Surgery Sunday

There were no parvo dogs (that I knew about) in the emergency clinic this weekend. What we did have was a mixed bag of rather serious medical cases and surgeries that did not always have a happy ending. And that was all on Sunday. Saturday was a stark contrast, as we only saw three patients during the course of my six-hour shift.

In fact, Saturday allowed time for me to continue reading (slowly) the novel I've been working on for over a month now. I also learned how to play a new card game, compliments of Dr. L. The game is Fluxx, and is being added to my Christmas list. It's a card game where the rules and the object of the game are constantly changing. Dr. L. commented that it was like working with another doctor in the hospital. You should always know what he wants before he says it, and his rules are subject to change at any given time. As unprofessional as it might have been, everyone playing the game could agree with her comment.

Per normal for the past couple weeks, I was unable to sleep at a decent hour on Saturday night. Luckily, I had company in my insomnia driven escapade. By 4:30, I finally turned in, knowing that it less than 12 hours, I would be back at the emergency clinic.

As soon as I walked in, literally before I even put my water in the tech room, Dr. L caught me as a "warm body" that could help her. On one of the treatment tables was a beagle mix that had a run-in with a car. The car won, but the dog was lucky. There were only a few puncture wounds and scrapes. No broken bones. Another tech and I worked on him, clipping the fur from the wounds and cleaning them up with Nolvasan solution. Mostly, I just pinned the dog to the table. He was a fiesty little thing. And while I had my forearm and elbow in his neck, and the down paws up off the table, he still managed to put a new L-shaped scratch mark on my left hand. Quite honestly, I'm about sick of this marks on my left hand.

There were a smattering of other cases in between the crazy beagle mix and the next case that caught my attention. When I arrived an hour or so earlier, there was a big black dog laying on the gurney at the end of the treatment room. I didn't get a history on it, because Dr. L snagged me first. But slowly pieces of what the dog was here for were coming together. The owner had recently consented to emergency surgery. The dog had an abdomen full of blood. The doctor suspected a bleeding tumor. The question now was had the tumored metastasized to other organs, or was it localized and removeable?

There was concern that the dog was in such poor condition that it might not even make it to the surgery table. And if it did make it to the surgery table, it's chances of making it off were not outstandingly high. The doctor had already talked to the client about the dog's chances - 50/50. The dog did make it to the table, but without about 10 minutes, the head technician was coming out into the room, asking me if I could suture...fast. Well, yes, I can suture. But I was not ready to volunteer my suturing skills under the requirement that I be "fast," when I haven't sutured in several months. I readily gave up the opportunity, and let another tech do it. She shoved a bath towel into the abdomen to soak up some of the bleeding, and simply sutured the skin back up. There was a tumor, and it had invaded the entire liver, spreading to the pancreas and possibly elsewhere. The doctor had suctioned off several liters of blood from the dog. We were suturing it up only so the owner could come into the surgery suite and say "good-bye." Twenty minutes later, the dog was euthanized and the endotracheal tube was removed. It was a very sad case, but then again, many that come in to the emergency clinic end less than happily.

"Mojo" was the next case that spent a bit of time in the surgery suite. I helped take the radiographs on that cat. Like most cats, he was not happy to be stretched out on the table and held down. Luckily though, this one did not add any more claw marks to my left hand (or right). When I pulled the films from the processor and hung them up on the light box, I was shocked to see something oddly shaped in the caudal abdomen. Admittedly, reading radiographs is not my strong suit, as of yet. I think it will just take time and practice in order to improve that skill. But, when I'm looking at a radiograph, I can definitely tell when something that large is there that is not normal. I pointed it out to the doctor, and she said "surgery." It was the most blatant and obvious GI foreign body I've seen on a radiograph to date.

While I continued to see other patients in the rooms, Dr. L scrubbed up again for surgery. When I had a free moment, I wandered to the surgery area, and saw the object in a little vial normally used for prescriptions. It looked somewhat like a bullet, or maybe like the end of an exploded firecracker. I turned the vial over several times in my hand, but still couldn't figure it out. I was smart, though. Another tech opened it up and smelled it. He was nearly knocked out by the stench of that little object. I don't know why smelling it was important? Later in the evening, "Mojo" was recovering just fine, and probably feeling a lot better.

The last surgery that I was a part of for the evening was yet another hit by car dog. It came in dripping blood all over the floor. There was a very large gash in its side, with exposed musculature. You'd never know that it was hit, though. It was tied to the end of the treatment table while we prepared to fix it. During the time, it was walking around, sniffing whatever it could within its reach, and trying to lick anyone who walked by the table. Once anesthetized and on the table, a closer examination revealed that the dog was oh-so-very lucky. The heart and lungs were just missed by the car. There were no holes in the lung, and the heart seemed undamaged. The doctor could literally stick her gloved finger into the gaping wound and touch pieces of the lung lobes. In the end, it was a very careful suturing job, and a very stylish bandage over the chest. "Oreo" was doing just fine when I left at midnight.

In between all of those cases, we saw a ferocious cat named "Toby." When the cat attacks the owner on a normal basis, even when it's feeling good, you know you've got a problem. Just opening the door, and the cat whirled around on the table, stood up on it's back legs, hissed, and batted its paws in the air. Was I going to try and take the temperature on this thing? No way, no how. it took two doctors and a squeeze cage to knock that cat out. Once knocked out, the doctor relieved the blockage, and sent it home. Had we kept it in the hospital, it surely would have bitten someone, maybe more than just one someone.

There was a kitten that was oversprayed with Hartz flea stuff. I can't express how entirely sick I am of seeing cases in the clinic where people try the easy way out by using the cheap stuff, and then using too much of the cheap stuff. The product is old, and not very safe. I don't even feel like writing about the case, though, because it's the same story every time.

There were a few allergic reactions. Those are generally pretty easy, "treat 'em and street 'em" cases. The only high maintenance in-hospital case we had was "Casey," a Sheltie that didn't seem to want to fight. It began as pancreatitis. The case progressed to aspiration pneumonia, when the dog apparently inhaled some of the vomitus. After that incident, it got put in a cage with a heated floor and set up with nasal oxygen. When the owners came to visit it, I was quite positive that the owners would elect to euthanize the patient. I was proven 100% wrong there. We monitored it through the evening, and the best the doctor could say at the end of my shift was that he was "guardedly optimistic." I wish I worked through the week in cases like this, so that I could find out what happened to them. As it is, I will not be back at the emergency clinic until next weekend.

There was a kitten that was oversprayed with Hartz flea stuff. I can't express how entirely sick I am of seeing cases in the clinic where people try the easy way out by using the cheap stuff, and then using too much of the cheap stuff. The product is old, and not very safe. I don't even feel like writing about the case, though, because it's the same story every time.

There were a few allergic reactions. Those are generally pretty easy, "treat 'em and street 'em" cases. The only high maintenance in-hospital case we had was "Casey," a Sheltie that didn't seem to want to fight. It began as pancreatitis. The case progressed to aspiration pneumonia, when the dog apparently inhaled some of the vomitus. After that incident, it got put in a cage with a heated floor and set up with nasal oxygen. When the owners came to visit it, I was quite positive that the owners would elect to euthanize the patient. I was proven 100% wrong there. We monitored it through the evening, and the best the doctor could say at the end of my shift was that he was "guardedly optimistic." I wish I worked through the week in cases like this, so that I could find out what happened to them. As it is, I will not be back at the emergency clinic until next weekend.

Plans are underway for the holidays at the emergency clinic. I'm in charge of making the arrangements for Thanksgiving Day food. I've decided to order a Thanksgiving dinner, or part of it, from one of the local groceries. I'll make a sign up sheet for everyone to bring side dishes, so that even if we're all away from our families for the holiday, we can still celebrate together. I wonder what creative and yummy dishes people will make for the event? All in all, it's got to be better than celebrating Thanksgiving dinner with fast food, which is normal clinic fare. I can't believe Thanksgiving is only 3 weeks and a bit away. Where has the time gone? In two months from Wednesday, I'll be back in Iowa, back in classes. Wow.