Category Archives: Blog

The Hooded Flaw

A number of new faces have appeared in the clinic in recent days. Jenny is working with us for the summer and (unlike me) she can work in reception. She’s always ready with a smile, and (fortunately for me) yesterday morning she was ready with some Voltarol when I arrived at work with a searing pain in my sacro-iliac joint. Relief all round, me for the pain, and everyone else because they didn’t have to put up with me being grumpy all day!

Leah has worked in the practice before as a nurse and is studying to be a vet. It was a proud moment when I entered theatre on Tuesday and found Jan-Arne teaching her the McGurk Method of cat castration. I did spend some time yesterday trying to convince Wivek that is what the technique should properly be called so that when it spreads throughout Norway (carried by emissaries such as Leah) I will become famous. Sadly she didn’t seem convinced.

In addition Marita, tall and blonde from the North of Norway is the new vet who will be covering for Guro when she goes on maternity leave in a few weeks time so it all seems very organised. I found extra-instruments in with standard operating kits, a bin-liner in the bucket used for draining water from the autoclave and three black bin bags in the paper-bin (down to a new night cleaner apparently – just making her presence felt) which I found strangely reassuring. It’s nice not to be the newest person!

Whilst I am not regularly consulting yet, I have begun to do a number of operations. Despite my experience (for a while in the UK, I locum’d in a practice where the main part of my job was as a soft-tissue surgeon) it is still a relief when I hear that things have worked out. A couple of weeks ago, I was asked to suture a bite wound which had failed to heal and was worsening. In my alternative life as a superhero lay assistant, I have spent a great deal of time searching cupboards to find out where things are and where things should be put away and in my exploration, I had spied what I thought was a Penrose drain (soft rubber tubing that allows fluids that might prevent healing to drain away) lurking amongst a tumble of stomach tubes. To my delight I found I was correct and I was able to rescue the drain from it’s dark corner and slide it into boiling water to sterilise it. I have always had a love of Penrose drains as I have had very good success with them in the past, but of course this was the first time I had tried it in Norway and it obviously was not routine practice at the clinic. To my delight Jan-Arne told me yesterday that he had taken the final stitches out and the wound had healed well. Bounding towards the list of things-to-be-ordered with a happy cry of “I’m going to order some Penrose Drains now” I was stopped in my tracks By Wivek. “They’ve already been ordered,” she said quietly as ever, and not long afterwards, she happily held up some new packs. Just bring on those dirty wounds!

Back to my favourite topic of food and drink. I was sitting having lunch with Guro on Tuesday when Jan-Arne appeared and grabbed a carton of Biola (a sweet fruity yogurt drink) from the fridge. Watching him with interest, I asked “Aren’t you supposed to be on a low carb diet?”. He shrugged and grinned sheepishly. “Yes but just this otherwise,” he said. Then throwing back his head, he took a large gulp straight from the carton and closed his eyes blissfully before announcing, “It just tastes so good.” Still walking forwards, he was suddenly arrested by something on the carton and with a cry of disgust, he strode over and tossed it in the bin. “It was out of date,” he said in horror as Guro and I just burst out laughing. A little later in the laboratory, I noticed a cola bottle filled with yellow fluid. It’s amazing what owners will use to submit their pets’ urine samples to us. Goodness knows how their persuaded their dog to pee into a bottle, but happily when I checked the expiry date, I discovered that there was still plenty of time to go, so if you are thirsty next week Jan-Arne, you know that that the content of that bottle is safe to drink!

Finally, before I consign myself to my holiday fate, I must mention hoodies, or more precisely hoods. It struck me a while back that it was quite unfair that all of the women in the practice have to wear surgical caps whenever we enter the operating theatre, whilst Jan-Arne’s beard is allowed unfettered access. Now it seems I have found the perfect answer in a Small Animal Surgery book. In a picture entitled “facial hair and sideburns should be covered with a hood” there is the most fantastic picture of 1970s man, all kitted out with enormous glasses and the most amazing blue paper hood. I just can’t wait to see Dagny again so that I can show her. After all, Norway is famed for its sexual equality. It wouldn’t do for the practice to let the side down.

Laden Bin and the Exploding Tomato

It’s holiday time here in Norway. Irene has been away two weeks, Boss Lady was off last week and next week Magne will go as well. It seems almost unthinkable, for me with my British mindset, for the two practice partners to be away at the same time. In the practices I worked for in the UK it would have been inconceivable for even two of the vets to vacation simultaneously, nor was anyone ever allowed to take more than two weeks in a row. The attitude here is quite different in all areas, health work seemingly included. The local car-workshop shuts for a month. Even the Thai take-away van in our village, which potentially might have had a roaring trade with all the campsites locally, has disappeared. Family and holidays come before trade and profit. Four or five weeks off in a row is normal and none of the businesses seem to have broken.

In the meantime, things are going on in the practice more or less as usual. The practice is busy, but not (to me) unbearably so. I spent most of yesterday sedating dogs and cleaning their teeth. I am gently sliding into doing consultations without ever setting out to do so, though the computer system remains a mystery and all my cases so far have been chalked up to other people. There are happy cases and sad ones. Euthanasia is always difficult. Jan-Arne asked yesterday whether it ever got any less emotional, and I had to reply that for me it hadn’t. I still routinely find tears in my eyes, even after twenty years. There are funny cases too. Yesterday a dog came in because its owner was worried about some lumps on his abdomen. Turned out they were nipples. Cue mixed relief and embarrassment on the part of the owner and laughter all round. As Jan-Arne said, it’s not the first time, and it won’t be the last.

On the assistant/nursing front, I continue to be busy. I haven’t mentioned it before, but Kari Anna is in the latter stages of pregnancy, and I am trying to learn as much as I can before she disappears. I can now carry out the early-morning room-checks before most of the vets arrive, and cleaning and sterilising the instruments has become routine. Some things continue to take me by surprise though. Periodically there is a problem with the bins. With all the waste, and especially with all the cardboard delivery boxes, there never seems to be quite enough space for all the rubbish. By the end of the cycle everything is starting to burst out of the top. A while back, Gerd had said something to me about hopping up on top of the paper-bin to squash down the contents. I dismissed this suggestion. I presumed that I had misheard, or misunderstood, or even perhaps this was a joke where she hoped I would climb up there and she could laugh at the naïve Scot who believed that anyone would really climb into a bin. So when Kari Anna suggested it again this week, I presumed the joke was continuing. To my horror, when I just laughed, she pulled up a wooden pallet and shinned up it. Before I knew what was happening, she was stomping around on top of the cardboard. I was petrified that she might fall and something awful might happen to the baby, but fortunately she made it down safely. Next time she suggests it, I’ll be up there like a shot.

Thursday’s communal meal is a highlight for me. There’s something very positive about getting everyone together in a room in a relaxed atmosphere and discussing how things are going. I’ve joked before about Norwegian attitudes to health and safety, but there is an injustice there; though safety may not be at the top of the agenda, health often is. The foods widely served in workplaces and schools seems to consist of brown bread, salad and fruit and a selection of toppings for the bread: cold meats, smoked salmon, eggs and cheese. There is some risk however, in even these innocent-sounding foods. Last week I popped a whole cherry tomato between my teeth and when I bit into it all the seeds exploded from my closed mouth all over the table. Luckily only Wivek and Dagny witnessed the ugly mess. Scarily, Dagny asked “What are you doing Sarah?”, but Wivek just giggled.

Yesterday there was a fly in the staff room. Most of us had eaten already. It was filled rolls this week for a change, and only one and a half remained on the unfolded cardboard box. After watching it for a moment as it took off and re-landed on Magne’s lunch, Kari Anna got to her feet, fetched a decorative orange and black fly swat from the kitchen and returned to the room with narrowed eyes. The evil-one was sitting at this point on the flattened cardboard a few inches from the food. A devastating flick of Kari Anna’s arm and there remained only a black full-stop adhering messily to the box. For a few long seconds, we sat there looking at it, and for a brief moment I thought it was just going to stay there, but Kari Anna retreated and came back with some paper towel and, efficient as ever, wiped it away. Just remind me never to get in her way if she’s carrying a whip.

Always Wet in Norway

And so we have returned from our wanderings in Denmark and the UK. I will upload some holiday photos shortly. We arrived home in a rain-storm very late on the 6th of August. Allegedly there had been warm weather the whole time we were away, but despite exhaustion from our journey, undisturbed sleep was impossible due to the most incredible thunderstorm I have ever (mostly) slept through. Periodically I was awoken by an explosion of thunder (it only rumbles when it’s a long way off; when the lightning is almost upon you the sound is like the crack of a shotgun) so loud and so brief that it felt the house was under siege. I was vaguely aware that it seemed to be going on for hours. The full extent of the attack only became visible in the morning when dawn dragged the world into some kind of daylight. The field behind our house was under water, and there was a river flowing through the farm that hadn’t been there before.

A new river.
A new river.

Remarkably the cellar was still dry, but as the water rose it started to fill. Unlike Noah we were unprepared, so instead of relaxing and gradually unpacking the car, we spent the day removing everything from the cellar that we could shift in time. The washing machine, freezer and fridge all had to go. Most of the food, the bottles of wine on the lower shelves, all the tools and batteries and drawers full of debris, and still the water was rising. The neighbouring village had been evacuated. We were told this when we went to ask the neighbour if we could move our car onto higher ground. We didn’t know if we should try to get out but most of the roads were blocked anyway. Eventually, some time in the afternoon (five o’clock came round while I thought it was about lunchtime) the fire-brigade arrived and started to pump the water out of the village, over the main road and down into the lagoon beside the beach. Later still, a small fire-service van made its way through the water at the side of the house and knocked on our front door. An unnamed neighbour had informed them our cellar was flooded. Could they pump it out for us? We were immensely grateful, both to them, and to the unknown neighbour who had bothered to let them know our plight.

The view from the front door.
The view from the front door.
The wonderful fire and emergency services.
The wonderful fire and emergency services.

Various things happened while I was away. Kari Anna has had a beautiful baby boy. That much I was expecting. After my return, on Facebook on Sunday there suddenly appeared photographs of Irene dressed mysteriously as a bride. Strange, I thought, because when I went away she had no holidays booked. Monday morning there were pictures of a champagne breakfast. I confess I was a little saddened that in the photographs of these events there was no sign of the chicken-head mask but obviously her plans must have changed while I was away and I concluded it could be a little busy at work as she would undoubtedly be on honeymoon.

By the time I returned to work on Tuesday I was, at least, fully rested, though as sometimes happens, the practice was going crazy. It’s always that way with veterinary work. Some days there are no emergencies and other days there are so many that it is impossible to fit everything in. As soon as I was in the door, Marvellous Magne, smiling (mostly I think with relief, possibly there was some pleasure there at my return but there was no time for chat) grabbed me and asked me to help him put a dog on a drip. For the next few hours I was in constant motion. All the bottles of Virkon for cleaning the tables needed to be refilled. I did them one at a time. Setting up the operating theatre, I noticed we were down to the last sterile surgical kit. As I held up the testicle that Magne was removing, my mind was working through my plan of campaign. From there I moved smoothly through to get the steriliser in action, set up the machine to distil some water, and then back to help with yet another case. It was an unusual case, a dog which probably has an insulinoma, and so it has chronically low blood sugar. It also seemed to be anaemic, and so we got permission to give the dog a small blood transfusion from a generous donor dog. Having added some blood into one vein, we set to and removed some from another to send into the laboratory to assess the dog’s insulin levels. In the meantime, Magne set up a programme of medical treatment to try to alleviate some of the dog’s clinical signs.

More cases followed, and for the first time since I have met him, Magne seemed weary. I offered to finish up his operations for him. Falling to his knees in gratitude (no not really, he’d only shatter his kneecaps which would be quite incapacitating) he thanked me and disappeared. A happy moment for me as I love surgery. To my amazement as I escaped from theatre at about one, Irene appeared, hair still tousled and highlighted as in her wedding photographs. She had got married, but for practical reasons she wasn’t going on honeymoon until next week. I was immensely glad to see her.

Thursday was much calmer and there was more time to ensure everything was up-to-date. Most of the afternoon was spent clearing some of the shelves in the Prep-Room as part of it is to be walled off to create my new consulting room (scary boss lady has declared that it is hers, but obviously it’s really for me). Every little corner that isn’t in constant use is now taken up with towels, uniforms, dog and cat food, reams of toilet paper, bottles of washing up-liquid, and some very strange unidentified instruments of torture including padded rings encased in (generally rather filthy) bandage with metal bars protruding out at strange angles and a special visor apparently for dogs. Maybe they need to be protected from the riots that regularly occur in the clinic on a Friday night. There was just one classic Irene moment. We had retrieved some boxes from the paper bin (this really is the most glamorous job anyone could devise), and stuck them back together, I was packing one box with huge soap and detergent bottles, and Irene was packing a smaller one with washing up-liquid. To fill up the remaining space, we piled in packets of toilet rolls and as she handed me a pack, she remarked, “You’ll have to stick it in yours, my hole isn’t big enough.” Luckily I didn’t quite wet myself laughing, so the rolls remained wrapped up.

At the end of the afternoon, Jan-Arne showed me his new baby: a Toyota Auris Hybrid Stasjonsvogn. It’s not quite as beautiful as Kari Anna’s new son, but I think Jan-Arne is almost as proud.Jan-Arne's car

Summer passing

Summer is drawing towards its end and the chillier nights are creeping in, but there is still warmth when the sun is high. Marian and I walked today on Ognaheia amidst overwhelming beauty: sparkling dew on tendrils of spider-silk, sunlight filtering into the dark places through the shivering silver birch, the red of the rowan and the woodland toadstools against the late-summer foliage, the blue intensity of the sky going on forever. As ever it seems impossible to catch these images on camera, but I have attempted to do so and will share the best with you.

Setting out from the farm.
Setting out from the farm.
Walking east into the morning sun.
Walking east into the morning sun.
Marian.
Marian.
Amanita muscaria.
Amanita muscaria.
Standing alone.
Standing alone.
From the tiny...
From the tiny…
... to drooping splendour.
… to drooping splendour.
... the woodland floor was replete...
… the woodland floor was replete…
... with reams of toadstools.
… with reams of toadstools.
This magnificent creature joined our mid-morning snack, bringing his newly-caught food with him.
This magnificent creature joined our mid-morning snack, bringing his newly-caught food with him.
Sparkling with reflected light.
Sparkling with reflected light.
Seemingly unafraid.
Seemingly unafraid.
Late-blooming heather.
Late-blooming heather.
Dewdrops scattering sunlight.
Dewdrops scattering sunlight.
More magnificent fungi.
More magnificent fungi.
And evidence of tiny creatures we couldn't even see.
And evidence of tiny creatures we couldn’t even see.
And a final flourish of red before the end.
And a final flourish of red before the end.

All the Wrong Words

Back to my normal two day week this week, and Tuesday was a good day. Irene’s working times had changed so that she was starting first thing in the morning with me. It was great to know, as I prepared theatre and assisted with the anaesthetics, that she was there for back-up, assisting the other vets and generally carrying out the other million little tasks that sometimes get pushed aside. Whenever I escaped from theatre I found her clearing and re-organising everything. I haven’t been able to find the scissors since, however this seems a small price to pay when everything looks so beautiful. Actually there is another downside to tidying things away. After Irene and I so carefully piled all the toilet rolls into boxes and put them in the cleaning cupboard a couple of weeks ago, someone else couldn’t find them. Assuming we had run out, a whole new enormous batch was ordered and now the clinic is swimming in them. Still, at least all our bottoms will be clean and shiny at all times and that is always important.

I’ve had two comments this week on my use of the Norwegian language and the first of them came on Tuesday. As I said, that day things were well under control. Free to pursue my aim of ensuring everything was perfect in the operating theatre, I felt I was entirely ready on Tuesday afternoon for the dog that was coming in for a major operation on its leg. The anaesthetic machine was on. I had investigated carefully and found the correct instruments, I had additional suture materials and extra swabs. I had pain-killers all worked out and drawn up, and I even had the gentamycin at the ready in case they wanted to use some antibiotics at the surgical site. Imagine my frustration then when Dagny looked through the window in the door and said, “Oh, there’s no cushion and pad.”

I confess I was annoyed at myself. All the complicated stuff complete and I had forgotten something utterly basic. I couldn’t help myself. ‘Unnskyld,’ I muttered as Dagny loaded herself up with the items and strode into theatre.

As she heard it, she turned round. ‘You shouldn’t say that,’ she said.

‘Um…. what?’

‘You don’t need to apologise. You’ve been busy all day.’ Ah! That old thing.

‘But I have to apologise all the time,’ I explained. ‘I’m British.’ She just laughed.

Thursday was an interesting day. For months there have been suggestions that I should start to consult, but frankly I’ve been putting it off. There’s something very freeing about not having ultimate responsibility for cases. I know when I became a vet, that was one of the hardest things to come to terms with. However Irene, in her new role as Scary Boss Lady Junior had decided that the appointments needed tidying up as well as the prep room, and so in order to allow for additional appointments, she made me my own list. Admittedly it had only two vaccinations on it but it’s a start.

And on Thursday afternoon, I had more feedback on my Norwegian usage, this time from Wivek. In my head, there is this enormous enthusiasm for helping people. And so when asked for assistance, instead of just saying ‘Yes,’ or ‘okay’, I often use the word ‘Sikker’. Now ‘Er du sikker?’ translates roughly as ‘Are you sure?’ and therefore, in my mind, when asked for help, I was enthusiastically agreeing. And so it was left to Wivek to very gently break it to me that when you say ‘Sikker’… it’s pretty much equivalent to rolling your eyes and saying ‘If I must.’ Obviously as I am beginning to see clients now, it is quite important that I don’t make such an error. But how excellent that for all this time I have been quite inadvertently rude to Dagny so often. And I wonder whether that is why Magne has so many little smiles when I agree to help him. I always thought it was just because he liked me. Still, from now on, at least I know the difference. And perhaps, so long as she doesn’t read this, I can go on saying it to Dagny for a while. And then I can have some little secret smiles of my own!

And finally, somehow or other, I managed to miss the fact that last week was Guro’s last before she went off on maternity leave. One of the sad things about not working on Fridays is that I don’t always realise when important things are happening. Anyway, I’ve missed you this week Guro, and I wish you all the best for the coming weeks and months.

Build

This week has been dominated by the construction of the new consulting room. The prep room has been unusable, partly due to dust, but more because of the noise. The crack of the nail gun causes immediate heart failure; I was only affected once or twice, but Jan-Arne died on several occasions. Marita also kicked the bucket in the dental room and I pointed out that in English this would be funny. For some reason, by the time I had explained that “kick the bucket” is an irreverent euphemism for dying, the hilarity was lost. Some things just don’t translate.

There has also been a rash of flank cat spays. Both Jan-Arne and Wivek had a go and the results looked very neat. As usual, the bubbling enthusiasm for trying new things is infectious. Scary Boss Lady’s cat, to my relief, was quite okay after last weeks operation, however Dagny, despite sharing the enthusiasm for new things, feels that except for nursing mothers, she will continue to use the traditional method as she can operate so quickly and cleanly already.

Somehow or other, I won the Smil again, partly because I had helped people with cat spays, but also for my anaesthetic skills on exotic pets and my apparent ability to hold onto cats that aren’t so very keen on being injected. I would love to feel I was an expert at cat-wrangling, however having seen British Veterinary nurses undertake this most dangerous of sports, I know that my skills are only a pale imitation of the real masters.

Irene spent Thursday defrosting the fridge in the kitchen. At some point, without me really noticing, an iceberg about the size of Mont Blanc had appeared in the left hand corner. So smooth and shiny was its surface that somehow I had believed it was an unusual curved part of the back wall, though what that says about my powers of fridge observation I’m not really sure. Still, armed only with a hairdryer and an enormous pile of incontinence pads, the intrepid Irene set forth to crush this enemy of refrigerator space. There was a moment of mystery half-way through when a small yellow Tupperware tub hove into view. After a few moments of frenzied hot-air, it was recovered but its content was sadly unidentifiable.

As I’ve said before, it’s never boring working at the clinic. Thursday afternoon was spent building some Ikea shelves. Dagny told me during lunch that she wanted my help. This sounded hilarious to me, because the Norwegian verb for assembling furniture is “skruer”. Again I tried some of my merry British wit by suggesting that after lunch I would be screwing with the boss, but nobody noticed. It actually fell to Leah and me to put the cabinet together and she is obviously very handy with a screwdriver. Sadly this is her last week for this summer, though she will be back at Christmas. Dagny commented during this process that I was always very quiet. I explained politely that while my brain was working, my mouth stood still, meaning that the translation process exacerbates my usual quietness, but someone else in the room (I think it was Jan-Arne, but I would be happy to be corrected) pointed out that the reason I was so quiet was because Dagny was always talking so much that I couldn’t get a word in. Of course the real reason, as I have probably said somewhere before, is that I like to live by the traditional maxim “Better to remain silent and be thought a fool than to open your mouth and remove all doubt”. It’s definitely a good ploy when you are working in such a crazy environment.

Dagny preparing to spay a cat by the traditional Norwegian method.
Dagny preparing to spay a cat by the traditional Norwegian method.

Laden Bin Strikes Back

It has been a week of big operations. On Tuesday, Dagny removed some of the largest anal-sacs that I have seen, from a dog. She uses a technique which involves filling the glands with a plastic fluid, which hardens almost immediately, allowing the surgeon to ensure that all of the tissue is removed. So much plastic went in that I wouldn’t have been entirely surprised if it started to come out of the dog’s mouth, but she was finally satisfied that they were full, and it was time for me to prepare the dog for theatre. Once she and the dog were gowned and draped, she set to, carefully clipping away and excising the diseased tissues. Towards the end of the op, as she gazed into the gaping cavity she had created, she commented, ‘This dog has a hole in its bottom as big as a cathedral.’

Quick as a flash as it burst into my brain, I shouted out. ‘Oh, so the dog has a holy bottom’. My outburst of wit was met with the kind of indifference that makes you peer down at your body to check if you have been rendered invisible. My hands were still there, so it seemed I was still present. They hadn’t understood obviously, but so pleased was I with my lightning bolt that I was unable to leave it.’You know, Cathedral… Holy… you know….’ My voice petered out as I realised that actually they didn’t. Maybe I should just give up on this untranslatable humour thing.

The other major operation was on Thursday, and it was big in every sense of the word. A beautiful young great dane had been smitten with a horrendous uterine infection, and so she was coming in to be spayed. It was serious surgery, and complicated by the fact that there were some abnormalities in the uterus, but Wivek and Magne worked away patiently and carefully to remove the organ safely. Wivek, it turns out, for all her quietness, has a wicked sense of humour. She suggested to Magne, that while we were inside the dog’s abdomen, we should do a gastropexy (attaching the stomach to the body wall to prevent gastric torsion – a life threatening condition in deep-chested dogs). The conversation then wandered off into complications that I couldn’t follow, and as so often when that occurs, I just carried on with the tasks at hand, oblivious to the discussion going on around me. Suddenly I caught the words ‘Sarah ALWAYS does that.’ Startled I looked around. Wivek was grinning at me. ‘So it’s true what you wrote in your blog then. So long as I don’t mention your name, I can just talk about you all I like!’

And later on, I was reminded of the reasons I should never, ever attempt any climbing. I have written before about the overfilled paper bin and its dancing challenges and as you know, I haven’t ever nerved myself to undertake the leap of faith required. Late in the afternoon, standing beside the overflowing bin in the glowing sunshine, I realised that here was my chance. The opportunity had arrived for me to practice my Bin Dance without an audience. Taking my courage in both hands, I grabbed a wooden pallet from the side wall and leaned it against the enormous blue bin.

When Irene had set out, she had eschewed the use of any kind of steps, choosing to take a flying leap upwards and scale the monster without assistance, but I, being cautious, decided to climb up more sedately. My first mistake was to pull the bin away from the wall before I started. Not such a good idea because as I clambered awkwardly up the pallet, the bin started to roll away towards the wall. Slithering upwards as fast as I could, I pulled myself onto the top of the precarious cardboard mountain and stood up… and hit my head on the air-conditioning unit. It had been moved along the wall when the new room was being built and was stealthily overhanging the bin, just waiting for some mug to come along.

Manoeuvring carefully, I lifted my head again, more circumspect now I was aware of the overhead hazard,  and did my best to tramp down the burgeoning piles of cardboard. Despite my best efforts, I was making little impression and the stacks were still above the top as I began my cautious descent. I reached gingerly over the edge and lined my foot up with the thick central board of the pallet. After all, I didn’t want to break the thinner wooden rungs. As I edged over the rim and the pallet took my weight again, the bin made a final lurch backwards and hit the wall… and the lid came crashing down, engulfing the top half of my body. A final indignity: the bin was trying to swallow me. Elbowing the heavy plastic upwards, I finally swung myself back down to the ground and brushed myself off before heading back inside. I think that perhaps it is important to realise that unlike these hardy Norwegians, I’m just not made for climbing.

Cute

The first thing I saw on Thursday morning when I got in was Dagny. Officially it was her day off, but she had received a message in the early hours of the morning about a whelping bitch, or more accurately, about a bitch that was not whelping, and by nine in the morning, Ninja’s owners had decided that she required some veterinary assistance. For the record, Ninja is a sweet little Chihuahua with big eyes, though when she arrived at the clinic, those big eyes looked definitely troubled. Not surprising because when Dagny carried out a vaginal examination, there was a puppy stuck in the passage.  Using plenty of lubricant, Dagny managed to draw the pup out into the world. Sadly despite all her efforts, the pup never started to breathe. An x-ray showed that there was another puppy, and by measuring its skull, Dagny estimated that it might still be born normally, and so instead of spending her time off relaxing, she stayed in the clinic while Ninja’s owners gave their pet some time to try to give birth naturally.

For me this could be only viewed as an opportunity. Thursday is the day that Irene has designated that the dental room and laboratory should be cleaned and maintenance carried out. I think everything in the lab is jogging along fine, but it was only recently I realised that there were weekly and monthly services to be carried out on the dental machine and that they weren’t being done. There is a sheet on the wall of the dental room that I hadn’t noticed, and on that sheet were daily and weekly spaces for initials. Leah had been doing the checks, but in the weeks since she left, the boxes have all remained blank, and when I checked with Irene, it transpired that she didn’t know either. Most of the time in between I have been distracted by other things, but now and then my imagination would go into overdrive as I pictured the whole dental machine seizing up through lack of oiling.

Dagny had tried to call the maintenance rep, but there was no reply and so  she suggested phoning Kari Anna, who is still on maternity leave. ‘After all,’ she said with a laugh, ‘It’s not as if she will have anything else better to do.’

This proved to be incorrect. Dagny held the phone away from her ear for a moment, and even I could hear the wails of the baby from across the room. Still, the dental machine is VERY important, and Kari Anna is VERY patient, so with her help, we managed to oil the handsets. All that was left then was to oil the compressors down in the bowels of the appliance, and so, by ten a.m., Dagny and I were crawling around on the floor of the dental room, pointing a handily discovered ultra-violet light into the guts of the machine.

There was a horrible moment when Dagny thought she had been pouring oil into the air-compressor itself, but happily, it did turn out to be the correct orifice (obviously it’s very important for a vet to get the right orifice).  Finally, the oil levels were back to the right place. As we finished, I pushed myself up from the floor and stretched. I fully expected Dagny to do the same, but for some reason, she was still on the floor.

‘I’m not sure if I should get up,’ she said. ‘This is my day off. Maybe I should just lie here.’  I offered to get her one of the cushions we use for patients, but she turned it down. She checked the time on her phone. ‘Actually,’ she said, ‘I should be at the gym,’ and before I knew what was happening, she had started to wave her feet around in the air.

I was taken away from all this excitement by Wivek. Her daughter had hurt herself at school, and as Wivek had run to work (what a healthy lot of people I work with) she had no car. I drove her to the school, but happily it transpired that the injury was not as serious as had originally been thought. I arrived back at the surgery to see Ninja and her owners taking a walk down the road and I assumed all was well, but when I went back in, I discovered that they were still waiting for pup number two to arrive.

She returned from her walk, and still was making no progress, and so finally Dagny and Ninja’s owners decided  it was time to go ahead with a Caesarean.  Dagny is a quick and decisive surgeon, and so within a very short time, the gorgeous little pup in the photo at the top of the page was born. It’s always lovely to see how all the staff gather round to help when there is a newborn to be revived. Somehow, even after years in practice, there is always something magical about the gift of birth.

Ninja still sleeping while her pup begins to explore.
Ninja still sleeping while her pup begins to explore.

 

 

 

 

It’s a gas

The past two Tuesdays have been busy with operations. So much so that I rarely set foot outside theatre on either day. Last week I assisted with the anaesthetics for an exploratory laparotomy, two cruciate ops and a  fracture repair. This week  there was an entropion op (to correct in-turned eyelids), an eye removal, a mammary tumour operation and yet another cruciate. Both weeks I ended up staying an hour late. We passed part of the time talking about the Julebord (Christmas party). It won’t be happening for two months, and yet it is already the subject of much discussion. It sounds quite a wild event. Apparently last year, Jan Arne had a candle on his head. The dress-code is listed as “Pyntet” which is the same word that is used for a Christmas tree when it has been decorated, but sometimes things can be taken a bit too far.

Thursdays are a bit more varied for me. As has been happening lately, I arrived to find Magne having coffee with a couple of the vets from the large animal practice next door. He invited me to join them and seemed disappointed when I said no, but when I explained that if I didn’t get on, his room wouldn’t be ready when he needed it, a wave of approval washed over me from all of them. Dedication is my middle name!

I found myself back in theatre later in the morning when Jan-Arne had a cat to spay. We were just examining the cat to check that it was healthy for its operation, when Jan-Arne spotted the fact that the cat’s mammary glands were distended. Having inspected them, and decided that he could still go ahead, he said something and suddenly started to giggle.

‘What is it?’ I asked him.

‘I just realised I said “pussy milk”‘ he said, and started laughing more.

He was quite insistent that I must add it to my blog, though I did express some concerns over the possible Google Searches it might send my way. I quite forgot to mention that my parents would be reading. Hello Mum. Hello dad!

As ever, a flank cat-spay seems to cause enormous interest in the practice. At one point I looked up to see Wivek, Magne and Irene all looking through the glass windows in the doors of the theatre. Seeing me looking at them, they all pulled crazy faces. I so regret not having my camera. I had never noticed the resemblance Wivek has for Jack Nicholson before, but it was very striking. Luckily she didn’t have an axe.

The operation itself was more difficult than usual. Most young cats have very little abdominal fat, but this one had more than average. It wasn’t hard to find the first ovary, but the second one was difficult and so Jan-Arne asked me to take over. It took a while to track down the offending ovary, but having finally located it behind the kidney, we were all able to relax a little. It seemed that the cat was not quite finished with us however. As I returned all the intestines to their correct place and prepared to close up, there arose in the room a vile miasma. The stench of cat-fart wafted around the room to a wretched chorus of groans and fluttering hands. The cat’s bowel had been quite distended before I pushed it back into the abdomen. Undoubtedly I had caused the stink. Without looking up I made a general apology to Jan-Arne, Kirsty and Marita, all of whom were standing in the room to watch.

‘Sorry about that.’

The silence in the room was palpable. So much so that I looked up, puzzled, only to see a wall of astonished and horrified faces (well, there may have been admiration on Jan-Arne’s. He is a man after all). It dawned on me that every single one of them thought that I was personally responsible for the awful odour.

‘Hey, no!’ I said, looking round at them all. ‘I only meant that I had caused it by handling the cat’s guts.’ The look of relief that came over the faces was hilarious. So much so that I began to giggle, and then Kirsty joined in, and then suddenly the whole room was filled with laughter. It was hard to stand up. About five minutes later, I was able to control myself enough to wipe away my tears and begin to stitch. So much for professionalism.

 

The picture at the top shows Ingo, a French bulldog who was in for an intravenous drip following a bout of illness. He was very patiently waiting for me to remove his drip so he could go home. Feel better Ingo!

Metzenbaum Meltdown

It’s been a week of instrument incidents this week, at least on Tuesday anyway. I didn’t sleep well on Monday night, and by nine o’clock on Tuesday morning, I confess I was wafting round the practice, trying to be all efficient. It wasn’t easy. Somehow the standard tasks of ensuring the rooms were well stocked with needles and syringes seemed unusually complicated. I thought I was finally getting into my stride though, as I emptied the instruments from the autoclave, put them away, and packed up a raft of new kits for sterilisation.

Irene came into the room at this point and started to chat. My brain being otherwise occupied (the routine tasks were taking up all of the limited space in my one cylinder brain) I looked at her vaguely and failed to answer to her satisfaction. She looked at me with narrowed eyes and her head on one side.

‘Are you tired this morning? You’re not usually this quiet. I went to a concert last night. I’m tired.’

I admitted that I wasn’t at my best. My inclination was to remain silent, but it seemed impolite. ‘What concert did you go to?’ I had to try to appear normal at least. She named a singer I had never heard of and I tried to carry on the discussion as I set up the autoclave to sterilise the instruments I had just packed.

The autoclave has something of a pre-set routine. When you first switch it on, it automatically says that the door is open, and the locking mechanism doesn’t work until the programs become available. So I meticulously emptied the outflow, ensured the distilled water was topped up and then, to pre-empt the frustrating period when the door won’t lock, I carefully pushed the door to and set the locking mechanism in place. With a sigh of relief that everything was beginning to settle down, I turned my back as the machine began to run through its program. Irene had continued chatting, but now she was looking at me with a very confused look in her eyes.

‘So what’s in the autoclave?’ she asked. I frowned at her for asking such a crazy question. Obviously the packs I had just set up so carefully, but her eyes weren’t looking at me. They were directed towards the neatly stacked rack with the kits all neatly packaged in their white paper parcels. I had just set the autoclave off on its hour long programme with nothing inside.

All day long, I seemed to be all fingers and thumbs. There had been a spell lately when it seemed I was unable to do the simplest task without dropping something on the floor, and on Tuesday the effect was magnified. Opening up some suture material while Dagny was operating, I thought that rather than risk handing it directly to her from the package, I would drop it on the instrument table. Of course, it flipped out of my hands and missed by several inches. Somehow, every needle I used became detached from the syringe. I spent so much time running in and out of theatre to get new ones that I began to worry that someone would comment. It was a relief therefore when Dagny, usually so efficient, managed to drop the straight scissors from her kit. I retrieved them and offered to get a new pair.

‘I’ll need some Metzenbaums anyway,’ she said ‘you can just get some of those and I can used the curved scissors for everything else.’ Metzenbaum scissors are long slim scissors designed to cut delicate tissue. I collected a pair from the instrument cupboard. Once again, Dagny being occupied with her operation, I decided to drop them directly onto the instrument table. I should have known better. They too slipped to the floor with a clatter that seemed so loud in the quiet operating room. Fortunately, Dagny was not in Scary mood (in fact, she has been so unscary lately, that if I didn’t know how much she loved her nickname, I might feel the need to change it) and she just laughed and asked if we had another pair. At this point, Magne, ever the gentleman obviously felt that he should join in with this game of throwing things on the floor and dropped the chuck-key of the drill. Really I didn’t feel so bad then. The final flourish occurred as Dagny was stitching up. As she went to set the scissors back on the table after cutting her suture material, she misjudged it and the last pair went toppling to the ground. She completed clipping the line of sutures using a scalpel blade. Obviously the idea of asking for yet another pair seemed too high a risk. After all, judging by earlier events, I probably would have stabbed her in the toe.

Thursday, thank goodness, was much more relaxed. Dagny’s sister-in-law brought in her lovely little dog (that’s him in the picture at the top of the page) to be castrated. In contrast to Tuesday, theatre was a hive of extreme efficiency. I’ve never seem Dagny operate so swiftly. So much so that I barely had time to stabilise the anaesthesia before it was time to switch the machine off. I spent the rest of the morning discussing some modification of the anaesthetic regimes with Wivek, who is thoroughly knowledgeable in this, as with so many other things. We want to be sure that the patients are as comfortable and as safe as possible during surgery, and so we are reviewing the analgesic (pain-relief) protocols. When all is said and done, however many times you throw your scissors on the floor, in a good veterinary practice the well-being of the animals always comes first.