Tag Archives: Jacqueline

Happy Birthday

Tomorrow is Jan-Arne’s birthday and at nine o’clock this morning, I received a message from Wivek to say that she and Marita were planning a special lunch for him at the clinic. I immediately wondered how I could contribute, and after some careful questioning, I managed to ascertain that whilst the savoury food was all planned, they were lacking a coherent cake strategy. Armed with only butter, eggs, flour sugar and cocoa powder, I began to throw something together. Luckily I also found some decorations hiding in my cupboard and so with only moments to spare, I made it in on time to join in. The other food was delicious. Marita had baked the most fantastic focaccia and aioli, and Wivek had provided a wonderful chicken salad. Somehow or other, I failed to take a decent photo of either, which is not like me at all. Like many food worshippers, usually I can’t resist taking photos of beautiful meals. Still Jan-Arne certainly looks happy.

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Last weekend, Tu Klinikk held its first CPD weekend on the subject of anaesthesia. CPD is vetspeak for Continuing Professional Development and in the UK, all vets are required under their agreement with the Royal College of Veterinary Surgeons to do an average of thirty five hours each year. The requirement in Norway is not quite so stringent I understand. More a recommendation rather than a requirement, as it was in the UK until only a few years ago.

Anyway, the subject of the weekend was anaesthesia. I confess I was delighted by this as I have spent a good part of the year working as anaesthetist for Dagny and Magne. It is unusual outside of the universities for vet practices to have a dedicated anaesthetist who is a fully qualified vet. Generally the vet who is carrying out the surgery also technically oversees the anaesthetic as well, and the patient is monitored by a nurse (or more rarely, an assistant). I find it very rewarding to have a ‘specialisation’. The lectures were in Norwegian (the lecturer came from Oslo). In the morning this was fine. I found I could follow quite easily, though my one-cylinder brain stopped translating as soon as I tried to write anything down so I had to make do with listening very carefully and plucking at Wivek’s sleeve at the end of each section for the bits that I knew I should have noted down, but didn’t manage.

I also managed to answer some questions that the lecturer posed about anaesthetic circuits, though slightly to my chagrin, I had to answer in English. I still don’t actually know how to say “one-way valve” in Norwegian, though as Wivek already laughed at me for my translation of “gas-flow rate” on my poster in theatre, I should have remembered that I really didn’t have to translate that one, other than adding an extra “s” onto the word gas. Just to make it more Norwegian you understand.

On my return to the practice on Tuesday morning, I discovered that Dagny and Magne had invested in some lovely new kit in the form of a drip driver, an infusion pump and a new oxygenation unit, so we will be able to make some positive changes to our anaesthetic regime. Whilst I fumbled through the set-up on my first run-through, it was obvious that Tornado Tawse already had everything running as smoothly as a weir in high summer. I only wish I could make everything look so effortless.

Infusion pump and syringe driver.
Infusion pump and syringe driver.

Wivek, true to form, was the first to use the new anaesthetic kit, putting her first heart-murmur dog on a propofol infusion. Like Jacqueline, she too seemed perfectly calm and utterly self-contained. I must say I was relieved when she confessed to me later that she thought that her own heart was hammering away far more rapidly than the happily anaesthetised patient.

Feeling that I had to make some contribution to this wonderful new era, I managed to create two pages of flow rates for ordinary surgical patients and shock patients, but the final task I set myself on Thursday afternoon was the rather complicated calculation required to work out the flow rate for post-operative patients where we won’t be using the drip driver. To give a brief oversight, you first have to work out how much fluid the patient will need in an hour. From that, you have to calculate how many millilitres will have to pass through in a minute. Then you have to work out how many drops that will be… and finally you have to split the minute into that number of drops so you can give a “time between drops” specification. Given that there are also two types of giving sets: one that gives 20 drops per millilitre, and one that gives 60, it is perhaps unsurprising that my brain came unstuck somewhere in this process and exploded messily all over the computer screen. Fortunately Jacqueline was there to clean up the vetty mess before anyone noticed. Just as well she’s as patient as she is efficient.

Happy birthday Jan-Arne.

Cake worship.
All hail the chocolate cake..

 

 

Miss Direction

It seems that last week in the clinic, I missed out on the exciting moment when one of our feline patients did the wall of death around consulting room A. Most of the cats here seem very reasonable, but apparently this one was half wild. It’s amazing how  much damage can be done by one cat on a dedicated shelf bombing mission. Fortunately Dagny’s arm was long enough to reach in to its hiding place behind the fridge and inject it with enough anaesthetic to calm it down.

Hair raising anaesthesia was also the order of the day earlier this week when one of the patients I was monitoring stopped breathing near the beginning of its operation. Of course with gas anaesthesia, it is straightforward enough to carry out assisted breathing, indeed on our anaesthesia course, the lecturer quite casually mentioned that it didn’t really matter whether the animal breathed itself or not as it was easy to respirate. I guess it happens often enough that it must eventually become almost routine. It has happened a few times and every single time it has been fine, but I still find myself checking and rechecking the equipment and assessing the animal in every way possible, whilst trying to look perfectly calm. Having been the surgeon in that situation, I know how disconcerting it is trying to operate and wondering all the time whether the animal is okay, and whether you should be doing something  to help. Trust is very important in those circumstances. Jacqueline has been incredibly calm before in that situation. Indeed when I asked her if everything was okay, she looked at me as if there was nothing untoward going on at all. My nerves are not as steely as hers though and I was profoundly happy when the dog woke up perfectly normally at the end of the operation.

On Wednesday I went in for my own hospital appointment. It seems that with tonsillectomy, there is a risk of post-operative bleeding and as I am attending a wedding in Scotland on the 24th May, I won’t be able to have my operation next week. They have rebooked it for Wednesday 27th May, just two days after I return. As I live an hour away from the hospital, they will be keeping me in overnight. Just as well as Charlie will be in Spain at the time. I’m glad now that I don’t have to wait any longer.

I was reminded the other night by a conversation with Wivek just how difficult it can be to get an accurate picture over the telephone and how confusing it can be when the owner has already made a diagnosis. It was Marita who was on call and Wivek was helping when they had a call from a client who told them that her bitch had a prolapsed uterus. In twenty or so years of veterinary practice, I have never seen such a thing in a dog. Plenty of cows, a couple of sheep and a very occasional pig, but never in a dog. Of course, such a conversation usually causes that lightning strike in your brain. How on earth will I deal with that? In that frozen state, it can be difficult to rationalise. So busy working out what you are going to have to do that alternative thought is banished. The reality is often that the owner hasn’t got things quite right, (in this case it turned out that the bitch had a polyp in her vagina) but I am sure I have a few extra grey hairs from this phenomenon.

Very occasionally the owner turns out to be correct. The one day old puppy I once saw with its liver hanging out really was just that. A proud moment for me when that dog reached six months of age. But more often, with hindsight, it is possible to look back and laugh, though obviously not in front of the client. Great tact was called for on the day when the owner rushed her dog into the clinic on an autumn day in Glasgow with a wound on the back leg which the lady thought had become infected.

‘It’s the wound on her leg. It’s gone all yellow.’ Dramatic hand to forehead. ‘Oh I can’t bear to look.’ Bending over the dog to inspect its leg, I was initially surprised by just how yellow it was until I realised that actually the dog must have sat down on a fallen leaf which had stuck to the slightly sticky wound. Another occasion, another panicky phone call.

‘My dog’s broken its leg. There’s a piece of bone hanging out,’ and then once again those portentous words, ‘Oh I can’t bear to look.’ On that occasion it was part of a stick of rock that was stuck to the leg. Quite how the owner had missed the fact that her dog was using its broken limb without even limping still passes me by.

My favourite story however is the apocryphal tale of the PDSA client who came into the clinic very angry. They had bought an expensive Rottweiler puppy and it wasn’t growing. It was left to the rather bemused vet to explain that the reason that the puppy was not making much progress was because it was actually a guinea pig. Somehow I have never been able to convince myself that story was true, even though I have been assured that it did really happen. Still it’s a great story, and there is just enough possibility in there to make it wonderfully tantalising. You really do need a great deal of tact to be a vet.

Today’s picture is Tiger who is in for a vaccination and is looking very fine at the great age of 16 years and 9 months.

 

 

 

Touched (in the Head)

It seems like an age since I have written here. In my last post I was about to head off to Scotland. That weekend already feels like a distant memory. It was a wonderful wedding. I won’t share all the details, but just as a random sample of how great it was, here are some photos of the venue and the  wedding cake.

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The day after I returned was a whirlwind of hospital appointments and seeing Charlie off to the airport and then suddenly it was Wednesday and time for my operation. Wivek very kindly drove me to the hospital, and to my surprise (and relief) rather than dropping me in the car park, she accompanied me up to the ward, helped me find where I had to go and then waited with me until the nurse arrived. I was bundled into a bed and given some pain relief. I don’t know what it was, but somehow I managed to fall asleep and they had to wake me up to take me into theatre.

I came round a while later to be presented with some ice-cubes to suck. These were oddly soothing, but there was a horrible taste in my mouth and I remember a strange moment of overwhelming gratitude when the nurse came over to me proffering a lurid pink and yellow ice lolly.

At some point I was reunited with my mobile phone and it struck me that it might be a good idea to let my nearest and dearest know that I had survived. Having sent a boringly factual message to Charlie, I then concluded that I should also let Wivek know. I’m not sure what kind of madness seized my brain at this point. Rather than repeating the factual tone, my fingers sketched in the abstract statement ‘Ice-cubes are my friends.’ At least I think it was something like that. Having typed this gibberish, my clouded brain then decided it would be a good plan to include Dagny and Jan-Arne. To their credit, Dagny and Wivek just wrote back saying they were glad.

Jan-Arne however was obviously confused. Unlike the other two, I suspect that he didn’t have my number programmed into his phone, and faced with some random babble about ice-cubery, he rapidly texted back ‘Que?’ Followed by another message saying ‘Who is this?’ When I let him know it was me, he decided to call me. Goodness knows what I sounded like with a swollen throat and a brain filled with opiates, but it was lovely to hear his friendly voice.

At some point, the surgeon also very kindly visited to let me know that although they wouldn’t have the definitive pathology back for a week or so, there had been no sign of anything severely wrong with my tonsils. As the reason I skipped the waiting-list was that there was some concern over my history of melanoma, this was an enormous relief.

Anyway, my two weeks off raced past in a blur of writing (trying to get Ready. Vet, Go edited in time for a summer onslaught of literary agents) and Come Dine With Me on the TV. In defence of my (appalling) taste in TV programmes, I must say that I only watch such drivel when my brain and body are drained.

And so yesterday, I returned to work. I had been there less than an hour when I began to feel shaky and exhausted. Somehow, everyone but me was swamped with work and this was doubly frustrating as a vomiting cat had been booked in for me and left by the client, and despite having time to spare, without another pair of hands, I was unable to examine it. In between flurries of washing, topping up and resetting the haematology machine, I spent quite a while sitting in the lunch room feeling utterly drained, mentally and physically. I struggled most of the day, both with my veterinary work (thanks are due to Wivek and Marita, who very patiently helped me with each and every case) and with my Norwegian. At one point, I saw a very stressed owner whose dog had been hit by a car. Whilst my emergency-clinic primed brain was still ticking over well enough to asses the dog,  I struggled so much with explaining the concept of keeping an eye on the dog’s breathing that I was worried that I wasn’t managing to reassure the owner well enough that she could cope with monitoring the dog for the rest of the day.

I was also still horribly aware of the poor cat which was awaiting a full assessment. I had checked him out and put him in a comfortable kennel with some water so I knew his condition wasn’t critical, but as soon as Jacqueline had arrived, Magne had rushed her in to help him in theatre and I was beginning to wonder whether I was ever going to get a chance to examine and blood test him. I think the emotional roller coaster of the past few weeks was taking its toll, because there were moments when without logical reason, I found my eyes were suddenly threatening to overflow. It’s a long time since I have felt so oddly helpless.

Still there were a few lighter moments which kept me from being overwhelmed. Marita had two cats booked in for clipping and grooming under sedation. She appeared in the prep room clutching the wrong end of one of those evil plastic aprons that come in a roll and from the quizzical way she was examining one of the side tapes, I could tell that she had no idea which part of the thing she was gripping. It became apparent to me at this moment, that despite the fact that most of the logical and language sections of my brain were running on empty, spatial awareness was still fizzing away in a miasma of over-efficiency. I took it from her, tore away the throwaway sections and handed it back to her the correct way up.

‘What kind of IQ do you need to sort out one of those things?’ she asked, rolling her eyes.

‘Not very high,’ I responded. ‘After all I managed it.’

I think this probably demonstrates just how disconnected my brain was. Fortunately, instead of thumping me as I deserved, she just laughed and fixed me with a fake glare.

‘So are you saying my IQ is really low then?’ she demanded. In response, I just grinned rather weakly.

After the road-traffic-accident dog, I managed to snaffle Jacqueline to help me with the vomiting cat. Having tried unsuccessfully earlier to take his temperature on my own, I finally managed it with her there to help. Logic however, had deserted. Somehow I had forgotten  it might be better to blood test him first before winding him up by inserting an object up his bottom, however fortunately for me, despite turning into a wildcat with the thermometer, he reverted to sweet pussy cat while I wielded the syringe to take blood from his jugular.

Time was going on, and we were broaching the Thursday communal lunch hour. There was no meeting as Dagny was absent, but people kept urging me to come and get my lunch. Thinking that this was mainly out of concern for my health, I stubbornly sat and waited for the cat’s blood test results, and when they came through, I burrowed my head in a laboratory book to check the significance. I think I had been once or twice into the lunch room. I had started to prepare my lunch and was frankly oblivious to what was going on around me. Suddenly someone started to sing ‘Happy birthday’ and I finally looked up from my book.

‘Whose birthday is it?’ I asked.

‘We’re singing it for you,’ they replied.

I confess that, at this point, I was a million miles away, utterly disconnected from the clinic and wishing I could go home.

‘It’s not my birthday.’ I said in grumpy confusion. There was a rather long silence, filled with suppressed giggles and when I finally managed to reconnect my brain, I realised they were all  glancing between me and some stunning flowers rather obviously placed right in the middle of the table.

‘They’re for you,’ they said. The message on the card welcomed me back and said they had missed me and it was signed by Irene, Wivek, Jan-Arne, Jacqueline and Marita. Suddenly my eyes were filled with tears again, but happy ones this time. This was a gift from my friends, not an official token from the clinic and that meant a lot.

Finally, as I was leaving, Jan-Arne came up and gave me a huge hug.

‘I really missed you,’ he said. ‘It just isn’t the same when you’re not here.’

Magne appeared in the passage behind him and said something, at which point Jan-Arne went over and offered to give him a hug as well, but he was humorously rebuffed. For a moment, I considered giving Magne a hug as well as I suspected that might have been more to his taste, but somehow at the last minute, we both lost our nerve. Instead he patted me rather awkwardly on the shoulder and told me how glad he was to see me back. Despite the fact that yesterday was my worst day at work for a very long time, I am  very grateful to all my colleagues for their obstinate insistence (despite all the evidence) that I am lovely.

Spray that Again

Holiday season has begun. This week Scary Boss Lady was off for her summer break. Just in case we were thinking of having a wild party with the Dechra rep who had made an appointment to come and tell us about their range of skin products, she left her daughters Ena and Sara in charge. Tornado Tawse was also presiding over the nursing duties and therefore the whole clinic was a hive of efficiency. Four pallets of pet food arrived at lunchtime on Thursday and within about ten seconds, the entire delivery had been redistributed onto the shelves. Before I knew it on Thursday, all the rooms had been cleaned. Luckily Gerd and Irene had booked me in some cases to see, otherwise I might actually have been at something of a loss for what to do.

One of the cases was desperately sad. A cat had been attacked by a dog and its injuries were serious enough that it had to be put to sleep. There was a little girl there. It is so difficult watching a child having to say goodbye to a loved pet. At the other end of the spectrum, Magne and I performed surgery on a lovely Cavalier King Charles spaniel for pyometra (infection in the uterus). Without our intervention, she would very likely have died. It was a pleasuritself to operate with Magne. This is the second time we have worked together on an uncomplicated pyometra and everything just clicked into place both times. It’s a delicate operation that requires nimble fingers and great care and the process itself was intensely satisfying, but the end result, when the dog comes round safely and greets its owner is the best feeling there is.

Due to the efficiency drive I mentioned above, I did have time to pop in and out of the dental room where Wivek and then Jan-Arne were working. Wivek was enormously helpful with the injured cat and so I was keen to do all I could to help her in return. Obviously she is much better than me at the actual work, but I was able to fetch things that she wanted. Jan-Arne was on good form as usual, telling me how simple Norwegian was. After all, he explained, there were very few words and some of them sounded exactly the same as each other. Prayers, beans and farmers are all pronounced in the same way, he said. At this point, he was about to set to with the ultrasonic descaler. His foot, he thought was not quite on the floor-pedal that operates it and so he reached out with his toe to pull it towards him. It was only when the instrument sent a jet of water right into my mouth that he realised that actually his foot had been on it the whole time. At least that was his excuse anyway. Personally I think it’s odd that that jet was pointed so accurately at my face. If I now come down with some awful cat-tooth disease, I know who is to blame.

The Dechra rep I mentioned at the beginning turned up late. He was meant to arrive at two thirty with lunch and so by two thirty five, everyone in the clinic was sitting in the staff room with bright expectant faces. For some reason, he had called into the clinic in the morning with boxes of sweets for everyone and as the clock ticked onwards, it seemed more and more likely that we were actually going to lunch on forty eight chocolate hearts and seven slightly-worse-for-wear grapes that someone had found lurking at the back of the fridge. However, at three pm, he finally arrived clutching a bag of seven enormous sandwiches to be split between the eight of us who were present. Looking around the table for someone to deal with this delicate situation, Gerd, officially recognising my superior surgical skills asked me if I could dissect each baguette into two. Sadly nobody had thought to tell the rep that Jacqueline was vegetarian and so she was left removing pieces of chicken to leave her with a lettuce and dressing salad. Hungry as ever, Jan-Arne demanded that she hand over the meat. Oddly though, when we later offered him the massed bits of cucumber, mayonnaise and chicken that had fallen from Ena’s sandwich and the slice of lemon that I had removed from mine, he seemed strangely to have lost his appetite.

The afternoon ended with Jaqueline delightedly swapping her Toffifee pack for a box of Sara’s chocolate hearts. Rarely have I seen such a pleased look on her face. Magne had to make do with the enormous pile of leaflets and pamphlets that the Dechra rep had left. For some reason, when I suggested he could take them home for a bit of light holiday reading, he seemed less enthusiastic. Anyone watching might easily have been fooled into thinking that really we clinic staff were actually more interested in the food than in the important information about what drugs the man was trying to sell. As if we were both hungry AND shallow people. Obviously though, as all of you kind people that read my blog know only too well, that could never be the case. Thanks for reading.

Today’s photo is Billy, who was in to see Wivek for some blood tests.

Heartwarming

We do get asked some bizarre questions now and then. This weeks prize goes to one of Jan-Arne’s clients, who wanted to know whether we could do a test to see if his dog was gay as he had failed to show interest when presented with a bitch in heat. Although he was almost certain, Jan-Arne, conscientious to the last, came to check with me and invited me into the room to look at the patient. Of course, there was nothing significant to find.

‘He just doesn’t like women,’ his owner commented to me after I had checked out his pet’s (entirelly normal) testes. It crossed my mind to reply that his dog seemed to like me perfectly well, but he seemed like a lovely man and he had been kind enough to speak in English after all (one of only two non-British clients who chose that path this week).

‘Some men just don’t.’ I replied with a shrug. ‘It’s nothing to worry about.’ Of course, it may be that given another bitch, his dog might change his mind. Love can be a fickle thing.

It has been a week of contrasts and working every day this week has meant I played a full part in all the drama at both ends of the spectrum. It is often the case that when a very old pet is reaching the end of its natural life, there comes a time when it needs a great deal of care. Sometimes just how much is brought home to an owner when they are faced with the decision of how to find someone to take responsibility for their animal during the vacation. It isn’t always possible. Even if you choose to take a holiday where your pet goes on your journey with you, it isn’t always suitable for an animal that is nearing the end of its life to travel at all and sometimes difficult decisions have to be made. The contrast to this has been seen in the number of kittens I have seen this week which have been found and adopted by their finders. The real generosity of some of our pet owners is deeply heart warming.

There was no sad ending for Ludwig, a delightful young Cairn terrier. Ludwig first arrived at the clinic on a Sunday evening, vomiting and in agony. After initially thinking that his pain was abdominal, Marita quickly discovered that poor Ludwig was actually suffering from a testicular torsion. He was given strong pain-killers and his excruciating condition was resolved by careful castration of the affected testicle.

To Marita’s delight, when he returned on Tuesday, as soon as Ludwig saw her across the waiting room, he  launched himself towards her and greeted her with delight. It has often been a source of rueful irony to me, that having loved animals enough to become a vet,  so many of them regard me with at best, suspicion and at worst, fear and dislike.  The only times I have seen this truly reversed was in the emergency clinic. It happened enough to convince me that when an animal comes into the clinic in real genuine pain, and you are the person who gives them relief, then there is no doubt that they feel grateful. I think anyone experiencing this would be left in no doubt of the complex nature of a dog’s consciousness.

I asked Ludwig’s owner if I could take his photo for my blog, and as he was too busy sniffing around the consulting room to pose, Marita picked him up for a cuddle. He immediately took advantage of the situation by kissing her most enthusiastically. Despite the fact that Marita likes him very much indeed, I’m not sure she enjoyed the experience as much as he did.IMG_6515

 

 

 

 

 

 

IMG_6516IMG_6514Still, understandably, she was both happy, and delighted with his reaction. There are few things better than knowing you have done a great job, especially when the result is seeing a lovely young animal make a full and happy recovery. If they like you as well, that really is the icing on the cake.

 

Todays featured image is of Turbo Trine, Irene’s lovely dog, who had been in to have her teeth cleaned.