Saturday, July 30, 2011

Thinking Back Through

I don't know why this showed up as Saturday, I posted it Thursday.   And there is a newer post below this one.  TBT

THE BIG THING:  First, and most important, Ayla is feeling almost normal this morning.  At least she is eating and drinking better, and she is walking around normally.  She is even hopping up on stuff.  I wish she wouldn't but I can't figure out how to stop her.  There is no room in the house that doesn't have SOMETHING to hop up on, and that is her passion.

Now, to look at the various vet visits with fresh eyes and more information.  I am calmer know, and have more information.  Part of what I am trying to do is heal myself from the fear in the events and trying to see where I misunderstood events.  I am not without some blame in all this...

I don't want anything I have posted to reflect badly on Dr. Miller, my regular vet.  My only cause of concern was that Ayla seemed to be bleeding the 1st night after the operation.  He explained that this was the 3rd cut through the same spot and scar tissue does not hold together as well.  He said that, had he known of the seepage, he would have advised me it was not an emergency and could wait til morning.  Apparently, it was some internal bleeding plus some internal bodily fluid.  Given that, he gave me his home phone number for future concerns.  I doubt he gives out his home phone number lightly.  He also expressed his regret on not warning me about the possibility. 

And I should have realized it was not mostly blood.  It wasn't sticky!  If I had simply been asked about bodily fluids seeping through an incision in an office discussion, I would have said it was "sera".  Yes, really.  But I saw red on my shirt and hands, from MY cat, and in THAT context red=blood!

The ER Vet is an oddly detached person and a bit strange, but I may have been more angry than I should have been.  Detachment isn't a good approach to dealing with upset pet owners, but perhaps his talent IS staying detached in emergencies.  I'm still thinking that part through.

Given that MY vet explained (the next day) that sera seepage is not very unusual in scar tissue incisions, I have to consider that the ER vet decided the situation was not  quite so urgent and could stand some observation, and finally deciding is was bad enough to require some bandaging after checking on Ayla for an hour.  And for all I know, he had worse cases to deal with back in the operating area.  There are always some things one does not know

I am a forgiving person.  not "forgive and forget"; I do NOT forget.  But I do forgive when new information or insights gives me a reason.  No one is perfect, no matter how expert they are.  There are many examples.  Scientists ruin an experiment because they read metric as inches.  NASA contractors install a simple altimeter upside down and the satellite crashes.  A top surgeon reads an x-ray upside down and removes the wrong kidney.  The most talented humans aren't perfect! 

I wonder what it is like to work ER situations?  All you see is misery.  And you have to just keep functioning and doing your best in the face of that.  I couldn't do it.  I cry every time I see a notice that another cat has gone over the Bridge.  Policemen mostly see criminals; if most of the people you dealt with each day, what would YOU think of "most people".

Now, I want to mention the positive aspects of the past few days...

I am so pleased with Dr. Miller's initial operation on Ayla.  He 1st and immediately ruled out urinary tract infections because they would have been easiest to deal with) and went to the reproductive issues.  He was correct.  I did not know at the time, but as soon as he saw the remnant uterus infection, he knew there was still an intact ovary.  He explained yesterday that only an attached ovary can cause that infection.  I have NO idea why, but I think I will research that soon.  Just to know...

Dr. Miller and every one on his staff show an abundance of caring about both the pets they care for and the people they live with.  It's not faked.  I worked in government office too many years to be fooled be fake sincerity.  They care!  When Ayla was out of the initial surgery Tuesday, I asked if they could take turns holding her for pictures.  They jostled each other for their turn with Alya, even Dr. Miller.  And I have never seen the slightest annoyance on their part with the loudest barking dog or most scratchy cat.  They not only accept it, the appreciate them all for what they are.

And I must say the same for the ER staff (well, the one lady who was there).  She obviously had computer work to do, but she talked to me as long as I wanted.  When I mentioned I blogged, she asked me for the URL and went and looked at it.  We had a great time looking around my blog.

It is possible that she was just really professional at distracting pet owners, but I know fake when I see it.  She was actually interested.  She didn't seem to know about pet blogs.  We stopped only when the 2 guys came in with their "dead or dying" dog.  I was upset when she said "group or individual (or whatever the exact quote was).  Looking back, she went suddenly cold toward them.  It makes me think now that they were regular customers.  Because they immediately said "group".  The difference in cost was only $20 ($89 group cremation, $119 single cremation).  My thought was that if they actually cared, I would give them the $20!  I don't understand that part at all, but there can always be internal personal dynamics that no one else understands.

After they left quickly, the desk manager lady whisked the dog into the back rooms, returned and we started talking again.  But she wasn't as cheerful.  I even said "they don't care, do they"?  She didn't answer.  She didn't have to.  Silence is an answer.

When the ER vet came out after 2 hours, he said that she was bandaged to stop the bleeding (well, that was the desciption I brought her there for), and said she should be all right, but that I should bring her to my regular vet after 5 hours which he knew was opening hours for my regular vet.   The part about charging "storage" if I waiting more than another 5 hours was real.  That was CRUEL and indifferent.  The ER vet is NOT off the hook for oddity and uncaring.  But maybe I understand a little more about that existence.

I am still angry about the ER treatment, it is WAS bad, but it may not been as bad as I initially thought in my anger and frustration.  There is room for forgiveness, maybe 30%.  The ER was better than NOTHING!  It got us through the night, and that was the most important thing to me at the time.

Sure, Dr. Miller knew Ayla wasn't in real danger, but I didn't.

I saw some offers to help with the vet expenses.  They were substantial, but we are fortunate that we can manage those.  But thanks for all offers.  The offers mattered, and we are very touched.  Thank you.  But others need help more than we do.


The Lee County Clowder said...

Sounds like the ER V*T's main problem was he didn't tell you (or anyone else, probably) what was going on. If he'd just said "It looks a lot worse than it is" or "It really isn't all blood" we suspect you would have felt a lot better.

ppuurrrrrrring that Ayla will recover and be fine now.

Prancer Pie said...

Very hard to think clearly when a loved one is in need of urgent care. At least you now know your urgent care place and what to expect there. Sounds like the doc there could have done alot to alleviate your fears and was too uncaring to do so. Continued purrs fur both of you.

Max said...

The Man does trauma surgery--well, he does the anesthesia for trauma surgery and he works closely with the surgeons and has a lot of experience with emergencies. He also has a lot of experience in the ICU from before he started passing gas.

It doesn't make it feel better for the patient and the patient families, but the people working the emergencies and traumas *do* have to develop the ability to detach. They can't get wrapped up in the horror of what they're treating really might be, or the stress of what other people feel.

This isn't a mean thing. Being able to do that means they can give reasonable care and make hard decisions fast. It's also a problem, because, like you found out, what seems like an emergency to someone else isn't to them, and they've been in the situation so often that they sometimes forget that. They look at what seems like an awful lot of blood and know it's not much at all. They listen to a patient's pain complaint, and know that the patient is really hurting but that it won't be fatal or even a problem if they have to wait until morning for treatment.

So sometimes they seem like total dorkwads, but it's mostly because they have to step back, and a lot of the time they've been in a situation a hundred times and to them it's just normal.

Also, too, they have to be careful how they phrase things. They can't risk giving false hope, and they can't risk saying something devastating when there's a chance the out come can be good.

Yeah, they should have all said at some point "this is what you can expect" and "This looks worse than it is," and it's not an excuse... but they really do forget.

I'm sorry they didn't so something to make you feel better right away. That's one thing the Man likes about his job--he takes the pain away, and he doesn't have to say the wrong thing to his patients. He just has to make sure they wake up.

Sparkle the Designer Cat said...

It sounds like a lot of it was a lack of communication all around. I think that vets see so much and are so used to pets and their various medical problems that they forget that their clients usually have NO idea what is going on and may panic at something that is actually routine. The ER vet? Unfortunately that sounds pretty typical. They are really not the best place to get care, which is stressful because if they are open, it generally means they are the ONLY place to get care! But anyhow, Ayla is healing and that is what is important.

Camie's Kitties said...

We like that you are able to step back after the stress and analyze what went right and what went wrong. We like that your v-e-t took time to apologize to you and to give you his number. We are so thankful that Ayla is feeling so well, and seems to be healing better.

Cody and Gracie (and Mom)

3 kats and a kwiltr said...

Dear Ayla and Mark,
We are sorry there was all this stress and fear but are really happy that Ayla is feeling better and getting back to normal. It is a sign of a good vet to acknowledge that there were things left unsaid that could have calmed your anxiety but when our mommy had surgery, her doctor forgot to tell her about seepage too and she feared she had split open her stitches, so it happens to people persons too.
Anywho, glad things are calming down and you can both relax and enjoy one another.
Taz, Runt, and Charlse

Natalie said...

It's good that you were able to step back and think back through the situation when you were in a calmer state of mind! Too bad about the ER vet, but I'm glad that you and Ayla made it through all that stress and that she is doing well. And hey, no more going into heat!

Milo and Alfie Marshall said...

Dear Mark, I read this post through very carefully and thoroughly ~ and I conclude that you are a very caring and fair man.
Given the circumstances I can understand why you panicked a bit and maybe reacted in a way you might not have, if feeling calm and in control. I'd have done the same ~ so would Peter. So would any pet owner with a precious beloved pet who was ill.
And your analysis of events afterwards shows someone who reasons things out and constantly learns instead of just trying to blame. Your comments are fair and justified ~ and if anything a little too generous to the professionals. Try not to blame yourself too much as the professionals should be practiced in dealing with worried pet owners ~ and if they're not good at it, they should consider brushing up on their skills. I agree that not one of us is perfect ~ but profesionals should try to be as good as they can be.
I'm so glad Ayla is feling better. And you are too. (((((hugs))))
Jan xx

Everycat said...

We're all very glad that Ayla is doing better now.

Our Mum finds that some vets just don't give enough information on discharge from a surgery (or ever) When enough info is given in a measured and clear way, it can mean the difference between knowing what to do and how to react and ending up panicking, fearing the worst and getting very angry. We wish that your own vet had explained the sera leak as a possible event to you and you hadn't had to go through so much distress. The ER vet, yes, they have to detach as do any health professionals, but there is a minimum of service a person should expect, prompt treatment and explanations are part of that bare minimum. We think you are being more than fair to all the vets involved with Ayla. We hope that Ayla is fixed up for good now and she continues to recover well.

Have a relaxed weekend with the kitties, we are still sending you all lots of purrs

Gerry, Oliver & The Ape

Megan said...

A very well written post Mark. Thank you for taking the time to share these thoughts.

I suspect that you've probably been too generous to the ER vet. The good news is that it seems that he was more technically competent than he appeared during the crisis. Hopefully that gives you confidence that should you ever need to go back there, at least your cat will be in the hands of someone who knows what they're doing.

But I really can't think of a good excuse for not being more compassionate towards you. By definition, every animal in the ER is in crisis, and that also means that most of the owners are upset, worried and stressed. Not having better skills in managing the total situation is inexusable in my view.

As for saying that all the ER vet sees is misery - I disagree. He would see animals in crisis and be able to do something to help. Even if an animal's life can't be saved, it could still be of comfort to have the capacity to alleviate its pain and suffering by ending its life peacefully. But often times, the ER vet will be instrumental in turning a crisis into a happy outcome - restoring an animal's health and handing it back to delighted and grateful owners.

It doesn't strike me as being an unreasonable expectation for a 'customer' to have that an ER will invest time and thought in addressing their emotional needs - even if it's just by providing information and an explanation of why they're doing what they're doing.

Even though your own vet has very generously given you his private number, it might still be worthwhile to ask him for information about other ER vets within reasonable driving distance of your home so that you feel that you have options should the need ever arise again.

Take care.

Sydney, Australia

Jacqueline said...

So glad this ordeal has turned out well and Ayla is on the road to recovery; I understand how scary/frustrating/confusing the last few days have been for you...You are a great Dad and kind hearted man, TBT=we love you and the way you care for your babies!...Thanks for the photos in the last post=it was great to see your precious girl back home and feeling better already...Get some rest and we hope your weekend is full of happiness and cuddles...big hugs...J, Calle, Halle, Sukki

ArtemisiaFSS said...

As aggravated as I am with my local ER vet, he diagnosed Charybdis with Strangles, when she was a kitten. I wonder if lack of sleep and the fact they only see urgent cases plays a part.

I would have panicked too. Glad Ayla is OK and that it wasn't as serious as it initially looked.

Brian said...

I am delighted that Ayla is doing so well now. As for the ER Vet, detached from the situation is one thing, but there is no real excuse for lack of communication and my humble opinion. A little clarity could have sure calmed a lot of fears.

Sweet Purrfections and Angel Praline said...

I understand what you are saying and I admire you for going back and retracing everything and realizing that everyone wasn't as bad. We all go into crisis mode when something happens to one of our furchildren and we expect everyone around us to give 100% toward both our pet and ourselves. Unfortunately, it doesn't always happen that way.

I wasn't totally happy with some of the situations with what happened with Sweet Praline near the end and I was hurt. I've since called the vet and realized there was miscommunication on their side, which caused hurt on my side. Things are better, but I do know my future furchildren will not go back to them.

Mom Paula

Eric and Flynn said...

OMC! We are just catching up. The post where Ayla had to go to the emergency vet didn't show in our reader, but the update did, so we assumed the update about Ayla being back home was after her surgery. We are glad she is feeling much better now and hope she continues to heal well. Our mum knows exactly the panic you were going through because something similar happened to her a few days after she came home from hospital after her operation. She got an emergency appointment and was told not to worry because it was quite a common thing to happen. It really scared her and dad at the time though.

The Island Cats said...

I know if I had been in your position and saw what I thought was blood coming from my cat, I would have panicked too and rushed her to the vet. I would have been hysterical, I know it! Hindsight is always 20/20, but at the time, you reacted like any of us would have. It's too bad the ER vet didn't communicate better with you, but like others have said, it probably is typical...but still not an excuse.

I'm just glad that Ayla is okay now.

Island Cats' mom Sue

Angus Mhor said...

Mark, my career as an OR nurse gives me a bit of perspective and I have to agree, somewhat, with your analysis of the ER vet and his actions. Sure, detachment is helpful and sometimes diffusing when tensions are high, but I've also seen a caring approach do the same thing. But, hindsight is always 20/20-for all of us! I'm thankful matters were no worse and that your doc was able to explain and help you through. There are not as many truly caring vets and staff as we'd all like. You've struck gold, my friend.

Spitty-the-Kitty said...

First, thank God Ayla is eating and drinking and walking (hopping!) and being nearly normal. That is the BEST news in all of this.

One thought about ER vets (or maybe even ER-for-human-docs): I wonder if a part of the reason they choose this career path is that their "interpersonal skills" are not always the best, and their talent is not in establishing long-term relationships with clients. I'm sure there are other reasons as well, but I have had a similar experience (bad personality/good outcome).

Anyway, the most important thing is the good outcome. Does the removal of that pesky "hidden" ovary mean that all Ayla's problems with going into heat should resolve now? Because that would be wonderful!

Have a wonderful weekend, evfurrybody!

Katnip Lounge said...

First and foremost, HURRAH for Ayla! Purrs for an ongoing speedy recovery.

My daughter is a paramedic, and oftentimes she'll call me before she goes home, so she can download some of the emotion she's had to contain all day. It can't be easy dealing with patients who can speak, let alone a mute pet...which is why it was all the more important (I think) for the ER vet to be more communicative with you.

It is good that you've thought all this through; it'll help resolve your feelings.

The Horde is sending Ayla lots of healing purrs...give her a smooch from me.


Meowers from Missouri said...

oh, thank cod!!! we has been terrorfied until mom read us yer post this morning!! *happy dance* that ayla is up an' around, the ofur kitties are acceptin' of her, an' yer mind is (mostly) settled again. we are still purrin' that this will all result in the end of ayla's "prollem". *gentle bonks* an' a soft nuzzle to ayla.

we ain't gonna say much onna various behaviors involved acause we doesn't furgiff quite as easily as you do, even though we unnerstans the reasons fur the behaviors. what we WILL say, is that we fink even if you is "detached" you kin STILL remember yer manners an' the fact that the furries' beans involved ISN'T "detached" an' they are in tremendous mental agony. we consider rememberin' that as a part of "first do no harm", too. (we knows that's human-vet werding, but if it ain't part of furry-vet-werding, it SHOULD be--there are, after all, beans involved.)

we are sendin' warm hugs to you, TBT, an' congratulate you on bein' a splendid human bein' as well as an excellent cat parent!! we purray's blessin's on you all!

ABBY said...

First and foremost we are all glad Ayla is doing well.
We do agree with you about the ER vets reaction, it is odd. We have seen mostly compassion when we had to rush any of our kitties to the ER. But there was distinct detachment. Considering the fact that you were unaware of Ayla's true condition, it makes so much sense for someone to have said that it wasn't as seriously as you understood it to be, that would have alleviated so much angst and worry on your part. But in my experiences with the medical field it is disturbing NOT to have the ability to distinguish what is critically important from what isn't, and so many times the medical person will not explain it.
Good positive news is that she is doing well and that is what matters most we are sure to you and all of us.

KnottedFingers said...

I'm glad that Ayla wasn't is immediate danger. But I can see how it would freak you out. Red stuff all over + cat + recent surgery would freak anyone out!

Shaggy, Scooby and Scout said...

We can't add much more than has already been said in the comments here. We would like to say that you are a kind and gentle man and we are so happy things were not as bad as they looked and Ayla is going to be fine.

Jan's Funny Farm said...

Is it Saturday already? No matter, we're glad to see a post that Ayla is okay and wasn't in as much danger as you were. That was a lot of stress since you weren't aware what she was going through was "normal."

Your ER vet sounded as rude and impersonal as Doc Martin (British comedy show) and we said so in a post. Dealing with the humans is a part of the ER job.

So glad things are better!

The Meezers or Billy said...

Mark - I am elated that Ayla is ok!I've been so worried! honestly, I think that I would have had the same thoughts and emotions that you had with the ER. I agree that if the regular vet had given you a little more information things probably would have been different, or at least gone smoother at the ER (belive me, I STILL would have taken my cat to the ER even with the additonal information about sera leakage!). We are sending you purrrrrss and {{HUGS}}!!! - Mary

Father Tom said...

Julie always seems when you need a gentle touch the most whether it's spiritual or emotional, there are those instances when it's sorely lacking. I completely understand your pain, your frustration and the hurt you felt at the time. Unfortunately for us, professionals no matter what the field, feel the fact that they do these procedures and see these circumstances day in and day out that sensitivity is forgotten. It's not intentional, but that doesn't make it any easier to bear.

We're so happy to hear the good news about Ayla. Honest to God, animals are such heroes, so strong despite their dependence on us. They teach us lessons each and every day.

Mark, please give all the kitties hugs from us, but particularly Ayla for being such a trooper and just like that--jumping and getting back to her routine!!

Tom & Julie

Daisy said...

You are such a good catdad! I am thrilled to learn that Ayla is so much better. We were so very skerred about her. Big hugs to you ALL!

Sabrina, Sam and Simon said...

TBT, we are so, so happy that Ayla is feeling better, we have been so worried about her and about you too, because we know how much you and Iza and Marley love her. We saw the pics of her insides, and it didn't bother us other than for the fact that they were still in there when they shouldn't have been. And we loved to see a pic of you, you are a handsome cat Daddy! TBT, please give Ayla hugs from us, and we are giving you hugs too!
Love and purrs,
Sabrina, Sam, Simon and Momma Jan

Cheysuli and gemini said...

It's tough to be an emergency veterinary worker. Our office was open on Saturdays when most weren't and so people would want to come to us. I know many of them thought we didn't care but it's hard to connect and get to know someone when everything is high stress--and your attention is demanded by the pet's condition. As Max said, the detachment is a way of dealing. You'd think we were all freaks if you heard the jokes we made about horrible things that happened in our office. It's a way of decompressing. I suspect that the Woman in front was interested--veterinary reception work is really poorly paid and the hours are horrible and as the receptionist, everything is ALWAYS YOUR FAULT. You don't work in that situation unless you love what you do and as a receptionist it helps to like animals but you really have to like people. Yes, the Woman does have veterinary reception work in her background. Best ad she ever saw after she left that work? Another vet wrote a job ad, "Lousy work, lousy pay, lousy hours. If you're still interested..." It's so true.

OKcats said...

I'm so glad to read this post. Often we vent our frustrations, but then we don't go back and tell those that we vented to 'the rest of the story' (which we learn later, as you said). I'm as guilty as the next person. But I'm very glad to hear the explanations for everything - hopefully it will help me or someone else if we encounter a similar situation. And I'm glad that you at least feel better with your normal vet, even if you're still not overly enthused with the emergency vet. Here's to hoping you'll NEVER need those services again!

Y'all have a great weekend!

Goldie, Shade and Banshee said...

What a lot to ponder! It is always good to sit back when things calm down and debrief a bit.

Too bad you didn't get the info about the seepage possibilities right off the bat. I bet a lot of people will be asking that very question now after their pets have any surgery.

The Crew said...

Sounds like a lack of communication caused you needless stress and worry. But, the bottom line is Ayla is OK, and that's what's important.