The Homeless Parrot: oil and water

Thursday, May 1, 2008

oil and water

i am the oil. everyone else in my life is the water. i don't know if it's because of my imminent graduation or my period or the huge changes pending in my life - but i am the oil these days. the rest of the world is the water with which i am thrown. i'm on a rotation with a good friend. we keep striking against each other like matches against flint. and jim - god - all we do these days is argue. we're considering buying a house. i came home with information, excited at the prospect of what finally feels like an adult life - and we wound up in an argument. seems to be the theme these days.

what is wrong with me lately?

i gained 5 lbs on my critical care (overnight) rotation. likely because all i did was eat to stay awake. it's made my self-esteem plummet - especially knowing i'll see my family in less than a week at graduation and have to hear that i'm stocky, i'll always be stocky...blah blah blah. i think i'd be okay with my body if my upbringing hadn't skewed me so badly and made me so self-conscious of how i look.

i shouldn't be depressed. i should be happy. i'm on the cusp of my professional life. 6 years ago - lost in the human medical insurance field - i was miserable, confused, searching for a job that i thought would bring me fulfillment. and now - here i am - about to be fulfilled. i don't deal well with change. and it's coming at me fast. i'm just not a very adaptable creature. evolution should probably have already weeded me out...

it's funny. as hard as the last 2 years have been - ever since my life came semi-crashing down - and as much as i swore i wanted to be away from the vet school - now that it's almost here, i'm scared. scared and sad and ... something else that i cannot put my finger on exactly. i don't want to say nostalgic. it's not quite that. it's nostalgia and fear and yearning and regret and wistfulness and wonder and loss - all at one time. there is no word for that.

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Medical terminology

Azotemia - elevation in kidney enzymes (BUN and creatinine) indicating dehydration, kidney failure, or urinary obstruction
Lactate - a salt/ester of lactic acid that is produced as energy for a cell when oxygen levels are low. In critically ill animals, elevated lactate can be an indicator of inadequate blood flow to organs (perfusion), decreased delivery of oxygen, and/or decreased oxygen uptake. Values > 6-7 are usually considered to be poor prognostic indicators for survival.
GI sloughing: when the cells lining the GI tract die (can be secondary to MANY things, including heatstroke) with resulting bloody diarrhea, bacterial translocation into the bloodstream and sepsis
TTJ: transfer to jesus: code for when an animal needs to be euthanized or die
DIC: disseminated intravascular coagulation: a very, very bad thing - when the hemostatic system gets out of whack, and clots start forming in the blood vessels until all clotting factors are wasted. once those are gone, internal hemorrhage ensues, followed by death, usually. also known as "death is coming"
Pleural effusion - fluid contained in the pleural space (chest) - this is not the same as fluid in the lungs (see pulm edema) - in cats can be caused by infection in the chest, heart failure, cancer, FIP, feline leukemia, FIV, and in some cases, the cause is never found (idiopathic)
Anisocoria - unequal pupil size (related to any number of causes including brain damage/head trauma)
Laterally recumbent - lying on side, unable to rise
Hyperglycemia - elevated blood glucose
Hyperkalemia: elevated blood potassium - a life-threatening condition related to several disorders (kidney failure, antifreeze toxicity, urethral obstruction...etc)
Sepsis - refers to a bacterial infection in the bloodstream or body tissues. This is a very broad term covering the presence of many types of microscopic disease-causing organisms.
Nephrectomy - kidney removal
Splenectomy - removal of spleen
Pulmonary edema - condition in which fluid accumulates in the lungs, usually because the heart's left ventricle does not pump adequately ( can be caused by heart failure, electrocution, drowning, too many IV fluids, to name a few)
Tick borne diseases - any of a myriad of diseases transmitted by ticks - including but not limited to Rocky Mtn Spotted fever, Lyme disease, Ehrlichia
Fine needle aspirate - A method of sampling in which a needle is used to suck in cells or tissue bits for diagnoses (good for diagnosing masses/lumps)
Blood glucose - The principal sugar produced by the body from food–especially carbohydrates, but also from proteins and fats; glucose is the body's major source of energy, is transported to cells via the circulation and used by cells in the presence of insulin (normal range in a dog/cat is 75-100)
PCV - packed cell volume - the volume of packed red cells in milliliters per 100 ml of blood (normal range 35-45)

Diseases I see/treat frequently

Dystocia - difficulty birthing. May be responsive to oxytocin administration (Pitocin, as in people) but may require c-section.
DKA - diabetic ketoacidosis: the extreme end of the diabetic scale. A patient that is diabetic can develop DKA when other diseases make the blood glucose hard to regulate. Other diseases that are commonly associated include urinary tract infection, pancreatitis, pyometra, skin infection, and cancer. In DKA, the body starts metabolizing fat and producing acids that cause a drop in blood pH, nausea, weakness, severe dehydration, electrolyte derangments, and death.
DCM - dilated cardiomyopathy: an idiopathic (cause unknown) cardiac disease in which the heart chambers become very thin/dilated, and cardiac output drops radically. Causes arrhythmias, tachycardia, and sudden death. Seen in large breed dogs like Dobermans, Great Danes, etc.
Lymphoma - cancer of the white blood cells, the most common and treatable form of cancer in dogs
Blocked cat - slang term for a male cat with a plug of mucus and crystals obstructing the urethra (fairly common in male cats) definitely a life-threatening because urine can't get out of the body! If present long enough, causes shock, acute renal failure, hyperkalemia (elevated potassium), coma, and death. Symptoms include straining in the litterbox, yowling while trying to urinate, producing small, bloody drops of urine (also symptoms of feline cystitis, a non-lethal condition)
GDV - stands for gastric-dilatation and volvulus - a condition of large breed, deep-chested dogs (usually) in which the stomach rotates 180 degrees on its axis and thus - nothing can enter or leave, considered the "mother of all emergencies" - it warrants immediate surgery and carries a guarded prognosis
IMHA - immune-mediated hemolytic anemia. A disease in which the immune system attacks the red blood cells and destroys them. It causes profound anemia and is life-threatening. Causes are primary (no known cause) and secondary ( tick borne disease, cancer, and heavy metal intoxication). Treatment is immunosuppression with drugs primarily. Prognosis is guarded at best.