Friday, 29 January 2016

Opportunity Days

A bunch of factors all at once resulted in us cancelling our trip to Ottawa.

Pet sitter backed out. I got really sick for several days so most of the preparation stuff didn't happen. The canal closed (then re-opened) so we just said 'screw it' and cancelled. We knew that since I have strep, there'd be at least one other person with it in the house by the weekend so it just seemed like a bad idea to go through with it and risk dealing with a sick kid while away from home, while we leave our house in the hands of someone we've not really had enough lead time to meet.

Some classmates did offer when I mentioned it on Facebook, and it was awfully sweet of them, but my husband and I agreed in the end that it was best to just cancel (fortunately no fees) instead of end up with a disastrous trip. Plus with our cat's vet bills recently, the cost of a totally unnecessary trip seemed a bit excessive.

We figured we'd just have fun here this weekend instead, and think about hitting Ottawa at a later date. The end weeks of the MFs tend to be fairly relaxed, so it's entirely possible we'll make it happen during the MF3-MF4 transition or something.

It seems like every time we have made plans to go to Ottawa since we moved away from there, a wrench ends up in the works, except for that one brief afternoon we spent there during the move. Ah well, we'll manage it eventually.

So we're relaxing at home this weekend. We went to the zoo today. We've gotten a lot of use out of those memberships, and the kids absolutely love going. It's really nice to be in the pavillions in the winter. Tropical warmth, lots of sunlight, and lots to do. Plus, no people. Win-win.

Tomorrow, I'm not sure if we'll go out on a trail or go bowling. My husband is definitely sick - I was pretty sure it'd be either him or our son who fell first - so probably bowling since I prefer to have another adult with me if I'm going on the trails with the kids.

Even though our plans changed fairly last minute, my son took it really well. I'm actually quite surprised, but happy about it at least. He does love the zoo, though, so the promise of that likely helped mitigate his disappointment.

She is so insanely cute in person. 

It's like a riot of fish. Kind of mesmerizing to watch them.

She gave me this 'my toddler is driving me insane' look while I was there. I don't know how anyone can look at a lowland gorilla and doubt our common ancestry. 

This beautiful lady came and checked us out for a good ten minutes, including trying to perch on my husband, who seems to just attract animals. I absolutely love black cockatoos. Have since I was a kid. 

Favourite shot of the day. 

Tuesday, 26 January 2016

Strep

I'm sick. As in, got sent home from medical school by my LFs (a family doctor and a social worker) because I'm sick. 

I'd emailed them this morning that I woke up with a fever (39.3° - a respectable fever in an adult) and was feeling horrible, suspected strep throat, and I was wondering what the guidelines are for when we should and shouldn't attend when it comes to illness. 

Turns out they were in a meeting so they couldn't respond. So I went because you don't mess around with absences in med school. I went to the procomp large group session and was miserable. When I got to small group, they saw that I was very sick and sent me home with a leave request form. 

My husband drove me straight to our doctor's office and a rapid strep test (he offered antibiotics without it but I'm trying to be a good med student and be mindful of antibiotics overuse) confirmed my suspicion. Well, most likely. False positives happen. But yay, I figured it out on my own before I got to the clinic. And now I'm on amoxicillin for ten days. 

He wrote me a note saying that I should rest for three days. 

...nah, that's not happening. I have clinical skills super Wednesday tomorrow and clin skills in the CSBL and I have tutorial on Thursday. I am not going to skip all of that. Even though right now I feel like I could sleep for a week. 



Saturday, 23 January 2016

On Women

Women make up more than half of medical school matriculants in Canada these days. My own class has 107 women to 98 men. Around 40% of Canadian physicians are women. 

Yet stereotypes persist. People still ask, when I have my med backpack on, stethoscope in my hand, "Medical Student" ID on a Medicine lanyard around my neck, if I'm going to be a nurse. 

I respect nurses a lot. I know how important they are to the care patients receive. I originally applied to nursing as I viewed it as an important way to contribute to health care without throwing myself into a decade of school. Yet I do still get annoyed by the assumption that a woman in health care must be a nurse, because I dislike gender-based assumptions. I've mentioned it before. Women have been becoming doctors for decades on a large scale (it's a century and a half since women physicians started being licensed in North America!) but these assumptions persist. And I know I won't change them, but I can express frustration about them. 

There are difficulties that women in medicine still face. Fewer now, but they still exist. That a woman's dedication to her field can be questioned because she also has a family or chooses to start one is frustrating. That a man like my husband who supports his career-driven wife's goals becomes a subject of jokes is insane. That terms like 'mommy track' persist is horrible. That women still make up a vanishingly small percentage of upper management in health care is depressing. That women physicians sometimes can't speak up for fear of being labeled troublemakers is infuriating. This is true of other traditionally male dominated fields where women are breaking in as well. 

Sexism persists in medicine and I can't speak for my classmates, but I feel I can't do a damned thing about it at this point. My entire career could be destroyed in its infancy by ruffling the wrong feathers.

In March, I'm hoping to attend a dinner event for women in medicine. It's being held in a country club sort of place; a touch amusing given that it wasn't too long ago that these sorts of places excluded women. Many of my classmates are interested in going and I'm really looking forward to it. I hope my MF3 schedule will permit me to attend. 

It's had me reflecting on how the presence and acceptance of women in medicine has changed. I have so many strong women in my class, women I'm proud to call colleagues. It has me thinking of how far we still have to go, but also about how far women have come in the last century. 

I recently watched Sufragette as I've always had a bit of a fascination with the women's suffrage movements (particularly the British) of the late nineteenth and early twentieth centuries. Fantastic film, highly recommend it. As a good film should, it makes you think. And the film along with the upcoming dinner and a meeting in two weeks left me reflecting on what being a woman in medicine today means to me.

A line from the film stayed with me. 

"We're half the human race, you can't stop us all."

Soon enough, we'll be half the medical profession. How is that going to change the face of medicine?

Wednesday, 20 January 2016

#%@$&###%^

Steven, my beloved Microsoft Surface (yes, it's named after Steve Jobs) has had a fatal hardware defect and now absolutely won't power on. Won't even acknowledge the attempt at powering on. Microsoft is sending me a replacement one which should be here Monday - great customer service, I must say - but it's damned inconvenient for all the work I have to do.  I'm on my somewhat decrepit laptop which I have hooked up to my peripherals so that it's like using my Surface in the dock but it's pretty slow even after ensuring only essential stuff is running. 

I'd had to reinstall Windows a couple weeks ago on the Surface (problem with a Windows update killed my network adapter driver, among others) and I forgot to reinstall Carbonite, so anything I did over the last two weeks - and any videos that I didn't manually back up, since Carbonite doesn't do that - that I didn't save to the cloud is toast. I think I saved most stuff to the OneDrive anyway so I don't have too much lost but this is ridiculously inconvenient. 

It would be funny how poorly my January seems to be going if not for the fact that I've barely slept in the last four days and I literally have not had a full night's sleep - more than five hours at a stretch - in nearly a month, and that last one was because I was out of it with a fever. I am the walking dead at this point. My mental filter is completely shot so I'm down to rambling and muttering. 

It's not even insomnia. It's life! Most nights the kids are up several times, even through the wee hours. I don't know why, but recently my daughter started having regular nightmares. My son has always been the type to get up in the night but we're really cracking down on that because he was sneaking around to play video games so any time he's up, I'm up to send him back to bed and there is always an argument over it. My daughter usually needs comfort every night around 2am and while I'm trying to get her to cope with it herself, it takes time. 

Beyond that, my lovely, wonderful, fantastically supportive husband snores like a wood chipper. Much as I love him, that does not minimize the impact of the unholy racket he makes every night and he invariably falls asleep at the drop of a hat and starts snoring long before Morpheus finds his way to my side of the bed. He actually had a sleep study about that last week, something he's needed for years, though it has to be repeated since he didn't actually fall asleep during the observation period. Having wires everywhere makes it difficult. Between the kids and him interrupting me every time I try to sleep, and the fact that I've gotten phone calls or had things arise during the day when I've attempted to take naps to get at least some level of rest, I am wiped to the nth degree. I have never been so tired in my life, and that includes when we had newborns. 

And I had to write a CAE this morning. Having had precisely no sleep; I was up all night. And I'd had only two hours the night before that and three Monday night. 

Tonight, I'm sleeping in my office with the door locked. It's on a different floor, away from the kids, on the opposite side of the house from the bedrooms. It is quiet.

Of course, thanks to spending my afternoon trying to get stuff sorted out about a child care thing and about my Surface and chasing documents hither and yon, I lost my six hours of mid-day tutorial prep time and now have to prepare for tomorrow's case right now which means I'm going to be up until around 2 and I need to be up by 6:30, 7 if I rush. 

Oh, and we have tutorial at 9am tomorrow instead of our usual 1pm so I can't even sleep in to try to make up for the late night I'm sure to have.

I think after making it through this month, I will be able to laugh in the face of residency. Frankly, I'm surprised I'm still sane at the moment. Or apparently sane. Who the hell knows. 

Sunday, 17 January 2016

Baby Egg

We have a little remote controlled BB-8 droid toy - which is awesome - and my daughter calls it "Baby egg" which amuses me endlessly. The title has nothing to do with the rest of this post, though. 

At the moment, the house is pretty peaceful. The youngest cat is watching the bird feeder. My dog is utterly confused because a squirrel came up to the window and she has no idea what to do about this. My son is using up his daily allowance of video game time. My daughter is running around with a conure on her shoulder, the cockatoo and Quaker are gleefully poaching my lunch (I'm not stopping them; it's a spinach and goat cheese salad. It's good for them too!) and my very old cockatiel is taking a nap. 

I would like to note that this is my son's conure, not my daughter's, but CB loves everyone. 


My husband is being kind enough to make lunch. I've had a bit of a medical issue this weekend which has left a bit low so I'm trying not to move much. Funny enough, my tutorial tomorrow is on the very thing that has me feeling horrible today. 

It's uncommon now that my husband is home on the weekend. His hours have been slashed at work (to about half) because of the Canadian dollar being so low. We are fortunate that we can weather this, more or less, but I'm sure his coworkers are hurting. We're actually on the lookout for an occasional sitter for the weekends, because weekends are apparently fair game for some parts of my curriculum so I need to be able to attend stuff with a minimum of fuss. 

On the note of doing stuff on weekends - I've volunteered to be a host for the interviews in April! I'm very excited to see the candidates for the class of 2019 and I'm very eager to welcome them. As I said last year, my husband and I are actually offering our home as a place to stay for applicants. We have one person already who is going to come stay with us and I'd love it if more do.

I'm so excited about next year's class. Once they receive their acceptances in May, my class is no longer the 'baby' class. We'll be senior to someone and the thought of it is a bit odd, considering we're only a few months into this. 

The next couple years are going to go so, so fast. I'm only 25.5 months away from receiving my match results. Really. I remember when I was thinking, in the spring of 2013, about being 24 months away from med acceptances. That doesn't seem so long ago and I know, in March 2018 when I find out where I'm going, looking back at today is going to seem like the blink of an eye. 
I





Thursday, 14 January 2016

(There have been) Better Days

Today is my son's ninth birthday. I'm super excited for him; he's really thrilled at reaching what he sees as a really big milestone. There's something about 9... I suppose because it's because it's the last of the single digits. It makes a kid a definite 'big kid' and really is a rather transitional age.

However, right now, I am very much not happy about the fact that his birthday coincides with my tutorial day.

I didn't sleep a wink last night.

My husband was off having a sleep study done (waste of time - he couldn't fall asleep either!) so I was on my own with the kids. Not usually a problem; I'm good at getting organized for the morning.

But my son was so excited about his birthday that he kept waking up.

He was up at 12:30. Got dressed and started getting ready for the day, thinking it was morning.

Took a half hour to get him back to bed.

I was trying to fall asleep, but then he was back up before I could.

Come 2am, he was up yet again. I still hadn't fallen asleep.

Rinse and repeat. At lest once an hour all of last night, my son was awake and kept coming in to whine at me about wanting to get on with his birthday activities.

I am, in a word, knackered.

I desperately want to go to sleep. My husband got home from his sleep study around 7 so I kipped for an hour or so early this morning, but I think I actually feel more tired now. Tutorial today in on type 1 diabetes and I had this grand old idea to only take notes on the super detailed portions - I took either only a few words of notes or no notes on the major aspects because I was going to rely on my memory.

BUT NOW I CAN'T REMEMBER ANYTHING!

I've had a couple of bad tutorial days so far this MF because of stuff going on outside school and it's just one thing after another right now. I've had comments about being affected by stuff going on outside school but the stuff that's gone on has been outside my control. And the fact that at least one person has expressed annoyance at me being affected by stuff outside of school means I'm terrified for today.

I'm usually good at functioning on little sleep - I am a mom and a future doctor, after all - but right now I'm freaking the hell out because today I'm just going to fall on my face because, yet again, I have family stuff that's going to impact my performance and as far as med school is concerned, I shouldn't ever let that happen.

This is the thing. I'm a mom first, a med student second. But medical school expects that medical school comes first and there are those that would say that if I can't do that I shouldn't be there.

I have to work harder to be seen as equally deserving.

And today, I'm just not going to pull it off because I am freaking out and I'm tired and I have averaged only three hours of sleep a night in the last two weeks and I am (if you will pardon the language) fucking exhausted. I am ready to cry and scream and hole myself up for two days in my office.

Tuesday, 12 January 2016

Sponsor?

I've known since I was five that I wanted to be a family doctor.

I've got some interest in emerg, but I know that at most I'll do a +1 EM because I just can't really justify a five year residency. Every exposure I've had to FM has me sure I'm going to be happy there, and in the grand scheme of things, minimizing my time between now and a stable career is of a higher priority than pursuing a particular specialty. 

I've decided that this fall I'm definitely going to apply for the family medicine sponsorship program. No one seems to know, at this point, exactly how the program would work for someone at a three year program. The program is pretty young and to my knowledge they haven't had any 3 year program applicants, as when I spoke with the recruiter's manager she didn't really know how it would work but I was invited to apply this year. 

Applications are due in mid-September, so I'm already starting to think about it. I need to get 3 letters from clinical preceptors or professors. I suppose tutorials or clin skills preceptors would do... I suppose that's something I'm going to have to get used to. Asking for letters. You've got to do a lot of it during clerkship, apparently. I'd really like to do a post-MF4 elective back home partly so that I can speak with an Island physician about practicing there and maybe ask if it's possible to get a letter from a physician back home to support how I'd fit into the Island health system. 

If I am selected for this program, it would mean I would not need to accrue any additional debt (above my student loans of which, keep in mind, I'm going to be eligible to have a significant portion forgiven) and I would be able to start paying down my LOC during residency and would realistically be debt free in year 2 of practice. Pretty appealing, particularly since my oldest will be off to university within just a few years of me entering practice. 

The downside is that it requires committing to family for good with only 12 months of medical education under my belt. 

People tell medical students not to decide on their specialty too soon, but the reality is I'm at Mac; I have a year less time than students at traditional programs to figure it out anyway. But I've known since day one that I wanted to minimize my overall time in training and that I wanted portability and flexibility, which are at a maximum with family med. FM is the swiss army knife of medicine, and that's what I want and what I have always wanted. I still haven't found anything that even comes close to changing my mind. 

Monday, 11 January 2016

Not-so-bad Eval

I was definitely too anxious about my self-eval. My groupmates are pretty awesome with the feedback.

Am I ever going to get over this generalized feeling of inadequacy with myself? Bah.

It's kind of crazy to realize that MF2 is now half over. We have our second CAE next week and our third on February 8th. That last one is the one that will be more endo-focused (the CAEs are cumulative but tend to focus more on recent material.) I'm really excited for endo - it's one of my favourite topics. But yeah, MF2 is over on February 12. We don't have any cases for the final week and since the CAE is the Monday, it'll be pretty relaxed I think.

Then it's into MF3, which is the same course length as MF2 but doesn't have a two week break in the middle. So MF3 will fly right on by and so will MF4 which is another 9 week block.

Then it's electives time. I've already submitted my name for two lotteries to try to get positions in the blocks for July 18-31 and August 1-14. I really want an emerg block elective but there's only a few spots and it's done by lottery. I've also applied for CTU, and I'm about to contact the community and rural education network to try to set up something rural. Rural family would be nice; that's really what I want to do. And maybe this psychiatry one that looks interesting.

I'm trying to sort out getting an elective back home but I don't know how likely that is. Working on it, though!

I was talking to a mom in the class of 2017 who was really lovely about putting my mind at ease about some things. I feel bad that I'm not participating in much of the extracurricular stuff but, frankly, I just don't have time. My kids are going to see little enough of me come clerkship and residency; I can't go sacrificing what little time I can spend with them for optional things. So I haven't really pursued the horizontals or the million and one ways to be involved during med school. I have some interest in a few areas, but timing for meetings hasn't usually worked out so I've had to pass.

One thing I am doing this week, and I'm pretty excited about it, is this QI workshop thing. It's a quality improvement research project sort of thing and it looks really interesting. I'm also officially now a Figure 1 Student Ambassador, which is fun considering how much I talk about it already. I've also signed up to host during interviews, and I really hope I'm selected for that. My hosts were fantastic and I'd love to pass on that hospitality.

Come to think of it, interview invites should be going out in a couple weeks. I am really excited to see who gets an interview and to see how admissions plays out.

It feels so surreal to realize that at this time last year, I didn't even know if I'd gotten an interview and yet here I am, thinking about welcoming the candidates for the class of 2019.

Bizarre...

Sunday, 10 January 2016

Self-Eval

First thing's first, there was a documentary filmed at Mac and our teaching sites and it's now online. You can take a look at it here.

I only appear in it from a distance for a couple seconds and I'm glad it wasn't more. My classmates and upper year colleagues did a fantastic job. I was pointing out people I know and places I've been to my husband while watching it. One of the students who does a fair bit of talking is one of the upper year moms I have been in contact with and she does a great job explaining how PBL prepares us for med. 

I'd really recommend taking a look at the documentary. 

In other news, tomorrow is our first self evaluation activity of MF2. It's self and peer eval so my peers and tutor will be giving me feedback tomorrow. I'm really anxious about it this time around because I've been underprepared for two tutorials so far, which is unlike me (I'm usually obsessive about preparing for stuff) but was just a pair of bad coincidences. 

The first was because my computer borked and I had to spend most of my prep time fixing it so I showed up flustered and didn't have my thoughts in order. 

The second time (last Thursday) was because I hadn't slept longer than two continuous hours in over two days and I'd spent 24 straight hours trying to keep my very beloved cat alive and ended up watching her fade and start actively dying in front of me too quickly to do anything about it. It's actually pretty traumatic to see an animal that you love greatly lose the ability to see or control her movements, to start stumbling around and apparently be unable to recognize you. 

We held her as she died two and a half hours before I was due at tutorial and I tried really hard to do what prep I could in that time, but I still showed up fairly disheveled and upset and unable to focus. I did my best to contribute. 

If it had been a job, I would have called in that day, though. 

But I was unprepared. I own it. I prioritized my cat over my tutorial prep and I don't apologize for that. But I think my general nervousness about my group (they've lovely and all, but I know I haven't been as confident as I can be) will mean my eval isn't great, and it'll be my first not-generally-awesome one. But being able to take suggestions for improvement - thought I'm not sure how they'd phrase that... "you should prioritize your schoolwork more, even over the critical illness and death of a family member" - is part of our professionalism and I have generally asked for areas to work on anyway. 

I suppose I'm unreasonably anxious about tomorrow because I just sort of generally have zero self confidence. Even though I know I'm doing very well, I still feel like it's only a matter of time before someone tells me I'm woefully unsuited to medicine. Imposter syndrome is in full swing, that's for sure. 

Thursday, 7 January 2016

We tried really hard

Nomi, April 1, 2007 to January 7, 2016


We had to put our girl down. Frankly, I have a lot I need to be doing right now, but I can't really stop crying long enough to actually study so I need to write this out so I can stop dwelling on it and be able to work. 

She wasn't managing feeds once she got home. I took her to the emergency vet clinic and he gave her some subq cerenia (an animal anti-emetic) and she tolerated a feed around midnight but she was tachypnoeic. I was up frequently throughout the night to monitor her and she was getting more and more distressed. 

She seemed a bit perkier first thing this morning and came up on the bed but she went downhill rapidly after that. Her RR was 100 at 9:15 (normal is 20-30.) By 9:20 she couldn't walk. By 9:45 her pupils were blown and she wasn't responding to light or other visual stimuli and we were positive it was hepatic encephalopathy. She seemed confused. We called the vet and she agreed it was HE. 

We got to the clinic at 10 and put her down shortly after. We stayed for a while with her.

We tried really, really hard to keep her alive and she fought. She just decompensated really quickly and there was nothing we could do. We could have re-hospitalized and tried to do an ultrasound to find out what was going on that was keeping her from responding to treatment, but we'd have been looking at another $1300 or so and, frankly, she was too far gone. She was very likely too sick to tolerate any further attempts at treatment, even if we got to the bottom of the cause of the hepatic lipidosis, it's almost certain that she was too sick to treat it.

So she died quietly in our arms, with pain control, being cuddled in a super soft, fuzzy blanket.

We rescued her from a farm outside of Ottawa when she was 4 weeks old. They were going to dispose of the kittens if they didn't find homes. She was the runt; tiny little thing, last kitten to find a home. She had the bluest eyes and the sweetest demeanour I've ever known in a kitten. She and my son were super tight right from the get-go and at least half of my pictures of him during his first year also include N. 

I've never met a cat like her. Kind, sweet, impossibly docile, and always happy with human cuddles. She grew up into quite possibly the best cat I've ever met. Everyone who met her loved her.

I have to prepare for tutorial. It's at 1, and I haven't even started because I lost almost all of yesterday to caring for her, and was up most of the night, and obviously didn't get anything done this morning. I may get in trouble, I don't know. Frankly, I'm going to be showing up all puffy-eyed, red and blotchy and it's going to be really hard not to cry during tutorial. But I don't think I can miss it because my cat died. It's usually only serious illness in self or an immediate family member that justifies missing tutorial. I tried to call my tutor to ask but he wasn't available. 

She got more use out of that damned seat than the kids did, even when she outgrew it.  
She kept up her habit of checking that the kids were breathing while they slept until last week, when she got too sick to continue. She did this every single night with both kids,. 

They really were inseparable.


Playmates. 

She was too gentle to even attempt to go after the birds. My quaker would preen her fur, and the finches would pull fur out of her belly to use as nesting material when she laid on their cage.

She spent much of her life in my lap. 

And she had to investigate everything.

She was always good at distracting me from studying.

Quite insistent about it actually. 

She taught my son how to spell.

And she'd remind us not to play video games too long. 

She was never far from us, and she could always find a warm spot to curl up nearby.


 

Wednesday, 6 January 2016

Stubborn Moggy

My kitty is home. She's still very ill, and recovery will take months, but at lest she's home.

Our vet is lovely. She's really just absolutely fantastic; so sweet and caring and she's very big on keeping us in the loop. She'd call multiple times a day to keep me updated, she'd tell me her labs and her current clinical picture. It's really helpful to have a vet like that, who realizes how much we care about our pets.

N does have hepatic lipidosis, so we're in for the long haul. She has a surgically placed feeding tube - an oesophagostomy tube - in her neck, with a little puffy collar that helps stabilize it. The treatment for feline hepatic lipidosis is to feed them by tube until they are taking sufficient food by mouth. They generally feel very ill and don't want to eat, which worsens the issue, so the only treatment is basically to force feed. Hence the tube.


She was completely out of it. This is after the tube (the blue thing there is the feeding tube cap) was inserted.

She was so severely dehydrated that she didn't start urinating until yesterday evening, and she'd been on 2.5 times maintenance IV fluids since Monday. As a complete aside, the vet clinic has the tiniest, cutest little infusion pump I have ever seen. It was smaller than a box of tea.

My cat is now on six different prescriptions including two antibiotics, an appetite stimulant, an antinauseant, vitamin K (for coagulation since her liver is very ill), and a supplement of sorts to help with the repair of her liver. Plus a probiotic which she'll take for a while since cats can apparently be pretty sensitive to antibiotics, Everything except the supplement, which she needs to take for two months, will be done in a week. I made up a schedule in Excel which is pretty much going to run my life for the next two months. Fortunately I worked her feeds around our schedules, so I can handle most of them (I don't think my husband is terribly enthusiastic about tube feeding the cat.)

The feeding schedule is pretty intense. She needs 210cc of slurry (it's a high protein recovery diet mixed with water so it's thin enough to take up into a syringe) a day. She can't tolerate very much though, so she's getting about 27cc per feed. We did try to give her a 35cc feed earlier, which is the max she should need per feed, and she couldn't keep that down so I'm going to give he only 20 at the next.

This is one feed. Three syringes of slurry, plus water for flush. 


She's just had her meds for the evening and she's feeling pretty nauseated (cats drool when they are nauseated - something that I just learned this week despite having had cats literally my entire life) so I'm thinking I might give her 12cc an hour until 11 instead of doing two feeds. It takes a long time to feed her. You start with a flush, feed at a rate of about 2-3cc/min, and finish with a flush. Keep in mind, I'm doing this with a syringe that is attached to a tube that is going into the neck of a cat. Cats are not well known for their patience with medical procedures.

I have to crush her tablets, mix with water, and give by syringe into the tube. I feel very much like an old school doctor who compounds their own drugs. 

Way I figure it, if I can get N through the next 6-8 weeks of tube feeds, I'm going to be the best clerk ever when it comes to wrangling toddlers during procedures.



(Regarding the title, 'moggy' is a term for a mixed breed cat; like 'mutt' for dogs. I think it's from the UK, but I've known and used it my whole life.)

Monday, 4 January 2016

The Other Doctor

We have a lot of pets, you may have gathered, though I don't think I've ever stated exactly how may on here. We have six birds, four cats, and a dog. It does tend to be a shifting number since around half our pets are seniors or came to us with existing health issues so they aren't necessarily with us for long but we make sure they enjoy whatever time we can give them.

She has this look which makes me feel like I'm being criticised.
Our nine year old cat, N, was supposed to be my son's cat but she's always taken a liking to me and she really is the perfect family cat. She's an absolute sweetheart, extremely tolerant of kid behaviour, plays with the dog, and is mischievous, playful, and always happy to cuddle. She's the cat who goes to check on both kids every evening as they get into bed. She almost died when she was 18 months old because she swallowed three feet of thread and it strangulated her intestines. Emergency surgery saved her life.

We've never been hesitant about getting our pets veterinary care when it is needed; it's our responsibility as pet owners to do so. Even then, I've been lucky to have great vets over the years who have taught me some skills so I can do first aid and some basic assessment and treatment with the animals. The birds in particular, since I've not often had access to an avian vet who can deal with exotics.  I'm no vet, for sure, but I'm a bit more experienced than a typical pet owner.

N started seeming lethargic over the last 5 days or so but it wasn't really pronounced until Saturday. I decided Saturday evening to bring her to the vet first thing Monday once I saw that she was getting a touch jaundiced around her ears. We could still get her to take some fluids and she wasn't complaining of any pain when I examined her, so I didn't think she needed the emergency vet.
I love her green eyes.
We took her in at 9:30 and I've just had a call from the vet confirming that she has feline hepatic lipidosis and she's sick enough we're looking at around a 50% chance of survival. Survival will mean weeks of tube feedings at home. Which we'll do if that is what it takes since she still has potentially a decade of life ahead of her to enjoy and that's worth fighting for.

But I'm very sad for my cat. She's been through a lot and she has still remained such an absolute sweetheart. She's really the best cat I've ever known. I'm very upset that she may die and I'm beating myself up a bit for not bringing her to the vet Saturday.

Given the high chance that this could be fatal, we'll be talking with the kids this evening about the fact that she is very sick and may die because we don't want them to be blindsided if it happens.

I'm not someone who asks for prayers or good thoughts or whatnot, but I just find it helpful to talk it out when there's something upsetting going on. Our animals are part of the family and it hurts for one of them to be so ill. If we lose her, it will be very hard for everyone considering how beloved she is.


They've been inseparable since they were tiny. 
Our 'perma-kitten' S (the brown one) adores her. For years, S barely tolerated humans but she was always with N.  

Sunday, 3 January 2016

Back to It

It's my last day of break and while I'm looking forward to getting back to school, I still think a three week break would have done me exponentially more good.

For one, let's face it - it's not that relaxing when the kids are home too. I love my children. They are fabulous, lovely, bright little things and my life is made so much better by their existence.

But dear gods if I hear either of my children wail about some minuscule or imagined slight or beg my intervention on a matter that most assuredly does not require it one more time, I am going to scream.

In my house, the kids are expected to sort out minor kerfuffles (even larger kerfuffles) between themselves. I do not hop in unless absolutely necessary. We have supplied these children with conflict resolution skills and we know for a fact that they are able to sort things. Why have they not caught on that asking me for the ten thousandth time to tell their sibling to do what they want is not going to work?

These two are at prime bickering ages. Much as I love having children who are fairly independent, and I pride myself on the fact that this is something we encourage (I will not be the mother who calls her child's university professors to complain about marks,) the process of fostering that independence is immensely frustrating. Because it's easy to intervene whenever your kids have a hiccup. It's easy to just tell them how to sort it so everyone is happy. It's awfully tempting to just jump in and solve the problem, but they need to work things out for themselves.

So I've listened to two weeks of bickering, because bickering is how they sort things. It's how they develop the self-advocacy and mediation skills that will serve them well as adults. Me jumping in to fix things will just take away opportunities for them to develop those skills.

But dammit, after two weeks of lovingly and patiently fostering independence in these children, I need a break! Which is why I think the winter hols should be three weeks.




Friday, 1 January 2016

Welcome 2016

I'm sitting in the rec room, with my dog beside me and a parrot on my shoulder. The kids are jumping around on pillows while we watch a movie together. 

There's a fire in the hearth, which smells lovely, laundry on the go, and it is, in every way, a perfect day.

My husband has, just by coincidence, been off work for nine days. Eight of them were scheduled off. He was supposed to work on Wednesday but ended up in emerg overnight Tuesday so he wasn't allowed to go to work. 

I think he has the flu. The clinic doctor I took my husband to Tuesday evening didn't think it was flu - partly because my husband is a poor historian and didn't tell him most of what had been going on  - and sent my husband to emerg for fluids and blood work because he was tachycardic. So my husband ended up with Wednesday off too which really worked out since I was pretty much unconscious when I came down with it myself. We're still both pretty weak and breathless, but if my suspicion (I'm like 90% sure it's flu...) is correct, our flu shots are serving their purpose and reducing the severity significantly. 

So yeah. The end of 2015 wasn't too great. Frankly, the start of 2015 sucked too, though much worse.  The bits in the middle were largely pretty good, like I posted yesterday. 

I do have some hopes for this year, though, and I want to write them here. 

I hope we will finish the year as a family of five. I hope my kids will continue their pattern of huge progress in all areas. I hope my husband will continue to enjoy his new job. I hope I will continue to enjoy school, even when I start into the somewhat intensive clerkship schedule in November. 

I hope I'll develop some close friendships and some good professional contacts here. 

I hope my friends who are applying will get into medical school this cycle. 

I hope I'll be granted my BSc. 

I hope that when I look back at 2016, it will not be as bittersweet as my reflection of 2015 is.

I hope. 

Those are probably the best words with which to begin the new year. 

Happy New Year, everyone. 

Yes, we keep a fire extinguisher beside the fireplace. It's practical, not paranoia. We have one on every floor of the house, including the one in the kitchen. If you've ever had a house fire, you will never consider yourself paranoid again.