Wednesday, February 22, 2012

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.

Monday, February 20, 2012

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...

Thursday, February 16, 2012

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?

Monday, February 13, 2012

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.

Thursday, February 2, 2012

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!