita is buried here, but I was mostly moved by this small grave, of a young girl who died in 1968 at the age of 24.  Her father placed this statue of her and her canine friend, and a poem (all in Italian) which mourned her.  "Why are you gone, and why am I still here?  Why is there this pain in my heart?  I believe in destiny, but why must I go on without you?  Per che? Per che?"  It was so poignant.  Anna and Colin liked the many friendly cats who make the cemetery their home.

We also went to the Evita museum, which was quite good, explaining her life.  Anna was impressed by all the dresses, shoes, and hats of hers on display.  The Museo de Belles Artes was also superb.  We toured the Buenos Aires Zoo.  It was an old fashioned zoo, where they sold "Comida para los animales,"  food that you could feed all of the animals, apparently.  ("How can they have one food that all the different species can eat?" Anthony wondered.) Mostly people were just throwing it at the animals, which was disturbing.  Except for the llamas - they really loved that animal chow and would reach for it.  They did have some beautiful big cats in large enclosures, and some monkeys that lived uncaged on small islands in the middle of a man made pond.  There were also lots of large free nutria, those massive rat-like rodents, that roamed the place and swam in the water, getting fat on the animal food.  It was cold, so we waited in line to go in the reptile house for some warmth.  Sometimes, you have to hold your baby, no matter how big he is.

We did enjoy Buenos Aires in the end, especially the beef and the kind people.  They were easier for me to understand than the Chileans with their crazy accent.  Our last meal was at a Chinese restaurant recommended to us by our hotel.  It was terrific, and we were the only non-Asians in the place, but it was a little tricky figuring out what to order from our Spanish-Chinese menu (we did fine, though).  One day I realized Colin had eaten nothing that day that wasn't bread, cheese, butter, or jamon.  I made sure we got some apples to crunch on while we walked the next day!  We also did some shopping - I got some beautiful leather boots, and the kids got some leather coin purses.  Anthony picked out a great leather bag for work, but just couldn't bring himself to buy it when he saw it was made in China.  We did enjoy using our travelers' skills, and practicing our Spanish more than we did when we were around Fran.  However, we were all looking forward to returning to Fran and her family, and the kids wanted to go "home" to our (Paolo's) apartment.

Fran picked us up from the airport, shouting, "I missed you guys! We are going to have a party tomorrow, and you're invited!"  The next day she picked us up and he hiked up a cerro (steep hill) for some fresh air and beautiful views of Santiago.

Then we descended to go eat Lomitos - sandwiches of sliced pork roast, filled with palta (guacamole), sliced tomatoes, pebre (their version of pico de gallo, heavy on the cilantro), and mayonnaise.  They are incredibly delicious!  Fran's dad is a great cook.  Her entire family was there (she is one of 5 brothers and sisters), and they welcomed and included us like we were members of the clan.

It is their tradition to all gather for a huge family lunch, nearly every Sunday.  Anna and Colin happily played outside with Fran's four neices (aged 6-9) while the adults chatted and tried some of our wines inside.  It was a great day, and an honor to be included.

On Monday while Fran worked, we took the metro into downtown Santiago to explore.  The kids loved the free postal museum, mostly because there was an old telegraph machine and a chart of Morse code.  They had never heard of it before and spent a long time tapping out their names and other words.  We visited the beautiful cathedral and had a "hot dog completo" for lunch.  We also hiked up Santa Lucia, a park on a steep hill in the middle of downtown Santiago.  It had great views of the city, air pollution not withstanding.  There were about a million steep and uneven steps to the top of the "castle", and Anna and Colin decided they needed to get to conquer it, racing to the top.  I'm sure if it had been our idea, they would have complained the whole way up, but it was fun when it was their idea.

Collecting daisies at the bottom of the hill.

Hard to believe after all of that we still had a week to go.  I'll pause here and finish later.   Right now, in real time, Anna and Colin are in New Mexico visiting my parents.  To escape the heat of Houston, my mom and dad rented a cabin in NM, and were starved for some grandchild-attention after being gone for 6 weeks.  A&C were also thrilled to continue their adventures, and to go on their first airplane trip alone.  We can iChat with them every night, and clearly they are all having a blast.  Anthony and I are also enjoying a kid break after all of us being together all the time for three weeks.  Our kids are good travellers, and great to be around in general, but we sure are enjoying going to dinner/movies/Ikea without worrying about a babysitter.  The house is quiet and stays clean!  So, to be continued...