Tag Archives: Operation

Shameless

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So life is going on and work is getting better and better. Tuesday was a bit mad because Kari Anna is on holiday this week. She’s the clinic’s resident veterinary nurse, and like most veterinary nurses, when she is there, she flits calmly around the practice and suddenly all the mess has disappeared and everything is under control. On Tuesday morning there was just Gerd (a veterinær assistent like me … well actually not much like me because she is sensible and mature and… well you get the picture) and me there, and Gerd was busy on reception where the phone was ringing madly and about a thousand people were waiting to be helped. So I found myself rushing around, trying to make sure everything was reasonably tidy. Unlike Kari Anna, I was unable to do this invisibly and just in case I thought I was doing rather well, mid-morning Jan-Arne came up to me with a look of confusion and asked why I was doing so much cleaning up today.

Anyway into the midst of all this came scary-boss lady herself [hei Dagny!!!!] and demanded asked very kindly that I should get theatre ready for two cat sterilisation operations. Despite the fact that I had done it before under the steady eye of Kari Anna, immediate panic set in. I knew which surgical kit it was, but which size of drape had I been told again? And which suture materials? What size was the pack of gauze swabs, two or five? So many things to go wrong. Worse still, as I commandeered the last two surgical kits from the shelf, I realised that very probably I should have put the other kits that I had so carefully sorted out into the steriliser, because if any other operations were coming in immediately afterwards…

AAAAAAAaaaaaaaaaargh!

So with my head spinning round on its axis like the child from the Exorcist, I started to hunt around for everything I needed. At that moment, Magnanimous Magne (the other boss) stuck his head round the door and asked whether I could help him with a blood sample. I’m sure I snapped “No” rather rudely, but he didn’t seem to notice anything untoward, and a few minutes later, fortunately I found a spare minute to set up the haematology analyser and run his test for him. The operations went smoothly and there were no screams from outside theatre, so presumably nobody needed another kit during the time we were busy. It was with relief that I finished with the surgery and was left to sort out the two patients and clean up the theatre while Dagny went to get on with other vetty things.

As soon as that was all clear, I rushed to the autoclave. Now what was it I had to do again? I had to drain some water out of one of those little tubes but was it the water from the tube on the left or the right? I thought it was probably the left, but when I tried to open the tube up for emptying, I couldn’t get the rubber bung off the end. Was it meant to come off, or was it attached and needing to be twisted or opened somehow? I didn’t want to rip it off and then find I’d broken it. And was it the left tube? There didn’t seem to be anything in that one. So it was probably the right. Gerd was still stuck with her three million clients, and there was nobody else around, so taking my life in my hands, I approached my scary lovely boss and asked her if she knew. Very helpfully she came through. She hadn’t used the machine for three years, but she would try to remember. Within moments she had successfully removed the bung from the right tube as I had asked. With a triumphant nod she left me to it.

It was only when I was still standing there, with about a gallon of water in the bucket at my feet that I began to have some disquiet over whether it really was the right tube. When Kari Anna showed me, surely there had only been a little drainage? Now there was something approaching a flood threatening to overwhelm the bucket. Shoving the bung back into the tube, I rushed through, and happily Gerd was able to spare me a moment. I had, she confirmed, as I had suspected, made a brave attempt at emptying the entre autoclave, but fortunately all was not lost. There was enough distilled water to refill it and no harm done. Better still, she even showed me how to make more distilled water. Lets face it, by the time I have to do it, I’ll probably have forgotten, but I’ll deal with that when it happens!

Thursday and Friday weren’t so fraught thank goodness. This afternoon I even had a brief period when I wasn’t sure what to do. Irene was being terribly efficient, and there is another girl doing work experience who was rushing round after everyone tidying up, and as I don’t like to sit around doing nothing, I went in to see if Jan-Arne needed a hand. He was examining a cat with mastitis so I helped him to sedate her. As he was cleaning out her wound, Irene put her head around the door. Was I available, she wanted to know, to help with a dental? Her question was directed at Jan-Arne. Did he really need me?

Jan-Arne looked up with a grin. “No,” he said, “I don’t really need her, it’s just more fun when she’s here.” ** And really, when all is said and done, that’s good enough for me.

Here he is:

Jan Arne and pig

That’s him on the right….

And what is it that is shameless? Well I shamelessly stole Jan-Arne’s beautiful photograph of a foal for the top of my page. Who could possibly resist?

**Technically he said it in Norwegian, but it’s a near enough translation.

Humour and Humanity

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I have seen a lot of SBL and Magmatic Magne this week: a lot of time in theatre, though I also endured some sessions with Mr Ikea, trying to follow the instructions for putting together a small and inoffensive chest of drawers. The thing had been undergoing assembly over several weeks now and the already-completed drawers had been huddling on a table in the corner, minding their own business except for the odd occasion when it was necessary to squeeze past them to get to the dog food. As is the tradition with Ikea furniture, a small error had been made at a crucial point about half-way through, thereafter it followed that everything else was just far enough out of place that the finished product wouldn’t go together. Dagny, active in this, as in all things was the perpetrator of this tiny error, and Magne had seized upon the opportunity to remind her of this fact, every time anyone went near. Still finally the thing was done, and all the drawers were in place. My first achievement of the week.

About an hour later, I found myself managing the anaesthetic for a mammary tumour operation. Dagny asked me to get theatre ready, and when she asked “Are we all set,” I replied (with the honesty and diligent self-confidence I try to maintain at all times) “I hope so.” In fact I wasn’t. I had failed to check if she wanted to use gaseous anaesthesia (a lot of the operations are carried out with a combination of deep sedation, local anaesthesia and propofol infusion) so she went and switched the machine on herself. A few minutes later, with the dog prepped and installed, I noticed the ominous stillness of the patient’s chest. She wasn’t breathing. The usual sense of consternation kicked in. Just work through it logically, I told myself, trying to remain calm. I checked the dog’s colour. It was pale, but it had been pale before we began. That meant that it was even more urgent though to discover what was wrong. I checked the level of anaesthesia. The eye was rotated down. Fine. I grabbed a stethoscope and listened for the heart because the heart-rate monitor wasn’t detecting anything. The heart was racing, as at this point was my own. It was at that point that Dagny quite casually pointed out that the rebreathing bag had filled up completely because the pressure valve hadn’t been reopened after testing. She hadn’t been aware that the dog was not breathing, and in her calm assessment, had just noticed what I was failing to pick up. Panic is a terrible thing. I can recall a time in the emergency clinic when whatever life threw at me, I knew I could handle it but five years off has sent me tumbling back into “starting out” mode.

Dagny talked a bit about her life during the operation. She told me that she was only six years old when she decided that she wanted to be a vet. Despite discouragement from those around her, who thought that as a woman she should do something less ambitious, more feminine, she planned out her life with ruthless efficiency and finally achieved her aim. No wonder then that with such determination to succeed, she ultimately went on to become a partner in the very first dedicated small-animal clinic in Norway.

By Thursday, I started to feel everything was more under control. I assisted Magne with a cherry-eye operation. It’s amazing to see him putting in the tiny sutures, ensuring that nothing is left to irritate the eye. Just before lunch a dog came in which was in respiratory distress. To my amazement my self-confidence suddenly kicked in and I was easily able to help out and even offer guidance. At one point, I suggested the possibility of draining the chest and Magne and Irene looked at me as if I had suddenly sprouted green bushy eyebrows. How odd it seemed, and yet it brought it home to me that despite the irony of the situation, I am much better with a frank emergency than with anything routine, and perhaps that shouldn’t be surprising given my history of working in an emergency and critical care setting for the last few years of my career in Scotland.

Later I found myself back in theatre once more, as Dagny and Magne, without even the benefit of Ikea instructions, set out to fix a fractured humerus in a young dog. After the lunchtime emergency, I managed to impress Magne once more with my astonishing ability to intubate a dog without a laparoscope. This has never seemed like any great achievement for me. I started out, all those years ago, in a small animal practice where everything was on gas, and everything was intubated and I don’t think I ever even saw a laparoscope. As with everything else, a good nurse and the correct positioning is essential, so thanks to Irene for that. When Magne returned from the hunt for the missing laporoscope, he found to his amazement that the dog was already in theatre, fully hooked up to the machine and almost ready to go.

“You know,” he said to me as he walked to the table, “you’re really quite useful to have around. I think you should work more hours!”
I felt rather diffident about this. I actually like just working two days a week and keeping my options open for overtime. “Well maybe I could come in and work Fridays as well,” I offered.
He just shook his head. “That would be no good at all,” he said with a twinkle in his eye. “I don’t work Fridays,” and with that, he turned away and started to cut.

Not German(e)

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A short week this week because Thursday was Ascension Day or as it is amusingly known in Norway, (assuming you have a mental age of six, as I do) Himmelfartsdag. I started out the morning anaesthetising a dog for a cruciate operation. For those who don’t know, the cruciate ligament is within the knee joint and it can rupture on occasion causing instability of the joint. The operation replaces the ligament, thus re-establishing normal movement. Kari Anna thought she would test me out by asking whether I had remembered to take the Gentamycin injection into theatre, and with a triumphant smile I was able to wave the box at her. Not quite so jubilantly, an hour and a half later I slunk towards the fridge with the drug opened and drawn up into a syringe, presumably to be wasted. When I had offered it to Dagny, she had said “No thanks!” with a radiant smile. I felt a little vindicated when I told Kari Anna I was placing the labelled syringe into the fridge. Like me, she had believed the official Spraying of the Gentamycin was a routine part of the operation.

Dagny has been talking on-and-off about the possibility that I might begin to consult on an official basis. The only spanner in the works (and admittedly it’s quite a hefty spanner) is that on the days I am working, there is no spare consulting room. Often they already have a vet in all three rooms as well as one taking up space in the prep-room. This time, for the first time, she mentioned something about the idea of building another room. Personally I think they should build it of brick and designate it the British Wing. Given the Norwegian love of DIY and my current observations of practice protocol, I expect Dagny will begin construction herself as Magne skulks around, unobtrusive but observing carefully, and he will smile to himself as she fails to line up the bricks correctly before stepping in and… getting me to fix it.

As well as the cruciate operation, I assisted with another two cherry-eyes. For some reason Magne has started to ask me for his surgical gloves in German, as if it wasn’t complicated enough working in Norwegian. “Do you speak German?” he asked me. “Just enough to know that you are asking for gloves,” I might have replied. Actually that wouldn’t be entirely true. I know three other very useful things in German (I won’t count the phrase, “That is a lamp” which was the very first thing I learned when I bought a German picture dictionary as a teenager). I know how to ask for beer of various kinds. And when I’ve had the beer, I know how to ask where the toilet is. But most importantly, I know the very useful word “scheiße” I always thing it is a very expressive word, and as my best friend when I was learning Norwegian was German, for me scheiße is a word that is screaming to be incorporated into the Norsk language. Anyway, back with the cherry-eyes, this time Magne encouraged me to sit at the end of the table instead of on the other side so that I could see better what he was doing. Perhaps having me sitting in the wrong place was a distraction however. He paused as he started to cut into the tissue and frowned. “What is it I have forgotten?” he asked, looking puzzled, but I couldn’t help. Then with a smile, he grabbed the head-piece with the magnifying lenses and placed them in front of his eyes. “I thought everything had suddenly got very small,” he said.

In all of this theatre work though, I feel I am seeing very little of Vivek, Guro and Jan-Arne which is sad. Perhaps if I begin to work sometimes on a Friday (the only day when there might be a room free) I will get to see them a bit more. In the meantime, I hope to spend some time with Jan-Arne at the weekend as he does some large animal work. Maybe if I’m really lucky, I may even get to bury my arm inside a cow. How about that for wallowing in nostalgia? Of course, at this time of year, with the cows just out on all that luscious new grass, nostalgia may not be the only thing I end up wallowing in. Only time will tell.

Blissful Ignorance

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Sunday this week: a lovely day, and the day I had arranged to go out and “see practice” with Jan-Arne. I had been hoping to do this for a while, but it had proved difficult to arrange. In the event I ended up seeing only one patient, though Jan-Arne did all that he could to drum up some additional business, first by telephoning the previous days clients to see if they needed a follow-up call, and secondly by driving me around the entire district in a vain attempt to run over an animal (or cyclist).

The single call was to a cow with mastitis. I walked into the barn and as with the small animal clinic, had an immediate feeling of coming home. I miss farm work so much. I love the sense of peace that I experience when I am in the presence of dairy cows. These large animals are so docile; they allow us to stand so close and rarely object to being handled, except now and then when they need to protect their calves and even that is mostly done with a doe-eyed gentleness. But there is also a sense of community in farming that is so very different from city life. Years ago in Scotland, working in a dairy practice, I felt almost (only almost) as if I belonged. I wasn’t born to it, and yet as a vet there was a sense of integration. I was wanted and needed within their society, and it is that feeling of belonging that appealed to me, almost as much as the animals themselves.

There were some interesting differences. Norwegian farms are strict on biosecurity. I was fascinated to see the gigantic pair of wellington boots that the farmer’s wife brought out from a cupboard. They fitted right over Jan-Arne’s trainers and he clomped around with feet like those of a yellow elephant. I had to make do with special plastic wellington boot covers. I had the tremendous feeling that I could just walk back into that lifestyle. It all felt so similar to the old days that I could almost see myself there.

Any delusions about that were shattered later when we visited a farm where Jan-Arne was friendly with the family. We looked at a couple of their bottle-fed lambs and all the time the conversation was rattling on around me. I couldn’t follow a word and the farmer couldn’t speak any English. They had a lovely young daughter though, who kept grinning at me conspiratorially. She wanted to show us her pet lambs and tried various methods to capture them, including an attempt to entice them with some food. Afterwards, she raced around the field chasing them, a streak of pink in a pair of purple wellingtons, childish hair flying everywhere. Finally she managed to catch one, a sturdy black lamb of a traditional Norwegian breed. My biggest regret of the day was that in my haste to leave the house I managed to forget my camera. Jan-Arne very kindly offered to take some shots of the field and the child and the sheep and here they are…

Jan-Arne's Sheep 1

Jan-Arne's Sheep 2

Jan-Arne's Sheep 3

Always difficult to get a good action shot, but it was a beautiful setting on a wonderful day.

The biggest revelation occurred when we got back to the practice where I had left my car. Jan-Arne pointed to the house next door.

‘I wonder if Magne and Gerd are in there, enjoying their day off,’ he said. ‘Did you know they lived there?’

Did I know they lived there? My mind was screaming.’Magne and Gerd are married?’ I managed to croak it out at last.

‘Didn’t you know?’ He was laughing at me.

Amazing the things I fail to register. Everyone else knows presumably and maybe they just forgot to tell me, but more likely I missed it. Perhaps they stand and chat at the desk about what they are going to have for dinner. I have no idea because after so long in Norway, my brain just switches off when other people are chatting to one another. They could be talking about me, and I would remain in a happy state of oblivion.

I realised recently that this was, in many ways, a blessing. When I return to Scotland, it always comes as a shock to overhear conversations which my mind automatically processes. There are so many preconceptions based around accent and word use, instant frustration at the banalities of life. Here I escape all of that. I wouldn’t change it, even if it means that occasionally things pass me by. I wondered recently whether this must be like for a young child, having a mind that passes over incomprehensible things that don’t really matter.

When I discovered Magne and Gerd were married, it leaped into my head that I should be worried about whether I had ever said anything reprehensible about one to the other, but of course I was able to dismiss that in an instant. I just don’t have those kinds of conversations. I would love to say I have never said anything offensive about anyone, but of course, there is Scary Boss Lady. Apparently the other staff found “All Change” so amusing that they had to tell her and she read it. Since then, she has tried to convince me she isn’t scary. She even appeared one day in a poncho with the words “Love Me” woven into it. I left no doubt, she told me over a mammary tumour, that it was her I referred to. In case there was any confusion, I had clearly stated “Dagny, the scary boss lady”. She tells me that it will follow her now. Even at the Christmas party, she is in no doubt that her name-tag will read “Scary Boss Lady”. Still, she can’t have been too offended. Apparently she told her friends in the cycling club about me on a train journey. I can imagine their wide-eyed shock as they asked her, “Did she know you would read it?” Of course, I didn’t know. But I was aware it was possible, because I had already friended some of the others on Facebook. Ah well, it’s always a good idea when starting in a new job to begin on good terms with your boss!

Scary

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This week I spayed Dagny’s cat. She has asked several times before whether I would commit this terrifying act, but until now each query has been a false alarm. Not so this week when this cute, fluffy being arrived in the practice looking a little afraid… with her cat in a basket. But that was Friday, and as I like things neat and tidy we should return to the beginning.

I’ve worked four days this week, Tuesday through to Friday, and I confess that I have found it exhausting. Tuesday was particularly traumatic. I can only assume that on Monday they were short-staffed in terms of assistants because though for the clients everything was still running smoothly, from my point of view I arrived to chaos. There were four kits (I counted them!) in the sink waiting to be washed, dried and sterilised. There were no sterile kits in the cupboard. There was wet washing in the machine and dry washing in the tumble drier. Crazy. And of course my job as an assistant is to clear the backlog and ensure everything is in place so that the vets can perform their duties. Obviously I have to achieve this Herculean task invisibly, and sadly unlike Harry Potter, my cloak is faulty. And so it was that Dagny came upon me dithering in the autoclave room, trying urgently to get a sterile kit ready for the operation that had arrived at nine o’clock.

I was away on holiday for five weeks. Rather too long, I suspect, as my head still wasn’t quite back in its Norwegian groove. So much so that when Gerd told me it was a dog to be sterilised, I hadn’t picked up on the fact that in Norway, “sterilised” is only used for females. This then was a bitch spay. Not the much smaller castration I had been fondly imagining. So there she was. Dagny in full serious operation mode.

“What are you doing here Sarah? We need you in theatre. We need to get the dog onto Isofluorane.”

“I’m getting you a kit. You’ll need one.”

“There’s one in Magne’s room.”

There you go you see. Still so much I don’t know. My faulty cloak is slipping as Dagny disappears and I follow. Set up the anaesthetic machine. Turn on the oxygen generator. Connect the hoses and set the correct bag in place. Switch on the blood-gas and pulse monitor. Attach the mechanism that registers the breathing and measures the carbon dioxide levels. Then test the machine to make sure there are no leaks. Fine to do so with the oxygen on 0.2. I know this because Kari Anna told me. All the same as usual and now Magne has entered with the patient. We connect her up.

“Shouldn’t the oxygen be on 2?” I’m slightly surprised. It’s not like him to ask questions. The patient is on the border: close to needing 1.2 litres per second, just below the limit. I have her on 1. She definitely doesn’t need 2. To keep him happy I turn the knob slightly and now she’s on 1.2.

And then Dagny is there and the operation is underway and I realise that although everything is working fine, I haven’t printed off the form to record the gas levels. I’m swithering again. Do I leave the room to try to get one printed and leave the anaesthetic unattended or do I stay and monitor but not record? Happily Gerd passes the door at that moment and I rush out and ask her to print one. She’s busy though. it might take a few minutes. Dagny is speaking again. I brace myself. My performance this morning has not been faultless. She’s not unkind, but it can be difficult when everything is falling about your head and searching questions are asked.

“Did you check the anaesthetic machine this morning? Was the pressure stable?”

“Yes.” I’m on sure ground here at least. Perhaps she doesn’t understand that my fluster this morning has been caused by the fact that I am utterly aware of the consequences of not being thorough. I would not allow an operation using a faulty anaesthetic machine any more than I would allow them to go ahead with instruments which were not sterile.

“Are you sure? There wasn’t a leak. Did you have the oxygen switched off?” Still on relatively firm ground, though the 0.2 oxygen is a pulse in my head. Kari Anna said so but she isn’t here to defend me. I’m on my own.

“Well there was a small amount of leakage. I had the oxygen on 0.2. Kari Anna said that was okay.”

“Well we checked it yesterday and it was definitely leaking then. We can check it again at the end. If it’s leaking, the oxygen should be up at two.” She isn’t being mean, just practical, and yet I feel like a teenager caught in some act of defiance, faced with irrefutable proof of my guilt, even though I know I have done nothing wrong. Pah to my highly-disciplined, polite, British upbringing where nothing was direct and everything was couched in euphemism.

But I had checked that machine. I had. Everything had been normal: the same as all the other times I had used it and all those times it had functioned perfectly. Not only that but the bag is full now. I can see there is no leak. Despite my personal feelings of disquiet I stand my ground and the oxygen stays as it is. It’s not as if I’m not watching the monitors after all. And then the ultimate jab of the knife as my final weakness is uncovered.

“Do you have an anaesthetic form?” I quit my dithering and run.

The mood improves. Dagny is talking now about families, food, normal things. When the operation is over I check the anaesthetic machine instructions. The pressure check can be carried out with the oxygen up to 0.3. Feeling vindicated I rush out to find Dagny and tell her.

“Oh yes,” she says. “That was all explained. Magne told me that it was a different bag we checked yesterday. He saw you reaching far back on the shelf to get that one.” Magnific Magne riding to my aid again, even though I hadn’t exactly needed rescuing. The day progresses and chaos no longer reigns. Guro has told me she thinks I am efficient.

“I didn’t know you were in charge of the washing as well as everything else,” she says. So much work. All of it invisible. Until it is left undone and then everything falls apart. The life of a veterinary nurse or lay assistant. I had always helped them out when I saw they were busy, but never really understood what they might be going through.

Wednesday was a good day. It started with helping Jan-Arne to anaesthetise a parrot. Happily I had arrived to the relative tidiness I had left behind me by the end of Tuesday and therefore I had time to read up on bird anaesthesia. Just as well because I was undoubtedly rusty. The book was reassuring; Isofluorane was the drug of choice and that was the regime that had been proposed. In place of Gerd, Leah was there behind the front desk and generously she helped me set up the machine. The parrot didn’t like men apparently. I’m not sure it really approved of me either as I wrapped it in a towel and inserted its beak into the mask but there was not much it could do. It couldn’t have gone much better. Jan-Arne was able to drain the lump on the parrot’s face and clean it out and the bird was happily back in his cage, clicking and muttering to himself as we handed him back to his owner.

By Thursday everything was so much under control that I had time to clean down the cupboards and the walls in the consulting rooms. Goodness knows what Jan-Arne (or maybe it was Dagny) had been aiming at the bin in room A. I wiped it away, wondering whether anyone would ever notice and yet feeling good about doing it. Surely it must be reassuring for the clients when everything looks clean. To my delight, I won the “Weeks smile”. Two votes, only one of them written down. “To Sarah for her skills in clipping claws”. Oh yes, I’m a talented woman! And then Dagny told the room I would be spaying her cat tomorrow. “I’m going to be talking about this for days,” she said. “Everyone must know.” She should steady on, I thought. Otherwise I might have to start calling her Lovely Boss Lady, and that just wouldn’t have the same ring about it.

Friday morning arrived and I thought for a couple of hours that it just wasn’t going to happen. Then Dagny arrives looking glamorous as she does in her non-working clothes. The cat is glamorous too, with its basket all covered in bows. Actually it looks a little like Sophie, my cat from the UK, now residing with my mother whose cute photograph I included at the beginning of last week’s blog. Dagny’s cat is fluffier though, and much younger. “I’ll leave it up to you,” Dagny says. “I don’t want to hang over you.” And she disappears for a moment. I rush through and check with Marita for the dosage of the sedative in cats. I have it in my head for dogs now, but I haven’t anaesthetised so many cats. She and Jan-Arne help me. Thank goodness everyone is so patient with me this week. For some reason I have been asking for help all week and everyone has been fantastic. Seamlessly I return. As does Dagny. So much for leaving me to it.

And then the cat is on the table and I am gloved and capped. The scalpel blade is in place and suddenly everyone in the practice files into the room, fascinated by this incredible event. No pressure then! I start to cut. The hole is bigger than I intended but there’s no going back and happily as I cut through the peritoneum, the ovary pops into view, to audible amazement from the audience. It isn’t always so easy, but I try to look nonchalant, though I am given away slightly by my not-quite-steady hands.

“You don’t need to shake,” Dagny says with a laugh. She always knows just the right thing to say! Happily the operation goes smoothly and within a few minutes it’s all over. The room is empty again and after spraying the wound and applying some Mepore, slowly I begin to tidy the theatre and wash everything down. Well some things just never change.

And for those who can’t speak Norwegian, the banana featured at the top of the page says “Have a good day.” It was sitting on the table when I arrived on Friday and I couldn’t resist its smiling presence.

Build

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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.

Cute

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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

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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!

The Eyes Have It

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It’s been an interesting and busy week in the clinic. Dagny and Magne were both away on holiday, and what with working an extra day and with not being so intensively taken up in theatre, I felt a wonderful growth of teamwork with Wivek, Jan-Arne, and particularly Marita, with whom I spent more time this week than ever before. Given that we were two vets down, and the clinic was still busy, I was pressed into more directly clinical work than usual, and although it can be stressful at times, when things go well there is a huge satisfaction in meeting the challenges and knowing that you are making things better for the animals.

Of course, as soon as Scary Boss Lady and Magnanimous Magne, the ocular specialists were out of the picture, two of the cases that came in were eye problems. The first, a handsome spaniel who had been out for a long moorland trek the day before, arrived with a very sore looking eye. He was in so much discomfort that he wouldn’t even let me look at it and the first thing I had to do was sedate him. It was then quite hard to examine the cornea, because his eye rolled down as he got sleepier and so I asked Marita to come in and give me a hand. The cornea looked to be all clear, and it was at that moment, that Connie, a student who has been helping out for the past couple of weeks pointed out that there was actually a tiny splinter of wood stuck on the white part of the eye. I was tremendously glad of Magne’s special tiny eye instruments as we clipped a tiny hole in the conjunctiva and removed it. It was wonderful to see him yesterday for his check-up looking much more comfortable.

The second case, the gorgeous seven-week-old pup at the top of the page came in on Tuesday morning. He’d had some kind of accident with his mother, and his eye had completely prolapsed from its socket. He too was in a lot of pain, and needed a full anaesthetic before we could start to try to put his eye back into the right place. Again Marita and I worked as a team to place some stitches into his eyelids before carefully sliding everything back into position. The stitches in his eye have to stay in for two or three weeks and although everything went well, we will only know for sure how much damage has been done to his eye when the sutures are removed. Happily Dagny and Magne will be back by then.

Jan-Arne has been his usual crazy, endearing self. I love the way he takes his time and gets to know the patients really well and goes out of his way to make them feel at home. I went in at the end of one of his consultations on Tuesday to find him sitting cross-legged on the floor. When I worked in the emergency clinic in Scotland, I gradually got more and more idiosyncratic and often consulted sitting down on the floor at dog level and I think he is the first other vet I have seen doing the same. I also overheard him yesterday singing back at a German Shepherd who had been singing at him. It was a beautiful duet.

And somehow, though the quiet week I had anticipated with only two or three vets consulting didn’t emerge, I still found a few minutes on Tuesday to complete the first part of a project I am undertaking with Wivek to set up a consistent anaesthetic protocol for the practice to ensure that we are completely up to date with providing anaesthesia that is both safe and provides a high level of pain-relief for all our surgical patients. Of course, as I am in Norway, I thought that it would be a good idea to provide the poster I was creating about Gas Flow Rates in Norwegian. Having showed it to Irene, who assured me it was fine, I proudly printed it out and laminated it… and then went to show Wivek. How was I to know that the word that means flow when it is water and electricity doesn’t apply to gas? And of course my assumption that if you exchanged the “c” in “maintenance” to an “s” would turn it into a Norwegian word seemed logical enough at the time. And litre… apparently the Noregians prefer the American spelling. Ah well, after six years in Norway, I am probably one of the most proficient writers of Norglish that the world has ever seen, and that is something to be very proud of.

Operation

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I can’t write too much this week as on Thursday I was in hospital myself for an operation. This weeks featured photograph is of an incredibly laid-back and friendly cat called Loke after the Norwegian God (spelled Loki in English). Loke was Jan-Arne’s patient, but I spotted him through the doorway and couldn’t resist asking if I could take his picture. Typically enough, Jan-Arne found the time to tell me all about Loke’s history… as well as the cat’s.

I stopped on my way into work on Tuesday. I was early, and couldn’t resist taking some photographs of the beautiful sky.

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Sadly I didn’t manage to get a view of the sea, which was a brilliant blue turquoise under that rose sky. I am lucky to live in such a beautiful place, though I confess that the drive might be more daunting in winter when the snow comes. Thank goodness for spiked tyres.

I have been waiting almost a year for my operation. It seems there are long waiting lists in Norway for non-urgent things. I finally received a telephone call last week from the hospital offering me a time at short notice… and Dagny very kindly agreed to allow me to accept. She even signed her get-well message “Scary Boss Lady”. She seemed impressed too with my Norglish gas-flow chart. It’s all good.

I arrived home on Tuesday to a favin (Favyn? feel free to correct me, oh kind Norwegians) of wood for the stove.

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It’s all neatly stacked in the garage now, though I will have to call the chimney sweep before lighting up. The sweep comes around here automatically, but sadly I managed to miss him. Unlike British chimney sweeps, who use a big vacuum cleaner in your living room, Norwegian sweeps climb up on the roof and knock the soot down from the top. There’s normally a ladder on the roof of each house to aid this ascent. Then there’s a little door in the cellar where he can go in and scoop it all out. On Tuesday night, I received a text message from Charlie who was out for a cycle, to say that the aurora was good. I went out and jumped in my car to drive to the top of the hill, and found to my surprise that the snow poles had been set in place already. I guess they have to go up as soon as the temperature starts to drop, just in case. Sorry to any of my lovely Norwegian friends who are reading this. To me it still all seems quite novel and exciting. A bit like being permanently on holiday.

Anyway, I must go now. Thanks for reading.