Tragic twists and turns

Last week one of my best clients said he was sending his dad's cats in to see me.  One of the cats had teeth trouble, and his parents' regular vet just kept giving steroids and antibiotics with no improvement, stating he was unwilling to anesthetize and take care of the cats teeth.  Since I am unafraid of anesthetizing older cats with our very safe protocol, and I love taking care of teeth, I encouraged him to send them in.

His sister ended up bringing in her very elderly father to the appointment, with the old cat, and the old cat's mother.  The cats had belonged to some neighbors who moved about 2 years ago, leaving the cats behind.  The old man had the cat in question sitting on his lap, and seemed delighted to meet me.  He grabbed my hand with both of his and smiled warmly when I introduced myself.  He was terribly hard of hearing, and seemed not to know exactly what was going on, but still enjoyed meeting people and connecting with them, especially if they were interested in his cats.

The cat in question was very friendly, but dried drool was all around his mouth.  His teeth weren't terrible, but there was a large mass under his tongue, with a necrotic center.  I relayed this information to the man and his daughter, continuing my exam.  The old man said, "Oh,"  and the daughter came close to me, and whispered, "His wife just died two weeks ago.  I don't know if he can handle this."

I finished my exam, reeling from this information.  Well, I'd better examine the cat's even older mother.  She weighed only 4 lbs (!), and had a pronounced heart murmur.  She seemed to have some labored breathing.  Oh, great.   The daughter and I left the old man with his cats to confer in the adjacent exam room.

"I am 95% sure that is a tumor under the cat's tongue," I told her.  "The only way I can be 100% sure is if we do a biopsy, but it will come back something bad like squamous cell carcinoma."  How I wished it was just a dental infection, something I could fix!  After conferring with me and her brother, we decided to euthanize the cat.  We sent off labwork on the older mother cat, and took a chest Xray, which showed an enlarged heart but no problems in the lungs.

The daughter thought it would be best to just leave the cat with us for euthanasia, and she would take her dad and the mother cat home, and let him know later what happened.  I brought her the permission form for euthanasia.  "Just initial here that he hasn't bitten anyone in the last 10 days," I said.

"But he has!" she said.  "He bit my dad last week, really bad, on the arm."

Oh no.  I checked the records faxed from their previous vet.  No history of a rabies vaccinations.  This was not good.

"Could you just look at his arm, and tell me what you think?" she asked.

"No," I said, "but here's what we're going to do.  After the euthanasia, I'll have to send the head to the state lab for rabies testing.  We can send the rest of the body for cremation."  Truly, since I am not a physician, I cannot give my opinion on a human's condition, and no one can tell by looking whether a bite has rabies or not.  But I do have to help protect public health, and by law this cat's brain had to be tested.

"What will I tell my father?" she asked.  I told her not to say anything; likely this cat had been vaccinated at some point in his lifetime, and in 24 hours we would have the rabies testing results.  If it came back positive, we'd let him know and deal with it then.

While the poor overwhelmed daughter finished the paperwork (remember, she'd just lost her mother two weeks ago, too), I went back into the room with the old man.  "You're going to go home with L. (the mama cat), and I'm going to take care of this one here," I told him.  "Okay," he said, "what was your name again?"  "I'm Jennifer," I said, dispensing with the dr. title, and we shook hands again.  He was so sweet and kind, and I felt terrible for him, but I knew it was the right thing for his poor cat.

Then, I humanely euthanized the cat and had the gruesome task of cutting off its head, and double bagging it for the lab.  Fortunately for us the lab is here in Austin; other parts of the state have to put it on  ice and send it via Greyhound.

The next day the results came back negative, and the mom's bloodwork showed some hyperthyroidism, a disease that is relatively easy to control with oral medication.  And there is talk of getting the old man a new cat, perhaps an adult cat from the shelter, one that also likes to sit in laps.

Summertime, the livin' is easy?

So apparently life is not getting less crowded now that school is out.  At least there isn't any homework, though!  The weekend after school finally let out, we had our first swim meet (5 am! yuk!) followed by the annual Danskin Triathlon.  Emily and I have been doing it annually for some time now.  It is a great way to make yourself get in shape for the summer.  This year we followed it with some spa pampering and massage.  That's the way to relax!

Last weekend was another super-birthday weekend.  My nieces and nephews and Anthony's birthdays are all in May.  Anna had choir camp all week.  She is such a little song bird, always singing in the shower, car, dinner table, hallway....  Also her parents met in college choir.  This was her first formal choral experience and she loved it.  Of course, she's a first soprano, and has been singing at the top of her new-found range ever since.

Anthony has been out of town a lot, and so has Wesley, our usual babysitter (he deserves a brief summer vacation, too).  This makes juggling the schedule extra complicated for me, with pinch-hitter babysitters and friends to the rescue.  Don't forget we are also doing daily swim team practices (not at the same time), ballet and piano.  Next weekend is another swim meet, another triathlon.

Don't worry, we are going to take a vacation.  In July, we run off to South America.  Hopefully I'll catch my breath before then, and the next post won't be a catch-up-here's-what-I-did-when-I-wasn't-blogging.

That was May

So my birthday weekend was enormous, amazing, overflowing with celebration and feasting.  Nearly everyone I invited came to my party (a few key people were there in spirit).  It was great to turn 40 and feel surrounded by love.

There was some singing, which I had not planned on but made me deleriously happy.

I made a vast 80s playlist for the party, and some guests went beyond the call of duty, dressing in vintage 80s clothes!  I loved it.  Unfortunately, there aren't tons of pictures because Anthony was doing an amazing job hosting the thing.  My entire family pitched in to put on an amazing event for me.

The next day we had to get up for Colin's birthday party.  Luckily for me he wanted a Harry Potter party just like Anna.  Therefore it required very brain effort or preparation.  However, Colin wanted to "Slay the Basilisk" with the sword of Godric Griffindor - and I lucked into getting a chinese dragon basilisk pinata two days before.

Also he chose to have a "Quaffle" cake instead of the Golden Snitch, which was pretty simple for Anthony once he got the color mixed.

Then my dad deserved a celebration befitting his septuagenarian status, and we had a 3rd rousing good time.

Anna performed well the next weekend in the ballet extravaganza, earning a Gold medal in Performance Awards and shining as usual on stage in the recital.  Hopefully I'll get links to videos of her Vocal Solo at school and the piano recital.  They both performed so well, even on their duet.  Anna is one of those rare souls who does better in performance than she ever does in rehearsal!

I also spoke at career day at a friend's school.  I am so lucky because my vocation is always the most popular.  Anna and Colin were jealous, so I also spoke to their classrooms last week.  I tell them about how important math is, how I use it every day, and writing, and reading, etc.  Then I show some Xrays, pass around some bones, and gross them out with the dog heart with worms in it.  Its really fun to do, and I love all the predictable and surprising questions.

This is our last week of school, then a full summer starts, bolting out of the starting gate this weekend:  first swim team meet Saturday morning, Danskin Triathlon Sunday, Choir camp for Anna starting Monday, another birthday weekend after that.

And its already wayyyyy too hot.

Too Busy to Post

I think I have to rename May.  NoPo-NoMo.

Tonight was Anna's school music program.  She had a small solo.  Her sweet voice lifted up everyone.

Thursday is the Piano Recital.  We're having a special on music this week!

40-7-70

We had an epic weekend.  Huge celebrations, customized to the birthday boy or girl's wishes.  First Emily came to town Wednesday, Steph and her crew on Friday, my parents on Saturday, my in-laws on Sunday. My 40th birthday party was on Saturday night, an enormous fete produced with much group effort by my family.  Colin's 7th birthday party was on Sunday afternoon.  Sunday was actually my dad's 70th birthday, and we took him out for a great dinner celebration.  Colin's actual birthday was on Monday, celebrated again with cupcakes at school and a sushi-Thai dinner (his choice).

I am still exhausted and giddy and still cleaning up.  More later!

Spell check

I work with some great people.  But  a few misspellings last week stopped me in my tracks.

The first was, "Scab on dog's right thy."
 (ie thigh)

Then, there was a cat with a problem on one of her nipples, or teat.  The receptionist asked, "How do you spell teats?  T - I - T - S?"

Uh, no, and please don't put that in the medical record!

It's May. Yay.

May means:

Hot weather
Mother's Day
My birthday (this year its a big one!)
My dad's birthday (ditto!)
Colin's birthday (7 years!)
Our Anniversary
Emily's birthday
Ballet recital
Piano recital
Swim team practice
Time to seriously get ready for the Triathlon season

I am not very excited about many of the items on this list, but I will try not to get over-extended like I did last year.  We'll see how that goes.



Last month, I had a toe ring party.  Like a tupperware party, except with custom fitted toe rings!  I went to one of them years ago and got my cute little toe ring that I have worn continuously since then.  When my friend Susan heard about that, she forced me to host a party.

Susan loves jewelry more than anyone else I know.  That's why Anna loves her so much.

Susan is very stylish and even wore a cute shrug designed for her by Bridgette.  (her dog)

Do men wear toe rings?

Only if they have a lot of tes-TOE-sterone!

Finally it was my turn.  Getting a toe ring is easier with lots of input from friends.

The salute at the end of a successful toe ring party!

Too Much

Last week I saw a cat in sad shape.  He'd lost a LOT of weight - 6 lbs off a formerly 18 lbs cat.  He was ravenous and drinking lots of water.  Worst of all was his fur coat - it was falling out in huge clumps, revealing thin, dandruffy skin under the orangey fluff.  He was friendly but looked terrible.

"He always loses some fur in the spring," the owner told me, "But I went out of town for a couple weeks and I came back to him looking like this!"  My techs were pretty concerned.  "What do you think is wrong with him?" two of them asked me.  Could be diabetes, hyperthyroidism, inflammatory bowel disease, intestinal lymphosarcoma... any number of things.  But my money was on diabetes based on his symptoms.  I even watched him walk around the room to see if he had diabetic neuropathy.  I sent blood and urine to the lab.

His results the next day confirmed Diabetes.  I called the owner, explaining the basics.  I asked her for a pharmacy so that I could call a prescription of insulin and needles in for her cat, and asked her to bring the prescription and the cat for an appointment later that day so we could go over insulin administration.  "Can I bring my children?  My son is 10, I think it would be good for him to learn so he can help me," she said.  Of course, I encouraged her to bring her kids to learn more about what was happening with their cat.

At the time of the appointment, I went into the room to find the happy cat on the table.  Also sitting on the table was a 6 year old girl looking at me with solemn eyes, and a chubby 10 year old boy who was avoiding all eye contact.  He really looked like he didn't want to be there.  Nevertheless, I think this stuff is cool, and started enthusiastically describing how insulin is the hormone, the thing that gets glucose into the cells, and without it the cells feel like they are starving.  That's why their cat was losing weight and hungry all the time.  Now he needed injections of this hormone that his pancreas was no longer producing.

"I'll give the first injection of insulin, then you can practice with a syringe of saline," I told the mom.  This is the standard training scenario to get owners familiar with giving little injections to their cats.  The needles are super tiny, so that the pet usually never feels it.  In fact, many cats seem to associate the injections with feeling better, and I recommend people give them at meal times so the cat is distracted anyway.  It is serious stuff, though, and overdosing on insulin can be rapidly fatal.

"Here's how you pull up two units," I demonstrated.

"Honey, you need to watch this," the mom said to her son.

"Mom, I don't want to," the boy softly whined, and suddenly tears coursed down his cheeks.

"You need to do this when I am out of town," mom said firmly.

"Mom, I can't..." he said.  His little sister looked at him, and tears welled up in her eyes, too.  He punched her, hard, on the knee.

Woah.  I give injections all day to animals, but I remember how nervous I was the first time.  Now I'd rather give an injection than a pill to a cat, but I don't want to force an unwilling little boy to give a "painful shot" to his sweet pet.  As mom continued to tell her son that he needed to do this, that remember its a small needle he probably won't feel, it will make him feel better, he'll die without it...  all I could think of was the large number of ADULTS that balk at giving their pets shots upon hearing the diagnosis of diabetes.  This was too much to put on this poor kid.

"You know, giving these shots is a big responsibility," I said.  "It needs to be done by an adult.  You said his grandparents will be staying with the kids when you're gone, and maybe they can be the ones to do it.  We can train them if they'd like.  We also have staff members who will come to your house and administer medications.  As a last resort, we also have diabetic patients who board with us, and we give them their injections here.  If he wants to help you, that's great, but its too much to trust to a kid."

"Oh, okay!" mom said, seeming flustered.  Then I demonstrated the insulin injection.  Mom had a turn with the saline; she did fine.  Then she asked her son if he wanted to try.

He seemed like he did.  So, I gave him a syringe of saline, repeated the steps of tenting the skin, burying the needle, then pushing the plunger.  He tented the skin, poked in the needle.  Then the cat shifted his weight, and the boy nervously bobbled his hand, the needle came out.  No big deal, but then he lost it.   He started crying and did not want to try again.  I thought over all he did great, but felt terrible for helping put him in this scary situation with needles.

Again, I offered to mom to have a technician come out to give the injections or board the cat, and repeated it was too much for a child.  "Oh no, I'm sure their grandparents can do it.  They are not old.  They are actually pretty young!" she cackled.  I walked them up front and scheduled a recheck in 5-7 days.  I hope that she heard me when I talked about how dangerous and immediately life threatening hypoglycemia can be, and that this is too much to entrust to a child.

How Much do I Love You?

My mother-in-law, Marion, made Anna a Queen-sized Afgan for her birthday.  Anna chose the colors months ago, and Oma's been hard at work.  She made one for Anthony years ago in totally 1970s colors: yellow, orange, and brown.  It is a favorite whenever we are sick with fever or just need serious warmth on a cold night.

It came with this poem:

How much do I Love you?

Let me count the ways.

320 double crochets per row.

4 rows per color stripe equals 1280 double crochets per color.

32 color stripes in your Afghan equals 40960 double crochets.

20 minutes to work a row, 80 minutes per color stripe.

There are 32 color stripes for a total of 2560 minutes or 42.6 hours.

16 balls of yard at 7 ounces equals 112 ounces or 7 pounds.

Each ball is 364 yards times 16 equals 5824 yards which equals 3.31 miles of yarn.

That is how much I love you.

Enjoy your Afgan for a long time and think of me some time.

Happy Birthday.  Love, Oma

Anna and Henley put it right to work, snuggling under it to watch a movie.  Anna has slept on it or under it every night since!

Celebrating Anna's Birthday

Anna started her birthday weekend by going on an adventure with Auntie Emily to get her ears pierced. It's something she's wanted for a long time, but she's been too afraid of the pain. Talking to Emily, she got courage, and they decided to go spur of the moment.

She was so chuffed, and I think she picked the most adorable pair of starter earrings!


Then, it was time to party! The theme was Harry Potter. Anna finished reading the entire series the Tuesday before the party. She asked her dad to make a "Golden Snitch" cake.




Anna dressed like Hermione, even with the wild hair! All the kids got "robes" to wear but Anna had an entire English school uniform.

Anna requested lots of crafts, so the kids decorated wands with glitter glue and notebooks for all their Hogwarts classes. We also repotted Mandrakes.

Mandrakes are a magical plant that can make a potion which cures people who have been petrified. They scream, though, when repotted, so the kids stuffed cotton in their ears and covered them up when the transfer occurred.



Then we had potions. A like-minded dad stepped in as Professor Snape and read the ingredients for The Draught of Peace. That's me in the limp wizard's hat.


The Draught was really just a root beer float. Colin approves.

Emily models the Griffyndor scarf I knitted for Anna (she was too busy to wear it), and my mom shows how windy it was!

Happy cousins after another successful party. We've had 8 parties in a row at that park, and each one of them has had glorious weather!









After the party, Anna also got her new bike. Fortunately she loves it, and has already been on some long bike rides!