Saturday, 25 March 2017

Pink Fluff and Career Stuff

My bird is still alive. After my last post, he took a turn for the worst and we were pretty positive he was going to die. He couldn't hold himself up well. He was shaking. We kept him on a heating pad, under his basking lamp all night, on the couch with us. We figured the best we could do is ensure he wouldn't die alone, in a cage. 

He survived, and that morning I noticed something thanks to my experience with birds which lead to us getting a med that has turned things around. 

So thanks to a lot of intensive care - tube feeds, crop washouts, IM meds at home - he's still alive and is actually improving. He's on six different medications, but he's doing surprisingly well. A week ago he was so emaciated you could have cut paper with his keel bone, but in the last few days he's gained back over 15% of his lowest body weight and he's got his attitude back (which includes taking swipes at me.) Birds with this disease never live their normal lifespan, but a rare few have survived a few years with it, so there's some hope we may be able to manage this long term. 

There's my update on the fluffy roseate dinosaur. 

The aforementioned fluffy roseate dinosaur, at the vet's office. He climbed up onto my shoulder which just does NOT happen. 

Now, to medicine. 

I've now finished my last OB/Gyn elective and have wrapped up three straight months of OB/Gyn (which for the rest of this post I will shorten to just OB.) I figured this stretch would decide for me once and for all whether I want to apply to OB. 

Well, I definitely love OB. All of it. I think I can handle the lifestyle too. 

I am not positive I can handle assisting in vaginal surgery. Specifically assisting; I think I could handle being the primary just fine, because then you're seated or standing straight. But assisting in vaginal surgery means being stooped over, half under the patient's leg, twisted sideways, with your arms outstretched, retracting without moving for hours at a time.

Spending 7+ hours in one day in a position that seems especially designed to be excruciating for someone with pre-existing back issues is... not optimal. My back has been screwed up since a bad fall I had when I was 15. I manage just fine most of the time, even though I deal with pretty much constant pain from it, but sometimes have to be a little extra cautious with my movements. 

There is a LOT of assisting in vaginal surgery during an OB residency, as one would expect. I am honestly not entirely sure I could handle five years of doing that regularly and I worry that I might make the already chronic pain I cope with so much worse. 

That's my one big hang up. I have no worries about my ability to manage the other requirements of the job or training for it. The five year residency is certainly daunting, but I'm up for it. I just feel so at home in OB. It's the part of medicine that comes to me most naturally, that I have the most interest in, that feels like where I belong. I don't want this one thing to hold me back from it, but at that same time, I don't want my career to disable me. 

I've given myself a deadline for making a decision about what residency/ies I'll apply to. End of June. That gives me time to apply to the family medicine sponsorship if I do decide to do family med instead. 

Thankfully my school has us have a mandatory career counselling session and mine is scheduled for early April, so I'll be able to get some feedback on my thoughts, I hope.

It's hard to believe that in less than a year I'll know what kind of doctor I'm going to be. 

Sunday, 19 March 2017

Under the Lights

I've been baking this weekend. Probably not the best past time, but enjoyable nonetheless and quite honestly I'm baking to feel like I can do something useful. 

We have our cockatoo home now, but he's dying. We're basically doing palliative care and waiting for him to die. There is a small, vanishingly small, possibility his illness may remit for months to years, but it's highly unlikely with him as sick as he is currently. He does not seem in pain at all or we would have him euthanized. He's enjoying eating his favourite foods, and spending time under his heat lamp and snuggling up to us. He's very sick, but essentially on a slow downhill trajectory. If he goes downhill fast or seems to be in pain, we'll call our vet to come to the house to euthanize him. As it is now, we're just trying to let him enjoy the rest of his time with us. 

My kids are learning some important lessons through helping take care of Gallifrey. We're coping with some big emotions, as we'd expect. 

I wish I could make this better. If he were human, there would be options. The virus would be better understood. The treatment options would be better than "we think this might help, so that's what we're doing." 

This illness - formerly known as macaw wasting disease, then PDD, then ABV, and now avian bornavirus ganglioneuritis - has been around as long as I've had birds. The virus is everywhere. Almost every flock will have a bird or two who carries the virus asymptomatically. It's somewhere around 25-40% of pet birds who have the virus. Whether it will progress to a clinical syndrome, as it has done in my bird, is unpredictable. This is the most likely time of year for it, because they're entering breeding season and the hormonal activity is stressful. 

I've been poring through what little literature I can find to see if there's anything else we can do, but he's already on the generally accepted treatment regimen that, in some birds, helps them live for years longer. 

It's pretty obvious he's not going to live for years more at this point. He's hanging out under his heat lamp and eating a bit. We're feeding him some hand feeding formula as easily accessible calories and fluids. 

We've done our best by him, and that's all we can do. Now we just have to help keep him comfortable and let him pass in his own time, in his own space, where he is happiest. 

He needs a bath, but I'm hesitant to give him one because he's having trouble maintaining his temp already. :-/

Wednesday, 15 March 2017

Vale Viceni

And just like that, I'm thirty. 

It has not been the most festive of birthdays. For two reasons. The first is that a friend's husband died on Monday. It was one of those extremely sad cases of stage four cancer out of nowhere followed by a rapid decline over a handful of weeks. A group of friends are all trying to support her; I absolutely cannot imagine what she is going through. They'd just had a baby a few months ago and so it's just an absolute mess and I'm feeling very sad for her and can't help but spend some time having a bit of a deep think about life. 

Beyond that, my cockatoo is very ill and is probably going to die. He's been at the vet since Sunday. We went to see him this evening and he's very, very ill-looking. It was quite sad to see him so poorly. He perked up and said "hi!" when the tech brought him in to see us, and we spent some time with him. 

This is the hard part about pets. Even when you take very good care of them, things happen. With birds in particular, there is often very little you can do. Last year, when we tried to save our cat, there was at least an aggressive course of action we could have tried to see if we could save her. With a parrot, there's little research on treatments so you just kind of have to hope that what you try will work. I've kept birds for twenty years and I have often not had access to an avian vet so I've had to learn some avian medicine and I can comfortably manage some stuff, but I'm very glad to have an actual avian vet guiding us now. 

It's just very hard to see him so sick, and to know it's probably not going to get better. My son dearly loves this bird - as do we all, but he's very close to him and few other beings - and I know losing him will be hard. 

So this has not been the best week. The fact that it's only Wednesday is not very reassuring. 

This will be a good week to see the back of. 

Sunday, 5 March 2017

Catching Up

This is the longest I've gone between posts in a while. The reason why is that I honestly just got really sick because of my stubbornness.

It took me 14 hours to drive home from Ottawa - a five hour drive - because I kept having to stop to sleep.

I had strep throat (lab confirmed) which essentially knocked me off my arse. I ended up with a fever on and off for five days, though basically medicated myself into some semblance of functionality for the bulk of it and since then I've essentially been asleep any time I've not been at work. I come home at the end of the day, get my stuff ready for the next day, and go to sleep.

In the last week and a half, I've spent almost no time with my kids, have let the ball drop on several commitments, have let pretty much every single thing in my life fall apart, and I'm still outright bloody exhausted. Clearly, I need time to recover that I simply don't have. It is taking absolutely everything I have to be at my best while at work and I have nothing left by the end of the day. It's a damn good thing I don't have call right now because that would just be a mess.

My current elective isn't even that physically demanding. I'm walking around most of the day, but that's hardly taxing. I'm at a fabulous clinic with some absolutely amazing staff, and some really wonderful residents I'd already come across. It's honestly a really good experience and I am very much enjoying it and am learning a whole lot. I just wish I wasn't so tired.

This is honestly making me wonder if I have what it takes for a surgical residency. I am so exhausted from a stupid strep infection because I didn't have enough recovery time. How will I manage being sick during residency? What if I have an asthma exacerbation and end up in emerg because I can't breathe, or there's a flu outbreak? Maybe OB/Gyn is a better option because I'll mostly be working with otherwise healthy patients? I don't know. I'm too tired to think very rationally right now.

I am planning to see my doctor about my currently disproportionate level of exhaustion since I have a day off coming up. My schedule for my next elective just kind of worked out that way, so I'm cramming all of the errands I need to run into one day because time off on weekdays is rare. Probably not the best plan, but there's no real way around that since I have time-sensitive things that need to be done.

As for the moment, I'm going to go lay out my clothes for the morning and then get to sleep. Have to be up at 5:30.