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Sunday, March 12, 2023

Hand Holding Anxiety. When You Love Too Much It Costs.

 Hand-holding vs. confident and competent?

Izzy takes a ride with Allie.

It occurred to me that as much as I hope to practice for the latter I see a lot of the former. Maybe I attract it?

Maybe I market it,,, albeit unknowingly.

Questions about intentions from the newest rescue we are helping.
This little one is about 10 weeks old and was rescued from a dump in deep Kentucky.
She had an ultrasound and some questions about the size of our position pillows.

The issue is not that one is better, or worse, than the other. The issue is that I am not as adaptive as I hope to be, or know others hope me to be. The issue is that I am too sensitive, too driven and too insanely compelled to practice for the benefit of the patient and forget to tailor my delivery to the client.

 The real issue is that I forget I am merely an extension of the leashes many avenues, and not the patients only resource to recovery. 

Teddy. TPLO surgery last Wednesday.
All sweetness and a pinch of Border Collie anticipation.

Yesterday was an example of this. Yesterday was Lilly. A bubbly, bouncy curly ginger girl who has had multiple trips to the ER and multiple trips to my clinic for her waxing waning intermittently, self-described as "violent" vomiting and diarrhea. She is owned by two doting millennials. The kind that the vet journals remind me to both recognize and cater to. They are the new generation of my bread and butter. They love their pets in place of having children and they will both spend for them and advocate for them. These are the couples with sets of pet outfits, all personally monogrammed with the family crest, one for each member. One for each holiday, each gathering and always captured in holiday post cards. They have vacations designed around "pet friendly" parameters. They are new parents who jump and take notice at the first sign of illness, discontent, or dismay. They are what I want every pet parent to be, not withstanding the narrow age bracket to remind me I still live in a rural place where people on farms still refer to all species with a prefix denoting "farm use." (The labels can literally kill you around here).

Skylar, also a TPLO surgery Wednesday.
The eyes, they always get me.
I spend a significant amount of my work day reassuring.

Lilly's mom arrived in her work clothes. A clean, dark, pet hair free, (I cannot remember the last time I had one of those outfits, likely never) pencil skirt, with mid-heeled black leather shoes,  and a tight fitting ruched shirt to match. She must work in an office where professional image matters, I think. I have yet to ever live that life,,, (and, yes, there is a side of me that is jealous about that). Compared to my professional attire which included; poorly matched scrubs, upper and lower hemispheres, and not-at-all comfortable, (nor supportive) sneakers with the laces untied dragging behind me swinging to and fro collecting hairball tumbleweeds as they traversed. I was reminded of the hazards by everyone I passed and still was too tired, too painfully arches in agony, to correct them. I have considered adding slippers, or Crocs, (I cannot believe I am here), to my wardrobe as the days get soo long I am reminded my body is decaying. Lilly's mom was intense, apologetic and fretful. Her dog is just over a year old and she has been to the vet a dozen times for the same thing. She is also, in quiet, subtle undertones, worried about the current place her vet bills lie and what the road ahead will look like to for retirement account if she stays on the current path for another decade.

It was 730 pm. We close at 8. I had fit her in after her call at 630 pm begging to be seen for her dogs "vomiting and diarrhea all over the place for the last 3 days." I had been in the clinic all day, 12 hours, and I was,,, done. Toast. And I know it.

I was exhausted. And now I have Lilly in front of me, with her worried mom,, and I am asking myself if I can see just one more case today? I remind myself silently that this, this profession, this day, and yes this moment,, is not about me. There are times, many times, and many days like this, where I am a bag of bones with untidy shoes, urine/fecal stained scrubs and a belly soo dehydrated and hungry I cannot adequately focus, nor separate myself from the clock calling me to close. I had arrived at the clinic at 8 am. I have not had a meal of any sort, nor sat down, nor taken a break to clear my cluttered head. There were 11 surgeries today. Two of which were my own pets. (Let's talk about how difficult that is). Then pile it on top of a day like this. I remind myself there won't be anything left of me to cremate when the burner expires within. I know this. I push my nose deeper into the ground and flex all fours to plow on. 

"Lilly's exam looks fairly normal." I reply. Lilly is now cowering behind her mom. She is drooling with anxiety and really wants me to go away. Pet hair free and upright on her kitten patent leather heels she asks me, "Why does this keep happening? And, how do we stop it?"

It's 745. That answer could take another 12 hours. 

Gunner, using the almost infallible tactic of,
"I'm too cute to ask to participate in an exam" ploy.

"Well, we have never gotten her a diagnosis. We are always treating the emergency and never investigating the in between times that might be leading her to this." I reply.

It's 750 pm. I sit down. I have to. I look up and meet her moms eyes. This was not the answer she wanted.

"Again, thank you for seeing me today. For fitting me in."

"You are welcome. I know you are worried." I suspect she is also worried about needing the ER, having to repeat an overnight stay. The x-rays, blood work, and ultrasound. Never mind the barium study. All of these have been done. And all were normal. 

"Maybe it would be helpful to keep a journal?" I suggest. Something for us to better understand what is happening between her visits? She is a normal weight. Normal size, normal coat. A picture of a healthy dog, but,,,, (bracing myself here),,, she is nervous. Mom is nervous. Is everyone in this household nervous? Stressed? How much exercise does she get? There is a direct correlation between dogs who play, act, and remain happy independent of their parents. I suspect she is a single pet in a perfectly doting home and maybe this isn't beneficial to her gi tract?

I suspect too much love is not what her inner self needs to grow up feeling confident, calm and content with the world she lives in. Good news is there is not an expensive diagnostic for that... just some difficult conversations and a few transitional anti-anxiety medications.. and,, "have you considered another dog?"

Pumpkin is waking up for a mega-dental extraction dental..
very common in older dachshunds.

Lilly is like so many cases I see everyday. I am never sure how problematic a medical problem is when I am not sure that the environment is influencing the clinical signs. Can you love a dog too much? Yes, when you complicate the problems with perception, actions and off setting the balance every life needs. That balance of allowing your pet to be who they are and not needing to live in the shadow of who you are and what you expect them to be. Feeding; the dilemma of feeling desperate to have your pet be happy with their meals, eat as much as you think they should be, and not buckling to offer them anything they find interesting,, too often poor quality, and too often ever changing as we chase the palatability compulsion. When I was in Ukraine rescuing dogs and cats I had a Romanian vet remind me that I needed to chill about the constant feeding concerns for the 12 animals we had transported in the car for the last 20 hours. He reminded me "that in the wild dogs might not eat for days." I wondered to my exhausted, cooked self if that included the stress of a tiny cage shoved in a tiny car running from wars? I loved those animals so much it will be the PTSD I never can shed about that broken place with all of its too many heartbreaking tales.


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