Jami, where the hell have you been?

Ugh. What a summer. I for one am glad to bid it good-bye. For reasons both internal and external, my mental health was on very shaky ground for most of the past 3-4 months.

Mental illness no longer carries quite the same stigma as it has in the past, but it is still not talked about much and there are still people who do not get the treatment they need. Is it shame? Is it lack of information? Is it hopelessness?

In June one of my former employees died (at the age of 31) due to complications of untreated depression. It did not need to happen.

Believe me, there is help out there.

I have had a few episodes in my life when the world just seemed to be a dark place and I was barely able to function beyond the basics. The first was when I was in middle school. I told no one and suffered alone with my thoughts for several months. I still recall the anxiety and despair I felt. I had another, shorter, episode a few years later. Again, it resolved with time.

About a dozen years ago I had a short nervous breakdown a few days after having surgery. I cried for 2 days and actually had to call in sick to work because I couldn't stop crying. I got an emergency appointment with a therapist and after a few days things were better.

As I've gotten older, my anxiety has increased. When the boys were infants I would wake up in a cold sweat thinking that terrible things were happening to them. Later, I started losing sleep and sometimes would drive to the vet clinic in the middle of the night because I was convinced that something had happened to a patient of mine. Last year I developed anxiety around doing spay procedures. That one was weird because I don't really know what triggered it. However, during every spay I would just envision the abdomen filling up with blood. That would make me super nervous, so I would start to make mistakes, which then sometimes did cause bleeding, so it was a self-fulfilling anxiety. No, I never had a patient bleed to death or anything. Last I also had a couple months of mild depression (or more accurately quiet hysteria) surrounding my breast cancer diagnosis/misdiagnosis.

So yeah, I have a history.

But nothing compared to this summer. My summer of mental anguish was precipitated by an event that caused so much shock and grief that it was almost unbearable. Until now I had never had to deal with a really major traumatic event. I had no idea how much such a loss can affect a person. Wow.

I did reach out. I talked to friends. I started therapy. I began to meditate. I tried several different medications (most had such terrible side effects in me that I would rather face my depression/anxiety than suffer through the medication). I read a ton of books. I'm sure it all helped but the one thing that really helped was time. We as a society do not give ourselves enough time to grieve. Any major loss can take months or years to recover from, and we are expected to "get over it", at least externally, in a few weeks. One helpful book for me was "The Year of Magical Thinking" by Joan Didion. In it she described in detail the year after her husband died. She is a normal, rational person but owned up to the fact that it took a year to even begin to function normally and rationally. I really wanted to rush through my grieving, thinking that if I just did a, b, and c, I would get better. But it doesn't work that way.

I was able to "function". I went to work every day. I took care of my kids. I even exercised a bit, although I lost 10 pounds in the first weeks and had no energy. But I completely shut down in every other way. No fun times. I shied away from almost all social events. No volunteering. No competitive races. I cried almost every day for months. The old Jami was a shadow of her former self. And yes, there were days when I really did wake up wondering if it was even worth facing life. Thank God for the kids. They at least gave me a reason to get out of bed.

Unfortunately, each and every one of us will experience profound loss in our lives. And we will all deal with it differently. I like to fix things, so I made my mental health a project. But in the process of trying to actively make myself better, I came to the realization that sometimes we just have to sit with our emotions. We have to feel uncomfortable. We have to feel sad. Not allowing ourselves to feel these emotions will prolong the healing process.

So I have felt a ton of sadness, discomfort, anxiety, anger, and despair these past few months. But that's what it is like to be human. We have these great big brains and ability to feel emotions like no other animals. It is a blessing and a curse.

Am I better? Yes. Better than I was in July, which was better than June, which was better than May. But I am still not fully healed. I have a ways to go. However, I can assure you that when I am "better", I won't be the old Jami. Traumatic times tend to change people. I have taken active steps to make sure that my changes are positive (and I will describe all of that in a future blog entry). I hope that ends up being the case. I would hate to "waste" this episode of life trauma and not grow from it.

In closing, I would like to thank all of my friends and family members who have put up with my mood swings and ramblings, my kids who have had to deal with a distracted parent, and my co-workers who have had to pick up my slack.

And please remember this. It does get better. And you don't need to do it alone.

I'm not all that.

I do not suffer from a low self esteem. In general I consider this to be a good thing, as it makes me confidant and willing to challenge myself, because I "know" I will be successful. I have high regards for myself partly because things have come relatively easy in my life. I have had many successes and few failures. I am good at a lot of things, and the things that I am not so good at I simply choose not to do (gymnastics, for example, since I have the balance and flexibility of a toothpick). And I'm funny to boot!

However, thinking that I am all that does have it downsides. It makes me too cocky to see things the way they really are. I makes me unwilling to challenge some of my thoughts and behaviors because I KNOW I am doing it the right way. It makes me lazy, because I often don't have to work very hard to do a good job.

In the past few days, my self esteem has been taken down a few notches. And I had the gall to actually be surprised when faced with failure, or when it was made very clear to me that I can be a big f**k up.

And I am not, I repeat NOT, writing this because I am looking for people to tell me that I'm a great person. I am not looking to be propped up now. I have already been made well aware of my awesomeness, and now it's time to take a look at the un-awesome me.

I don't know what to do with myself. All this talk I've been doing lately about self-discovery or finding inner peace might be fine and dandy when I thought I was perfect, but it all changes when I find out I'm not. I don't need to find myself. I need to FIX myself. I have flaws, and not just the cute flaws that make me so endearing either.

I will be 42 next month. A fine age to realize that I have a lot of growing up to do. And that my way isn't the best way after all.

I guess admitting that is the first step, right?

Can't always be a hero. Damn.

Even though I've been a veterinarian for almost 16 years, I still have cases where I am surprised, or get bit in the ass, or both. Last week I saw one of them.

"Mac" (not his real name) was a middle aged large breed dog, a long-time patient of ours. He had been seen a couple of times recently for intermittent vomiting and lethargy. My associate vet saw him both times, and the second time (after x-rays were taken), we jointly diagnosed free fluid in his abdomen. Abdominal fluid is never a good thing. It could be blood (indicating internal bleeding), pus (indicating bacteria in the abdomen, or septic peritonitis), fluid containing cancer cells, or a clear serum-type fluid (most commonly seen with liver or heart disease). Anyway, I called the owner and even though the dog was feeling better, I told him to come in so we could work the problem up further. The dog had a 1:30 pm appointment.

On exam, Mac was fairly bright, but his gums were pale and his heartrate was elevated. I tapped his abdomen (basically a quick procedure where I poked his belly with a needle and syringe) and easily pulled out a syringeful of blood. In a dog of his age and breed, a bleeding tumor was most likely. I discussed Mac's condition at length. Statistically, most of these tumors are on the spleen and successfully removing the spleen can solve the problem. At least temporarily. A large percentage of these tumors are malignant and will come back. However, unless we see evidence of metastases during surgery, we cannot tell a malignant tumor from a benign tumor without sending it in to the lab. In addition, I told the owner that if he wanted to do surgery, today was the day. Mac could crash and bleed out at any time and now he was about as stable a surgery patient as he could be. We discussed doing an abdominal ultrasound to make sure the tumor was in fact on the spleen, but I didn't think I could get one done that day. His chest x-rays were clear and his bloodwork showed only mild anemia. So we took our chances and headed for surgery.

As I opened his abdomen, I was stuck by how much blood there was. In fact, I was a bit surprised that he was as stable as he was! I suctioned out at least a liter of blood from his abdomen, and there was plenty more in there. I had a hard time visualizing anything, but my heart sunk when I pulled out the spleen. No tumor. Damn! Where is it??? Finally, deep in the right side of his abdomen, I felt it. an orange-side mass on his liver. LIVER! Not a common area for this type of tumor, but I have seen it before. Once. That dog did not make it. You see, removing the spleen is one thing. Just tie off a bunch of vessels and you're done. The liver lobe, especially the right caudate lobe, is best left to a specialist. In fact, should only be left to a specialist. I pulled out all of my surgery books and none of them had very good instructions on how to remove this liver lobe. In fact, one book only said that it was rarely performed. Thanks. So helpful. In the region is the pancreas, the portal vein, the vena cava, and the gallbladder, among other things. And in this case a mess of blood made it even more difficult to see everything. Plus, it's all deep in the abdomen and cannot be pulled out for better visualization.

And, from what I did see of this tumor, it had started bleeding again. Alot. Perhaps I dislodged a clot when I was suctioning the abdomen or feeling around. Who knows. But the blood! So much bleeding! I had to do something so I placed a big clamp right at the base of the lobe. The bleeding stopped but I was certain that my clamp contained many delicate things that were not supposed to be clamped. Plus, now what was I going to do? I had no idea. So I scrubbed out and called a surgeon. Can I send the dog to you with the clamp inside the abdomen, so you can clean up my mess? Or can you talk me through the surgery here? Hmmm. He said. The surgery is too difficult for me to be able to explain. You could send the dog to me, but it is very risky (duh!).

So I called the owner and explained everything. It didn't take long for them to make their decision. Euthanize Mac on the table. I admit that even after hearing those words I did try to remove the liver lobe. Well, for about 30 seconds. But then he started to bleed so profusely that I just slammed the euthanasia solution into his IV line. Nobody wants to see an animal bleed to death, even if they are under anesthesia.

We all want to be heroes. And in this profession, I am sometimes given the opportunity to be just that. However, this profession is also very humbling and often reminds me that there are problems bigger than I can fix.

A week later, I am still a little upset about the outcome. However, today I called the owners to see how they were doing and they were actually doing pretty good. They figured that it was meant to be. And they are getting another puppy this weekend! Nothing like a puppy to heal the soul, right? After last week, maybe I need a puppy too...

Small Group Ministry - or Learning How to Listen. Or Eat Lice.

A few months ago our minister started up a Small Group Ministry program. He asked for volunteers to be part of the inaugural group, with the expectation that those members would be facilitators of future small group ministries. Since I don't have nearly enough on my plate, I decided to try it out. To be honest, I had no idea what small group ministry is. All I knew is that I am still trying to "find" myself and I thought this would be a good place to continue down the path of self-examintion. I am now the veteran of 6 small group ministry meetings and this is what I can tell you. There are about 8 of us (we started with 10 but a couple of people dropped out), including the facilitator (who in this case is the minister). We sit in a circle. We are not allowed to talk unless we are holding the "talking stick" (or talking figurine in this case). Because we're UUs, we start by lighting the chalice while the facilitator reads a reading. I assume that in other religions, there might be an opening prayer or something. Then there is a "check-in", where we go around the circle and one by one answer a check-in question, which usually pertains to "How are you doing?" Last week it was "How is your soul?" (To which one person answered - "I am trying to lose my soul. So I don't think I have a soul right now." Remember, we're UUs.) Each person gets a few minutes to answer the question, as deeply and honestly as they feel comfortable doing, while the rest of the group just listens. We can't talk back, make judgements, or give advice. It's a beautiful thing!

OK, I admit that initially I was a little confused by that format, but it is becoming clear that it really does serve a purpose. By answering these deep questions without fear of interruption or judgement, we find our own truth. It's an interesting phenomenon. And by being forced to listen, we are learning something about the person speaking. And about life. Because everyone has something, some viewpoint, some experience to contribute. And we are also learning the very-important-but-not-often-used skill of LISTENING. Just sitting there and listening. And not offering advice, or a smart-ass remark (a I am prone to doing), or an anecdote. This is someone else's story and I can wait until it's my turn, for crying out loud! At first the speaking part was challenging. How do I answer? What if I'm way off base? What if I am JUDGED? But as we have beocome more comfortable with each other and with the process, I no longer have anxiety over that. Then it was the listening that was hard. At first I would spend the time where others were speaking just daydreaming, or formulating what I was going to say when it was my turn. And that's ok. But it started to shift a couple of sessions ago. I gave up thinking and just listened. Because that's what we're there for. To be there. The presence of the other small group members acts sort of like a silent sounding board. And just the act of sitting in silence and paying attention to what someone else is saying is powerful. Try it some time. Just listen to someone tell a story or complain about their day. Don't say a word, but make it known that you are paying attention. It is a mighty good skill to have!

 After the check-in question, there are 2-3 further questions, usually revolving around a theme. Last night the theme was our gifts - what energizes us, what we are good at, and how we can use our skills for the church. It was interesting that it took us all awhile to be comfortable speaking out loud about our gifts. Like we we didn't want to be accused of bragging. But we can! That's the question! And no one can judge! As you can imagine, I had no trouble listing some of my many skills and talents. I could have talked for hours! Actually, the most interesting thing about that question is that even I immediately wanted to answer it with some of the things I am NOT good at. Why is that?

Anyway, after a total of 3-4 questions and a closing reading or prayer, we're done. The session starts on time and ends on time - 90 minutes later. There are no breaks, no food, no small talk (except for before and after). And, after 8-12 sessions, when we're finally starting to get really tight as a group, we are supposed to break up! And form new groups! Sad. I will miss my new friends, but I can see how doing this for 3-4 groups per year allows one to form really close bonds with a whole bunch of people. OK, you may think this is weird, but I have an anaolgy for this. A few weeks ago we saw the movie "Chimpanzee". In it, the narrator talked about how important grooming each other (you know, going through each other's fur and eating the little insects that are crawling around) was in maintaining the bonds within a pack of chimps.  In a way, small group ministry is a lot like that. We meet every few weeks and figuratively pick off insects from each other as a way to bond the group. Just sayin'.

Gay Marriage and the MN Marriage Amendment

Yesterday I gave a talk at church about how I feel about the  proposed MN Marriage Amendment. Since I am too busy (and lazy) to write new material for my blog, here is a copy of my talk (edited a little).

 This November the people of Minnesota will be asked to vote for or against the following measure: Shall the Minnesota Constitution be amended to provide that only the union between one man and one woman shall be recognized as marriage in Minnesota?

My partner, Lisa, and I have been a couple for over 16 years. During that time, we graduated from veterinary school, moved to three different states, started our careers, and had four kids. We now live in Maple Grove, MN, which is about as white-bread an American suburb as one can get. And we like it!

Three years ago, I gave a ten minute talk about my family as part of a GBLT service at church. During my speech, I brought up the subject of gay marriage. While I lost the hard copy of my speech somewhere along the way, I distinctly remember saying that I was pretty ambivalent about the whole thing. For one, I wasn’t really big on the institution of marriage. It certainly doesn’t seem to mean much, when 43% of first-time, and an even higher percentage of second or later marriages end in divorce. Plus, marriage doesn’t even seem to be the norm these days. In 2007, unwed mothers accounted for almost 40% of births. Finally, I consider myself a rather strong and independent person. One who is sort of taken aback when I see straight people clamoring for the right for ME to marry my partner. Heck, I think. It’s my fight, and I will fight it if I feel like it.

However, something happened a couple of months ago that is making me re-think my views. It involves my mom. Out of the blue, she gave me a check for $50, which to a retired person on a fixed income, is a lot of money, and told me to donate it to an organization that is fighting the Minnesota marriage amendment. I haven’t even donated anything myself, and here was MY MOM giving me money for the cause. My mom doesn’t really donate to causes, and other than voting every 2-4 years, she is not at all involved with politics of any kind.

Why would my mom care so much about this issue? Well, of course we’re Scandinavian so we won’t be talking about it, but I suspect it could be for a couple of reasons. First, she only has one daughter, and that daughter has never walked down the aisle on her wedding day. Maybe she feels that I, and she, is missing out on a big moment in life. Or maybe it’s because she doesn’t want her grandchildren raised, I don’t know, illegitimately. Or maybe, and I suspect this is the real reason, she doesn’t want her daughter to be discriminated against. No parent wants anything but the best for their kids, and because of the political atmosphere right now, her daughter cannot enjoy the same rights as her heterosexual son. And if nothing else, my mom was always fair to her children.

Anyway, if my mom is willing to put some skin into the game, maybe I should too. But first, I have to come to grips with a few things. One is that even some of my good friends and close relatives do not want me to have the right to marry my life partner. Their religious and political views make them draw the line at marriage, even though they are apparently accepting of my sexuality. In fact, my cousin, who LOVES Lisa (and me, of course), left his church for a different one because his former church was liberalizing its views on homosexuality.  Another thing to consider is that being married adds weight to one’s relationship. Standing up in front of a bunch of people and professing to love and honor each other until death do us part, means something. It means it is for real. And maybe, like Brad and Angelina’s kids, our kids would want that security too. Finally, it is no secret that being in an unmarried domestic partnership is a pain. It is more expensive – we pay more in taxes and had to go through expensive adoption and will-writing and power of attorney processes. It is more complicated, it is fraught with potential holes where inheritance, or hospital visitation, or the rights of one partner to make decisions for the other if needed could be jeopardized. And if we split up, I can’t imagine the mess that would have to be sorted out. What would happen to our property and our kids? Who would decide?

But let’s put the legal and financial implications aside, and talk about how the issue of denying gay marriage makes me feel. And I feel hurt. Society is telling me, “Hey Jami. We like you. You are a nice person and a productive member. But your relationship with the person you love? The commitment that is 16 years old and produced four children? That’s not good enough for us. You can’t join our club. You relationship is less important, less valid than our straight marriages. And I guess that makes you less important too. Sorry!”

Lots to think about.  But the reality is that it is an injustice. I am a productive and law-abiding  citizen but I am not granted the same rights and privileges that are given to most of you. And even in the year 2012 there are many people, even in the semi-liberal state of Minnesota, who want to defend marriage by making it inaccessible to me. It doesn’t make sense. Allowing gay people to marry each other doesn’t threaten marriage. Adultery, abuse, divorce, couples not putting their marriage first, not honoring those vows, OR not getting married in the first place - those are the real threats to the institution of marriage. There is a phrase floating around on Facebook these days. It says: “Giving someone else equal rights does not infringe or take away the rights of you. It just makes it illegal to enforce your prejudice and hate. It’s that simple.” 

My Big Gay Night Out

Well, lo and behold, we actually had some takers to my gay bar invitation in the last post! Our friends Michael and Jason have been together for like 14 years but had never been to a gay bar together! AND because they moved here a few years ago from the east coast, they had never been to a gay bar in Minnesota! So no time like the present, right?

We picked the Gay 90's, probably the most famous of the Twin Cities gay bars. Lisa and were last there in 1996, when it was really just a hole-in-the-wall gay bar. All I remember of that adventure is the two of us being picked up by a straight guy. Well, he attempted to, anyway. Yep, that's what two lesbians want more than anything - to go home with a guy for a little threesome. Ick.

I guess that a few years later the 90's became a really popular dance bar for straight people and continues to draw them to this day. They have a drag show on Saturday nights at 9:45 so the four of us decided to meet then. Wow, getting to a bar a 9:45! I'm usually in bed by then!

The drag show was pretty good. It was entertaining and raunchy. I would say that about 1/3 of the audience were straight gals out for someone's birthday or bachelorette party, 1/3 were gay men, and the remaining 1/3 was made up of straight men (dragged in by their girlfriends) and lesbians. Those straight girls got into it the most for sure! I do have one burning question, however. Where do drag queens hide it? I mean it! I don't get it where it goes!

Not to overanalyze it (but then again, that's what I do), but it is sort of a mixed blessing that gay bars and drag shows have become so popular among straight people. I mean, it's great that homosexuality is becoming more acceptable, but on the other hand, I think that it is sometimes sort of glamorized and put on display (like art, or zoo animals), especially at the drag shows. Straight people can feel really cool and open-minded, but they are being shown a really extreme side of "the life". Kind of a cartoon version of gay life. Kind of like... dare I say... black face performers a hundred years ago? Discuss.

We stayed out until after midnight! I know! And I was called Ellen Degeneres only twice during our walk on Hennepin Avenue to and from the bar. Ellen who?

Anyway, it still was fun and we may just do it again! As you now know, it is perfectly acceptable for straight people to go to gay bars, so if we go again, who wants to be on our invite list?

Am I gay enough?

My family had a 12 hour car ride today, so Lisa and I had plenty of time to talk and we somehow got to reminiscing about the first few years of our relationship. It was a thrilling/scary period in my life, because I had the tandem events of falling in love and coming out at the same time. The falling in love part, of course, was incredible. The coming out part was a little more challenging. I finally had to accept what I (and even a former boyfriend of mine) had suspected for years. I was gay. Then, I had to navigate through the entire coming out process - first to my vet school roommates, then to my friends, then to my brother, then to my ex-boyfriend (who was obviously not surprised), then to my parents. And then my friends and family had to come to terms with that information and then out me to their friends and family. And the tide continued until pretty much everyone in my life at the time knew. 

But as any gay person will testify, you have to keep coming out your entire life, any time you meet someone new and choose to tell the truth about your family. I admit, I don't tell every person I meet - I have been known to lie by omission if the situation warranted it. But I am continually meeting new people, and most of them (especially since I have kids) assume I am straight. Here we go again. That awkward moment of me explaining my family, followed by the awkward moment on the other person's part, where they apologize for making a wrong assumption. And I never really know how they feel about it, do I? Are they ok with me being gay? Will they still bring their pets to me? Will they allow our kids to play together? Will they still want to hang out with me?

So, being gay is challenging. But I wouldn't trade it for anything. For one thing, if I weren't gay, I wouldn't be with Lisa, right? For another, I belong to a minority group, with its own culture. I am "in" with the gay/lesbian crowd because I am one of them. I get it. You can be as gay-friendly as you want, but if you're not gay, your not 100% in. And it's sort of cool. I can go to Pride events as "one of them". I can bring my kids to Rainbow Family conferences and talk about what it's like to be a gay parent, and what it must be like to be a kid with gay parents. I can play in lesbian softball league (which is where I met many of my lesbian friends).

However, I am not as gay as I was 15 years ago. Not that I am not as attracted to women as I was (in fact, the opposite is true - the more comfortable I am with my sexuality, the more I am open to being attracted to members of the same sex). The thing is, I am no longer really living the gay lifestyle. We don't go to gay bars, I stopped playing lesbian softball years ago (too much drama!), and now that we have kids, we have more in common with our straight married-with-kids-and-possibly-even-Republican-suburbanites than we do with some of our gay friends. And to be honest, the Rainbow Family conference scares me a little - too many crunchy lesbians raising their kids with a vegan diet and no TV. What do I have in common with these people??

Lisa used to have a rainbow flag hanging on our wall and a rainbow triangle on our car. Now we don't have any of that. I think it's because when you first come out, you want to announce it to the world. And you also want to find others like you. But then we kind of became comfortable enough in our sexuality that we didn't feel we needed to wear it on our sleeves. And maybe having kids changes things a little too. I don't know. 

But I miss it. I miss the camaraderie. I miss going to gay bars and being able to dance with my spouse without anyone giving it a thought. I miss being able to talk to gay people about what it's like, or not having to talk about it because they get it too. I miss not having to explain my family, because it's already assumed that I'm gay.

Anyway, Lisa and I decided to jump back into the fold. We're going to a gay bar Saturday night. Who's in? Or better yet, where can we find one?

Reflecting. On reflecting.

For various reasons, lately I have been reflecting on my life and who I am. Ah, who am I kidding; I am always reflecting on my life! And one of the things I reflect about is why others don't do the same. Why can some people make their way through this world without giving it much thought? Or is that true? Maybe I'm us more vocal about it. However, I do think that I suffer from some sort self-awareness overdrive. And it's maddening. I think too much. I can't just be in the moment - I have to contemplate why the moment exists, whether I am happy or sad, what this moment means for the future, what am I learning from it. God, I can go on and on.

The good things about this personality trait are:
I am very self-aware. I know who I am.
I am constantly trying to learn from my mistakes and become a better person.
I am working on becoming more spiritual. I assume this is a good thing.

The bad things about this personalty trait are:
I really don't know who I am. The more I contemplate the more confused I become.
I can annoy people (especially those close to me) by overanalyzng every situation, every interaction.
I am so self-absorbed, I don't really know what is going on with other people.
I am frustrated when others don't seem to think like I do.
I think so much, I sometimes have a hard time concentrating on the task at hand. Or sleeping.
I am never really satisfied with where I am. I am always searching for more.

OK. Looking at this list, it looks like the negative outweighs the positive, doesn't it? Dammit! I knew it!

Well, I can't change my personality, can I? And I certainly can't change the personality of others. So I guess that means I have more reflecting to do - how to accept myself and others for who they are.

Appointment #20 - Breast MRI #2

It's been almost three months since I discovered the lump in my left breast. I was panicky at first, but now it's sort of become just another part of me. I don't even check it very often - maybe every few days, rather than every few minutes like when I first felt it. However, this breast MRI appointment had been looming in the horizon so I couldn't ignore it completely.

To bring you up to speed, I am supposed to have an MRI once a year until I hit menopause. My last one was in April, right after the DCIS diagnosis. She doesn't think the mass it is anything too concerning, but she moved the MRI up a couple of months because the lump wasn't going away.

A breast MRI has to be performed during the part of one's menstrual cycle when the tissue is the least dense. That means between days 7 and 10 after your period starts. Just so you know. I was hoping to get into the new breast MRI center at Westhealth, but they delayed their opening until March. Doing the math, days 7-10 of my March cycle would be right in the middle of spring break, when we are planning a skiing trip to Colorado. Now you know all about my menstrual cycle! Yay! Besides, I sort of want it done sooner rather than later. So today was the day. Taking another trip down to Abbott.

The drive in wasn't too bad, since it was the middle of the morning. However, I had to park on the roof of the parking ramp, and even then it was difficult to find a spot. So I was already a little late. Then, when I checked in at the information desk, they sent me to the wrong imaging center (being a hospital, there are of course multiple MRI machines). I finally ended up at the Piper building, checked in, and removed my clothing and jewelry. I was pretty anal about making sure I took anything metallic off of my body, since a few years ago i read an article about a little boy dying in an MRI machine because an oxygen tank was left in the room and the strong magnets pulled it into the MRI like a missile. The radiology technician got my IV catheter in right away (yay!) and I was ready to open up my gown and lie facedown on the MRI table (with cut outs for the breasts). They gave me headphones to play music (which is kind of a joke because the machine is so loud you can't hear much) and started the first cycle. I immediately felt my fingers vibrating. Dammit! I forgot to remove my rings!!! How could I let that happen??? I squeezed the panic bulb to get the technicians' attention and almost bolted out of the machine when she didn't stop it right away. Oops, sorry, I left my rings on! The technician yanked them off and re-started the first cycle.

The procedure took about 30 minutes and other than breathing, I didn't move at all. Last time they told me there was some movement artifact towards the end and I didn't want that to happen again! They pulled my IV cath, I changed into my street clothes and replaced my jewelry, and spent over 45 minutes trying to get home (they re-routed the street due to construction).

Man, my breasts sure do cost me a lot of time. And now, because we have a high-deductible insurance plan, they will be costing me a bit of money as well (I'll let you know how much this test is going to cost me when I get the bill).

Funny thing is I think of myself as a healthy person. I don't have any chronic medical conditions and I'm in good shape. But I think have been to more doctors in my 41 years than most people. I believe that I've had 6 MRIs and one brain CT scan. Heck, this is my 20th appointment in the past year just for my breasts! And that's only one part of my body!

Anyway, I should find out the results in the next day or two. I am trying to be zen about it, but I have a weird feeling I'll be called back for more testing. I will certainly let you know.

What is social networking doing to our families?

My brother and I were coversing earlier this evening about social networking. Specifically, about how social networking is leading to the demise of our normal family and friend relationships. His point was that because of texting, email, Facebook, blogs, and the like, we spend more of our time and energy interacting with, in some cases, relative strangers than we do with our own spouses and kids.

True.

I am as guilty of computer abuse as anyone. And the advent of the iPad has made it even worse. At least our old laptop would take a few minutes to boot up, so you really had to want to check your email in order to sit through that. Now with my iPad, I push a button, type in my 4 character password, and the internet is there at my disposal. Plus, it is small and light, so I can carry it everywhere. And unlike my laptop, the battery actually lasts more than an hour, so I am not tied to the electric outlet.

I find myself online when eating with the kids, when conversing with my spouse, when watching TV, when (I hate to admit) using the bathroom. Lisa and I even have our own iPads, so we'll hunker down in bed for the night and turn on our respective personal electronic devices, and check our own separate email, Facebook, and Words with Friends games (we're not even playing each other!) before turning to our Kindle apps to read a few pages before falling asleep. We don't even talk to each other during this time.

Wow, is this what life is like in 2012?

Or, are these devices simply just our generation's way of doing the same thing people have been doing for hundreds of years? Yes, ignoring their loved ones! Don't tell me your parents didn't read their own books before bed, and watch tv from separate chairs (or even separate tv shows in different areas of the house). And their parents likely settled in for the evening each doing their own things. Grandpa was smoking a pipe on the porch while Grandma chrocheted in the parlor. Or whatever. (I don't have very vivid memories of my grandparents.)

And I don't recall too many family dinners when I was growing up that had conversations involving anything other than "finish your peas or I'll get the wooden spoon." Is that any better than what we're doing now?

Is it engrained in us to yearn for connections that extand beyond one's walls? I remember my parents would sometimes be on the phone for HOURS. I hardly ever talk on the phone. Of course I make up for it on other ways. It's just that times are different, but human nature remains the same.

Ben (my brother) told me he thinks we should implement a media-free hour every night, so that we would connect with our spouse and kids without the tugs of the outer world. And I totally agree that it would be a great idea. But I also suspect that we would quickly find other ways to distance ourselves from our immediate family. I foresee many hours working in the garage, for instance.

So, is that just the way it is, or should I then embark on a new project to make our family actually want to spend time with each other? I'm sure there's a book on that out there somewhere. I'll go check out the Amazon website right now...

Grad School? What?

As I get older it's becoming apparent to me that I'm never satisfied. Which is crazy given that I live a life that's rich with challenges and joys. But I've talked to other people who are the same way, so I know it's not just me.

So now what? I have my doctorate. I have a business. I have a busy family. I don't have much spare time. But still...

After writing up my case reports for ABVP certification (which, for those of you who don't know, is an extra certification that a vet can get after being in practice for at least 6 years. They just have to jump through a bunch of hoops, submit two case reports, and take an exam. More info can be obtained at www.abvp.com. There is really no extra glory or more pay that goes along with certification, but there is satisfaction in knowing that you are trying to take your practice to a higher level.), I realized two things: 1. I like scientific writing and 2. I like the in-depth study of medicine. Funny I should feel that way, since while in vet school I couldn't wait to get away from the book training and into the real world of practicing. But things change.

So here are my options. I could to go back to do a residency, where I would spend 3 years at a university working 50-70 hours a week for little pay in order to pursue speciality training. I could become specialized in medicine, dermatology, pathology, ophthalmology, reproduction, surgery, you name it. Shortly after vet school Lisa completed a 3 year residency in emergency and critical care, which is how she ended up becoming a clinical professor at the U of MN vet school.

Another option is to go to graduate school. I could get a master's or PhD in something veterinary related, which would set me up for a career in research, government, or possibly industry. Possible post-doc degrees include immunology, public health, microbiology, physiology, pharmacology, etc. What this would involve is 2-4 years (depending on the degree and program) of classes and research, making little or no money during that time, unless I decide to go to school while still working (which I could only do for a master's, not a PhD). But then when would I see my family and train for marathons?

Or, I could continue to do what I am doing, which is a fine enough life.

However, I couldn't just let it go, so I did speak to a professor in the vet school PhD program. She set me up to attend the graduate school recruiting event last week, which was a great experience. During this event, the graduate school was sort of trying to impress candidates who had applied for positions, while the candidates tried to impress the school. Sort of like a dating game for nerds. I was the oddball in that I hadn't applied for anything! But I was grateful for their hospitality. I got to meet one-on-one with several professors (many of which were my teachers back when I was in vet school), get tours of the campuses, and talk to current and prospective grad students. And it ended with bowling and beer! Good fun.

So what did I decide? Nothing yet. I have a good thing going and I don't even know what I would do with an extra degree. I may just continue on with ABVP, and then possibly pain management certification. Or I can add a master's on top of that. Which would cost quite a bit of money (vs. a PhD, which would be paid for, plus a decent stipend, but I wouldn't be able to practice at my clinic during that time). So I need to consider the financial ramifications, the overall financial benefit, and how much time and effort I want to put forth.

Or maybe I should just spend a little bit of money on therapy so I can figure out why I'm never conent to leave well enough alone?

My Gratitude Journal

A couple of weeks ago I helped wth the church service. It was about spirituality and spiritual practices. Honestly, I didn't really know what either of them really were. And being that I don't believe in God, it makes it even harder. Can an atheist such as myself have a spiritual practice?

So in my portion of the service I asked those questions. It was the task of the minister, Kent, to answer them. He did a very good job. His answer (and I suspect there are many different answers) is that a spiritual practice is something tht is done regularly and intentionally to engange i or spiritual side. And spirituality involes humility (knowing that there re many parts of our lives over which we have no control) and recognizing our connections to the rest of the universe.

Prayer, obviously, can be a spiritua practice, because it is done regularly, with intention, and in it one submits both to a higher power (demonstrating humility) and also recognizes that one is connected to the world around. However there are other ways to engage in a spiritual practice. Kent told us that one of his was to write in his journal. Specifically, for one month he set out to write about only things for which he was grateful.

What a good idea! I thought. So I started a Gratitude Journal myself. It is one way for me to try to become more spiritual, which is something I would like to be but I don't really have the patience to meditate and reflect (and I certainly don't pray).

I've been doing this for a little over a week, and I've alread missed 4 days (I forgot). Funny how it can slip your mind if you aren't used to doing it every day. But I'll keep on trying, at least for a while longer. It is helpful to think about these things, rather than spend so much time dwelling on missed opportunities or things that didn't go my way.

And I am finding that even on so-called bad days, there is much that I have to be grateful for. And for the really bad days, Kent said, sometimes all you can write is that you are grateful to have made it through the day. Which, unfortunately, is not the case for far too many people.

Tiny Tim

Tiny Tim was brought to our clinic as an itty bitty kitten in December of 2009. He was found as a stray and a Community Service Officer brought him to be checked out. You see, Tiny Tim had no rear feet. There were open infected stumps where his feet should be. His right rear leg went to the ankle, but his left rear leg only made it a little past the kneee. We aren't sure what happened. Were they chewed off, perhaps by his mother? Was he born that way? If only he could talk...

 No matter. He was a cute little guy and of course I couldn't put him to sleep. So we told the grateful CSO that we would take him on and try to find him a home. He spent about a week at the clinic on antibiotics and then my associate vet surgically closed the open stumps. A few weeks later I had to go in and shorten the shorter leg because it wasn't healing right.

Once we thought he was going to be ok, we put the word out that he needed a home. As is always the case, it took about 10 minutes for someone to adopt him. I often joke that the best way to find a home for a pet is to cut off one of its legs. In this instance, Tiny Tim was doubly lucky!

We got to watch Tiny Tim grow into a not-so-tiny adult cat. At his home, he gets around just fine on his stumps, and uses his front legs to help pull him up onto furniture. However, last month Tiny Tim stopped using his shorter leg and was diagnosed with a luxating patella (where his kneecap comes out of its groove) as well as an infection at the tip of the stump. I consulted with two veterinary surgeons, and even my human orthopedic surgeon (the one who operated on my elbow) and decided that I should shorten the stump to just above the knee, removing the kneecap as well. However, this is not a commonly done procedure; normally we amputate the rear leg at the hip or just below, as dogs and cats don't tend to do well with stumps for legs. However, Tiny Tim has been doing so good on his stumps that I wanted to give his left rear leg a chance.

So, today I did a partial amputation of Tiny Tim's left rea leg, taking it off just above the knee. Below are some photos of the procedure, and a warning for the squeamish. Despite a bunch of pain medicaiton, Tiny is pretty unhappy right now, but hopefully he'll thank me in a couple of days. If he does well, I just may write this up as a case report for publication... the Stromberg Technique for Distal Femoral Hindlimb Amputation in a Cat...

Tiny Tim as a baby



His stumps today

 Today before surgery

Getting around ok, but not really using his left rear leg

 I'm about to cut the femur

The femur after I sawed it off 

 Closing large flaps of muscle over the exposed bone, hoepfully to provide lots of padding

 After surgery

I can't delete this picture, so you get to see it again!

What's that thing hanging out of his butt???

Don't you hate it when it's slow all day at work and you finally get to leave and just as you start walking out the door the police drive up? Because at my practice, that only means one thing - they have a stray that they need me to examine. And for some reason the police don't feel the need to call ahead to schedule an appointment. 

So, I was supposed to pick up the girls from daycare but now I got to stay late, and for little money to boot. You see, we give the city of Brooklyn Park a hefty 50% discount to evaluate and treat the stray animals they bring by (although the city hasn't found it in its heart to give me a discount on my taxes and fees). This newby police officer was struggling to get what appeared to be a dog out of the back of the squad car. Must be vicious, I thought, as I approached the car, only to find a little 12 week old pitbull puppy. With the biggest rectal prolapse I have ever seen.

What is a rectal prolapse? Well, it's when the rectum inverts on itself and pokes out of the anus. We see it more often in cats than in dogs, and it is definitely more prevalent in younger animals. It is commonly due to chronic straining, say from diarrhea due to parasites or a viral infection. Certain genetic defects, such as a the messed up back end you get in the tail-less Manx cat, can also lead to this problem. The treatment consists of placing the rectum back inside where it belongs and then suturing the anus partially closed for a few weeks so that it can't come back out. In severe cases, the rectum could be damaged and may need to be trimmed. And if none of that works, you may need to go into the abdomen and tack the rectum to the inside body wall so that it will stay in place.

Anyway, in most cases maybe an inch of rectum comes out. In this pup, however, it was at least 6, if not 8 inches. It looked like a long red balloon. I admit I felt a little like a large animal vet as I tried to replace it (don't they often have to do this when a cow prolapes her uterus?). Anyway, I couldn't shove it all back in (for one thing, the pup was straining against my efforts to push it in), so I told the police officer that the next step would be to sedate the dog and suture the anus. With the City Discount, the estimate was $100-150. For a dog that will be going to the pound to wait its five days for an owner that won't show up and then may be euthanized because pitbulls are not so easy to place. I didn't think they would go for it, but the officer called his supervisor and got the ok! Good for the puppy, bad for me because now I wouldn't be able to pick up my daughters as planned.

The procedure actually went really well (be slow, be gentle, and use lots of lube - a mantra that was repeated to our class by many a professor in vet school, as it pertains to all sorts of situations) and within 20 minutes the puppy was awake and no longer had a red balloon thing hanging out of his butt. Because of the severity of the prolapse, I give him a 60:40 chance of his body parts still being where they belong tomorrow when I come into the clinic.

So, anyone want a pitbull puppy?

Appointment 19 - Breast Lump Recheck

It has been exactly six weeks since I saw my surgeon for a mass in my breast. She wasn't too worried about it but she wanted to recheck it in six week. So here we are. I will say that the past six weeks have inched by very slowly. Sort of like my pregnancy, which seemed to last about two years. I have been very patient and, as you may have noticed, I haven't even mentioned it in awhile. But the lump is still there. It hasn't changed much but it hasn't gone away either.

No matter how rich or successful or good-looking you think you are, being a patient for a breast exam is a humbling experience. For one thing, you can dress up all you want, but in the end, there you are, sitting on the sterile exam room table wearing a paper gown. At least my pants looked nice.

So, the doc walks in, apologizes for her cold hands (that's ok, I reply. I could never do your job because my hands are always cold.), and proceeds to check out my boobs. At least this time she found the mass relatively easily. So I'm not crazy, anyway.

I still think it's fibrous tissue, she tells me. Are you at least 99% sure? I ask. Because I can take a 99% chance it's ok. Yes, she replies. But....  let's move up your breast MRI anyway. It looks like it's due in April, but we can shoot for February. In fact, the Piper Breast Center is opening a new breast MRI unit at Westhealth (where I was for my appointment) on February 1st. Sweet! I said. I can be their first patient!

So, that's the plan. I'm waiting to hear from the Brand New Westhealth Piper Center Breast MRI people to get scheduled.

I'll keep you posted. Because I know you are dying know all about my breast status.

Happy new year?

OK. Fine. I've had a few drinks (it is New Years Eve after all) and I'm not really sure what I am planning to say here. But since we are at precipice of a new year, I feel like I should say something.

I've been blogging for about 9 months. It was an almost daily occurrence early on, but I sort of ran out of things to say after awhile. And time. I don't have enough time to formulate and write a good blog every day. A blog is sort of like a diary, except I can't say EVERYTHING I feel because anyone can read it. But I say most of what I feel.

I've come to realize that I am a stress case. I thrive on stress but it also, well, stresses me out. And then I start to think about and process all of the stressors and it continues to build. So having an outlet is helpful for me.

One thing I'd like to interject here is that I am REALLY enjoying the buzz from the 3-4 Moscow mules I had tonight. Or whatever they're called. And it's almost midnight and I'm still awake!

What has 2011 meant for me? What will 2012 bring? 2011 was a difficult year and I'm glad to bid it goodbye. So, goodbye, 2011. I hope that 2012 is a better year. My goal for the coming year are to work on being a better parent, get ABVP certified, do some more triathlons (it's been a few years), and maybe complete another marathon. Maybe.

But mostly I would like my sanity back. I know it seems weird to say that, but there are times when I really feel lost. I like to have control over things and lately there is much that is out of my control. I don't know what will change it all, or if I will ever regain control, but I will continue to try. Or, maybe I have to accept the loss of control. That's ok too as long as I feel ok. Yes, I do realize that this paragraph is not very well written.

Don't get me wrong, I am fine. I just hope to be better in 2012. I hope I am healthy. I hope to improve on the way I relate to people. I hope that my business does well. I hope that I stop freaking out about doing spays. I hope that I give more than I take. I hope to become more fit. I hope that I have fun. I hope that I don't completely f**k up my kids. I hope to let go of the anger that I feel too often. I hope to communicate better. I hope I am grateful.

And I hope that your 2012 is all that you want it to be as well.