Sunday, May 07, 2006

Wow, I'm in a writing mood. That hasn't happened in a while. :)

The title of this blog is 'the life of dr. brown' - and that life has been pretty interesting lately. From some massive calvings gone wrong to dealing with a dog whose tongue was ripped off (literally) I can say that my job has been anything but boring.

But it seems that when I talk about my job, most of my references go back to that first year. There are just so many good stories to tell. Adventures in my 5-speed truck, adapting to the personal side of dealing with clients, and dealing with farmers who would rather 'have a man to come out and do the job.' What a year that was. I so wish I had kept a blog or even a journal. Oh well.

What I can do is re-create the past several weeks of work. It's spring - lots of babies, lots of vaccinating horses, lots of work period. There are some days that I just drive all over creation vaccinating horses - which is great (to a point) for there are far worse places to drive around than central VA in the Spring. :) It really is beautiful here.

Several, several weeks ago I had two significant calvings in a week. I don't remember the first - but I remember that it wasn't a big deal. The second was a true breech - tail first - that took some work to deliver. The calf was dead, but not rotten. I did my normal clean up routine and went about my business. Several days later I began to feel very tired. VERY tired. Go to bed at 7pm tired. I lost my appetite. And though I never developed a fever, I began to experience some lymph node enlargement and significant discomfort in my right armpit. The one lymph node continued to enlarge and the two nodes below it began to enlarge as well. The entire area ached even when I was laying still - any kind of movement was oh so painful. My roomate is a nurse and finally conviced me to go to the doctor. I have a GP here - but I've only seen him once (it's not often that I'm sick.) He took a look at my nodes (the largest of which was about the size of a large grape) and made the statement that he 'was worried.' I'm a doctor. I know doctor speak. "I'm worried" means "I'm worried that it's cancer." He arranged for me to have some bloodwork done and a referral to a surgeon for a possible biopsy. The surgeon couldn't see me for a week. I asked my boss to just go ahead and aspirate my lymph node so I could know something. He wouldn't. So I had to wait and wonder for a week. Not fun. I went to the surgeon. My lymph nodes were going down. My bloodwork was normal. No need for any further tests. He said that it was probably just something viral and to try to rest and take better care of myself. Well, I thought, at least it's not cancer. Cancer doesn't just go away.

I began to feel better. I slept alot. I tried to eat better. I had a 4 day weekend with some of my best friends on the planet. I came back a new person. Ready to be a vet again.

Fast forward to 2 weeks ago - I worked the weekend - was quite busy - and was looking forward to sleeping in on my customary "I worked the weekend so I don't have to be in till 10am" Monday. One problem. I'm on call till 7am. The pager goes off at 6:45am. sigh. It's a calving. It's 45 minutes away. It's at Dr. Bowman's brother's farm. I have to go.

Get up. Eat. Drive. Show up at the farm to find a very small heifer that's been in labor for several hours. I figure it's a breech (tail first) - but I was quite surprised to reach in and feel front feet and a head. Hmmm. But the calf is laying sideways. I quickly straighten it out and plan on delivering it with relative ease. I can tell it's a large calf and it's alive - but I am confident of a normal birth. Well, to make a long story short - it was too big - as we tried to pull on the front feet - the head turned backwards behind the cervix. I knew immediately that the calf was not going to be delivered normally and I had to act fast to deliver it via C-section. They give me the go-ahead to proceed with the section (even though I've never done one before) and I start prepping her. My clippers die. Rargh. They have a pair. Whew. I give the cow a sedative and an epidural (though she is already laying down - I would rather have had her standing) and a local block where I am going to make my incision. I clean her up - clean myself up - and dive in. I find the uterus quickly enough, but I can't find any feet to pull the calf (and the uterus) up to my incision to see what I'm doing. The one farmer pushes the front feet from out of the back of the vulva into the uterus so I can feel them, but we both are unable to pull the calf 'up' into the incision. So, I shield my scalpel in my hand and go in blindly. Dodging intestines and other vital organs, I locate a foot and carefully (CAREFULLY) make an incision over the calf's front leg. I expose one front leg, but it is all I can do. I can feel the other leg, but I am physically unable to pull the other leg up. The farmer is able. We get both front feet up and the head and it takes all 3 of us to pull that calf out of that cow. Is he still alive? no. That sucks. Keep going. Time to sew up the cow. I am shaking at this point for my blood sugar is so low. I am covered in blood. But I am in good shape compared to the cow. She keeps rocking her incision into the dirt. (Not ideal.) I sew everything up and give her a death sentence. She proves me a brilliant doctor by dying 2 days later.

I do have to say that I've never had a better cheer-leader for something than Dr. Bowman's brother, Thomas. Guess it runs in the family. :)

Also, that calf was about 150# and the cow was about 700# - whether you use geometry or physics - those numbers equal a problem.

I drive back to the clinic and the construction workers gafaw at my appearance as I emerge from my truck - blood soaked and looking very, very tired. I clean up and jump right into work. I was so tired. I was so hungry. I had to take a break for I was about to pass out. I felt guilty for taking a break - we were so busy. So much to do. That is the way it was been lately.

Three days later I am having a busy morning. But, I had some time blocked off in the middle of the day for a large animal emergency - and one appeared. Another calving. Oh joy. This one is 55 minutes away in the other direction from the one on Monday. I took along with me my tallest (and longest armed) technician. The last time she and I did a calving together it turned into a 4 hours ordeal with no successful delivery of the calf. That one was in the middle of August and the calf had been dead for at least 36 hours. We had a little de-ja-vou. THIS ordeal was so crazy, though!

This ordeal involved a good sized beef cow. A very nice pet cow with a name, Molly, who had been in labor.... for a while. All that was coming out was fluid. Rotten fluid. Oh joy, really. When I reached in I was greeted not by a tail, not by feet, but by ribs. WHAT? Ribs. I was feeling the literal side of the calf. The backbone was on top, ribs went to the right, abdomen to the left. As far as I could reach, I felt no tail, no head, no feet. Oh wait, there's one leg - but I can't reach the foot. This turned into a 3 1/2 hour ordeal that involved me slicing the calf open and removing it's innards (the calf was very way dead), cutting the calf in half, FINALLY getting that one leg up and then..... giving up. Jenny nor I could feel any more feet. We couldn't find anything else to pull on. We had to send Molly to the butcher. And boy, did we stink.

Side note: the 'stain cycle' on my new GE front load washer gets extra credit. They washed and dried my calving clothes at the clinic - but they were still stained and still smelly. My 3 hour 'stain cycle' got them spotless and smelling good. Incredible. Go tide. Go GE.

Maybe I can submit that to the mastercard commercial. Farm call: $40. 3 1/2 hours of stinky hard labor with no result: $200. New GE Front-load washing machine: $1000. Having a washing machine that can remove the stench of death from your clothes: priceless.

Anyway, the rest of this saga is that 2 days later my lymph nodes start getting enlarged again. Right armpit. Either I'm allergic to uterine fluid or I have some crazy disease. I've got some people working on it. As for now, I'm sleeping a lot, my appetite is ok - not great - but, I'm hanging in there.

Ok, now for a cooler story. I had just returned from a farm call and my tech meets me in the parking lot (never good) to inform me that we had an emergency. A year old Amstaff (think Pit Bull) had just had it's tongue quite literally ripped off by her brother. There was blood everywhere, but her tongue had stopped bleeding and I could see what was left of it - a 1 inch stump, just in front of her epiglottis. She is just sitting there calmly - letting us all look in her mouth. I treat her for her blood loss and pain and then get on the phone. Is there any hope that she can eat again? Drink? The owners decide to euthanize the culprit (he has been showing increasing aggression) and they ask me if we can transplant his tongue to hers. Hmmm. I don't know. Turns out 'no.' But, if we can find her tongue, we might be able to sew that back on. The owners do eventually find her tongue - but it's too late to try and put it back. I do an oversew of the stump of her tongue the next day and boot her to a specialist to place a feeding tube until she learns to cope. Turns out that dogs are amazingly adaptive and can learn to eat and drink with no tongue. Cool, eh? She's a sweet dog and is doing well.

Her name is Ripp. Not so funny.

But a little.

Ok, enough for tonight.