Tag Archives: Wivek

Belated Bacon Powder

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As some of you might have noticed, I didn’t blog last week. Sadly, last Friday I was on my way to Scotland for the funeral of my much-loved father-in-law. Among the sadness however there were some bright moments. On Sunday morning with the official ceremonies behind us, we paid a visit to the Barras Market which was fascinating. I loved it, but felt utterly out of place: a real tourist in a land I couldn’t fit into, and I couldn’t help but wonder what it would feel like to be a part of that culture. Still Monday brought us back to Norway and to normality, and although for a moment I felt a little homesick, the return to work steadied me, as it always does.

Now and then at work, someone will bring in home-baking, and last week I decided to take in some scones (recipe here). I took in strawberry jam, and squirty cream to eat with them, and they went down very well. Jan-Arne, of course, who is as fascinated with food as I am, said that he had heard about scones, and that he had expected them to be much drier. I suspect that whoever told him about them probably had eaten one when it was a bit stale, because of course, they don’t last long.

‘So how do you make them?’ was his next question.

I explained that you used flour and baking powder, and then rubbed in some butter and brought it all together with milk, but I could see his face cloud over, and his next question really confused me.

‘But what makes it rise?’ he said. Before I go on, I should explain that in Norway, the self-raising flour that I took completely for granted when I was in the UK just doesn’t exist here. For almost all baked goods thicker than biscuits*, you use baking power, so it seemed almost impossible that he hadn’t understood.

‘Well, the baking powder makes it rise,’ I said, and his face suddenly cleared.

‘Oh!’ A long drawn out sound. ‘That explains, it. I thought you said bacon powder,’ and he went off into his trademark giggle.

At this point Wivek arrived and asked what we were laughing about, and so we explained. ‘We’d probably all get a rise if she had used bacon powder.’ was her rather dry comment.

I don’t remember so many outstanding cases from the past two weeks. I know that last Thursday, Perle, the dog in the picture at the top of the page was booked in for a possible operation to relieve a build up of fluid following cruciate surgery, but that when she came, the situation was beginning to resolve and so the op was cancelled. That meant that my normal morning anaesthetic duties were out of the window, and as there were a few rooms that needed cleaning, I decided to get on with them. After sorting out the kennel room, the lab, and the x-ray room, I was walking towards consulting room A with my bucket, when Jacqueline, who had been clipping the claws of a dog for Marita came out of the dental room and yawned widely. It really was that kind of morning.

Of course, nothing is reliable in vet practice, and despite having hours of time in the morning to clean, I shouldn’t have been surprised when mid-afternoon, at the time when if I was working in an office I might be winding down for the last half-hour of the day, an emergency operation arrived and as everyone else was busy, I rolled up my sleeves (well metaphorically. In reality, I donned a surgical gown and gloves) and got on with it.

Thursday this week was quite quiet as well. Lucky for me, as I am trying to get up to speed on everything before I start officially consulting next week. Years ago, I was so used to my job that almost everything could be done on automatic pilot. I would say the same things over and over when I admitted an animal for an operation, and I knew exactly which drugs I would choose for a typical skin infection or diarrhoea case. Although I have re-learned a lot of things since starting work, I also (because I have done it all before) am aware of how many things I don’t remember. In the UK, it is common to have all the tablets and medicines in the practice, so if you are a bit stumped about dosages or applications, you can just pop through to the pharmacy and read the box. Here, almost all the drugs are provided via a prescription, so you have to know where to look everything up, and even when you do, it’s all in Norwegian, so it doesn’t only take a second to read, as it would have done before. No doubt once I start, it will all begin to come together, but just looking at it from the outside, it is a tiny bit daunting. I don’t really have any real uncertainty that it is the right thing to do though. It’s time I was properly back in harness.

As part of the learning process, I did get to spend some time in consulting rooms with my colleagues, and late on Thursday I found myself practising writing up the computer in Jan-Arne’s room. He had just micro-chipped a cat, and idly he started to run the scanner over his own neck.

‘Wouldn’t it be weird and alarming, if I were actually to find something,’ he said idly. Picking up one of the unused chips, still in its covering, he held it up to my back and scanned it so that the machine beeped. Of course, having seen him picking up the packet, I knew he was just messing around, but even as I watched him, I saw a mischievous look come over his face.

‘Where’s Marita?’ he said. ‘I want to see how she reacts.’ Of course, Jan-Arne in this mood is irresistible, and barely able to supress a giggle, I followed him. We couldn’t immediately find her, but sticking our heads into the prep-room, we saw Jaqueline sitting at the computer.

‘Why don’t you try it on her,’ I whispered to him, but he shook his head.

‘She’ll never fall for it,’ he said. I couldn’t imagine that anyone would really, but still always ready for some fun, I continued to follow him until he tracked Marita down, sitting in the office beside reception, looking at the computer. Sidling up behind her, he waved the microchip reader at her and ostentatiously started to scan himself.

‘Wouldn’t it be weird if I found something,’ he said, his face completely deadpan. Then without asking, he started to run the scanner over Marita’s  neck and back, and I watched as he slid the chip up into place and ran the machine over it. Marita’s face was a picture as she heard the beep, and for a moment it was obvious she really thought he had found something, but as she turned, she caught site of the package in his hand.

‘Uh!’ she rolled her eyes at him and laughed ruefully and I must confess that what impressed me most about this whole scenario, was Jan-Arnes unerring instinct for playing pranks to maximum effect. He really is a fun guy to be around.

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*I have been told by a friend from Texas, that what I call a scone is called a biscuit where she lives, and that the thing I call a biscuit, she calls a cookie, so if the whole of the recipe discussion is incomprehensible in your part of the world, I can only apologise.

In Which I have to Speak Norwegian.

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So it’s been an exciting week for me on two fronts. Firstly on Monday, I was lucky enough to spend a day out with Åsulf from the large animal practice, and second, I am now officially employed by Tu Dyreklinikk as a Veterinary Surgeon and not as an assistant. Of course, the terminology might be confusing to those who work in veterinary practice in the UK, because there my official title was always “Veterinary Assistant” because that is the normal term for vets who are not partners. Anyway, I feel very proud of my new role.

Mostly the transition has gone smoothly. I have handled consultations before at times when things have been especially busy, or clients have arrived unexpectedly, so it wasn’t wholly new. But like most people I find any kind of change comes with a degree of uncertainty. My mind was distracted doing my assistant work in the morning (I start consulting at twelve) as I contemplated the cases I was to see later. Indeed I had a particularly embarrassing moment when I started to shave a dog’s leg for a cruciate operation. Unfortunately, with my head wrapping itself around the potential complications of a male dog who had blood in his urine, I started to shave the dog’s hip instead of the knee. It suddenly came to me, about two clipper strokes in, when the damage to the coat was so great that there was no way to hide it. I contemplated just shaving a massive area off to try to cover the error, but it would have been obvious, and so I had to crawl red-faced to Dagny and tell her. Happily she just laughed, although she did toy with me evilly when she came through by suggesting that I had shaved up the wrong leg. I was very restrained though. Even after she carefully aimed a spurting artery at me in a later operation, I refrained from trying to drop sharp scissors into her toes.

One of the conditions of my change of employment is that I am strictly to speak Norwegian at work from now on. Although I had started out well, I had fallen into the easy habit of speaking English most of the time with my colleagues, although to clients I have always tried to stick with Norwegian unless they have indicated that they want me to do otherwise. Naturally though, Dagny’s is very concerned that the practice’s clients are satisfied with my performance, and therefore she did spend some time with a very serious look on her face urging me to always speak Norwegian to the clients.

On Tuesday then, my appointment list was full. Happily my first client was Kari-Anna, the nurse who is on maternity leave, and her dog was in for a blood test, so that was pretty much stress-free, as was my next case which was a cat with a cut on its neck whose owner had left it for examination, so there was no owner, no history to take, and until the owner returned, no discussion at all. It fell therefore, that my first genuine official client was the owner of a dog that had been in a fight and had a wound over its eye.

Gerd brought the owner and patient through, and as I led the them into the consulting room, the owner said to me

“It’s okay if you would rather speak English.’

With Dagny’s dire warnings about language still ringing in my head, I replied in Norwegian that it was quite alright, and if it was easier for her, that would be fine. She started to laugh,

*I’m actually from Scotland,’ she announced, and after that we got on like a house on fire. I really hope that she will ask to see me if she comes back in.

Thursday was a little less busy than Tuesday. Today’s photo is of Trøffen, who came in to have a cyst removed from his head. Wivek was operating, and she called me through to the consulting room before she started to check with me whether I felt that she would be able to bring the skin together on his head if we removed the rather large lump. Trøffen is only eleven and a half though, and the cyst had already been emptied and had refilled, so there was a risk in leaving it as it might have become bigger. She decided to go ahead, and as you can see, she has done a beautiful neat job. Trøffen is a really lovely cat. Indeed I’m finding great pleasure in working with so many cats. Both Jan-Arne and Magne prefer dogs, and so I like to help out wherever possible. Magne was really impressed with me yesterday, when having easily taken a blood sample from a patient that has not always been wholly compliant, I also managed to give it a worming tablet. I guess I’ve always been fortunate, as most cats seem to like me as much as I like them.

The day out with Åsulf though was a revelation. It was utterly delightful from start to finish, even though the first visit was to a pig farm, and because of the way pigs smell and squeal, they have never been my favourite patients. I was very impressed though with Åsulf’s injection technique. He made it look easy, when experience has taught me that really it isn’t. As we went around, checking calves, examining cows (and yes, I did have my hand up a few cow’s bottoms) I felt completely at home. It just seemed so natural, and I really felt I could just slide right back into that way of life. It’s very different from small animal practice. And for the first time, I found I had very little difficulty with the language. For the first time, I felt that at some point in the future, it might not be impossible for me to work with production animals again. Anyway, for the moment I will continue with improving my Norwegian, and maybe I will ask Jan-Arne if I can go out with him again one Monday, as he now works there one day a week. Who knows. I might even be able to teach him something.

 

 

The Cat Charmer and the Messy Chef

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There’s a game I remember from childhood parties at my grandmother’s house. A tempting bar of chocolate was set on an table in the middle of a ring of children. Each child had to throw a pair of dice and if you got two sixes, you had a chance to go to the table and eat the chocolate. Before you could do so, however, you first had to put on a large pair of mittens followed by a woolly hat and scarf. Then, and only then, could you go and attack the chocolate, which you had to eat with a knife and fork, but woe betide you if another child threw two sixes before the process was complete. I was reminded of that game this week in the dental room. Whenever we are using the ultrasonic descaler, we put on protective gloves and a face mask and normally this takes seconds.

However, for some reason, the latest batch of masks are different from normal. Rather than elastic which slides easily behind your ears, these have individual ties, one set at the top and one at the bottom. Twice this week, one of my colleagues has come to me and asked, ‘Could you just begin this dental for me?’ and both times I have found myself putting on the latex gloves first (as I have always done in the past) and then went to put on the mask and found myself fiddling around for ages, trying to tie the bows at top and bottom. It sounds easy, but what with trying to get both tight enough so that the thing doesn’t slide off, and with my hair getting woven in, all hindered somewhat by the tight gloves which seemed specially designed for hair tanglage, I was inexorably reminded of the chocolate game as I wondered frustratedly whether the colleague in question would return before I had even managed to don the protective clothing.

I seem to have spent a lot of time in the dental room this week (not all of it getting myself tied in knots). Dagny called me in yesterday as she had decided the dog she was working on needed to go on a drip. Irene came to help me to put in the i/v catheter and both of them watched with some sympathy as I doused the leg in alcohol and then started doing the traditional ‘my fingers are nipping’ dance where you jig around the room shaking your hand where the alcohol has entered a wound.

‘Is it sore?’ Dagny asked (in Norwegian you understand).

‘Yes,’ I gazed down at both thumbs which were stinging horribly. ‘I must have a hole.’ It took me a minute or two to register that both Irene and Dagny were laughing at me, and a moment longer to realise what I had said. Of course we have been in this position before, only in English and with the roles reversed. Existing in a language that isn’t your mother tongue really does lead to a lot of faux pas.

With their laughter still ringing in my ears, I set up the drip and hung it up on a hook on the wall and Dagny said something to me. Thinking it was something about getting the drip into place, I failed to turn round to look at her… only to hear a few seconds later,

‘Ahem. Sarah.’ It was that tone. The one that lets me know I have missed something. I turned round… and realised that as I had hung up the drip bag, I had inadvertently turned the spotlight out. Dagny was trying to work in the dark. Fortunately she just laughed at my expression and carried on. At least she was using the light as it was meant to be used. Later in the day, in a moment of confusion, Wivek pulled the light fitting into position against a cats jaw. This would have all been very well if she was needing more light, but as she was trying to take an x-ray at the time, it was somewhat ineffective.

The cat in question was a beautiful cat called Laila. Earlier I had gone into Wivek’s consulting room to help with her sedation. It can be difficult to get cats out of their baskets when you want to examine them, but I was amused to see that Wivek, in a continuation of last week’s singing, decided that the way to charm Laila from her cage was by chanting her name very tunefully over and over. It was at least partially successful. Laila’s head appeared as she looked outside to see who it was who was singing so beautifully. Poor Laila. It must have felt a bit like the Siren’s song: irresistibly sweet, but concluding with an injection that sent her to sleep. Though whether those who were seduced by the real Sirens woke up with beautifully clean teeth, no-one will ever know.

Marita too was thinking of a change in direction this week as she stood in theatre, removing some tumours from a dog. She had discovered the pleasure of removing lipomas (fatty lumps) from under the skin by ‘dissecting’ bluntly using her fingers. It’s amazing how efficiently a lipoma can be removed as they are usually well defined and ‘shell-out’ quite easily.

‘I feel like a messy chef,’ she commented idly as she ran her fingers around the mass. She didn’t seem particularly amused when I suggested that after she was finished, she could use the lumps to make meatballs.

This week’s picture is of Dagny suturing a puppy’s eye. The unlucky pup had been scratched by an angry cat and as you can see in the picture, Dagny used the microscope to carry out the repair to the cornea using tiny suture material that was about the same thickness as a human hair. After stitching up the breach, Dagny clipped a section of the conjunctiva and sutured a flap over the damaged area both to protect it, and to carry blood to the area, which has no natural blood supply. The flap will be left in place for at least six weeks. Dagny’s final act was to inject some fluid into the front of the eye to make up for that which had leaked out. The whole process was utterly fascinating. Best of all though, without such care, the pup would have definitely lost one of her eyes. Hopefully this operation will give her a chance to grow up with both.

Specialist eye instruments (tiny scissors and forceps)
Specialist eye instruments (tiny scissors and forceps)

 

Happy Birthday

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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..

 

 

Jan-Arne and the Well Preserved Eye

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Intravenous catheters can be frustrating things. When I was working in the emergency clinic, almost every patient we admitted had to be put on a drip, so back then I got quite good at inserting them. Nowadays it seems a bit more hit and miss. There’s a definite pattern though. If I’m on my own, generally I can get them in without too much problem. Under the benevolent gaze of Magnificent Magne or Jan-Arne, it’s usually not too difficult. But both Dagny and Wivek make the thing look so simple that I seem to go to pieces whenever they are watching. Dagny doesn’t even have to be watching. She only has to be in the room for the difficulties to take effect.

Early on Tuesday morning, Dagny had all her kit laid out for an operation and (tactfully) wasn’t watching me in my attempts, but stood chatting to one of the other staff. The dog was a dachshund, and its legs were so short, that even after I had shaved quite an extensive area of its foreleg, its body hair was so long that it obscured almost everything. With shoulders that were becoming decidedly tense already, I selected the smallest possible catheter and took aim. Slipping the stylet through the skin, I was encouraged by seeing a tiny droplet of blood moving up into the breach. Quickly, I slid the needle a nanometer further in… and the bleeding stopped. I had gone right through. Trying to keep my breathing steady, I withdrew a little, but it wasn’t to be.

I decided at that point upon a tactical withdrawal. Often it is better to start again with a fresh catheter, which can’t be blocked and hasn’t been blunted by its first traverse through the skin. Selecting a slightly bigger catheter (sometimes this works better as they are less flexible) I set the tourniquet back in place to raise the vein and once again tried heroically to keep the hair out of the way with the final two fingers of my left hand whilst still stabilising the vein between my finger and thumb. This time, the catheter went into the vein, but when I tried to slide the sheath down off the stylet, it just bent. Through all of this, Dagny had been carefully not watching, but I could tell she wanted to get on. I confess I was relieved as she finally elbowed me out of the way and did it herself. A few moments later, with the catheter triumphantly in place, she looked around for the laryngoscope so that she could put the tube into the trachea for the gaseous anaesthetic but it wasn’t there. Ever efficient with her cleaning, Irene had already tidied it away.

A little later, and another dog, this time a little pug dog (or mops, as they are called here). This one was having its corneas treated with the cryoscope. Marita came into the room and began to ask Dagny about the freezing effect, and how strong it was. Ever the scientist, Dagny thought it would be a good idea to try it on herself. She held it against the back of her hand for a moment.

‘It’s not sore,’ she announced airily, and moved the tip to a different place with a smile.

‘Ouch!’ A moment later, she was staring at a white mark on her skin- ‘Okay,’ she admitted ruefully, ‘Maybe it does hurt.’

Jan-Arne managed to injure himself this week as well.  On Wednesday, he had taken a biopsy and opened up the small container filled with formaldehyde that would preserve the sample while it was sent to the laboratory. With an aim that he presumably couldn’t recreate, even if he tried, he managed to drop the sample into the pot in such a way that some of the formalin splashed up into his eye. After much salt water washing, he was packed off to the doctor’s to get it checked over. Fortunately there was no permanent damage.

He has though, been evilly trying to tempt me with birthday cake all this week. He brought in the leftovers on Tuesday. Heroically I managed to resist. I’m not really sure how many birthday cakes one person needs, but he seems to have been very well supplied. Then again, he’s so generous to everyone that he deserves good things in return.

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The remnants of the cake were still there on Thursday, but I confess I found it much easier to abstain. Also, someone had brought in a pack of freshly baked boller. Boller are widely available in Norway. They are a kind of sweet bread roll or bun, often with raisins or chocolate chips inside. These ones had bits of Smash: chocolate with caramel and salt. After taking one and eating it, Irene announced that she had discovered a new taste sensation. Jan-Arne and I, both foodies, were looking at her very intently.

‘I had a piece of the boller with a bit of cucumber,’ she said, with wonder in her voice. ‘It was lovely.’

There was wonder in my head. Specifically I was wondering whether such a combination could possibly be delicious or whether Irene had finally lost the plot. I hadn’t come this far with my resistance to eating extraneous sweet things lightly however, and somehow I managed to curb my enthusiasm towards this idea.

‘You could design a new boller,’ Gerd offered. ‘An Agurk Boller.’ (Agurk being Norwegian for cucumber).

‘A Cucumboll?’ suggested Marita.

‘What’s English for boller?’ Irene asked.

‘Bun,’ came the reply.

And so the CucumBun was born. At least it will be, when someone takes the time to make it.

 

Todays picture is Chika who was in for her first vaccination.

The Need to Feed

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I attended my first ever Webinar last night on the subject of nutrition in acute gastrointestinal disease. An interesting experience, not least because the lecturer, Ava Firth, is a friend and someone I used to work with in the UK at Vets Now. Wivek also linked up to listen. It was announced that 300 people round the world had signed up, which I thought was pretty impressive. Ava is very practical and always relevant so it was a worthwhile use of my CPD time.

She was talking about gastro-enteritis, amongst other things and it struck me that I haven’t seen a single case of Parvo since I have been working here. This scourge, which is an ongoing cause of distress in every area of Britain (and I believe, the US) has never gained a foothold here, though I believe there have been a couple of sporadic outbreaks. As Ava commented, Parvo often affects puppies and is therefore intensely traumatic, both for the owner and the vets and nurses who have to carry out their care when (as they often do) they require hospitalisation. I wondered when I began consulting here, why they had no oral rehydration treatments available (up until now, most cases I have seen have been treated with anti-emetics and pro-biotics).  Ava definitely managed to remind and (re)-convert me though. I will be asking Gerd if we can buy some Oralade, even if only for the many dogs we seem to have in with foreign bodies. It’ll certainly be a more up-to-date solution than the current recommendation of giving fishballs to sick pets. I confess that is a nutritional suggestion I have never come across outside Norway.

Speaking of foreign bodies, I saw a competition somewhere last week for radiographs of “most amusing things swallowed by a dog”. I think the oddest thing I ever found inside a dog was half a pair of knickers. Since coming here, there has been the odd natural product such as pieces of wood and pine cones. There has also been a teat from a baby’s dummy, which I believe is quite common. But the latest feeding frenzy seems to be… tampons. Wivek removed two from a dog’s stomach only last week. There was even one a few months back where the string had caught around the dog’s tongue and it had to be retrieved under sedation. Sadly none of these things show up on radiographs, so we won’t be winning any competition, but this special canine enthusiasm is just one of the more interesting international differences I have noticed.

It hasn’t been the best week for me. Two weeks ago, I saw an ear, nose and throat doctor. I have had tonsil stones for years and although it has gradually been getting worse, I’ve lived with it so long that I didn’t think much about it until I thought I saw a black speck on my left tonsil. With a long history of melanomata, I had to get it checked out. By the time the ENT actually got round to seeing me, the fleck had disappeared (perhaps it was a blood blister), but to my shock, he said I had to have my tonsils out. I was relieved however when he said there was a six to nine month waiting list: plenty of time to get used to the idea. My shock was much greater when an appointment arrived on Wednesday for the 13th May.

Fortunately, Wivek was there to listen to my wailings. One thing that interests me is that from comments I have seen on the internet, the most up-to date recommendation is to eat rough crunchy food afterwards(think toast and cornflakes). I was disappointed that the old fashioned jelly and ice-cream was no longer on the table. Happily  it seems Norway is behind the times in these matters, and so the recommendations here are still for soft non-warmed foods. Wivek did point out that it was fortunate that we had a nutritional webinar coming up, which would obviously answer all my questions. Sadly tonsillectomy wasn’t one of the topics covered. I expect though, that fish-balls will not be on my eating list. That would be a step too far.

 

 

 

Miss Direction

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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.

 

 

 

Party Animals

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“It’s a tough job being a vet, but you can never ruin our appetites.”

Wivek came up with this statement last week. I went in to join my colleagues for lunch on one of my days off and as I had arrived a bit early, Wivek collared me and dragged me off to her consulting room to show me a particularly unappealing case. We do get all sorts of unpleasant things in to deal with, from stinking abscesses to rabbits that are infested with maggots. Yet as soon as someone says “It’s time for lunch,” we can be immediately ready to eat. Of course, we would never leave an ongoing case that needed treatment. Sometimes, if it’s just too busy, we miss out on lunch completely. But there is almost nothing that occurs with animals that would put me off washing my hands and going off to devour whatever delight I have with me.

I do seem to have done more socialising this week than actual work. Tuesday was very quiet and Thursday was a day off for ascension day and on Wednesday night, Irene had a party. Not just any party, I might add. This was a Singstar party. If (like me about two weeks ago) you have no idea what Singstar is, it’s a PlayStation video game where two (or more) people compete by singing along to a music track. I confess that I found this concept almost as appealing as being poo’d on by an elephant with diarrhoea, but with promises of Jan-Arne’s sweet potato fries and Marita’s wonderful focaccia, I was finally convinced that there might be enough positives to make up for the potential trauma of making an absolute ass of myself.

I needn’t have worried. Having arrived unfashionably early (like about an hour before anyone else) to Jan-Arne’s party a few months back, I checked carefully with Irene what time things would be getting under way. Having been told I could get there from about seven (and help set things up) I finally managed to get out of my own front door at about eight-fifteen. Obviously I have a talent for arriving at the wrong time, whenever that might be. Still, there was much food preparation still taking place. Jan-Arne was rushing around dressed in shorts (and at one point a pair of blue light-up cats ears) trying to get three enormous trayfuls of sweet-potatoes to turn crispy. Wivek arrived with her dog Ida (pictured at the top of the page) clutching an enormous meringue base and a punnet of strawberries. Meanwhile Marita and Per Egil were bashing into the wine, presumably in a (very sensible) attempt to ensure their vocal cords were suitably lubricated to allow them to sing beautifully.

In the event, the food was wonderful. And I only managed to stay for three songs (none of them sung by me) as I had to dash off and collect Charlie from the airport. Despite my best efforts to convince him to return to the party with me, he politely declined. Obviously when it comes to being a party-animal, he’s more of a Scottish wildcat than a friendly lion.

Anyway, enough of the words. Time for some photos.

Not sure the screen was quite big enough.
Not sure the screen was quite big enough.
Mesmerising Marita. Focaccia queen.
Mesmerising Marita. Focaccia queen.
The nursing team: Kari-Anna and Jacqueline
The nursing team: Kari-Anna and Jacqueline
The Pussy Cat Doll (and Wivek)
The Pussy Cat Doll (and Wivek)
Ooooohhh... Young Maaaaan!
Ooooohhh… Young Maaaaan!
Turtally gorgeous
Turtally gorgeous
Jenny and her Australian friend (sorry, I can't remember your name)
Jenny and her Australian friend (sorry, I can’t remember your name)
Per Egil: Singing Legend
Per Egil: Singing Legend
Beautiful Ena wants to dance with somebody
Beautiful Ena wants to dance with somebody

 

The real stars of the show
The real stars of the show

 

 

 

Waltzing along

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This week’s blog is going to be brief. Not only are we off to Scotland tomorrow for a wedding (Charlie has spent the last three hours on the computer writing his best-man speech) but also due to the impendingness of next week’s surgery, my brain has become as flaky as a West Highland White terrier with atopy.

Dagny’s neighbour Matilde has been in doing work experience this week. She has amazed me with the way she mucks in and helps with clearing up and holding things. I confess that when I was 14 or 15, I would probably have been too scared to touch anything without being specifically asked. She has also been with Dagny and me in the operating theatre watching some quite gory stuff. Again she impressed me by looking on with interest as Magne wielded his bone drill, rather than horror or faintness.

Of course, even my initial interaction with her showed signs of my erratic brain. I asked her on Tuesday morning what her name was, and completely forgot to tell her mine. Fortunately Dagny was there to remind me. I was trying to remember though, how introductions tended to occur back in Scotland. Here in Norway, it is a very set thing that when you meet someone new, you shake their hand and introduce yourself. Whilst this is probably very practical for most people, my available memory is now smaller than that of a fifteen year old laptop so within three seconds I have forgotten. Still, I suspect in Scotland that there might have been occasions when I could get through a whole week of work-experience student visits without them ever knowing what I was called. If they were lucky, the receptionist probably told them. Despite the readiness of the words “Sorry,” and “Thank you” on my lips, I fear that the reality is that I am just terribly rude sometimes.

Still I have been pleased to go into work this week. The (probably unwarranted) adrenaline flow over next week’s tonsillectomy has made me jumpy and there’s something reassuring about arriving in the morning and going through the consulting rooms to check the drawers whilst automatically assessing how many surgical kits are awaiting assembly and whether there is enough distilled water. Routine is my friend. As are Irene, who noticed I was quiet and gave me a hug, Wivek who is driving me to hospital next week, Marita who helped me with a dental this afternoon, Dagny, who told me to take the rest of Tuesday off after I have been for pre-op blood test and check-up, Jaqueline, who volunteered to speak to the owner of the dental so I could go home and Jan-Arne who made me laugh when I walked into the changing room and found a cuddly man there dressed only in a pair of stars-and-stripes boxer shorts. How lucky I am.

So I’m not sure whether there will be a blog next week. I will be in hospital overnight from Wednesday, hopefully home Thursday. Who knows, maybe something will happen on my ward that is so ridiculous that I can’t wait to share it with you. Au revoir mes amis. See you all soon.

 

This week’s photo is of Mika, who had been managing to lick his stitches. Hopefully his new, larger buster collar will discourage him. He is just as cute as he looks!

Touched (in the Head)

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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.