Thursday, January 22, 2009

sorry for the previous unapologetically pathetic post- brought to you by the last non-selective serotonin reuptake inhibitor dependent person in north america. maybe i should just join the masses of the over-medicated and start popping paxil or zoloft or lexapro...

before i left to come here, i had 2 cases that were eh...nightmares, shall we say? one was a cute big terrier (40lbs). he was a skye blue terrier or some other breed that we only see rarely. he presented in status epilepticus. SE is an extension of epilepsy. it occurs when a seizure does not terminate on its own - usually if a seizure lasts beyond 1 minute or so, it is termed status epilepticus. treatment is aimed at trying to "reset" the seizure focus by a variety of methods. one such method includes inducing a coma with a medication called propofol (often used to induce anesthesia in humans - known as "mother's milk" due to its white color). despite this, we could not get the seizuring under control. every time we attempted to wake this little guy from his drug-induced sleep, he would begin to seizure within the hour.

in the cage next to this unlucky soul was an ancient pomeranian - 13years old. he had a condition called collapsing trachea. it's a poorly understood disease of small breed, fat, older dogs in which the trachea (windpipe) collapses when they become excited. for some reason, the cartilage holding the trachea open becomes weak, allowing the airway to collapse under stress. this - as you can imagine - can be a very bad thing. this little guy's collapsing trachea was so bad that he was put on a ventilator by my intern-mate. i wasn't sure WHY she'd opted to put this dog on a ventilator, as his prognosis was very, very poor. he needed surgery - assuming that he lived and recovered to have surgery.

in the end, both of these were euthanized.

despite these sad endings, they were excellent (though challenging and a tad frightening) learning cases. i had never cared for a ventilator patient myself, and so i was very nervous and uber-conscious of checking everything i was supposed to be checking. despite the poor outcome, i learned a great deal.

i'm headed home shortly. my flight leaves orlando-sanford international at 5:15. i have to drop off the car at alamo and get through security, so i'll be leaving shortly.

talk to you on the other side...

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