"And, when you want something, the entire Universe conspires in helping you to achieve it." -The Alchemist, by Paulo Coehlo



Sunday, July 5, 2015

Lily Update

On Saturday morning I woke up way too early and sat at the computer typing up the previous post while waiting for a phone call, with my vet tech side telling my impatient owner side to take a chill pill. 

Another insider look at how things work in our world: at 24 hour specialty hospitals, rounds usually start between 7 and 8 am. All of the daytime specialists and staff doctors meet with the overnight doctors and the overnight vets tell the daytime vets what happened overnight, which cases were admitted, any special notes about the patients or their owners, and what their intended plan is for the hospitalized cases. When there are interns and residents involved, they get positively grilled by the senior doctors: this is part of the learning experience for the interns and residents. Depending on the hospital, this can be a torturous experience for the younger vets: it can be sort of an emotional and psychological bloodbath, with tears involved. 

Contrary to popular belief, veterinary interns are full-fledged doctors. They finished vet school, have their vet license, but choose to do an internship at a specialty hospital so they can get a glimpse of what specialty medicine is like. Some of those interns choose to specialize themselves and move on into residencies; some of them go back out into the world to be very well-rounded general practitioners. It's a great experience but it is a very difficult one: these doctors learn a wealth of information but often work 90+ hour weeks for less pay than what techs get. It's only a year, but it is an incredibly difficult year full of stress, learning, reading, getting blasted by senior doctors, on very little pay and very little sleep. Vets that choose to do internships are commendable and they have my utmost respect. Which is why I love working with interns! They start out with less hands-on experience than a specialty tech but end their internship with so much more knowledge! We get to see them grow up during their internship, and it's actually one of the few times when tech and doctor roles are reversed for a few months: often times, we get to show the doctors how to do some of the more specialized things, like placing nasogastric feeding tubes or talking them through a male cat urinary catheter placement. Our baby doctors make us proud. <3 

Veterinary interns start their internships during the summer. By July 1 they have their doctor's licenses and are ready to rumble. They have the medical and technical skills to do their job but it takes them a while to get the hang of how things are done at their hospital of choice. Which can slow things down significantly in the meantime. 



The main reason why things had taken so long the night Lily was admitted at New Bolton was in part because there were interns and residents working their very first shift ever, with Dr. S supervising them. Just the night before, I had gone through the same thing with our new interns: we had three assigned to us on Thursday night (our busiest weekday) with only one staff doctor and one 2nd year resident to oversee them. The staff doctor and the resident have to see their own cases as well as approve the intern's treatment plan before us techs can proceed with treatments. So there was that + them having to start learning how things were done in terms of paperwork, radiology request forms, presentation of estimates, how much of a deposit clients should leave, etc. 

So I sat at my computer typing away, reminding myself of all of these things + the fact that it had been busy at New Bolton the night before and decided that if I hadn't heard from them by 11:00 am, I would call myself. Rounds can take 2-3 hours average but I'm going to guess they take even longer at university teaching hospitals: I ultimately did end up calling myself. 

The receptionist paged Dr. S and I was able to talk to her directly: she had indeed been able to do Lily's surgery with her standing and she had done great. They had placed the drain and bandaged the leg and Lily was in a stall eating, drinking, pooping and staying calm. The bandage would be changed for the first time on Sunday. It was excellent news. Dr. S was rushed with her explanations so I didn't ask a bazillion questions and just told her we would be at the hospital between 2 and 3 pm to visit. She said that was fine. Their visiting hours are from 8 or 9 am (I can't remember) to 5:00 pm.

We headed out towards PA around noon. Southern States was open despite the holiday and we had to stop at the gas station near them to get gas, so we swung by and I got a large bag of Stud Muffins for Lily. It's her favoritest treat ever. 

It took exactly 2 hours to get there, despite the rain. We went to the Admissions desk and the receptionist called the tech with the Australian accent, who took us to Lily's stall. 

Barn aisle
She has a fan and her own thermometer. Not sure what they are giving her that requires the nasogastric tubing outside her door. The other two horses in her barn didn't have that in front of their stalls.

He said if we needed anything at all, to go to the desk and he would come. We were left alone after that. The barn was quiet; there was no one else around, and only 3 horses were hospitalized in this barn. I'm guessing this barn is similar to a sort of intermediate care ward (they have other barns): the horse next to Lily was in for a nosebleed and the other horse was there for a tendon sheath injury.

She is getting IV antibiotics - you can see her jugular IV catheter in this photo.
Lily did not turn to look at us when we walked into the stall. She was standing as you see her in the photo above. 

I walked up to her and scratched her withers and Charles produced the Stud Muffins. 

One whiff and her entire expression changed. It was like she was waking up from a dream. Best idea ever. Guys, if your horse is ever hospitalized (I hope never ever ever, please God) bring them treats. 

Look at her face. <3
She basically frisked us. I had to laugh at her. She is NEVER like that about treats. I broke them into little pieces and gave her tiny bits one at a time. And she remembered that I used to make her do stretches for treats. Which meant that if I took too long to produce another piece, she would bow for more. 

"MOAR TREATS DAMMIT."
Seriously. How can you say no to that?

We gave her a third of the bag. I had to tell Charles to stop because she she's not used to too many treats! :) Thankfully, one of the barn staff members stopped by and fed Lily some grain around then. I was happy to see they get a grain lunch. She's getting 2 lbs of sweet feed at a time, based on the card in front of her stall. 

Lily scarfed. 

Charles wanted to know what they fed. She didn't take her head out of that bucket until she was finished eating!
Support wrap on her right hind.
Big ole bandage on her left hind. There were a few poop stains on the Vetrap, which is to be expected, but no strikethrough (where fluid/blood seeps through the bandage) to be seen.


She had had some nasty scrapes above her hock as well. They had cast padding behind the leg under the Elastikon.
Om nom nom
The stalls have concrete floors for easy disinfecting. The straw bedding is better than shavings for injured horses: it's less likely to get under bandages.
I then sat on the floor of the stall to watch her finish her lunch. Once she was done, she moved around the stall, looking for every last bit of grain she could find to clean up, ate some hay, and then came over to me to see if I had anything else for her. 

"Food?"
I wished I'd brought baby carrots as well.
She kept looking out her window.
Her stall looks out into the parking lot and a green field beyond.


Her view. Not a bad one, just hard to capture with the phone camera. The field beyond the parking lot is beautiful. There is a glass window beyond the metal screen, which means it can be closed for added warmth in the winter.

Once she was done eating I got up and gave her a massage along her back. She gets tight with stall rest. She stood very still and would occasionally turn her head to look at me. I think she enjoyed it. I then gently pulled back on her tail (used in chiropractic) and pulled her front legs forward to stretch. She didn't sit back on her hinds like she normally would for that (of course, because surgery on hind leg), but she extended each front forward and grunted. 

She was even more relaxed after that. 

The hardest part was leaving. I'm used to seeing her every day. We chose our apartment location based on its proximity to several Frederick barns. I'm used to seeing her anywhere from 4-7 days a week, ever since I bought her for a dollar 4 years ago. It was harder to leave her on this day than it was the night that she was admitted to the hospital because I didn't know when I would see her next. 

When we stepped out of the stall, she resumed her position by the corner next to the hay rack. 

It broke my heart a little. I was glad to see her so calm, and I knew she was standing in that corner because it was closest to the horse next door, and I know she is in good hands...but when your horse is hospitalized you just want to be able to see them every day, you know? Not just for yourself but for them. It can make such a difference for them to see their people while in a strange place with strange people doing treatments on them. Seeing her brighten up while I was there made it so much harder to leave. 

I wanted to talk to Dr. S but there was nothing to talk about: she had already told me everything she knew that morning and nothing had changed. We wouldn't know more until the bandage was changed on Sunday.

I was somber on the way back down to MD in the car and Charles noticed it. Of course he did, because he can read me better than I can myself. 

I called my mom to give her an update and my Aunt Lucy insisted we go out for dinner on her. 

We swung by the barn so I could give Gracie her joint supplement...and then I told Charles I absolutely needed to ride, even if only for 15 minutes. Gracie was being a doll, though I got the impression she missed her sister. I tacked her up and she gave me one of the most spectacular rides she has ever offered to date.

I'm saving the rest of the photos for a Wordless Wednesday. :D
But my grin in this photo says it all!
She got loved on by both of us, I thanked her for an incredible ride, and she too got Stud Muffins...she thought she had died and gone to heaven. Silly girl.

Initially we were going to go to a little Mexican place over by our apartment for dinner but we ended up going to Bushwaller's, our favorite Irish pub in downtown Frederick. We didn't have high hopes for finding a parking spot on July 4th (they have fireworks in the park downtown) but we figured we would give it a whirl. 

As luck would have it, not only were we able to find a parking spot, it was free! While walking to Bushwaller's, I heard someone calling my name and turned to find my vet, Dr. L: she was in Frederick for the fireworks. It was weird to see her in civilian clothes...we all look so different in scrubs! I told her about Lily and told her to thank Dr. E when she was back in the office on Monday, and added that I was glad she was off for the holiday. She is one hell of a hard-working vet and she deserves a vacation. 4th of July can be crazy in vet med...ask me how I know!

Dinner was amazing and Charles and I decided to walk over to the park afterwards. We found a spot on the grass and sat down to talk (and laugh. Because Charles is good at that!) until the fireworks started. We finally, finally got to see 4th of July fireworks for the first time since moving to MD 2.5 years ago. 


It was a great ending to a day that otherwise would have been kind of strange.

I woke up this morning right before Dr. S called: Lily's bandage had been changed. Everything looked as expected: some mild swelling around the wound, but otherwise all of her tendons and ligaments looked great and if she continues as planned, she should be able to come home mid-week.

Keep praying, guys. Thank you so, so, soooo much for all of the positive thoughts, energy and candles. You are all the absolute BEST!

26 comments:

  1. So glad to hear she's doing well!

    Last Christmas, my boss's horse was hospitalized for a month after surgery and she brought a little stocking to hang on his door at OSU. Every time we were there and then when the students were around, they'd give him peppermints. It really made his day!

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    1. That is a brilliant idea and I wish I had thought of that!

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  2. It is certainly hard leaving them behind, but she looks really good and all the news is good news.

    I remember residency very well. July was the hardest month on everyone since that is when all the new interns and fellows and residents start. I can still hear one of my favorite attendings telling me to never get hurt or severely sick from June (when the 3rd years are mentally checked out) through September.

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    1. Residencies are tough! Far more than internships, whether veterinary or medical. I can totally understand your attendings' threat!

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  3. I am so sorry Saiph... I am just catching up after the long weekend. Trust me, I know what you are going through. I am so happy that Lily is going to be ok.

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  4. Sending good thoughts and prayers for Lily <3 Glad she's doing better and you got that very much needed ride on Gracie!

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  5. So glad she is healing well! It's also great that she was hungry and happy in the hospital. The time my QH was hospitalized, he acted really colicy and sad so I FREAKED OUT and had him put on "extra special watch" for more money. Ah, fun times.

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    1. Oh God. I can see how that would happen. Your poor guy. :( Lily ended up with GI ulcers last time she was on stall rest. Thankfully I have some UlcerGard on hand! I'm anxious to have a better idea how long the stall rest part of all of this is going to be once she comes home. She will tolerate it, but she is ultimately not happy about being locked up. We shall see.

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  6. poor Lily - sounds like she's mostly resigned to the stall rest tho, which is definitely preferably to the alternative. sending lots of happy healing thoughts your way - and hopefully yesterday's bandage change went well!

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    1. It did! Bandage changes have continued to go well: the drain was pulled today. :) Thank you Emma!

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  7. So glad for this good update, though Lily in the stall with her head in the corner is very sad looking. I am glad she is settled and not being silly in there, and that she looks so happy to see you! Stud Muffins to the rescue, those things are pretty fantastic.

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    1. It was a huge relief to see her so calm. Stud Muffins are pretty fantastic indeed! :)

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  8. Good update! Speedy recovery Lilly!

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  9. Woo hoo! *high five* for a great update! I agree with irish horse, that pic is pretty sad, but her bowing totally made up for that. Go Lily!! Looking forward to more good news and the post about her trip home!

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    1. *High five* Can't wait for the moment when I get to write that post!

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  10. So glad Lily is okay! Best wishes for a speedy recovery - thank goodness for Stud Muffins! :)

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  11. So glad Lily is doing well! I know you must miss her a lot! I'm keeping my fingers crossed that she gets to come home soon!

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    1. I do. It's so weird to go to the barn and only see Gracie. Thank you! <3

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  12. So so so glad to see she's doing well. Still thinking of you both!

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    1. Thanks Amanda! All the positive thoughts help!

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