I have a lovely client, one of the best when it comes to her pets. She is attractive and generous. She drops them off twice yearly for comprehensive wellness checks. She sends us trays - no, PLATTERS of delicious food from our local gourmet grocer at Christmastime; just when we are about to die from sugar overload she sends us cheeses and kabobs and spinach dip, etc. The entire staff loves her.
She's been dropping her cats off for the last year and a half, so I haven't actually seen her in a while. When she came in last week to pick her newest kitty up, I ran up front to say hello.
I didn't recognize her. Her upper lip was puffed up like a duck's, her brow was creepily smooth. She was supernaturally tan with white skin under her eyes. Her hair had been uber-highlighted, and perky breasts cleaved under her V-neck.
"You look so tan!" I sputtered. She said she's been hanging at the pool with her friend and a new baby. I tried not to stare at her lips as she spoke. Why would such a beautiful woman - beautiful inside and out - do this to herself? The puffy upper lip was especially distracting. Everyone agreed she looked not younger, but scarier.
I will never understand why women choose to mutilate themselves this way. I hate growing older and losing my youth, too, but botox and restylane et al don't fool anyone. I think most women just go in for a little injection, then pretty soon they're checking out with a full meal deal. Those plastic surgeons are good salesmen.
Just say NO!
Monday, October 25, 2010
Thursday, October 14, 2010
On again, Off again
Saturday I saw a dog who had eaten a bunch of pillow stuffing the previous Sunday. Throughout the week, his appetite and came and gone, as well as some intermittent vomiting. But Friday night he refused to eat, then vomited a lot overnight. So Saturday his concerned owners brought him to me.
I took some abdominal Xrays, and saw what I expected: a very full stomach, empty gassey intestines. For the stomach to be full in a dog that had not eaten in 24 hours, I knew something was amiss. I diagnosed a gastric obstruction - much better overall than an intestinal obstruction, but still, a surgical problem. I told the staff to prepare for a surgery.
The owners asked me if it was still in the stomach, could it be removed endoscopically? Clearly, this would be preferable to an open abdomen. There would be fewer complications and a faster recovery. But we don't have an endoscope, so I called our referral surgical center.
"Yes! We can do that procedure! Are they coming soon?" was their first response. Then I got a call back requesting the Xrays. Since I can send them digitally, they soon called me again. "You know, with something fibrous like stuffing, and with the way those Xrays look, I think we'll work on this patient for 3 hours, pulling little bits up, then send them to surgery anyway. It will be much longer and more expensive than surgery alone." The owners understood, and asked if instead we would do the surgery. So we were back on.
I was excited about doing an exploratory gastrotomy, even if it was after close on a Saturday. "Couldn't we just give this dog something to make it vomit up all the stuffing?" my technician asked. "Silly Susan," I said, "He's been vomiting all week. It's not coming up."
Our pre-anesthetic medication contains morphine, which makes a lot of patients vomit. The dog urped up a little stuffing. "Oh, well, I guess now we know we're doing the right thing with surgery," I said. Then he HEAVED about 4 times, bringing up a stomach sized amount of disgusting polyfoam stuffing.
We took another Xray, and sure enough, empty stomach. I called the owners. "Wow, you are fast!" she said. "No seriously, did we forget to sign something?" When I told her about the very productive vomiting, she was very happy. I sent the dog to the after hours emergency clinic for some monitoring, but he went home that evening, free from stuffing AND surgery.
I took some abdominal Xrays, and saw what I expected: a very full stomach, empty gassey intestines. For the stomach to be full in a dog that had not eaten in 24 hours, I knew something was amiss. I diagnosed a gastric obstruction - much better overall than an intestinal obstruction, but still, a surgical problem. I told the staff to prepare for a surgery.
The owners asked me if it was still in the stomach, could it be removed endoscopically? Clearly, this would be preferable to an open abdomen. There would be fewer complications and a faster recovery. But we don't have an endoscope, so I called our referral surgical center.
"Yes! We can do that procedure! Are they coming soon?" was their first response. Then I got a call back requesting the Xrays. Since I can send them digitally, they soon called me again. "You know, with something fibrous like stuffing, and with the way those Xrays look, I think we'll work on this patient for 3 hours, pulling little bits up, then send them to surgery anyway. It will be much longer and more expensive than surgery alone." The owners understood, and asked if instead we would do the surgery. So we were back on.
I was excited about doing an exploratory gastrotomy, even if it was after close on a Saturday. "Couldn't we just give this dog something to make it vomit up all the stuffing?" my technician asked. "Silly Susan," I said, "He's been vomiting all week. It's not coming up."
Our pre-anesthetic medication contains morphine, which makes a lot of patients vomit. The dog urped up a little stuffing. "Oh, well, I guess now we know we're doing the right thing with surgery," I said. Then he HEAVED about 4 times, bringing up a stomach sized amount of disgusting polyfoam stuffing.
We took another Xray, and sure enough, empty stomach. I called the owners. "Wow, you are fast!" she said. "No seriously, did we forget to sign something?" When I told her about the very productive vomiting, she was very happy. I sent the dog to the after hours emergency clinic for some monitoring, but he went home that evening, free from stuffing AND surgery.
Monday, October 04, 2010
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?
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.
Can't you feel his joy?
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